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; adding an informed 
  1.10            consent provision for abortion procedures; creating a 
  1.11            child maltreatment review panel; requiring studies; 
  1.12            adding provisions relating to termination of parental 
  1.13            rights; appropriating money; amending Minnesota 
  1.14            Statutes 2000, sections 13.46, subdivision 4; 13.461, 
  1.15            subdivision 17; 13B.06, subdivision 4; 62A.48, 
  1.16            subdivision 4, by adding subdivisions; 62S.01, by 
  1.17            adding subdivisions; 62S.26; 103I.101, subdivision 6; 
  1.18            103I.112; 103I.208, subdivisions 1, 2; 103I.235, 
  1.19            subdivision 1; 103I.525, subdivisions 2, 6, 8, 9; 
  1.20            103I.531, subdivisions 2, 6, 8, 9; 103I.535, 
  1.21            subdivisions 2, 6, 8, 9; 103I.541, subdivisions 2b, 4, 
  1.22            5; 103I.545; 121A.15, subdivision 6; 135A.14, by 
  1.23            adding a subdivision; 144.057; 144.1202, subdivision 
  1.24            4; 144.122; 144.1222, by adding a subdivision; 
  1.25            144.1464; 144.148, subdivision 2; 144.226, subdivision 
  1.26            4; 144.551, subdivision 1; 144.98, subdivision 3; 
  1.27            144A.071, subdivisions 1, 1a, 2, 4a; 144A.073, 
  1.28            subdivisions 2, 4; 144A.44, subdivision 1; 144A.4605, 
  1.29            subdivision 4; 144A.62, subdivisions 1, 2, 3, 4; 
  1.30            144D.03, subdivision 2; 144D.04, subdivisions 2, 3; 
  1.31            144D.06; 145.881, subdivision 2; 145.882, subdivision 
  1.32            7, by adding a subdivision; 145.885, subdivision 2; 
  1.33            145.924; 145.925, subdivisions 1, 1a; 145A.15, 
  1.34            subdivision 1, by adding a subdivision; 145A.16, 
  1.35            subdivision 1, by adding a subdivision; 148.212; 
  1.36            148B.21, subdivision 6a; 148B.22, subdivision 3; 
  1.37            157.16, subdivision 3; 157.22; 214.104; 245.462, 
  1.38            subdivisions 8, 18, by adding a subdivision; 245.4871, 
  1.39            subdivisions 10, 27; 245.4876, subdivision 1, by 
  1.40            adding a subdivision; 245.4885, subdivision 1; 
  1.41            245.4886, subdivision 1; 245.99, subdivision 4; 
  1.42            245A.03, subdivision 2b; 245A.04, subdivisions 3, 3a, 
  1.43            3b, 3c, 3d; 245A.05; 245A.06; 245A.07; 245A.08; 
  1.44            245A.13, subdivisions 7, 8; 245A.14, by adding a 
  1.45            subdivision; 245A.16, subdivision 1; 245B.08, 
  1.46            subdivision 3; 246.57, by adding a subdivision; 
  2.1             252.275, subdivision 4b; 252A.02, subdivisions 12, 13, 
  2.2             by adding a subdivision; 252A.111, subdivision 6; 
  2.3             252A.16, subdivision 1; 252A.19, subdivision 2; 
  2.4             252A.20, subdivision 1; 254B.02, subdivision 3; 
  2.5             254B.03, subdivision 1; 254B.04, subdivision 1; 
  2.6             254B.09, by adding a subdivision; 256.01, subdivisions 
  2.7             2, 18, by adding a subdivision; 256.045, subdivisions 
  2.8             3, 3b, 4; 256.476, subdivisions 1, 2, 3, 4, 5, 8; 
  2.9             256.482, subdivision 8; 256.955, subdivision 2b; 
  2.10            256.9657, subdivision 2; 256.969, subdivisions 2b, 3a, 
  2.11            by adding a subdivision; 256.973, by adding a 
  2.12            subdivision; 256.975, by adding subdivisions; 256B.04, 
  2.13            by adding a subdivision; 256B.055, subdivision 3a; 
  2.14            256B.056, subdivisions 1a, 3, 4, 5; 256B.057, 
  2.15            subdivision 9, by adding a subdivision; 256B.0625, 
  2.16            subdivisions 3b, 7, 13, 13a, 17, 17a, 18a, 19a, 19c, 
  2.17            20, 30, 34, by adding subdivisions; 256B.0627, 
  2.18            subdivisions 1, 2, 4, 5, 7, 8, 10, 11, by adding 
  2.19            subdivisions; 256B.0635, subdivisions 1, 2; 256B.0911, 
  2.20            subdivisions 1, 3, 5, 6, 7, by adding subdivisions; 
  2.21            256B.0913, subdivisions 1, 2, 4, 5, 6, 7, 8, 9, 10, 
  2.22            11, 12, 13, 14; 256B.0915, subdivisions 1d, 3, 5; 
  2.23            256B.0916, subdivisions 1, 7, 9, by adding a 
  2.24            subdivision; 256B.0917, subdivision 7; 256B.092, 
  2.25            subdivisions 2a, 5; 256B.093, subdivision 3; 256B.095; 
  2.26            256B.0951, subdivisions 1, 3, 4, 5, 7, by adding 
  2.27            subdivisions; 256B.0952, subdivisions 1, 4; 256B.431, 
  2.28            subdivision 17, by adding subdivisions; 256B.434, 
  2.29            subdivision 4, by adding subdivisions; 256B.49, by 
  2.30            adding subdivisions; 256B.501, by adding a 
  2.31            subdivision; 256B.69, subdivisions 4, 5, 5b, 23, by 
  2.32            adding a subdivision; 256B.75; 256B.76; 256D.03, 
  2.33            subdivisions 3, 4; 256D.35, by adding subdivisions; 
  2.34            256D.44, subdivision 5; 256I.05, subdivision 1e; 
  2.35            256J.09, subdivisions 1, 2, 3, by adding subdivisions; 
  2.36            256J.15, by adding a subdivision; 256J.24, subdivision 
  2.37            10; 256J.26, subdivision 1; 256J.31, subdivisions 4, 
  2.38            12; 256J.32, subdivision 7a; 256J.42, by adding a 
  2.39            subdivision; 256J.45, subdivision 1; 256J.46, 
  2.40            subdivisions 1, 2a, by adding a subdivision; 256J.50, 
  2.41            subdivisions 1, 7; 256J.56; 256J.57, subdivision 2; 
  2.42            256J.62, subdivision 9; 256J.625, subdivisions 1, 2, 
  2.43            4; 256J.751; 256K.03, subdivision 1; 256K.07; 256K.25, 
  2.44            subdivisions 1, 3, 4, 5, 6; 256L.06, subdivision 3; 
  2.45            256L.12, subdivision 9, by adding a subdivision; 
  2.46            256L.16; 260C.301, by adding subdivisions; 260C.307, 
  2.47            subdivision 3; 260C.317, by adding a subdivision; 
  2.48            261.062; 268.0122, subdivision 2; 626.556, 
  2.49            subdivisions 3, 3c, 10, 10b, 10d, 10e, 10f, 10i, 11, 
  2.50            12, by adding subdivisions; 626.557, subdivisions 3, 
  2.51            9d; 626.5572, subdivision 17; 626.559, subdivision 2; 
  2.52            Laws 1995, chapter 178, article 2, section 36; Laws 
  2.53            1995, chapter 207, article 3, section 21, as amended; 
  2.54            Laws 1997, chapter 203, article 9, section 21, as 
  2.55            amended; Laws 1999, chapter 152, sections 1, 4; Laws 
  2.56            1999, chapter 245, article 3, section 45, as amended; 
  2.57            Laws 1999, chapter 245, article 4, section 110; 
  2.58            proposing coding for new law in Minnesota Statutes, 
  2.59            chapters 62S; 144; 144A; 145; 145A; 246; 256; 256B; 
  2.60            256I; 256J; 260; 299A; 325F; repealing Minnesota 
  2.61            Statutes 2000, sections 144.0721, subdivision 1; 
  2.62            144.148, subdivision 8; 145.882, subdivisions 3, 4; 
  2.63            145.9245; 145.927; 252A.111, subdivision 3; 256.476, 
  2.64            subdivision 7; 256B.037, subdivision 5; 256B.0635, 
  2.65            subdivision 3; 256B.0911, subdivisions 2, 2a, 4, 8, 9; 
  2.66            256B.0912; 256B.0913, subdivisions 3, 15a, 15b, 15c, 
  2.67            16; 256B.0915, subdivisions 3a, 3b, 3c; 256B.0951, 
  2.68            subdivision 6; 256B.434, subdivision 5; 256B.49, 
  2.69            subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10; 256E.06, 
  2.70            subdivision 2b; 256J.42, subdivision 4; 256J.44; 
  2.71            256J.46, subdivision 1a; Laws 1995, chapter 178, 
  3.1             article 2, section 48, subdivision 6; Minnesota Rules, 
  3.2             parts 9505.2390; 9505.2395; 9505.2396; 9505.2400; 
  3.3             9505.2405; 9505.2410; 9505.2413; 9505.2415; 9505.2420; 
  3.4             9505.2425; 9505.2426; 9505.2430; 9505.2435; 9505.2440; 
  3.5             9505.2445; 9505.2450; 9505.2455; 9505.2458; 9505.2460; 
  3.6             9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 
  3.7             9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 
  3.8             9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 
  3.9             9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 
  3.10            9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 
  3.11            9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 
  3.12            9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 
  3.13            9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 
  3.14            9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 
  3.15            9505.3660; 9505.3670. 
  3.16  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  3.17                             ARTICLE 1 
  3.18                         HEALTH DEPARTMENT 
  3.19     Section 1.  Minnesota Statutes 2000, section 103I.101, 
  3.20  subdivision 6, is amended to read: 
  3.21     Subd. 6.  [FEES FOR VARIANCES.] The commissioner shall 
  3.22  charge a nonrefundable application fee of $120 $150 to cover the 
  3.23  administrative cost of processing a request for a variance or 
  3.24  modification of rules adopted by the commissioner under this 
  3.25  chapter. 
  3.26     Sec. 2.  Minnesota Statutes 2000, section 103I.112, is 
  3.27  amended to read: 
  3.28     103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.] 
  3.29     (a) The commissioner of health may not charge fees required 
  3.30  under this chapter to a federal agency, state agency, or a local 
  3.31  unit of government or to a subcontractor performing work for the 
  3.32  state agency or local unit of government.  
  3.33     (b) "Local unit of government" means a statutory or home 
  3.34  rule charter city, town, county, or soil and water conservation 
  3.35  district, watershed district, an organization formed for the 
  3.36  joint exercise of powers under section 471.59, a board of health 
  3.37  or community health board, or other special purpose district or 
  3.38  authority with local jurisdiction in water and related land 
  3.39  resources management. 
  3.40     Sec. 3.  Minnesota Statutes 2000, section 103I.208, 
  3.41  subdivision 1, is amended to read: 
  3.42     Subdivision 1.  [WELL NOTIFICATION FEE.] The well 
  3.43  notification fee to be paid by a property owner is:  
  4.1      (1) for a new well, $120 $150, which includes the state 
  4.2   core function fee; 
  4.3      (2) for a well sealing, $20 $30 for each well, which 
  4.4   includes the state core function fee, except that for monitoring 
  4.5   wells constructed on a single property, having depths within a 
  4.6   25 foot range, and sealed within 48 hours of start of 
  4.7   construction, a single fee of $20 $30; and 
  4.8      (3) for construction of a dewatering well, $120 $150, which 
  4.9   includes the state core function fee, for each well except a 
  4.10  dewatering project comprising five or more wells shall be 
  4.11  assessed a single fee of $600 $750 for the wells recorded on the 
  4.12  notification. 
  4.13     Sec. 4.  Minnesota Statutes 2000, section 103I.208, 
  4.14  subdivision 2, is amended to read: 
  4.15     Subd. 2.  [PERMIT FEE.] The permit fee to be paid by a 
  4.16  property owner is:  
  4.17     (1) for a well that is not in use under a maintenance 
  4.18  permit, $100 $125 annually; 
  4.19     (2) for construction of a monitoring well, $120 $150, which 
  4.20  includes the state core function fee; 
  4.21     (3) for a monitoring well that is unsealed under a 
  4.22  maintenance permit, $100 $125 annually; 
  4.23     (4) for monitoring wells used as a leak detection device at 
  4.24  a single motor fuel retail outlet, a single petroleum bulk 
  4.25  storage site excluding tank farms, or a single agricultural 
  4.26  chemical facility site, the construction permit fee 
  4.27  is $120 $150, which includes the state core function fee, per 
  4.28  site regardless of the number of wells constructed on the site, 
  4.29  and the annual fee for a maintenance permit for unsealed 
  4.30  monitoring wells is $100 $125 per site regardless of the number 
  4.31  of monitoring wells located on site; 
  4.32     (5) for a groundwater thermal exchange device, in addition 
  4.33  to the notification fee for wells, $120 $150, which includes the 
  4.34  state core function fee; 
  4.35     (6) for a vertical heat exchanger, $120 $150; 
  4.36     (7) for a dewatering well that is unsealed under a 
  5.1   maintenance permit, $100 $125 annually for each well, except a 
  5.2   dewatering project comprising more than five wells shall be 
  5.3   issued a single permit for $500 $625 annually for wells recorded 
  5.4   on the permit; and 
  5.5      (8) for excavating holes for the purpose of installing 
  5.6   elevator shafts, $120 $150 for each hole. 
  5.7      Sec. 5.  Minnesota Statutes 2000, section 103I.235, 
  5.8   subdivision 1, is amended to read: 
  5.9      Subdivision 1.  [DISCLOSURE OF WELLS TO BUYER.] (a) Before 
  5.10  signing an agreement to sell or transfer real property, the 
  5.11  seller must disclose in writing to the buyer information about 
  5.12  the status and location of all known wells on the property, by 
  5.13  delivering to the buyer either a statement by the seller that 
  5.14  the seller does not know of any wells on the property, or a 
  5.15  disclosure statement indicating the legal description and 
  5.16  county, and a map drawn from available information showing the 
  5.17  location of each well to the extent practicable.  In the 
  5.18  disclosure statement, the seller must indicate, for each well, 
  5.19  whether the well is in use, not in use, or sealed.  
  5.20     (b) At the time of closing of the sale, the disclosure 
  5.21  statement information, name and mailing address of the buyer, 
  5.22  and the quartile, section, township, and range in which each 
  5.23  well is located must be provided on a well disclosure 
  5.24  certificate signed by the seller or a person authorized to act 
  5.25  on behalf of the seller. 
  5.26     (c) A well disclosure certificate need not be provided if 
  5.27  the seller does not know of any wells on the property and the 
  5.28  deed or other instrument of conveyance contains the statement:  
  5.29  "The Seller certifies that the Seller does not know of any wells 
  5.30  on the described real property."  
  5.31     (d) If a deed is given pursuant to a contract for deed, the 
  5.32  well disclosure certificate required by this subdivision shall 
  5.33  be signed by the buyer or a person authorized to act on behalf 
  5.34  of the buyer.  If the buyer knows of no wells on the property, a 
  5.35  well disclosure certificate is not required if the following 
  5.36  statement appears on the deed followed by the signature of the 
  6.1   grantee or, if there is more than one grantee, the signature of 
  6.2   at least one of the grantees:  "The Grantee certifies that the 
  6.3   Grantee does not know of any wells on the described real 
  6.4   property."  The statement and signature of the grantee may be on 
  6.5   the front or back of the deed or on an attached sheet and an 
  6.6   acknowledgment of the statement by the grantee is not required 
  6.7   for the deed to be recordable. 
  6.8      (e) This subdivision does not apply to the sale, exchange, 
  6.9   or transfer of real property:  
  6.10     (1) that consists solely of a sale or transfer of severed 
  6.11  mineral interests; or 
  6.12     (2) that consists of an individual condominium unit as 
  6.13  described in chapters 515 and 515B. 
  6.14     (f) For an area owned in common under chapter 515 or 515B 
  6.15  the association or other responsible person must report to the 
  6.16  commissioner by July 1, 1992, the location and status of all 
  6.17  wells in the common area.  The association or other responsible 
  6.18  person must notify the commissioner within 30 days of any change 
  6.19  in the reported status of wells. 
  6.20     (g) For real property sold by the state under section 
  6.21  92.67, the lessee at the time of the sale is responsible for 
  6.22  compliance with this subdivision. 
  6.23     (h) If the seller fails to provide a required well 
  6.24  disclosure certificate, the buyer, or a person authorized to act 
  6.25  on behalf of the buyer, may sign a well disclosure certificate 
  6.26  based on the information provided on the disclosure statement 
  6.27  required by this section or based on other available information.
  6.28     (i) A county recorder or registrar of titles may not record 
  6.29  a deed or other instrument of conveyance dated after October 31, 
  6.30  1990, for which a certificate of value is required under section 
  6.31  272.115, or any deed or other instrument of conveyance dated 
  6.32  after October 31, 1990, from a governmental body exempt from the 
  6.33  payment of state deed tax, unless the deed or other instrument 
  6.34  of conveyance contains the statement made in accordance with 
  6.35  paragraph (c) or (d) or is accompanied by the well disclosure 
  6.36  certificate containing all the information required by paragraph 
  7.1   (b) or (d).  The county recorder or registrar of titles must not 
  7.2   accept a certificate unless it contains all the required 
  7.3   information.  The county recorder or registrar of titles shall 
  7.4   note on each deed or other instrument of conveyance accompanied 
  7.5   by a well disclosure certificate that the well disclosure 
  7.6   certificate was received.  The notation must include the 
  7.7   statement "No wells on property" if the disclosure certificate 
  7.8   states there are no wells on the property.  The well disclosure 
  7.9   certificate shall not be filed or recorded in the records 
  7.10  maintained by the county recorder or registrar of titles.  After 
  7.11  noting "No wells on property" on the deed or other instrument of 
  7.12  conveyance, the county recorder or registrar of titles shall 
  7.13  destroy or return to the buyer the well disclosure certificate.  
  7.14  The county recorder or registrar of titles shall collect from 
  7.15  the buyer or the person seeking to record a deed or other 
  7.16  instrument of conveyance, a fee of $20 $30 for receipt of a 
  7.17  completed well disclosure certificate.  By the tenth day of each 
  7.18  month, the county recorder or registrar of titles shall transmit 
  7.19  the well disclosure certificates to the commissioner of health.  
  7.20  By the tenth day after the end of each calendar quarter, the 
  7.21  county recorder or registrar of titles shall transmit to the 
  7.22  commissioner of health $17.50 $27.50 of the fee for each well 
  7.23  disclosure certificate received during the quarter.  The 
  7.24  commissioner shall maintain the well disclosure certificate for 
  7.25  at least six years.  The commissioner may store the certificate 
  7.26  as an electronic image.  A copy of that image shall be as valid 
  7.27  as the original. 
  7.28     (j) No new well disclosure certificate is required under 
  7.29  this subdivision if the buyer or seller, or a person authorized 
  7.30  to act on behalf of the buyer or seller, certifies on the deed 
  7.31  or other instrument of conveyance that the status and number of 
  7.32  wells on the property have not changed since the last previously 
  7.33  filed well disclosure certificate.  The following statement, if 
  7.34  followed by the signature of the person making the statement, is 
  7.35  sufficient to comply with the certification requirement of this 
  7.36  paragraph:  "I am familiar with the property described in this 
  8.1   instrument and I certify that the status and number of wells on 
  8.2   the described real property have not changed since the last 
  8.3   previously filed well disclosure certificate."  The 
  8.4   certification and signature may be on the front or back of the 
  8.5   deed or on an attached sheet and an acknowledgment of the 
  8.6   statement is not required for the deed or other instrument of 
  8.7   conveyance to be recordable. 
  8.8      (k) The commissioner in consultation with county recorders 
  8.9   shall prescribe the form for a well disclosure certificate and 
  8.10  provide well disclosure certificate forms to county recorders 
  8.11  and registrars of titles and other interested persons. 
  8.12     (l) Failure to comply with a requirement of this 
  8.13  subdivision does not impair: 
  8.14     (1) the validity of a deed or other instrument of 
  8.15  conveyance as between the parties to the deed or instrument or 
  8.16  as to any other person who otherwise would be bound by the deed 
  8.17  or instrument; or 
  8.18     (2) the record, as notice, of any deed or other instrument 
  8.19  of conveyance accepted for filing or recording contrary to the 
  8.20  provisions of this subdivision. 
  8.21     Sec. 6.  Minnesota Statutes 2000, section 103I.525, 
  8.22  subdivision 2, is amended to read: 
  8.23     Subd. 2.  [APPLICATION FEE.] The application fee for a well 
  8.24  contractor's license is $50 $75.  The commissioner may not act 
  8.25  on an application until the application fee is paid.  
  8.26     Sec. 7.  Minnesota Statutes 2000, section 103I.525, 
  8.27  subdivision 6, is amended to read: 
  8.28     Subd. 6.  [LICENSE FEE.] The fee for a well contractor's 
  8.29  license is $250, except the fee for an individual well 
  8.30  contractor's license is $50 $75. 
  8.31     Sec. 8.  Minnesota Statutes 2000, section 103I.525, 
  8.32  subdivision 8, is amended to read: 
  8.33     Subd. 8.  [RENEWAL.] (a) A licensee must file an 
  8.34  application and a renewal application fee to renew the license 
  8.35  by the date stated in the license.  
  8.36     (b) The renewal application fee shall be set by the 
  9.1   commissioner under section 16A.1285 for a well contractor's 
  9.2   license is $250.  
  9.3      (c) The renewal application must include information that 
  9.4   the applicant has met continuing education requirements 
  9.5   established by the commissioner by rule.  
  9.6      (d) At the time of the renewal, the commissioner must have 
  9.7   on file all properly completed well reports, well sealing 
  9.8   reports, reports of excavations to construct elevator shafts, 
  9.9   well permits, and well notifications for work conducted by the 
  9.10  licensee since the last license renewal. 
  9.11     Sec. 9.  Minnesota Statutes 2000, section 103I.525, 
  9.12  subdivision 9, is amended to read: 
  9.13     Subd. 9.  [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 
  9.14  to submit all information required for renewal in subdivision 8 
  9.15  or submits the application and information after the required 
  9.16  renewal date: 
  9.17     (1) the licensee must include an additional a late fee set 
  9.18  by the commissioner of $75; and 
  9.19     (2) the licensee may not conduct activities authorized by 
  9.20  the well contractor's license until the renewal application, 
  9.21  renewal application fee, late fee, and all other information 
  9.22  required in subdivision 8 are submitted. 
  9.23     Sec. 10.  Minnesota Statutes 2000, section 103I.531, 
  9.24  subdivision 2, is amended to read: 
  9.25     Subd. 2.  [APPLICATION FEE.] The application fee for a 
  9.26  limited well/boring contractor's license is $50 $75.  The 
  9.27  commissioner may not act on an application until the application 
  9.28  fee is paid.  
  9.29     Sec. 11.  Minnesota Statutes 2000, section 103I.531, 
  9.30  subdivision 6, is amended to read: 
  9.31     Subd. 6.  [LICENSE FEE.] The fee for a limited well/boring 
  9.32  contractor's license is $50 $75.  
  9.33     Sec. 12.  Minnesota Statutes 2000, section 103I.531, 
  9.34  subdivision 8, is amended to read: 
  9.35     Subd. 8.  [RENEWAL.] (a) A person must file an application 
  9.36  and a renewal application fee to renew the limited well/boring 
 10.1   contractor's license by the date stated in the license.  
 10.2      (b) The renewal application fee shall be set by the 
 10.3   commissioner under section 16A.1285 for a limited well/boring 
 10.4   contractor's license is $75.  
 10.5      (c) The renewal application must include information that 
 10.6   the applicant has met continuing education requirements 
 10.7   established by the commissioner by rule.  
 10.8      (d) At the time of the renewal, the commissioner must have 
 10.9   on file all properly completed well sealing reports, well 
 10.10  permits, vertical heat exchanger permits, and well notifications 
 10.11  for work conducted by the licensee since the last license 
 10.12  renewal. 
 10.13     Sec. 13.  Minnesota Statutes 2000, section 103I.531, 
 10.14  subdivision 9, is amended to read: 
 10.15     Subd. 9.  [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 
 10.16  to submit all information required for renewal in subdivision 8 
 10.17  or submits the application and information after the required 
 10.18  renewal date: 
 10.19     (1) the licensee must include an additional a late fee set 
 10.20  by the commissioner of $75; and 
 10.21     (2) the licensee may not conduct activities authorized by 
 10.22  the limited well/boring contractor's license until the renewal 
 10.23  application, renewal application fee, and late fee, and all 
 10.24  other information required in subdivision 8 are submitted. 
 10.25     Sec. 14.  Minnesota Statutes 2000, section 103I.535, 
 10.26  subdivision 2, is amended to read: 
 10.27     Subd. 2.  [APPLICATION FEE.] The application fee for an 
 10.28  elevator shaft contractor's license is $50 $75.  The 
 10.29  commissioner may not act on an application until the application 
 10.30  fee is paid. 
 10.31     Sec. 15.  Minnesota Statutes 2000, section 103I.535, 
 10.32  subdivision 6, is amended to read: 
 10.33     Subd. 6.  [LICENSE FEE.] The fee for an elevator shaft 
 10.34  contractor's license is $50 $75.  
 10.35     Sec. 16.  Minnesota Statutes 2000, section 103I.535, 
 10.36  subdivision 8, is amended to read: 
 11.1      Subd. 8.  [RENEWAL.] (a) A person must file an application 
 11.2   and a renewal application fee to renew the license by the date 
 11.3   stated in the license.  
 11.4      (b) The renewal application fee shall be set by the 
 11.5   commissioner under section 16A.1285 for an elevator shaft 
 11.6   contractor's license is $75.  
 11.7      (c) The renewal application must include information that 
 11.8   the applicant has met continuing education requirements 
 11.9   established by the commissioner by rule.  
 11.10     (d) At the time of renewal, the commissioner must have on 
 11.11  file all reports and permits for elevator shaft work conducted 
 11.12  by the licensee since the last license renewal. 
 11.13     Sec. 17.  Minnesota Statutes 2000, section 103I.535, 
 11.14  subdivision 9, is amended to read: 
 11.15     Subd. 9.  [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 
 11.16  to submit all information required for renewal in subdivision 8 
 11.17  or submits the application and information after the required 
 11.18  renewal date: 
 11.19     (1) the licensee must include an additional a late fee set 
 11.20  by the commissioner of $75; and 
 11.21     (2) the licensee may not conduct activities authorized by 
 11.22  the elevator shaft contractor's license until the renewal 
 11.23  application, renewal application fee, and late fee, and all 
 11.24  other information required in subdivision 8 are submitted. 
 11.25     Sec. 18.  Minnesota Statutes 2000, section 103I.541, 
 11.26  subdivision 2b, is amended to read: 
 11.27     Subd. 2b.  [APPLICATION FEE.] The application fee for a 
 11.28  monitoring well contractor registration is $50 $75.  The 
 11.29  commissioner may not act on an application until the application 
 11.30  fee is paid.  
 11.31     Sec. 19.  Minnesota Statutes 2000, section 103I.541, 
 11.32  subdivision 4, is amended to read: 
 11.33     Subd. 4.  [RENEWAL.] (a) A person must file an application 
 11.34  and a renewal application fee to renew the registration by the 
 11.35  date stated in the registration.  
 11.36     (b) The renewal application fee shall be set by the 
 12.1   commissioner under section 16A.1285 for a monitoring well 
 12.2   contractor's registration is $75.  
 12.3      (c) The renewal application must include information that 
 12.4   the applicant has met continuing education requirements 
 12.5   established by the commissioner by rule.  
 12.6      (d) At the time of the renewal, the commissioner must have 
 12.7   on file all well reports, well sealing reports, well permits, 
 12.8   and notifications for work conducted by the registered person 
 12.9   since the last registration renewal. 
 12.10     Sec. 20.  Minnesota Statutes 2000, section 103I.541, 
 12.11  subdivision 5, is amended to read: 
 12.12     Subd. 5.  [INCOMPLETE OR LATE RENEWAL.] If a registered 
 12.13  person submits a renewal application after the required renewal 
 12.14  date: 
 12.15     (1) the registered person must include an additional a late 
 12.16  fee set by the commissioner of $75; and 
 12.17     (2) the registered person may not conduct activities 
 12.18  authorized by the monitoring well contractor's registration 
 12.19  until the renewal application, renewal application fee, late 
 12.20  fee, and all other information required in subdivision 4 are 
 12.21  submitted. 
 12.22     Sec. 21.  Minnesota Statutes 2000, section 103I.545, is 
 12.23  amended to read: 
 12.24     103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.] 
 12.25     Subdivision 1.  [DRILLING MACHINE.] (a) A person may not 
 12.26  use a drilling machine such as a cable tool, rotary tool, hollow 
 12.27  rod tool, or auger for a drilling activity requiring a license 
 12.28  or registration under this chapter unless the drilling machine 
 12.29  is registered with the commissioner.  
 12.30     (b) A person must apply for the registration on forms 
 12.31  prescribed by the commissioner and submit a $50 $75 registration 
 12.32  fee. 
 12.33     (c) A registration is valid for one year.  
 12.34     Subd. 2.  [PUMP HOIST.] (a) A person may not use a machine 
 12.35  such as a pump hoist for an activity requiring a license or 
 12.36  registration under this chapter to repair wells or borings, seal 
 13.1   wells or borings, or install pumps unless the machine is 
 13.2   registered with the commissioner.  
 13.3      (b) A person must apply for the registration on forms 
 13.4   prescribed by the commissioner and submit a $50 $75 registration 
 13.5   fee. 
 13.6      (c) A registration is valid for one year. 
 13.7      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
 13.8      Sec. 22.  Minnesota Statutes 2000, section 121A.15, 
 13.9   subdivision 6, is amended to read: 
 13.10     Subd. 6.  [SUSPENSION OF IMMUNIZATION REQUIREMENT; 
 13.11  MODIFICATION TO SCHEDULE.] (a) The commissioner of health, on 
 13.12  finding that an immunization required pursuant to this section 
 13.13  is not necessary to protect the public's health, may suspend for 
 13.14  one year the requirement that children receive that immunization.
 13.15     (b) During portions of the year in which the legislature is 
 13.16  not meeting in regular or special session, the commissioner of 
 13.17  health may modify the immunization requirements of this section. 
 13.18  A modification made under this paragraph must be part of the 
 13.19  current immunization recommendations of each of the following 
 13.20  organizations:  the United States Public Health Service's 
 13.21  Advisory Committee on Immunization Practices, the American 
 13.22  Academy of Family Physicians, and the American Academy of 
 13.23  Pediatrics.  The commissioner shall modify the immunization 
 13.24  requirements through rulemaking using the expedited process in 
 13.25  section 14.389.  A rule adopted under this paragraph shall be in 
 13.26  effect until the adjournment of the next regular legislative 
 13.27  session held after the rule is adopted.  The commissioner shall 
 13.28  report to the legislature on any rules adopted under this 
 13.29  paragraph during the previous calendar year.  Such reports are 
 13.30  due by January 15 of the year following the calendar year in 
 13.31  which the rule is adopted, except that if a rule is adopted in 
 13.32  January, a report on that rule is due by February 15 of that 
 13.33  year. 
 13.34     Sec. 23.  Minnesota Statutes 2000, section 135A.14, is 
 13.35  amended by adding a subdivision to read: 
 13.36     Subd. 7.  [MODIFICATIONS TO SCHEDULE.] During portions of 
 14.1   the year in which the legislature is not meeting in regular or 
 14.2   special session, the commissioner of health may modify the 
 14.3   immunization requirements of this section.  A modification made 
 14.4   under this subdivision must be part of the current immunization 
 14.5   recommendations of each of the following organizations:  the 
 14.6   United States Public Health Service's Advisory Committee on 
 14.7   Immunization Practices, the American Academy of Family 
 14.8   Physicians, and the American Academy of Pediatrics.  The 
 14.9   commissioner shall modify the immunization requirements through 
 14.10  rulemaking using the expedited process in section 14.389.  A 
 14.11  rule adopted under this subdivision shall be in effect until the 
 14.12  adjournment of the next regular legislative session held after 
 14.13  the rule is adopted.  The commissioner shall report to the 
 14.14  legislature on any rules adopted under this subdivision during 
 14.15  the previous calendar year.  Such reports are due by January 15 
 14.16  of the year following the calendar year in which the rule is 
 14.17  adopted, except that if a rule is adopted in January, a report 
 14.18  on that rule is due by February 15 of that year. 
 14.19     Sec. 24.  [144.0751] [HEALTH STANDARDS.] 
 14.20     When establishing or revising safe drinking water or air 
 14.21  quality standards, the commissioner shall take into account only 
 14.22  peer-reviewed, scientifically acceptable information which 
 14.23  includes a reasonable margin of safety in setting the standards 
 14.24  to adequately protect the health of infants, children, and 
 14.25  adults by taking into consideration each of the following 
 14.26  specific risks: 
 14.27     (1) reproductive development and function; 
 14.28     (2) respiratory function; 
 14.29     (3) immunologic suppression or hypersensitization; 
 14.30     (4) development of the brain and nervous system; 
 14.31     (5) endocrine (hormonal) function; 
 14.32     (6) cancer; 
 14.33     (7) general infant and child development; and 
 14.34     (8) any other important health outcomes identified by the 
 14.35  commissioner. 
 14.36     Sec. 25.  Minnesota Statutes 2000, section 144.1202, 
 15.1   subdivision 4, is amended to read: 
 15.2      Subd. 4.  [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 
 15.3   agreement entered into before August 2, 2002 2003, must remain 
 15.4   in effect until terminated under the Atomic Energy Act of 1954, 
 15.5   United States Code, title 42, section 2021, paragraph (j).  The 
 15.6   governor may not enter into an initial agreement with the 
 15.7   Nuclear Regulatory Commission after August 1, 2002 2003.  If an 
 15.8   agreement is not entered into by August 1, 2002 2003, any rules 
 15.9   adopted under this section are repealed effective August 1, 2002 
 15.10  2003. 
 15.11     (b) An agreement authorized under subdivision 1 must be 
 15.12  approved by law before it may be implemented. 
 15.13     Sec. 26.  [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 
 15.14  SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 
 15.15     Subdivision 1.  [APPLICATION AND LICENSE RENEWAL FEE.] When 
 15.16  a license is required for radioactive material or source or 
 15.17  special nuclear material by a rule adopted under section 
 15.18  144.1202, subdivision 2, an application fee according to 
 15.19  subdivision 4 must be paid upon initial application for a 
 15.20  license.  The licensee must renew the license 60 days before the 
 15.21  expiration date of the license by paying a license renewal fee 
 15.22  equal to the application fee under subdivision 4.  The 
 15.23  expiration date of a license is the date set by the United 
 15.24  States Nuclear Regulatory Commission before transfer of the 
 15.25  licensing program under section 144.1202 and thereafter as 
 15.26  specified by rule of the commissioner of health. 
 15.27     Subd. 2.  [ANNUAL FEE.] A licensee must pay an annual fee 
 15.28  at least 60 days before the anniversary date of the issuance of 
 15.29  the license.  The annual fee is an amount equal to 80 percent of 
 15.30  the application fee under subdivision 4, rounded to the nearest 
 15.31  whole dollar. 
 15.32     Subd. 3.  [FEE CATEGORIES; INCORPORATION OF FEDERAL 
 15.33  LICENSING CATEGORIES.] (a) Fee categories under this section are 
 15.34  equivalent to the licensing categories used by the United States 
 15.35  Nuclear Regulatory Commission under Code of Federal Regulations, 
 15.36  title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 
 16.1   provided in paragraph (b). 
 16.2      (b) The category of "Academic, small" is the type of 
 16.3   license required for the use of radioactive materials in a 
 16.4   teaching institution.  Radioactive materials are limited to ten 
 16.5   radionuclides not to exceed a total activity amount of one curie.
 16.6      Subd. 4.  [APPLICATION FEE.] A licensee must pay an 
 16.7   application fee as follows: 
 16.8   Radioactive material,  Application    U.S. Nuclear Regulatory
 16.9   source and             fee            Commission licensing
 16.10  special material                      category as reference
 16.12  Type A broadscope      $20,000        Medical institution type A
 16.13  Type B broadscope      $15,000        Research and development
 16.14                                        type B
 16.15  Type C broadscope      $10,000        Academic type C
 16.16  Medical use            $4,000         Medical
 16.17                                        Medical institution
 16.18                                        Medical private practice
 16.19  Mobile nuclear                                                 
 16.20  medical laboratory     $4,000         Mobile medical laboratory
 16.21  Medical special use                                     
 16.22  sealed sources         $6,000         Teletherapy
 16.23                                        High dose rate remote
 16.24                                        afterloaders
 16.25                                        Stereotactic
 16.26                                        radiosurgery devices
 16.27  In vitro testing       $2,300         In vitro testing
 16.28                                        laboratories
 16.29  Measuring gauge,
 16.30  sealed sources         $2,000         Fixed gauges
 16.31                                        Portable gauges
 16.32                                        Analytical instruments
 16.33                                        Measuring systems - other
 16.34  Gas chromatographs     $1,200         Gas chromatographs
 16.35  Manufacturing and 
 16.36  distribution           $14,700        Manufacturing and 
 17.1                                         distribution - other
 17.2   Distribution only      $8,800         Distribution of
 17.3                                         radioactive material
 17.4                                         for commercial use only
 17.5   Other services         $1,500         Other services
 17.6   Nuclear medicine 
 17.7   pharmacy               $4,100         Nuclear pharmacy
 17.8   Waste disposal         $9,400         Waste disposal service
 17.9                                         prepackage
 17.10                                        Waste disposal service
 17.11                                        processing/repackage
 17.12  Waste storage only     $7,000         To receive and store
 17.13                                        radioactive material waste
 17.14  Industrial
 17.15  radiography            $8,400         Industrial radiography
 17.16                                        fixed location
 17.17                                        Industrial radiography
 17.18                                        portable/temporary sites
 17.19  Irradiator - 
 17.20  self-shielded          $4,100         Irradiators self-shielded
 17.21                                        less than 10,000 curies
 17.22  Irradiator - 
 17.23  less than 10,000 Ci    $7,500         Irradiators less than
 17.24                                        10,000 curies
 17.25  Irradiator - 
 17.26  more than 10,000 Ci    $11,500        Irradiators greater than
 17.27                                        10,000 curies
 17.28  Research and
 17.29  development,
 17.30  no distribution        $4,100         Research and development
 17.31  Radioactive material 
 17.32  possession only        $1,000         By-product possession only
 17.33  Source material        $1,000         Source material shielding
 17.34  Special nuclear 
 17.35  material, less than 
 17.36  200 grams              $1,000         Special nuclear material
 18.1                                         plutonium-neutron sources
 18.2                                         less than 200 grams
 18.3   Pacemaker
 18.4   manufacturing          $1,000         Pacemaker by-product
 18.5                                         and/or special nuclear
 18.6                                         material - medical
 18.7                                         institution
 18.8   General license
 18.9   distribution           $2,100         General license
 18.10                                        distribution
 18.11  General license 
 18.12  distribution, exempt   $1,500         General license 
 18.13                                        distribution -
 18.14                                        certain exempt items
 18.15  Academic, small        $1,000         Possession limit of ten
 18.16                                        radionuclides, not to
 18.17                                        exceed a total of one curie
 18.18                                        of activity
 18.19  Veterinary             $2,000         Veterinary use
 18.20  Well logging           $5,000         Well logging
 18.21     Subd. 5.  [PENALTY FOR LATE PAYMENT.] An annual fee or a 
 18.22  license renewal fee submitted to the commissioner after the due 
 18.23  date specified by rule must be accompanied by an additional 
 18.24  amount equal to 25 percent of the fee due. 
 18.25     Subd. 6.  [INSPECTIONS.] The commissioner of health shall 
 18.26  make periodic safety inspections of the radioactive material and 
 18.27  source and special nuclear material of a licensee.  The 
 18.28  commissioner shall prescribe the frequency of safety inspections 
 18.29  by rule. 
 18.30     Subd. 7.  [RECOVERY OF REINSPECTION COST.] If the 
 18.31  commissioner finds serious violations of public health standards 
 18.32  during an inspection under subdivision 6, the licensee must pay 
 18.33  all costs associated with subsequent reinspection of the 
 18.34  source.  The costs shall be the actual costs incurred by the 
 18.35  commissioner and include, but are not limited to, labor, 
 18.36  transportation, per diem, materials, legal fees, testing, and 
 19.1   monitoring costs. 
 19.2      Subd. 8.  [RECIPROCITY FEE.] A licensee submitting an 
 19.3   application for reciprocal recognition of a materials license 
 19.4   issued by another agreement state or the United States Nuclear 
 19.5   Regulatory Commission for a period of 180 days or less during a 
 19.6   calendar year must pay one-half of the application fee specified 
 19.7   under subdivision 4.  For a period of 181 days or more, the 
 19.8   licensee must pay the entire application fee under subdivision 4.
 19.9      Subd. 9.  [FEES FOR LICENSE AMENDMENTS.] A licensee must 
 19.10  pay a fee to amend a license as follows: 
 19.11     (1) to amend a license requiring no license review 
 19.12  including, but not limited to, facility name change or removal 
 19.13  of a previously authorized user, no fee; 
 19.14     (2) to amend a license requiring review including, but not 
 19.15  limited to, addition of isotopes, procedure changes, new 
 19.16  authorized users, or a new radiation safety officer, $200; and 
 19.17     (3) to amend a license requiring review and a site visit 
 19.18  including, but not limited to, facility move or addition of 
 19.19  processes, $400. 
 19.20     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
 19.21     Sec. 27.  Minnesota Statutes 2000, section 144.122, is 
 19.22  amended to read: 
 19.23     144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 
 19.24     (a) The state commissioner of health, by rule, may 
 19.25  prescribe reasonable procedures and fees for filing with the 
 19.26  commissioner as prescribed by statute and for the issuance of 
 19.27  original and renewal permits, licenses, registrations, and 
 19.28  certifications issued under authority of the commissioner.  The 
 19.29  expiration dates of the various licenses, permits, 
 19.30  registrations, and certifications as prescribed by the rules 
 19.31  shall be plainly marked thereon.  Fees may include application 
 19.32  and examination fees and a penalty fee for renewal applications 
 19.33  submitted after the expiration date of the previously issued 
 19.34  permit, license, registration, and certification.  The 
 19.35  commissioner may also prescribe, by rule, reduced fees for 
 19.36  permits, licenses, registrations, and certifications when the 
 20.1   application therefor is submitted during the last three months 
 20.2   of the permit, license, registration, or certification period.  
 20.3   Fees proposed to be prescribed in the rules shall be first 
 20.4   approved by the department of finance.  All fees proposed to be 
 20.5   prescribed in rules shall be reasonable.  The fees shall be in 
 20.6   an amount so that the total fees collected by the commissioner 
 20.7   will, where practical, approximate the cost to the commissioner 
 20.8   in administering the program.  All fees collected shall be 
 20.9   deposited in the state treasury and credited to the state 
 20.10  government special revenue fund unless otherwise specifically 
 20.11  appropriated by law for specific purposes. 
 20.12     (b) The commissioner may charge a fee for voluntary 
 20.13  certification of medical laboratories and environmental 
 20.14  laboratories, and for environmental and medical laboratory 
 20.15  services provided by the department, without complying with 
 20.16  paragraph (a) or chapter 14.  Fees charged for environment and 
 20.17  medical laboratory services provided by the department must be 
 20.18  approximately equal to the costs of providing the services.  
 20.19     (c) The commissioner may develop a schedule of fees for 
 20.20  diagnostic evaluations conducted at clinics held by the services 
 20.21  for children with handicaps program.  All receipts generated by 
 20.22  the program are annually appropriated to the commissioner for 
 20.23  use in the maternal and child health program. 
 20.24     (d) The commissioner, for fiscal years 1996 and beyond, 
 20.25  shall set license fees for hospitals and nursing homes that are 
 20.26  not boarding care homes at the following levels: 
 20.27  Joint Commission on Accreditation of Healthcare 
 20.28  Organizations (JCAHO hospitals)      $1,017
 20.29                                       $7,055
 20.30  Non-JCAHO hospitals                  $762 plus $34 per bed
 20.31                                       $4,680 plus $234 per bed
 20.32  Nursing home                         $78 plus $19 per bed
 20.33                                       $183 plus $91 per bed
 20.34     For fiscal years 1996 and beyond, The commissioner shall 
 20.35  set license fees for outpatient surgical centers, boarding care 
 20.36  homes, and supervised living facilities at the following levels: 
 21.1   Outpatient surgical centers          $517
 21.2                                        $1,512
 21.3   Boarding care homes                  $78 plus $19 per bed
 21.4                                        $183 plus $91 per bed
 21.5   Supervised living facilities         $78 plus $19 per bed
 21.6                                        $183 plus $91 per bed.
 21.7      (e) Unless prohibited by federal law, the commissioner of 
 21.8   health shall charge applicants the following fees to cover the 
 21.9   cost of any initial certification surveys required to determine 
 21.10  a provider's eligibility to participate in the Medicare or 
 21.11  Medicaid program: 
 21.12  Prospective payment surveys for          $  900
 21.13  hospitals
 21.15  Swing bed surveys for nursing homes      $1,200
 21.17  Psychiatric hospitals                    $1,400
 21.19  Rural health facilities                  $1,100
 21.21  Portable X-ray providers                 $  500
 21.23  Home health agencies                     $1,800
 21.25  Outpatient therapy agencies              $  800
 21.27  End stage renal dialysis providers       $2,100
 21.29  Independent therapists                   $  800
 21.31  Comprehensive rehabilitation             $1,200
 21.32  outpatient facilities
 21.34  Hospice providers                        $1,700
 21.36  Ambulatory surgical providers            $1,800
 21.38  Hospitals                                $4,200
 21.40  Other provider categories or             Actual surveyor costs:
 21.41  additional resurveys required            average surveyor cost x
 21.42  to complete initial certification        number of hours for the
 21.43                                           survey process.
 21.44     These fees shall be submitted at the time of the 
 21.45  application for federal certification and shall not be 
 21.46  refunded.  All fees collected after the date that the imposition 
 21.47  of fees is not prohibited by federal law shall be deposited in 
 21.48  the state treasury and credited to the state government special 
 21.49  revenue fund. 
 21.50     Sec. 28.  Minnesota Statutes 2000, section 144.148, 
 21.51  subdivision 2, is amended to read: 
 22.1      Subd. 2.  [PROGRAM.] (a) The commissioner of health shall 
 22.2   award rural hospital capital improvement grants to eligible 
 22.3   rural hospitals.  Except as provided in paragraph (b), A grant 
 22.4   shall not exceed $300,000 per hospital. Prior to the receipt of 
 22.5   any grant, the hospital must certify to the commissioner that at 
 22.6   least one-quarter of the grant amount, which may include in-kind 
 22.7   services, is available for the same purposes from nonstate 
 22.8   resources.  
 22.9      (b) A grant shall not exceed $1,500,000 per eligible rural 
 22.10  hospital that also satisfies the following criteria: 
 22.11     (1) is the only hospital in a county; 
 22.12     (2) has 25 or fewer licensed hospital beds with a net 
 22.13  hospital operating margin not greater than an average of two 
 22.14  percent over the three fiscal years prior to application; 
 22.15     (3) is located in a medically underserved community (MUC) 
 22.16  or a health professional shortage area (HPSA); 
 22.17     (4) is located near a migrant worker employment site and 
 22.18  regularly treats significant numbers of migrant workers and 
 22.19  their families; and 
 22.20     (5) has not previously received a grant under this section 
 22.21  prior to July 1, 1999. 
 22.22     Sec. 29.  Minnesota Statutes 2000, section 144.226, 
 22.23  subdivision 4, is amended to read: 
 22.24     Subd. 4.  [VITAL RECORDS SURCHARGE.] In addition to any fee 
 22.25  prescribed under subdivision 1, there is a nonrefundable 
 22.26  surcharge of $3 $2 for each certified and noncertified birth or 
 22.27  death record, and for a certification that the record cannot be 
 22.28  found.  The local or state registrar shall forward this amount 
 22.29  to the state treasurer to be deposited into the state government 
 22.30  special revenue fund.  This surcharge shall not be charged under 
 22.31  those circumstances in which no fee for a birth or death record 
 22.32  is permitted under subdivision 1, paragraph (a).  This surcharge 
 22.33  requirement expires June 30, 2002. 
 22.34     Sec. 30.  Minnesota Statutes 2000, section 144.551, 
 22.35  subdivision 1, is amended to read: 
 22.36     Subdivision 1.  [RESTRICTED CONSTRUCTION OR MODIFICATION.] 
 23.1   (a) The following construction or modification may not be 
 23.2   commenced:  
 23.3      (1) any erection, building, alteration, reconstruction, 
 23.4   modernization, improvement, extension, lease, or other 
 23.5   acquisition by or on behalf of a hospital that increases the bed 
 23.6   capacity of a hospital, relocates hospital beds from one 
 23.7   physical facility, complex, or site to another, or otherwise 
 23.8   results in an increase or redistribution of hospital beds within 
 23.9   the state; and 
 23.10     (2) the establishment of a new hospital.  
 23.11     (b) This section does not apply to:  
 23.12     (1) construction or relocation within a county by a 
 23.13  hospital, clinic, or other health care facility that is a 
 23.14  national referral center engaged in substantial programs of 
 23.15  patient care, medical research, and medical education meeting 
 23.16  state and national needs that receives more than 40 percent of 
 23.17  its patients from outside the state of Minnesota; 
 23.18     (2) a project for construction or modification for which a 
 23.19  health care facility held an approved certificate of need on May 
 23.20  1, 1984, regardless of the date of expiration of the 
 23.21  certificate; 
 23.22     (3) a project for which a certificate of need was denied 
 23.23  before July 1, 1990, if a timely appeal results in an order 
 23.24  reversing the denial; 
 23.25     (4) a project exempted from certificate of need 
 23.26  requirements by Laws 1981, chapter 200, section 2; 
 23.27     (5) a project involving consolidation of pediatric 
 23.28  specialty hospital services within the Minneapolis-St. Paul 
 23.29  metropolitan area that would not result in a net increase in the 
 23.30  number of pediatric specialty hospital beds among the hospitals 
 23.31  being consolidated; 
 23.32     (6) a project involving the temporary relocation of 
 23.33  pediatric-orthopedic hospital beds to an existing licensed 
 23.34  hospital that will allow for the reconstruction of a new 
 23.35  philanthropic, pediatric-orthopedic hospital on an existing site 
 23.36  and that will not result in a net increase in the number of 
 24.1   hospital beds.  Upon completion of the reconstruction, the 
 24.2   licenses of both hospitals must be reinstated at the capacity 
 24.3   that existed on each site before the relocation; 
 24.4      (7) the relocation or redistribution of hospital beds 
 24.5   within a hospital building or identifiable complex of buildings 
 24.6   provided the relocation or redistribution does not result in: 
 24.7   (i) an increase in the overall bed capacity at that site; (ii) 
 24.8   relocation of hospital beds from one physical site or complex to 
 24.9   another; or (iii) redistribution of hospital beds within the 
 24.10  state or a region of the state; 
 24.11     (8) relocation or redistribution of hospital beds within a 
 24.12  hospital corporate system that involves the transfer of beds 
 24.13  from a closed facility site or complex to an existing site or 
 24.14  complex provided that:  (i) no more than 50 percent of the 
 24.15  capacity of the closed facility is transferred; (ii) the 
 24.16  capacity of the site or complex to which the beds are 
 24.17  transferred does not increase by more than 50 percent; (iii) the 
 24.18  beds are not transferred outside of a federal health systems 
 24.19  agency boundary in place on July 1, 1983; and (iv) the 
 24.20  relocation or redistribution does not involve the construction 
 24.21  of a new hospital building; 
 24.22     (9) a construction project involving up to 35 new beds in a 
 24.23  psychiatric hospital in Rice county that primarily serves 
 24.24  adolescents and that receives more than 70 percent of its 
 24.25  patients from outside the state of Minnesota; 
 24.26     (10) a project to replace a hospital or hospitals with a 
 24.27  combined licensed capacity of 130 beds or less if:  (i) the new 
 24.28  hospital site is located within five miles of the current site; 
 24.29  and (ii) the total licensed capacity of the replacement 
 24.30  hospital, either at the time of construction of the initial 
 24.31  building or as the result of future expansion, will not exceed 
 24.32  70 licensed hospital beds, or the combined licensed capacity of 
 24.33  the hospitals, whichever is less; 
 24.34     (11) the relocation of licensed hospital beds from an 
 24.35  existing state facility operated by the commissioner of human 
 24.36  services to a new or existing facility, building, or complex 
 25.1   operated by the commissioner of human services; from one 
 25.2   regional treatment center site to another; or from one building 
 25.3   or site to a new or existing building or site on the same 
 25.4   campus; 
 25.5      (12) the construction or relocation of hospital beds 
 25.6   operated by a hospital having a statutory obligation to provide 
 25.7   hospital and medical services for the indigent that does not 
 25.8   result in a net increase in the number of hospital beds; or 
 25.9      (13) a construction project involving the addition of up to 
 25.10  31 new beds in an existing nonfederal hospital in Beltrami 
 25.11  county; or 
 25.12     (14) a construction project involving the addition of up to 
 25.13  eight new beds in an existing nonfederal hospital in Otter Tail 
 25.14  county with 100 licensed acute care beds. 
 25.15     Sec. 31.  [144.585] [HOSPITAL CHARITY CARE AID.] 
 25.16     Subdivision 1.  [PURPOSE.] The purpose of charity care aid 
 25.17  is to help offset excess charity care burdens at Minnesota acute 
 25.18  care, short-term hospitals. 
 25.19     Subd. 2.  [DEFINITIONS.] (a) For purposes of this section, 
 25.20  the terms in this subdivision have the meanings given to them. 
 25.21     (b) "Charity care" is the dollar amount of charity care 
 25.22  adjustments as determined under subdivision 3. 
 25.23     (c) "Cost-to-charge ratio" means a hospital's total 
 25.24  operating expenses over the sum of gross patient revenue and 
 25.25  other operating revenue, as reported to the commissioner of 
 25.26  health under rules adopted under sections 144.695 to 144.703.  
 25.27  The commissioner shall use the most recently available data to 
 25.28  calculate the cost-to-charge ratio. 
 25.29     Subd. 3.  [CHARITY CARE REPORTING.] (a) For a hospital to 
 25.30  report amounts as charity care adjustments, the hospital: 
 25.31     (1) must generate and record a charge; 
 25.32     (2) have a policy on the provision of charity care and must 
 25.33  communicate the policy to the public; 
 25.34     (3) have made a reasonable effort to identify a third party 
 25.35  payer, encourage the patient to enroll in public programs, and 
 25.36  should, to the extent possible, aid the patient in the 
 26.1   enrollment process; and 
 26.2      (4) ensure that the patient meets the charity care criteria 
 26.3   of this subdivision, which must be consistent with statewide 
 26.4   income standards set out in paragraph (c). 
 26.5      (b) In determining whether to classify care as charity 
 26.6   care, the hospital must consider the following: 
 26.7      (1) charity care may include services which the provider is 
 26.8   obligated to render independently of the ability to collect; 
 26.9      (2) charity care may include care provided to low-income 
 26.10  patients who meet the charity care income standards under 
 26.11  paragraph (c) and have partial coverage, but are unable to pay 
 26.12  the remainder of their medical bills.  This does not apply to 
 26.13  that portion of the bill which has been determined to be the 
 26.14  patient's responsibility after a partial charity care 
 26.15  classification; 
 26.16     (3) charity care may include care provided to low-income 
 26.17  patients who may qualify for a public health insurance program 
 26.18  and meet the statewide eligibility criteria for charity care, 
 26.19  but who do not complete the application process for public 
 26.20  insurance despite the facility's best efforts; 
 26.21     (4) charity care may include care to individuals whose 
 26.22  eligibility for charity care was determined through third party 
 26.23  services employed by the hospital for information gathering 
 26.24  purposes only; 
 26.25     (5) charity care may not include contractual allowances, 
 26.26  which is the difference between gross charges and payments 
 26.27  received under contractual arrangements with insurance companies 
 26.28  and payers; 
 26.29     (6) charity care may not include bad debt; 
 26.30     (7) charity care may not include what may be perceived as 
 26.31  underpayments for operating public programs; 
 26.32     (8) charity care may not include cases which are paid 
 26.33  through a charitable contribution through a third party or 
 26.34  facility-related foundation; 
 26.35     (9) charity care may not include unreimbursed costs of 
 26.36  basic or clinical research and of professional education and 
 27.1   training; 
 27.2      (10) charity care may not include professional courtesy 
 27.3   discounts; 
 27.4      (11) charity care may not include community service or 
 27.5   outreach activities; and 
 27.6      (12) charity care may not include services for patients 
 27.7   against whom collection actions where taken which result in a 
 27.8   credit report. 
 27.9      (c) The hospital must use the income standards in this 
 27.10  paragraph for determining charity care eligibility for reporting 
 27.11  purposes.  The hospital does not need to make a patient asset 
 27.12  determination in order to apply charity care income standards. 
 27.13     (1) Care to a patient with a family income at or below 150 
 27.14  percent of the Federal Poverty Guideline (FPG) may be reported 
 27.15  as full charity care or free care. 
 27.16     (2) The hospital's share of discounted charges for care to 
 27.17  a patient with family income below 275 percent of the FPG 
 27.18  qualifies for classification as charity care.  The following 
 27.19  sliding fee schedules apply: 
 27.20     income as     charges paid      corresponding
 27.21      % of FPG       by patient       charity care
 27.22      151-200%           20%               80%
 27.23      201-225%           40%               60%
 27.24      226-250%           60%               40%
 27.25      251-275%           80%               20%
 27.26     (3) Care to a patient is considered medical hardship when 
 27.27  qualified medical expenses, as defined for the purposes of 
 27.28  federal income tax deductibility, exceeds 30 percent of family 
 27.29  income.  Qualified medical expenses may be counted as charity 
 27.30  care in the amount that exceeds 30 percent of family income.  
 27.31  This clause applies even if the patient's family income exceeds 
 27.32  the charity care income standards in clauses (1) and (2). 
 27.33     Subd. 4.  [APPLICATION.] To be eligible for funds under 
 27.34  this section, hospitals must submit an application to the 
 27.35  commissioner of health by the deadline established by the 
 27.36  commissioner.  Applications must meet the criteria as 
 28.1   established by the commissioner, but must contain: 
 28.2      (1) the dollar amount of charity care in the previous year, 
 28.3   as defined in subdivision 3, paragraphs (b) and (c); 
 28.4      (2) a list with the most common diagnoses for which charity 
 28.5   care is provided; and 
 28.6      (3) descriptive aggregate statistics of the characteristics 
 28.7   of patients who receive charity care. 
 28.8      Subd. 5.  [ALLOCATION OF FUNDS.] A hospital's share of the 
 28.9   available charity care aid is equal to that hospital's share of 
 28.10  charity care relative to the total charity care provided by 
 28.11  applicants. 
 28.12     Sec. 32.  Minnesota Statutes 2000, section 144.98, 
 28.13  subdivision 3, is amended to read: 
 28.14     Subd. 3.  [FEES.] (a) An application for certification 
 28.15  under subdivision 1 must be accompanied by the biennial fee 
 28.16  specified in this subdivision.  The fees are for: 
 28.17     (1) nonrefundable base certification fee, $500 $1,200; and 
 28.18     (2) test category certification fees: 
 28.19  Test Category                                  Certification Fee
 28.20  Clean water program bacteriology                      $200 $600
 28.21  Safe drinking water program bacteriology                   $600
 28.22  Clean water program inorganic chemistry, 
 28.23    fewer than four constituents                        $100 $600
 28.24  Safe drinking water program inorganic chemistry, 
 28.25    four or more constituents                           $300 $600
 28.26  Clean water program chemistry metals, 
 28.27    fewer than four constituents                        $200 $800
 28.28  Safe drinking water program chemistry metals, 
 28.29    four or more constituents                           $500 $800
 28.30  Resource conservation and recovery program 
 28.31    chemistry metals                                         $800
 28.32  Clean water program volatile organic compounds      $600 $1,200
 28.33  Safe drinking water program 
 28.34    volatile organic compounds                             $1,200
 28.35  Resource conservation and recovery program 
 28.36    volatile organic compounds                             $1,200
 29.1   Underground storage tank program
 29.2     volatile organic compounds                             $1,200
 29.3   Clean water program other organic compounds         $600 $1,200
 29.4   Safe drinking water program other organic compounds      $1,200
 29.5   Resource conservation and recovery program
 29.6     other organic compounds                                $1,200
 29.7      (b) The total biennial certification fee is the base fee 
 29.8   plus the applicable test category fees.  The biennial 
 29.9   certification fee for a contract laboratory is 1.5 times the 
 29.10  total certification fee. 
 29.11     (c) Laboratories located outside of this state that require 
 29.12  an on-site survey will be assessed an additional $1,200 $2,500 
 29.13  fee. 
 29.14     (d) Fees must be set so that the total fees support the 
 29.15  laboratory certification program.  Direct costs of the 
 29.16  certification service include program administration, 
 29.17  inspections, the agency's general support costs, and attorney 
 29.18  general costs attributable to the fee function. 
 29.19     (e) A change fee shall be assessed if a laboratory requests 
 29.20  additional analytes or methods at any time other than when 
 29.21  applying for or renewing its certification.  The change fee is 
 29.22  equal to the test category certification fee for the analyte.  
 29.23     (f) A variance fee shall be assessed if a laboratory 
 29.24  requests and is granted a variance from a rule adopted under 
 29.25  this section.  The variance fee is $500 per variance. 
 29.26     (g) Refunds or credits shall not be made for analytes or 
 29.27  methods requested but not approved.  
 29.28     (h) Certification of a laboratory shall not be awarded 
 29.29  until all fees are paid. 
 29.30     Sec. 33.  Minnesota Statutes 2000, section 144A.44, 
 29.31  subdivision 1, is amended to read: 
 29.32     Subdivision 1.  [STATEMENT OF RIGHTS.] A person who 
 29.33  receives home care services has these rights: 
 29.34     (1) the right to receive written information about rights 
 29.35  in advance of receiving care or during the initial evaluation 
 29.36  visit before the initiation of treatment, including what to do 
 30.1   if rights are violated; 
 30.2      (2) the right to receive care and services according to a 
 30.3   suitable and up-to-date plan, and subject to accepted medical or 
 30.4   nursing standards, to take an active part in creating and 
 30.5   changing the plan and evaluating care and services; 
 30.6      (3) the right to be told in advance of receiving care about 
 30.7   the services that will be provided, the disciplines that will 
 30.8   furnish care, the frequency of visits proposed to be furnished, 
 30.9   other choices that are available, and the consequences of these 
 30.10  choices including the consequences of refusing these services; 
 30.11     (4) the right to be told in advance of any change in the 
 30.12  plan of care and to take an active part in any change; 
 30.13     (5) the right to refuse services or treatment; 
 30.14     (6) the right to know, in advance, any limits to the 
 30.15  services available from a provider, and the provider's grounds 
 30.16  for a termination of services; 
 30.17     (7) the right to know in advance of receiving care whether 
 30.18  the services are covered by health insurance, medical 
 30.19  assistance, or other health programs, the charges for services 
 30.20  that will not be covered by Medicare, and the charges that the 
 30.21  individual may have to pay; 
 30.22     (8) the right to know what the charges are for services, no 
 30.23  matter who will be paying the bill; 
 30.24     (9) the right to know that there may be other services 
 30.25  available in the community, including other home care services 
 30.26  and providers, and to know where to go for information about 
 30.27  these services; 
 30.28     (10) the right to choose freely among available providers 
 30.29  and to change providers after services have begun, within the 
 30.30  limits of health insurance, medical assistance, or other health 
 30.31  programs; 
 30.32     (11) the right to have personal, financial, and medical 
 30.33  information kept private, and to be advised of the provider's 
 30.34  policies and procedures regarding disclosure of such 
 30.35  information; 
 30.36     (12) the right to be allowed access to records and written 
 31.1   information from records in accordance with section 144.335; 
 31.2      (13) the right to be served by people who are properly 
 31.3   trained and competent to perform their duties; 
 31.4      (14) the right to be treated with courtesy and respect, and 
 31.5   to have the patient's property treated with respect; 
 31.6      (15) the right to be free from physical and verbal abuse; 
 31.7      (16) the right to reasonable, advance notice of changes in 
 31.8   services or charges, including at least ten days' advance notice 
 31.9   of the termination of a service by a provider, except in cases 
 31.10  where: 
 31.11     (i) the recipient of services engages in conduct that 
 31.12  alters the conditions of employment as specified in the 
 31.13  employment contract between the home care provider and the 
 31.14  individual providing home care services, or creates an abusive 
 31.15  or unsafe work environment for the individual providing home 
 31.16  care services; or 
 31.17     (ii) an emergency for the informal caregiver or a 
 31.18  significant change in the recipient's condition has resulted in 
 31.19  service needs that exceed the current service provider agreement 
 31.20  and that cannot be safely met by the home care provider; 
 31.21     (17) the right to a coordinated transfer when there will be 
 31.22  a change in the provider of services; 
 31.23     (18) the right to voice grievances regarding treatment or 
 31.24  care that is, or fails to be, furnished, or regarding the lack 
 31.25  of courtesy or respect to the patient or the patient's property; 
 31.26     (19) the right to know how to contact an individual 
 31.27  associated with the provider who is responsible for handling 
 31.28  problems and to have the provider investigate and attempt to 
 31.29  resolve the grievance or complaint; 
 31.30     (20) the right to know the name and address of the state or 
 31.31  county agency to contact for additional information or 
 31.32  assistance; and 
 31.33     (21) the right to assert these rights personally, or have 
 31.34  them asserted by the patient's family or guardian when the 
 31.35  patient has been judged incompetent, without retaliation. 
 31.36     Sec. 34.  Minnesota Statutes 2000, section 144A.4605, 
 32.1   subdivision 4, is amended to read: 
 32.2      Subd. 4.  [LICENSE REQUIRED.] (a) A housing with services 
 32.3   establishment registered under chapter 144D that is required to 
 32.4   obtain a home care license must obtain an assisted living home 
 32.5   care license according to this section or a class A or class E 
 32.6   license according to rule.  A housing with services 
 32.7   establishment that obtains a class E license under this 
 32.8   subdivision remains subject to the payment limitations in 
 32.9   sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, 
 32.10  subdivision 3, paragraph (g). 
 32.11     (b) A board and lodging establishment registered for 
 32.12  special services as of December 31, 1996, and also registered as 
 32.13  a housing with services establishment under chapter 144D, must 
 32.14  deliver home care services according to sections 144A.43 to 
 32.15  144A.48, and may apply for a waiver from requirements under 
 32.16  Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 
 32.17  licensed agency under the standards of section 157.17.  Such 
 32.18  waivers as may be granted by the department will expire upon 
 32.19  promulgation of home care rules implementing section 144A.4605. 
 32.20     (c) An adult foster care provider licensed by the 
 32.21  department of human services and registered under chapter 144D 
 32.22  may continue to provide health-related services under its foster 
 32.23  care license until the promulgation of home care rules 
 32.24  implementing this section. 
 32.25     (d) An assisted living home care provider licensed under 
 32.26  this section must comply with the disclosure provisions of 
 32.27  section 325F.691 to the extent they are applicable. 
 32.28     Sec. 35.  Minnesota Statutes 2000, section 144D.03, 
 32.29  subdivision 2, is amended to read: 
 32.30     Subd. 2.  [REGISTRATION INFORMATION.] The establishment 
 32.31  shall provide the following information to the commissioner in 
 32.32  order to be registered: 
 32.33     (1) the business name, street address, and mailing address 
 32.34  of the establishment; 
 32.35     (2) the name and mailing address of the owner or owners of 
 32.36  the establishment and, if the owner or owners are not natural 
 33.1   persons, identification of the type of business entity of the 
 33.2   owner or owners, and the names and addresses of the officers and 
 33.3   members of the governing body, or comparable persons for 
 33.4   partnerships, limited liability corporations, or other types of 
 33.5   business organizations of the owner or owners; 
 33.6      (3) the name and mailing address of the managing agent, 
 33.7   whether through management agreement or lease agreement, of the 
 33.8   establishment, if different from the owner or owners, and the 
 33.9   name of the on-site manager, if any; 
 33.10     (4) verification that the establishment has entered into an 
 33.11  elderly housing with services contract, as required in section 
 33.12  144D.04, with each resident or resident's representative; 
 33.13     (5) verification that the establishment is complying with 
 33.14  the requirements of section 325F.691, if applicable; 
 33.15     (5) (6) the name and address of at least one natural person 
 33.16  who shall be responsible for dealing with the commissioner on 
 33.17  all matters provided for in sections 144D.01 to 144D.06, and on 
 33.18  whom personal service of all notices and orders shall be made, 
 33.19  and who shall be authorized to accept service on behalf of the 
 33.20  owner or owners and the managing agent, if any; and 
 33.21     (6) (7) the signature of the authorized representative of 
 33.22  the owner or owners or, if the owner or owners are not natural 
 33.23  persons, signatures of at least two authorized representatives 
 33.24  of each owner, one of which shall be an officer of the owner. 
 33.25     Personal service on the person identified under clause (5) 
 33.26  (6) by the owner or owners in the registration shall be 
 33.27  considered service on the owner or owners, and it shall not be a 
 33.28  defense to any action that personal service was not made on each 
 33.29  individual or entity.  The designation of one or more 
 33.30  individuals under this subdivision shall not affect the legal 
 33.31  responsibility of the owner or owners under sections 144D.01 to 
 33.32  144D.06. 
 33.33     Sec. 36.  Minnesota Statutes 2000, section 144D.04, 
 33.34  subdivision 2, is amended to read: 
 33.35     Subd. 2.  [CONTENTS OF CONTRACT.] An elderly housing with 
 33.36  services contract, which need not be entitled as such to comply 
 34.1   with this section, shall include at least the following elements 
 34.2   in itself or through supporting documents or attachments: 
 34.3      (1) name, street address, and mailing address of the 
 34.4   establishment; 
 34.5      (2) the name and mailing address of the owner or owners of 
 34.6   the establishment and, if the owner or owners is not a natural 
 34.7   person, identification of the type of business entity of the 
 34.8   owner or owners; 
 34.9      (3) the name and mailing address of the managing agent, 
 34.10  through management agreement or lease agreement, of the 
 34.11  establishment, if different from the owner or owners; 
 34.12     (4) the name and address of at least one natural person who 
 34.13  is authorized to accept service on behalf of the owner or owners 
 34.14  and managing agent; 
 34.15     (5) statement describing the registration and licensure 
 34.16  status of the establishment and any provider providing 
 34.17  health-related or supportive services under an arrangement with 
 34.18  the establishment; 
 34.19     (6) term of the contract; 
 34.20     (7) description of the services to be provided to the 
 34.21  resident in the base rate to be paid by resident; 
 34.22     (8) description of any additional services available for an 
 34.23  additional fee from the establishment directly or through 
 34.24  arrangements with the establishment; 
 34.25     (9) fee schedules outlining the cost of any additional 
 34.26  services; 
 34.27     (10) description of the process through which the contract 
 34.28  may be modified, amended, or terminated; 
 34.29     (11) description of the establishment's complaint 
 34.30  resolution process available to residents including the 
 34.31  toll-free complaint line for the office of ombudsman for older 
 34.32  Minnesotans; 
 34.33     (12) the resident's designated representative, if any; 
 34.34     (13) the establishment's referral procedures if the 
 34.35  contract is terminated; 
 34.36     (14) criteria used by the establishment to determine who 
 35.1   may continue to reside in the elderly housing with services 
 35.2   establishment; 
 35.3      (15) billing and payment procedures and requirements; 
 35.4      (16) statement regarding the ability of residents to 
 35.5   receive services from service providers with whom the 
 35.6   establishment does not have an arrangement; and 
 35.7      (17) statement regarding the availability of public funds 
 35.8   for payment for residence or services in the establishment. 
 35.9      Sec. 37.  Minnesota Statutes 2000, section 144D.04, 
 35.10  subdivision 3, is amended to read: 
 35.11     Subd. 3.  [CONTRACTS IN PERMANENT FILES.] Elderly housing 
 35.12  with services contracts and related documents executed by each 
 35.13  resident or resident's representative shall be maintained by the 
 35.14  establishment in files from the date of execution until three 
 35.15  years after the contract is terminated.  The contracts and the 
 35.16  written disclosures required under section 325F.691, if 
 35.17  applicable, shall be made available for on-site inspection by 
 35.18  the commissioner upon request at any time. 
 35.19     Sec. 38.  Minnesota Statutes 2000, section 144D.06, is 
 35.20  amended to read: 
 35.21     144D.06 [OTHER LAWS.] 
 35.22     A housing with services establishment shall obtain and 
 35.23  maintain all other licenses, permits, registrations, or other 
 35.24  governmental approvals required of it in addition to 
 35.25  registration under this chapter.  A housing with services 
 35.26  establishment is subject to the provisions of section 325F.691 
 35.27  and chapter 504B. 
 35.28     Sec. 39.  [145.4241] [DEFINITIONS.] 
 35.29     Subdivision 1.  [APPLICABILITY.] As used in sections 
 35.30  145.4241 to 145.4246, the following terms have the meaning given 
 35.31  them. 
 35.32     Subd. 2.  [ABORTION.] "Abortion" includes an act, 
 35.33  procedure, or use of any instrument, medicine, or drug which is 
 35.34  supplied or prescribed for or administered to a woman known to 
 35.35  be pregnant with the intention to terminate the pregnancy with 
 35.36  an intention other than to increase the probability of live 
 36.1   birth, to preserve the life or health of the child after live 
 36.2   birth, or to remove a dead fetus. 
 36.3      Subd. 3.  [ATTEMPT TO PERFORM AN ABORTION.] "Attempt to 
 36.4   perform an abortion" means an act, or an omission of a 
 36.5   statutorily required act, that, under the circumstances as the 
 36.6   actor believes them to be, constitutes a substantial step in a 
 36.7   course of conduct planned to culminate in the performance of an 
 36.8   abortion in Minnesota in violation of sections 145.4241 to 
 36.9   145.4246. 
 36.10     Subd. 4.  [MEDICAL EMERGENCY.] "Medical emergency" means 
 36.11  any condition that, on the basis of the physician's good faith 
 36.12  clinical judgment, complicates the medical condition of a 
 36.13  pregnant female to the extent that: 
 36.14     (1) an immediate abortion of her pregnancy is necessary to 
 36.15  avert her death; or 
 36.16     (2) a 24-hour delay in performing an abortion creates a 
 36.17  serious risk of substantial injury or impairment of a major 
 36.18  bodily function. 
 36.19     Subd. 5.  [PHYSICIAN.] "Physician" means a person licensed 
 36.20  under chapter 147. 
 36.21     Subd. 6.  [PROBABLE GESTATIONAL AGE OF THE FETUS.] 
 36.22  "Probable gestational age of the fetus" means what will, in the 
 36.23  judgment of the physician, with reasonable probability, be the 
 36.24  gestational age of the fetus at the time the abortion is planned 
 36.25  to be performed. 
 36.26     Sec. 40.  [145.4242] [INFORMED CONSENT.] 
 36.27     (a) No abortion shall be performed in this state except 
 36.28  with the voluntary and informed consent of the female upon whom 
 36.29  the abortion is to be performed.  Except in the case of a 
 36.30  medical emergency, consent to an abortion is voluntary and 
 36.31  informed only if the female is told the following, by telephone 
 36.32  or in person, by the physician who is to perform the abortion, 
 36.33  the referring physician, a registered nurse, or a licensed 
 36.34  practical nurse, at least 24 hours prior to the abortion: 
 36.35     (1) the particular medical risks associated with the 
 36.36  particular abortion procedure to be employed including, when 
 37.1   medically accurate, the risks of infection, hemorrhage, breast 
 37.2   cancer, danger to subsequent pregnancies, and infertility; 
 37.3      (2) the probable gestational age of the fetus at the time 
 37.4   the abortion is to be performed; 
 37.5      (3) the medical risks associated with carrying to term; 
 37.6      (4) that medical assistance benefits may be available for 
 37.7   prenatal care, childbirth, and neonatal care; 
 37.8      (5) that the father is liable to assist in the support of 
 37.9   her child except under certain circumstances, even in instances 
 37.10  when the father has offered to pay for the abortion; 
 37.11     (6) the availability of a toll-free number and Web site 
 37.12  that can provide information on support services during 
 37.13  pregnancy and while the child is dependent and offer 
 37.14  alternatives to abortion; and 
 37.15     (7) that she has the right to review the printed materials 
 37.16  described in section 145.4243, and the printed materials are 
 37.17  available on the state Web site.  
 37.18     (b) The physician or the physician's agent shall orally 
 37.19  inform the female that the materials have been provided by the 
 37.20  state of Minnesota and that they describe the unborn child and 
 37.21  list agencies that offer alternatives to abortion. 
 37.22     (c) The physician or the physician's agent shall orally 
 37.23  inform the female of the Web site address and toll-free number. 
 37.24     (d) If the female chooses to view the materials, they shall 
 37.25  either be given to her at least 24 hours before the abortion or 
 37.26  mailed to her at least 72 hours before the abortion by first 
 37.27  class mail, or at the woman's request, by certified mail, 
 37.28  restricted delivery to addressee, which means the postal 
 37.29  employee may only deliver the mail to the addressee.  The 
 37.30  envelope used by the physician shall not identify the name of 
 37.31  the physician or the physician's clinic or business. 
 37.32     (e) If a physical examination, tests, or the availability 
 37.33  of other information to the physician subsequently indicates, in 
 37.34  the medical judgment of the physician, a revision of the 
 37.35  information previously supplied to the patient, that revised 
 37.36  information may be communicated to the patient at any time prior 
 38.1   to the performance of the abortion. 
 38.2      Sec. 41.  [145.4243] [PRINTED INFORMATION.] 
 38.3      Subdivision 1.  [MATERIALS.] (a) Within 90 days after the 
 38.4   effective date of sections 145.4241 to 145.4246, the department 
 38.5   of health shall cause to be published, in English and in each 
 38.6   language that is the primary language of two percent or more of 
 38.7   the state's population, the printed materials described in 
 38.8   paragraphs (b) and (c) in such a way as to ensure that the 
 38.9   information is easily comprehensible. 
 38.10     (b) The materials must be designed to inform the female of 
 38.11  the probable anatomical and physiological characteristics of the 
 38.12  fetus at two-week gestational increments from the time when a 
 38.13  female can be known to be pregnant to full term, including any 
 38.14  relevant information on the possibility of the fetus' survival 
 38.15  and pictures or drawings representing the development of the 
 38.16  fetus at two-week gestational increments, provided that any such 
 38.17  pictures or drawings must contain the dimensions of the fetus 
 38.18  and must be realistic and appropriate for the stage of pregnancy 
 38.19  depicted.  The materials must be objective, nonjudgmental, and 
 38.20  designed to convey only accurate scientific information about 
 38.21  the fetus at the various gestational ages. 
 38.22     (c) The materials must contain objective information 
 38.23  describing the methods of abortion procedures commonly employed, 
 38.24  the medical risks commonly associated with each procedure, the 
 38.25  possible detrimental psychological effects of abortion, and the 
 38.26  medical risks commonly associated with carrying a child to term. 
 38.27     Subd. 2.  [TYPEFACE; AVAILABILITY.] The materials referred 
 38.28  to in this section must be printed in a typeface large enough to 
 38.29  be clearly legible.  The materials required under this section 
 38.30  must be available from the department of health upon request and 
 38.31  in appropriate number to any person, facility, or hospital at no 
 38.32  cost. 
 38.33     Sec. 42.  [145.4244] [PROCEDURE IN CASE OF MEDICAL 
 38.34  EMERGENCY.] 
 38.35     When a medical emergency compels the performance of an 
 38.36  abortion, the physician shall inform the female, prior to the 
 39.1   abortion if possible, of the medical indications supporting the 
 39.2   physician's judgment that an abortion is necessary to avert her 
 39.3   death or that a 24-hour delay in conformance with section 
 39.4   145.4242 creates a serious risk of substantial injury or 
 39.5   impairment of a major bodily function. 
 39.6      Sec. 43.  [145.4245] [TOLL-FREE TELEPHONE NUMBER AND WEB 
 39.7   SITE.] 
 39.8      Subdivision 1.  [RIGHT TO KNOW.] All pregnant women have 
 39.9   the right to know information about resources available to 
 39.10  assist them and their families.  The commissioner of health 
 39.11  shall establish and maintain a statewide toll-free telephone 
 39.12  number available seven days a week to provide information and 
 39.13  referrals to local community resources to assist women and 
 39.14  families through pregnancy and childbirth and while the child is 
 39.15  dependent. 
 39.16     Subd. 2.  [INFORMATION.] The toll-free telephone number 
 39.17  must provide information regarding community resources on the 
 39.18  following topics: 
 39.19     (1) information regarding avoiding unplanned pregnancies; 
 39.20     (2) prenatal care, including the need for an initial risk 
 39.21  screening and assessment; 
 39.22     (3) adoption; 
 39.23     (4) health education, including the importance of good 
 39.24  nutrition during pregnancy and the risks associated with alcohol 
 39.25  and tobacco use during pregnancy; 
 39.26     (5) available social services, including medical assistance 
 39.27  benefits for prenatal care, childbirth, and neonatal care; 
 39.28     (6) legal assistance in obtaining child support; and 
 39.29     (7) community support services and other resources to 
 39.30  enhance family strengths and reduce the possibility of family 
 39.31  violence. 
 39.32     Subd. 3.  [WEB SITE.] The commissioner shall design and 
 39.33  maintain a secure Web site to provide the information described 
 39.34  under subdivision 2 and section 145.4243 with a minimum 
 39.35  resolution of 72 PPI.  The Web site shall provide the toll-free 
 39.36  information and referral telephone number described under 
 40.1   subdivision 2. 
 40.2      Sec. 44.  [145.4246] [ENFORCEMENT PENALTIES.] 
 40.3      Subdivision 1.  [STANDING.] A person with standing may 
 40.4   maintain an action against the performance or attempted 
 40.5   performance of abortions in violation of section 145.4242.  
 40.6   Those with standing are: 
 40.7      (1) a woman upon whom an abortion in violation of section 
 40.8   145.4242 has been performed or attempted to be performed; and 
 40.9      (2) the parent of an unemancipated minor upon whom an 
 40.10  abortion in violation of section 145.4242 has been, is about to 
 40.11  be, or was attempted to be performed; and 
 40.12     (3) attorney general of the state of Minnesota. 
 40.13     Subd. 2.  [INJUNCTIONS.] Parties bringing actions against 
 40.14  the performance or attempted performance of abortions in 
 40.15  violation of section 145.4242 may seek temporary restraining 
 40.16  orders, preliminary injunctions, and injunctions related only to 
 40.17  the physician or facility where the violation occurred in 
 40.18  accordance with the Rules of Civil Procedure.  Persons with 
 40.19  standing must bring any actions within six months of the date of 
 40.20  the performed or attempted performance of abortions in violation 
 40.21  of section 145.4242.  
 40.22     Subd. 3.  [CONTEMPT.] Any person knowingly violating the 
 40.23  terms of an injunction against the performance or attempted 
 40.24  performance of abortions in violation of section 145.4242 is 
 40.25  subject to civil contempt, and shall be fined no more than 
 40.26  $1,000 for the first violation, no more than $5,000 for the 
 40.27  second violation, no more than $10,000 for the third violation, 
 40.28  and for each successive violation an amount sufficient to deter 
 40.29  future violations.  The fine shall be the exclusive penalty for 
 40.30  a violation.  Each performance or attempted performance of 
 40.31  abortion in violation of section 145.4242 is a separate 
 40.32  violation.  No fine shall be assessed against the woman on whom 
 40.33  an abortion is performed or attempted. 
 40.34     Subd. 4.  [REALLOCATION OF THE FINE.] Any fines collected 
 40.35  under this section must be sent to a special account at the 
 40.36  Minnesota department of health to be used for materials cited in 
 41.1   section 145.4243. 
 41.2      Sec. 45.  [145.4247] [CUMULATIVE RIGHTS.] 
 41.3      The provisions of sections 145.4241 to 145.4246 are 
 41.4   cumulative with existing law regarding an individual's right to 
 41.5   consent to medical treatment and shall not impair any existing 
 41.6   right any patient may have under the common law or statutes of 
 41.7   this state. 
 41.8      Sec. 46.  Minnesota Statutes 2000, section 145.881, 
 41.9   subdivision 2, is amended to read: 
 41.10     Subd. 2.  [DUTIES.] The advisory task force shall meet on a 
 41.11  regular basis to perform the following duties:  
 41.12     (a) review and report on the health care needs of mothers 
 41.13  and children throughout the state of Minnesota; 
 41.14     (b) review and report on the type, frequency and impact of 
 41.15  maternal and child health care services provided to mothers and 
 41.16  children under existing maternal and child health care programs, 
 41.17  including programs administered by the commissioner of health; 
 41.18     (c) establish, review, and report to the commissioner a 
 41.19  list of program guidelines and criteria which the advisory task 
 41.20  force considers essential to providing an effective maternal and 
 41.21  child health care program to low income populations and high 
 41.22  risk persons and fulfilling the purposes defined in section 
 41.23  145.88; 
 41.24     (d) review staff recommendations of the department of 
 41.25  health regarding maternal and child health grant awards before 
 41.26  the awards are made; 
 41.27     (e) make recommendations to the commissioner for the use of 
 41.28  other federal and state funds available to meet maternal and 
 41.29  child health needs; 
 41.30     (f) make recommendations to the commissioner of health on 
 41.31  priorities for funding the following maternal and child health 
 41.32  services:  (1) prenatal, delivery and postpartum care, (2) 
 41.33  comprehensive health care for children, especially from birth 
 41.34  through five years of age, (3) adolescent health services, (4) 
 41.35  family planning services, (5) preventive dental care, (6) 
 41.36  special services for chronically ill and handicapped children 
 42.1   and (7) any other services which promote the health of mothers 
 42.2   and children; and 
 42.3      (g) make recommendations to the commissioner of health on 
 42.4   the process to distribute, award and administer the maternal and 
 42.5   child health block grant funds; and 
 42.6      (h) review the measures that are used to define the 
 42.7   variables of the funding distribution formula in section 
 42.8   145.882, subdivision 4a, every two years and make 
 42.9   recommendations to the commissioner of health for changes based 
 42.10  upon principles established by the advisory task force for this 
 42.11  purpose.  
 42.12     Sec. 47.  Minnesota Statutes 2000, section 145.882, is 
 42.13  amended by adding a subdivision to read: 
 42.14     Subd. 4a.  [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) 
 42.15  Federal maternal and child health block grant money remaining 
 42.16  after distributions made under subdivision 2 and money 
 42.17  appropriated for allocation to community health boards must be 
 42.18  allocated according to paragraphs (b) to (d) to community health 
 42.19  boards as defined in section 145A.02, subdivision 5.  
 42.20     (b) All community health boards must receive 95 percent of 
 42.21  the funding awarded to them for the 1998-1999 funding cycle.  If 
 42.22  the amount of state and federal funding available is less than 
 42.23  95 percent of the amount awarded to community health boards for 
 42.24  the 1998-1999 funding cycle, the available funding must be 
 42.25  apportioned to reflect a proportional decrease for each 
 42.26  recipient. 
 42.27     (c) The federal and state funding remaining after 
 42.28  distributions made under paragraph (b) must be allocated to each 
 42.29  community health board based on the following three variables: 
 42.30     (1) 25 percent based on the maternal and child population 
 42.31  in the area served by the community health board; 
 42.32     (2) 50 percent based on the following factors, as 
 42.33  determined by averaging the data available for the three most 
 42.34  recent years: 
 42.35     (i) the proportion of infants in the area served by the 
 42.36  community health board whose weight at birth was less than 2,500 
 43.1   grams; 
 43.2      (ii) the proportion of mothers in the area served by the 
 43.3   community health board who received inadequate or no prenatal 
 43.4   care; 
 43.5      (iii) the proportion of births in the area served by the 
 43.6   community health board to women under age 19; and 
 43.7      (iv) the proportion of births in the area served by the 
 43.8   community health board to American Indian women and women of 
 43.9   color; and 
 43.10     (3) 25 percent based on the income of the maternal and 
 43.11  child population in the area served by the community health 
 43.12  board. 
 43.13     (d) Each variable must be expressed as a city or county 
 43.14  score consisting of the city or county frequency of each 
 43.15  variable in relation to the statewide frequency of the 
 43.16  variable.  A total score for each city or county jurisdiction 
 43.17  must be computed by totaling the scores of the three variables.  
 43.18  Each community health board must be allocated an amount equal to 
 43.19  the total score obtained for the city, county, or counties in 
 43.20  its area multiplied by the amount of money available. 
 43.21     Sec. 48.  Minnesota Statutes 2000, section 145.882, 
 43.22  subdivision 7, is amended to read: 
 43.23     Subd. 7.  [USE OF BLOCK GRANT MONEY.] (a) Maternal and 
 43.24  child health block grant money allocated to a community health 
 43.25  board or community health services area under this section must 
 43.26  be used for qualified programs for high risk and low-income 
 43.27  individuals.  Block grant money must be used for programs that: 
 43.28     (1) specifically address the highest risk populations, 
 43.29  particularly low-income and minority groups with a high rate of 
 43.30  infant mortality and children with low birth weight, by 
 43.31  providing services, including excluding prepregnancy family 
 43.32  planning services, calculated to produce measurable decreases in 
 43.33  infant mortality rates, instances of children with low birth 
 43.34  weight, and medical complications associated with pregnancy and 
 43.35  childbirth, including infant mortality, low birth rates, and 
 43.36  medical complications arising from chemical abuse by a mother 
 44.1   during pregnancy; 
 44.2      (2) specifically target pregnant women whose age, medical 
 44.3   condition, maternal history, or chemical abuse substantially 
 44.4   increases the likelihood of complications associated with 
 44.5   pregnancy and childbirth or the birth of a child with an 
 44.6   illness, disability, or special medical needs; 
 44.7      (3) specifically address the health needs of young children 
 44.8   who have or are likely to have a chronic disease or disability 
 44.9   or special medical needs, including physical, neurological, 
 44.10  emotional, and developmental problems that arise from chemical 
 44.11  abuse by a mother during pregnancy; 
 44.12     (4) provide family planning and preventive medical care, 
 44.13  excluding prepregnancy family planning services, for 
 44.14  specifically identified target populations, such as minority and 
 44.15  low-income teenagers, in a manner calculated to decrease the 
 44.16  occurrence of inappropriate pregnancy and minimize the risk of 
 44.17  complications associated with pregnancy and childbirth; or 
 44.18     (5) specifically address the frequency and severity of 
 44.19  childhood injuries and other child and adolescent health 
 44.20  problems in high-risk target populations by providing services, 
 44.21  excluding prepregnancy family planning services, calculated to 
 44.22  produce measurable decreases in mortality and 
 44.23  morbidity.  However, money may be used for this purpose only if 
 44.24  the community health board's application includes program 
 44.25  components for the purposes in clauses (1) to (4) in the 
 44.26  proposed geographic service area and the total expenditure for 
 44.27  injury-related programs under this clause does not exceed ten 
 44.28  percent of the total allocation under subdivision 3. 
 44.29     (b) Maternal and child health block grant money may be used 
 44.30  for purposes other than the purposes listed in this subdivision 
 44.31  only under the following conditions:  
 44.32     (1) the community health board or community health services 
 44.33  area can demonstrate that existing programs fully address the 
 44.34  needs of the highest risk target populations described in this 
 44.35  subdivision; or 
 44.36     (2) the money is used to continue projects that received 
 45.1   funding before creation of the maternal and child health block 
 45.2   grant in 1981. 
 45.3      (c) Projects that received funding before creation of the 
 45.4   maternal and child health block grant in 1981, must be allocated 
 45.5   at least the amount of maternal and child health special project 
 45.6   grant funds received in 1989, unless (1) the local board of 
 45.7   health provides equivalent alternative funding for the project 
 45.8   from another source; or (2) the local board of health 
 45.9   demonstrates that the need for the specific services provided by 
 45.10  the project has significantly decreased as a result of changes 
 45.11  in the demographic characteristics of the population, or other 
 45.12  factors that have a major impact on the demand for services.  If 
 45.13  the amount of federal funding to the state for the maternal and 
 45.14  child health block grant is decreased, these projects must 
 45.15  receive a proportional decrease as required in subdivision 1.  
 45.16  Increases in allocation amounts to local boards of health under 
 45.17  subdivision 4 may be used to increase funding levels for these 
 45.18  projects. 
 45.19     Sec. 49.  Minnesota Statutes 2000, section 145.885, 
 45.20  subdivision 2, is amended to read: 
 45.21     Subd. 2.  [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF 
 45.22  HEALTH.] Applications by community health boards as defined in 
 45.23  section 145A.02, subdivision 5, under section 145.882, 
 45.24  subdivision 3 4a, must also contain a summary of the process 
 45.25  used to develop the local program, including evidence that the 
 45.26  community health board notified local public and private 
 45.27  providers of the availability of funding through the community 
 45.28  health board for maternal and child health services; a list of 
 45.29  all public and private agency requests for grants submitted to 
 45.30  the community health board indicating which requests were 
 45.31  included in the grant application; and an explanation of how 
 45.32  priorities were established for selecting the requests to be 
 45.33  included in the grant application.  The community health board 
 45.34  shall include, with the grant application, a written statement 
 45.35  of the criteria to be applied to public and private agency 
 45.36  requests for funding. 
 46.1      Sec. 50.  Minnesota Statutes 2000, section 145.924, is 
 46.2   amended to read: 
 46.3      145.924 [AIDS PREVENTION GRANTS.] 
 46.4      Subdivision 1.  [GRANT AWARDS.] (a) The commissioner may 
 46.5   award grants to boards of health as defined in section 145A.02, 
 46.6   subdivision 2, state agencies, state councils, or nonprofit 
 46.7   corporations to provide evaluation and counseling services to 
 46.8   populations at risk for acquiring human immunodeficiency virus 
 46.9   infection, including, but not limited to, minorities, 
 46.10  adolescents, intravenous drug users, and homosexual men.  
 46.11     (b) The commissioner may award grants to agencies 
 46.12  experienced in providing services to communities of color, for 
 46.13  the design of innovative outreach and education programs for 
 46.14  targeted groups within the community who may be at risk of 
 46.15  acquiring the human immunodeficiency virus infection, including 
 46.16  intravenous drug users and their partners, adolescents, gay and 
 46.17  bisexual individuals and women.  Grants shall be awarded on a 
 46.18  request for proposal basis and shall include funds for 
 46.19  administrative costs.  Priority for grants shall be given to 
 46.20  agencies or organizations that have experience in providing 
 46.21  service to the particular community which the grantee proposes 
 46.22  to serve; that have policymakers representative of the targeted 
 46.23  population; that have experience in dealing with issues relating 
 46.24  to HIV/AIDS; and that have the capacity to deal effectively with 
 46.25  persons of differing sexual orientations.  For purposes of this 
 46.26  paragraph, the "communities of color" are:  the American-Indian 
 46.27  community; the Hispanic community; the African-American 
 46.28  community; and the Asian-Pacific community. 
 46.29     (c) All state grants awarded under this section subdivision 
 46.30  for programs targeted to adolescents shall include the promotion 
 46.31  of abstinence from sexual activity and drug use. 
 46.32     Subd. 2.  [OUTCOMES.] The commissioner, in consultation 
 46.33  with boards of health, agencies, councils, and nonprofit 
 46.34  organizations involved in human immunodeficiency virus infection 
 46.35  prevention efforts shall establish measurable outcomes to 
 46.36  determine the effectiveness of the grants provided under this 
 47.1   section in reducing the number of people who acquire human 
 47.2   immunodeficiency virus, the rates of infection, and average 
 47.3   numbers of sexual partners for populations served by grants 
 47.4   funded under this section. 
 47.5      Subd. 3.  [EVALUATION.] (a) Using the outcomes established 
 47.6   according to subdivision 2, the commissioner shall conduct a 
 47.7   biennial evaluation of activities funded under this section.  
 47.8   The evaluation must include: 
 47.9      (1) the effect of these activities on the number of people 
 47.10  who acquire human immunodeficiency virus and the rates of 
 47.11  infection; 
 47.12     (2) the effect of these activities on average numbers of 
 47.13  sexual partners for populations served by grants funded under 
 47.14  this section; and 
 47.15     (3) a longitudinal tracking of outcomes for targeted 
 47.16  populations who are served under subdivision 1, paragraphs (a) 
 47.17  and (b). 
 47.18     (b) Grant recipients shall cooperate with the commissioner 
 47.19  in the evaluation and shall provide the commissioner with the 
 47.20  information needed to conduct the evaluation.  Beginning January 
 47.21  15, 2003, the results of each evaluation must be submitted to 
 47.22  the chairs of the policy and finance committees in the house and 
 47.23  senate with jurisdiction over health and human services. 
 47.24     Sec. 51.  Minnesota Statutes 2000, section 145.925, 
 47.25  subdivision 1, is amended to read: 
 47.26     Subdivision 1.  [ELIGIBLE ORGANIZATIONS; PURPOSE.] The 
 47.27  commissioner of health may make special grants to cities, 
 47.28  counties, tribal governments, or groups of cities or, counties, 
 47.29  or nonprofit corporations or tribal governments to provide 
 47.30  prepregnancy family planning services. targeted to low-income 
 47.31  and minority populations.  A city, county, tribal government, or 
 47.32  group of cities, counties, or tribal governments that receives a 
 47.33  grant is responsible for ensuring that the grant funds are used 
 47.34  for services targeted to low-income and minority populations, 
 47.35  and must establish a goal for reducing specific pregnancy rates 
 47.36  in the service area.  In determining populations to serve and 
 48.1   services to provide, a city, county, tribal government, or group 
 48.2   of cities, counties, or tribal governments must consider the 
 48.3   spacing of pregnancies in low-income and minority populations in 
 48.4   the service area, teen birth rates in the service area, and the 
 48.5   needs of populations of color in the service area.  A city, 
 48.6   county, tribal government, or group of cities, counties, or 
 48.7   tribal governments may contract for the provision of 
 48.8   prepregnancy family planning services using grant funds provided 
 48.9   under this section only if the contract is specifically 
 48.10  authorized by the governing body of the city, county, or tribal 
 48.11  government that is contracting for the services. 
 48.12     Any organization or an affiliate of an organization which 
 48.13  provides abortions, promotes abortions, or directly refers for 
 48.14  abortions, shall be ineligible to receive funds under this 
 48.15  subdivision. 
 48.16     Sec. 52.  Minnesota Statutes 2000, section 145.925, 
 48.17  subdivision 1a, is amended to read: 
 48.18     Subd. 1a.  [FAMILY PLANNING SERVICES; DEFINED.] "Family 
 48.19  planning services" means counseling by trained personnel 
 48.20  regarding family planning; distribution of information relating 
 48.21  to family planning, referral to licensed physicians or local 
 48.22  health agencies for consultation, examination, medical 
 48.23  treatment, genetic counseling, and prescriptions for the purpose 
 48.24  of family planning; and the distribution of family planning 
 48.25  products, such as charts, thermometers, drugs, medical 
 48.26  preparations, and contraceptive devices.  Family planning 
 48.27  services do not include services that, directly or indirectly, 
 48.28  encourage, counsel, refer, or provide abortions or abortion 
 48.29  referrals.  For purposes of sections 145A.01 to 145A.14, family 
 48.30  planning shall mean voluntary action by individuals to prevent 
 48.31  or aid conception but does not include the performance, or make 
 48.32  referrals for encouragement of voluntary termination of 
 48.33  pregnancy services that, directly or indirectly, encourage, 
 48.34  counsel, refer, or provide abortions or abortion referrals.  
 48.35     Sec. 53.  [145.9257] [TEEN PREGNANCY PREVENTION.] 
 48.36     Subdivision 1.  [GOAL.] It is the goal of the state to 
 49.1   reduce teen pregnancy rates by 24 percent by 2006.  To do so, 
 49.2   the commissioner of health shall establish a grant program to 
 49.3   reduce the rates of unintended teen pregnancies in the state.  
 49.4   If this goal of reducing teen pregnancy rates by 24 percent is 
 49.5   not met by December 31, 2006, this section expires June 30, 
 49.6   2007.  No funds awarded under this section may be used for 
 49.7   medical services or family planning services or for services 
 49.8   that, directly or indirectly, encourage, counsel, refer, or 
 49.9   provide abortions or abortion referrals. 
 49.10     Any organization or an affiliate of an organization which 
 49.11  provides abortions, promotes abortions, or directly refers for 
 49.12  abortions, shall be ineligible to receive funds under this 
 49.13  section. 
 49.14     Subd. 2.  [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 
 49.15  commissioner, in consultation with the commissioner of children, 
 49.16  families, and learning; the commissioner of human services; the 
 49.17  maternal and child health advisory task force under section 
 49.18  145.881; the Indian affairs council under section 3.922; the 
 49.19  council on affairs of Chicano/Latino people under section 
 49.20  3.9223; the council on Black Minnesotans under section 3.9225; 
 49.21  the council on Asian-Pacific Minnesotans under section 3.9226; 
 49.22  community health boards as defined in section 145A.02; tribal 
 49.23  governments; nonprofit community organizations; and others 
 49.24  interested in teen pregnancy prevention, shall develop and 
 49.25  implement a comprehensive, coordinated plan to reduce the number 
 49.26  of teen pregnancies. 
 49.27     Subd. 3.  [MEASURABLE OUTCOMES.] The commissioner, in 
 49.28  consultation with the commissioners and community partners 
 49.29  listed in subdivision 2, shall establish measurable outcomes to 
 49.30  achieve the goal specified in subdivision 1 and to determine the 
 49.31  effectiveness of the grants provided under this section in 
 49.32  reducing teen pregnancies.  The development of measurable 
 49.33  outcomes must be completed before any funds are distributed 
 49.34  under this section. 
 49.35     Subd. 4.  [STATEWIDE ASSESSMENT.] The commissioner shall 
 49.36  use and enhance current statewide assessments of teen pregnancy 
 50.1   risk behaviors and attitudes among youth to establish a baseline 
 50.2   to measure the statewide effect of teen pregnancy prevention 
 50.3   activities.  To the extent feasible, the commissioner shall 
 50.4   conduct the assessment so that the results may be compared to 
 50.5   national data. 
 50.6      Subd. 5.  [PROCESS.] The commissioner, in consultation with 
 50.7   the commissioners and community partners listed in subdivision 
 50.8   2, shall develop the criteria and procedures used to allocate 
 50.9   grants under this section.  In developing the criteria, the 
 50.10  commissioner shall establish an administrative cost limit for 
 50.11  grant recipients.  At the time a grant is awarded, the 
 50.12  commissioner shall provide a grant recipient with information on 
 50.13  the outcomes established according to subdivision 3. 
 50.14     Subd. 6.  [TEEN PREGNANCY PREVENTION DISPARITY GRANTS.] (a) 
 50.15  The commissioner shall award competitive grants to eligible 
 50.16  applicants for projects to reduce disparities in unintended teen 
 50.17  pregnancy rates for American Indians and populations of color, 
 50.18  as compared with unintended teen pregnancy rates for whites. 
 50.19     (b) No funds awarded under this subdivision may be used for 
 50.20  medical services or family planning services or for services 
 50.21  that, directly or indirectly, encourage, counsel, refer, or 
 50.22  provide abortions or abortion referrals. 
 50.23     Any organization or an affiliate of an organization which 
 50.24  provides abortions, promotes abortions, or directly refers for 
 50.25  abortions, shall be ineligible to receive funds under this 
 50.26  subdivision. 
 50.27     (c) Eligible applicants may include, but are not limited 
 50.28  to, nonprofit organizations, school districts, faith-based 
 50.29  organizations, community health boards, and tribal governments.  
 50.30  Applicants must submit proposals to the commissioner.  A 
 50.31  proposal must specify the strategies to be implemented and must 
 50.32  take into account the need for a coordinated, statewide teen 
 50.33  pregnancy prevention effort.  Strategies may include youth 
 50.34  development programs, after-school enrichment programs, youth 
 50.35  mentoring programs, academic support programs, and abstinence 
 50.36  until marriage education programs. 
 51.1      (d) The commissioner shall give priority to applicants who 
 51.2   demonstrate that their proposed project:  
 51.3      (1) emphasizes abstinence until marriage; 
 51.4      (2) is research-based or based on proven, effective 
 51.5   strategies; 
 51.6      (3) is designed to coordinate with related youth risk 
 51.7   behavior reduction activities; 
 51.8      (4) involves youth and parents in the project's development 
 51.9   and implementation; 
 51.10     (5) reflects racially and ethnically appropriate 
 51.11  approaches; and 
 51.12     (6) will be implemented through or with persons or 
 51.13  community-based organizations that reflect the race or ethnicity 
 51.14  of the population to be reached. 
 51.15     Subd. 7.  [HIGH-RISK COMMUNITY TEEN PREGNANCY PREVENTION 
 51.16  GRANTS.] (a) The commissioner shall award grants to communities 
 51.17  that have significant risk factors for teen pregnancies, that 
 51.18  currently have in place youth development programs, and that are 
 51.19  interested in expanding existing efforts to prevent teen 
 51.20  pregnancies. 
 51.21     (b) No funds awarded under this subdivision may be used for 
 51.22  medical services or family planning services or for services 
 51.23  that, directly or indirectly, encourage, counsel, refer, or 
 51.24  provide abortions or abortion referrals. 
 51.25     Any organization or an affiliate of an organization which 
 51.26  provides abortions, promotes abortions, or directly refers for 
 51.27  abortions, shall be ineligible to receive funds under this 
 51.28  subdivision. 
 51.29     (c) To be eligible for a grant under this subdivision, an 
 51.30  applicant must be a tribal government or a community health 
 51.31  board as defined in section 145A.02.  Applicants must submit 
 51.32  proposals to the commissioner.  A proposal must specify the 
 51.33  strategies to be implemented.  Strategies may include, but are 
 51.34  not limited to, youth development programs, youth mentoring 
 51.35  programs, academic support programs, and abstinence until 
 51.36  marriage education programs.  Applicants must demonstrate that a 
 52.1   proposed project: 
 52.2      (1) emphasizes abstinence until marriage; 
 52.3      (2) is research-based or based on proven, effective 
 52.4   strategies; 
 52.5      (3) is designed to coordinate with related youth risk 
 52.6   behavior reduction activities; 
 52.7      (4) involves youth and parents in the project's development 
 52.8   and implementation; 
 52.9      (5) reflects racially and ethnically appropriate 
 52.10  approaches; and 
 52.11     (6) will be implemented through or with persons or 
 52.12  community-based organizations that reflect the race or ethnicity 
 52.13  of the population to be reached. 
 52.14     (d) Grants may be awarded to up to 15 community health 
 52.15  boards and three tribal governments based on areas having the 
 52.16  highest risk factors for teen pregnancies.  The commissioner 
 52.17  shall award grants based on the following risk factors: 
 52.18     (1) the proportion of teens in the applicant's service area 
 52.19  who are sexually active; 
 52.20     (2) the proportion of births to teens in the applicant's 
 52.21  service area; and 
 52.22     (3) the proportion of births to teens who are American 
 52.23  Indian or of a population of color in the applicant's service 
 52.24  area. 
 52.25     Subd. 8.  [ADOLESCENT PARENT GRANTS.] The commissioner 
 52.26  shall transfer funds to the commissioner of children, families, 
 52.27  and learning to increase the number of adolescent parent grants 
 52.28  currently provided by the commissioner of children, families, 
 52.29  and learning under section 124D.33. 
 52.30     Subd. 9.  [COORDINATION.] The commissioner shall coordinate 
 52.31  the projects and initiatives funded under this section with 
 52.32  other efforts at the local, state, and national levels to avoid 
 52.33  duplication and promote complementary efforts. 
 52.34     Subd. 10.  [EVALUATION.] Using the outcomes established 
 52.35  according to subdivision 3, the commissioner shall conduct a 
 52.36  biennial evaluation of the impact of each teen pregnancy 
 53.1   prevention initiative in this section.  Grant recipients and the 
 53.2   commissioner of children, families, and learning shall cooperate 
 53.3   with the commissioner in the evaluation and shall provide the 
 53.4   commissioner with the information needed to conduct the 
 53.5   evaluation. 
 53.6      Subd. 11.  [REPORT.] By January 15, 2002, and January 15 of 
 53.7   each even-numbered year thereafter, the commissioner shall 
 53.8   submit a report to the legislature on the projects funded under 
 53.9   this section and the results of the biennial evaluation. 
 53.10     Sec. 54.  [145.9268] [COMMUNITY CLINIC GRANTS.] 
 53.11     Subdivision 1.  [DEFINITION.] For purposes of this section, 
 53.12  "eligible community clinic" means: 
 53.13     (1) a clinic that provides services under conditions as 
 53.14  defined in Minnesota Rules, part 9505.0255 or 9505.0380, and 
 53.15  utilizes a sliding fee scale to determine eligibility for 
 53.16  charity care; 
 53.17     (2) an Indian tribal government or Indian health service 
 53.18  unit; or 
 53.19     (3) a consortium of clinics comprised of entities under 
 53.20  clause (1) or (2). 
 53.21     Subd. 2.  [GRANTS AUTHORIZED.] The commissioner of health 
 53.22  shall award grants to eligible community clinics to improve the 
 53.23  ongoing viability of Minnesota's clinic-based safety net 
 53.24  providers.  Grants shall be awarded to support the capacity of 
 53.25  eligible community clinics to serve low-income populations, 
 53.26  reduce current or future uncompensated care burdens, or provide 
 53.27  for improved care delivery infrastructure. 
 53.28     Subd. 3.  [ALLOCATION OF GRANTS.] (a) To receive a grant 
 53.29  under this section, an eligible community clinic must submit an 
 53.30  application to the commissioner of health by the deadline 
 53.31  established by the commissioner.  A grant may be awarded upon 
 53.32  the signing of a grant contract. 
 53.33     (b) An application must be on a form and contain 
 53.34  information as specified by the commissioner but at a minimum 
 53.35  must contain: 
 53.36     (1) a description of the project for which grant funds will 
 54.1   be used; 
 54.2      (2) a description of the problem the proposed project will 
 54.3   address; and 
 54.4      (3) a description of achievable objectives, a workplan, and 
 54.5   a timeline for project completion. 
 54.6      (c) The commissioner shall review each application to 
 54.7   determine whether the application is complete and whether the 
 54.8   applicant and the project are eligible for a grant.  In 
 54.9   evaluating applications according to paragraph (e), the 
 54.10  commissioner shall establish criteria including, but not limited 
 54.11  to:  the priority level of the project; the applicant's 
 54.12  thoroughness and clarity in describing the problem; a 
 54.13  description of the applicant's proposed project; the manner in 
 54.14  which the applicant will demonstrate the effectiveness of the 
 54.15  project; and evidence of efficiencies and effectiveness gained 
 54.16  through collaborative efforts.  The commissioner may also take 
 54.17  into account other relevant factors, including, but not limited 
 54.18  to, the percentage for which uninsured patients represent the 
 54.19  applicant's patient base.  During application review, the 
 54.20  commissioner may request additional information about a proposed 
 54.21  project, including information on project cost.  Failure to 
 54.22  provide the information requested disqualifies an applicant. 
 54.23     (d) A grant awarded to an eligible community clinic may not 
 54.24  exceed $300,000 per eligible community clinic.  For an applicant 
 54.25  applying as a consortium of clinics, a grant may not exceed 
 54.26  $300,000 per clinic included in the consortium.  The 
 54.27  commissioner has discretion over the number of grants awarded. 
 54.28     (e) In determining which eligible community clinics will 
 54.29  receive grants under this section, the commissioner shall give 
 54.30  preference to those grant applications that show evidence of 
 54.31  collaboration with other eligible community clinics, hospitals, 
 54.32  health care providers, or community organizations.  In addition, 
 54.33  the commissioner shall give priority, in declining order, to 
 54.34  grant applications for projects that: 
 54.35     (1) establish, update, or improve information, data 
 54.36  collection, or billing systems; 
 55.1      (2) procure, modernize, remodel, or replace equipment used 
 55.2   an the delivery of direct patient care at a clinic; 
 55.3      (3) provide improvements for care delivery, such as 
 55.4   increased translation and interpretation services; 
 55.5      (4) provide a direct offset to expenses incurred for 
 55.6   charity care services; or 
 55.7      (5) other projects determined by the commissioner to 
 55.8   improve the ability of applicants to provide care to the 
 55.9   vulnerable populations they serve. 
 55.10     Subd. 4.  [EVALUATION.] The commissioner of health shall 
 55.11  evaluate the overall effectiveness of the grant program.  The 
 55.12  commissioner shall collect progress reports to evaluate the 
 55.13  grant program from the eligible community clinics receiving 
 55.14  grants. 
 55.15     Sec. 55.  [145.928] [ELIMINATING HEALTH DISPARITIES.] 
 55.16     Subdivision 1.  [GOAL; ESTABLISHMENT.] It is the goal of 
 55.17  the state, by 2010, to decrease by 50 percent the disparities in 
 55.18  infant mortality rates and adult and child immunization rates 
 55.19  for American Indians and populations of color, as compared with 
 55.20  rates for whites.  To do so and to achieve other measurable 
 55.21  outcomes, the commissioner of health shall establish a program 
 55.22  to close the gap in the health status of American Indians and 
 55.23  populations of color as compared with whites in the following 
 55.24  priority areas:  infant mortality, breast and cervical cancer 
 55.25  screening, HIV/AIDS and sexually transmitted infections, adult 
 55.26  and child immunizations, cardiovascular disease, diabetes, and 
 55.27  accidental injuries and violence.  If this goal of reducing 
 55.28  disparities in infant mortality rates and adult and child 
 55.29  immunization rates is not met by December 31, 2010, this section 
 55.30  expires June 30, 2011. 
 55.31     Subd. 2.  [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 
 55.32  commissioner, in partnership with culturally-based community 
 55.33  organizations; the Indian affairs council under section 3.922; 
 55.34  the council on affairs of Chicano/Latino people under section 
 55.35  3.9223; the council on Black Minnesotans under section 3.9225; 
 55.36  the council on Asian-Pacific Minnesotans under section 3.9226; 
 56.1   community health boards as defined in section 145A.02; and 
 56.2   tribal governments, shall develop and implement a comprehensive, 
 56.3   coordinated plan to reduce health disparities in the health 
 56.4   disparity priority areas identified in subdivision 1. 
 56.5      Subd. 3.  [MEASURABLE OUTCOMES.] The commissioner, in 
 56.6   consultation with the community partners listed in subdivision 
 56.7   2, shall establish measurable outcomes to achieve the goal 
 56.8   specified in subdivision 1 and to determine the effectiveness of 
 56.9   the grants and other activities funded under this section in 
 56.10  reducing health disparities in the priority areas identified in 
 56.11  subdivision 1.  The development of measurable outcomes must be 
 56.12  completed before any funds are distributed under this section. 
 56.13     Subd. 4.  [STATEWIDE ASSESSMENT.] The commissioner shall 
 56.14  enhance current data tools to ensure a statewide assessment of 
 56.15  the risk behaviors associated with the health disparity priority 
 56.16  areas identified in subdivision 1.  The statewide assessment 
 56.17  must be used to establish a baseline to measure the effect of 
 56.18  activities funded under this section.  To the extent feasible, 
 56.19  the commissioner shall conduct the assessment so that the 
 56.20  results may be compared to national data. 
 56.21     Subd. 5.  [TECHNICAL ASSISTANCE.] The commissioner shall 
 56.22  provide the necessary expertise to grant applicants to ensure 
 56.23  that submitted proposals are likely to be successful in reducing 
 56.24  the health disparities identified in subdivision 1.  The 
 56.25  commissioner shall provide grant recipients with guidance and 
 56.26  training on best or most promising strategies to use to reduce 
 56.27  the health disparities identified in subdivision 1.  The 
 56.28  commissioner shall also assist grant recipients in the 
 56.29  development of materials and procedures to evaluate local 
 56.30  community activities. 
 56.31     Subd. 6.  [PROCESS.] (a) The commissioner, in consultation 
 56.32  with the community partners listed in subdivision 2, shall 
 56.33  develop the criteria and procedures used to allocate grants 
 56.34  under this section.  In developing the criteria, the 
 56.35  commissioner shall establish an administrative cost limit for 
 56.36  grant recipients.  At the time a grant is awarded, the 
 57.1   commissioner must provide a grant recipient with information on 
 57.2   the outcomes established according to subdivision 3. 
 57.3      (b) A grant recipient must coordinate its activities to 
 57.4   reduce health disparities with other entities receiving funds 
 57.5   under this section that are in the grant recipient's service 
 57.6   area. 
 57.7      Subd. 7.  [COMMUNITY GRANT PROGRAM; IMMUNIZATION RATES AND 
 57.8   INFANT MORTALITY RATES.] (a) The commissioner shall award grants 
 57.9   to eligible applicants for local or regional projects and 
 57.10  initiatives directed at reducing health disparities in one or 
 57.11  both of the following priority areas: 
 57.12     (1) decreasing racial and ethnic disparities in infant 
 57.13  mortality rates; or 
 57.14     (2) increasing adult and child immunization rates in 
 57.15  nonwhite racial and ethnic populations. 
 57.16     (b) The commissioner may award up to 20 percent of the 
 57.17  funds available as planning grants.  Planning grants must be 
 57.18  used to address such areas as community assessment, coordination 
 57.19  activities, and development of community supported strategies. 
 57.20     (c) Eligible applicants may include, but are not limited 
 57.21  to, faith-based organizations, social service organizations, 
 57.22  community nonprofit organizations, community health boards, 
 57.23  tribal governments, and community clinics.  Applicants must 
 57.24  submit proposals to the commissioner.  A proposal must specify 
 57.25  the strategies to be implemented to address one or both of the 
 57.26  priority areas listed in paragraph (a) and must be targeted to 
 57.27  achieve the outcomes established according to subdivision 3. 
 57.28     (d) The commissioner shall give priority to applicants who 
 57.29  demonstrate that their proposed project or initiative: 
 57.30     (1) is supported by the community the applicant will serve; 
 57.31     (2) is research-based or based on promising strategies; 
 57.32     (3) is designed to complement other related community 
 57.33  activities; 
 57.34     (4) utilizes strategies that positively impact both 
 57.35  priority areas; 
 57.36     (5) reflects racially and ethnically appropriate 
 58.1   approaches; and 
 58.2      (6) will be implemented through or with community-based 
 58.3   organizations that reflect the race or ethnicity of the 
 58.4   population to be reached. 
 58.5      Subd. 8.  [COMMUNITY GRANT PROGRAM; OTHER HEALTH 
 58.6   DISPARITIES.] (a) The commissioner shall award grants to 
 58.7   eligible applicants for local or regional projects and 
 58.8   initiatives directed at reducing health disparities in one or 
 58.9   more of the following priority areas: 
 58.10     (1) decreasing racial and ethnic disparities in morbidity 
 58.11  and mortality rates from breast and cervical cancer; 
 58.12     (2) decreasing racial and ethnic disparities in morbidity 
 58.13  and mortality rates from HIV/AIDS and sexually transmitted 
 58.14  infections; 
 58.15     (3) decreasing racial and ethnic disparities in morbidity 
 58.16  and mortality rates from cardiovascular disease; 
 58.17     (4) decreasing racial and ethnic disparities in morbidity 
 58.18  and mortality rates from diabetes; or 
 58.19     (5) decreasing racial and ethnic disparities in morbidity 
 58.20  and mortality rates from accidental injuries or violence. 
 58.21     (b) The commissioner may award up to 20 percent of the 
 58.22  funds available as planning grants.  Planning grants must be 
 58.23  used to address such areas as community assessment, determining 
 58.24  community priority areas, coordination activities, and 
 58.25  development of community supported strategies. 
 58.26     (c) Eligible applicants may include, but are not limited 
 58.27  to, faith-based organizations, social service organizations, 
 58.28  community nonprofit organizations, community health boards, 
 58.29  tribal governments, and community clinics.  Applicants shall 
 58.30  submit proposals to the commissioner.  A proposal must specify 
 58.31  the strategies to be implemented to address one or more of the 
 58.32  priority areas listed in paragraph (a) and must be targeted to 
 58.33  achieve the outcomes established according to subdivision 3. 
 58.34     (d) The commissioner shall give priority to applicants who 
 58.35  demonstrate that their proposed project or initiative: 
 58.36     (1) is supported by the community the applicant will serve; 
 59.1      (2) is research-based or based on promising strategies; 
 59.2      (3) is designed to complement other related community 
 59.3   activities; 
 59.4      (4) utilizes strategies that positively impact more than 
 59.5   one priority area; 
 59.6      (5) reflects racially and ethnically appropriate 
 59.7   approaches; and 
 59.8      (6) will be implemented through or with community-based 
 59.9   organizations that reflect the race or ethnicity of the 
 59.10  population to be reached. 
 59.11     Subd. 9.  [REFUGEE AND IMMIGRANT HEALTH.] (a) The 
 59.12  commissioner shall distribute funds to community health boards 
 59.13  for health screening and follow-up services for tuberculosis for 
 59.14  refugees.  Funds shall be distributed based on the following 
 59.15  formula: 
 59.16     (1) $1,500 per refugee with pulmonary tuberculosis in the 
 59.17  community health board's service area; 
 59.18     (2) $500 per refugee with extrapulmonary tuberculosis in 
 59.19  the community health board's service area; 
 59.20     (3) $500 per month of directly observed therapy provided by 
 59.21  the community health board for each uninsured refugee with 
 59.22  pulmonary or extrapulmonary tuberculosis; and 
 59.23     (4) $50 per refugee in the community health board's service 
 59.24  area. 
 59.25     (b) Payments must be made at the end of each state fiscal 
 59.26  year.  The amount paid per tuberculosis case, per month of 
 59.27  directly observed therapy, and per refugee must be 
 59.28  proportionately increased or decreased to fit the actual amount 
 59.29  appropriated for that fiscal year. 
 59.30     Subd. 10.  [COORDINATION.] The commissioner shall 
 59.31  coordinate the projects and initiatives funded under this 
 59.32  section with other efforts at the local, state, or national 
 59.33  level to avoid duplication and promote complementary efforts. 
 59.34     Subd. 11.  [EVALUATION.] Using the outcomes established 
 59.35  according to subdivision 3, the commissioner shall conduct a 
 59.36  biennial evaluation of the community grant programs under 
 60.1   subdivisions 7 and 8.  Grant recipients shall cooperate with the 
 60.2   commissioner in the evaluation and shall provide the 
 60.3   commissioner with the information needed to conduct the 
 60.4   evaluation. 
 60.5      Subd. 12.  [REPORT.] By January 15, 2002, and January 15 of 
 60.6   each even-numbered year thereafter, the commissioner shall 
 60.7   submit a report to the legislature on the local community 
 60.8   projects and community health board activities funded under this 
 60.9   section.  The report must include information on grant 
 60.10  recipients, activities conducted using grant funds, and 
 60.11  evaluation data and outcome measures if available. 
 60.12     Sec. 56.  Minnesota Statutes 2000, section 145A.15, 
 60.13  subdivision 1, is amended to read: 
 60.14     Subdivision 1.  [ESTABLISHMENT.] (a) The commissioner of 
 60.15  health shall expand the current grant program to fund additional 
 60.16  projects designed to prevent child abuse and neglect and reduce 
 60.17  juvenile delinquency by promoting positive parenting, resiliency 
 60.18  in children, and a healthy beginning for children by providing 
 60.19  early intervention services for families in need.  Grant dollars 
 60.20  shall be available to train paraprofessionals to provide in-home 
 60.21  intervention services and to allow public health nurses to do 
 60.22  case management of services.  The grant program shall provide 
 60.23  early intervention services for families in need and will 
 60.24  include: 
 60.25     (1) expansion of current public health nurse and family 
 60.26  aide home visiting programs and public health home visiting 
 60.27  projects which prevent child abuse and neglect, prevent juvenile 
 60.28  delinquency, and build resiliency in children; 
 60.29     (2) early intervention to promote a healthy and nurturing 
 60.30  beginning; 
 60.31     (3) distribution of educational and public information 
 60.32  programs and materials in hospital maternity divisions, 
 60.33  well-baby clinics, obstetrical clinics, and community clinics; 
 60.34  and 
 60.35     (4) training of home visitors in skills necessary for 
 60.36  comprehensive home visiting which promotes a healthy and 
 61.1   nurturing beginning for the child. 
 61.2      (b) No new grants shall be awarded under this section after 
 61.3   June 30, 2001.  Grant contracts awarded and in effect under this 
 61.4   section as of July 1, 2001, shall continue until their 
 61.5   expiration date. 
 61.6      Sec. 57.  Minnesota Statutes 2000, section 145A.15, is 
 61.7   amended by adding a subdivision to read: 
 61.8      Subd. 5.  [EXPIRATION.] This section expires June 30, 2003. 
 61.9      Sec. 58.  Minnesota Statutes 2000, section 145A.16, 
 61.10  subdivision 1, is amended to read: 
 61.11     Subdivision 1.  [ESTABLISHMENT.] The commissioner shall 
 61.12  establish a grant program to fund universally offered home 
 61.13  visiting programs designed to serve all live births in 
 61.14  designated geographic areas.  The commissioner shall designate 
 61.15  the geographic area to be served by each program.  At least one 
 61.16  program must provide home visiting services to families within 
 61.17  the seven-county metropolitan area, and at least one program 
 61.18  must provide home visiting services to families outside the 
 61.19  metropolitan area.  The purpose of the program is to strengthen 
 61.20  families and to promote positive parenting and healthy child 
 61.21  development.  No new grants shall be awarded under this section 
 61.22  after June 30, 2001.  Competitive grant contracts awarded and in 
 61.23  effect under this section as of July 1, 2001, shall expire 
 61.24  December 31, 2003. 
 61.25     Sec. 59.  Minnesota Statutes 2000, section 145A.16, is 
 61.26  amended by adding a subdivision to read: 
 61.27     Subd. 10.  [EXPIRATION.] This section expires December 31, 
 61.28  2003. 
 61.29     Sec. 60.  [145A.17] [FAMILY HOME VISITING PROGRAMS.] 
 61.30     Subdivision 1.  [ESTABLISHMENT; GOALS.] The commissioner 
 61.31  shall establish a program to fund family home visiting programs 
 61.32  designed to foster a healthy beginning for children in families 
 61.33  at or below 200 percent of the federal poverty guidelines, 
 61.34  prevent child abuse and neglect, reduce juvenile delinquency, 
 61.35  promote positive parenting and resiliency in children, and 
 61.36  promote family health and economic self-sufficiency.  A program 
 62.1   funded under this section must serve families at or below 200 
 62.2   percent of the federal poverty guidelines, and other families 
 62.3   determined to be at risk for child abuse, neglect, or juvenile 
 62.4   delinquency.  Programs must give priority for services to 
 62.5   families considered to be in need of services, including but not 
 62.6   limited to families with: 
 62.7      (1) adolescent parents; 
 62.8      (2) a history of alcohol or other drug abuse; 
 62.9      (3) a history of child abuse, domestic abuse, or other 
 62.10  types of violence; 
 62.11     (4) a history of domestic abuse, rape, or other forms of 
 62.12  victimization; 
 62.13     (5) reduced cognitive functioning; 
 62.14     (6) a lack of knowledge of child growth and development 
 62.15  stages; 
 62.16     (7) low resiliency to adversities and environmental 
 62.17  stresses; or 
 62.18     (8) insufficient financial resources to meet family needs. 
 62.19     Subd. 2.  [ALLOCATION OF FUNDS.] The commissioner shall 
 62.20  distribute funds available under this section to community 
 62.21  health boards, as defined in section 145A.02, and to tribal 
 62.22  governments.  Funds shall be distributed to community health 
 62.23  boards as follows:  (1) each community health board shall 
 62.24  receive an allocation of $25,000 per year; and (2) remaining 
 62.25  funds available to community health boards shall be distributed 
 62.26  according to the formula in section 256J.625, subdivision 3.  
 62.27  The commissioner, in consultation with tribal governments, shall 
 62.28  establish a formula for distributing funds to tribal governments.
 62.29     Subd. 3.  [REQUIREMENTS FOR PROGRAMS; PROCESS.] (a) Before 
 62.30  a community health board or tribal government may receive an 
 62.31  allocation under subdivision 2, a community health board or 
 62.32  tribal government must submit a proposal to the commissioner 
 62.33  that includes identification, based on a community assessment, 
 62.34  of the populations at or below 200 percent of the federal 
 62.35  poverty guidelines that will be served and the other populations 
 62.36  that will be served.  Each program that receives funds must: 
 63.1      (1) use either a broad community-based or selective 
 63.2   community-based strategy to provide preventive and early 
 63.3   intervention home visiting services; 
 63.4      (2) offer a home visit by a trained home visitor.  If a 
 63.5   home visit is accepted, the first home visit must occur 
 63.6   prenatally or as soon after birth as possible and must include a 
 63.7   public health nursing assessment by a public health nurse; 
 63.8      (3) offer, at a minimum, information on infant care, child 
 63.9   growth and development, positive parenting, preventing diseases, 
 63.10  preventing exposure to environmental hazards, and support 
 63.11  services available in the community; 
 63.12     (4) provide information on and referrals to health care 
 63.13  services, if needed, including information on health care 
 63.14  coverage for which the child or family may be eligible; and 
 63.15  provide information on preventive services, developmental 
 63.16  assessments, and the availability of public assistance programs 
 63.17  as appropriate; 
 63.18     (5) recruit home visitors who will represent, to the extent 
 63.19  possible, the races, cultures, and languages spoken by families 
 63.20  that may be served; 
 63.21     (6) train and supervise home visitors in accordance with 
 63.22  the requirements established under subdivision 4; 
 63.23     (7) maximize resources and minimize duplication by 
 63.24  coordinating activities with local social and human services 
 63.25  organizations, education organizations, and other appropriate 
 63.26  governmental entities and community-based organizations and 
 63.27  agencies; and 
 63.28     (8) utilize appropriate racial and ethnic approaches to 
 63.29  providing home visiting services. 
 63.30     (b) Funds available under this section shall not be used 
 63.31  for medical services.  The commissioner shall establish an 
 63.32  administrative cost limit for recipients of funds.  The outcome 
 63.33  measures established under subdivision 6 must be specified to 
 63.34  recipients of funds at the time the funds are distributed. 
 63.35     (c) Data collected on individuals served by the home 
 63.36  visiting programs must remain confidential and must not be 
 64.1   disclosed by providers of home visiting services without a 
 64.2   specific informed written consent that identifies disclosures to 
 64.3   be made.  Upon request, agencies providing home visiting 
 64.4   services must provide recipients with information on 
 64.5   disclosures, including the names of entities and individuals 
 64.6   receiving the information and the general purpose of the 
 64.7   disclosure.  Prospective and current recipients of home visiting 
 64.8   services must be told and informed in writing that written 
 64.9   consent for disclosure of data is not required for access to 
 64.10  home visiting services. 
 64.11     Subd. 4.  [TRAINING.] The commissioner shall establish 
 64.12  training requirements for home visitors and minimum requirements 
 64.13  for supervision by a public health nurse.  The requirements for 
 64.14  nurses must be consistent with chapter 148.  Training must 
 64.15  include child development, positive parenting techniques, and 
 64.16  diverse cultural practices in child rearing and family systems. 
 64.17     Subd. 5.  [TECHNICAL ASSISTANCE.] The commissioner shall 
 64.18  provide administrative and technical assistance to each program, 
 64.19  including assistance in data collection and other activities 
 64.20  related to conducting short- and long-term evaluations of the 
 64.21  programs as required under subdivision 7.  The commissioner may 
 64.22  request research and evaluation support from the University of 
 64.23  Minnesota. 
 64.24     Subd. 6.  [OUTCOME MEASURES.] The commissioner shall 
 64.25  establish outcomes to determine the impact of family home 
 64.26  visiting programs funded under this section on the following 
 64.27  areas: 
 64.28     (1) appropriate utilization of preventive health care; 
 64.29     (2) rates of substantiated child abuse and neglect; 
 64.30     (3) rates of unintentional child injuries; and 
 64.31     (4) any additional qualitative goals and quantitative 
 64.32  measures established by the commissioner. 
 64.33     Subd. 7.  [EVALUATION.] Using the qualitative goals and 
 64.34  quantitative outcome measures established under subdivisions 1 
 64.35  and 6, the commissioner shall conduct ongoing evaluations of the 
 64.36  programs funded under this section.  Community health boards and 
 65.1   tribal governments shall cooperate with the commissioner in the 
 65.2   evaluations and shall provide the commissioner with the 
 65.3   information necessary to conduct the evaluations.  As part of 
 65.4   the ongoing evaluations, the commissioner shall rate the impact 
 65.5   of the programs on the outcome measures listed in subdivision 6, 
 65.6   and shall periodically determine whether home visiting programs 
 65.7   are the best way to achieve the qualitative goals established in 
 65.8   subdivision 1 and by the commissioner.  If the commissioner 
 65.9   determines that home visiting programs are not the best way to 
 65.10  achieve these goals, the commissioner shall provide the 
 65.11  legislature with alternative methods for achieving them. 
 65.12     Subd. 8.  [REPORT.] By January 15, 2002, and January 15 of 
 65.13  each even-numbered year thereafter, the commissioner shall 
 65.14  submit a report to the legislature on the family home visiting 
 65.15  programs funded under this section and on the results of the 
 65.16  evaluations conducted under subdivision 7. 
 65.17     Subd. 9.  [NO SUPPLANTING OF EXISTING FUNDS.] Funding 
 65.18  available under this section may be used only to supplement, not 
 65.19  to replace, nonstate funds being used for home visiting services 
 65.20  as of July 1, 2001. 
 65.21     Sec. 61.  Minnesota Statutes 2000, section 157.16, 
 65.22  subdivision 3, is amended to read: 
 65.23     Subd. 3.  [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 
 65.24  following fees are required for food and beverage service 
 65.25  establishments, hotels, motels, lodging establishments, and 
 65.26  resorts licensed under this chapter.  Food and beverage service 
 65.27  establishments must pay the highest applicable fee under 
 65.28  paragraph (e), clause (1), (2), (3), or (4), and establishments 
 65.29  serving alcohol must pay the highest applicable fee under 
 65.30  paragraph (e), clause (6) or (7).  The license fee for new 
 65.31  operators previously licensed under this chapter for the same 
 65.32  calendar year is one-half of the appropriate annual license fee, 
 65.33  plus any penalty that may be required.  The license fee for 
 65.34  operators opening on or after October 1 is one-half of the 
 65.35  appropriate annual license fee, plus any penalty that may be 
 65.36  required.  The fees in paragraphs (b), (c), and (d) effective 
 66.1   until June 30, 2001, shall be phased up as specified in section 
 66.2   64 to the fee amounts effective beginning July 1, 2004.  
 66.3   Notwithstanding section 16A.1285, in fiscal years 2002, 2003, 
 66.4   and 2004, the commissioner shall regulate food and beverage 
 66.5   service establishments, hotels, motels, lodging establishments, 
 66.6   and resorts with the fees collected for that purpose. 
 66.7      (b) All food and beverage service establishments, except 
 66.8   special event food stands, and all hotels, motels, lodging 
 66.9   establishments, and resorts shall pay an annual base fee of $100 
 66.10  until June 30, 2001.  Effective July 1, 2004, the annual base 
 66.11  fee shall be $145. 
 66.12     (c) A special event food stand shall pay a flat fee of $30 
 66.13  annually until June 30, 2001.  Effective July 1, 2004, the 
 66.14  annual flat fee shall be $35.  "Special event food stand" means 
 66.15  a fee category where food is prepared or served in conjunction 
 66.16  with celebrations, county fairs, or special events from a 
 66.17  special event food stand as defined in section 157.15. 
 66.18     (d) In addition to the base fee in paragraph (b), each food 
 66.19  and beverage service establishment, other than a special event 
 66.20  food stand, and each hotel, motel, lodging establishment, and 
 66.21  resort shall pay an additional annual fee for each fee category 
 66.22  as specified in this paragraph: 
 66.23     (1) Limited food menu selection, $30 until June 30, 2001.  
 66.24  Effective July 1, 2004, the annual fee shall be $40.  "Limited 
 66.25  food menu selection" means a fee category that provides one or 
 66.26  more of the following: 
 66.27     (i) prepackaged food that receives heat treatment and is 
 66.28  served in the package; 
 66.29     (ii) frozen pizza that is heated and served; 
 66.30     (iii) a continental breakfast such as rolls, coffee, juice, 
 66.31  milk, and cold cereal; 
 66.32     (iv) soft drinks, coffee, or nonalcoholic beverages; or 
 66.33     (v) cleaning for eating, drinking, or cooking utensils, 
 66.34  when the only food served is prepared off site. 
 66.35     (2) Small establishment, including boarding establishments, 
 66.36  $55 until June 30, 2001.  Effective July 1, 2004, the annual fee 
 67.1   shall be $75.  "Small establishment" means a fee category that 
 67.2   has no salad bar and meets one or more of the following: 
 67.3      (i) possesses food service equipment that consists of no 
 67.4   more than a deep fat fryer, a grill, two hot holding containers, 
 67.5   and one or more microwave ovens; 
 67.6      (ii) serves dipped ice cream or soft serve frozen desserts; 
 67.7      (iii) serves breakfast in an owner-occupied bed and 
 67.8   breakfast establishment; 
 67.9      (iv) is a boarding establishment; or 
 67.10     (v) meets the equipment criteria in clause (3), item (i) or 
 67.11  (ii), and has a maximum patron seating capacity of not more than 
 67.12  50.  
 67.13     (3) Medium establishment, $150 until June 30, 2001.  
 67.14  Effective July 1, 2004, the annual fee shall be $210.  "Medium 
 67.15  establishment" means a fee category that meets one or more of 
 67.16  the following: 
 67.17     (i) possesses food service equipment that includes a range, 
 67.18  oven, steam table, salad bar, or salad preparation area; 
 67.19     (ii) possesses food service equipment that includes more 
 67.20  than one deep fat fryer, one grill, or two hot holding 
 67.21  containers; or 
 67.22     (iii) is an establishment where food is prepared at one 
 67.23  location and served at one or more separate locations. 
 67.24     Establishments meeting criteria in clause (2), item (v), 
 67.25  are not included in this fee category.  
 67.26     (4) Large establishment, $250 until June 30, 2001.  
 67.27  Effective July 1, 2004, the annual fee shall be $350.  "Large 
 67.28  establishment" means either: 
 67.29     (i) a fee category that (A) meets the criteria in clause 
 67.30  (3), items (i) or (ii), for a medium establishment, (B) seats 
 67.31  more than 175 people, and (C) offers the full menu selection an 
 67.32  average of five or more days a week during the weeks of 
 67.33  operation; or 
 67.34     (ii) a fee category that (A) meets the criteria in clause 
 67.35  (3), item (iii), for a medium establishment, and (B) prepares 
 67.36  and serves 500 or more meals per day. 
 68.1      (5) Other food and beverage service, including food carts, 
 68.2   mobile food units, seasonal temporary food stands, and seasonal 
 68.3   permanent food stands, $30 until June 30, 2001.  Effective July 
 68.4   1, 2004, the annual fee shall be $40. 
 68.5      (6) Beer or wine table service, $30 until June 30, 2001.  
 68.6   Effective July 1, 2004, the annual fee shall be $40.  "Beer or 
 68.7   wine table service" means a fee category where the only 
 68.8   alcoholic beverage service is beer or wine, served to customers 
 68.9   seated at tables. 
 68.10     (7) Alcoholic beverage service, other than beer or wine 
 68.11  table service, $75 until June 30, 2001.  Effective July 1, 2004, 
 68.12  the annual fee shall be $105. 
 68.13     "Alcohol beverage service, other than beer or wine table 
 68.14  service" means a fee category where alcoholic mixed drinks are 
 68.15  served or where beer or wine are served from a bar. 
 68.16     (8) Until June 30, 2001, lodging per sleeping accommodation 
 68.17  unit, $4, including hotels, motels, lodging establishments, and 
 68.18  resorts, up to a maximum of $400.  Effective July 1, 2004, 
 68.19  lodging per sleeping accommodation unit, $6, including hotels, 
 68.20  motels, lodging establishments, and resorts, up to a maximum of 
 68.21  $600.  "Lodging per sleeping accommodation unit" means a fee 
 68.22  category including the number of guest rooms, cottages, or other 
 68.23  rental units of a hotel, motel, lodging establishment, or 
 68.24  resort; or the number of beds in a dormitory. 
 68.25     (9) First public swimming pool, $100 until June 30, 2001; 
 68.26  each additional public swimming pool, $50 until June 30, 2001.  
 68.27  Effective July 1, 2004, first public swimming pool, $140; each 
 68.28  additional public swimming pool, $80.  "Public swimming pool" 
 68.29  means a fee category that has the meaning given in Minnesota 
 68.30  Rules, part 4717.0250, subpart 8. 
 68.31     (10) First spa, $50 until June 30, 2001; each additional 
 68.32  spa, $25 until June 30, 2001.  Effective July 1, 2004, first 
 68.33  spa, $80; each additional spa, $40.  "Spa pool" means a fee 
 68.34  category that has the meaning given in Minnesota Rules, part 
 68.35  4717.0250, subpart 9. 
 68.36     (11) Private sewer or water, $30 until June 30, 2001.  
 69.1   Effective July 1, 2004, private sewer or water, $40.  
 69.2   "Individual private water" means a fee category with a water 
 69.3   supply other than a community public water supply as defined in 
 69.4   Minnesota Rules, chapter 4720.  "Individual private sewer" means 
 69.5   a fee category with an individual sewage treatment system which 
 69.6   uses subsurface treatment and disposal. 
 69.7      (e) A fee is not required for a food and beverage service 
 69.8   establishment operated by a school as defined in sections 
 69.9   120A.05, subdivisions 9, 11, 13, and 17 and 120A.22. 
 69.10     (f) A fee of $150 for review of the construction plans must 
 69.11  accompany the initial license application for food and beverage 
 69.12  service establishments, hotels, motels, lodging establishments, 
 69.13  or resorts. 
 69.14     (g) (f) When existing food and beverage service 
 69.15  establishments, hotels, motels, lodging establishments, or 
 69.16  resorts are extensively remodeled, a fee of $150 must be 
 69.17  submitted with the remodeling plans. 
 69.18     (h) (g) Seasonal temporary food stands and special event 
 69.19  food stands are not required to submit construction or 
 69.20  remodeling plans for review. 
 69.21     Sec. 62.  Minnesota Statutes 2000, section 157.22, is 
 69.22  amended to read: 
 69.23     157.22 [EXEMPTIONS.] 
 69.24     This chapter shall not be construed to apply to: 
 69.25     (1) interstate carriers under the supervision of the United 
 69.26  States Department of Health and Human Services; 
 69.27     (2) any building constructed and primarily used for 
 69.28  religious worship; 
 69.29     (3) any building owned, operated, and used by a college or 
 69.30  university in accordance with health regulations promulgated by 
 69.31  the college or university under chapter 14; 
 69.32     (4) any person, firm, or corporation whose principal mode 
 69.33  of business is licensed under sections 28A.04 and 28A.05, is 
 69.34  exempt at that premises from licensure as a food or beverage 
 69.35  establishment; provided that the holding of any license pursuant 
 69.36  to sections 28A.04 and 28A.05 shall not exempt any person, firm, 
 70.1   or corporation from the applicable provisions of this chapter or 
 70.2   the rules of the state commissioner of health relating to food 
 70.3   and beverage service establishments; 
 70.4      (5) family day care homes and group family day care homes 
 70.5   governed by sections 245A.01 to 245A.16; 
 70.6      (6) nonprofit senior citizen centers for the sale of 
 70.7   home-baked goods; and 
 70.8      (7) food not prepared at an establishment and brought in by 
 70.9   individuals attending a potluck event for consumption at the 
 70.10  potluck event.  An organization sponsoring a potluck event under 
 70.11  this clause may advertise the potluck event to the public 
 70.12  through any means.  Individuals who are not members of an 
 70.13  organization sponsoring a potluck event under this clause may 
 70.14  attend the potluck event and consume the food at the event.  
 70.15  Licensed food establishments cannot be sponsors of potluck 
 70.16  events.  Potluck event food shall not be brought into a licensed 
 70.17  food establishment kitchen; and 
 70.18     (8) a home school in which a child is provided instruction 
 70.19  at home. 
 70.20     Sec. 63.  [325F.691] [DISCLOSURE OF SPECIAL CARE STATUS 
 70.21  REQUIRED.] 
 70.22     Subdivision 1.  [PERSONS TO WHOM DISCLOSURE IS 
 70.23  REQUIRED.] Housing with services establishments, as defined in 
 70.24  sections 144D.01 to 144D.07, that secure, segregate, or provide 
 70.25  a special program or special unit for residents with a diagnosis 
 70.26  of probable Alzheimer's disease or a related disorder or that 
 70.27  advertise, market, or otherwise promote the establishment as 
 70.28  providing specialized care for Alzheimer's disease or a related 
 70.29  disorder are considered a "special care unit."  All special care 
 70.30  units shall provide a written disclosure to the following: 
 70.31     (1) the commissioner of health, if requested; 
 70.32     (2) the office of ombudsman for older Minnesotans; and 
 70.33     (3) each person seeking placement within a residence, or 
 70.34  the person's authorized representative, before an agreement to 
 70.35  provide the care is entered into. 
 70.36     Subd. 2.  [CONTENT.] Written disclosure shall include, but 
 71.1   is not limited to, the following: 
 71.2      (1) a statement of the overall philosophy and how it 
 71.3   reflects the special needs of residents with Alzheimer's disease 
 71.4   or other dementias; 
 71.5      (2) the criteria for determining who may reside in the 
 71.6   special care unit; 
 71.7      (3) the process used for assessment and establishment of 
 71.8   the service plan or agreement, including how the plan is 
 71.9   responsive to changes in the resident's condition; 
 71.10     (4) staffing credentials, job descriptions, and staff 
 71.11  duties and availability, including any training specific to 
 71.12  dementia; 
 71.13     (5) physical environment as well as design and security 
 71.14  features that specifically address the needs of residents with 
 71.15  Alzheimer's disease or other dementias; 
 71.16     (6) frequency and type of programs and activities for 
 71.17  residents of the special care unit; 
 71.18     (7) involvement of families in resident care and 
 71.19  availability of family support programs; 
 71.20     (8) fee schedules for additional services to the residents 
 71.21  of the special care unit; and 
 71.22     (9) a statement that residents will be given a written 
 71.23  notice 30 days prior to changes in the fee schedule. 
 71.24     Subd. 3.  [DUTY TO UPDATE.] Substantial changes to 
 71.25  disclosures must be reported to the parties listed in 
 71.26  subdivision 1 at the time the change is made. 
 71.27     Subd. 4.  [REMEDY.] The attorney general may seek the 
 71.28  remedies set forth in section 8.31 for repeated and intentional 
 71.29  violations of this section.  However, no private right of action 
 71.30  may be maintained as provided under section 8.31, subdivision 3a.
 71.31     Sec. 64.  [ESTABLISHMENT FEES DURING TRANSITION PERIOD.] 
 71.32     For fiscal years 2002, 2003, and 2004, the following fees 
 71.33  shall apply to food and beverage service establishments, hotels, 
 71.34  motels, lodging establishments, and resorts for which fees are 
 71.35  established under Minnesota Statutes, section 157.16, 
 71.36  subdivision 3, paragraphs (b), (c), and (d): 
 72.1                           Fiscal Year   Fiscal Year   Fiscal Year
 72.2   Fee Category                2002          2003          2004
 72.3   Annual base fee, all      $111.25       $122.50       $133.75
 72.4   food and beverage
 72.5   service establishments
 72.6   except special event
 72.7   food stands and all
 72.8   hotels, motels, lodging
 72.9   establishments, and
 72.10  resorts
 72.11  Special event food        $ 31.25       $ 32.50       $ 33.75
 72.12  stand
 72.13  Establishment with        $ 32.50       $ 35.00       $ 37.50
 72.14  limited food menu
 72.15  selection
 72.16  Small establishment       $ 60.00       $ 65.00       $ 70.00
 72.17  Medium establishment      $165.00       $180.00       $195.00
 72.18  Large establishment       $275.00       $300.00       $325.00
 72.19  Other food and            $ 32.50       $ 35.00       $ 37.50
 72.20  beverage service
 72.21  Beer or wine table        $ 32.50       $ 35.00       $ 37.50
 72.22  service
 72.23  Alcoholic beverage        $ 82.50       $ 90.00       $ 97.50
 72.24  service other than
 72.25  beer or wine table
 72.26  service
 72.27  Lodging per sleeping    $4.50 per     $5.00 per     $5.50 per
 72.28  accommodation unit,    unit, $450    unit, $500    unit, $550
 72.29  up to a specified         maximum       maximum       maximum
 72.30  maximum
 72.31  First public              $110.00       $120.00       $130.00
 72.32  swimming pool
 72.33  Each additional           $ 57.50       $ 65.00       $ 72.50
 72.34  public swimming pool
 72.35  First spa                 $ 57.50       $ 65.00       $ 72.50
 72.36  Each additional spa       $ 28.75       $ 32.50       $ 36.25
 73.1   Private sewer or          $ 32.50       $ 35.00       $ 37.50
 73.2   water
 73.3      Sec. 65.  [RECOMMENDATIONS; INCENTIVES FOR MAGNET 
 73.4   HOSPITALS.] 
 73.5      The commissioner of health shall develop recommendations 
 73.6   for incentives that may be implemented to increase the number of 
 73.7   magnet hospitals in Minnesota.  These recommendations must be 
 73.8   reported by December 1, 2001 to the chairs of the house and 
 73.9   senate committees with jurisdiction over health and human 
 73.10  services policy and finance issues. 
 73.11     Sec. 66.  [STUDY; REIMBURSEMENT FOR CERTAIN ANTI-TOBACCO 
 73.12  USE EDUCATION ACTIVITIES.] 
 73.13     The commissioner of health, in consultation with persons 
 73.14  who have had laryngectomies to treat larynx cancer, who use 
 73.15  artificial larynxes for communication, and who engage in 
 73.16  anti-tobacco use education activities, shall study and develop 
 73.17  recommendations establishing a program to reimburse these 
 73.18  persons for mileage and other costs associated with traveling to 
 73.19  schools in the state to educate students about the health risks 
 73.20  of tobacco use.  The recommendations must include proposals for 
 73.21  reimbursement levels, a funding source, expenses for which 
 73.22  persons may be reimbursed, and persons eligible for 
 73.23  reimbursement.  The recommendations must be reported to the 
 73.24  chairs of the policy and finance committees in the House and 
 73.25  Senate with jurisdiction over health and human services issues 
 73.26  by January 15, 2002. 
 73.27     Sec. 67.  [STUDY; EFFECTS OF NURSE STAFFING SHORTAGES.] 
 73.28     The commissioner of health, in consultation with consumers, 
 73.29  representatives of the Minnesota nurses association, and 
 73.30  representatives of the Minnesota hospital and healthcare 
 73.31  partnership, shall study and identify the effects of nurse 
 73.32  staffing shortages in health care facilities on patient care and 
 73.33  patient safety.  The results of this study shall be reported by 
 73.34  December 1, 2001 to the chairs of the house and senate 
 73.35  committees with jurisdiction over health and human services 
 73.36  policy issues. 
 74.1      Sec. 68.  [REPEALER.] 
 74.2      (a) Minnesota Statutes 2000, sections 145.882, subdivisions 
 74.3   3 and 4; and 145.927, are repealed. 
 74.4      (b) Minnesota Statutes 2000, section 144.148, subdivision 
 74.5   8, is repealed. 
 74.6      <h>[EFFECTIVE DATE.]</h> Paragraph (b) of this section is 
 74.7   effective the day following final enactment. 
 74.8                              ARTICLE 2 
 74.9                             HEALTH CARE 
 74.10     Section 1.  Minnesota Statutes 2000, section 256.01, 
 74.11  subdivision 2, is amended to read: 
 74.12     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
 74.13  section 241.021, subdivision 2, the commissioner of human 
 74.14  services shall: 
 74.15     (1) Administer and supervise all forms of public assistance 
 74.16  provided for by state law and other welfare activities or 
 74.17  services as are vested in the commissioner.  Administration and 
 74.18  supervision of human services activities or services includes, 
 74.19  but is not limited to, assuring timely and accurate distribution 
 74.20  of benefits, completeness of service, and quality program 
 74.21  management.  In addition to administering and supervising human 
 74.22  services activities vested by law in the department, the 
 74.23  commissioner shall have the authority to: 
 74.24     (a) require county agency participation in training and 
 74.25  technical assistance programs to promote compliance with 
 74.26  statutes, rules, federal laws, regulations, and policies 
 74.27  governing human services; 
 74.28     (b) monitor, on an ongoing basis, the performance of county 
 74.29  agencies in the operation and administration of human services, 
 74.30  enforce compliance with statutes, rules, federal laws, 
 74.31  regulations, and policies governing welfare services and promote 
 74.32  excellence of administration and program operation; 
 74.33     (c) develop a quality control program or other monitoring 
 74.34  program to review county performance and accuracy of benefit 
 74.35  determinations; 
 74.36     (d) require county agencies to make an adjustment to the 
 75.1   public assistance benefits issued to any individual consistent 
 75.2   with federal law and regulation and state law and rule and to 
 75.3   issue or recover benefits as appropriate; 
 75.4      (e) delay or deny payment of all or part of the state and 
 75.5   federal share of benefits and administrative reimbursement 
 75.6   according to the procedures set forth in section 256.017; 
 75.7      (f) make contracts with and grants to public and private 
 75.8   agencies and organizations, both profit and nonprofit, and 
 75.9   individuals, using appropriated funds; and 
 75.10     (g) enter into contractual agreements with federally 
 75.11  recognized Indian tribes with a reservation in Minnesota to the 
 75.12  extent necessary for the tribe to operate a federally approved 
 75.13  family assistance program or any other program under the 
 75.14  supervision of the commissioner.  The commissioner shall consult 
 75.15  with the affected county or counties in the contractual 
 75.16  agreement negotiations, if the county or counties wish to be 
 75.17  included, in order to avoid the duplication of county and tribal 
 75.18  assistance program services.  The commissioner may establish 
 75.19  necessary accounts for the purposes of receiving and disbursing 
 75.20  funds as necessary for the operation of the programs. 
 75.21     (2) Inform county agencies, on a timely basis, of changes 
 75.22  in statute, rule, federal law, regulation, and policy necessary 
 75.23  to county agency administration of the programs. 
 75.24     (3) Administer and supervise all child welfare activities; 
 75.25  promote the enforcement of laws protecting handicapped, 
 75.26  dependent, neglected and delinquent children, and children born 
 75.27  to mothers who were not married to the children's fathers at the 
 75.28  times of the conception nor at the births of the children; 
 75.29  license and supervise child-caring and child-placing agencies 
 75.30  and institutions; supervise the care of children in boarding and 
 75.31  foster homes or in private institutions; and generally perform 
 75.32  all functions relating to the field of child welfare now vested 
 75.33  in the state board of control. 
 75.34     (4) Administer and supervise all noninstitutional service 
 75.35  to handicapped persons, including those who are visually 
 75.36  impaired, hearing impaired, or physically impaired or otherwise 
 76.1   handicapped.  The commissioner may provide and contract for the 
 76.2   care and treatment of qualified indigent children in facilities 
 76.3   other than those located and available at state hospitals when 
 76.4   it is not feasible to provide the service in state hospitals. 
 76.5      (5) Assist and actively cooperate with other departments, 
 76.6   agencies and institutions, local, state, and federal, by 
 76.7   performing services in conformity with the purposes of Laws 
 76.8   1939, chapter 431. 
 76.9      (6) Act as the agent of and cooperate with the federal 
 76.10  government in matters of mutual concern relative to and in 
 76.11  conformity with the provisions of Laws 1939, chapter 431, 
 76.12  including the administration of any federal funds granted to the 
 76.13  state to aid in the performance of any functions of the 
 76.14  commissioner as specified in Laws 1939, chapter 431, and 
 76.15  including the promulgation of rules making uniformly available 
 76.16  medical care benefits to all recipients of public assistance, at 
 76.17  such times as the federal government increases its participation 
 76.18  in assistance expenditures for medical care to recipients of 
 76.19  public assistance, the cost thereof to be borne in the same 
 76.20  proportion as are grants of aid to said recipients. 
 76.21     (7) Establish and maintain any administrative units 
 76.22  reasonably necessary for the performance of administrative 
 76.23  functions common to all divisions of the department. 
 76.24     (8) Act as designated guardian of both the estate and the 
 76.25  person of all the wards of the state of Minnesota, whether by 
 76.26  operation of law or by an order of court, without any further 
 76.27  act or proceeding whatever, except as to persons committed as 
 76.28  mentally retarded.  For children under the guardianship of the 
 76.29  commissioner whose interests would be best served by adoptive 
 76.30  placement, the commissioner may contract with a licensed 
 76.31  child-placing agency to provide adoption services.  A contract 
 76.32  with a licensed child-placing agency must be designed to 
 76.33  supplement existing county efforts and may not replace existing 
 76.34  county programs, unless the replacement is agreed to by the 
 76.35  county board and the appropriate exclusive bargaining 
 76.36  representative or the commissioner has evidence that child 
 77.1   placements of the county continue to be substantially below that 
 77.2   of other counties.  Funds encumbered and obligated under an 
 77.3   agreement for a specific child shall remain available until the 
 77.4   terms of the agreement are fulfilled or the agreement is 
 77.5   terminated. 
 77.6      (9) Act as coordinating referral and informational center 
 77.7   on requests for service for newly arrived immigrants coming to 
 77.8   Minnesota. 
 77.9      (10) The specific enumeration of powers and duties as 
 77.10  hereinabove set forth shall in no way be construed to be a 
 77.11  limitation upon the general transfer of powers herein contained. 
 77.12     (11) Establish county, regional, or statewide schedules of 
 77.13  maximum fees and charges which may be paid by county agencies 
 77.14  for medical, dental, surgical, hospital, nursing and nursing 
 77.15  home care and medicine and medical supplies under all programs 
 77.16  of medical care provided by the state and for congregate living 
 77.17  care under the income maintenance programs. 
 77.18     (12) Have the authority to conduct and administer 
 77.19  experimental projects to test methods and procedures of 
 77.20  administering assistance and services to recipients or potential 
 77.21  recipients of public welfare.  To carry out such experimental 
 77.22  projects, it is further provided that the commissioner of human 
 77.23  services is authorized to waive the enforcement of existing 
 77.24  specific statutory program requirements, rules, and standards in 
 77.25  one or more counties.  The order establishing the waiver shall 
 77.26  provide alternative methods and procedures of administration, 
 77.27  shall not be in conflict with the basic purposes, coverage, or 
 77.28  benefits provided by law, and in no event shall the duration of 
 77.29  a project exceed four years.  It is further provided that no 
 77.30  order establishing an experimental project as authorized by the 
 77.31  provisions of this section shall become effective until the 
 77.32  following conditions have been met: 
 77.33     (a) The secretary of health and human services of the 
 77.34  United States has agreed, for the same project, to waive state 
 77.35  plan requirements relative to statewide uniformity. 
 77.36     (b) A comprehensive plan, including estimated project 
 78.1   costs, shall be approved by the legislative advisory commission 
 78.2   and filed with the commissioner of administration.  
 78.3      (13) According to federal requirements, establish 
 78.4   procedures to be followed by local welfare boards in creating 
 78.5   citizen advisory committees, including procedures for selection 
 78.6   of committee members. 
 78.7      (14) Allocate federal fiscal disallowances or sanctions 
 78.8   which are based on quality control error rates for the aid to 
 78.9   families with dependent children program formerly codified in 
 78.10  sections 256.72 to 256.87, medical assistance, or food stamp 
 78.11  program in the following manner:  
 78.12     (a) One-half of the total amount of the disallowance shall 
 78.13  be borne by the county boards responsible for administering the 
 78.14  programs.  For the medical assistance and the AFDC program 
 78.15  formerly codified in sections 256.72 to 256.87, disallowances 
 78.16  shall be shared by each county board in the same proportion as 
 78.17  that county's expenditures for the sanctioned program are to the 
 78.18  total of all counties' expenditures for the AFDC program 
 78.19  formerly codified in sections 256.72 to 256.87, and medical 
 78.20  assistance programs.  For the food stamp program, sanctions 
 78.21  shall be shared by each county board, with 50 percent of the 
 78.22  sanction being distributed to each county in the same proportion 
 78.23  as that county's administrative costs for food stamps are to the 
 78.24  total of all food stamp administrative costs for all counties, 
 78.25  and 50 percent of the sanctions being distributed to each county 
 78.26  in the same proportion as that county's value of food stamp 
 78.27  benefits issued are to the total of all benefits issued for all 
 78.28  counties.  Each county shall pay its share of the disallowance 
 78.29  to the state of Minnesota.  When a county fails to pay the 
 78.30  amount due hereunder, the commissioner may deduct the amount 
 78.31  from reimbursement otherwise due the county, or the attorney 
 78.32  general, upon the request of the commissioner, may institute 
 78.33  civil action to recover the amount due. 
 78.34     (b) Notwithstanding the provisions of paragraph (a), if the 
 78.35  disallowance results from knowing noncompliance by one or more 
 78.36  counties with a specific program instruction, and that knowing 
 79.1   noncompliance is a matter of official county board record, the 
 79.2   commissioner may require payment or recover from the county or 
 79.3   counties, in the manner prescribed in paragraph (a), an amount 
 79.4   equal to the portion of the total disallowance which resulted 
 79.5   from the noncompliance, and may distribute the balance of the 
 79.6   disallowance according to paragraph (a).  
 79.7      (15) Develop and implement special projects that maximize 
 79.8   reimbursements and result in the recovery of money to the 
 79.9   state.  For the purpose of recovering state money, the 
 79.10  commissioner may enter into contracts with third parties.  Any 
 79.11  recoveries that result from projects or contracts entered into 
 79.12  under this paragraph shall be deposited in the state treasury 
 79.13  and credited to a special account until the balance in the 
 79.14  account reaches $1,000,000.  When the balance in the account 
 79.15  exceeds $1,000,000, the excess shall be transferred and credited 
 79.16  to the general fund.  All money in the account is appropriated 
 79.17  to the commissioner for the purposes of this paragraph. 
 79.18     (16) Have the authority to make direct payments to 
 79.19  facilities providing shelter to women and their children 
 79.20  according to section 256D.05, subdivision 3.  Upon the written 
 79.21  request of a shelter facility that has been denied payments 
 79.22  under section 256D.05, subdivision 3, the commissioner shall 
 79.23  review all relevant evidence and make a determination within 30 
 79.24  days of the request for review regarding issuance of direct 
 79.25  payments to the shelter facility.  Failure to act within 30 days 
 79.26  shall be considered a determination not to issue direct payments.
 79.27     (17) Have the authority to establish and enforce the 
 79.28  following county reporting requirements:  
 79.29     (a) The commissioner shall establish fiscal and statistical 
 79.30  reporting requirements necessary to account for the expenditure 
 79.31  of funds allocated to counties for human services programs.  
 79.32  When establishing financial and statistical reporting 
 79.33  requirements, the commissioner shall evaluate all reports, in 
 79.34  consultation with the counties, to determine if the reports can 
 79.35  be simplified or the number of reports can be reduced. 
 79.36     (b) The county board shall submit monthly or quarterly 
 80.1   reports to the department as required by the commissioner.  
 80.2   Monthly reports are due no later than 15 working days after the 
 80.3   end of the month.  Quarterly reports are due no later than 30 
 80.4   calendar days after the end of the quarter, unless the 
 80.5   commissioner determines that the deadline must be shortened to 
 80.6   20 calendar days to avoid jeopardizing compliance with federal 
 80.7   deadlines or risking a loss of federal funding.  Only reports 
 80.8   that are complete, legible, and in the required format shall be 
 80.9   accepted by the commissioner.  
 80.10     (c) If the required reports are not received by the 
 80.11  deadlines established in clause (b), the commissioner may delay 
 80.12  payments and withhold funds from the county board until the next 
 80.13  reporting period.  When the report is needed to account for the 
 80.14  use of federal funds and the late report results in a reduction 
 80.15  in federal funding, the commissioner shall withhold from the 
 80.16  county boards with late reports an amount equal to the reduction 
 80.17  in federal funding until full federal funding is received.  
 80.18     (d) A county board that submits reports that are late, 
 80.19  illegible, incomplete, or not in the required format for two out 
 80.20  of three consecutive reporting periods is considered 
 80.21  noncompliant.  When a county board is found to be noncompliant, 
 80.22  the commissioner shall notify the county board of the reason the 
 80.23  county board is considered noncompliant and request that the 
 80.24  county board develop a corrective action plan stating how the 
 80.25  county board plans to correct the problem.  The corrective 
 80.26  action plan must be submitted to the commissioner within 45 days 
 80.27  after the date the county board received notice of noncompliance.
 80.28     (e) The final deadline for fiscal reports or amendments to 
 80.29  fiscal reports is one year after the date the report was 
 80.30  originally due.  If the commissioner does not receive a report 
 80.31  by the final deadline, the county board forfeits the funding 
 80.32  associated with the report for that reporting period and the 
 80.33  county board must repay any funds associated with the report 
 80.34  received for that reporting period. 
 80.35     (f) The commissioner may not delay payments, withhold 
 80.36  funds, or require repayment under paragraph (c) or (e) if the 
 81.1   county demonstrates that the commissioner failed to provide 
 81.2   appropriate forms, guidelines, and technical assistance to 
 81.3   enable the county to comply with the requirements.  If the 
 81.4   county board disagrees with an action taken by the commissioner 
 81.5   under paragraph (c) or (e), the county board may appeal the 
 81.6   action according to sections 14.57 to 14.69. 
 81.7      (g) Counties subject to withholding of funds under 
 81.8   paragraph (c) or forfeiture or repayment of funds under 
 81.9   paragraph (e) shall not reduce or withhold benefits or services 
 81.10  to clients to cover costs incurred due to actions taken by the 
 81.11  commissioner under paragraph (c) or (e). 
 81.12     (18) Allocate federal fiscal disallowances or sanctions for 
 81.13  audit exceptions when federal fiscal disallowances or sanctions 
 81.14  are based on a statewide random sample for the foster care 
 81.15  program under title IV-E of the Social Security Act, United 
 81.16  States Code, title 42, in direct proportion to each county's 
 81.17  title IV-E foster care maintenance claim for that period. 
 81.18     (19) Be responsible for ensuring the detection, prevention, 
 81.19  investigation, and resolution of fraudulent activities or 
 81.20  behavior by applicants, recipients, and other participants in 
 81.21  the human services programs administered by the department. 
 81.22     (20) Require county agencies to identify overpayments, 
 81.23  establish claims, and utilize all available and cost-beneficial 
 81.24  methodologies to collect and recover these overpayments in the 
 81.25  human services programs administered by the department. 
 81.26     (21) Have the authority to administer a drug rebate program 
 81.27  for drugs purchased pursuant to the prescription drug program 
 81.28  established under section 256.955 after the beneficiary's 
 81.29  satisfaction of any deductible established in the program.  The 
 81.30  commissioner shall require a rebate agreement from all 
 81.31  manufacturers of covered drugs as defined in section 256B.0625, 
 81.32  subdivision 13.  Rebate agreements for prescription drugs 
 81.33  delivered on or after July 1, 2002, must include rebates for 
 81.34  individuals covered under the prescription drug program who are 
 81.35  under 65 years of age.  For each drug, the amount of the rebate 
 81.36  shall be equal to the basic rebate as defined for purposes of 
 82.1   the federal rebate program in United States Code, title 42, 
 82.2   section 1396r-8(c)(1).  This basic rebate shall be applied to 
 82.3   single-source and multiple-source drugs.  The manufacturers must 
 82.4   provide full payment within 30 days of receipt of the state 
 82.5   invoice for the rebate within the terms and conditions used for 
 82.6   the federal rebate program established pursuant to section 1927 
 82.7   of title XIX of the Social Security Act.  The manufacturers must 
 82.8   provide the commissioner with any information necessary to 
 82.9   verify the rebate determined per drug.  The rebate program shall 
 82.10  utilize the terms and conditions used for the federal rebate 
 82.11  program established pursuant to section 1927 of title XIX of the 
 82.12  Social Security Act. 
 82.13     (22) Have the authority to administer the federal drug 
 82.14  rebate program for drugs purchased under the medical assistance 
 82.15  program as allowed by section 1927 of title XIX of the Social 
 82.16  Security Act and according to the terms and conditions of 
 82.17  section 1927.  Rebates shall be collected for all drugs that 
 82.18  have been dispensed or administered in an outpatient setting and 
 82.19  that are from manufacturers who have signed a rebate agreement 
 82.20  with the United States Department of Health and Human Services. 
 82.21     (22) (23) Operate the department's communication systems 
 82.22  account established in Laws 1993, First Special Session chapter 
 82.23  1, article 1, section 2, subdivision 2, to manage shared 
 82.24  communication costs necessary for the operation of the programs 
 82.25  the commissioner supervises.  A communications account may also 
 82.26  be established for each regional treatment center which operates 
 82.27  communications systems.  Each account must be used to manage 
 82.28  shared communication costs necessary for the operations of the 
 82.29  programs the commissioner supervises.  The commissioner may 
 82.30  distribute the costs of operating and maintaining communication 
 82.31  systems to participants in a manner that reflects actual usage. 
 82.32  Costs may include acquisition, licensing, insurance, 
 82.33  maintenance, repair, staff time and other costs as determined by 
 82.34  the commissioner.  Nonprofit organizations and state, county, 
 82.35  and local government agencies involved in the operation of 
 82.36  programs the commissioner supervises may participate in the use 
 83.1   of the department's communications technology and share in the 
 83.2   cost of operation.  The commissioner may accept on behalf of the 
 83.3   state any gift, bequest, devise or personal property of any 
 83.4   kind, or money tendered to the state for any lawful purpose 
 83.5   pertaining to the communication activities of the department.  
 83.6   Any money received for this purpose must be deposited in the 
 83.7   department's communication systems accounts.  Money collected by 
 83.8   the commissioner for the use of communication systems must be 
 83.9   deposited in the state communication systems account and is 
 83.10  appropriated to the commissioner for purposes of this section. 
 83.11     (23) (24) Receive any federal matching money that is made 
 83.12  available through the medical assistance program for the 
 83.13  consumer satisfaction survey.  Any federal money received for 
 83.14  the survey is appropriated to the commissioner for this 
 83.15  purpose.  The commissioner may expend the federal money received 
 83.16  for the consumer satisfaction survey in either year of the 
 83.17  biennium. 
 83.18     (24) (25) Incorporate cost reimbursement claims from First 
 83.19  Call Minnesota into the federal cost reimbursement claiming 
 83.20  processes of the department according to federal law, rule, and 
 83.21  regulations.  Any reimbursement received is appropriated to the 
 83.22  commissioner and shall be disbursed to First Call Minnesota 
 83.23  according to normal department payment schedules. 
 83.24     (25) (26) Develop recommended standards for foster care 
 83.25  homes that address the components of specialized therapeutic 
 83.26  services to be provided by foster care homes with those services.
 83.27     Sec. 2.  Minnesota Statutes 2000, section 256.955, 
 83.28  subdivision 2b, is amended to read: 
 83.29     Subd. 2b.  [ELIGIBILITY.] Effective July 1, 2002, an 
 83.30  individual satisfying the following requirements and the 
 83.31  requirements described in subdivision 2, paragraph (d), is 
 83.32  eligible for the prescription drug program: 
 83.33     (1) is under 65 years of age; and 
 83.34     (2) is eligible as a qualified Medicare beneficiary 
 83.35  according to section 256B.057, subdivision 3 or 3a, or is 
 83.36  eligible under section 256B.057, subdivision 3 or 3a, and is 
 84.1   also eligible for medical assistance or general assistance 
 84.2   medical care with a spenddown as defined in section 256B.056, 
 84.3   subdivision 5. 
 84.4      Sec. 3.  [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.] 
 84.5      Subdivision 1.  [DEFINITIONS.] For purposes of this 
 84.6   section, the following definitions apply:  
 84.7      (a) "Commissioner" means the commissioner of human services.
 84.8      (b) "Health plan" means a policy, contract, or certificate 
 84.9   issued by a health plan company to a qualifying purchasing 
 84.10  alliance.  Any health plan issued to the members of a qualifying 
 84.11  purchasing alliance must meet the requirements of chapter 62L.  
 84.12     (c) "Health plan company" means: 
 84.13     (1) a health carrier as defined under section 62A.011, 
 84.14  subdivision 2; 
 84.15     (2) a community integrated service network operating under 
 84.16  chapter 62N; or 
 84.17     (3) an accountable provider network operating under chapter 
 84.18  62T.  
 84.19     (d) "Qualifying employer" means an employer who: 
 84.20     (1) is a member of a qualifying purchasing alliance; 
 84.21     (2) has at least one employee but no more than ten 
 84.22  employees or is a sole proprietor or farmer; 
 84.23     (3) did not offer employer-subsidized health care coverage 
 84.24  to its employees for at least 12 months prior to joining the 
 84.25  purchasing alliance; and 
 84.26     (4) is offering health coverage through the purchasing 
 84.27  alliance to all employees who work at least 20 hours per week 
 84.28  unless the employee is eligible for Medicare. 
 84.29  For purposes of this subdivision, "employer-subsidized health 
 84.30  coverage" means health coverage for which the employer pays at 
 84.31  least 50 percent of the cost of coverage for the employee.  
 84.32     (e) "Qualifying enrollee" means an employee of a qualifying 
 84.33  employer or the employee's dependent covered by a health plan.  
 84.34     (f) "Qualifying purchasing alliance" means a purchasing 
 84.35  alliance as defined in section 62T.01, subdivision 2, that: 
 84.36     (1) meets the requirements of chapter 62T; 
 85.1      (2) services a geographic area located in outstate 
 85.2   Minnesota, excluding the city of Duluth; and 
 85.3      (3) is organized and operating before May 1, 2001. 
 85.4      The criteria used by the qualifying purchasing alliance for 
 85.5   membership must be approved by the commissioner of health.  A 
 85.6   qualifying purchasing alliance may begin enrolling qualifying 
 85.7   employers after July 1, 2001, with enrollment ending by December 
 85.8   31, 2003.  
 85.9      Subd. 2.  [CREATION OF ACCOUNT.] A purchasing alliance 
 85.10  stop-loss fund account is established in the general fund.  The 
 85.11  commissioner shall use the money to establish a stop-loss fund 
 85.12  from which a health plan company may receive reimbursement for 
 85.13  claims paid for qualifying enrollees.  The account consists of 
 85.14  money appropriated by the legislature.  Money from the account 
 85.15  must be used for the stop-loss fund.  
 85.16     Subd. 3.  [REIMBURSEMENT.] (a) A health plan company may 
 85.17  receive reimbursement from the fund for 90 percent of the 
 85.18  portion of the claim that exceeds $30,000 but not of the portion 
 85.19  that exceeds $100,000 in a calendar year for a qualifying 
 85.20  enrollee.  
 85.21     (b) Claims shall be reported and funds shall be distributed 
 85.22  on a calendar-year basis.  Claims shall be eligible for 
 85.23  reimbursement only for the calendar year in which the claims 
 85.24  were paid.  
 85.25     (c) Once claims paid on behalf of a qualifying enrollee 
 85.26  reach $100,000 in a given calendar year, no further claims may 
 85.27  be submitted for reimbursement on behalf of that enrollee in 
 85.28  that calendar year.  
 85.29     Subd. 4.  [REQUEST PROCESS.] (a) Each health plan company 
 85.30  must submit a request for reimbursement from the fund on a form 
 85.31  prescribed by the commissioner.  Requests for payment must be 
 85.32  submitted no later than April 1 following the end of the 
 85.33  calendar year for which the reimbursement request is being made, 
 85.34  beginning April 1, 2002. 
 85.35     (b) The commissioner may require a health plan company to 
 85.36  submit claims data as needed in connection with the 
 86.1   reimbursement request.  
 86.2      Subd. 5.  [DISTRIBUTION.] (a) The commissioner shall 
 86.3   calculate the total claims reimbursement amount for all 
 86.4   qualifying health plan companies for the calendar year for which 
 86.5   claims are being reported and shall distribute the stop-loss 
 86.6   funds on an annual basis.  
 86.7      (b) In the event that the total amount requested for 
 86.8   reimbursement by the health plan companies for a calendar year 
 86.9   exceeds the funds available for distribution for claims paid by 
 86.10  all health plan companies during the same calendar year, the 
 86.11  commissioner shall provide for the pro rata distribution of the 
 86.12  available funds.  Each health plan company shall be eligible to 
 86.13  receive only a proportionate amount of the available funds as 
 86.14  the health plan company's total eligible claims paid compares to 
 86.15  the total eligible claims paid by all health plan companies.  
 86.16     (c) In the event that funds available for distribution for 
 86.17  claims paid by all health plan companies during a calendar year 
 86.18  exceed the total amount requested for reimbursement by all 
 86.19  health plan companies during the same calendar year, any excess 
 86.20  funds shall be reallocated for distribution in the next calendar 
 86.21  year.  
 86.22     Subd. 6.  [DATA.] Upon the request of the commissioner, 
 86.23  each health plan company shall furnish such data as the 
 86.24  commissioner deems necessary to administer the fund.  The 
 86.25  commissioner may require that such data be submitted on a per 
 86.26  enrollee, aggregate, or categorical basis.  Any data submitted 
 86.27  under this section shall be classified as private data or 
 86.28  nonpublic data as defined in section 13.02. 
 86.29     Subd. 7.  [DELEGATION.] The commissioner may delegate any 
 86.30  or all of the commissioner's administrative duties to another 
 86.31  state agency or to a private contractor.  
 86.32     Subd. 8.  [REPORT.] The commissioner of commerce, in 
 86.33  consultation with the office of rural health and the qualifying 
 86.34  purchasing alliances, shall evaluate the extent to which the 
 86.35  purchasing alliance stop-loss fund increases the availability of 
 86.36  employer-subsidized health care coverage for residents residing 
 87.1   in the geographic areas served by the qualifying purchasing 
 87.2   alliances.  A preliminary report must be submitted to the 
 87.3   legislature by February 15, 2003, and a final report must be 
 87.4   submitted by February 15, 2004.  
 87.5      Subd. 9.  [SUNSET.] This section shall expire January 1, 
 87.6   2005. 
 87.7      Sec. 4.  [256.958] [RETIRED DENTIST PROGRAM.] 
 87.8      Subdivision 1.  [PROGRAM.] The commissioner of human 
 87.9   services shall establish a program to reimburse a retired 
 87.10  dentist for the dentist's license fee and for the cost of 
 87.11  malpractice insurance in exchange for the dentist providing 100 
 87.12  hours of dental services on a volunteer basis within a 12-month 
 87.13  period at a community dental clinic or a dental training clinic 
 87.14  located at a Minnesota state college or university.  
 87.15     Subd. 2.  [DOCUMENTATION.] Upon completion of the required 
 87.16  hours, the retired dentist shall submit to the commissioner the 
 87.17  following: 
 87.18     (1) documentation of service provided; 
 87.19     (2) the cost of malpractice insurance for the 12-month 
 87.20  period; and 
 87.21     (3) the cost of the license.  
 87.22     Subd. 3.  [REIMBURSEMENT.] Upon receipt of the information 
 87.23  described in subdivision 2, the commissioner shall provide 
 87.24  reimbursement to the retired dentist for the cost of malpractice 
 87.25  insurance for the previous 12-month period and the cost of the 
 87.26  license. 
 87.27     Sec. 5.  Minnesota Statutes 2000, section 256.9657, 
 87.28  subdivision 2, is amended to read: 
 87.29     Subd. 2.  [HOSPITAL SURCHARGE.] (a) Effective October 1, 
 87.30  1992, each Minnesota hospital except facilities of the federal 
 87.31  Indian Health Service and regional treatment centers shall pay 
 87.32  to the medical assistance account a surcharge equal to 1.4 
 87.33  percent of net patient revenues excluding net Medicare revenues 
 87.34  reported by that provider to the health care cost information 
 87.35  system according to the schedule in subdivision 4.  
 87.36     (b) Effective July 1, 1994, the surcharge under paragraph 
 88.1   (a) is increased to 1.56 percent. 
 88.2      (c) Notwithstanding the Medicare cost finding and allowable 
 88.3   cost principles, the hospital surcharge is not an allowable cost 
 88.4   for purposes of rate setting under sections 256.9685 to 256.9695.
 88.5      Sec. 6.  Minnesota Statutes 2000, section 256.969, 
 88.6   subdivision 2b, is amended to read: 
 88.7      Subd. 2b.  [OPERATING PAYMENT RATES.] In determining 
 88.8   operating payment rates for admissions occurring on or after the 
 88.9   rate year beginning January 1, 1991, and every two years after, 
 88.10  or more frequently as determined by the commissioner, the 
 88.11  commissioner shall obtain operating data from an updated base 
 88.12  year and, within the limits of available appropriations, 
 88.13  establish operating payment rates per admission for each 
 88.14  hospital based on the cost-finding methods and allowable costs 
 88.15  of the Medicare program in effect during the base year.  Rates 
 88.16  under the general assistance medical care, medical assistance, 
 88.17  and MinnesotaCare programs shall not be rebased to more current 
 88.18  data on January 1, 1997.  The base year operating payment rate 
 88.19  per admission is standardized by the case mix index and adjusted 
 88.20  by the hospital cost index, relative values, and 
 88.21  disproportionate population adjustment.  The cost and charge 
 88.22  data used to establish operating rates shall only reflect 
 88.23  inpatient services covered by medical assistance and shall not 
 88.24  include property cost information and costs recognized in 
 88.25  outlier payments. 
 88.26     Sec. 7.  Minnesota Statutes 2000, section 256.969, is 
 88.27  amended by adding a subdivision to read: 
 88.28     Subd. 26.  [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE 
 88.29  30, 2001.] (a) For admissions occurring after June 30, 2001, the 
 88.30  commissioner shall pay all medical assistance inpatient 
 88.31  fee-for-service admissions for the diagnosis-related groups 
 88.32  specified in paragraph (b) at hospitals located outside of the 
 88.33  seven-county metropolitan area at the higher of:  
 88.34     (1) the hospital's current payment rate for the diagnostic 
 88.35  category to which the diagnosis-related group belongs, exclusive 
 88.36  of disproportionate population adjustments received under 
 89.1   subdivision 9 and hospital payment adjustments received under 
 89.2   subdivision 23; or 
 89.3      (2) the rate in clause (1) plus a proportion of the 
 89.4   difference between the current average payment rate for that 
 89.5   diagnostic category for hospitals located within the 
 89.6   seven-county metropolitan area, exclusive of disproportionate 
 89.7   population adjustments received under subdivision 9 and hospital 
 89.8   payment adjustments received under subdivision 23, and the 
 89.9   current rate in clause (1).  This proportion shall be 12.5 
 89.10  percent for the fiscal year beginning July 1, 2001, and shall 
 89.11  increase by 12.5 percentage points for each of the next seven 
 89.12  fiscal years, such that the proportion is 100 percent for the 
 89.13  fiscal year beginning July 1, 2008. 
 89.14     (b) The reimbursement increases provided in paragraph (a) 
 89.15  apply to the following diagnosis-related groups as they fall 
 89.16  within the diagnostic categories: 
 89.17     (1) 370 C-section with complicating diagnosis; 
 89.18     (2) 371 C-section without complicating diagnosis; 
 89.19     (3) 372 vaginal delivery with complicating diagnosis; 
 89.20     (4) 373 vaginal delivery without complicating diagnosis; 
 89.21     (5) 386 extreme immaturity, weight greater than 1,500 
 89.22  grams; 
 89.23     (6) 388 full-term neonates with other problems; 
 89.24     (7) 390 prematurity without major problems; 
 89.25     (8) 391 normal newborn case; 
 89.26     (9) 385 neonate, died or transferred to another health care 
 89.27  facility; 
 89.28     (10) 425 acute adjustment reaction and psychosocial 
 89.29  dysfunctioning; 
 89.30     (11) 430 psychosis; 
 89.31     (12) 431 childhood mental disorders; and 
 89.32     (13) 164-167 appendectomy. 
 89.33     Sec. 8.  Minnesota Statutes 2000, section 256B.04, is 
 89.34  amended by adding a subdivision to read: 
 89.35     Subd. 1b.  [CONTRACT FOR SERVICES FOR AMERICAN INDIAN 
 89.36  CHILDREN.] Notwithstanding subdivision 1, the commissioner may 
 90.1   contract with federally recognized Indian tribes with a 
 90.2   reservation in Minnesota for the provision of early and periodic 
 90.3   screening, diagnosis, and treatment administrative services for 
 90.4   American Indian children, according to Code of Federal 
 90.5   Regulations, title 42, section 441, subpart B, and Minnesota 
 90.6   Rules, part 9505.1693 et seq., when the tribe chooses to provide 
 90.7   such services.  For purposes of this subdivision, "American 
 90.8   Indian" has the meaning given to persons to whom services will 
 90.9   be provided for in Code of Federal Regulations, title 42, 
 90.10  section 36.12.  Notwithstanding Minnesota Rules, part 9505.1748, 
 90.11  subpart 1, the commissioner, the local agency, and the tribe may 
 90.12  contract with any entity for the provision of early and periodic 
 90.13  screening, diagnosis, and treatment administrative services. 
 90.14     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
 90.15  following final enactment. 
 90.16     Sec. 9.  Minnesota Statutes 2000, section 256B.055, 
 90.17  subdivision 3a, is amended to read: 
 90.18     Subd. 3a.  [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR 
 90.19  AFDC RULES.] (a) Beginning January 1, 1998, or on the date that 
 90.20  MFIP-S is implemented in counties, medical assistance may be 
 90.21  paid for a person receiving public assistance under the MFIP-S 
 90.22  program.  Beginning July 1, 2002, medical assistance may be paid 
 90.23  for a person who would have been eligible, but for excess income 
 90.24  or assets, under the state's AFDC plan in effect as of July 16, 
 90.25  1996, with the base AFDC standard increased by three percent 
 90.26  effective July 1, 2000.  
 90.27     (b) Beginning January 1, 1998, July 1, 2002, medical 
 90.28  assistance may be paid for a person who would have been eligible 
 90.29  for public assistance under the income and resource assets 
 90.30  standards, or who would have been eligible but for excess income 
 90.31  or assets, under the state's AFDC plan in effect as of July 16, 
 90.32  1996, as required by the Personal Responsibility and Work 
 90.33  Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 
 90.34  Number 104-193 with the base AFDC rate increased by three 
 90.35  percent effective July 1, 2000.  
 90.36     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
 91.1      Sec. 10.  Minnesota Statutes 2000, section 256B.056, 
 91.2   subdivision 1a, is amended to read: 
 91.3      Subd. 1a.  [INCOME AND ASSETS GENERALLY.] Unless 
 91.4   specifically required by state law or rule or federal law or 
 91.5   regulation, the methodologies used in counting income and assets 
 91.6   to determine eligibility for medical assistance for persons 
 91.7   whose eligibility category is based on blindness, disability, or 
 91.8   age of 65 or more years, the methodologies for the supplemental 
 91.9   security income program shall be used.  Effective upon federal 
 91.10  approval, for children eligible under section 256B.055, 
 91.11  subdivision 12, or for home and community-based waiver services 
 91.12  whose eligibility for medical assistance is determined without 
 91.13  regard to parental income, child support payments, including any 
 91.14  payments made by an obligor in satisfaction of or in addition to 
 91.15  a temporary or permanent order for child support, social 
 91.16  security payments, and other benefits for basic needs are not 
 91.17  counted as income.  For families and children, which includes 
 91.18  all other eligibility categories, the methodologies under the 
 91.19  state's AFDC plan in effect as of July 16, 1996, as required by 
 91.20  the Personal Responsibility and Work Opportunity Reconciliation 
 91.21  Act of 1996 (PRWORA), Public Law Number 104-193, shall be used.  
 91.22  Effective upon federal approval, in-kind contributions to, and 
 91.23  payments made on behalf of, a recipient, by an obligor, in 
 91.24  satisfaction of or in addition to a temporary or permanent order 
 91.25  for child support or maintenance, shall be considered income to 
 91.26  the recipient.  For these purposes, a "methodology" does not 
 91.27  include an asset or income standard, or accounting method, or 
 91.28  method of determining effective dates. 
 91.29     Sec. 11.  Minnesota Statutes 2000, section 256B.056, 
 91.30  subdivision 3, is amended to read: 
 91.31     Subd. 3.  [ASSET LIMITATIONS.] To be eligible for medical 
 91.32  assistance, a person must not individually own more than $3,000 
 91.33  in assets, or if a member of a household with two family 
 91.34  members, husband and wife, or parent and child, the household 
 91.35  must not own more than $6,000 in assets, plus $200 for each 
 91.36  additional legal dependent.  In addition to these maximum 
 92.1   amounts, an eligible individual or family may accrue interest on 
 92.2   these amounts, but they must be reduced to the maximum at the 
 92.3   time of an eligibility redetermination.  The accumulation of the 
 92.4   clothing and personal needs allowance according to section 
 92.5   256B.35 must also be reduced to the maximum at the time of the 
 92.6   eligibility redetermination.  The value of assets that are not 
 92.7   considered in determining eligibility for medical assistance is 
 92.8   the value of those assets excluded under the AFDC state plan as 
 92.9   of July 16, 1996, as required by the Personal Responsibility and 
 92.10  Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 
 92.11  Number 104-193, for families and children, and the supplemental 
 92.12  security income program for aged, blind, and disabled persons, 
 92.13  with the following exceptions: 
 92.14     (a) Household goods and personal effects are not considered.
 92.15     (b) Capital and operating assets of a trade or business 
 92.16  that the local agency determines are necessary to the person's 
 92.17  ability to earn an income are not considered. 
 92.18     (c) Motor vehicles are excluded to the same extent excluded 
 92.19  by the supplemental security income program. 
 92.20     (d) Assets designated as burial expenses are excluded to 
 92.21  the same extent excluded by the supplemental security income 
 92.22  program. 
 92.23     (e) Effective upon federal approval, for a person who no 
 92.24  longer qualifies as an employed person with a disability due to 
 92.25  loss of earnings, assets allowed while eligible for medical 
 92.26  assistance under section 256B.057, subdivision 9, are not 
 92.27  considered for 12 months, beginning with the first month of 
 92.28  ineligibility as an employed person with a disability, to the 
 92.29  extent that the person's total assets remain within the allowed 
 92.30  limits of section 256B.057, subdivision 9, paragraph (b). 
 92.31     Sec. 12.  Minnesota Statutes 2000, section 256B.056, 
 92.32  subdivision 4, is amended to read: 
 92.33     Subd. 4.  [INCOME.] (a) To be eligible for medical 
 92.34  assistance, a person eligible under section 256B.055, 
 92.35  subdivision subdivisions 7, 7a, and 12, not receiving 
 92.36  supplemental security income program payments, and may have 
 93.1   income up to the following specified percentages of the federal 
 93.2   poverty guidelines for the family size effective on April 1 of 
 93.3   each year: 
 93.4      (1) 80 percent, effective July 1, 2002; 
 93.5      (2) 90 percent, effective July 1, 2003; 
 93.6      (3) 100 percent, effective July 1, 2004. 
 93.7   Increases in benefits under title II of the Social Security Act 
 93.8   shall not be counted as income for purposes of this subdivision 
 93.9   until the first day of the second full month following 
 93.10  publication of the change in the federal poverty guidelines. 
 93.11     (b) To be eligible for medical assistance, families and 
 93.12  children may have an income up to 133-1/3 percent of the AFDC 
 93.13  income standard in effect under the July 16, 1996, AFDC state 
 93.14  plan.  Effective July 1, 2000, the base AFDC standard in effect 
 93.15  on July 16, 1996, shall be increased by three percent. Effective 
 93.16  January 1, 2000, and each successive January, recipients of 
 93.17  supplemental security income may have an income up to the 
 93.18  supplemental security income standard in effect on that date. 
 93.19     (c) Effective July 1, 2002, to be eligible for medical 
 93.20  assistance, families and children may have an income up to 100 
 93.21  percent of the federal poverty guidelines for the family size 
 93.22  effective on April 1 of each year. 
 93.23     (d) In computing income to determine eligibility of persons 
 93.24  under paragraphs (a) to (c) who are not residents of long-term 
 93.25  care facilities, the commissioner shall disregard increases in 
 93.26  income as required by Public Law Numbers 94-566, section 503; 
 93.27  99-272; and 99-509.  Veterans aid and attendance benefits and 
 93.28  Veterans Administration unusual medical expense payments are 
 93.29  considered income to the recipient. 
 93.30     Sec. 13.  Minnesota Statutes 2000, section 256B.056, 
 93.31  subdivision 5, is amended to read: 
 93.32     Subd. 5.  [EXCESS INCOME.] A person who has excess income 
 93.33  is eligible for medical assistance if the person has expenses 
 93.34  for medical care that are more than the amount of the person's 
 93.35  excess income, computed by deducting incurred medical expenses 
 93.36  from the excess income to reduce the excess to the income 
 94.1   standard specified in subdivision 4, except that if federal 
 94.2   authorization to use the standard in subdivision 4 is not 
 94.3   obtained, the medically needy standard for purposes of a 
 94.4   spenddown shall be 133 and 1/3 percent of the AFDC income 
 94.5   standard in effect under the July 16, 1996, AFDC state plan, 
 94.6   increased by three percent.  The person shall elect to have the 
 94.7   medical expenses deducted at the beginning of a one-month budget 
 94.8   period or at the beginning of a six-month budget period.  The 
 94.9   commissioner shall allow persons eligible for assistance on a 
 94.10  one-month spenddown basis under this subdivision to elect to pay 
 94.11  the monthly spenddown amount in advance of the month of 
 94.12  eligibility to the state agency in order to maintain eligibility 
 94.13  on a continuous basis.  If the recipient does not pay the 
 94.14  spenddown amount on or before the 20th of the month, the 
 94.15  recipient is ineligible for this option for the following 
 94.16  month.  The local agency shall code the Medicaid Management 
 94.17  Information System (MMIS) to indicate that the recipient has 
 94.18  elected this option.  The state agency shall convey recipient 
 94.19  eligibility information relative to the collection of the 
 94.20  spenddown to providers through the Electronic Verification 
 94.21  System (EVS).  A recipient electing advance payment must pay the 
 94.22  state agency the monthly spenddown amount on or before the 20th 
 94.23  of the month in order to be eligible for this option in the 
 94.24  following month.  
 94.25     Sec. 14.  Minnesota Statutes 2000, section 256B.057, 
 94.26  subdivision 9, is amended to read: 
 94.27     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
 94.28  assistance may be paid for a person who is employed and who: 
 94.29     (1) meets the definition of disabled under the supplemental 
 94.30  security income program; 
 94.31     (2) is at least 16 but less than 65 years of age; 
 94.32     (3) meets the asset limits in paragraph (b); and 
 94.33     (4) pays a premium, if required, under paragraph (c).  
 94.34  Any spousal income or assets shall be disregarded for purposes 
 94.35  of eligibility and premium determinations. 
 94.36     (b) For purposes of determining eligibility under this 
 95.1   subdivision, a person's assets must not exceed $20,000, 
 95.2   excluding: 
 95.3      (1) all assets excluded under section 256B.056; 
 95.4      (2) retirement accounts, including individual accounts, 
 95.5   401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 
 95.6      (3) medical expense accounts set up through the person's 
 95.7   employer. 
 95.8      (c) A person whose earned and unearned income is equal to 
 95.9   or greater than 200 100 percent of federal poverty guidelines 
 95.10  for the applicable family size must pay a premium to be eligible 
 95.11  for medical assistance under this subdivision.  The premium 
 95.12  shall be equal to ten percent of based on the person's gross 
 95.13  earned and unearned income above 200 percent of federal poverty 
 95.14  guidelines for and the applicable family size up to the cost of 
 95.15  coverage, using a sliding fee scale established by the 
 95.16  commissioner which begins at one percent of income at 100 
 95.17  percent of the federal poverty guidelines and gradually 
 95.18  increases to 7.5 percent of income for those with incomes at or 
 95.19  above 300 percent of the federal poverty guidelines. 
 95.20     (d) A person's eligibility and premium shall be determined 
 95.21  by the local county agency.  Premiums must be paid to the 
 95.22  commissioner.  All premiums are dedicated to the commissioner. 
 95.23     (e) Any required premium shall be determined at application 
 95.24  and redetermined annually at recertification or when a change in 
 95.25  income or family size occurs. 
 95.26     (f) Premium payment is due upon notification from the 
 95.27  commissioner of the premium amount required.  Premiums may be 
 95.28  paid in installments at the discretion of the commissioner. 
 95.29     (g) Nonpayment of the premium shall result in denial or 
 95.30  termination of medical assistance unless the person demonstrates 
 95.31  good cause for nonpayment.  Good cause exists if the 
 95.32  requirements specified in Minnesota Rules, part 9506.0040, 
 95.33  subpart 7, items B to D, are met.  Nonpayment shall include 
 95.34  payment with a returned, refused, or dishonored instrument.  The 
 95.35  commissioner may require a guaranteed form of payment as the 
 95.36  only means to replace a returned, refused, or dishonored 
 96.1   instrument. 
 96.2      <h>[EFFECTIVE DATE.]</h> This section is effective September 1, 
 96.3   2001. 
 96.4      Sec. 15.  Minnesota Statutes 2000, section 256B.057, is 
 96.5   amended by adding a subdivision to read: 
 96.6      Subd. 10.  [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 
 96.7   CERVICAL CANCER.] (a) Medical assistance may be paid for a 
 96.8   person who: 
 96.9      (1) has been screened for breast or cervical cancer by the 
 96.10  Minnesota breast and cervical cancer control program, and 
 96.11  program funds have been used to pay for the person's screening; 
 96.12     (2) according to the person's treating health professional, 
 96.13  needs treatment, including diagnostic services necessary to 
 96.14  determine the extent and proper course of treatment, for breast 
 96.15  or cervical cancer, including precancerous conditions and early 
 96.16  stage cancer; 
 96.17     (3) meets the income eligibility guidelines for the 
 96.18  Minnesota breast and cervical cancer control program; 
 96.19     (4) is under age 65; 
 96.20     (5) is not otherwise eligible for medical assistance under 
 96.21  United States Code, title 42, section 1396(a)(10)(A)(i); and 
 96.22     (6) is not otherwise covered under creditable coverage, as 
 96.23  defined under United States Code, title 42, section 300gg(c). 
 96.24     (b) Medical assistance provided for an eligible person 
 96.25  under this subdivision shall be limited to services provided 
 96.26  during the period that the person receives treatment for breast 
 96.27  or cervical cancer. 
 96.28     (c) A person meeting the criteria in paragraph (a) is 
 96.29  eligible for medical assistance without meeting the eligibility 
 96.30  criteria relating to income and assets in section 256B.056, 
 96.31  subdivisions 1a to 5b. 
 96.32     Sec. 16.  Minnesota Statutes 2000, section 256B.0625, 
 96.33  subdivision 3b, is amended to read: 
 96.34     Subd. 3b.  [TELEMEDICINE CONSULTATIONS.] (a) Medical 
 96.35  assistance covers telemedicine consultations.  Telemedicine 
 96.36  consultations must be made via two-way, interactive video or 
 97.1   store-and-forward technology.  Store-and-forward technology 
 97.2   includes telemedicine consultations that do not occur in real 
 97.3   time via synchronous transmissions, and that do not require a 
 97.4   face-to-face encounter with the patient for all or any part of 
 97.5   any such telemedicine consultation.  The patient record must 
 97.6   include a written opinion from the consulting physician 
 97.7   providing the telemedicine consultation.  A communication 
 97.8   between two physicians that consists solely of a telephone 
 97.9   conversation is not a telemedicine consultation.  Coverage is 
 97.10  limited to three telemedicine consultations per recipient per 
 97.11  calendar week.  Telemedicine consultations shall be paid at the 
 97.12  full allowable rate. 
 97.13     (b) This subdivision expires July 1, 2001.  
 97.14     Sec. 17.  Minnesota Statutes 2000, section 256B.0625, is 
 97.15  amended by adding a subdivision to read: 
 97.16     Subd. 5a.  [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 
 97.17  SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a) 
 97.18  [COVERAGE.] Medical assistance covers home-based intensive early 
 97.19  intervention behavior therapy for children with autism spectrum 
 97.20  disorders.  Children with autism spectrum disorder, and their 
 97.21  custodial parents or foster parents, may access other covered 
 97.22  services to treat autism spectrum disorder, and are not required 
 97.23  to receive intensive early intervention behavior therapy 
 97.24  services under this subdivision.  Intensive early intervention 
 97.25  behavior therapy does not include coverage for services to treat 
 97.26  developmental disorders of language, early onset psychosis, 
 97.27  Rett's disorder, selective mutism, social anxiety disorder, 
 97.28  stereotypic movement disorder, dementia, obsessive compulsive 
 97.29  disorder, schizoid personality disorder, avoidant personality 
 97.30  disorder, or reactive attachment disorder.  If a child with 
 97.31  autism spectrum disorder is diagnosed to have one or more of 
 97.32  these conditions, intensive early intervention behavior therapy 
 97.33  includes coverage only for services necessary to treat the 
 97.34  autism spectrum disorder. 
 97.35     (b) [PURPOSE OF INTENSIVE EARLY INTERVENTION BEHAVIOR 
 97.36  THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to improve 
 98.1   the child's behavioral functioning, to prevent development of 
 98.2   challenging behaviors, to eliminate autistic behaviors, to 
 98.3   reduce the risk of out-of-home placement, and to establish 
 98.4   independent typical functioning in language and social 
 98.5   behavior.  The procedures used to accomplish these goals are 
 98.6   based upon research in applied behavior analysis. 
 98.7      (c) [ELIGIBLE CHILDREN.] A child is eligible to initiate 
 98.8   IEIBTS if, the child meets the additional eligibility criteria 
 98.9   in paragraph (d) and in a diagnostic assessment by a mental 
 98.10  health professional who is not under the employ of the service 
 98.11  provider, the child: 
 98.12     (1) is found to have an autism spectrum disorder; 
 98.13     (2) has a current IQ of either untestable, or at least 30; 
 98.14     (3) if nonverbal, initiated behavior therapy by 42 months 
 98.15  of age; 
 98.16     (4) if verbal, initiated behavior therapy by 48 months of 
 98.17  age; or 
 98.18     (5) if having an IQ of at least 50, initiated behavior 
 98.19  therapy by 84 months of age. 
 98.20  To continue in IEIBTS, at least one of the child's custodial 
 98.21  parents or foster parents must participate in an average of at 
 98.22  least five hours of documented behavior therapy per week for six 
 98.23  months, and consistently implement behavior therapy 
 98.24  recommendations 24 hours a day.  To continue after six-month 
 98.25  individualized treatment plan (ITP) reviews, the child must show 
 98.26  documented progress toward mastery of six-month benchmark 
 98.27  behavior objectives.  The maximum number of months during which 
 98.28  services may be billed is 54.  If significant progress towards 
 98.29  treatment goals has not been achieved after 24 months of 
 98.30  treatment, treatment must be discontinued. 
 98.31     (d) [ADDITIONAL ELIGIBILITY CRITERIA.] A child is eligible 
 98.32  to initiate IEIBTS if: 
 98.33     (1) in medical and diagnostic assessments by medical and 
 98.34  mental health professionals, it is determined that the child 
 98.35  does not have severe or profound mental retardation; 
 98.36     (2) an accurate assessment of the child's hearing has been 
 99.1   performed, including audiometry if the brain stem auditory 
 99.2   evokes response; 
 99.3      (3) a blood lead test has been performed prior to 
 99.4   initiation of treatment; and 
 99.5      (4) an EEG or neurologic evaluation is done, prior to 
 99.6   initiation of treatment, if the child has a history of staring 
 99.7   spells or developmental regression.  
 99.8      (e) [COVERED SERVICES.] The focus of IEIBTS must be to 
 99.9   treat the principal diagnostic features of the autism spectrum 
 99.10  disorder.  All IEIBTS must be delivered by a team of 
 99.11  practitioners under the consistent supervision of a single 
 99.12  clinical supervisor.  A mental health professional must develop 
 99.13  the ITP for IEIBTS.  The ITP must include six-month benchmark 
 99.14  behavior objectives.  All behavior therapy must be based upon 
 99.15  research in applied behavior analysis, with an emphasis upon 
 99.16  positive reinforcement of carefully task-analyzed skills for 
 99.17  optimum rates of progress.  All behavior therapy must be 
 99.18  consistently applied and generalized throughout the 24-hour day 
 99.19  and seven-day week by all of the child's regular care 
 99.20  providers.  When placing the child in school activities, a 
 99.21  majority of the peers must have no mental health diagnosis, and 
 99.22  the child must have sufficient social skills to succeed with 80 
 99.23  percent of the school activities.  Reactive consequences, such 
 99.24  as redirection, correction, positive practice, or time-out, must 
 99.25  be used only when necessary to improve the child's success when 
 99.26  proactive procedures alone have not been effective.  IEIBTS must 
 99.27  be delivered by a team of behavior therapy practitioners who are 
 99.28  employed under the direction of the same agency.  The team may 
 99.29  deliver up to 200 billable hours per year of direct clinical 
 99.30  supervisor services, up to 750 billable hours per year of senior 
 99.31  behavior therapist services, and up to 1,800 billable hours per 
 99.32  year of direct behavior therapist services.  A one-hour clinical 
 99.33  review meeting for the child, parents, and staff must be 
 99.34  scheduled 50 weeks a year, at which behavior therapy is reviewed 
 99.35  and planned.  At least one-quarter of the annual clinical 
 99.36  supervisor billable hours shall consist of on-site clinical 
100.1   meeting time.  At least one-half of the annual senior behavior 
100.2   therapist billable hours shall consist of direct services to the 
100.3   child or parents.  All of the behavioral therapist billable 
100.4   hours shall consist of direct on-site services to the child or 
100.5   parents.  None of the senior behavior therapist billable hours 
100.6   or behavior therapist billable hours shall consist of clinical 
100.7   meeting time.  If there is any regression of the autistic 
100.8   spectrum disorder after 12 months of therapy, a neurologic 
100.9   consultation must be performed. 
100.10     (f) [PROVIDER QUALIFICATIONS.] The provider agency must be 
100.11  capable of delivering consistent applied behavior analysis 
100.12  (ABA)-based behavior therapy in the home.  The site director of 
100.13  the agency must be a mental health professional certified as a 
100.14  behavior analyst by the Association for Behavior Analysis.  Each 
100.15  clinical supervisor must be certified as a behavior analyst by 
100.16  the Association for Behavior Analysis. 
100.17     (g) [SUPERVISION REQUIREMENTS.] (1) Each behavior therapist 
100.18  practitioner must be continuously supervised while in the home 
100.19  until the practitioner has mastered competencies for independent 
100.20  practice.  Each behavior therapist must have mastered three 
100.21  credits of academic content and practice in an ABA sequence at 
100.22  an accredited university.  A college degree or minimum hours of 
100.23  experience are not required.  Each behavior therapist must 
100.24  continue training through weekly direct observation by the 
100.25  senior behavior therapist, through demonstrated performance in 
100.26  clinical meetings with the clinical supervisor, and annual 
100.27  training in ABA. 
100.28     (2) Each senior behavior therapist practitioner must have 
100.29  mastered the senior behavior therapy competencies, completed one 
100.30  year of practice as a behavior therapist, and six months of 
100.31  co-therapy training with another senior behavior therapist or 
100.32  have an equivalent amount of experience in ABA.  Each senior 
100.33  behavior therapist must have mastered 12 credits of academic 
100.34  content and practice in an ABA sequence at an accredited 
100.35  university.  Each senior behavior therapist must continue 
100.36  training through demonstrated performance in clinical meetings 
101.1   with the clinical supervisor, and annual training in ABA. 
101.2      (3) Each clinical supervisor practitioner must have 
101.3   mastered the clinical supervisor and family consultation 
101.4   competencies, completed two years of practice as a senior 
101.5   behavior therapist and one year of co-therapy training with 
101.6   another clinical supervisor, or equivalent experience in ABA.  
101.7   Each clinical supervisor must continue training through annual 
101.8   training in ABA. 
101.9      (h) [PLACE OF SERVICE.] IEIBTS are provided primarily in 
101.10  the child's home and community.  Services may be provided in the 
101.11  child's natural school or preschool classroom, home of a 
101.12  relative, natural recreational setting, or day care. 
101.13     (i) [PRIOR AUTHORIZATION REQUIREMENTS.] Prior authorization 
101.14  shall be required for services provided after 200 hours of 
101.15  clinical supervisor, 750 hours of senior behavior therapist, or 
101.16  1,800 hours of behavior therapist services per year. 
101.17     (j) [PAYMENT RATES.] The following payment rates apply: 
101.18     (1) for an IEIBTS clinical supervisor practitioner under 
101.19  supervision of a mental health professional, the lower of the 
101.20  submitted charge or $137 per hour unit; 
101.21     (2) for an IEIBTS senior behavior therapist practitioner 
101.22  under supervision of a mental health professional, the lower of 
101.23  the submitted charge or $56 per hour unit; or 
101.24     (3) for an IEIBTS behavior therapist practitioner under 
101.25  supervision of a mental health professional, the lower of the 
101.26  submitted charge or $19 per hour unit. 
101.27  An IEIBTS practitioner may receive payment for travel time which 
101.28  exceeds 50 minutes one-way.  The maximum payment allowed will be 
101.29  $0.51 per minute for up to a maximum of 300 hours per year. 
101.30     For any week during which the above charges are made to 
101.31  medical assistance, payments for the following services are 
101.32  excluded:  supervising mental health professional hours and 
101.33  personal care attendant, home-based mental health, 
101.34  family-community support, or mental health behavioral aide hours.
101.35     (k) [REPORT.] The commissioner shall collect evidence of 
101.36  the effectiveness of intensive early intervention behavior 
102.1   therapy services and present a report to the legislature by July 
102.2   1, 2006. 
102.3      <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
102.4      Sec. 18.  Minnesota Statutes 2000, section 256B.0625, 
102.5   subdivision 13, is amended to read: 
102.6      Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
102.7   except for fertility drugs when specifically used to enhance 
102.8   fertility, if prescribed by a licensed practitioner and 
102.9   dispensed by a licensed pharmacist, by a physician enrolled in 
102.10  the medical assistance program as a dispensing physician, or by 
102.11  a physician or a nurse practitioner employed by or under 
102.12  contract with a community health board as defined in section 
102.13  145A.02, subdivision 5, for the purposes of communicable disease 
102.14  control.  The commissioner, after receiving recommendations from 
102.15  professional medical associations and professional pharmacist 
102.16  associations, shall designate a formulary committee to advise 
102.17  the commissioner on the names of drugs for which payment is 
102.18  made, recommend a system for reimbursing providers on a set fee 
102.19  or charge basis rather than the present system, and develop 
102.20  methods encouraging use of generic drugs when they are less 
102.21  expensive and equally effective as trademark drugs.  The 
102.22  formulary committee shall consist of nine members, four of whom 
102.23  shall be physicians who are not employed by the department of 
102.24  human services, and a majority of whose practice is for persons 
102.25  paying privately or through health insurance, three of whom 
102.26  shall be pharmacists who are not employed by the department of 
102.27  human services, and a majority of whose practice is for persons 
102.28  paying privately or through health insurance, a consumer 
102.29  representative, and a nursing home representative.  Committee 
102.30  members shall serve three-year terms and shall serve without 
102.31  compensation.  Members may be reappointed once.  
102.32     (b) The commissioner shall establish a drug formulary.  Its 
102.33  establishment and publication shall not be subject to the 
102.34  requirements of the Administrative Procedure Act, but the 
102.35  formulary committee shall review and comment on the formulary 
102.36  contents.  The formulary committee shall review and recommend 
103.1   drugs which require prior authorization.  The formulary 
103.2   committee may recommend drugs for prior authorization directly 
103.3   to the commissioner, as long as opportunity for public input is 
103.4   provided.  Prior authorization may be requested by the 
103.5   commissioner based on medical and clinical criteria before 
103.6   certain drugs are eligible for payment.  Before a drug may be 
103.7   considered for prior authorization at the request of the 
103.8   commissioner:  
103.9      (1) the drug formulary committee must develop criteria to 
103.10  be used for identifying drugs; the development of these criteria 
103.11  is not subject to the requirements of chapter 14, but the 
103.12  formulary committee shall provide opportunity for public input 
103.13  in developing criteria; 
103.14     (2) the drug formulary committee must hold a public forum 
103.15  and receive public comment for an additional 15 days; and 
103.16     (3) the commissioner must provide information to the 
103.17  formulary committee on the impact that placing the drug on prior 
103.18  authorization will have on the quality of patient care and 
103.19  information regarding whether the drug is subject to clinical 
103.20  abuse or misuse.  Prior authorization may be required by the 
103.21  commissioner before certain formulary drugs are eligible for 
103.22  payment.  The formulary shall not include:  
103.23     (i) drugs or products for which there is no federal 
103.24  funding; 
103.25     (ii) over-the-counter drugs, except for antacids, 
103.26  acetaminophen, family planning products, aspirin, insulin, 
103.27  products for the treatment of lice, vitamins for adults with 
103.28  documented vitamin deficiencies, vitamins for children under the 
103.29  age of seven and pregnant or nursing women, and any other 
103.30  over-the-counter drug identified by the commissioner, in 
103.31  consultation with the drug formulary committee, as necessary, 
103.32  appropriate, and cost-effective for the treatment of certain 
103.33  specified chronic diseases, conditions or disorders, and this 
103.34  determination shall not be subject to the requirements of 
103.35  chapter 14; 
103.36     (iii) anorectics, except that medically necessary 
104.1   anorectics shall be covered for a recipient previously diagnosed 
104.2   as having pickwickian syndrome and currently diagnosed as having 
104.3   diabetes and being morbidly obese; 
104.4      (iv) drugs for which medical value has not been 
104.5   established; and 
104.6      (v) drugs from manufacturers who have not signed a rebate 
104.7   agreement with the Department of Health and Human Services 
104.8   pursuant to section 1927 of title XIX of the Social Security Act.
104.9      The commissioner shall publish conditions for prohibiting 
104.10  payment for specific drugs after considering the formulary 
104.11  committee's recommendations.  An honorarium of $100 per meeting 
104.12  and reimbursement for mileage shall be paid to each committee 
104.13  member in attendance.  
104.14     (c) The basis for determining the amount of payment shall 
104.15  be the lower of the actual acquisition costs of the drugs plus a 
104.16  fixed dispensing fee; the maximum allowable cost set by the 
104.17  federal government or by the commissioner plus the fixed 
104.18  dispensing fee; or the usual and customary price charged to the 
104.19  public.  The pharmacy dispensing fee shall be $3.65, except that 
104.20  the dispensing fee for intravenous solutions which must be 
104.21  compounded by the pharmacist shall be $8 per bag, $14 per bag 
104.22  for cancer chemotherapy products, and $30 per bag for total 
104.23  parenteral nutritional products dispensed in one liter 
104.24  quantities, or $44 per bag for total parenteral nutritional 
104.25  products dispensed in quantities greater than one liter.  Actual 
104.26  acquisition cost includes quantity and other special discounts 
104.27  except time and cash discounts.  The actual acquisition cost of 
104.28  a drug shall be estimated by the commissioner, at average 
104.29  wholesale price minus nine percent, except that where a drug has 
104.30  had its wholesale price reduced as a result of the actions of 
104.31  the National Association of Medicaid Fraud Control Units, the 
104.32  estimated actual acquisition cost shall be the reduced average 
104.33  wholesale price, without the nine percent deduction.  The 
104.34  maximum allowable cost of a multisource drug may be set by the 
104.35  commissioner and it shall be comparable to, but no higher than, 
104.36  the maximum amount paid by other third-party payors in this 
105.1   state who have maximum allowable cost programs.  The 
105.2   commissioner shall set maximum allowable costs for multisource 
105.3   drugs that are not on the federal upper limit list as described 
105.4   in United States Code, title 42, chapter 7, section 1396r-8(e), 
105.5   the Social Security Act, and Code of Federal Regulations, title 
105.6   42, part 447, section 447.332.  Establishment of the amount of 
105.7   payment for drugs shall not be subject to the requirements of 
105.8   the Administrative Procedure Act.  An additional dispensing fee 
105.9   of $.30 may be added to the dispensing fee paid to pharmacists 
105.10  for legend drug prescriptions dispensed to residents of 
105.11  long-term care facilities when a unit dose blister card system, 
105.12  approved by the department, is used.  Under this type of 
105.13  dispensing system, the pharmacist must dispense a 30-day supply 
105.14  of drug.  The National Drug Code (NDC) from the drug container 
105.15  used to fill the blister card must be identified on the claim to 
105.16  the department.  The unit dose blister card containing the drug 
105.17  must meet the packaging standards set forth in Minnesota Rules, 
105.18  part 6800.2700, that govern the return of unused drugs to the 
105.19  pharmacy for reuse.  The pharmacy provider will be required to 
105.20  credit the department for the actual acquisition cost of all 
105.21  unused drugs that are eligible for reuse.  Over-the-counter 
105.22  medications must be dispensed in the manufacturer's unopened 
105.23  package.  The commissioner may permit the drug clozapine to be 
105.24  dispensed in a quantity that is less than a 30-day supply.  
105.25  Whenever a generically equivalent product is available, payment 
105.26  shall be on the basis of the actual acquisition cost of the 
105.27  generic drug, unless the prescriber specifically indicates 
105.28  "dispense as written - brand necessary" on the prescription as 
105.29  required by section 151.21, subdivision 2. 
105.30     (d) For purposes of this subdivision, "multisource drugs" 
105.31  means covered outpatient drugs, excluding innovator multisource 
105.32  drugs for which there are two or more drug products, which: 
105.33     (1) are related as therapeutically equivalent under the 
105.34  Food and Drug Administration's most recent publication of 
105.35  "Approved Drug Products with Therapeutic Equivalence 
105.36  Evaluations"; 
106.1      (2) are pharmaceutically equivalent and bioequivalent as 
106.2   determined by the Food and Drug Administration; and 
106.3      (3) are sold or marketed in Minnesota. 
106.4   "Innovator multisource drug" means a multisource drug that was 
106.5   originally marketed under an original new drug application 
106.6   approved by the Food and Drug Administration. 
106.7      (e) The basis for determining the amount of payment for 
106.8   drugs administered in an outpatient setting shall be the lower 
106.9   of the usual and customary cost submitted by the provider; the 
106.10  average wholesale price minus five percent; or the maximum 
106.11  allowable cost set by the federal government under United States 
106.12  Code, title 42, chapter 7, section 1396r-8(e) and Code of 
106.13  Federal Regulations, title 42, section 447.332, or by the 
106.14  commissioner under paragraph (c). 
106.15     Sec. 19.  Minnesota Statutes 2000, section 256B.0625, 
106.16  subdivision 13a, is amended to read: 
106.17     Subd. 13a.  [DRUG UTILIZATION REVIEW BOARD.] A nine-member 
106.18  drug utilization review board is established.  The board is 
106.19  comprised of at least three but no more than four licensed 
106.20  physicians actively engaged in the practice of medicine in 
106.21  Minnesota; at least three licensed pharmacists actively engaged 
106.22  in the practice of pharmacy in Minnesota; and one consumer 
106.23  representative; the remainder to be made up of health care 
106.24  professionals who are licensed in their field and have 
106.25  recognized knowledge in the clinically appropriate prescribing, 
106.26  dispensing, and monitoring of covered outpatient drugs.  The 
106.27  board shall be staffed by an employee of the department who 
106.28  shall serve as an ex officio nonvoting member of the board.  The 
106.29  members of the board shall be appointed by the commissioner and 
106.30  shall serve three-year terms.  The members shall be selected 
106.31  from lists submitted by professional associations.  The 
106.32  commissioner shall appoint the initial members of the board for 
106.33  terms expiring as follows:  three members for terms expiring 
106.34  June 30, 1996; three members for terms expiring June 30, 1997; 
106.35  and three members for terms expiring June 30, 1998.  Members may 
106.36  be reappointed once.  The board shall annually elect a chair 
107.1   from among the members. 
107.2      The commissioner shall, with the advice of the board: 
107.3      (1) implement a medical assistance retrospective and 
107.4   prospective drug utilization review program as required by 
107.5   United States Code, title 42, section 1396r-8(g)(3); 
107.6      (2) develop and implement the predetermined criteria and 
107.7   practice parameters for appropriate prescribing to be used in 
107.8   retrospective and prospective drug utilization review; 
107.9      (3) develop, select, implement, and assess interventions 
107.10  for physicians, pharmacists, and patients that are educational 
107.11  and not punitive in nature; 
107.12     (4) establish a grievance and appeals process for 
107.13  physicians and pharmacists under this section; 
107.14     (5) publish and disseminate educational information to 
107.15  physicians and pharmacists regarding the board and the review 
107.16  program; 
107.17     (6) adopt and implement procedures designed to ensure the 
107.18  confidentiality of any information collected, stored, retrieved, 
107.19  assessed, or analyzed by the board, staff to the board, or 
107.20  contractors to the review program that identifies individual 
107.21  physicians, pharmacists, or recipients; 
107.22     (7) establish and implement an ongoing process to (i) 
107.23  receive public comment regarding drug utilization review 
107.24  criteria and standards, and (ii) consider the comments along 
107.25  with other scientific and clinical information in order to 
107.26  revise criteria and standards on a timely basis; and 
107.27     (8) adopt any rules necessary to carry out this section. 
107.28     The board may establish advisory committees.  The 
107.29  commissioner may contract with appropriate organizations to 
107.30  assist the board in carrying out the board's duties.  The 
107.31  commissioner may enter into contracts for services to develop 
107.32  and implement a retrospective and prospective review program. 
107.33     The board shall report to the commissioner annually on the 
107.34  date the Drug Utilization Review Annual Report is due to the 
107.35  Health Care Financing Administration.  This report is to cover 
107.36  the preceding federal fiscal year.  The commissioner shall make 
108.1   the report available to the public upon request.  The report 
108.2   must include information on the activities of the board and the 
108.3   program; the effectiveness of implemented interventions; 
108.4   administrative costs; and any fiscal impact resulting from the 
108.5   program.  An honorarium of $50 $100 per meeting and 
108.6   reimbursement for mileage shall be paid to each board member in 
108.7   attendance. 
108.8      Sec. 20.  Minnesota Statutes 2000, section 256B.0625, 
108.9   subdivision 17, is amended to read: 
108.10     Subd. 17.  [TRANSPORTATION COSTS.] (a) Medical assistance 
108.11  covers transportation costs incurred solely for obtaining 
108.12  emergency medical care or transportation costs incurred by 
108.13  nonambulatory persons in obtaining emergency or nonemergency 
108.14  medical care when paid directly to an ambulance company, common 
108.15  carrier, or other recognized providers of transportation 
108.16  services.  For the purpose of this subdivision, a person who is 
108.17  incapable of transport by taxicab or bus shall be considered to 
108.18  be nonambulatory. 
108.19     (b) Medical assistance covers special transportation, as 
108.20  defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 
108.21  if the provider receives and maintains a current physician's 
108.22  order by the recipient's attending physician certifying that the 
108.23  recipient has a physical or mental impairment that would 
108.24  prohibit the recipient from safely accessing and using a bus, 
108.25  taxi, other commercial transportation, or private automobile.  
108.26  Special transportation includes driver-assisted service to 
108.27  eligible individuals.  Driver-assisted service includes 
108.28  passenger pickup at and return to the individual's residence or 
108.29  place of business, assistance with admittance of the individual 
108.30  to the medical facility, and assistance in passenger securement 
108.31  or in securing of wheelchairs or stretchers in the vehicle.  The 
108.32  commissioner shall establish maximum medical assistance 
108.33  reimbursement rates for special transportation services for 
108.34  persons who need a wheelchair lift accessible van or 
108.35  stretcher-equipped vehicle and for those who do not need a 
108.36  wheelchair lift accessible van or stretcher-equipped vehicle.  
109.1   The average of these two rates per trip must not exceed $15 for 
109.2   the base rate and $1.20 $1.50 per mile.  Special transportation 
109.3   provided to nonambulatory ambulatory persons who do not need a 
109.4   wheelchair lift van or stretcher-equipped vehicle, may be 
109.5   reimbursed at a lower rate than special transportation provided 
109.6   to persons who need a wheelchair lift van or stretcher-equipped 
109.7   vehicle. 
109.8      Sec. 21.  Minnesota Statutes 2000, section 256B.0625, 
109.9   subdivision 17a, is amended to read: 
109.10     Subd. 17a.  [PAYMENT FOR AMBULANCE SERVICES.] Effective for 
109.11  services rendered on or after July 1, 1999 2001, medical 
109.12  assistance payments for ambulance services shall be increased by 
109.13  five percent paid at the greater of:  (1) the medical assistance 
109.14  reimbursement rate in effect on June 30, 2000; or (2) the 
109.15  current Medicare reimbursement rate for ambulance services. 
109.16     Sec. 22.  Minnesota Statutes 2000, section 256B.0625, 
109.17  subdivision 18a, is amended to read: 
109.18     Subd. 18a.  [PAYMENT FOR MEALS AND LODGING ACCESS TO 
109.19  MEDICAL SERVICES.] (a) Medical assistance reimbursement for 
109.20  meals for persons traveling to receive medical care may not 
109.21  exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner. 
109.22     (b) Medical assistance reimbursement for lodging for 
109.23  persons traveling to receive medical care may not exceed $50 per 
109.24  day unless prior authorized by the local agency. 
109.25     (c) Medical assistance direct mileage reimbursement to the 
109.26  eligible person or the eligible person's driver may not exceed 
109.27  20 cents per mile. 
109.28     (d) Medical assistance covers oral language interpreter 
109.29  services when provided by an enrolled health care provider 
109.30  during the course of providing a direct, person-to-person 
109.31  covered health care service to an enrolled recipient with 
109.32  limited English proficiency. 
109.33     Sec. 23.  Minnesota Statutes 2000, section 256B.0625, 
109.34  subdivision 30, is amended to read: 
109.35     Subd. 30.  [OTHER CLINIC SERVICES.] (a) Medical assistance 
109.36  covers rural health clinic services, federally qualified health 
110.1   center services, nonprofit community health clinic services, 
110.2   public health clinic services, and the services of a clinic 
110.3   meeting the criteria established in rule by the commissioner.  
110.4   Rural health clinic services and federally qualified health 
110.5   center services mean services defined in United States Code, 
110.6   title 42, section 1396d(a)(2)(B) and (C).  Payment for rural 
110.7   health clinic and federally qualified health center services 
110.8   shall be made according to applicable federal law and regulation.
110.9      (b) A federally qualified health center that is beginning 
110.10  initial operation shall submit an estimate of budgeted costs and 
110.11  visits for the initial reporting period in the form and detail 
110.12  required by the commissioner.  A federally qualified health 
110.13  center that is already in operation shall submit an initial 
110.14  report using actual costs and visits for the initial reporting 
110.15  period.  Within 90 days of the end of its reporting period, a 
110.16  federally qualified health center shall submit, in the form and 
110.17  detail required by the commissioner, a report of its operations, 
110.18  including allowable costs actually incurred for the period and 
110.19  the actual number of visits for services furnished during the 
110.20  period, and other information required by the commissioner.  
110.21  Federally qualified health centers that file Medicare cost 
110.22  reports shall provide the commissioner with a copy of the most 
110.23  recent Medicare cost report filed with the Medicare program 
110.24  intermediary for the reporting year which support the costs 
110.25  claimed on their cost report to the state. 
110.26     (c) In order to continue cost-based payment under the 
110.27  medical assistance program according to paragraphs (a) and (b), 
110.28  a federally qualified health center or rural health clinic must 
110.29  apply for designation as an essential community provider within 
110.30  six months of final adoption of rules by the department of 
110.31  health according to section 62Q.19, subdivision 7.  For those 
110.32  federally qualified health centers and rural health clinics that 
110.33  have applied for essential community provider status within the 
110.34  six-month time prescribed, medical assistance payments will 
110.35  continue to be made according to paragraphs (a) and (b) for the 
110.36  first three years after application.  For federally qualified 
111.1   health centers and rural health clinics that either do not apply 
111.2   within the time specified above or who have had essential 
111.3   community provider status for three years, medical assistance 
111.4   payments for health services provided by these entities shall be 
111.5   according to the same rates and conditions applicable to the 
111.6   same service provided by health care providers that are not 
111.7   federally qualified health centers or rural health clinics.  
111.8      (d) Effective July 1, 1999, the provisions of paragraph (c) 
111.9   requiring a federally qualified health center or a rural health 
111.10  clinic to make application for an essential community provider 
111.11  designation in order to have cost-based payments made according 
111.12  to paragraphs (a) and (b) no longer apply. 
111.13     (e) Effective January 1, 2000, payments made according to 
111.14  paragraphs (a) and (b) shall be limited to the cost phase-out 
111.15  schedule of the Balanced Budget Act of 1997. 
111.16     (f) Effective January 1, 2001, each federally qualified 
111.17  health center and rural health clinic may elect to be paid 
111.18  either under the prospective payment system established in 
111.19  United States Code, title 42, section 1396a, paragraph (a) or 
111.20  under an alternative payment methodology consistent with the 
111.21  requirements of United States Code, title 42, section 1392a, 
111.22  paragraph (a) and approved by the health care financing 
111.23  administration.  The alternative payment methodology shall be 
111.24  100 percent of cost as determined according to Medicare cost 
111.25  principles. 
111.26     Sec. 24.  Minnesota Statutes 2000, section 256B.0625, 
111.27  subdivision 34, is amended to read: 
111.28     Subd. 34.  [INDIAN HEALTH SERVICES FACILITIES.] Medical 
111.29  assistance payments and MinnesotaCare payments to facilities of 
111.30  the Indian health service and facilities operated by a tribe or 
111.31  tribal organization under funding authorized by United States 
111.32  Code, title 25, sections 450f to 450n, or title III of the 
111.33  Indian Self-Determination and Education Assistance Act, Public 
111.34  Law Number 93-638, for enrollees who are eligible for federal 
111.35  financial participation, shall be at the option of the facility 
111.36  in accordance with the rate published by the United States 
112.1   Assistant Secretary for Health under the authority of United 
112.2   States Code, title 42, sections 248(a) and 249(b).  General 
112.3   assistance medical care payments to facilities of the Indian 
112.4   health services and facilities operated by a tribe or tribal 
112.5   organization for the provision of outpatient medical care 
112.6   services billed after June 30, 1990, must be in accordance with 
112.7   the general assistance medical care rates paid for the same 
112.8   services when provided in a facility other than a facility of 
112.9   the Indian health service or a facility operated by a tribe or 
112.10  tribal organization.  MinnesotaCare payments for enrollees who 
112.11  are not eligible for federal financial participation at 
112.12  facilities of the Indian Health Service and facilities operated 
112.13  by a tribe or tribal organization for the provision of 
112.14  outpatient medical services must be in accordance with the 
112.15  medical assistance rates paid for the same services when 
112.16  provided in a facility other than a facility of the Indian 
112.17  Health Service or a facility operated by a tribe or tribal 
112.18  organization. 
112.19     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
112.20  following final enactment. 
112.21     Sec. 25.  Minnesota Statutes 2000, section 256B.0635, 
112.22  subdivision 1, is amended to read: 
112.23     Subdivision 1.  [INCREASED EMPLOYMENT.] Beginning January 
112.24  1, 1998 (a) Until June 30, 2002, medical assistance may be paid 
112.25  for persons who received MFIP-S or medical assistance for 
112.26  families and children in at least three of six months preceding 
112.27  the month in which the person became ineligible for MFIP-S or 
112.28  medical assistance, if the ineligibility was due to an increase 
112.29  in hours of employment or employment income or due to the loss 
112.30  of an earned income disregard.  In addition, to receive 
112.31  continued assistance under this section, persons who received 
112.32  medical assistance for families and children but did not receive 
112.33  MFIP-S must have had income less than or equal to the assistance 
112.34  standard for their family size under the state's AFDC plan in 
112.35  effect as of July 16, 1996, as required by the Personal 
112.36  Responsibility and Work Opportunity Reconciliation Act of 1996 
113.1   (PRWORA), Public Law Number 104-193, increased by three percent 
113.2   effective July 1, 2000, at the time medical assistance 
113.3   eligibility began.  A person who is eligible for extended 
113.4   medical assistance is entitled to six months of assistance 
113.5   without reapplication, unless the assistance unit ceases to 
113.6   include a dependent child.  For a person under 21 years of age, 
113.7   medical assistance may not be discontinued within the six-month 
113.8   period of extended eligibility until it has been determined that 
113.9   the person is not otherwise eligible for medical assistance.  
113.10  Medical assistance may be continued for an additional six months 
113.11  if the person meets all requirements for the additional six 
113.12  months, according to title XIX of the Social Security Act, as 
113.13  amended by section 303 of the Family Support Act of 1988, Public 
113.14  Law Number 100-485. 
113.15     (b) Beginning July 1, 2002, medical assistance for families 
113.16  and children may be paid for persons who were eligible under 
113.17  section 256B.055, subdivision 3a, paragraph (b), in at least 
113.18  three of six months preceding the month in which the person 
113.19  became ineligible under that section if the ineligibility was 
113.20  due to an increase in hours of employment or employment income 
113.21  or due to the loss of an earned income disregard.  A person who 
113.22  is eligible for extended medical assistance is entitled to six 
113.23  months of assistance without reapplication, unless the 
113.24  assistance unit ceases to include a dependent child, except 
113.25  medical assistance may not be discontinued for that dependent 
113.26  child under 21 years of age within the six-month period of 
113.27  extended eligibility until it has been determined that the 
113.28  person is not otherwise eligible for medical assistance.  
113.29  Medical assistance may be continued for an additional six months 
113.30  if the person meets all requirements for the additional six 
113.31  months, according to title XIX of the Social Security Act, as 
113.32  amended by section 303 of the Family Support Act of 1988, Public 
113.33  Law Number 100-485. 
113.34     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
113.35     Sec. 26.  Minnesota Statutes 2000, section 256B.0635, 
113.36  subdivision 2, is amended to read: 
114.1      Subd. 2.  [INCREASED CHILD OR SPOUSAL SUPPORT.] Beginning 
114.2   January 1, 1998 (a) Until June 30, 2002, medical assistance may 
114.3   be paid for persons who received MFIP-S or medical assistance 
114.4   for families and children in at least three of the six months 
114.5   preceding the month in which the person became ineligible for 
114.6   MFIP-S or medical assistance, if the ineligibility was the 
114.7   result of the collection of child or spousal support under part 
114.8   D of title IV of the Social Security Act.  In addition, to 
114.9   receive continued assistance under this section, persons who 
114.10  received medical assistance for families and children but did 
114.11  not receive MFIP-S must have had income less than or equal to 
114.12  the assistance standard for their family size under the state's 
114.13  AFDC plan in effect as of July 16, 1996, as required by the 
114.14  Personal Responsibility and Work Opportunity Reconciliation Act 
114.15  of 1996 (PRWORA), Public Law Number 104-193 increased by three 
114.16  percent effective July 1, 2000, at the time medical assistance 
114.17  eligibility began.  A person who is eligible for extended 
114.18  medical assistance under this subdivision is entitled to four 
114.19  months of assistance without reapplication, unless the 
114.20  assistance unit ceases to include a dependent child.  For a 
114.21  person under 21 years of age, except medical assistance may not 
114.22  be discontinued for that dependent child under 21 years of age 
114.23  within the four-month period of extended eligibility until it 
114.24  has been determined that the person is not otherwise eligible 
114.25  for medical assistance. 
114.26     (b) Beginning July 1, 2002, medical assistance for families 
114.27  and children may be paid for persons who were eligible under 
114.28  section 256B.055, subdivision 3a, paragraph (b), in at least 
114.29  three of the six months preceding the month in which the person 
114.30  became ineligible under that section if the ineligibility was 
114.31  the result of the collection of child or spousal support under 
114.32  part D of title IV of the Social Security Act.  A person who is 
114.33  eligible for extended medical assistance under this subdivision 
114.34  is entitled to four months of assistance without reapplication, 
114.35  unless the assistance unit ceases to include a dependent child, 
114.36  except medical assistance may not be discontinued for that 
115.1   dependent child under 21 years of age within the four-month 
115.2   period of extended eligibility until it has been determined that 
115.3   the person is not otherwise eligible for medical assistance. 
115.4      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
115.5      Sec. 27.  [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN 
115.6   PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.] 
115.7      Medical assistance is available during a presumptive 
115.8   eligibility period for persons who meet the criteria in section 
115.9   256B.057, subdivision 10.  For purposes of this section, the 
115.10  presumptive eligibility period begins on the date on which an 
115.11  entity designated by the commissioner determines, based on 
115.12  preliminary information, that the person meets the criteria in 
115.13  section 256B.057, subdivision 10.  The presumptive eligibility 
115.14  period ends on the day on which a determination is made as to 
115.15  the person's eligibility, except that if an application is not 
115.16  submitted by the last day of the month following the month 
115.17  during which the determination based on preliminary information 
115.18  is made, the presumptive eligibility period ends on that last 
115.19  day of the month. 
115.20     Sec. 28.  [256B.195] [HEALTH CARE SAFETY NET PRESERVATION.] 
115.21     Subdivision 1.  [INTERGOVERNMENTAL TRANSFERS AND RELATED 
115.22  PAYMENTS.] (a) This section is contingent on federal approval of 
115.23  the intergovernmental transfers and payments to safety net 
115.24  hospitals authorized under this section. 
115.25     (b) In addition to the percentage contribution paid by a 
115.26  county under section 256B.19, subdivision 1, the governmental 
115.27  units designated in this subdivision shall be responsible for an 
115.28  additional portion of the nonfederal share of medical assistance 
115.29  costs attributable to them.  For purposes of this section, 
115.30  "designated governmental unit" means Hennepin county, Ramsey 
115.31  county, or the University of Minnesota.  For purposes of this 
115.32  section, "nonstate, government hospital" means Hennepin County 
115.33  Medical Center, the successor or assignee to St. Paul-Ramsey 
115.34  Medical Center as described in section 383A.91, or Fairview 
115.35  University Medical Center. 
115.36     (c) Effective July 1, 2001, the governmental units 
116.1   designated in paragraph (a) shall in total transfer $2,833,333 
116.2   on a monthly basis to the state Medicaid agency.  The 
116.3   commissioner shall allocate this assessment between the 
116.4   governmental units based on the proportion of the Medicare upper 
116.5   payment limit for each nonstate, government hospital located 
116.6   within the governmental unit to the total Medicare upper payment 
116.7   limit of all participating hospitals in paragraph (b).  
116.8      (d) The commissioner shall distribute the proceeds of this 
116.9   intergovernmental transfer, including the federal Medicaid 
116.10  match, as follows: 
116.11     (1) Proceeds may be no less than the amount of the 
116.12  intergovernmental transfer in paragraph (c) multiplied by 1.75. 
116.13     (2) The remaining proceeds provide funding for hospital 
116.14  charity care aid under section 144.585.  The commissioner of 
116.15  human services shall work with the commissioner of health to 
116.16  assure that hospital charity care aid payments are administered 
116.17  in a manner that generates Medicaid matching funds.  
116.18     (e) The successor or assignee to St. Paul-Ramsey Medical 
116.19  Center shall transfer on a monthly basis to Ramsey county an 
116.20  amount equal to the county assessment under paragraph (c). 
116.21     Subd. 2.  [DETERMINATION OF INTERGOVERNMENTAL TRANSFER 
116.22  AMOUNTS.] Medicaid rate changes, including those required to 
116.23  obtain federal financial participation under section 62J.692, 
116.24  subdivision 8, enacted prior to the effective date of this 
116.25  legislation, shall precede the determination of 
116.26  intergovernmental transfer amounts determined in this section.  
116.27  Participation in the intergovernmental transfer program shall 
116.28  not result in the offset of any nonstate, government hospital's 
116.29  receipt of Medicaid payment increases. 
116.30     Subd. 3.  [STATE PLAN AMENDMENTS.] The commissioner shall 
116.31  amend the state Medicaid plan as necessary to implement this 
116.32  section. 
116.33     Subd. 4.  [PROPORTIONATE ADJUSTMENTS.] (a) The commissioner 
116.34  shall adjust the intergovernmental transfers under subdivision 
116.35  1, paragraph (c), and the payments under subdivision 1, 
116.36  paragraph (d), upon the approval of the designated governmental 
117.1   unit named in subdivision 1, paragraph (b), based on the 
117.2   commissioner's determination of Medicare upper payment limits, 
117.3   hospital-specific federal limitations on disproportionate share 
117.4   payments or to maximize additional federal reimbursements. 
117.5      (b) In the event that:  (i) federal approval is not 
117.6   received for the total intergovernmental transfer amount 
117.7   specified in subdivision 1, paragraph (d), or, (ii) federal 
117.8   rules regarding the establishment of the 150 percent Medicare 
117.9   upper payment limit, section 1102 of the Social Security Act, 
117.10  United States Code, title 42, section 1302, enacted on March 13, 
117.11  2001, are rescinded or, (iii) the federal 150 percent Medicare 
117.12  upper payment limit is reduced to 100 percent, the amount of the 
117.13  intergovernmental transfers and Medicaid payments to the 
117.14  nonstate, government hospitals named in subdivision 1, paragraph 
117.15  (b), shall be adjusted for each hospital based on the proportion 
117.16  of each hospital's Medicaid inpatient hospital days to the total 
117.17  Medicaid inpatient hospital days provided by all participating 
117.18  hospitals.  
117.19     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
117.20     Sec. 29.  Minnesota Statutes 2000, section 256B.69, 
117.21  subdivision 4, is amended to read: 
117.22     Subd. 4.  [LIMITATION OF CHOICE.] The commissioner shall 
117.23  develop criteria to determine when limitation of choice may be 
117.24  implemented in the experimental counties.  The criteria shall 
117.25  ensure that all eligible individuals in the county have 
117.26  continuing access to the full range of medical assistance 
117.27  services as specified in subdivision 6.  The commissioner shall 
117.28  exempt the following persons from participation in the project, 
117.29  in addition to those who do not meet the criteria for limitation 
117.30  of choice:  
117.31     (1) persons eligible for medical assistance according to 
117.32  section 256B.055, subdivision 1; 
117.33     (2) persons eligible for medical assistance due to 
117.34  blindness or disability as determined by the social security 
117.35  administration or the state medical review team, unless:  
117.36     (i) they are 65 years of age or older,; or 
118.1      (ii) they reside in Itasca county or they reside in a 
118.2   county in which the commissioner conducts a pilot project under 
118.3   a waiver granted pursuant to section 1115 of the Social Security 
118.4   Act; 
118.5      (3) recipients who currently have private coverage through 
118.6   a health maintenance organization; 
118.7      (4) recipients who are eligible for medical assistance by 
118.8   spending down excess income for medical expenses other than the 
118.9   nursing facility per diem expense; 
118.10     (5) recipients who receive benefits under the Refugee 
118.11  Assistance Program, established under United States Code, title 
118.12  8, section 1522(e); 
118.13     (6) children who are both determined to be severely 
118.14  emotionally disturbed and receiving case management services 
118.15  according to section 256B.0625, subdivision 20; and 
118.16     (7) adults who are both determined to be seriously and 
118.17  persistently mentally ill and received case management services 
118.18  according to section 256B.0625, subdivision 20; and 
118.19     (8) persons eligible for medical assistance according to 
118.20  section 256B.057, subdivision 10.  
118.21  Children under age 21 who are in foster placement may enroll in 
118.22  the project on an elective basis.  Individuals excluded under 
118.23  clauses (6) and (7) may choose to enroll on an elective basis.  
118.24  The commissioner may allow persons with a one-month spenddown 
118.25  who are otherwise eligible to enroll to voluntarily enroll or 
118.26  remain enrolled, if they elect to prepay their monthly spenddown 
118.27  to the state.  Beginning on or after July 1, 1997, The 
118.28  commissioner may require those individuals to enroll in the 
118.29  prepaid medical assistance program who otherwise would have been 
118.30  excluded under clauses (1) and, (3), and (8), and under 
118.31  Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.  
118.32  Before limitation of choice is implemented, eligible individuals 
118.33  shall be notified and after notification, shall be allowed to 
118.34  choose only among demonstration providers.  The commissioner may 
118.35  assign an individual with private coverage through a health 
118.36  maintenance organization, to the same health maintenance 
119.1   organization for medical assistance coverage, if the health 
119.2   maintenance organization is under contract for medical 
119.3   assistance in the individual's county of residence.  After 
119.4   initially choosing a provider, the recipient is allowed to 
119.5   change that choice only at specified times as allowed by the 
119.6   commissioner.  If a demonstration provider ends participation in 
119.7   the project for any reason, a recipient enrolled with that 
119.8   provider must select a new provider but may change providers 
119.9   without cause once more within the first 60 days after 
119.10  enrollment with the second provider. 
119.11     Sec. 30.  Minnesota Statutes 2000, section 256B.69, 
119.12  subdivision 5, is amended to read: 
119.13     Subd. 5.  [PROSPECTIVE PER CAPITA PAYMENT.] The 
119.14  commissioner shall establish the method and amount of payments 
119.15  for services.  The commissioner shall annually contract with 
119.16  demonstration providers to provide services consistent with 
119.17  these established methods and amounts for payment.  Payment 
119.18  rates established by the commissioner must be within the limits 
119.19  of available appropriations.  
119.20     If allowed by the commissioner, a demonstration provider 
119.21  may contract with an insurer, health care provider, nonprofit 
119.22  health service plan corporation, or the commissioner, to provide 
119.23  insurance or similar protection against the cost of care 
119.24  provided by the demonstration provider or to provide coverage 
119.25  against the risks incurred by demonstration providers under this 
119.26  section.  The recipients enrolled with a demonstration provider 
119.27  are a permissible group under group insurance laws and chapter 
119.28  62C, the Nonprofit Health Service Plan Corporations Act.  Under 
119.29  this type of contract, the insurer or corporation may make 
119.30  benefit payments to a demonstration provider for services 
119.31  rendered or to be rendered to a recipient.  Any insurer or 
119.32  nonprofit health service plan corporation licensed to do 
119.33  business in this state is authorized to provide this insurance 
119.34  or similar protection.  
119.35     Payments to providers participating in the project are 
119.36  exempt from the requirements of sections 256.966 and 256B.03, 
120.1   subdivision 2.  The commissioner shall complete development of 
120.2   capitation rates for payments before delivery of services under 
120.3   this section is begun.  For payments made during calendar year 
120.4   1990 and later years, the commissioner shall contract with an 
120.5   independent actuary to establish prepayment rates. 
120.6      By January 15, 1996, the commissioner shall report to the 
120.7   legislature on the methodology used to allocate to participating 
120.8   counties available administrative reimbursement for advocacy and 
120.9   enrollment costs.  The report shall reflect the commissioner's 
120.10  judgment as to the adequacy of the funds made available and of 
120.11  the methodology for equitable distribution of the funds.  The 
120.12  commissioner must involve participating counties in the 
120.13  development of the report. 
120.14     Sec. 31.  Minnesota Statutes 2000, section 256B.69, 
120.15  subdivision 5b, is amended to read: 
120.16     Subd. 5b.  [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 
120.17  prepaid medical assistance and general assistance medical care 
120.18  program contract rates set by the commissioner under subdivision 
120.19  5 and effective on or after January 1, 1998, capitation rates 
120.20  for nonmetropolitan counties shall on a weighted average be no 
120.21  less than 88 percent of the capitation rates for metropolitan 
120.22  counties, excluding Hennepin county.  The commissioner shall 
120.23  make a pro rata adjustment in capitation rates paid to counties 
120.24  other than nonmetropolitan counties in order to make this 
120.25  provision budget neutral.  
120.26     (b) For prepaid medical assistance program contract rates 
120.27  set by the commissioner under subdivision 5 and effective on or 
120.28  after January 1, 2001 2002, capitation rates for nonmetropolitan 
120.29  counties shall, on a weighted average, be no less than 89 95 
120.30  percent of the capitation rates for metropolitan counties, 
120.31  excluding Hennepin county.  The commissioner shall make a pro 
120.32  rata adjustment in capitation rates paid to Hennepin county in 
120.33  order to make the portion of the increase between 89 and 95 
120.34  percent budget neutral. 
120.35     (c) This subdivision shall not affect the nongeographically 
120.36  based risk adjusted rates established under section 62Q.03, 
121.1   subdivision 5a, paragraph (f). 
121.2      (d) The commissioner shall require prepaid health plans to 
121.3   use all revenue received from the increase in capitation rates 
121.4   for nonmetropolitan counties from 89 to no less than 95 percent 
121.5   of the capitation rate for metropolitan counties, excluding 
121.6   Hennepin county, to increase reimbursement rates, effective 
121.7   January 1, 2002, for providers under contract with the prepaid 
121.8   health plan to serve enrollees from nonmetropolitan counties. 
121.9      Sec. 32.  Minnesota Statutes 2000, section 256B.69, is 
121.10  amended by adding a subdivision to read: 
121.11     Subd. 6c.  [DENTAL SERVICES DEMONSTRATION PROJECT.] The 
121.12  commissioner shall establish a dental services demonstration 
121.13  project in Crow Wing, Todd, Morrison, Wadena, and Cass counties 
121.14  for provision of dental services to medical assistance, general 
121.15  assistance medical care, and MinnesotaCare recipients.  The 
121.16  commissioner may contract on a prospective per capita payment 
121.17  basis for these dental services with an organization licensed 
121.18  under chapter 62C, 62D, or 62N in accordance with section 
121.19  256B.037 or may establish and administer a fee-for-service 
121.20  system for the reimbursement of dental services.  
121.21     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
121.22     Sec. 33.  Minnesota Statutes 2000, section 256B.75, is 
121.23  amended to read: 
121.24     256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
121.25     (a) For outpatient hospital facility fee payments for 
121.26  services rendered on or after October 1, 1992, the commissioner 
121.27  of human services shall pay the lower of (1) submitted charge, 
121.28  or (2) 32 percent above the rate in effect on June 30, 1992, 
121.29  except for those services for which there is a federal maximum 
121.30  allowable payment.  Effective for services rendered on or after 
121.31  January 1, 2000, payment rates for nonsurgical outpatient 
121.32  hospital facility fees and emergency room facility fees shall be 
121.33  increased by eight percent over the rates in effect on December 
121.34  31, 1999, except for those services for which there is a federal 
121.35  maximum allowable payment.  Services for which there is a 
121.36  federal maximum allowable payment shall be paid at the lower of 
122.1   (1) submitted charge, or (2) the federal maximum allowable 
122.2   payment.  Total aggregate payment for outpatient hospital 
122.3   facility fee services shall not exceed the Medicare upper 
122.4   limit.  If it is determined that a provision of this section 
122.5   conflicts with existing or future requirements of the United 
122.6   States government with respect to federal financial 
122.7   participation in medical assistance, the federal requirements 
122.8   prevail.  The commissioner may, in the aggregate, prospectively 
122.9   reduce payment rates to avoid reduced federal financial 
122.10  participation resulting from rates that are in excess of the 
122.11  Medicare upper limitations. 
122.12     (b) Notwithstanding paragraph (a), payment for outpatient, 
122.13  emergency, and ambulatory surgery hospital facility fee services 
122.14  for critical access hospitals designated under section 144.1483, 
122.15  clause (11), shall be paid on a cost-based payment system that 
122.16  is based on the cost-finding methods and allowable costs of the 
122.17  Medicare program. 
122.18     (c) Effective for services provided on or after July 1, 
122.19  2002, rates that are based on the Medicare outpatient 
122.20  prospective payment system shall be replaced by a budget neutral 
122.21  prospective payment system that is derived using medical 
122.22  assistance data.  The department shall provide a proposal to the 
122.23  2002 legislature to define and implement this provision. 
122.24     Sec. 34.  Minnesota Statutes 2000, section 256B.76, is 
122.25  amended to read: 
122.26     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
122.27     (a) Effective for services rendered on or after October 1, 
122.28  1992, the commissioner shall make payments for physician 
122.29  services as follows: 
122.30     (1) payment for level one Health Care Finance 
122.31  Administration's common procedural coding system (HCPCS) codes 
122.32  titled "office and other outpatient services," "preventive 
122.33  medicine new and established patient," "delivery, antepartum, 
122.34  and postpartum care," "critical care," Caesarean cesarean 
122.35  delivery and pharmacologic management provided to psychiatric 
122.36  patients, and HCPCS level three codes for enhanced services for 
123.1   prenatal high risk, shall be paid at the lower of (i) submitted 
123.2   charges, or (ii) 25 percent above the rate in effect on June 30, 
123.3   1992.  If the rate on any procedure code within these categories 
123.4   is different than the rate that would have been paid under the 
123.5   methodology in section 256B.74, subdivision 2, then the larger 
123.6   rate shall be paid; 
123.7      (2) payments for all other services shall be paid at the 
123.8   lower of (i) submitted charges, or (ii) 15.4 percent above the 
123.9   rate in effect on June 30, 1992; 
123.10     (3) all physician rates shall be converted from the 50th 
123.11  percentile of 1982 to the 50th percentile of 1989, less the 
123.12  percent in aggregate necessary to equal the above increases 
123.13  except that payment rates for home health agency services shall 
123.14  be the rates in effect on September 30, 1992; 
123.15     (4) effective for services rendered on or after January 1, 
123.16  2000, payment rates for physician and professional services 
123.17  shall be increased by three percent over the rates in effect on 
123.18  December 31, 1999, except for home health agency and family 
123.19  planning agency services; and 
123.20     (5) the increases in clause (4) shall be implemented 
123.21  January 1, 2000, for managed care. 
123.22     (b) Effective for services rendered on or after October 1, 
123.23  1992, the commissioner shall make payments for dental services 
123.24  as follows: 
123.25     (1) dental services shall be paid at the lower of (i) 
123.26  submitted charges, or (ii) 25 percent above the rate in effect 
123.27  on June 30, 1992; 
123.28     (2) dental rates shall be converted from the 50th 
123.29  percentile of 1982 to the 50th percentile of 1989, less the 
123.30  percent in aggregate necessary to equal the above increases; 
123.31     (3) effective for services rendered on or after January 1, 
123.32  2000, payment rates for dental services shall be increased by 
123.33  three percent over the rates in effect on December 31, 1999; 
123.34     (4) the commissioner shall award grants to community 
123.35  clinics or other nonprofit community organizations, political 
123.36  subdivisions, professional associations, or other organizations 
124.1   that demonstrate the ability to provide dental services 
124.2   effectively to public program recipients.  Grants may be used to 
124.3   fund the costs related to coordinating access for recipients, 
124.4   developing and implementing patient care criteria, upgrading or 
124.5   establishing new facilities, acquiring furnishings or equipment, 
124.6   recruiting new providers, or other development costs that will 
124.7   improve access to dental care in a region.  In awarding grants, 
124.8   the commissioner shall give priority to applicants that plan to 
124.9   serve areas of the state in which the number of dental providers 
124.10  is not currently sufficient to meet the needs of recipients of 
124.11  public programs or uninsured individuals.  The commissioner 
124.12  shall consider the following in awarding the grants:  (i) 
124.13  potential to successfully increase access to an underserved 
124.14  population; (ii) the ability to raise matching funds; (iii) the 
124.15  long-term viability of the project to improve access beyond the 
124.16  period of initial funding; (iv) the efficiency in the use of the 
124.17  funding; and (v) the experience of the proposers in providing 
124.18  services to the target population. 
124.19     The commissioner shall monitor the grants and may terminate 
124.20  a grant if the grantee does not increase dental access for 
124.21  public program recipients.  The commissioner shall consider 
124.22  grants for the following: 
124.23     (i) implementation of new programs or continued expansion 
124.24  of current access programs that have demonstrated success in 
124.25  providing dental services in underserved areas; 
124.26     (ii) a pilot program for utilizing hygienists outside of a 
124.27  traditional dental office to provide dental hygiene services; 
124.28  and 
124.29     (iii) a program that organizes a network of volunteer 
124.30  dentists, establishes a system to refer eligible individuals to 
124.31  volunteer dentists, and through that network provides donated 
124.32  dental care services to public program recipients or uninsured 
124.33  individuals. 
124.34     (5) beginning October 1, 1999, the payment for tooth 
124.35  sealants and fluoride treatments shall be the lower of (i) 
124.36  submitted charge, or (ii) 80 percent of median 1997 charges; and 
125.1      (6) the increases listed in clauses (3) and (5) shall be 
125.2   implemented January 1, 2000, for managed care; and 
125.3      (7) effective for services provided on or after October 1, 
125.4   2001, payment for diagnostic examinations and dental x-rays 
125.5   provided to children under age 21 shall be the lower of (i) the 
125.6   submitted charge, or (ii) 85 percent of median 1999 charges.  
125.7      (c) Effective for dental services rendered on or after July 
125.8   1, 2001, the commissioner may increase reimbursements to 
125.9   dentists and dental clinics deemed by the commissioner to be 
125.10  critical access dental providers.  Reimbursement to a critical 
125.11  access dental provider may be increased by not more than 50 
125.12  percent above the reimbursement rate that would otherwise be 
125.13  paid to the provider.  Payments to health plan companies shall 
125.14  be adjusted to reflect increased reimbursements to critical 
125.15  access dental providers as approved by the commissioner.  In 
125.16  determining which dentists and dental clinics shall be deemed 
125.17  critical access dental providers, the commissioner shall review: 
125.18     (1) the utilization rate in the service area in which the 
125.19  dentist or dental clinic operates for dental services to 
125.20  patients covered by medical assistance, general assistance 
125.21  medical care, or MinnesotaCare as their primary source of 
125.22  coverage; 
125.23     (2) the level of services provided by the dentist or dental 
125.24  clinic to patients covered by medical assistance, general 
125.25  assistance medical care, or MinnesotaCare as their primary 
125.26  source of coverage; and 
125.27     (3) whether the level of services provided by the dentist 
125.28  or dental clinic is critical to maintaining adequate levels of 
125.29  patient access within the service area. 
125.30  In the absence of a critical access dental provider in a service 
125.31  area, the commissioner may designate a dentist or dental clinic 
125.32  as a critical access dental provider if the dentist or dental 
125.33  clinic is willing to provide care to patients covered by medical 
125.34  assistance, general assistance medical care, or MinnesotaCare at 
125.35  a level which significantly increases access to dental care in 
125.36  the service area. 
126.1      (d) An entity that operates both a Medicare certified 
126.2   comprehensive outpatient rehabilitation facility and a facility 
126.3   which was certified prior to January 1, 1993, that is licensed 
126.4   under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
126.5   whom at least 33 percent of the clients receiving rehabilitation 
126.6   services in the most recent calendar year are medical assistance 
126.7   recipients, shall be reimbursed by the commissioner for 
126.8   rehabilitation services at rates that are 38 percent greater 
126.9   than the maximum reimbursement rate allowed under paragraph (a), 
126.10  clause (2), when those services are (1) provided within the 
126.11  comprehensive outpatient rehabilitation facility and (2) 
126.12  provided to residents of nursing facilities owned by the entity. 
126.13     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
126.14  following final enactment. 
126.15     Sec. 35.  [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION 
126.16  PROJECT FOR FAMILY PLANNING SERVICES.] 
126.17     (a) The commissioner of human services shall establish a 
126.18  medical assistance demonstration project to determine whether 
126.19  improved access to coverage of prepregnancy family planning 
126.20  services reduces medical assistance and MFIP costs. 
126.21     (b) This section is effective upon federal approval of the 
126.22  demonstration project. 
126.23     Sec. 36.  Minnesota Statutes 2000, section 256D.03, 
126.24  subdivision 3, is amended to read: 
126.25     Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
126.26  (a) General assistance medical care may be paid for any person 
126.27  who is not eligible for medical assistance under chapter 256B, 
126.28  including eligibility for medical assistance based on a 
126.29  spenddown of excess income according to section 256B.056, 
126.30  subdivision 5, or MinnesotaCare as defined in paragraph (b), 
126.31  except as provided in paragraph (c); and: 
126.32     (1) who is receiving assistance under section 256D.05, 
126.33  except for families with children who are eligible under 
126.34  Minnesota family investment program-statewide (MFIP-S), who is 
126.35  having a payment made on the person's behalf under sections 
126.36  256I.01 to 256I.06, or who resides in group residential housing 
127.1   as defined in chapter 256I and can meet a spenddown using the 
127.2   cost of remedial services received through group residential 
127.3   housing; or 
127.4      (2)(i) who is a resident of Minnesota; and whose equity in 
127.5   assets is not in excess of $1,000 per assistance unit.  Exempt 
127.6   assets, the reduction of excess assets, and the waiver of excess 
127.7   assets must conform to the medical assistance program in chapter 
127.8   256B, with the following exception:  the maximum amount of 
127.9   undistributed funds in a trust that could be distributed to or 
127.10  on behalf of the beneficiary by the trustee, assuming the full 
127.11  exercise of the trustee's discretion under the terms of the 
127.12  trust, must be applied toward the asset maximum; and 
127.13     (ii) who has countable income not in excess of the 
127.14  assistance standards established in section 256B.056, 
127.15  subdivision 4 that does not exceed 133 and 1/3 percent of the 
127.16  AFDC income standard in effect under the July 16, 1996, AFDC 
127.17  state plan, increased by three percent, or whose excess income 
127.18  is spent down according to section 256B.056, subdivision 5, 
127.19  using a six-month budget period.  The method for calculating 
127.20  earned income disregards and deductions for a person who resides 
127.21  with a dependent child under age 21 shall follow section 
127.22  256B.056, subdivision 1a.  However, if a disregard of $30 and 
127.23  one-third of the remainder has been applied to the wage earner's 
127.24  income, the disregard shall not be applied again until the wage 
127.25  earner's income has not been considered in an eligibility 
127.26  determination for general assistance, general assistance medical 
127.27  care, medical assistance, or MFIP-S for 12 consecutive months.  
127.28  The earned income and work expense deductions for a person who 
127.29  does not reside with a dependent child under age 21 shall be the 
127.30  same as the method used to determine eligibility for a person 
127.31  under section 256D.06, subdivision 1, except the disregard of 
127.32  the first $50 of earned income is not allowed; 
127.33     (3) who would be eligible for medical assistance except 
127.34  that the person resides in a facility that is determined by the 
127.35  commissioner or the federal Health Care Financing Administration 
127.36  to be an institution for mental diseases; or 
128.1      (4) who is ineligible for medical assistance under chapter 
128.2   256B or general assistance medical care under any other 
128.3   provision of this section, and is receiving care and 
128.4   rehabilitation services from a nonprofit center established to 
128.5   serve victims of torture.  These individuals are eligible for 
128.6   general assistance medical care only for the period during which 
128.7   they are receiving services from the center.  During this period 
128.8   of eligibility, individuals eligible under this clause shall not 
128.9   be required to participate in prepaid general assistance medical 
128.10  care.  
128.11     (b) Beginning January 1, 2000, applicants or recipients who 
128.12  meet all eligibility requirements of MinnesotaCare as defined in 
128.13  sections 256L.01 to 256L.16, and are: 
128.14     (i) adults with dependent children under 21 whose gross 
128.15  family income is equal to or less than 275 percent of the 
128.16  federal poverty guidelines; or 
128.17     (ii) adults without children with earned income and whose 
128.18  family gross income is between 75 percent of the federal poverty 
128.19  guidelines and the amount set by section 256L.04, subdivision 7, 
128.20  shall be terminated from general assistance medical care upon 
128.21  enrollment in MinnesotaCare. 
128.22     (c) For services rendered on or after July 1, 1997, 
128.23  eligibility is limited to one month prior to application if the 
128.24  person is determined eligible in the prior month.  A 
128.25  redetermination of eligibility must occur every 12 months.  
128.26  Beginning January 1, 2000, Minnesota health care program 
128.27  applications completed by recipients and applicants who are 
128.28  persons described in paragraph (b), may be returned to the 
128.29  county agency to be forwarded to the department of human 
128.30  services or sent directly to the department of human services 
128.31  for enrollment in MinnesotaCare.  If all other eligibility 
128.32  requirements of this subdivision are met, eligibility for 
128.33  general assistance medical care shall be available in any month 
128.34  during which a MinnesotaCare eligibility determination and 
128.35  enrollment are pending.  Upon notification of eligibility for 
128.36  MinnesotaCare, notice of termination for eligibility for general 
129.1   assistance medical care shall be sent to an applicant or 
129.2   recipient.  If all other eligibility requirements of this 
129.3   subdivision are met, eligibility for general assistance medical 
129.4   care shall be available until enrollment in MinnesotaCare 
129.5   subject to the provisions of paragraph (e). 
129.6      (d) The date of an initial Minnesota health care program 
129.7   application necessary to begin a determination of eligibility 
129.8   shall be the date the applicant has provided a name, address, 
129.9   and social security number, signed and dated, to the county 
129.10  agency or the department of human services.  If the applicant is 
129.11  unable to provide an initial application when health care is 
129.12  delivered due to a medical condition or disability, a health 
129.13  care provider may act on the person's behalf to complete the 
129.14  initial application.  The applicant must complete the remainder 
129.15  of the application and provide necessary verification before 
129.16  eligibility can be determined.  The county agency must assist 
129.17  the applicant in obtaining verification if necessary.  On the 
129.18  basis of information provided on the completed application, an 
129.19  applicant who meets the following criteria shall be determined 
129.20  eligible beginning in the month of application: 
129.21     (1) has gross income less than 90 percent of the applicable 
129.22  income standard; 
129.23     (2) has liquid assets that total within $300 of the asset 
129.24  standard; 
129.25     (3) does not reside in a long-term care facility; and 
129.26     (4) meets all other eligibility requirements. 
129.27  The applicant must provide all required verifications within 30 
129.28  days' notice of the eligibility determination or eligibility 
129.29  shall be terminated. 
129.30     (e) County agencies are authorized to use all automated 
129.31  databases containing information regarding recipients' or 
129.32  applicants' income in order to determine eligibility for general 
129.33  assistance medical care or MinnesotaCare.  Such use shall be 
129.34  considered sufficient in order to determine eligibility and 
129.35  premium payments by the county agency. 
129.36     (f) General assistance medical care is not available for a 
130.1   person in a correctional facility unless the person is detained 
130.2   by law for less than one year in a county correctional or 
130.3   detention facility as a person accused or convicted of a crime, 
130.4   or admitted as an inpatient to a hospital on a criminal hold 
130.5   order, and the person is a recipient of general assistance 
130.6   medical care at the time the person is detained by law or 
130.7   admitted on a criminal hold order and as long as the person 
130.8   continues to meet other eligibility requirements of this 
130.9   subdivision.  
130.10     (g) General assistance medical care is not available for 
130.11  applicants or recipients who do not cooperate with the county 
130.12  agency to meet the requirements of medical assistance.  General 
130.13  assistance medical care is limited to payment of emergency 
130.14  services only for applicants or recipients as described in 
130.15  paragraph (b), whose MinnesotaCare coverage is denied or 
130.16  terminated for nonpayment of premiums as required by sections 
130.17  256L.06 and 256L.07.  
130.18     (h) In determining the amount of assets of an individual, 
130.19  there shall be included any asset or interest in an asset, 
130.20  including an asset excluded under paragraph (a), that was given 
130.21  away, sold, or disposed of for less than fair market value 
130.22  within the 60 months preceding application for general 
130.23  assistance medical care or during the period of eligibility.  
130.24  Any transfer described in this paragraph shall be presumed to 
130.25  have been for the purpose of establishing eligibility for 
130.26  general assistance medical care, unless the individual furnishes 
130.27  convincing evidence to establish that the transaction was 
130.28  exclusively for another purpose.  For purposes of this 
130.29  paragraph, the value of the asset or interest shall be the fair 
130.30  market value at the time it was given away, sold, or disposed 
130.31  of, less the amount of compensation received.  For any 
130.32  uncompensated transfer, the number of months of ineligibility, 
130.33  including partial months, shall be calculated by dividing the 
130.34  uncompensated transfer amount by the average monthly per person 
130.35  payment made by the medical assistance program to skilled 
130.36  nursing facilities for the previous calendar year.  The 
131.1   individual shall remain ineligible until this fixed period has 
131.2   expired.  The period of ineligibility may exceed 30 months, and 
131.3   a reapplication for benefits after 30 months from the date of 
131.4   the transfer shall not result in eligibility unless and until 
131.5   the period of ineligibility has expired.  The period of 
131.6   ineligibility begins in the month the transfer was reported to 
131.7   the county agency, or if the transfer was not reported, the 
131.8   month in which the county agency discovered the transfer, 
131.9   whichever comes first.  For applicants, the period of 
131.10  ineligibility begins on the date of the first approved 
131.11  application. 
131.12     (i) When determining eligibility for any state benefits 
131.13  under this subdivision, the income and resources of all 
131.14  noncitizens shall be deemed to include their sponsor's income 
131.15  and resources as defined in the Personal Responsibility and Work 
131.16  Opportunity Reconciliation Act of 1996, title IV, Public Law 
131.17  Number 104-193, sections 421 and 422, and subsequently set out 
131.18  in federal rules. 
131.19     (j)(1) An undocumented noncitizen or a nonimmigrant is 
131.20  ineligible for general assistance medical care other than 
131.21  emergency services.  For purposes of this subdivision, a 
131.22  nonimmigrant is an individual in one or more of the classes 
131.23  listed in United States Code, title 8, section 1101(a)(15), and 
131.24  an undocumented noncitizen is an individual who resides in the 
131.25  United States without the approval or acquiescence of the 
131.26  Immigration and Naturalization Service. 
131.27     (2) This paragraph does not apply to a child under age 18, 
131.28  to a Cuban or Haitian entrant as defined in Public Law Number 
131.29  96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 
131.30  aged, blind, or disabled as defined in Code of Federal 
131.31  Regulations, title 42, sections 435.520, 435.530, 435.531, 
131.32  435.540, and 435.541, or effective October 1, 1998, to an 
131.33  individual eligible for general assistance medical care under 
131.34  paragraph (a), clause (4), who cooperates with the Immigration 
131.35  and Naturalization Service to pursue any applicable immigration 
131.36  status, including citizenship, that would qualify the individual 
132.1   for medical assistance with federal financial participation. 
132.2      (k) For purposes of paragraphs (g) and (j), "emergency 
132.3   services" has the meaning given in Code of Federal Regulations, 
132.4   title 42, section 440.255(b)(1), except that it also means 
132.5   services rendered because of suspected or actual pesticide 
132.6   poisoning. 
132.7      (l) Notwithstanding any other provision of law, a 
132.8   noncitizen who is ineligible for medical assistance due to the 
132.9   deeming of a sponsor's income and resources, is ineligible for 
132.10  general assistance medical care. 
132.11     Sec. 37.  Minnesota Statutes 2000, section 256D.03, 
132.12  subdivision 4, is amended to read: 
132.13     Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
132.14  For a person who is eligible under subdivision 3, paragraph (a), 
132.15  clause (3), general assistance medical care covers, except as 
132.16  provided in paragraph (c): 
132.17     (1) inpatient hospital services; 
132.18     (2) outpatient hospital services; 
132.19     (3) services provided by Medicare certified rehabilitation 
132.20  agencies; 
132.21     (4) prescription drugs and other products recommended 
132.22  through the process established in section 256B.0625, 
132.23  subdivision 13; 
132.24     (5) equipment necessary to administer insulin and 
132.25  diagnostic supplies and equipment for diabetics to monitor blood 
132.26  sugar level; 
132.27     (6) eyeglasses and eye examinations provided by a physician 
132.28  or optometrist; 
132.29     (7) hearing aids; 
132.30     (8) prosthetic devices; 
132.31     (9) laboratory and X-ray services; 
132.32     (10) physician's services; 
132.33     (11) medical transportation; 
132.34     (12) chiropractic services as covered under the medical 
132.35  assistance program; 
132.36     (13) podiatric services; 
133.1      (14) dental services; 
133.2      (15) outpatient services provided by a mental health center 
133.3   or clinic that is under contract with the county board and is 
133.4   established under section 245.62; 
133.5      (16) day treatment services for mental illness provided 
133.6   under contract with the county board; 
133.7      (17) prescribed medications for persons who have been 
133.8   diagnosed as mentally ill as necessary to prevent more 
133.9   restrictive institutionalization; 
133.10     (18) psychological services, medical supplies and 
133.11  equipment, and Medicare premiums, coinsurance and deductible 
133.12  payments; 
133.13     (19) medical equipment not specifically listed in this 
133.14  paragraph when the use of the equipment will prevent the need 
133.15  for costlier services that are reimbursable under this 
133.16  subdivision; 
133.17     (20) services performed by a certified pediatric nurse 
133.18  practitioner, a certified family nurse practitioner, a certified 
133.19  adult nurse practitioner, a certified obstetric/gynecological 
133.20  nurse practitioner, a certified neonatal nurse practitioner, or 
133.21  a certified geriatric nurse practitioner in independent 
133.22  practice, if (1) the service is otherwise covered under this 
133.23  chapter as a physician service, (2) the service provided on an 
133.24  inpatient basis is not included as part of the cost for 
133.25  inpatient services included in the operating payment rate, and 
133.26  (3) the service is within the scope of practice of the nurse 
133.27  practitioner's license as a registered nurse, as defined in 
133.28  section 148.171; 
133.29     (21) services of a certified public health nurse or a 
133.30  registered nurse practicing in a public health nursing clinic 
133.31  that is a department of, or that operates under the direct 
133.32  authority of, a unit of government, if the service is within the 
133.33  scope of practice of the public health nurse's license as a 
133.34  registered nurse, as defined in section 148.171; and 
133.35     (22) telemedicine consultations, to the extent they are 
133.36  covered under section 256B.0625, subdivision 3b.  
134.1      (b) Except as provided in paragraph (c), for a recipient 
134.2   who is eligible under subdivision 3, paragraph (a), clause (1) 
134.3   or (2), general assistance medical care covers the services 
134.4   listed in paragraph (a) with the exception of special 
134.5   transportation services. 
134.6      (c) Gender reassignment surgery and related services are 
134.7   not covered services under this subdivision unless the 
134.8   individual began receiving gender reassignment services prior to 
134.9   July 1, 1995.  
134.10     (d) In order to contain costs, the commissioner of human 
134.11  services shall select vendors of medical care who can provide 
134.12  the most economical care consistent with high medical standards 
134.13  and shall where possible contract with organizations on a 
134.14  prepaid capitation basis to provide these services.  The 
134.15  commissioner shall consider proposals by counties and vendors 
134.16  for prepaid health plans, competitive bidding programs, block 
134.17  grants, or other vendor payment mechanisms designed to provide 
134.18  services in an economical manner or to control utilization, with 
134.19  safeguards to ensure that necessary services are provided.  
134.20  Before implementing prepaid programs in counties with a county 
134.21  operated or affiliated public teaching hospital or a hospital or 
134.22  clinic operated by the University of Minnesota, the commissioner 
134.23  shall consider the risks the prepaid program creates for the 
134.24  hospital and allow the county or hospital the opportunity to 
134.25  participate in the program in a manner that reflects the risk of 
134.26  adverse selection and the nature of the patients served by the 
134.27  hospital, provided the terms of participation in the program are 
134.28  competitive with the terms of other participants considering the 
134.29  nature of the population served.  Payment for services provided 
134.30  pursuant to this subdivision shall be as provided to medical 
134.31  assistance vendors of these services under sections 256B.02, 
134.32  subdivision 8, and 256B.0625.  For payments made during fiscal 
134.33  year 1990 and later years, the commissioner shall consult with 
134.34  an independent actuary in establishing prepayment rates, but 
134.35  shall retain final control over the rate methodology.  Payment 
134.36  rates established by the commissioner must be within the limits 
135.1   of available appropriations.  Notwithstanding the provisions of 
135.2   subdivision 3, an individual who becomes ineligible for general 
135.3   assistance medical care because of failure to submit income 
135.4   reports or recertification forms in a timely manner, shall 
135.5   remain enrolled in the prepaid health plan and shall remain 
135.6   eligible for general assistance medical care coverage through 
135.7   the last day of the month in which the enrollee became 
135.8   ineligible for general assistance medical care. 
135.9      (e) There shall be no copayment required of any recipient 
135.10  of benefits for any services provided under this subdivision.  A 
135.11  hospital receiving a reduced payment as a result of this section 
135.12  may apply the unpaid balance toward satisfaction of the 
135.13  hospital's bad debts. 
135.14     (f) Any county may, from its own resources, provide medical 
135.15  payments for which state payments are not made. 
135.16     (g) Chemical dependency services that are reimbursed under 
135.17  chapter 254B must not be reimbursed under general assistance 
135.18  medical care. 
135.19     (h) The maximum payment for new vendors enrolled in the 
135.20  general assistance medical care program after the base year 
135.21  shall be determined from the average usual and customary charge 
135.22  of the same vendor type enrolled in the base year. 
135.23     (i) The conditions of payment for services under this 
135.24  subdivision are the same as the conditions specified in rules 
135.25  adopted under chapter 256B governing the medical assistance 
135.26  program, unless otherwise provided by statute or rule. 
135.27     Sec. 38.  Minnesota Statutes 2000, section 256J.31, 
135.28  subdivision 12, is amended to read: 
135.29     Subd. 12.  [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 
135.30  participant who is not in vendor payment status may discontinue 
135.31  receipt of the cash assistance portion of the MFIP assistance 
135.32  grant and retain eligibility for child care assistance under 
135.33  section 119B.05 and for medical assistance under sections 
135.34  256B.055, subdivision 3a, and 256B.0635.  For the months a 
135.35  participant chooses to discontinue the receipt of the cash 
135.36  portion of the MFIP grant, the assistance unit accrues months of 
136.1   eligibility to be applied toward eligibility for child care 
136.2   under section 119B.05 and for medical assistance under sections 
136.3   256B.055, subdivision 3a, and 256B.0635. 
136.4      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
136.5      Sec. 39.  Minnesota Statutes 2000, section 256K.03, 
136.6   subdivision 1, is amended to read: 
136.7      Subdivision 1.  [NOTIFICATION OF PROGRAM.] Except for the 
136.8   provisions in this section, the provisions for the MFIP 
136.9   application process shall be followed.  Within two days after 
136.10  receipt of a completed combined application form, the county 
136.11  agency must refer to the provider the applicant who meets the 
136.12  conditions under section 256K.02, and notify the applicant in 
136.13  writing of the program including the following provisions: 
136.14     (1) notification that, as part of the application process, 
136.15  applicants are required to attend orientation, to be followed 
136.16  immediately by a job search; 
136.17     (2) the program provider, the date, time, and location of 
136.18  the scheduled program orientation; 
136.19     (3) the procedures for qualifying for and receiving 
136.20  benefits under the program; 
136.21     (4) the immediate availability of supportive services, 
136.22  including, but not limited to, child care, transportation, 
136.23  medical assistance, and other work-related aid; and 
136.24     (5) the rights, responsibilities, and obligations of 
136.25  participants in the program, including, but not limited to, the 
136.26  grounds for exemptions and deferrals, the consequences for 
136.27  refusing or failing to participate fully, and the appeal process.
136.28     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
136.29     Sec. 40.  Minnesota Statutes 2000, section 256K.07, is 
136.30  amended to read: 
136.31     256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE, 
136.32  AND CHILD CARE.] 
136.33     The participant shall be treated as an MFIP recipient for 
136.34  food stamps, medical assistance, and child care eligibility 
136.35  purposes.  The participant who leaves the program as a result of 
136.36  increased earnings from employment shall be eligible for 
137.1   transitional medical assistance and child care without regard to 
137.2   MFIP receipt in three of the six months preceding ineligibility. 
137.3      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
137.4      Sec. 41.  Minnesota Statutes 2000, section 256L.06, 
137.5   subdivision 3, is amended to read: 
137.6      Subd. 3.  [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 
137.7   Premiums are dedicated to the commissioner for MinnesotaCare. 
137.8      (b) The commissioner shall develop and implement procedures 
137.9   to:  (1) require enrollees to report changes in income; (2) 
137.10  adjust sliding scale premium payments, based upon changes in 
137.11  enrollee income; and (3) disenroll enrollees from MinnesotaCare 
137.12  for failure to pay required premiums.  Failure to pay includes 
137.13  payment with a dishonored check, a returned automatic bank 
137.14  withdrawal, or a refused credit card or debit card payment.  The 
137.15  commissioner may demand a guaranteed form of payment, including 
137.16  a cashier's check or a money order, as the only means to replace 
137.17  a dishonored, returned, or refused payment. 
137.18     (c) Premiums are calculated on a calendar month basis and 
137.19  may be paid on a monthly, quarterly, or annual basis, with the 
137.20  first payment due upon notice from the commissioner of the 
137.21  premium amount required.  The commissioner shall inform 
137.22  applicants and enrollees of these premium payment options. 
137.23  Premium payment is required before enrollment is complete and to 
137.24  maintain eligibility in MinnesotaCare.  
137.25     (d) Nonpayment of the premium will result in disenrollment 
137.26  from the plan within one calendar month after the due date 
137.27  effective for the calendar month for which the premium was due.  
137.28  Persons disenrolled for nonpayment or who voluntarily terminate 
137.29  coverage from the program may not reenroll until four calendar 
137.30  months have elapsed.  Persons disenrolled for nonpayment who pay 
137.31  all past due premiums as well as current premiums due, including 
137.32  premiums due for the period of disenrollment, within 20 days of 
137.33  disenrollment, shall be reenrolled retroactively to the first 
137.34  day of disenrollment.  Persons disenrolled for nonpayment or who 
137.35  voluntarily terminate coverage from the program may not reenroll 
137.36  for four calendar months unless the person demonstrates good 
138.1   cause for nonpayment.  Good cause does not exist if a person 
138.2   chooses to pay other family expenses instead of the premium.  
138.3   The commissioner shall define good cause in rule. 
138.4      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
138.5      Sec. 42.  Minnesota Statutes 2000, section 256L.12, 
138.6   subdivision 9, is amended to read: 
138.7      Subd. 9.  [RATE SETTING.] Rates will be prospective, per 
138.8   capita, where possible.  The commissioner may allow health plans 
138.9   to arrange for inpatient hospital services on a risk or nonrisk 
138.10  basis.  The commissioner shall consult with an independent 
138.11  actuary to determine appropriate rates.  Rates established by 
138.12  the commissioner must be within the limits of available 
138.13  appropriations. 
138.14     Sec. 43.  Minnesota Statutes 2000, section 256L.12, is 
138.15  amended by adding a subdivision to read: 
138.16     Subd. 11.  [COVERAGE AT INDIAN HEALTH SERVICE 
138.17  FACILITIES.] For American Indian enrollees of MinnesotaCare, 
138.18  MinnesotaCare shall cover health care services provided at 
138.19  Indian Health Service facilities and facilities operated by a 
138.20  tribe or tribal organization under funding authorized by United 
138.21  States Code, title 25, sections 450f to 450n, or title III of 
138.22  the Indian Self-Determination and Education Act, Public Law 
138.23  Number 93-638, if those services would otherwise be covered 
138.24  under section 256L.03.  Payments for services provided under 
138.25  this subdivision shall be made on a fee-for-service basis, and 
138.26  may, at the option of the tribe or organization, be made at the 
138.27  rates authorized under sections 256.969, subdivision 16, and 
138.28  256B.0625, subdivision 34, for those MinnesotaCare enrollees 
138.29  eligible for coverage at medical assistance rates.  For purposes 
138.30  of this subdivision, "American Indian" has the meaning given to 
138.31  persons to whom services will be provided for in the Code of 
138.32  Federal Regulations, title 42, section 36.12. 
138.33     Sec. 44.  Minnesota Statutes 2000, section 256L.16, is 
138.34  amended to read: 
138.35     256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN 
138.36  UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.] 
139.1      Section 256L.11, subdivision 2, shall not apply to services 
139.2   provided to children families with children who are eligible to 
139.3   receive expanded services according to section 256L.03, 
139.4   subdivision 1a 256L.04, subdivision 1, paragraph (a). 
139.5      Sec. 45.  Laws 1995, chapter 178, article 2, section 36, is 
139.6   amended to read: 
139.7      Sec. 36.  [EMPOWERMENT ZONES; ADMINISTRATIVE SIMPLIFICATION 
139.8   OF WELFARE LAWS.] 
139.9      (a) The commissioner of human services shall make 
139.10  recommendations to effectuate the changes in federal laws and 
139.11  regulations, state laws and rules, and the state plan to improve 
139.12  the administrative efficiency of the aid to families with 
139.13  dependent children, general assistance, work readiness, family 
139.14  general assistance, medical assistance, general assistance 
139.15  medical care, and food stamp programs.  At a minimum, the 
139.16  following administrative standards and procedures must be 
139.17  changed. 
139.18     The commissioner shall: 
139.19     (1) require income or eligibility reviews no more 
139.20  frequently than annually for cases in which income is normally 
139.21  invariant, as in aid to families with dependent children cases 
139.22  where the only source of household income is Supplemental Social 
139.23  Security Income; 
139.24     (2) permit households to report income annually when the 
139.25  source of income is excluded, such as a minor's earnings; 
139.26     (3) require income or eligibility reviews no more 
139.27  frequently than annually for extended medical assistance cases; 
139.28     (4) require income or eligibility reviews no more 
139.29  frequently than annually for a medical assistance postpartum 
139.30  client, where the client previously had eligibility under a 
139.31  different basis prior to pregnancy or if other household members 
139.32  have eligibility with the same income/basis that applies to the 
139.33  client; 
139.34     (5) (4) permit all income or eligibility reviews for foster 
139.35  care medical assistance cases to use the short application form; 
139.36  and 
140.1      (6) (5) make dependent care expenses declaratory for 
140.2   medical assistance; and 
140.3      (7) permit households to only report gifts worth $100 or 
140.4   more per month. 
140.5      (b) The county's administrative savings resulting from 
140.6   these changes may be allocated to fund any lawful purpose. 
140.7      (c) The recommendations must be provided in a report to the 
140.8   chairs of the appropriate legislative committees by August 1, 
140.9   1995.  The recommendations must include a list of the 
140.10  administrative standards and procedures that require approval by 
140.11  the federal government before implementation, and also which 
140.12  administrative simplification standards and procedures may be 
140.13  implemented by a county prior to receiving a federal waiver. 
140.14     (d) The commissioner shall seek the necessary waivers from 
140.15  the federal government as soon as possible to implement the 
140.16  administrative simplification standards and procedures. 
140.17     Sec. 46.  Laws 1999, chapter 245, article 4, section 110, 
140.18  is amended to read: 
140.19     Sec. 110.  [PROGRAMS FOR SENIOR CITIZENS.] 
140.20     The commissioner of human services shall study the 
140.21  eligibility criteria of and benefits provided to persons age 65 
140.22  and over through the array of cash assistance and health care 
140.23  programs administered by the department, and the extent to which 
140.24  these programs can be combined, simplified, or coordinated to 
140.25  reduce administrative costs and improve access.  The 
140.26  commissioner shall also study potential barriers to enrollment 
140.27  for low-income seniors who would otherwise deplete resources 
140.28  necessary to maintain independent community living.  At a 
140.29  minimum, the study must include an evaluation of asset 
140.30  requirements and enrollment sites.  The commissioner shall 
140.31  report study findings and recommendations to the legislature by 
140.32  June September 30, 2001. 
140.33     Sec. 47.  [NOTICE OF NEW PREMIUM SCHEDULE.] 
140.34     The commissioner of human services shall provide medical 
140.35  assistance enrollees subject to premiums as employed persons 
140.36  with disabilities with prior notice of the new premium schedule 
141.1   established under the section 13 amendment to section 256B.057, 
141.2   subdivision 9, paragraph (c).  This notice must be provided at 
141.3   least two months before the month in which the first premium 
141.4   payment under the new schedule is due. 
141.5      Sec. 48.  [MEDICATION THERAPY MANAGEMENT PILOT PROGRAM.] 
141.6      Subdivision 1.  [ESTABLISHMENT.] The commissioner of human 
141.7   services, in consultation with the advisory committee 
141.8   established under subdivision 2, shall implement, beginning July 
141.9   1, 2001, a two-year medication therapy management pilot program 
141.10  for medical assistance enrollees.  Medication therapy management 
141.11  must be provided by teams of physicians and pharmacists working 
141.12  in collaborative practice, as defined in Minnesota Statutes, 
141.13  section 151.01, subdivision 27, clause (5), to help patients use 
141.14  medications safely and effectively.  The commissioner may enroll 
141.15  individual pharmacists who participate in the pilot program as 
141.16  medical assistance providers and shall seek to ensure that 
141.17  participating pharmacists represent all geographic regions of 
141.18  the state. 
141.19     Subd. 2.  [ADVISORY COMMITTEE.] The commissioner shall 
141.20  establish a ten-member medication therapy management advisory 
141.21  committee, to advise the commissioner in the implementation and 
141.22  administration of the program and the development of eligibility 
141.23  criteria for enrollees and providers and requirements for 
141.24  collaborative practice agreements.  The committee shall be 
141.25  comprised of:  two licensed physicians; two licensed 
141.26  pharmacists; two consumer representatives; three members with 
141.27  expertise in the area of medication therapy management, who may 
141.28  be licensed physicians or licensed pharmacists; and a 
141.29  representative of the commissioner, who shall serve as an 
141.30  ex-officio nonvoting member.  In appointing members who are not 
141.31  consumer representatives, the commissioner shall consider 
141.32  recommendations of associations representing pharmacy and 
141.33  medical practitioners.  The committee is governed by section 
141.34  15.059, except that committee members do not receive 
141.35  compensation or reimbursement for expenses. 
141.36     Subd. 3.  [EVALUATION.] The commissioner shall evaluate the 
142.1   cost-effectiveness of the pilot program and its effect on 
142.2   patient outcomes and quality of care, and shall report to the 
142.3   legislature by December 15, 2003.  The commissioner may contract 
142.4   with a vendor to conduct the evaluation. 
142.5      Sec. 49.  [REGULATORY SIMPLIFICATION FOR STATE HEALTH CARE 
142.6   PROGRAM PROVIDERS.] 
142.7      The commissioner of human services, in consultation with 
142.8   providers participating in state health care programs, shall 
142.9   identify nonfinancial barriers to increased provider enrollment 
142.10  and provider retention in state health care programs, and shall 
142.11  implement procedures to address these barriers.  Areas to be 
142.12  examined by the commissioner shall include, but are not limited 
142.13  to, regulatory complexity and inconsistencies between state 
142.14  health care programs, provider requirements, provision of 
142.15  technical assistance to providers, responsiveness to provider 
142.16  inquiries and complaints, claims processing turnaround times, 
142.17  and policies for rejecting provider claims.  The commissioner 
142.18  shall report to the legislature by February 15, 2002, on any 
142.19  changes to the administration of state health care programs that 
142.20  will be implemented as a result of the study, and present 
142.21  recommendations for any necessary changes in state law. 
142.22     Sec. 50.  [REPEALER.] 
142.23     (a) Minnesota Statutes 2000, section 256B.037, subdivision 
142.24  5, is repealed effective January 1, 2002. 
142.25     (b) Minnesota Statutes 2000, section 256B.0635, subdivision 
142.26  3, is repealed effective July 1, 2002. 
142.27                             ARTICLE 3 
142.28                   CONTINUING CARE AND HOME CARE 
142.29     Section 1.  Minnesota Statutes 2000, section 245A.13, 
142.30  subdivision 7, is amended to read: 
142.31     Subd. 7.  [RATE RECOMMENDATION.] The commissioner of human 
142.32  services may review rates of a residential program participating 
142.33  in the medical assistance program which is in receivership and 
142.34  that has needs or deficiencies documented by the department of 
142.35  health or the department of human services.  If the commissioner 
142.36  of human services determines that a review of the rate 
143.1   established under section 256B.501 sections 256B.5012 and 
143.2   256B.5013 is needed, the commissioner shall: 
143.3      (1) review the order or determination that cites the 
143.4   deficiencies or needs; and 
143.5      (2) determine the need for additional staff, additional 
143.6   annual hours by type of employee, and additional consultants, 
143.7   services, supplies, equipment, repairs, or capital assets 
143.8   necessary to satisfy the needs or deficiencies. 
143.9      Sec. 2.  Minnesota Statutes 2000, section 245A.13, 
143.10  subdivision 8, is amended to read: 
143.11     Subd. 8.  [ADJUSTMENT TO THE RATE.] Upon review of rates 
143.12  under subdivision 7, the commissioner may adjust the residential 
143.13  program's payment rate.  The commissioner shall review the 
143.14  circumstances, together with the residential program cost report 
143.15  program's most recent income and expense report, to determine 
143.16  whether or not the deficiencies or needs can be corrected or met 
143.17  by reallocating residential program staff, costs, revenues, 
143.18  or any other resources including any investments, efficiency 
143.19  incentives, or allowances.  If the commissioner determines that 
143.20  any deficiency cannot be corrected or the need cannot be met 
143.21  with the payment rate currently being paid, the commissioner 
143.22  shall determine the payment rate adjustment by dividing the 
143.23  additional annual costs established during the commissioner's 
143.24  review by the residential program's actual resident days from 
143.25  the most recent desk-audited cost income and expense report or 
143.26  the estimated resident days in the projected receivership 
143.27  period.  The payment rate adjustment must meet the conditions in 
143.28  Minnesota Rules, parts 9553.0010 to 9553.0080, and remains in 
143.29  effect during the period of the receivership or until another 
143.30  date set by the commissioner.  Upon the subsequent sale, 
143.31  closure, or transfer of the residential program, the 
143.32  commissioner may recover amounts that were paid as payment rate 
143.33  adjustments under this subdivision.  This recovery shall be 
143.34  determined through a review of actual costs and resident days in 
143.35  the receivership period.  The costs the commissioner finds to be 
143.36  allowable shall be divided by the actual resident days for the 
144.1   receivership period.  This rate shall be compared to the rate 
144.2   paid throughout the receivership period, with the difference, 
144.3   multiplied by resident days, being the amount to be repaid to 
144.4   the commissioner.  Allowable costs shall be determined by the 
144.5   commissioner as those ordinary, necessary, and related to 
144.6   resident care by prudent and cost-conscious management.  The 
144.7   buyer or transferee shall repay this amount to the commissioner 
144.8   within 60 days after the commissioner notifies the buyer or 
144.9   transferee of the obligation to repay.  This provision does not 
144.10  limit the liability of the seller to the commissioner pursuant 
144.11  to section 256B.0641. 
144.12     Sec. 3.  Minnesota Statutes 2000, section 252.275, 
144.13  subdivision 4b, is amended to read: 
144.14     Subd. 4b.  [GUARANTEED FLOOR.] Each county with an original 
144.15  allocation for the preceding year that is equal to or less than 
144.16  the guaranteed floor minimum index shall have a guaranteed floor 
144.17  equal to its original allocation for the preceding year.  Each 
144.18  county with an original allocation for the preceding year that 
144.19  is greater than the guaranteed floor minimum index shall have a 
144.20  guaranteed floor equal to the lesser of clause (1) or (2): 
144.21     (1) the county's original allocation for the preceding 
144.22  year; or 
144.23     (2) 70 percent of the county's reported expenditures 
144.24  eligible for reimbursement during the 12 months ending on June 
144.25  30 of the preceding calendar year. 
144.26     For calendar year 1993, the guaranteed floor minimum index 
144.27  shall be $20,000.  For each subsequent year, the index shall be 
144.28  adjusted by the projected change in the average value in the 
144.29  United States Department of Labor Bureau of Labor Statistics 
144.30  consumer price index (all urban) for that year. 
144.31     Notwithstanding this subdivision, no county shall be 
144.32  allocated a guaranteed floor of less than $1,000. 
144.33     When the amount of funds available for allocation is less 
144.34  than the amount available in the previous year, each county's 
144.35  previous year allocation shall be reduced in proportion to the 
144.36  reduction in the statewide funding, to establish each county's 
145.1   guaranteed floor. 
145.2      Sec. 4.  Minnesota Statutes 2000, section 254B.02, 
145.3   subdivision 3, is amended to read: 
145.4      Subd. 3.  [RESERVE ACCOUNT.] The commissioner shall 
145.5   allocate money from the reserve account to counties that, during 
145.6   the current fiscal year, have met or exceeded the base level of 
145.7   expenditures for eligible chemical dependency services from 
145.8   local money.  The commissioner shall establish the base level 
145.9   for fiscal year 1988 as the amount of local money used for 
145.10  eligible services in calendar year 1986.  In later years, the 
145.11  base level must be increased in the same proportion as state 
145.12  appropriations to implement Laws 1986, chapter 394, sections 8 
145.13  to 20, are increased.  The base level must be decreased if the 
145.14  fund balance from which allocations are made under section 
145.15  254B.02, subdivision 1, is decreased in later years.  The local 
145.16  match rate for the reserve account is the same rate as applied 
145.17  to the initial allocation.  Reserve account payments must not be 
145.18  included when calculating the county adjustments made according 
145.19  to subdivision 2.  For counties providing medical assistance or 
145.20  general assistance medical care through managed care plans on 
145.21  January 1, 1996, the base year is fiscal year 1995.  For 
145.22  counties beginning provision of managed care after January 1, 
145.23  1996, the base year is the most recent fiscal year before 
145.24  enrollment in managed care begins.  For counties providing 
145.25  managed care, the base level will be increased or decreased in 
145.26  proportion to changes in the fund balance from which allocations 
145.27  are made under subdivision 2, but will be additionally increased 
145.28  or decreased in proportion to the change in county adjusted 
145.29  population made in subdivision 1, paragraphs (b) and 
145.30  (c).  Effective July 1, 2001, funds deposited in the reserve 
145.31  account in excess of those needed to meet obligations for 
145.32  services provided during the biennium under this section and 
145.33  sections 254B.06 and 254B.09 shall cancel to the general fund. 
145.34     Sec. 5.  Minnesota Statutes 2000, section 254B.03, 
145.35  subdivision 1, is amended to read: 
145.36     Subdivision 1.  [LOCAL AGENCY DUTIES.] (a) Every local 
146.1   agency shall provide chemical dependency services to persons 
146.2   residing within its jurisdiction who meet criteria established 
146.3   by the commissioner for placement in a chemical dependency 
146.4   residential or nonresidential treatment service.  Chemical 
146.5   dependency money must be administered by the local agencies 
146.6   according to law and rules adopted by the commissioner under 
146.7   sections 14.001 to 14.69. 
146.8      (b) In order to contain costs, the county board shall, with 
146.9   the approval of the commissioner of human services, select 
146.10  eligible vendors of chemical dependency services who can provide 
146.11  economical and appropriate treatment.  Unless the local agency 
146.12  is a social services department directly administered by a 
146.13  county or human services board, the local agency shall not be an 
146.14  eligible vendor under section 254B.05.  The commissioner may 
146.15  approve proposals from county boards to provide services in an 
146.16  economical manner or to control utilization, with safeguards to 
146.17  ensure that necessary services are provided.  If a county 
146.18  implements a demonstration or experimental medical services 
146.19  funding plan, the commissioner shall transfer the money as 
146.20  appropriate.  If a county selects a vendor located in another 
146.21  state, the county shall ensure that the vendor is in compliance 
146.22  with the rules governing licensure of programs located in the 
146.23  state. 
146.24     (c) The calendar year 1998 2002 rate for vendors may not 
146.25  increase more than three two percent above the rate approved in 
146.26  effect on January 1, 1997 2001.  The calendar year 1999 2003 
146.27  rate for vendors may not increase more than three two percent 
146.28  above the rate in effect on January 1, 1998 2002.  The calendar 
146.29  years 2004 and 2005 rates may not exceed the rate in effect on 
146.30  January 1, 2003. 
146.31     (d) A culturally specific vendor that provides assessments 
146.32  under a variance under Minnesota Rules, part 9530.6610, shall be 
146.33  allowed to provide assessment services to persons not covered by 
146.34  the variance. 
146.35     Sec. 6.  Minnesota Statutes 2000, section 254B.04, 
146.36  subdivision 1, is amended to read: 
147.1      Subdivision 1.  [ELIGIBILITY.] (a) Persons eligible for 
147.2   benefits under Code of Federal Regulations, title 25, part 20, 
147.3   persons eligible for medical assistance benefits under sections 
147.4   256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 
147.5   or who meet the income standards of section 256B.056, 
147.6   subdivision 4, and persons eligible for general assistance 
147.7   medical care under section 256D.03, subdivision 3, are entitled 
147.8   to chemical dependency fund services.  State money appropriated 
147.9   for this paragraph must be placed in a separate account 
147.10  established for this purpose.  
147.11     Persons with dependent children who are determined to be in 
147.12  need of chemical dependency treatment pursuant to an assessment 
147.13  under section 626.556, subdivision 10, or a case plan under 
147.14  section 260C.201, subdivision 6, or 260C.212, shall be assisted 
147.15  by the local agency to access needed treatment services.  
147.16  Treatment services must be appropriate for the individual or 
147.17  family, which may include long-term care treatment or treatment 
147.18  in a facility that allows the dependent children to stay in the 
147.19  treatment facility.  The county shall pay for out-of-home 
147.20  placement costs, if applicable. 
147.21     (b) A person not entitled to services under paragraph (a), 
147.22  but with family income that is less than the 1997 federal 
147.23  poverty guidelines equivalent of 60 percent of the state median 
147.24  income for a family of like size and composition, shall be 
147.25  eligible to receive chemical dependency fund services within the 
147.26  limit of funds available after persons entitled to services 
147.27  under paragraph (a) have been served appropriated for this group 
147.28  for the fiscal year.  If notified by the state agency of limited 
147.29  funds, a county must give preferential treatment to persons with 
147.30  dependent children who are in need of chemical dependency 
147.31  treatment pursuant to an assessment under section 626.556, 
147.32  subdivision 10, or a case plan under section 260C.201, 
147.33  subdivision 6, or 260C.212.  A county may spend money from its 
147.34  own sources to serve persons under this paragraph.  State money 
147.35  appropriated for this paragraph must be placed in a separate 
147.36  account established for this purpose. 
148.1      (c) Persons whose income is between the 1997 federal 
148.2   poverty guidelines equivalent of 60 percent and 115 percent of 
148.3   the state median income shall be eligible for chemical 
148.4   dependency services on a sliding fee basis, within the limit of 
148.5   funds available, after persons entitled to services under 
148.6   paragraph (a) and persons eligible for services under paragraph 
148.7   (b) have been served appropriated for this group for the fiscal 
148.8   year.  Persons eligible under this paragraph must contribute to 
148.9   the cost of services according to the sliding fee scale 
148.10  established under subdivision 3.  A county may spend money from 
148.11  its own sources to provide services to persons under this 
148.12  paragraph.  State money appropriated for this paragraph must be 
148.13  placed in a separate account established for this purpose. 
148.14     Sec. 7.  Minnesota Statutes 2000, section 254B.09, is 
148.15  amended by adding a subdivision to read: 
148.16     Subd. 8.  [PAYMENTS TO IMPROVE SERVICES TO AMERICAN 
148.17  INDIANS.] The commissioner may set rates for chemical dependency 
148.18  services according to the American Indian Health Improvement 
148.19  Act, Public Law Number 94-437, for eligible vendors.  These 
148.20  rates shall supersede rates set in county purchase of service 
148.21  agreements when payments are made on behalf of clients eligible 
148.22  according to Public Law Number 94-437. 
148.23     Sec. 8.  Minnesota Statutes 2000, section 256.01, is 
148.24  amended by adding a subdivision to read: 
148.25     Subd. 19.  [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS 
148.26  WITH HIV OR AIDS.] The commissioner may award grants to eligible 
148.27  vendors for the development, implementation, and evaluation of 
148.28  case management services for individuals infected with the human 
148.29  immunodeficiency virus.  HIV/AIDs case management services will 
148.30  be provided to increase access to cost effective health care 
148.31  services, to reduce the risk of HIV transmission, to ensure that 
148.32  basic client needs are met, and to increase client access to 
148.33  needed community supports or services. 
148.34     Sec. 9.  Minnesota Statutes 2000, section 256.476, 
148.35  subdivision 1, is amended to read: 
148.36     Subdivision 1.  [PURPOSE AND GOALS.] The commissioner of 
149.1   human services shall establish a consumer support grant 
149.2   program to assist for individuals with functional limitations 
149.3   and their families in purchasing and securing supports which the 
149.4   individuals need to live as independently and productively in 
149.5   the community as possible who wish to purchase and secure their 
149.6   own supports.  The commissioner and local agencies shall jointly 
149.7   develop an implementation plan which must include a way to 
149.8   resolve the issues related to county liability.  The program 
149.9   shall: 
149.10     (1) make support grants available to individuals or 
149.11  families as an effective alternative to existing programs and 
149.12  services, such as the developmental disability family support 
149.13  program, the alternative care program, personal care attendant 
149.14  services, home health aide services, and private duty nursing 
149.15  facility services; 
149.16     (2) provide consumers more control, flexibility, and 
149.17  responsibility over the needed supports their services and 
149.18  supports; 
149.19     (3) promote local program management and decision making; 
149.20  and 
149.21     (4) encourage the use of informal and typical community 
149.22  supports. 
149.23     Sec. 10.  Minnesota Statutes 2000, section 256.476, 
149.24  subdivision 2, is amended to read: 
149.25     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
149.26  following terms have the meanings given them: 
149.27     (a) "County board" means the county board of commissioners 
149.28  for the county of financial responsibility as defined in section 
149.29  256G.02, subdivision 4, or its designated representative.  When 
149.30  a human services board has been established under sections 
149.31  402.01 to 402.10, it shall be considered the county board for 
149.32  the purposes of this section. 
149.33     (b) "Family" means the person's birth parents, adoptive 
149.34  parents or stepparents, siblings or stepsiblings, children or 
149.35  stepchildren, grandparents, grandchildren, niece, nephew, aunt, 
149.36  uncle, or spouse.  For the purposes of this section, a family 
150.1   member is at least 18 years of age. 
150.2      (c) "Functional limitations" means the long-term inability 
150.3   to perform an activity or task in one or more areas of major 
150.4   life activity, including self-care, understanding and use of 
150.5   language, learning, mobility, self-direction, and capacity for 
150.6   independent living.  For the purpose of this section, the 
150.7   inability to perform an activity or task results from a mental, 
150.8   emotional, psychological, sensory, or physical disability, 
150.9   condition, or illness. 
150.10     (d) "Informed choice" means a voluntary decision made by 
150.11  the person or the person's legal representative, after becoming 
150.12  familiarized with the alternatives to: 
150.13     (1) select a preferred alternative from a number of 
150.14  feasible alternatives; 
150.15     (2) select an alternative which may be developed in the 
150.16  future; and 
150.17     (3) refuse any or all alternatives. 
150.18     (e) "Local agency" means the local agency authorized by the 
150.19  county board to carry out the provisions of this section. 
150.20     (f) "Person" or "persons" means a person or persons meeting 
150.21  the eligibility criteria in subdivision 3. 
150.22     (g) "Authorized representative" means an individual 
150.23  designated by the person or their legal representative to act on 
150.24  their behalf.  This individual may be a family member, guardian, 
150.25  representative payee, or other individual designated by the 
150.26  person or their legal representative, if any, to assist in 
150.27  purchasing and arranging for supports.  For the purposes of this 
150.28  section, an authorized representative is at least 18 years of 
150.29  age. 
150.30     (h) "Screening" means the screening of a person's service 
150.31  needs under sections 256B.0911 and 256B.092. 
150.32     (i) "Supports" means services, care, aids, home 
150.33  environmental modifications, or assistance purchased by the 
150.34  person or the person's family.  Examples of supports include 
150.35  respite care, assistance with daily living, and adaptive aids 
150.36  assistive technology.  For the purpose of this section, 
151.1   notwithstanding the provisions of section 144A.43, supports 
151.2   purchased under the consumer support program are not considered 
151.3   home care services. 
151.4      (j) "Program of origination" means the program the 
151.5   individual transferred from when approved for the consumer 
151.6   support grant program. 
151.7      Sec. 11.  Minnesota Statutes 2000, section 256.476, 
151.8   subdivision 3, is amended to read: 
151.9      Subd. 3.  [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 
151.10  is eligible to apply for a consumer support grant if the person 
151.11  meets all of the following criteria: 
151.12     (1) the person is eligible for and has been approved to 
151.13  receive services under medical assistance as determined under 
151.14  sections 256B.055 and 256B.056 or the person is eligible for and 
151.15  has been approved to receive services under alternative care 
151.16  services as determined under section 256B.0913 or the person has 
151.17  been approved to receive a grant under the developmental 
151.18  disability family support program under section 252.32; 
151.19     (2) the person is able to direct and purchase the person's 
151.20  own care and supports, or the person has a family member, legal 
151.21  representative, or other authorized representative who can 
151.22  purchase and arrange supports on the person's behalf; 
151.23     (3) the person has functional limitations, requires ongoing 
151.24  supports to live in the community, and is at risk of or would 
151.25  continue institutionalization without such supports; and 
151.26     (4) the person will live in a home.  For the purpose of 
151.27  this section, "home" means the person's own home or home of a 
151.28  person's family member.  These homes are natural home settings 
151.29  and are not licensed by the department of health or human 
151.30  services. 
151.31     (b) Persons may not concurrently receive a consumer support 
151.32  grant if they are: 
151.33     (1) receiving home and community-based services under 
151.34  United States Code, title 42, section 1396h(c); personal care 
151.35  attendant and home health aide services under section 256B.0625; 
151.36  a developmental disability family support grant; or alternative 
152.1   care services under section 256B.0913; or 
152.2      (2) residing in an institutional or congregate care setting.
152.3      (c) A person or person's family receiving a consumer 
152.4   support grant shall not be charged a fee or premium by a local 
152.5   agency for participating in the program.  
152.6      (d) The commissioner may limit the participation of nursing 
152.7   facility residents, residents of intermediate care facilities 
152.8   for persons with mental retardation, and the recipients of 
152.9   services from federal waiver programs in the consumer support 
152.10  grant program if the participation of these individuals will 
152.11  result in an increase in the cost to the state. 
152.12     (e) The commissioner shall establish a budgeted 
152.13  appropriation each fiscal year for the consumer support grant 
152.14  program.  The number of individuals participating in the program 
152.15  will be adjusted so the total amount allocated to counties does 
152.16  not exceed the amount of the budgeted appropriation.  The 
152.17  budgeted appropriation will be adjusted annually to accommodate 
152.18  changes in demand for the consumer support grants. 
152.19     Sec. 12.  Minnesota Statutes 2000, section 256.476, 
152.20  subdivision 4, is amended to read: 
152.21     Subd. 4.  [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 
152.22  county board may choose to participate in the consumer support 
152.23  grant program.  If a county board chooses to participate in the 
152.24  program, the local agency shall establish written procedures and 
152.25  criteria to determine the amount and use of support grants.  
152.26  These procedures must include, at least, the availability of 
152.27  respite care, assistance with daily living, and adaptive aids.  
152.28  The local agency may establish monthly or annual maximum amounts 
152.29  for grants and procedures where exceptional resources may be 
152.30  required to meet the health and safety needs of the person on a 
152.31  time-limited basis, however, the total amount awarded to each 
152.32  individual may not exceed the limits established in subdivision 
152.33  5, paragraph (f). 
152.34     (b) Support grants to a person or a person's family will be 
152.35  provided through a monthly subsidy payment and be in the form of 
152.36  cash, voucher, or direct county payment to vendor.  Support 
153.1   grant amounts must be determined by the local agency.  Each 
153.2   service and item purchased with a support grant must meet all of 
153.3   the following criteria:  
153.4      (1) it must be over and above the normal cost of caring for 
153.5   the person if the person did not have functional limitations; 
153.6      (2) it must be directly attributable to the person's 
153.7   functional limitations; 
153.8      (3) it must enable the person or the person's family to 
153.9   delay or prevent out-of-home placement of the person; and 
153.10     (4) it must be consistent with the needs identified in the 
153.11  service plan, when applicable. 
153.12     (c) Items and services purchased with support grants must 
153.13  be those for which there are no other public or private funds 
153.14  available to the person or the person's family.  Fees assessed 
153.15  to the person or the person's family for health and human 
153.16  services are not reimbursable through the grant. 
153.17     (d) In approving or denying applications, the local agency 
153.18  shall consider the following factors:  
153.19     (1) the extent and areas of the person's functional 
153.20  limitations; 
153.21     (2) the degree of need in the home environment for 
153.22  additional support; and 
153.23     (3) the potential effectiveness of the grant to maintain 
153.24  and support the person in the family environment or the person's 
153.25  own home. 
153.26     (e) At the time of application to the program or screening 
153.27  for other services, the person or the person's family shall be 
153.28  provided sufficient information to ensure an informed choice of 
153.29  alternatives by the person, the person's legal representative, 
153.30  if any, or the person's family.  The application shall be made 
153.31  to the local agency and shall specify the needs of the person 
153.32  and family, the form and amount of grant requested, the items 
153.33  and services to be reimbursed, and evidence of eligibility for 
153.34  medical assistance or alternative care program. 
153.35     (f) Upon approval of an application by the local agency and 
153.36  agreement on a support plan for the person or person's family, 
154.1   the local agency shall make grants to the person or the person's 
154.2   family.  The grant shall be in an amount for the direct costs of 
154.3   the services or supports outlined in the service agreement.  
154.4      (g) Reimbursable costs shall not include costs for 
154.5   resources already available, such as special education classes, 
154.6   day training and habilitation, case management, other services 
154.7   to which the person is entitled, medical costs covered by 
154.8   insurance or other health programs, or other resources usually 
154.9   available at no cost to the person or the person's family. 
154.10     (h) The state of Minnesota, the county boards participating 
154.11  in the consumer support grant program, or the agencies acting on 
154.12  behalf of the county boards in the implementation and 
154.13  administration of the consumer support grant program shall not 
154.14  be liable for damages, injuries, or liabilities sustained 
154.15  through the purchase of support by the individual, the 
154.16  individual's family, or the authorized representative under this 
154.17  section with funds received through the consumer support grant 
154.18  program.  Liabilities include but are not limited to:  workers' 
154.19  compensation liability, the Federal Insurance Contributions Act 
154.20  (FICA), or the Federal Unemployment Tax Act (FUTA).  For 
154.21  purposes of this section, participating county boards and 
154.22  agencies acting on behalf of county boards are exempt from the 
154.23  provisions of section 268.04. 
154.24     Sec. 13.  Minnesota Statutes 2000, section 256.476, 
154.25  subdivision 5, is amended to read: 
154.26     Subd. 5.  [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 
154.27  For the purpose of transferring persons to the consumer support 
154.28  grant program from specific programs or services, such as the 
154.29  developmental disability family support program and alternative 
154.30  care program, personal care attendant assistant services, home 
154.31  health aide services, or nursing facility private duty nursing 
154.32  services, the amount of funds transferred by the commissioner 
154.33  between the developmental disability family support program 
154.34  account, the alternative care account, the medical assistance 
154.35  account, or the consumer support grant account shall be based on 
154.36  each county's participation in transferring persons to the 
155.1   consumer support grant program from those programs and services. 
155.2      (b) At the beginning of each fiscal year, county 
155.3   allocations for consumer support grants shall be based on: 
155.4      (1) the number of persons to whom the county board expects 
155.5   to provide consumer supports grants; 
155.6      (2) their eligibility for current program and services; 
155.7      (3) the amount of nonfederal dollars expended on those 
155.8   individuals for those programs and services or, in situations 
155.9   where an individual is unable to obtain the support needed from 
155.10  the program of origination due to the unavailability of service 
155.11  providers at the time or the location where the supports are 
155.12  needed, the allocation will be based on the county's best 
155.13  estimate of the nonfederal dollars that would have been expended 
155.14  if the services had been available; and 
155.15     (4) projected dates when persons will start receiving 
155.16  grants.  County allocations shall be adjusted periodically by 
155.17  the commissioner based on the actual transfer of persons or 
155.18  service openings, and the nonfederal dollars associated with 
155.19  those persons or service openings, to the consumer support grant 
155.20  program. 
155.21     (c) The amount of funds transferred by the commissioner 
155.22  from the alternative care account and the medical assistance 
155.23  account for an individual may be changed if it is determined by 
155.24  the county or its agent that the individual's need for support 
155.25  has changed. 
155.26     (d) The authority to utilize funds transferred to the 
155.27  consumer support grant account for the purposes of implementing 
155.28  and administering the consumer support grant program will not be 
155.29  limited or constrained by the spending authority provided to the 
155.30  program of origination. 
155.31     (e) The commissioner shall may use up to five percent of 
155.32  each county's allocation, as adjusted, for payments to that 
155.33  county for administrative expenses, to be paid as a 
155.34  proportionate addition to reported direct service expenditures. 
155.35     (f) Except as provided in this paragraph, the county 
155.36  allocation for each individual or individual's family cannot 
156.1   exceed 80 percent of the total nonfederal dollars expended on 
156.2   the individual by the program of origination except for the 
156.3   developmental disabilities family support grant program which 
156.4   can be approved up to 100 percent of the nonfederal dollars and 
156.5   in situations as described in paragraph (b), clause (3).  In 
156.6   situations where exceptional need exists or the individual's 
156.7   need for support increases, up to 100 percent of the nonfederal 
156.8   dollars expended by the consumer's program of origination may be 
156.9   allocated to the county.  Allocations that exceed 80 percent of 
156.10  the nonfederal dollars expended on the individual by the program 
156.11  of origination must be approved by the commissioner.  The 
156.12  remainder of the amount expended on the individual by the 
156.13  program of origination will be used in the following 
156.14  proportions:  half will be made available to the consumer 
156.15  support grant program and participating counties for consumer 
156.16  training, resource development, and other costs, and half will 
156.17  be returned to the state general fund. 
156.18     (g) The commissioner may recover, suspend, or withhold 
156.19  payments if the county board, local agency, or grantee does not 
156.20  comply with the requirements of this section. 
156.21     (h) Grant funds unexpended by consumers shall return to the 
156.22  state once a year.  The annual return of unexpended grant funds 
156.23  shall occur in the quarter following the end of the state fiscal 
156.24  year. 
156.25     Sec. 14.  Minnesota Statutes 2000, section 256.476, 
156.26  subdivision 8, is amended to read: 
156.27     Subd. 8.  [COMMISSIONER RESPONSIBILITIES.] The commissioner 
156.28  shall: 
156.29     (1) transfer and allocate funds pursuant to this section; 
156.30     (2) determine allocations based on projected and actual 
156.31  local agency use; 
156.32     (3) monitor and oversee overall program spending; 
156.33     (4) evaluate the effectiveness of the program; 
156.34     (5) provide training and technical assistance for local 
156.35  agencies and consumers to help identify potential applicants to 
156.36  the program; and 
157.1      (6) develop guidelines for local agency program 
157.2   administration and consumer information; and.  
157.3      (7) apply for a federal waiver or take any other action 
157.4   necessary to maximize federal funding for the program by 
157.5   September 1, 1999. 
157.6      Sec. 15.  Minnesota Statutes 2000, section 256B.0625, 
157.7   subdivision 7, is amended to read: 
157.8      Subd. 7.  [PRIVATE DUTY NURSING.] Medical assistance covers 
157.9   private duty nursing services in a recipient's home.  Recipients 
157.10  who are authorized to receive private duty nursing services in 
157.11  their home may use approved hours outside of the home during 
157.12  hours when normal life activities take them outside of their 
157.13  home and when, without the provision of private duty nursing, 
157.14  their health and safety would be jeopardized.  To use private 
157.15  duty nursing services at school, the recipient or responsible 
157.16  party must provide written authorization in the care plan 
157.17  identifying the chosen provider and the daily amount of services 
157.18  to be used at school.  Medical assistance does not cover private 
157.19  duty nursing services for residents of a hospital, nursing 
157.20  facility, intermediate care facility, or a health care facility 
157.21  licensed by the commissioner of health, except as authorized in 
157.22  section 256B.64 for ventilator-dependent recipients in hospitals 
157.23  or unless a resident who is otherwise eligible is on leave from 
157.24  the facility and the facility either pays for the private duty 
157.25  nursing services or forgoes the facility per diem for the leave 
157.26  days that private duty nursing services are used.  Total hours 
157.27  of service and payment allowed for services outside the home 
157.28  cannot exceed that which is otherwise allowed in an in-home 
157.29  setting according to section 256B.0627.  All private duty 
157.30  nursing services must be provided according to the limits 
157.31  established under section 256B.0627.  Private duty nursing 
157.32  services may not be reimbursed if the nurse is the spouse of the 
157.33  recipient or the parent or foster care provider of a recipient 
157.34  who is under age 18, or the recipient's legal guardian. 
157.35     Sec. 16.  Minnesota Statutes 2000, section 256B.0625, 
157.36  subdivision 19a, is amended to read: 
158.1      Subd. 19a.  [PERSONAL CARE ASSISTANT SERVICES.] Medical 
158.2   assistance covers personal care assistant services in a 
158.3   recipient's home.  To qualify for personal care assistant 
158.4   services, recipients or responsible parties must be able to 
158.5   identify the recipient's needs, direct and evaluate task 
158.6   accomplishment, and provide for health and safety.  Approved 
158.7   hours may be used outside the home when normal life activities 
158.8   take them outside the home and when, without the provision of 
158.9   personal care, their health and safety would be jeopardized.  To 
158.10  use personal care assistant services at school, the recipient or 
158.11  responsible party must provide written authorization in the care 
158.12  plan identifying the chosen provider and the daily amount of 
158.13  services to be used at school.  Total hours for services, 
158.14  whether actually performed inside or outside the recipient's 
158.15  home, cannot exceed that which is otherwise allowed for personal 
158.16  care assistant services in an in-home setting according to 
158.17  section 256B.0627.  Medical assistance does not cover personal 
158.18  care assistant services for residents of a hospital, nursing 
158.19  facility, intermediate care facility, health care facility 
158.20  licensed by the commissioner of health, or unless a resident who 
158.21  is otherwise eligible is on leave from the facility and the 
158.22  facility either pays for the personal care assistant services or 
158.23  forgoes the facility per diem for the leave days that personal 
158.24  care assistant services are used.  All personal care services 
158.25  must be provided according to section 256B.0627.  Personal 
158.26  care assistant services may not be reimbursed if the personal 
158.27  care assistant is the spouse or legal guardian of the recipient 
158.28  or the parent of a recipient under age 18, or the responsible 
158.29  party or the foster care provider of a recipient who cannot 
158.30  direct the recipient's own care unless, in the case of a foster 
158.31  care provider, a county or state case manager visits the 
158.32  recipient as needed, but not less than every six months, to 
158.33  monitor the health and safety of the recipient and to ensure the 
158.34  goals of the care plan are met.  Parents of adult recipients, 
158.35  adult children of the recipient or adult siblings of the 
158.36  recipient may be reimbursed for personal care assistant services 
159.1   if they are not the recipient's legal guardian and, if they are 
159.2   granted a waiver under section 256B.0627.  Until July 1, 2001, 
159.3   and Notwithstanding the provisions of section 256B.0627, 
159.4   subdivision 4, paragraph (b), clause (4), the noncorporate legal 
159.5   guardian or conservator of an adult, who is not the responsible 
159.6   party and not the personal care provider organization, may be 
159.7   granted a hardship waiver under section 256B.0627, to be 
159.8   reimbursed to provide personal care assistant services to the 
159.9   recipient, and shall not be considered to have a service 
159.10  provider interest for purposes of participation on the screening 
159.11  team under section 256B.092, subdivision 7. 
159.12     Sec. 17.  Minnesota Statutes 2000, section 256B.0625, 
159.13  subdivision 19c, is amended to read: 
159.14     Subd. 19c.  [PERSONAL CARE.] Medical assistance covers 
159.15  personal care assistant services provided by an individual who 
159.16  is qualified to provide the services according to subdivision 
159.17  19a and section 256B.0627, where the services are prescribed by 
159.18  a physician in accordance with a plan of treatment and are 
159.19  supervised by the recipient under the fiscal agent option 
159.20  according to section 256B.0627, subdivision 10, or a qualified 
159.21  professional.  "Qualified professional" means a mental health 
159.22  professional as defined in section 245.462, subdivision 18, or 
159.23  245.4871, subdivision 27; or a registered nurse as defined in 
159.24  sections 148.171 to 148.285.  As part of the assessment, the 
159.25  county public health nurse will consult with assist the 
159.26  recipient or responsible party and to identify the most 
159.27  appropriate person to provide supervision of the personal care 
159.28  assistant.  The qualified professional shall perform the duties 
159.29  described in Minnesota Rules, part 9505.0335, subpart 4.  
159.30     Sec. 18.  Minnesota Statutes 2000, section 256B.0625, 
159.31  subdivision 20, is amended to read: 
159.32     Subd. 20.  [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 
159.33  extent authorized by rule of the state agency, medical 
159.34  assistance covers case management services to persons with 
159.35  serious and persistent mental illness and children with severe 
159.36  emotional disturbance.  Services provided under this section 
160.1   must meet the relevant standards in sections 245.461 to 
160.2   245.4888, the Comprehensive Adult and Children's Mental Health 
160.3   Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 
160.4   9505.0322, excluding subpart 10. 
160.5      (b) Entities meeting program standards set out in rules 
160.6   governing family community support services as defined in 
160.7   section 245.4871, subdivision 17, are eligible for medical 
160.8   assistance reimbursement for case management services for 
160.9   children with severe emotional disturbance when these services 
160.10  meet the program standards in Minnesota Rules, parts 9520.0900 
160.11  to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
160.12     (c) Medical assistance and MinnesotaCare payment for mental 
160.13  health case management shall be made on a monthly basis.  In 
160.14  order to receive payment for an eligible child, the provider 
160.15  must document at least a face-to-face contact with the child, 
160.16  the child's parents, or the child's legal representative.  To 
160.17  receive payment for an eligible adult, the provider must 
160.18  document: 
160.19     (1) at least a face-to-face contact with the adult or the 
160.20  adult's legal representative; or 
160.21     (2) at least a telephone contact with the adult or the 
160.22  adult's legal representative and document a face-to-face contact 
160.23  with the adult or the adult's legal representative within the 
160.24  preceding two months. 
160.25     (d) Payment for mental health case management provided by 
160.26  county or state staff shall be based on the monthly rate 
160.27  methodology under section 256B.094, subdivision 6, paragraph 
160.28  (b), with separate rates calculated for child welfare and mental 
160.29  health, and within mental health, separate rates for children 
160.30  and adults. 
160.31     (e) Payment for mental health case management provided by 
160.32  county-contracted vendors shall be based on a monthly rate 
160.33  negotiated by the host county.  The negotiated rate must not 
160.34  exceed the rate charged by the vendor for the same service to 
160.35  other payers.  If the service is provided by a team of 
160.36  contracted vendors, the county may negotiate a team rate with a 
161.1   vendor who is a member of the team.  The team shall determine 
161.2   how to distribute the rate among its members.  No reimbursement 
161.3   received by contracted vendors shall be returned to the county, 
161.4   except to reimburse the county for advance funding provided by 
161.5   the county to the vendor. 
161.6      (f) If the service is provided by a team which includes 
161.7   contracted vendors and county or state staff, the costs for 
161.8   county or state staff participation in the team shall be 
161.9   included in the rate for county-provided services.  In this 
161.10  case, the contracted vendor and the county may each receive 
161.11  separate payment for services provided by each entity in the 
161.12  same month.  In order to prevent duplication of services, the 
161.13  county must document, in the recipient's file, the need for team 
161.14  case management and a description of the roles of the team 
161.15  members. 
161.16     (g) The commissioner shall calculate the nonfederal share 
161.17  of actual medical assistance and general assistance medical care 
161.18  payments for each county, based on the higher of calendar year 
161.19  1995 or 1996, by service date, project that amount forward to 
161.20  1999, and transfer one-half of the result from medical 
161.21  assistance and general assistance medical care to each county's 
161.22  mental health grants under sections 245.4886 and 256E.12 for 
161.23  calendar year 1999.  The annualized minimum amount added to each 
161.24  county's mental health grant shall be $3,000 per year for 
161.25  children and $5,000 per year for adults.  The commissioner may 
161.26  reduce the statewide growth factor in order to fund these 
161.27  minimums.  The annualized total amount transferred shall become 
161.28  part of the base for future mental health grants for each county.
161.29     (h) Any net increase in revenue to the county as a result 
161.30  of the change in this section must be used to provide expanded 
161.31  mental health services as defined in sections 245.461 to 
161.32  245.4888, the Comprehensive Adult and Children's Mental Health 
161.33  Acts, excluding inpatient and residential treatment.  For 
161.34  adults, increased revenue may also be used for services and 
161.35  consumer supports which are part of adult mental health projects 
161.36  approved under Laws 1997, chapter 203, article 7, section 25.  
162.1   For children, increased revenue may also be used for respite 
162.2   care and nonresidential individualized rehabilitation services 
162.3   as defined in section 245.492, subdivisions 17 and 23.  
162.4   "Increased revenue" has the meaning given in Minnesota Rules, 
162.5   part 9520.0903, subpart 3.  
162.6      (i) Notwithstanding section 256B.19, subdivision 1, the 
162.7   nonfederal share of costs for mental health case management 
162.8   shall be provided by the recipient's county of responsibility, 
162.9   as defined in sections 256G.01 to 256G.12, from sources other 
162.10  than federal funds or funds used to match other federal funds.  
162.11     (j) The commissioner may suspend, reduce, or terminate the 
162.12  reimbursement to a provider that does not meet the reporting or 
162.13  other requirements of this section.  The county of 
162.14  responsibility, as defined in sections 256G.01 to 256G.12, is 
162.15  responsible for any federal disallowances.  The county may share 
162.16  this responsibility with its contracted vendors.  
162.17     (k) The commissioner shall set aside a portion of the 
162.18  federal funds earned under this section to repay the special 
162.19  revenue maximization account under section 256.01, subdivision 
162.20  2, clause (15).  The repayment is limited to: 
162.21     (1) the costs of developing and implementing this section; 
162.22  and 
162.23     (2) programming the information systems. 
162.24     (l) Notwithstanding section 256.025, subdivision 2, 
162.25  payments to counties for case management expenditures under this 
162.26  section shall only be made from federal earnings from services 
162.27  provided under this section.  Payments to contracted vendors 
162.28  shall include both the federal earnings and the county share. 
162.29     (m) Notwithstanding section 256B.041, county payments for 
162.30  the cost of mental health case management services provided by 
162.31  county or state staff shall not be made to the state treasurer.  
162.32  For the purposes of mental health case management services 
162.33  provided by county or state staff under this section, the 
162.34  centralized disbursement of payments to counties under section 
162.35  256B.041 consists only of federal earnings from services 
162.36  provided under this section. 
163.1      (n) Case management services under this subdivision do not 
163.2   include therapy, treatment, legal, or outreach services. 
163.3      (o) If the recipient is a resident of a nursing facility, 
163.4   intermediate care facility, or hospital, and the recipient's 
163.5   institutional care is paid by medical assistance, payment for 
163.6   case management services under this subdivision is limited to 
163.7   the last 30 180 days of the recipient's residency in that 
163.8   facility and may not exceed more than two six months in a 
163.9   calendar year. 
163.10     (p) Payment for case management services under this 
163.11  subdivision shall not duplicate payments made under other 
163.12  program authorities for the same purpose. 
163.13     (q) By July 1, 2000, the commissioner shall evaluate the 
163.14  effectiveness of the changes required by this section, including 
163.15  changes in number of persons receiving mental health case 
163.16  management, changes in hours of service per person, and changes 
163.17  in caseload size. 
163.18     (r) For each calendar year beginning with the calendar year 
163.19  2001, the annualized amount of state funds for each county 
163.20  determined under paragraph (g) shall be adjusted by the county's 
163.21  percentage change in the average number of clients per month who 
163.22  received case management under this section during the fiscal 
163.23  year that ended six months prior to the calendar year in 
163.24  question, in comparison to the prior fiscal year. 
163.25     (s) For counties receiving the minimum allocation of $3,000 
163.26  or $5,000 described in paragraph (g), the adjustment in 
163.27  paragraph (r) shall be determined so that the county receives 
163.28  the higher of the following amounts: 
163.29     (1) a continuation of the minimum allocation in paragraph 
163.30  (g); or 
163.31     (2) an amount based on that county's average number of 
163.32  clients per month who received case management under this 
163.33  section during the fiscal year that ended six months prior to 
163.34  the calendar year in question, in comparison to the prior fiscal 
163.35  year, times the average statewide grant per person per month for 
163.36  counties not receiving the minimum allocation. 
164.1      (t) The adjustments in paragraphs (r) and (s) shall be 
164.2   calculated separately for children and adults. 
164.3      Sec. 19.  Minnesota Statutes 2000, section 256B.0625, is 
164.4   amended by adding a subdivision to read: 
164.5      Subd. 43.  [TARGETED CASE MANAGEMENT.] For purposes of 
164.6   subdivisions 43a to 43h, the following terms have the meanings 
164.7   given them: 
164.8      (1) "Home care service recipients" means those individuals 
164.9   receiving the following services under section 256B.0627:  
164.10  skilled nursing visits, home health aide visits, private duty 
164.11  nursing, personal care assistants, or therapies provided through 
164.12  a home health agency. 
164.13     (2) "Home care targeted case management" means the 
164.14  provision of targeted case management services for the purpose 
164.15  of assisting home care service recipients to gain access to 
164.16  needed services and supports so that they may remain in the 
164.17  community. 
164.18     (3) "Institutions" means hospitals, consistent with Code of 
164.19  Federal Regulations, title 42, section 440.10; regional 
164.20  treatment center inpatient services, consistent with section 
164.21  245.474; nursing facilities; and intermediate care facilities 
164.22  for persons with mental retardation. 
164.23     (4) "Relocation targeted case management" means the 
164.24  provision of targeted case management services for the purpose 
164.25  of assisting recipients to gain access to needed services and 
164.26  supports if they choose to move from an institution to the 
164.27  community.  Relocation targeted case management may be provided 
164.28  during the last 180 consecutive days of an eligible recipient's 
164.29  institutional stay. 
164.30     (5) "Targeted case management" means case management 
164.31  services provided to help recipients gain access to needed 
164.32  medical, social, educational, and other services and supports. 
164.33     Sec. 20.  Minnesota Statutes 2000, section 256B.0625, is 
164.34  amended by adding a subdivision to read: 
164.35     Subd. 43a.  [ELIGIBILITY.] The following persons are 
164.36  eligible for relocation targeted case management or home care 
165.1   targeted case management: 
165.2      (1) medical assistance eligible persons residing in 
165.3   institutions who choose to move into the community are eligible 
165.4   for relocation targeted case management services; and 
165.5      (2) medical assistance eligible persons receiving home care 
165.6   services, who are not eligible for any other medical assistance 
165.7   reimbursable case management service, are eligible for home care 
165.8   targeted case management services beginning January 1, 2003.  
165.9      Sec. 21.  Minnesota Statutes 2000, section 256B.0625, is 
165.10  amended by adding a subdivision to read: 
165.11     Subd. 43b.  [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 
165.12  QUALIFICATIONS.] The following qualifications and certification 
165.13  standards must be met by providers of relocation targeted case 
165.14  management: 
165.15     (a) The commissioner must certify each provider of 
165.16  relocation targeted case management before enrollment.  The 
165.17  certification process shall examine the provider's ability to 
165.18  meet the requirements in this subdivision and other federal and 
165.19  state requirements of this service.  A certified relocation 
165.20  targeted case management provider may subcontract with another 
165.21  provider to deliver relocation targeted case management 
165.22  services.  Subcontracted providers must demonstrate the ability 
165.23  to provide the services outlined in subdivision 43d. 
165.24     (b) A relocation targeted case management provider is an 
165.25  enrolled medical assistance provider who is determined by the 
165.26  commissioner to have all of the following characteristics: 
165.27     (1) the legal authority to provide public welfare under 
165.28  sections 393.01, subdivision 7; and 393.07, or a federally 
165.29  recognized Indian tribe; 
165.30     (2) the demonstrated capacity and experience to provide the 
165.31  components of case management to coordinate and link community 
165.32  resources needed by the eligible population; 
165.33     (3) the administrative capacity and experience to serve the 
165.34  target population for whom it will provide services and ensure 
165.35  quality of services under state and federal requirements; 
165.36     (4) the legal authority to provide complete investigative 
166.1   and protective services under section 626.556, subdivision 10, 
166.2   and child welfare and foster care services under section 393.07, 
166.3   subdivisions 1 and 2, or a federally recognized Indian tribe; 
166.4      (5) a financial management system that provides accurate 
166.5   documentation of services and costs under state and federal 
166.6   requirements; and 
166.7      (6) the capacity to document and maintain individual case 
166.8   records under state and federal requirements. 
166.9   A provider of targeted case management under subdivision 20 may 
166.10  be deemed a certified provider of relocation targeted case 
166.11  management. 
166.12     Sec. 22. Minnesota Statutes 2000, section 256B.0625, is 
166.13  amended by adding a subdivision to read: 
166.14     Subd. 43c.  [HOME CARE TARGETED CASE MANAGEMENT PROVIDER 
166.15  QUALIFICATIONS.] The following qualifications and certification 
166.16  standards must be met by providers of home care targeted case 
166.17  management. 
166.18     (a) The commissioner must certify each provider of home 
166.19  care targeted case management before enrollment.  The 
166.20  certification process shall examine the provider's ability to 
166.21  meet the requirements in this subdivision and other state and 
166.22  federal requirements of this service. 
166.23     (b) A home care targeted case management provider is an 
166.24  enrolled medical assistance provider who has a minimum of a 
166.25  bachelor's degree or a license in a health or human services 
166.26  field, and is determined by the commissioner to have all of the 
166.27  following characteristics: 
166.28     (1) the demonstrated capacity and experience to provide the 
166.29  components of case management to coordinate and link community 
166.30  resources needed by the eligible population; 
166.31     (2) the administrative capacity and experience to serve the 
166.32  target population for whom it will provide services and ensure 
166.33  quality of services under state and federal requirements; 
166.34     (3) a financial management system that provides accurate 
166.35  documentation of services and costs under state and federal 
166.36  requirements; 
167.1      (4) the capacity to document and maintain individual case 
167.2   records under state and federal requirements; and 
167.3      (5) the capacity to coordinate with county administrative 
167.4   functions. 
167.5      Sec. 23.  Minnesota Statutes 2000, section 256B.0625, is 
167.6   amended by adding a subdivision to read: 
167.7      Subd. 43d.  [ELIGIBLE SERVICES.] Services eligible for 
167.8   medical assistance reimbursement as targeted case management 
167.9   include: 
167.10     (1) assessment of the recipient's need for targeted case 
167.11  management services; 
167.12     (2) development, completion, and regular review of a 
167.13  written individual service plan, which is based upon the 
167.14  assessment of the recipient's needs and choices, and which will 
167.15  ensure access to medical, social, educational, and other related 
167.16  services and supports; 
167.17     (3) routine contact or communication with the recipient, 
167.18  recipient's family, primary caregiver, legal representative, 
167.19  substitute care provider, service providers, or other relevant 
167.20  persons identified as necessary to the development or 
167.21  implementation of the goals of the individual service plan; 
167.22     (4) coordinating referrals for, and the provision of, case 
167.23  management services for the recipient with appropriate service 
167.24  providers, consistent with section 1902(a)(23) of the Social 
167.25  Security Act; 
167.26     (5) coordinating and monitoring the overall service 
167.27  delivery to ensure quality of services, appropriateness, and 
167.28  continued need; 
167.29     (6) completing and maintaining necessary documentation that 
167.30  supports and verifies the activities in this subdivision; 
167.31     (7) traveling to conduct a visit with the recipient or 
167.32  other relevant person necessary to develop or implement the 
167.33  goals of the individual service plan; and 
167.34     (8) coordinating with the institution discharge planner in 
167.35  the 180-day period before the recipient's discharge. 
167.36     Sec. 24.  Minnesota Statutes 2000, section 256B.0625, is 
168.1   amended by adding a subdivision to read: 
168.2      Subd. 43e.  [TIME LINES.] The following time lines must be 
168.3   met for assigning a case manager: 
168.4      (1) for relocation targeted case management, an eligible 
168.5   recipient must be assigned a case manager who visits the person 
168.6   within 20 working days of requesting a case manager from their 
168.7   county of financial responsibility as determined under chapter 
168.8   256G.  If a county agency does not provide case management 
168.9   services as required, the recipient may, after written notice to 
168.10  the county agency, obtain targeted relocation case management 
168.11  services from a home care targeted case management provider, as 
168.12  defined in subdivision 43c; and 
168.13     (2) for home care targeted case management, an eligible 
168.14  recipient must be assigned a case manager within 20 working days 
168.15  of requesting a case manager from a home care targeted case 
168.16  management provider, as defined in subdivision 43c. 
168.17     Sec. 25.  Minnesota Statutes 2000, section 256B.0625, is 
168.18  amended by adding a subdivision to read: 
168.19     Subd. 43f.  [EVALUATION.] The commissioner shall evaluate 
168.20  the delivery of targeted case management, including, but not 
168.21  limited to, access to case management services, consumer 
168.22  satisfaction with case management services, and quality of case 
168.23  management services. 
168.24     Sec. 26.  Minnesota Statutes 2000, section 256B.0625, is 
168.25  amended by adding a subdivision to read: 
168.26     Subd. 43g.  [CONTACT DOCUMENTATION.] The case manager must 
168.27  document each face-to-face and telephone contact with the 
168.28  recipient and others involved in the recipient's individual 
168.29  service plan. 
168.30     Sec. 27.  Minnesota Statutes 2000, section 256B.0625, is 
168.31  amended by adding a subdivision to read: 
168.32     Subd. 43h.  [PAYMENT RATES.] The commissioner shall set 
168.33  payment rates for targeted case management under this 
168.34  subdivision.  Case managers may bill according to the following 
168.35  criteria: 
168.36     (1) for relocation targeted case management, case managers 
169.1   may bill for direct case management activities, including 
169.2   face-to-face and telephone contacts, in the 180 days preceding 
169.3   an eligible recipient's discharge from an institution; 
169.4      (2) for home care targeted case management, case managers 
169.5   may bill for direct case management activities, including 
169.6   face-to-face and telephone contacts; and 
169.7      (3) billings for targeted case management services under 
169.8   this subdivision shall not duplicate payments made under other 
169.9   program authorities for the same purpose. 
169.10     Sec. 28.  Minnesota Statutes 2000, section 256B.0627, 
169.11  subdivision 1, is amended to read: 
169.12     Subdivision 1.  [DEFINITION.] (a) "Activities of daily 
169.13  living" includes eating, toileting, grooming, dressing, bathing, 
169.14  transferring, mobility, and positioning.  
169.15     (b) "Assessment" means a review and evaluation of a 
169.16  recipient's need for home care services conducted in person.  
169.17  Assessments for private duty nursing shall be conducted by a 
169.18  registered private duty nurse.  Assessments for home health 
169.19  agency services shall be conducted by a home health agency 
169.20  nurse.  Assessments for personal care assistant services shall 
169.21  be conducted by the county public health nurse or a certified 
169.22  public health nurse under contract with the county.  A 
169.23  face-to-face assessment must include:  documentation of health 
169.24  status, determination of need, evaluation of service 
169.25  effectiveness, identification of appropriate services, service 
169.26  plan development or modification, coordination of services, 
169.27  referrals and follow-up to appropriate payers and community 
169.28  resources, completion of required reports, recommendation of 
169.29  service authorization, and consumer education.  Once the need 
169.30  for personal care assistant services is determined under this 
169.31  section, the county public health nurse or certified public 
169.32  health nurse under contract with the county is responsible for 
169.33  communicating this recommendation to the commissioner and the 
169.34  recipient.  A face-to-face assessment for personal 
169.35  care assistant services is conducted on those recipients who 
169.36  have never had a county public health nurse assessment.  A 
170.1   face-to-face assessment must occur at least annually or when 
170.2   there is a significant change in the recipient's condition or 
170.3   when there is a change in the need for personal care assistant 
170.4   services.  A service update may substitute for the annual 
170.5   face-to-face assessment when there is not a significant change 
170.6   in recipient condition or a change in the need for personal care 
170.7   assistant service.  A service update or review for temporary 
170.8   increase includes a review of initial baseline data, evaluation 
170.9   of service effectiveness, redetermination of service need, 
170.10  modification of service plan and appropriate referrals, update 
170.11  of initial forms, obtaining service authorization, and on going 
170.12  consumer education.  Assessments for medical assistance home 
170.13  care services for mental retardation or related conditions and 
170.14  alternative care services for developmentally disabled home and 
170.15  community-based waivered recipients may be conducted by the 
170.16  county public health nurse to ensure coordination and avoid 
170.17  duplication.  Assessments must be completed on forms provided by 
170.18  the commissioner within 30 days of a request for home care 
170.19  services by a recipient or responsible party. 
170.20     (b) (c) "Care plan" means a written description of personal 
170.21  care assistant services developed by the qualified 
170.22  professional or the recipient's physician with the recipient or 
170.23  responsible party to be used by the personal care assistant with 
170.24  a copy provided to the recipient or responsible party. 
170.25     (d) "Complex and regular private duty nursing care" means, 
170.26  effective July 1, 2001:  
170.27     (1) complex care is private duty nursing provided to 
170.28  recipients who are ventilator dependent or for whom a physician 
170.29  has certified that were it not for private duty nursing the 
170.30  recipient would meet the criteria for inpatient hospital 
170.31  intensive care unit (ICU) level of care; and 
170.32     (2) regular care is private duty nursing provided to all 
170.33  other recipients. 
170.34     (e) "Health-related functions" means functions that can be 
170.35  delegated or assigned by a licensed health care professional 
170.36  under state law to be performed by a personal care attendant. 
171.1      (c) (f) "Home care services" means a health service, 
171.2   determined by the commissioner as medically necessary, that is 
171.3   ordered by a physician and documented in a service plan that is 
171.4   reviewed by the physician at least once every 62 60 days for the 
171.5   provision of home health services, or private duty nursing, or 
171.6   at least once every 365 days for personal care.  Home care 
171.7   services are provided to the recipient at the recipient's 
171.8   residence that is a place other than a hospital or long-term 
171.9   care facility or as specified in section 256B.0625.  
171.10     (g) "Instrumental activities of daily living" includes meal 
171.11  planning and preparation, managing finances, shopping for food, 
171.12  clothing, and other essential items, performing essential 
171.13  household chores, communication by telephone and other media, 
171.14  and getting around and participating in the community. 
171.15     (d) (h) "Medically necessary" has the meaning given in 
171.16  Minnesota Rules, parts 9505.0170 to 9505.0475.  
171.17     (e) (i) "Personal care assistant" means a person who:  
171.18     (1) is at least 18 years old, except for persons 16 to 18 
171.19  years of age who participated in a related school-based job 
171.20  training program or have completed a certified home health aide 
171.21  competency evaluation; 
171.22     (2) is able to effectively communicate with the recipient 
171.23  and personal care provider organization; 
171.24     (3) effective July 1, 1996, has completed one of the 
171.25  training requirements as specified in Minnesota Rules, part 
171.26  9505.0335, subpart 3, items A to D; 
171.27     (4) has the ability to, and provides covered personal care 
171.28  assistant services according to the recipient's care plan, 
171.29  responds appropriately to recipient needs, and reports changes 
171.30  in the recipient's condition to the supervising qualified 
171.31  professional or physician; 
171.32     (5) is not a consumer of personal care assistant services; 
171.33  and 
171.34     (6) is subject to criminal background checks and procedures 
171.35  specified in section 245A.04.  
171.36     (f) (j) "Personal care provider organization" means an 
172.1   organization enrolled to provide personal care assistant 
172.2   services under the medical assistance program that complies with 
172.3   the following:  (1) owners who have a five percent interest or 
172.4   more, and managerial officials are subject to a background study 
172.5   as provided in section 245A.04.  This applies to currently 
172.6   enrolled personal care provider organizations and those agencies 
172.7   seeking enrollment as a personal care provider organization.  An 
172.8   organization will be barred from enrollment if an owner or 
172.9   managerial official of the organization has been convicted of a 
172.10  crime specified in section 245A.04, or a comparable crime in 
172.11  another jurisdiction, unless the owner or managerial official 
172.12  meets the reconsideration criteria specified in section 245A.04; 
172.13  (2) the organization must maintain a surety bond and liability 
172.14  insurance throughout the duration of enrollment and provides 
172.15  proof thereof.  The insurer must notify the department of human 
172.16  services of the cancellation or lapse of policy; and (3) the 
172.17  organization must maintain documentation of services as 
172.18  specified in Minnesota Rules, part 9505.2175, subpart 7, as well 
172.19  as evidence of compliance with personal care assistant training 
172.20  requirements. 
172.21     (g) (k) "Responsible party" means an individual residing 
172.22  with a recipient of personal care assistant services who is 
172.23  capable of providing the supportive care necessary to assist the 
172.24  recipient to live in the community, is at least 18 years old, 
172.25  and is not a personal care assistant.  Responsible parties who 
172.26  are parents of minors or guardians of minors or incapacitated 
172.27  persons may delegate the responsibility to another adult during 
172.28  a temporary absence of at least 24 hours but not more than six 
172.29  months.  The person delegated as a responsible party must be 
172.30  able to meet the definition of responsible party, except that 
172.31  the delegated responsible party is required to reside with the 
172.32  recipient only while serving as the responsible party.  Foster 
172.33  care license holders may be designated the responsible party for 
172.34  residents of the foster care home if case management is provided 
172.35  as required in section 256B.0625, subdivision 19a.  For persons 
172.36  who, as of April 1, 1992, are sharing personal care assistant 
173.1   services in order to obtain the availability of 24-hour 
173.2   coverage, an employee of the personal care provider organization 
173.3   may be designated as the responsible party if case management is 
173.4   provided as required in section 256B.0625, subdivision 19a. 
173.5      (h) (l) "Service plan" means a written description of the 
173.6   services needed based on the assessment developed by the nurse 
173.7   who conducts the assessment together with the recipient or 
173.8   responsible party.  The service plan shall include a description 
173.9   of the covered home care services, frequency and duration of 
173.10  services, and expected outcomes and goals.  The recipient and 
173.11  the provider chosen by the recipient or responsible party must 
173.12  be given a copy of the completed service plan within 30 calendar 
173.13  days of the request for home care services by the recipient or 
173.14  responsible party. 
173.15     (i) (m) "Skilled nurse visits" are provided in a 
173.16  recipient's residence under a plan of care or service plan that 
173.17  specifies a level of care which the nurse is qualified to 
173.18  provide.  These services are: 
173.19     (1) nursing services according to the written plan of care 
173.20  or service plan and accepted standards of medical and nursing 
173.21  practice in accordance with chapter 148; 
173.22     (2) services which due to the recipient's medical condition 
173.23  may only be safely and effectively provided by a registered 
173.24  nurse or a licensed practical nurse; 
173.25     (3) assessments performed only by a registered nurse; and 
173.26     (4) teaching and training the recipient, the recipient's 
173.27  family, or other caregivers requiring the skills of a registered 
173.28  nurse or licensed practical nurse. 
173.29     (n) "Telehomecare" means the use of telecommunications 
173.30  technology by a home health care professional to deliver home 
173.31  health care services, within the professional's scope of 
173.32  practice, to a patient located at a site other than the site 
173.33  where the practitioner is located. 
173.34     Sec. 29.  Minnesota Statutes 2000, section 256B.0627, 
173.35  subdivision 2, is amended to read: 
173.36     Subd. 2.  [SERVICES COVERED.] Home care services covered 
174.1   under this section include:  
174.2      (1) nursing services under section 256B.0625, subdivision 
174.3   6a; 
174.4      (2) private duty nursing services under section 256B.0625, 
174.5   subdivision 7; 
174.6      (3) home health aide services under section 256B.0625, 
174.7   subdivision 6a; 
174.8      (4) personal care assistant services under section 
174.9   256B.0625, subdivision 19a; 
174.10     (5) supervision of personal care assistant services 
174.11  provided by a qualified professional under section 256B.0625, 
174.12  subdivision 19a; 
174.13     (6) consulting qualified professional of personal care 
174.14  assistant services under the fiscal agent intermediary option as 
174.15  specified in subdivision 10; 
174.16     (7) face-to-face assessments by county public health nurses 
174.17  for services under section 256B.0625, subdivision 19a; and 
174.18     (8) service updates and review of temporary increases for 
174.19  personal care assistant services by the county public health 
174.20  nurse for services under section 256B.0625, subdivision 19a. 
174.21     Sec. 30.  Minnesota Statutes 2000, section 256B.0627, 
174.22  subdivision 4, is amended to read: 
174.23     Subd. 4.  [PERSONAL CARE ASSISTANT SERVICES.] (a) The 
174.24  personal care assistant services that are eligible for payment 
174.25  are the following: services and supports furnished to an 
174.26  individual, as needed, to assist in accomplishing activities of 
174.27  daily living; instrumental activities of daily living; 
174.28  health-related functions through hands-on assistance, 
174.29  supervision, and cuing; and redirection and intervention for 
174.30  behavior including observation and monitoring.  
174.31     (b) Payment for services will be made within the limits 
174.32  approved using the prior authorized process established in 
174.33  subdivision 5. 
174.34     (c) The amount and type of services authorized shall be 
174.35  based on an assessment of the recipient's needs in these areas: 
174.36     (1) bowel and bladder care; 
175.1      (2) skin care to maintain the health of the skin; 
175.2      (3) repetitive maintenance range of motion, muscle 
175.3   strengthening exercises, and other tasks specific to maintaining 
175.4   a recipient's optimal level of function; 
175.5      (4) respiratory assistance; 
175.6      (5) transfers and ambulation; 
175.7      (6) bathing, grooming, and hairwashing necessary for 
175.8   personal hygiene; 
175.9      (7) turning and positioning; 
175.10     (8) assistance with furnishing medication that is 
175.11  self-administered; 
175.12     (9) application and maintenance of prosthetics and 
175.13  orthotics; 
175.14     (10) cleaning medical equipment; 
175.15     (11) dressing or undressing; 
175.16     (12) assistance with eating and meal preparation and 
175.17  necessary grocery shopping; 
175.18     (13) accompanying a recipient to obtain medical diagnosis 
175.19  or treatment; 
175.20     (14) assisting, monitoring, or prompting the recipient to 
175.21  complete the services in clauses (1) to (13); 
175.22     (15) redirection, monitoring, and observation that are 
175.23  medically necessary and an integral part of completing the 
175.24  personal care assistant services described in clauses (1) to 
175.25  (14); 
175.26     (16) redirection and intervention for behavior, including 
175.27  observation and monitoring; 
175.28     (17) interventions for seizure disorders, including 
175.29  monitoring and observation if the recipient has had a seizure 
175.30  that requires intervention within the past three months; 
175.31     (18) tracheostomy suctioning using a clean procedure if the 
175.32  procedure is properly delegated by a registered nurse.  Before 
175.33  this procedure can be delegated to a personal care assistant, a 
175.34  registered nurse must determine that the tracheostomy suctioning 
175.35  can be accomplished utilizing a clean rather than a sterile 
175.36  procedure and must ensure that the personal care assistant has 
176.1   been taught the proper procedure; and 
176.2      (19) incidental household services that are an integral 
176.3   part of a personal care service described in clauses (1) to (18).
176.4   For purposes of this subdivision, monitoring and observation 
176.5   means watching for outward visible signs that are likely to 
176.6   occur and for which there is a covered personal care service or 
176.7   an appropriate personal care intervention.  For purposes of this 
176.8   subdivision, a clean procedure refers to a procedure that 
176.9   reduces the numbers of microorganisms or prevents or reduces the 
176.10  transmission of microorganisms from one person or place to 
176.11  another.  A clean procedure may be used beginning 14 days after 
176.12  insertion. 
176.13     (b) (d) The personal care assistant services that are not 
176.14  eligible for payment are the following:  
176.15     (1) services not ordered by the physician; 
176.16     (2) assessments by personal care assistant provider 
176.17  organizations or by independently enrolled registered nurses; 
176.18     (3) services that are not in the service plan; 
176.19     (4) services provided by the recipient's spouse, legal 
176.20  guardian for an adult or child recipient, or parent of a 
176.21  recipient under age 18; 
176.22     (5) services provided by a foster care provider of a 
176.23  recipient who cannot direct the recipient's own care, unless 
176.24  monitored by a county or state case manager under section 
176.25  256B.0625, subdivision 19a; 
176.26     (6) services provided by the residential or program license 
176.27  holder in a residence for more than four persons; 
176.28     (7) services that are the responsibility of a residential 
176.29  or program license holder under the terms of a service agreement 
176.30  and administrative rules; 
176.31     (8) sterile procedures; 
176.32     (9) injections of fluids into veins, muscles, or skin; 
176.33     (10) services provided by parents of adult recipients, 
176.34  adult children, or siblings of the recipient, unless these 
176.35  relatives meet one of the following hardship criteria and the 
176.36  commissioner waives this requirement: 
177.1      (i) the relative resigns from a part-time or full-time job 
177.2   to provide personal care for the recipient; 
177.3      (ii) the relative goes from a full-time to a part-time job 
177.4   with less compensation to provide personal care for the 
177.5   recipient; 
177.6      (iii) the relative takes a leave of absence without pay to 
177.7   provide personal care for the recipient; 
177.8      (iv) the relative incurs substantial expenses by providing 
177.9   personal care for the recipient; or 
177.10     (v) because of labor conditions, special language needs, or 
177.11  intermittent hours of care needed, the relative is needed in 
177.12  order to provide an adequate number of qualified personal care 
177.13  assistants to meet the medical needs of the recipient; 
177.14     (11) homemaker services that are not an integral part of a 
177.15  personal care assistant services; 
177.16     (12) home maintenance, or chore services; 
177.17     (13) services not specified under paragraph (a); and 
177.18     (14) services not authorized by the commissioner or the 
177.19  commissioner's designee. 
177.20     (e) The recipient or responsible party may choose to 
177.21  supervise the personal care assistant or to have a qualified 
177.22  professional, as defined in section 256B.0625, subdivision 19c, 
177.23  provide the supervision.  As required under section 256B.0625, 
177.24  subdivision 19c, the county public health nurse, as a part of 
177.25  the assessment, will assist the recipient or responsible party 
177.26  to identify the most appropriate person to provide supervision 
177.27  of the personal care assistant.  Health-related delegated tasks 
177.28  performed by the personal care assistant will be under the 
177.29  supervision of a qualified professional or the direction of the 
177.30  recipient's physician.  If the recipient has a qualified 
177.31  professional, Minnesota Rules, part 9505.0335, subpart 4, 
177.32  applies. 
177.33     Sec. 31.  Minnesota Statutes 2000, section 256B.0627, 
177.34  subdivision 5, is amended to read: 
177.35     Subd. 5.  [LIMITATION ON PAYMENTS.] Medical assistance 
177.36  payments for home care services shall be limited according to 
178.1   this subdivision.  
178.2      (a)  [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 
178.3   recipient may receive the following home care services during a 
178.4   calendar year: 
178.5      (1) up to two face-to-face assessments to determine a 
178.6   recipient's need for personal care assistant services; 
178.7      (2) one service update done to determine a recipient's need 
178.8   for personal care assistant services; and 
178.9      (3) up to five nine skilled nurse visits.  
178.10     (b)  [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 
178.11  services above the limits in paragraph (a) must receive the 
178.12  commissioner's prior authorization, except when: 
178.13     (1) the home care services were required to treat an 
178.14  emergency medical condition that if not immediately treated 
178.15  could cause a recipient serious physical or mental disability, 
178.16  continuation of severe pain, or death.  The provider must 
178.17  request retroactive authorization no later than five working 
178.18  days after giving the initial service.  The provider must be 
178.19  able to substantiate the emergency by documentation such as 
178.20  reports, notes, and admission or discharge histories; 
178.21     (2) the home care services were provided on or after the 
178.22  date on which the recipient's eligibility began, but before the 
178.23  date on which the recipient was notified that the case was 
178.24  opened.  Authorization will be considered if the request is 
178.25  submitted by the provider within 20 working days of the date the 
178.26  recipient was notified that the case was opened; 
178.27     (3) a third-party payor for home care services has denied 
178.28  or adjusted a payment.  Authorization requests must be submitted 
178.29  by the provider within 20 working days of the notice of denial 
178.30  or adjustment.  A copy of the notice must be included with the 
178.31  request; 
178.32     (4) the commissioner has determined that a county or state 
178.33  human services agency has made an error; or 
178.34     (5) the professional nurse determines an immediate need for 
178.35  up to 40 skilled nursing or home health aide visits per calendar 
178.36  year and submits a request for authorization within 20 working 
179.1   days of the initial service date, and medical assistance is 
179.2   determined to be the appropriate payer. 
179.3      (c)  [RETROACTIVE AUTHORIZATION.] A request for retroactive 
179.4   authorization will be evaluated according to the same criteria 
179.5   applied to prior authorization requests.  
179.6      (d)  [ASSESSMENT AND SERVICE PLAN.] Assessments under 
179.7   section 256B.0627, subdivision 1, paragraph (a), shall be 
179.8   conducted initially, and at least annually thereafter, in person 
179.9   with the recipient and result in a completed service plan using 
179.10  forms specified by the commissioner.  Within 30 days of 
179.11  recipient or responsible party request for home care services, 
179.12  the assessment, the service plan, and other information 
179.13  necessary to determine medical necessity such as diagnostic or 
179.14  testing information, social or medical histories, and hospital 
179.15  or facility discharge summaries shall be submitted to the 
179.16  commissioner.  For personal care assistant services: 
179.17     (1) The amount and type of service authorized based upon 
179.18  the assessment and service plan will follow the recipient if the 
179.19  recipient chooses to change providers.  
179.20     (2) If the recipient's medical need changes, the 
179.21  recipient's provider may assess the need for a change in service 
179.22  authorization and request the change from the county public 
179.23  health nurse.  Within 30 days of the request, the public health 
179.24  nurse will determine whether to request the change in services 
179.25  based upon the provider assessment, or conduct a home visit to 
179.26  assess the need and determine whether the change is appropriate. 
179.27     (3) To continue to receive personal care assistant services 
179.28  after the first year, the recipient or the responsible party, in 
179.29  conjunction with the public health nurse, may complete a service 
179.30  update on forms developed by the commissioner according to 
179.31  criteria and procedures in subdivision 1.  
179.32     (e)  [PRIOR AUTHORIZATION.] The commissioner, or the 
179.33  commissioner's designee, shall review the assessment, service 
179.34  update, request for temporary services, service plan, and any 
179.35  additional information that is submitted.  The commissioner 
179.36  shall, within 30 days after receiving a complete request, 
180.1   assessment, and service plan, authorize home care services as 
180.2   follows:  
180.3      (1)  [HOME HEALTH SERVICES.] All home health services 
180.4   provided by a licensed nurse or a home health aide must be prior 
180.5   authorized by the commissioner or the commissioner's designee.  
180.6   Prior authorization must be based on medical necessity and 
180.7   cost-effectiveness when compared with other care options.  When 
180.8   home health services are used in combination with personal care 
180.9   and private duty nursing, the cost of all home care services 
180.10  shall be considered for cost-effectiveness.  The commissioner 
180.11  shall limit nurse and home health aide visits to no more than 
180.12  one visit each per day.  The commissioner, or the commissioner's 
180.13  designee, may authorize up to two skilled nurse visits per day. 
180.14     (2)  [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal 
180.15  care assistant services and supervision by a qualified 
180.16  professional, if requested by the recipient, must be prior 
180.17  authorized by the commissioner or the commissioner's designee 
180.18  except for the assessments established in paragraph (a).  The 
180.19  amount of personal care assistant services authorized must be 
180.20  based on the recipient's home care rating.  A child may not be 
180.21  found to be dependent in an activity of daily living if because 
180.22  of the child's age an adult would either perform the activity 
180.23  for the child or assist the child with the activity and the 
180.24  amount of assistance needed is similar to the assistance 
180.25  appropriate for a typical child of the same age.  Based on 
180.26  medical necessity, the commissioner may authorize: 
180.27     (A) up to two times the average number of direct care hours 
180.28  provided in nursing facilities for the recipient's comparable 
180.29  case mix level; or 
180.30     (B) up to three times the average number of direct care 
180.31  hours provided in nursing facilities for recipients who have 
180.32  complex medical needs or are dependent in at least seven 
180.33  activities of daily living and need physical assistance with 
180.34  eating or have a neurological diagnosis; or 
180.35     (C) up to 60 percent of the average reimbursement rate, as 
180.36  of July 1, 1991, for care provided in a regional treatment 
181.1   center for recipients who have Level I behavior, plus any 
181.2   inflation adjustment as provided by the legislature for personal 
181.3   care service; or 
181.4      (D) up to the amount the commissioner would pay, as of July 
181.5   1, 1991, plus any inflation adjustment provided for home care 
181.6   services, for care provided in a regional treatment center for 
181.7   recipients referred to the commissioner by a regional treatment 
181.8   center preadmission evaluation team.  For purposes of this 
181.9   clause, home care services means all services provided in the 
181.10  home or community that would be included in the payment to a 
181.11  regional treatment center; or 
181.12     (E) up to the amount medical assistance would reimburse for 
181.13  facility care for recipients referred to the commissioner by a 
181.14  preadmission screening team established under section 256B.0911 
181.15  or 256B.092; and 
181.16     (F) a reasonable amount of time for the provision of 
181.17  supervision by a qualified professional of personal 
181.18  care assistant services, if a qualified professional is 
181.19  requested by the recipient or responsible party.  
181.20     (ii) The number of direct care hours shall be determined 
181.21  according to the annual cost report submitted to the department 
181.22  by nursing facilities.  The average number of direct care hours, 
181.23  as established by May 1, 1992, shall be calculated and 
181.24  incorporated into the home care limits on July 1, 1992.  These 
181.25  limits shall be calculated to the nearest quarter hour. 
181.26     (iii) The home care rating shall be determined by the 
181.27  commissioner or the commissioner's designee based on information 
181.28  submitted to the commissioner by the county public health nurse 
181.29  on forms specified by the commissioner.  The home care rating 
181.30  shall be a combination of current assessment tools developed 
181.31  under sections 256B.0911 and 256B.501 with an addition for 
181.32  seizure activity that will assess the frequency and severity of 
181.33  seizure activity and with adjustments, additions, and 
181.34  clarifications that are necessary to reflect the needs and 
181.35  conditions of recipients who need home care including children 
181.36  and adults under 65 years of age.  The commissioner shall 
182.1   establish these forms and protocols under this section and shall 
182.2   use an advisory group, including representatives of recipients, 
182.3   providers, and counties, for consultation in establishing and 
182.4   revising the forms and protocols. 
182.5      (iv) A recipient shall qualify as having complex medical 
182.6   needs if the care required is difficult to perform and because 
182.7   of recipient's medical condition requires more time than 
182.8   community-based standards allow or requires more skill than 
182.9   would ordinarily be required and the recipient needs or has one 
182.10  or more of the following: 
182.11     (A) daily tube feedings; 
182.12     (B) daily parenteral therapy; 
182.13     (C) wound or decubiti care; 
182.14     (D) postural drainage, percussion, nebulizer treatments, 
182.15  suctioning, tracheotomy care, oxygen, mechanical ventilation; 
182.16     (E) catheterization; 
182.17     (F) ostomy care; 
182.18     (G) quadriplegia; or 
182.19     (H) other comparable medical conditions or treatments the 
182.20  commissioner determines would otherwise require institutional 
182.21  care.  
182.22     (v) A recipient shall qualify as having Level I behavior if 
182.23  there is reasonable supporting evidence that the recipient 
182.24  exhibits, or that without supervision, observation, or 
182.25  redirection would exhibit, one or more of the following 
182.26  behaviors that cause, or have the potential to cause: 
182.27     (A) injury to the recipient's own body; 
182.28     (B) physical injury to other people; or 
182.29     (C) destruction of property. 
182.30     (vi) Time authorized for personal care relating to Level I 
182.31  behavior in subclause (v), items (A) to (C), shall be based on 
182.32  the predictability, frequency, and amount of intervention 
182.33  required. 
182.34     (vii) A recipient shall qualify as having Level II behavior 
182.35  if the recipient exhibits on a daily basis one or more of the 
182.36  following behaviors that interfere with the completion of 
183.1   personal care assistant services under subdivision 4, paragraph 
183.2   (a): 
183.3      (A) unusual or repetitive habits; 
183.4      (B) withdrawn behavior; or 
183.5      (C) offensive behavior. 
183.6      (viii) A recipient with a home care rating of Level II 
183.7   behavior in subclause (vii), items (A) to (C), shall be rated as 
183.8   comparable to a recipient with complex medical needs under 
183.9   subclause (iv).  If a recipient has both complex medical needs 
183.10  and Level II behavior, the home care rating shall be the next 
183.11  complex category up to the maximum rating under subclause (i), 
183.12  item (B). 
183.13     (3)  [PRIVATE DUTY NURSING SERVICES.] All private duty 
183.14  nursing services shall be prior authorized by the commissioner 
183.15  or the commissioner's designee.  Prior authorization for private 
183.16  duty nursing services shall be based on medical necessity and 
183.17  cost-effectiveness when compared with alternative care options.  
183.18  The commissioner may authorize medically necessary private duty 
183.19  nursing services in quarter-hour units when: 
183.20     (i) the recipient requires more individual and continuous 
183.21  care than can be provided during a nurse visit; or 
183.22     (ii) the cares are outside of the scope of services that 
183.23  can be provided by a home health aide or personal care assistant.
183.24     The commissioner may authorize: 
183.25     (A) up to two times the average amount of direct care hours 
183.26  provided in nursing facilities statewide for case mix 
183.27  classification "K" as established by the annual cost report 
183.28  submitted to the department by nursing facilities in May 1992; 
183.29     (B) private duty nursing in combination with other home 
183.30  care services up to the total cost allowed under clause (2); 
183.31     (C) up to 16 hours per day if the recipient requires more 
183.32  nursing than the maximum number of direct care hours as 
183.33  established in item (A) and the recipient meets the hospital 
183.34  admission criteria established under Minnesota Rules, parts 
183.35  9505.0500 9505.0501 to 9505.0540.  
183.36     The commissioner may authorize up to 16 hours per day of 
184.1   medically necessary private duty nursing services or up to 24 
184.2   hours per day of medically necessary private duty nursing 
184.3   services until such time as the commissioner is able to make a 
184.4   determination of eligibility for recipients who are 
184.5   cooperatively applying for home care services under the 
184.6   community alternative care program developed under section 
184.7   256B.49, or until it is determined by the appropriate regulatory 
184.8   agency that a health benefit plan is or is not required to pay 
184.9   for appropriate medically necessary health care services.  
184.10  Recipients or their representatives must cooperatively assist 
184.11  the commissioner in obtaining this determination.  Recipients 
184.12  who are eligible for the community alternative care program may 
184.13  not receive more hours of nursing under this section than would 
184.14  otherwise be authorized under section 256B.49.  
184.15     Beginning July 1, 2001, private duty nursing services shall 
184.16  be authorized for complex and regular care according to 
184.17  subdivision 1. 
184.18     (4)  [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 
184.19  ventilator-dependent, the monthly medical assistance 
184.20  authorization for home care services shall not exceed what the 
184.21  commissioner would pay for care at the highest cost hospital 
184.22  designated as a long-term hospital under the Medicare program.  
184.23  For purposes of this clause, home care services means all 
184.24  services provided in the home that would be included in the 
184.25  payment for care at the long-term hospital.  
184.26  "Ventilator-dependent" means an individual who receives 
184.27  mechanical ventilation for life support at least six hours per 
184.28  day and is expected to be or has been dependent for at least 30 
184.29  consecutive days.  
184.30     (f)  [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 
184.31  or the commissioner's designee shall determine the time period 
184.32  for which a prior authorization shall be effective.  If the 
184.33  recipient continues to require home care services beyond the 
184.34  duration of the prior authorization, the home care provider must 
184.35  request a new prior authorization.  Under no circumstances, 
184.36  other than the exceptions in paragraph (b), shall a prior 
185.1   authorization be valid prior to the date the commissioner 
185.2   receives the request or for more than 12 months.  A recipient 
185.3   who appeals a reduction in previously authorized home care 
185.4   services may continue previously authorized services, other than 
185.5   temporary services under paragraph (h), pending an appeal under 
185.6   section 256.045.  The commissioner must provide a detailed 
185.7   explanation of why the authorized services are reduced in amount 
185.8   from those requested by the home care provider.  
185.9      (g)  [APPROVAL OF HOME CARE SERVICES.] The commissioner or 
185.10  the commissioner's designee shall determine the medical 
185.11  necessity of home care services, the level of caregiver 
185.12  according to subdivision 2, and the institutional comparison 
185.13  according to this subdivision, the cost-effectiveness of 
185.14  services, and the amount, scope, and duration of home care 
185.15  services reimbursable by medical assistance, based on the 
185.16  assessment, primary payer coverage determination information as 
185.17  required, the service plan, the recipient's age, the cost of 
185.18  services, the recipient's medical condition, and diagnosis or 
185.19  disability.  The commissioner may publish additional criteria 
185.20  for determining medical necessity according to section 256B.04. 
185.21     (h)  [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 
185.22  The agency nurse, the independently enrolled private duty nurse, 
185.23  or county public health nurse may request a temporary 
185.24  authorization for home care services by telephone.  The 
185.25  commissioner may approve a temporary level of home care services 
185.26  based on the assessment, and service or care plan information, 
185.27  and primary payer coverage determination information as required.
185.28  Authorization for a temporary level of home care services 
185.29  including nurse supervision is limited to the time specified by 
185.30  the commissioner, but shall not exceed 45 days, unless extended 
185.31  because the county public health nurse has not completed the 
185.32  required assessment and service plan, or the commissioner's 
185.33  determination has not been made.  The level of services 
185.34  authorized under this provision shall have no bearing on a 
185.35  future prior authorization. 
185.36     (i)  [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 
186.1   Home care services provided in an adult or child foster care 
186.2   setting must receive prior authorization by the department 
186.3   according to the limits established in paragraph (a). 
186.4      The commissioner may not authorize: 
186.5      (1) home care services that are the responsibility of the 
186.6   foster care provider under the terms of the foster care 
186.7   placement agreement and administrative rules; 
186.8      (2) personal care assistant services when the foster care 
186.9   license holder is also the personal care provider or personal 
186.10  care assistant unless the recipient can direct the recipient's 
186.11  own care, or case management is provided as required in section 
186.12  256B.0625, subdivision 19a; 
186.13     (3) personal care assistant services when the responsible 
186.14  party is an employee of, or under contract with, or has any 
186.15  direct or indirect financial relationship with the personal care 
186.16  provider or personal care assistant, unless case management is 
186.17  provided as required in section 256B.0625, subdivision 19a; or 
186.18     (4) personal care assistant and private duty nursing 
186.19  services when the number of foster care residents is greater 
186.20  than four unless the county responsible for the recipient's 
186.21  foster placement made the placement prior to April 1, 1992, 
186.22  requests that personal care assistant and private duty nursing 
186.23  services be provided, and case management is provided as 
186.24  required in section 256B.0625, subdivision 19a. 
186.25     Sec. 32.  Minnesota Statutes 2000, section 256B.0627, 
186.26  subdivision 7, is amended to read: 
186.27     Subd. 7.  [NONCOVERED HOME CARE SERVICES.] The following 
186.28  home care services are not eligible for payment under medical 
186.29  assistance:  
186.30     (1) skilled nurse visits for the sole purpose of 
186.31  supervision of the home health aide; 
186.32     (2) a skilled nursing visit: 
186.33     (i) only for the purpose of monitoring medication 
186.34  compliance with an established medication program for a 
186.35  recipient; or 
186.36     (ii) to administer or assist with medication 
187.1   administration, including injections, prefilling syringes for 
187.2   injections, or oral medication set-up of an adult recipient, 
187.3   when as determined and documented by the registered nurse, the 
187.4   need can be met by an available pharmacy or the recipient is 
187.5   physically and mentally able to self-administer or prefill a 
187.6   medication; 
187.7      (3) home care services to a recipient who is eligible for 
187.8   covered services including hospice, if elected by the recipient, 
187.9   under the Medicare program or any other insurance held by the 
187.10  recipient; 
187.11     (4) services to other members of the recipient's household; 
187.12     (5) a visit made by a skilled nurse solely to train other 
187.13  home health agency workers; 
187.14     (6) any home care service included in the daily rate of the 
187.15  community-based residential facility where the recipient is 
187.16  residing; 
187.17     (7) nursing and rehabilitation therapy services that are 
187.18  reasonably accessible to a recipient outside the recipient's 
187.19  place of residence, excluding the assessment, counseling and 
187.20  education, and personal assistant care; 
187.21     (8) any home health agency service, excluding personal care 
187.22  assistant services and private duty nursing services, which are 
187.23  performed in a place other than the recipient's residence; and 
187.24     (9) Medicare evaluation or administrative nursing visits on 
187.25  dual-eligible recipients that do not qualify for Medicare visit 
187.26  billing. 
187.27     Sec. 33.  Minnesota Statutes 2000, section 256B.0627, 
187.28  subdivision 8, is amended to read: 
187.29     Subd. 8.  [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) 
187.30  Medical assistance payments for shared personal care assistance 
187.31  services shall be limited according to this subdivision. 
187.32     (b) Recipients of personal care assistant services may 
187.33  share staff and the commissioner shall provide a rate system for 
187.34  shared personal care assistant services.  For two persons 
187.35  sharing services, the rate paid to a provider shall not exceed 
187.36  1-1/2 times the rate paid for serving a single individual, and 
188.1   for three persons sharing services, the rate paid to a provider 
188.2   shall not exceed twice the rate paid for serving a single 
188.3   individual.  These rates apply only to situations in which all 
188.4   recipients were present and received shared services on the date 
188.5   for which the service is billed.  No more than three persons may 
188.6   receive shared services from a personal care assistant in a 
188.7   single setting. 
188.8      (c) Shared service is the provision of personal 
188.9   care assistant services by a personal care assistant to two or 
188.10  three recipients at the same time and in the same setting.  For 
188.11  the purposes of this subdivision, "setting" means: 
188.12     (1) the home or foster care home of one of the individual 
188.13  recipients; or 
188.14     (2) a child care program in which all recipients served by 
188.15  one personal care assistant are participating, which is licensed 
188.16  under chapter 245A or operated by a local school district or 
188.17  private school; or 
188.18     (3) outside the home or foster care home of one of the 
188.19  recipients when normal life activities take the recipients 
188.20  outside the home.  
188.21     The provisions of this subdivision do not apply when a 
188.22  personal care assistant is caring for multiple recipients in 
188.23  more than one setting. 
188.24     (d) The recipient or the recipient's responsible party, in 
188.25  conjunction with the county public health nurse, shall determine:
188.26     (1) whether shared personal care assistant services is an 
188.27  appropriate option based on the individual needs and preferences 
188.28  of the recipient; and 
188.29     (2) the amount of shared services allocated as part of the 
188.30  overall authorization of personal care assistant services. 
188.31     The recipient or the responsible party, in conjunction with 
188.32  the supervising qualified professional, if a qualified 
188.33  professional is requested by any one of the recipients or 
188.34  responsible parties, shall arrange the setting and grouping of 
188.35  shared services based on the individual needs and preferences of 
188.36  the recipients.  Decisions on the selection of recipients to 
189.1   share services must be based on the ages of the recipients, 
189.2   compatibility, and coordination of their care needs. 
189.3      (e) The following items must be considered by the recipient 
189.4   or the responsible party and the supervising qualified 
189.5   professional, if a qualified professional has been requested by 
189.6   any one of the recipients or responsible parties, and documented 
189.7   in the recipient's health service record: 
189.8      (1) the additional qualifications needed by the personal 
189.9   care assistant to provide care to several recipients in the same 
189.10  setting; 
189.11     (2) the additional training and supervision needed by the 
189.12  personal care assistant to ensure that the needs of the 
189.13  recipient are met appropriately and safely.  The provider must 
189.14  provide on-site supervision by a qualified professional within 
189.15  the first 14 days of shared services, and monthly thereafter, if 
189.16  supervision by a qualified provider has been requested by any 
189.17  one of the recipients or responsible parties; 
189.18     (3) the setting in which the shared services will be 
189.19  provided; 
189.20     (4) the ongoing monitoring and evaluation of the 
189.21  effectiveness and appropriateness of the service and process 
189.22  used to make changes in service or setting; and 
189.23     (5) a contingency plan which accounts for absence of the 
189.24  recipient in a shared services setting due to illness or other 
189.25  circumstances and staffing contingencies. 
189.26     (f) The provider must offer the recipient or the 
189.27  responsible party the option of shared or one-on-one personal 
189.28  care assistant services.  The recipient or the responsible party 
189.29  can withdraw from participating in a shared services arrangement 
189.30  at any time. 
189.31     (g) In addition to documentation requirements under 
189.32  Minnesota Rules, part 9505.2175, a personal care provider must 
189.33  meet documentation requirements for shared personal care 
189.34  assistant services and must document the following in the health 
189.35  service record for each individual recipient sharing services: 
189.36     (1) permission by the recipient or the recipient's 
190.1   responsible party, if any, for the maximum number of shared 
190.2   services hours per week chosen by the recipient; 
190.3      (2) permission by the recipient or the recipient's 
190.4   responsible party, if any, for personal care assistant services 
190.5   provided outside the recipient's residence; 
190.6      (3) permission by the recipient or the recipient's 
190.7   responsible party, if any, for others to receive shared services 
190.8   in the recipient's residence; 
190.9      (4) revocation by the recipient or the recipient's 
190.10  responsible party, if any, of the shared service authorization, 
190.11  or the shared service to be provided to others in the 
190.12  recipient's residence, or the shared service to be provided 
190.13  outside the recipient's residence; 
190.14     (5) supervision of the shared personal care assistant 
190.15  services by the qualified professional, if a qualified 
190.16  professional is requested by one of the recipients or 
190.17  responsible parties, including the date, time of day, number of 
190.18  hours spent supervising the provision of shared services, 
190.19  whether the supervision was face-to-face or another method of 
190.20  supervision, changes in the recipient's condition, shared 
190.21  services scheduling issues and recommendations; 
190.22     (6) documentation by the qualified professional, if a 
190.23  qualified professional is requested by one of the recipients or 
190.24  responsible parties, of telephone calls or other discussions 
190.25  with the personal care assistant regarding services being 
190.26  provided to the recipient who has requested the supervision; and 
190.27     (7) daily documentation of the shared services provided by 
190.28  each identified personal care assistant including: 
190.29     (i) the names of each recipient receiving shared services 
190.30  together; 
190.31     (ii) the setting for the shared services, including the 
190.32  starting and ending times that the recipient received shared 
190.33  services; and 
190.34     (iii) notes by the personal care assistant regarding 
190.35  changes in the recipient's condition, problems that may arise 
190.36  from the sharing of services, scheduling issues, care issues, 
191.1   and other notes as required by the qualified professional, if a 
191.2   qualified professional is requested by one of the recipients or 
191.3   responsible parties. 
191.4      (h) Unless otherwise provided in this subdivision, all 
191.5   other statutory and regulatory provisions relating to personal 
191.6   care assistant services apply to shared services. 
191.7      (i) In the event that supervision by a qualified 
191.8   professional has been requested by one or more recipients, but 
191.9   not by all of the recipients, the supervision duties of the 
191.10  qualified professional shall be limited to only those recipients 
191.11  who have requested the supervision. 
191.12     Nothing in this subdivision shall be construed to reduce 
191.13  the total number of hours authorized for an individual recipient.
191.14     Sec. 34.  Minnesota Statutes 2000, section 256B.0627, 
191.15  subdivision 10, is amended to read: 
191.16     Subd. 10.  [FISCAL AGENT INTERMEDIARY OPTION AVAILABLE FOR 
191.17  PERSONAL CARE ASSISTANT SERVICES.] (a) "Fiscal agent option" is 
191.18  an option that allows the recipient to: 
191.19     (1) use a fiscal agent instead of a personal care provider 
191.20  organization; 
191.21     (2) supervise the personal care assistant; and 
191.22     (3) use a consulting professional. 
191.23     The commissioner may allow a recipient of personal care 
191.24  assistant services to use a fiscal agent intermediary to assist 
191.25  the recipient in paying and accounting for medically necessary 
191.26  covered personal care assistant services authorized in 
191.27  subdivision 4 and within the payment parameters of subdivision 
191.28  5.  Unless otherwise provided in this subdivision, all other 
191.29  statutory and regulatory provisions relating to personal care 
191.30  assistant services apply to a recipient using the fiscal agent 
191.31  intermediary option. 
191.32     (b) The recipient or responsible party shall: 
191.33     (1) hire, and terminate the personal care assistant and 
191.34  consulting professional, with the fiscal agent recruit, hire, 
191.35  and terminate a qualified professional, if a qualified 
191.36  professional is requested by the recipient or responsible party; 
192.1      (2) recruit the personal care assistant and consulting 
192.2   professional and orient and train the personal care assistant in 
192.3   areas that do not require professional delegation as determined 
192.4   by the county public health nurse verify and document the 
192.5   credentials of the qualified professional, if a qualified 
192.6   professional is requested by the recipient or responsible party; 
192.7      (3) supervise and evaluate the personal care assistant in 
192.8   areas that do not require professional delegation as determined 
192.9   in the assessment; 
192.10     (4) cooperate with a consulting develop a service plan 
192.11  based on physician orders and public health nurse assessment 
192.12  with the assistance of a qualified professional and implement 
192.13  recommendations pertaining to the health and safety of the 
192.14  recipient, if a qualified professional is requested by the 
192.15  recipient or responsible party, that addresses the health and 
192.16  safety of the recipient; 
192.17     (5) hire a qualified professional to train and supervise 
192.18  the performance of delegated tasks done by (4) recruit, hire, 
192.19  and terminate the personal care assistant; 
192.20     (6) monitor services and verify in writing the hours worked 
192.21  by the personal care assistant and the consulting (5) orient and 
192.22  train the personal care assistant with assistance as needed from 
192.23  the qualified professional; 
192.24     (7) develop and revise a care plan with assistance from a 
192.25  consulting (6) supervise and evaluate the personal care 
192.26  assistant with assistance as needed from the recipient's 
192.27  physician or the qualified professional; 
192.28     (8) verify and document the credentials of the consulting 
192.29  (7) monitor and verify in writing and report to the fiscal 
192.30  intermediary the number of hours worked by the personal care 
192.31  assistant and the qualified professional; and 
192.32     (9) (8) enter into a written agreement, as specified in 
192.33  paragraph (f). 
192.34     (c) The duties of the fiscal agent intermediary shall be to:
192.35     (1) bill the medical assistance program for personal care 
192.36  assistant and consulting qualified professional services; 
193.1      (2) request and secure background checks on personal care 
193.2   assistants and consulting qualified professionals according to 
193.3   section 245A.04; 
193.4      (3) pay the personal care assistant and consulting 
193.5   qualified professional based on actual hours of services 
193.6   provided; 
193.7      (4) withhold and pay all applicable federal and state 
193.8   taxes; 
193.9      (5) verify and document keep records of hours worked by the 
193.10  personal care assistant and consulting qualified professional; 
193.11     (6) make the arrangements and pay unemployment insurance, 
193.12  taxes, workers' compensation, liability insurance, and other 
193.13  benefits, if any; 
193.14     (7) enroll in the medical assistance program as a fiscal 
193.15  agent intermediary; and 
193.16     (8) enter into a written agreement as specified in 
193.17  paragraph (f) before services are provided. 
193.18     (d) The fiscal agent intermediary: 
193.19     (1) may not be related to the recipient, consulting 
193.20  qualified professional, or the personal care assistant; 
193.21     (2) must ensure arm's length transactions with the 
193.22  recipient and personal care assistant; and 
193.23     (3) shall be considered a joint employer of the personal 
193.24  care assistant and consulting qualified professional to the 
193.25  extent specified in this section. 
193.26     The fiscal agent intermediary or owners of the entity that 
193.27  provides fiscal agent intermediary services under this 
193.28  subdivision must pass a criminal background check as required in 
193.29  section 256B.0627, subdivision 1, paragraph (e). 
193.30     (e) If the recipient or responsible party requests a 
193.31  qualified professional, the consulting qualified professional 
193.32  providing assistance to the recipient shall meet the 
193.33  qualifications specified in section 256B.0625, subdivision 19c.  
193.34  The consulting qualified professional shall assist the recipient 
193.35  in developing and revising a plan to meet the 
193.36  recipient's assessed needs, and supervise the performance of 
194.1   delegated tasks, as determined by the public health nurse as 
194.2   assessed by the public health nurse.  In performing this 
194.3   function, the consulting qualified professional must visit the 
194.4   recipient in the recipient's home at least once annually.  
194.5   The consulting qualified professional must report to the local 
194.6   county public health nurse concerns relating to the health and 
194.7   safety of the recipient, and any suspected abuse, neglect, or 
194.8   financial exploitation of the recipient to the appropriate 
194.9   authorities.  
194.10     (f) The fiscal agent intermediary, recipient or responsible 
194.11  party, personal care assistant, and consulting qualified 
194.12  professional shall enter into a written agreement before 
194.13  services are started.  The agreement shall include: 
194.14     (1) the duties of the recipient, qualified professional, 
194.15  personal care assistant, and fiscal agent based on paragraphs 
194.16  (a) to (e); 
194.17     (2) the salary and benefits for the personal care assistant 
194.18  and those providing professional consultation the qualified 
194.19  professional; 
194.20     (3) the administrative fee of the fiscal agent intermediary 
194.21  and services paid for with that fee, including background check 
194.22  fees; 
194.23     (4) procedures to respond to billing or payment complaints; 
194.24  and 
194.25     (5) procedures for hiring and terminating the personal care 
194.26  assistant and those providing professional consultation the 
194.27  qualified professional. 
194.28     (g) The rates paid for personal care assistant services, 
194.29  qualified professional assistance services, and fiscal agency 
194.30  intermediary services under this subdivision shall be the same 
194.31  rates paid for personal care assistant services and qualified 
194.32  professional services under subdivision 2 respectively.  Except 
194.33  for the administrative fee of the fiscal agent intermediary 
194.34  specified in paragraph (f), the remainder of the rates paid to 
194.35  the fiscal agent intermediary must be used to pay for the salary 
194.36  and benefits for the personal care assistant or those providing 
195.1   professional consultation the qualified professional. 
195.2      (h) As part of the assessment defined in subdivision 1, the 
195.3   following conditions must be met to use or continue use of a 
195.4   fiscal agent intermediary: 
195.5      (1) the recipient must be able to direct the recipient's 
195.6   own care, or the responsible party for the recipient must be 
195.7   readily available to direct the care of the personal care 
195.8   assistant; 
195.9      (2) the recipient or responsible party must be 
195.10  knowledgeable of the health care needs of the recipient and be 
195.11  able to effectively communicate those needs; 
195.12     (3) a face-to-face assessment must be conducted by the 
195.13  local county public health nurse at least annually, or when 
195.14  there is a significant change in the recipient's condition or 
195.15  change in the need for personal care assistant services.  The 
195.16  county public health nurse shall determine the services that 
195.17  require professional delegation, if any, and the amount and 
195.18  frequency of related supervision; 
195.19     (4) the recipient cannot select the shared services option 
195.20  as specified in subdivision 8; and 
195.21     (5) parties must be in compliance with the written 
195.22  agreement specified in paragraph (f). 
195.23     (i) The commissioner shall deny, revoke, or suspend the 
195.24  authorization to use the fiscal agent intermediary option if: 
195.25     (1) it has been determined by the consulting qualified 
195.26  professional or local county public health nurse that the use of 
195.27  this option jeopardizes the recipient's health and safety; 
195.28     (2) the parties have failed to comply with the written 
195.29  agreement specified in paragraph (f); or 
195.30     (3) the use of the option has led to abusive or fraudulent 
195.31  billing for personal care assistant services.  
195.32     The recipient or responsible party may appeal the 
195.33  commissioner's action according to section 256.045.  The denial, 
195.34  revocation, or suspension to use the fiscal agent intermediary 
195.35  option shall not affect the recipient's authorized level of 
195.36  personal care assistant services as determined in subdivision 5. 
196.1      Sec. 35.  Minnesota Statutes 2000, section 256B.0627, 
196.2   subdivision 11, is amended to read: 
196.3      Subd. 11.  [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 
196.4   Medical assistance payments for shared private duty nursing 
196.5   services by a private duty nurse shall be limited according to 
196.6   this subdivision.  For the purposes of this section, "private 
196.7   duty nursing agency" means an agency licensed under chapter 144A 
196.8   to provide private duty nursing services. 
196.9      (b) Recipients of private duty nursing services may share 
196.10  nursing staff and the commissioner shall provide a rate 
196.11  methodology for shared private duty nursing.  For two persons 
196.12  sharing nursing care, the rate paid to a provider shall not 
196.13  exceed 1.5 times the nonwaivered regular private duty nursing 
196.14  rates paid for serving a single individual who is not ventilator 
196.15  dependent, by a registered nurse or licensed practical nurse.  
196.16  These rates apply only to situations in which both recipients 
196.17  are present and receive shared private duty nursing care on the 
196.18  date for which the service is billed.  No more than two persons 
196.19  may receive shared private duty nursing services from a private 
196.20  duty nurse in a single setting. 
196.21     (c) Shared private duty nursing care is the provision of 
196.22  nursing services by a private duty nurse to two recipients at 
196.23  the same time and in the same setting.  For the purposes of this 
196.24  subdivision, "setting" means: 
196.25     (1) the home or foster care home of one of the individual 
196.26  recipients; or 
196.27     (2) a child care program licensed under chapter 245A or 
196.28  operated by a local school district or private school; or 
196.29     (3) an adult day care service licensed under chapter 245A; 
196.30  or 
196.31     (4) outside the home or foster care home of one of the 
196.32  recipients when normal life activities take the recipients 
196.33  outside the home.  
196.34     This subdivision does not apply when a private duty nurse 
196.35  is caring for multiple recipients in more than one setting. 
196.36     (d) The recipient or the recipient's legal representative, 
197.1   and the recipient's physician, in conjunction with the home 
197.2   health care agency, shall determine: 
197.3      (1) whether shared private duty nursing care is an 
197.4   appropriate option based on the individual needs and preferences 
197.5   of the recipient; and 
197.6      (2) the amount of shared private duty nursing services 
197.7   authorized as part of the overall authorization of nursing 
197.8   services. 
197.9      (e) The recipient or the recipient's legal representative, 
197.10  in conjunction with the private duty nursing agency, shall 
197.11  approve the setting, grouping, and arrangement of shared private 
197.12  duty nursing care based on the individual needs and preferences 
197.13  of the recipients.  Decisions on the selection of recipients to 
197.14  share services must be based on the ages of the recipients, 
197.15  compatibility, and coordination of their care needs. 
197.16     (f) The following items must be considered by the recipient 
197.17  or the recipient's legal representative and the private duty 
197.18  nursing agency, and documented in the recipient's health service 
197.19  record: 
197.20     (1) the additional training needed by the private duty 
197.21  nurse to provide care to two recipients in the same setting and 
197.22  to ensure that the needs of the recipients are met appropriately 
197.23  and safely; 
197.24     (2) the setting in which the shared private duty nursing 
197.25  care will be provided; 
197.26     (3) the ongoing monitoring and evaluation of the 
197.27  effectiveness and appropriateness of the service and process 
197.28  used to make changes in service or setting; 
197.29     (4) a contingency plan which accounts for absence of the 
197.30  recipient in a shared private duty nursing setting due to 
197.31  illness or other circumstances; 
197.32     (5) staffing backup contingencies in the event of employee 
197.33  illness or absence; and 
197.34     (6) arrangements for additional assistance to respond to 
197.35  urgent or emergency care needs of the recipients. 
197.36     (g) The provider must offer the recipient or responsible 
198.1   party the option of shared or one-on-one private duty nursing 
198.2   services.  The recipient or responsible party can withdraw from 
198.3   participating in a shared service arrangement at any time. 
198.4      (h) The private duty nursing agency must document the 
198.5   following in the health service record for each individual 
198.6   recipient sharing private duty nursing care: 
198.7      (1) permission by the recipient or the recipient's legal 
198.8   representative for the maximum number of shared nursing care 
198.9   hours per week chosen by the recipient; 
198.10     (2) permission by the recipient or the recipient's legal 
198.11  representative for shared private duty nursing services provided 
198.12  outside the recipient's residence; 
198.13     (3) permission by the recipient or the recipient's legal 
198.14  representative for others to receive shared private duty nursing 
198.15  services in the recipient's residence; 
198.16     (4) revocation by the recipient or the recipient's legal 
198.17  representative of the shared private duty nursing care 
198.18  authorization, or the shared care to be provided to others in 
198.19  the recipient's residence, or the shared private duty nursing 
198.20  services to be provided outside the recipient's residence; and 
198.21     (5) daily documentation of the shared private duty nursing 
198.22  services provided by each identified private duty nurse, 
198.23  including: 
198.24     (i) the names of each recipient receiving shared private 
198.25  duty nursing services together; 
198.26     (ii) the setting for the shared services, including the 
198.27  starting and ending times that the recipient received shared 
198.28  private duty nursing care; and 
198.29     (iii) notes by the private duty nurse regarding changes in 
198.30  the recipient's condition, problems that may arise from the 
198.31  sharing of private duty nursing services, and scheduling and 
198.32  care issues. 
198.33     (i) Unless otherwise provided in this subdivision, all 
198.34  other statutory and regulatory provisions relating to private 
198.35  duty nursing services apply to shared private duty nursing 
198.36  services. 
199.1      Nothing in this subdivision shall be construed to reduce 
199.2   the total number of private duty nursing hours authorized for an 
199.3   individual recipient under subdivision 5. 
199.4      Sec. 36.  Minnesota Statutes 2000, section 256B.0627, is 
199.5   amended by adding a subdivision to read: 
199.6      Subd. 13.  [CONSUMER-DIRECTED HOME CARE DEMONSTRATION 
199.7   PROJECT.] (a) Upon the receipt of federal waiver authority, the 
199.8   commissioner shall implement a consumer-directed home care 
199.9   demonstration project.  The consumer-directed home care 
199.10  demonstration project must demonstrate and evaluate the outcomes 
199.11  of a consumer-directed service delivery alternative to improve 
199.12  access, increase consumer control and accountability over 
199.13  available resources, and enable the use of supports that are 
199.14  more individualized and cost-effective for eligible medical 
199.15  assistance recipients receiving certain medical assistance home 
199.16  care services.  The consumer-directed home care demonstration 
199.17  project will be administered locally by county agencies, tribal 
199.18  governments, or administrative entities under contract with the 
199.19  state in regions where counties choose not to provide this 
199.20  service. 
199.21     (b) Grant awards for persons who have been receiving 
199.22  medical assistance covered personal care, home health aide, or 
199.23  private duty nursing services for a period of 12 consecutive 
199.24  months or more prior to enrollment in the consumer-directed home 
199.25  care demonstration project will be established on a case-by-case 
199.26  basis using historical service expenditure data.  An average 
199.27  monthly expenditure for each continuing enrollee will be 
199.28  calculated based on historical expenditures made on behalf of 
199.29  the enrollee for personal care, home health aide, or private 
199.30  duty nursing services during the 12 month period directly prior 
199.31  to enrollment in the project.  The grant award will equal 90 
199.32  percent of the average monthly expenditure. 
199.33     (c) Grant awards for project enrollees who have been 
199.34  receiving medical assistance covered personal care, home health 
199.35  aide, or private duty nursing services for a period of less than 
199.36  12 consecutive months prior to project enrollment will be 
200.1   calculated on a case-by-case basis using the service 
200.2   authorization in place at the time of enrollment.  The total 
200.3   number of units of personal care, home health aide, or private 
200.4   duty nursing services the enrollee has been authorized to 
200.5   receive will be converted to the total cost of the authorized 
200.6   services in a given month using the statewide average service 
200.7   payment rates.  To determine an estimated monthly expenditure, 
200.8   the total authorized monthly personal care, home health aide or 
200.9   private duty nursing service costs will be reduced by a 
200.10  percentage rate equivalent to the difference between the 
200.11  statewide average service authorization and the statewide 
200.12  average utilization rate for each of the services by medical 
200.13  assistance eligibles during the most recent fiscal year for 
200.14  which 12 months of data is available.  The grant award will 
200.15  equal 90 percent of the estimated monthly expenditure. 
200.16     (d) The state of Minnesota, county agencies, tribal 
200.17  governments, or administrative entities under contract with the 
200.18  state that participate in the implementation and administration 
200.19  of the consumer-directed home care demonstration project, shall 
200.20  not be liable for damages, injuries, or liabilities sustained 
200.21  through the purchase of support by the individual, the 
200.22  individual's family, or the authorized representative under this 
200.23  section with funds received through the consumer-directed home 
200.24  care demonstration project.  Liabilities include but are not 
200.25  limited to:  workers' compensation liability, the Federal 
200.26  Insurance Contributions Act (FICA), or the Federal Unemployment 
200.27  Tax Act (FUTA). 
200.28     Sec. 37.  Minnesota Statutes 2000, section 256B.0627, is 
200.29  amended by adding a subdivision to read: 
200.30     Subd. 14.  [TELEHOMECARE; SKILLED NURSE VISITS.] Medical 
200.31  assistance covers skilled nurse visits according to section 
200.32  256B.0625, subdivision 6a, provided via telehomecare, for 
200.33  services which do not require hands-on care between the home 
200.34  care nurse and recipient.  The provision of telehomecare must be 
200.35  made via live, two-way interactive audiovisual technology and 
200.36  may be augmented by utilizing store-and-forward technologies.  
201.1   Store-and-forward technology includes telehomecare services that 
201.2   do not occur in real time via synchronous transmissions, and 
201.3   that do not require a face-to-face encounter with the recipient 
201.4   for all or any part of any such telehomecare visit.  
201.5   Individually identifiable patient data obtained through 
201.6   real-time or store-and-forward technology must be maintained in 
201.7   a confidential manner.  If the video is used for research, 
201.8   training, or other purposes unrelated to the care of the 
201.9   patient, the identity of the patient must be concealed.  A 
201.10  communication between the home care nurse and recipient that 
201.11  consists solely of a telephone conversation, facsimile, 
201.12  electronic mail, or a consultation between two health care 
201.13  practitioners, is not to be considered a telehomecare visit.  
201.14  Multiple daily skilled nurse visits provided via telehomecare 
201.15  are allowed.  Coverage of telehomecare is limited to two visits 
201.16  per day.  All skilled nurse visits provided via telehomecare 
201.17  must be prior authorized by the commissioner or the 
201.18  commissioner's designee and will be covered at the same 
201.19  allowable rate as skilled nurse visits provided in-person. 
201.20     Sec. 38.  Minnesota Statutes 2000, section 256B.0627, is 
201.21  amended by adding a subdivision to read: 
201.22     Subd. 15.  [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a)  
201.23  [PHYSICAL THERAPY.] Medical assistance covers physical therapy 
201.24  and related services, including specialized maintenance 
201.25  therapy.  Services provided by a physical therapy assistant 
201.26  shall be reimbursed at the same rate as services performed by a 
201.27  physical therapist when the services of the physical therapy 
201.28  assistant are provided under the direction of a physical 
201.29  therapist who is on the premises.  Services provided by a 
201.30  physical therapy assistant that are provided under the direction 
201.31  of a physical therapist who is not on the premises shall be 
201.32  reimbursed at 65 percent of the physical therapist rate.  
201.33  Direction of the physical therapy assistant must be provided by 
201.34  the physical therapist as described in Minnesota Rules, part 
201.35  9505.0390, subpart 1, item B.  The physical therapist and 
201.36  physical therapist assistant may not both bill for services 
202.1   provided to a recipient on the same day. 
202.2      (b)  [OCCUPATIONAL THERAPY.] Medical assistance covers 
202.3   occupational therapy and related services, including specialized 
202.4   maintenance therapy.  Services provided by an occupational 
202.5   therapy assistant shall be reimbursed at the same rate as 
202.6   services performed by an occupational therapist when the 
202.7   services of the occupational therapy assistant are provided 
202.8   under the direction of the occupational therapist who is on the 
202.9   premises.  Services provided by an occupational therapy 
202.10  assistant under the direction of an occupational therapist who 
202.11  is not on the premises shall be reimbursed at 65 percent of the 
202.12  occupational therapist rate.  Direction of the occupational 
202.13  therapy assistant must be provided by the occupational therapist 
202.14  as described in Minnesota Rules, part 9505.0390, subpart 1, item 
202.15  B.  The occupational therapist and occupational therapist 
202.16  assistant may not both bill for services provided to a recipient 
202.17  on the same day. 
202.18     Sec. 39.  Minnesota Statutes 2000, section 256B.0627, is 
202.19  amended by adding a subdivision to read: 
202.20     Subd. 16.  [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) 
202.21  Payment is allowed for extraordinary services that require 
202.22  specialized nursing skills and are provided by parents of minor 
202.23  children, spouses, and legal guardians who are providing private 
202.24  duty nursing care under the following conditions: 
202.25     (1) the provision of these services is not legally required 
202.26  of the parents, spouses, or legal guardians; 
202.27     (2) the services are necessary to prevent hospitalization 
202.28  of the recipient; and 
202.29     (3) the recipient is eligible for state plan home care or a 
202.30  home and community-based waiver and one of the following 
202.31  hardship criteria are met: 
202.32     (i) the parent, spouse, or legal guardian resigns from a 
202.33  part-time or full-time job to provide nursing care for the 
202.34  recipient; or 
202.35     (ii) the parent, spouse, or legal guardian goes from a 
202.36  full-time to a part-time job with less compensation to provide 
203.1   nursing care for the recipient; or 
203.2      (iii) the parent, spouse, or legal guardian takes a leave 
203.3   of absence without pay to provide nursing care for the 
203.4   recipient; or 
203.5      (iv) because of labor conditions, special language needs, 
203.6   or intermittent hours of care needed, the parent, spouse, or 
203.7   legal guardian is needed in order to provide adequate private 
203.8   duty nursing services to meet the medical needs of the recipient.
203.9      (b) Private duty nursing may be provided by a parent, 
203.10  spouse, or legal guardian who is a nurse licensed in Minnesota.  
203.11  Private duty nursing services provided by a parent, spouse, or 
203.12  legal guardian cannot be used in lieu of nursing services 
203.13  covered and available under liable third-party payers, including 
203.14  Medicare.  The private duty nursing provided by a parent, 
203.15  spouse, or legal guardian must be included in the service plan.  
203.16  Authorized skilled nursing services provided by the parent, 
203.17  spouse, or legal guardian may not exceed 50 percent of the total 
203.18  approved nursing hours, or eight hours per day, whichever is 
203.19  less, up to a maximum of 40 hours per week.  Nothing in this 
203.20  subdivision precludes the parent's, spouse's, or legal 
203.21  guardian's obligation of assuming the nonreimbursed family 
203.22  responsibilities of emergency backup caregiver and primary 
203.23  caregiver. 
203.24     (c) A parent or a spouse may not be paid to provide private 
203.25  duty nursing care if the parent or spouse fails to pass a 
203.26  criminal background check according to section 245A.04, or if it 
203.27  has been determined by the home health agency, the case manager, 
203.28  or the physician that the private duty nursing care provided by 
203.29  the parent, spouse, or legal guardian is unsafe. 
203.30     Sec. 40.  Minnesota Statutes 2000, section 256B.0627, is 
203.31  amended by adding a subdivision to read: 
203.32     Subd. 17.  [QUALITY ASSURANCE PLAN FOR PERSONAL CARE 
203.33  ASSISTANT SERVICES.] The commissioner shall establish a quality 
203.34  assurance plan for personal care assistant services that 
203.35  includes: 
203.36     (1) performance-based provider agreements; 
204.1      (2) meaningful consumer input, which may include consumer 
204.2   surveys, that measure the extent to which participants receive 
204.3   the services and supports described in the individual plan and 
204.4   participant satisfaction with such services and supports; 
204.5      (3) ongoing monitoring of the health and well-being of 
204.6   consumers; and 
204.7      (4) an ongoing public process for development, 
204.8   implementation, and review of the quality assurance plan.  
204.9      Sec. 41.  Minnesota Statutes 2000, section 256B.0911, is 
204.10  amended by adding a subdivision to read: 
204.11     Subd. 4a.  [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 
204.12  YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 
204.13  ensure that individuals with disabilities or chronic illness are 
204.14  served in the most integrated setting appropriate to their needs 
204.15  and have the necessary information to make informed choices 
204.16  about home and community-based service options. 
204.17     (b) Individuals under 65 years of age who are admitted to a 
204.18  nursing facility from a hospital must be screened prior to 
204.19  admission as outlined in subdivision 4. 
204.20     (c) Individuals under 65 years of age who are admitted to 
204.21  nursing facilities with only a telephone screening must receive 
204.22  a face-to-face assessment from the long-term care consultation 
204.23  team member of the county in which the facility is located or 
204.24  from the recipient's county case manager within 20 working days 
204.25  of admission. 
204.26     (d) At the face-to-face assessment, the long-term care 
204.27  consultation team member or county case manager must perform the 
204.28  activities required under subdivision 3. 
204.29     (e) For individuals under 21 years of age, the screening or 
204.30  assessment which recommends nursing facility admission must be 
204.31  approved by the commissioner before the individual is admitted 
204.32  to the nursing facility. 
204.33     (f) In the event that an individual under 65 years of age 
204.34  is admitted to a nursing facility on an emergency basis, the 
204.35  county must be notified of the admission on the next working 
204.36  day, and a face-to-face assessment as described in paragraph (c) 
205.1   must be conducted within 20 working days of admission. 
205.2      (g) At the face-to-face assessment, the long-term care 
205.3   consultation team member or the case manager must present 
205.4   information about home and community-based options so the 
205.5   individual can make informed choices.  If the individual chooses 
205.6   home and community-based services, the long-term care 
205.7   consultation team member or case manager must complete a written 
205.8   relocation plan within 20 working days of the visit.  The plan 
205.9   shall describe the services needed to move out of the facility 
205.10  and a time line for the move which is designed to ensure a 
205.11  smooth transition to the individual's home and community. 
205.12     (h) An individual under 65 years of age residing in a 
205.13  nursing facility shall receive a face-to-face assessment at 
205.14  least every 12 months to review the person's service choices and 
205.15  available alternatives unless the individual indicates, in 
205.16  writing, that annual visits are not desired.  In this case, the 
205.17  individual must receive a face-to-face assessment at least once 
205.18  every 36 months for the same purposes. 
205.19     (i) Notwithstanding the provisions of subdivision 6, the 
205.20  commissioner may pay county agencies directly for face-to-face 
205.21  assessments for individuals who are eligible for medical 
205.22  assistance, under 65 years of age, and being considered for 
205.23  placement or residing in a nursing facility. 
205.24     Sec. 42.  Minnesota Statutes 2000, section 256B.0916, 
205.25  subdivision 1, is amended to read: 
205.26     Subdivision 1.  [REDUCTION OF WAITING LIST.] (a) The 
205.27  legislature recognizes that as of January 1, 1999, 3,300 persons 
205.28  with mental retardation or related conditions have been screened 
205.29  and determined eligible for the home and community-based waiver 
205.30  services program for persons with mental retardation or related 
205.31  conditions.  Many wait for several years before receiving 
205.32  service. 
205.33     (b) The waiting list for this program shall be reduced or 
205.34  eliminated by June 30, 2003.  In order to reduce the number of 
205.35  eligible persons waiting for identified services provided 
205.36  through the home and community-based waiver for persons with 
206.1   mental retardation or related conditions, during the period from 
206.2   July 1, 1999, to June 30, 2003, funding shall be increased to 
206.3   add 100 additional eligible persons each year beyond the 
206.4   February 1999 medical assistance forecast. 
206.5      (c) The commissioner shall allocate resources in such a 
206.6   manner as to use all resources budgeted during a biennium for 
206.7   the home and community-based waiver for persons with mental 
206.8   retardation or related conditions according to the priorities 
206.9   listed in subdivision 2, paragraph (b), and then to serve other 
206.10  persons on the waiting list.  Resources allocated for a fiscal 
206.11  year to serve persons affected by public and private sector 
206.12  ICF/MR closures, but not expected to be expended for that 
206.13  purpose, must be reallocated within that fiscal year to serve 
206.14  other persons on the waiting list, and the number of waiver 
206.15  diversion slots shall be adjusted accordingly. 
206.16     (d) For fiscal year 2001, at least one-half of the increase 
206.17  in funding over the previous year provided in the February 1999 
206.18  medical assistance forecast for the home and community-based 
206.19  waiver for persons with mental retardation and related 
206.20  conditions, including changes made by the 1999 legislature, must 
206.21  be used to serve persons who are not affected by public and 
206.22  private sector ICF/MR closures. 
206.23     (e) The commissioner of finance shall not reduce the 
206.24  expenditure forecast for a biennium for which appropriations 
206.25  have been made, if at the time of the forecast there is a 
206.26  waiting list for waiver services for persons with mental 
206.27  retardation or related conditions who need services within the 
206.28  next 30 months.  Funds that would have resulted from a projected 
206.29  reduction in expenditures must be used by the commissioner of 
206.30  human services to serve persons with developmental disabilities 
206.31  through the home and community-based waiver for persons with 
206.32  mental retardation or related conditions. 
206.33     Sec. 43.  Minnesota Statutes 2000, section 256B.0916, is 
206.34  amended by adding a subdivision to read: 
206.35     Subd. 6a.  [STATEWIDE AVAILABILITY OF CONSUMER-DIRECTED 
206.36  COMMUNITY SUPPORT SERVICES.] (a) The commissioner shall submit 
207.1   to the federal Health Care Financing Administration by August 1, 
207.2   2001, an amendment to the home and community-based waiver for 
207.3   persons with mental retardation or related conditions to make 
207.4   consumer-directed community support services available in every 
207.5   county of the state by January 1, 2002. 
207.6      (b) If a county declines to meet the requirements for 
207.7   provision of consumer-directed community supports, the 
207.8   commissioner shall contract with another county, a group of 
207.9   counties, or a private agency to plan for and administer 
207.10  consumer-directed community supports in that county. 
207.11     (c) The state of Minnesota, county agencies, tribal 
207.12  governments, or administrative entities under contract to 
207.13  participate in the implementation and administration of the home 
207.14  and community-based waiver for persons with mental retardation 
207.15  or a related condition, shall not be liable for damages, 
207.16  injuries, or liabilities sustained through the purchase of 
207.17  support by the individual, the individual's family, or the 
207.18  authorized representative with funds received through the 
207.19  consumer-directed community support service under this section.  
207.20  Liabilities include but are not limited to:  workers' 
207.21  compensation liability, the Federal Insurance Contributions Act 
207.22  (FICA), or the Federal Unemployment Tax Act (FUTA). 
207.23     Sec. 44.  Minnesota Statutes 2000, section 256B.0916, 
207.24  subdivision 7, is amended to read: 
207.25     Subd. 7.  [ANNUAL REPORT BY COMMISSIONER.] Beginning 
207.26  October 1, 1999, and each October 1 November 1, 2001, and each 
207.27  November 1 thereafter, the commissioner shall issue an annual 
207.28  report on county and state use of available resources for the 
207.29  home and community-based waiver for persons with mental 
207.30  retardation or related conditions.  For each county or county 
207.31  partnership, the report shall include: 
207.32     (1) the amount of funds allocated but not used; 
207.33     (2) the county specific allowed reserve amount approved and 
207.34  used; 
207.35     (3) the number, ages, and living situations of individuals 
207.36  screened and waiting for services; 
208.1      (4) the urgency of need for services to begin within one, 
208.2   two, or more than two years for each individual; 
208.3      (5) the services needed; 
208.4      (6) the number of additional persons served by approval of 
208.5   increased capacity within existing allocations; 
208.6      (7) results of action by the commissioner to streamline 
208.7   administrative requirements and improve county resource 
208.8   management; and 
208.9      (8) additional action that would decrease the number of 
208.10  those eligible and waiting for waivered services. 
208.11  The commissioner shall specify intended outcomes for the program 
208.12  and the degree to which these specified outcomes are attained. 
208.13     Sec. 45.  Minnesota Statutes 2000, section 256B.0916, 
208.14  subdivision 9, is amended to read: 
208.15     Subd. 9.  [LEGAL REPRESENTATIVE PARTICIPATION EXCEPTION.] 
208.16  The commissioner, in cooperation with representatives of 
208.17  counties, service providers, service recipients, family members, 
208.18  legal representatives and advocates, shall develop criteria to 
208.19  allow legal representatives to be reimbursed for providing 
208.20  specific support services to meet the person's needs when a plan 
208.21  which assures health and safety has been agreed upon and carried 
208.22  out by the legal representative, the person, and the county.  
208.23  Legal representatives providing support under consumer-directed 
208.24  community support services pursuant to section 256B.092, 
208.25  subdivision 4, the home and community-based waiver for persons 
208.26  with mental retardation or related conditions or the consumer 
208.27  support grant program pursuant to section 256B.092, subdivision 
208.28  7 256.476, shall not be considered to have a direct or indirect 
208.29  service provider interest under section 256B.092, subdivision 7, 
208.30  if a health and safety plan which meets the criteria established 
208.31  has been agreed upon and implemented.  By October 1, 1999 August 
208.32  1, 2001, the commissioner shall submit, for federal approval, 
208.33  amendments to allow legal representatives to provide support and 
208.34  receive reimbursement under the consumer-directed community 
208.35  support services section of the home and community-based waiver 
208.36  plan. 
209.1      Sec. 46.  Minnesota Statutes 2000, section 256B.092, 
209.2   subdivision 2a, is amended to read: 
209.3      Subd. 2a.  [MEDICAL ASSISTANCE FOR CASE MANAGEMENT 
209.4   ACTIVITIES UNDER THE STATE PLAN MEDICAID OPTION.] (a) Upon 
209.5   receipt of federal approval, the commissioner shall make 
209.6   payments to approved vendors counties, private individuals, and 
209.7   agencies enrolled as providers of case management services 
209.8   participating in the medical assistance program to reimburse 
209.9   costs for providing case management service activities to 
209.10  medical assistance eligible persons with mental retardation or a 
209.11  related condition, in accordance with the state Medicaid plan, 
209.12  the home and community-based waiver for persons with mental 
209.13  retardation and related conditions plan, and federal 
209.14  requirements and limitations.  
209.15     (b) The commissioner shall ensure that each eligible person 
209.16  is given a choice of county and private agency case management 
209.17  service providers.  Case management service providers are 
209.18  prohibited from providing any other service to the person 
209.19  receiving case management services. 
209.20     Sec. 47.  Minnesota Statutes 2000, section 256B.092, 
209.21  subdivision 5, is amended to read: 
209.22     Subd. 5.  [FEDERAL WAIVERS.] (a) The commissioner shall 
209.23  apply for any federal waivers necessary to secure, to the extent 
209.24  allowed by law, federal financial participation under United 
209.25  States Code, title 42, sections 1396 et seq., as amended, for 
209.26  the provision of services to persons who, in the absence of the 
209.27  services, would need the level of care provided in a regional 
209.28  treatment center or a community intermediate care facility for 
209.29  persons with mental retardation or related conditions.  The 
209.30  commissioner may seek amendments to the waivers or apply for 
209.31  additional waivers under United States Code, title 42, sections 
209.32  1396 et seq., as amended, to contain costs.  The commissioner 
209.33  shall ensure that payment for the cost of providing home and 
209.34  community-based alternative services under the federal waiver 
209.35  plan shall not exceed the cost of intermediate care services 
209.36  including day training and habilitation services that would have 
210.1   been provided without the waivered services.  
210.2      (b) The commissioner, in administering home and 
210.3   community-based waivers for persons with mental retardation and 
210.4   related conditions, shall ensure that day services for eligible 
210.5   persons are not provided by the person's residential service 
210.6   provider, unless the person or the person's legal representative 
210.7   is offered a choice of providers and agrees in writing to 
210.8   provision of day services by the residential service provider.  
210.9   The individual service plan for individuals who choose to have 
210.10  their residential service provider provide their day services 
210.11  must describe how health, safety, and protection needs will be 
210.12  met by frequent and regular contact with persons other than the 
210.13  residential service provider. 
210.14     Sec. 48.  Minnesota Statutes 2000, section 256B.093, 
210.15  subdivision 3, is amended to read: 
210.16     Subd. 3.  [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The 
210.17  department shall fund administrative case management under this 
210.18  subdivision using medical assistance administrative funds.  The 
210.19  traumatic brain injury program duties include: 
210.20     (1) recommending to the commissioner in consultation with 
210.21  the medical review agent according to Minnesota Rules, parts 
210.22  9505.0500 to 9505.0540, the approval or denial of medical 
210.23  assistance funds to pay for out-of-state placements for 
210.24  traumatic brain injury services and in-state traumatic brain 
210.25  injury services provided by designated Medicare long-term care 
210.26  hospitals; 
210.27     (2) coordinating the traumatic brain injury home and 
210.28  community-based waiver; 
210.29     (3) approving traumatic brain injury waiver eligibility or 
210.30  care plans or both; 
210.31     (4) providing ongoing technical assistance and consultation 
210.32  to county and facility case managers to facilitate care plan 
210.33  development for appropriate, accessible, and cost-effective 
210.34  medical assistance services; 
210.35     (5) (4) providing technical assistance to promote statewide 
210.36  development of appropriate, accessible, and cost-effective 
211.1   medical assistance services and related policy; 
211.2      (6) (5) providing training and outreach to facilitate 
211.3   access to appropriate home and community-based services to 
211.4   prevent institutionalization; 
211.5      (7) (6) facilitating appropriate admissions, continued stay 
211.6   review, discharges, and utilization review for neurobehavioral 
211.7   hospitals and other specialized institutions; 
211.8      (8) (7) providing technical assistance on the use of prior 
211.9   authorization of home care services and coordination of these 
211.10  services with other medical assistance services; 
211.11     (9) (8) developing a system for identification of nursing 
211.12  facility and hospital residents with traumatic brain injury to 
211.13  assist in long-term planning for medical assistance services.  
211.14  Factors will include, but are not limited to, number of 
211.15  individuals served, length of stay, services received, and 
211.16  barriers to community placement; and 
211.17     (10) (9) providing information, referral, and case 
211.18  consultation to access medical assistance services for 
211.19  recipients without a county or facility case manager.  Direct 
211.20  access to this assistance may be limited due to the structure of 
211.21  the program. 
211.22     Sec. 49.  Minnesota Statutes 2000, section 256B.095, is 
211.23  amended to read: 
211.24     256B.095 [THREE-YEAR QUALITY ASSURANCE PILOT PROJECT 
211.25  ESTABLISHED.] 
211.26     Effective July 1, 1998, an alternative quality assurance 
211.27  licensing system pilot project for programs for persons with 
211.28  developmental disabilities is established in Dodge, Fillmore, 
211.29  Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 
211.30  Wabasha, and Winona counties for the purpose of improving the 
211.31  quality of services provided to persons with developmental 
211.32  disabilities.  A county, at its option, may choose to have all 
211.33  programs for persons with developmental disabilities located 
211.34  within the county licensed under chapter 245A using standards 
211.35  determined under the alternative quality assurance licensing 
211.36  system pilot project or may continue regulation of these 
212.1   programs under the licensing system operated by the 
212.2   commissioner.  The pilot project expires on June 30, 2001 2005. 
212.3      Sec. 50.  Minnesota Statutes 2000, section 256B.0951, 
212.4   subdivision 1, is amended to read: 
212.5      Subdivision 1.  [MEMBERSHIP.] The region 10 quality 
212.6   assurance commission is established.  The commission consists of 
212.7   at least 14 but not more than 21 members as follows:  at least 
212.8   three but not more than five members representing advocacy 
212.9   organizations; at least three but not more than five members 
212.10  representing consumers, families, and their legal 
212.11  representatives; at least three but not more than five members 
212.12  representing service providers; at least three but not more than 
212.13  five members representing counties; and the commissioner of 
212.14  human services or the commissioner's designee.  Initial 
212.15  membership of the commission shall be recruited and approved by 
212.16  the region 10 stakeholders group.  Prior to approving the 
212.17  commission's membership, the stakeholders group shall provide to 
212.18  the commissioner a list of the membership in the stakeholders 
212.19  group, as of February 1, 1997, a brief summary of meetings held 
212.20  by the group since July 1, 1996, and copies of any materials 
212.21  prepared by the group for public distribution.  The first 
212.22  commission shall establish membership guidelines for the 
212.23  transition and recruitment of membership for the commission's 
212.24  ongoing existence.  Members of the commission who do not receive 
212.25  a salary or wages from an employer for time spent on commission 
212.26  duties may receive a per diem payment when performing commission 
212.27  duties and functions.  All members may be reimbursed for 
212.28  expenses related to commission activities.  Notwithstanding the 
212.29  provisions of section 15.059, subdivision 5, the commission 
212.30  expires on June 30, 2001 2005. 
212.31     Sec. 51.  Minnesota Statutes 2000, section 256B.0951, 
212.32  subdivision 3, is amended to read: 
212.33     Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
212.34  commission, in cooperation with the commissioners of human 
212.35  services and health, shall do the following:  (1) approve an 
212.36  alternative quality assurance licensing system based on the 
213.1   evaluation of outcomes; (2) approve measurable outcomes in the 
213.2   areas of health and safety, consumer evaluation, education and 
213.3   training, providers, and systems that shall be evaluated during 
213.4   the alternative licensing process; and (3) establish variable 
213.5   licensure periods not to exceed three years based on outcomes 
213.6   achieved.  For purposes of this subdivision, "outcome" means the 
213.7   behavior, action, or status of a person that can be observed or 
213.8   measured and can be reliably and validly determined. 
213.9      (b) By January 15, 1998, the commission shall approve, in 
213.10  cooperation with the commissioner of human services, a training 
213.11  program for members of the quality assurance teams established 
213.12  under section 256B.0952, subdivision 4. 
213.13     (c) The commission and the commissioner shall establish an 
213.14  ongoing review process for the alternative quality assurance 
213.15  licensing system.  The review shall take into account the 
213.16  comprehensive nature of the alternative system, which is 
213.17  designed to evaluate the broad spectrum of licensed and 
213.18  unlicensed entities that provide services to clients, as 
213.19  compared to the current licensing system.  
213.20     (d) The commission shall contract with an independent 
213.21  entity to conduct a financial review of the alternative quality 
213.22  assurance pilot project.  The review shall take into account the 
213.23  comprehensive nature of the alternative system, which is 
213.24  designed to evaluate the broad spectrum of licensed and 
213.25  unlicensed entities that provide services to clients, as 
213.26  compared to the current licensing system.  The review shall 
213.27  include an evaluation of possible budgetary savings within the 
213.28  department of human services as a result of implementation of 
213.29  the alternative quality assurance pilot project.  If a federal 
213.30  waiver is approved under subdivision 7, the financial review 
213.31  shall also evaluate possible savings within the department of 
213.32  health.  This review must be completed by December 15, 2000. 
213.33     (e) The commission shall submit a report to the legislature 
213.34  by January 15, 2001, on the results of the review process for 
213.35  the alternative quality assurance pilot project, a summary of 
213.36  the results of the independent financial review, and a 
214.1   recommendation on whether the pilot project should be extended 
214.2   beyond June 30, 2001. 
214.3      (f) The commissioner, in consultation with the commission, 
214.4   shall examine the feasibility of expanding the project to other 
214.5   populations or geographic areas and identify barriers to 
214.6   expansion.  The commissioner shall report findings and 
214.7   recommendations to the legislature by December 15, 2004. 
214.8      Sec. 52.  Minnesota Statutes 2000, section 256B.0951, 
214.9   subdivision 4, is amended to read: 
214.10     Subd. 4.  [COMMISSION'S AUTHORITY TO RECOMMEND VARIANCES OF 
214.11  LICENSING STANDARDS.] The commission may recommend to the 
214.12  commissioners of human services and health variances from the 
214.13  standards governing licensure of programs for persons with 
214.14  developmental disabilities in order to improve the quality of 
214.15  services by implementing an alternative developmental 
214.16  disabilities licensing system if the commission determines that 
214.17  the alternative licensing system does not adversely affect the 
214.18  health or safety of persons being served by the licensed program 
214.19  nor compromise the qualifications of staff to provide services. 
214.20     Sec. 53.  Minnesota Statutes 2000, section 256B.0951, 
214.21  subdivision 5, is amended to read: 
214.22     Subd. 5.  [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 
214.23  safety standards, rights, or procedural protections under 
214.24  sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 
214.25  3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 
214.26  and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 
214.27  subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 
214.28  procedures for the monitoring of psychotropic medications shall 
214.29  not be varied under the alternative licensing system pilot 
214.30  project.  The commission may make recommendations to the 
214.31  commissioners of human services and health or to the legislature 
214.32  regarding alternatives to or modifications of the rules and 
214.33  procedures referenced in this subdivision. 
214.34     Sec. 54.  Minnesota Statutes 2000, section 256B.0951, 
214.35  subdivision 7, is amended to read: 
214.36     Subd. 7.  [WAIVER OF RULES.] The commissioner of health may 
215.1   exempt residents of intermediate care facilities for persons 
215.2   with mental retardation (ICFs/MR) who participate in the 
215.3   three-year quality assurance pilot project established in 
215.4   section 256B.095 from the requirements of Minnesota Rules, 
215.5   chapter 4665, upon approval by the federal government of a 
215.6   waiver of federal certification requirements for ICFs/MR.  The 
215.7   commissioners of health and human services shall apply for any 
215.8   necessary waivers as soon as practicable and shall submit the 
215.9   concept paper to the federal government by June 1, 1998.  
215.10     Sec. 55.  Minnesota Statutes 2000, section 256B.0951, is 
215.11  amended by adding a subdivision to read: 
215.12     Subd. 8.  [FEDERAL WAIVER.] The commissioner of human 
215.13  services shall seek federal authority to waive provisions of 
215.14  intermediate care facilities for persons with mental retardation 
215.15  (ICFs/MR) regulations to enable the demonstration and evaluation 
215.16  of the alternative quality assurance system for ICFs/MR under 
215.17  the project.  The commissioner of human services shall apply for 
215.18  any necessary waivers as soon as practicable. 
215.19     Sec. 56.  Minnesota Statutes 2000, section 256B.0951, is 
215.20  amended by adding a subdivision to read: 
215.21     Subd. 9.  [EVALUATION.] The commission, in consultation 
215.22  with the commissioner of human services, shall conduct an 
215.23  evaluation of the alternative quality assurance system, and 
215.24  present a report to the commissioner by June 30, 2004. 
215.25     Sec. 57.  Minnesota Statutes 2000, section 256B.0952, 
215.26  subdivision 1, is amended to read: 
215.27     Subdivision 1.  [NOTIFICATION.] By January 15, 1998, each 
215.28  affected county shall notify the commission and the 
215.29  commissioners of human services and health as to whether it 
215.30  chooses to implement on July 1, 1998, the alternative licensing 
215.31  system for the pilot project.  A county that does not implement 
215.32  the alternative licensing system on July 1, 1998, may give 
215.33  notice to the commission and the commissioners by January 15, 
215.34  1999, or January 15, 2000, that it will implement the 
215.35  alternative licensing system on the following July 1.  A county 
215.36  that implements the alternative licensing system commits to 
216.1   participate until June 30, 2001.  For each year of the project, 
216.2   region 10 counties shall give notice to the commission and 
216.3   commissioners of human services and health by March 15 of intent 
216.4   to join the quality assurance alternative licensing system, 
216.5   effective July 1 of that year.  A county choosing to participate 
216.6   in the alternative licensing system commits to participate until 
216.7   June 30, 2005.  Counties participating in the quality assurance 
216.8   alternative licensing system as of January 1, 2001, shall notify 
216.9   the commission and the commissioners of human services and 
216.10  health by March 15, 2001, of intent to continue participation.  
216.11  Counties that elect to continue participation must participate 
216.12  in the alternative licensing system until June 30, 2005. 
216.13     Sec. 58.  Minnesota Statutes 2000, section 256B.0952, 
216.14  subdivision 4, is amended to read: 
216.15     Subd. 4.  [APPOINTMENT OF QUALITY ASSURANCE MANAGER.] (a) A 
216.16  county or group of counties that chooses to participate in the 
216.17  alternative licensing system shall designate a quality assurance 
216.18  manager and shall establish quality assurance teams in 
216.19  accordance with subdivision 5.  The manager shall recruit, 
216.20  train, and assign duties to the quality assurance team members.  
216.21  In assigning team members to conduct the quality assurance 
216.22  process at a facility, program, or service, the manager shall 
216.23  take into account the size of the service provider, the number 
216.24  of services to be reviewed, the skills necessary for team 
216.25  members to complete the process, and other relevant factors.  
216.26  The manager shall ensure that no team member has a financial, 
216.27  personal, or family relationship with the facility, program, or 
216.28  service being reviewed or with any clients of the facility, 
216.29  program, or service. 
216.30     (b) Quality assurance teams shall report the findings of 
216.31  their quality assurance reviews to the quality assurance manager.
216.32  The quality assurance manager shall provide the report from the 
216.33  quality assurance team to the county and, upon request, to the 
216.34  commissioners of human services and health, and shall provide a 
216.35  summary of the report to the quality assurance review council.  
216.36     Sec. 59.  Minnesota Statutes 2000, section 256B.49, is 
217.1   amended by adding a subdivision to read: 
217.2      Subd. 11.  [AUTHORITY.] (a) The commissioner is authorized 
217.3   to apply for home and community-based service waivers, as 
217.4   authorized under section 1915(c) of the Social Security Act to 
217.5   serve persons under the age of 65 who are determined to require 
217.6   the level of care provided in a nursing home and persons who 
217.7   require the level of care provided in a hospital.  The 
217.8   commissioner shall apply for the home and community-based 
217.9   waivers in order to:  (i) promote the support of persons with 
217.10  disabilities in the most integrated settings; (ii) expand the 
217.11  availability of services for persons who are eligible for 
217.12  medical assistance; (iii) promote cost-effective options to 
217.13  institutional care; and (iv) obtain federal financial 
217.14  participation.  
217.15     (b) The provision of waivered services to medical 
217.16  assistance recipients with disabilities shall comply with the 
217.17  requirements outlined in the federally approved applications for 
217.18  home and community-based services and subsequent amendments, 
217.19  including provision of services according to a service plan 
217.20  designed to meet the needs of the individual.  For purposes of 
217.21  this section, the approved home and community-based application 
217.22  is considered the necessary federal requirement. 
217.23     (c) The commissioner shall provide interested persons 
217.24  serving on agency advisory committees and task forces, and 
217.25  others upon request, with notice of, and an opportunity to 
217.26  comment on, any changes or amendments to the federally approved 
217.27  applications for home and community-based waivers, prior to 
217.28  their submission to the federal health care financing 
217.29  administration. 
217.30     (d) The commissioner shall seek approval, as authorized 
217.31  under section 1915(c) of the Social Security Act, to allow 
217.32  medical assistance eligibility under this section for children 
217.33  under age 21 without deeming of parental income or assets. 
217.34     (e) The commissioner shall seek approval, as authorized 
217.35  under section 1915(c) of the Social Act, to allow medical 
217.36  assistance eligibility under this section for individuals under 
218.1   age 65 without deeming the spouse's income or assets. 
218.2      Sec. 60.  Minnesota Statutes 2000, section 256B.49, is 
218.3   amended by adding a subdivision to read: 
218.4      Subd. 12.  [INFORMED CHOICE.] Persons who are determined 
218.5   likely to require the level of care provided in a nursing 
218.6   facility or hospital shall be informed of the home and 
218.7   community-based support alternatives to the provision of 
218.8   inpatient hospital services or nursing facility services.  Each 
218.9   person must be given the choice of either institutional or home 
218.10  and community-based services, using the provisions described in 
218.11  section 256B.77, subdivision 2, paragraph (p). 
218.12     Sec. 61.  Minnesota Statutes 2000, section 256B.49, is 
218.13  amended by adding a subdivision to read: 
218.14     Subd. 13.  [CASE MANAGEMENT.] (a) Each recipient of a home 
218.15  and community-based waiver shall be provided case management 
218.16  services by qualified vendors as described in the federally 
218.17  approved waiver application.  The case management service 
218.18  activities provided will include: 
218.19     (1) assessing the needs of the individual within 20 working 
218.20  days of a recipient's request; 
218.21     (2) developing the written individual service plan within 
218.22  ten working days after the assessment is completed; 
218.23     (3) informing the recipient or the recipient's legal 
218.24  guardian or conservator of service options; 
218.25     (4) assisting the recipient in the identification of 
218.26  potential service providers; 
218.27     (5) assisting the recipient to access services; 
218.28     (6) coordinating, evaluating, and monitoring of the 
218.29  services identified in the service plan; 
218.30     (7) completing the annual reviews of the service plan; and 
218.31     (8) informing the recipient or legal representative of the 
218.32  right to have assessments completed and service plans developed 
218.33  within specified time periods, and to appeal county action or 
218.34  inaction under section 256.045, subdivision 3. 
218.35     (b) The case manager may delegate certain aspects of the 
218.36  case management service activities to another individual 
219.1   provided there is oversight by the case manager.  The case 
219.2   manager may not delegate those aspects which require 
219.3   professional judgment including assessments, reassessments, and 
219.4   care plan development. 
219.5      Sec. 62.  Minnesota Statutes 2000, section 256B.49, is 
219.6   amended by adding a subdivision to read: 
219.7      Subd. 14.  [ASSESSMENT AND REASSESSMENT.] (a) Assessments 
219.8   of each recipient's strengths, informal support systems, and 
219.9   need for services shall be completed within 20 working days of 
219.10  the recipient's request.  Reassessment of each recipient's 
219.11  strengths, support systems, and need for services shall be 
219.12  conducted at least every 12 months and at other times when there 
219.13  has been a significant change in the recipient's functioning. 
219.14     (b) Persons with mental retardation or a related condition 
219.15  who apply for services under the nursing facility level waiver 
219.16  programs shall be screened for the appropriate level of care 
219.17  according to section 256B.092. 
219.18     (c) Recipients who are found eligible for home and 
219.19  community-based services under this section before their 65th 
219.20  birthday may remain eligible for these services after their 65th 
219.21  birthday if they continue to meet all other eligibility factors. 
219.22     Sec. 63.  Minnesota Statutes 2000, section 256B.49, is 
219.23  amended by adding a subdivision to read: 
219.24     Subd. 15.  [INDIVIDUALIZED SERVICE PLAN.] Each recipient of 
219.25  home and community-based waivered services shall be provided a 
219.26  copy of the written service plan which: 
219.27     (1) is developed and signed by the recipient within ten 
219.28  working days of the completion of the assessment; 
219.29     (2) meets the assessed needs of the recipient; 
219.30     (3) reasonably ensures the health and safety of the 
219.31  recipient; 
219.32     (4) promotes independence; 
219.33     (5) allows for services to be provided in the most 
219.34  integrated settings; and 
219.35     (6) provides for an informed choice, as defined in section 
219.36  256B.77, subdivision 2, paragraph (p), of service and support 
220.1   providers. 
220.2      Sec. 64.  Minnesota Statutes 2000, section 256B.49, is 
220.3   amended by adding a subdivision to read: 
220.4      Subd. 16.  [SERVICES AND SUPPORTS.] (a) Services and 
220.5   supports included in the home and community-based waivers for 
220.6   persons with disabilities shall meet the requirements set out in 
220.7   United States Code, title 42, section 1396n.  The services and 
220.8   supports, which are offered as alternatives to institutional 
220.9   care, shall promote consumer choice, community inclusion, 
220.10  self-sufficiency, and self-determination. 
220.11     (b) Beginning January 1, 2003, the commissioner shall 
220.12  simplify and improve access to home and community-based waivered 
220.13  services, to the extent possible, through the establishment of a 
220.14  common service menu that is available to eligible recipients 
220.15  regardless of age, disability type, or waiver program. 
220.16     (c) Consumer directed community support services shall be 
220.17  offered as an option to all persons eligible for services under 
220.18  subdivision 11, by January 1, 2002. 
220.19     (d) Services and supports shall be arranged and provided 
220.20  consistent with individualized written plans of care for 
220.21  eligible waiver recipients. 
220.22     (e) The state of Minnesota and county agencies that 
220.23  administer home and community-based waivered services for 
220.24  persons with disabilities, shall not be liable for damages, 
220.25  injuries, or liabilities sustained through the purchase of 
220.26  supports by the individual, the individual's family, or the 
220.27  authorized representative with funds received through the 
220.28  consumer-directed community support service under this section.  
220.29  Liabilities include but are not limited to:  workers' 
220.30  compensation liability, the Federal Insurance Contributions Act 
220.31  (FICA), or the Federal Unemployment Tax Act (FUTA). 
220.32     Sec. 65.  Minnesota Statutes 2000, section 256B.49, is 
220.33  amended by adding a subdivision to read: 
220.34     Subd. 17.  [COST OF SERVICES AND SUPPORTS.] (a) The 
220.35  commissioner shall ensure that the average per capita 
220.36  expenditures estimated in any fiscal year for home and 
221.1   community-based waiver recipients does not exceed the average 
221.2   per capita expenditures that would have been made to provide 
221.3   institutional services for recipients in the absence of the 
221.4   waiver. 
221.5      (b) The commissioner shall implement on January 1, 2002, 
221.6   one or more aggregate, need-based methods for allocating to 
221.7   local agencies the home and community-based waivered service 
221.8   resources available to support recipients with disabilities in 
221.9   need of the level of care provided in a nursing facility or a 
221.10  hospital.  The commissioner shall allocate resources to single 
221.11  counties and county partnerships in a manner that reflects 
221.12  consideration of: 
221.13     (1) an incentive-based payment process for achieving 
221.14  outcomes; 
221.15     (2) the need for a state-level risk pool; 
221.16     (3) the need for retention of management responsibility at 
221.17  the state agency level; and 
221.18     (4) a phase-in strategy as appropriate. 
221.19     (c) Until the allocation methods described in paragraph (b) 
221.20  are implemented, the annual allowable reimbursement level of 
221.21  home and community-based waiver services shall be the greater of:
221.22     (1) the statewide average payment amount which the 
221.23  recipient is assigned under the waiver reimbursement system in 
221.24  place on June 30, 2001, modified by the percentage of any 
221.25  provider rate increase appropriated for home and community-based 
221.26  services; or 
221.27     (2) an amount approved by the commissioner based on the 
221.28  recipient's extraordinary needs that cannot be met within the 
221.29  current allowable reimbursement level.  The increased 
221.30  reimbursement level must be necessary to allow the recipient to 
221.31  be discharged from an institution or to prevent imminent 
221.32  placement in an institution.  The additional reimbursement may 
221.33  be used to secure environmental modifications; assistive 
221.34  technology and equipment; and increased costs for supervision, 
221.35  training, and support services necessary to address the 
221.36  recipient's extraordinary needs.  The commissioner may approve 
222.1   an increased reimbursement level for up to one year of the 
222.2   recipient's relocation from an institution or up to six months 
222.3   of a determination that a current waiver recipient is at 
222.4   imminent risk of being placed in an institution. 
222.5      (d) Beginning July 1, 2001, medically necessary private 
222.6   duty nursing services will be authorized under this section as 
222.7   complex and regular care according to section 256B.0627. 
222.8      Sec. 66.  Minnesota Statutes 2000, section 256B.49, is 
222.9   amended by adding a subdivision to read: 
222.10     Subd. 18.  [PAYMENTS.] The commissioner shall reimburse 
222.11  approved vendors from the medical assistance account for the 
222.12  costs of providing home and community-based services to eligible 
222.13  recipients using the invoice processing procedures of the 
222.14  Medicaid management information system (MMIS).  Recipients will 
222.15  be screened and authorized for services according to the 
222.16  federally approved waiver application and its subsequent 
222.17  amendments. 
222.18     Sec. 67.  Minnesota Statutes 2000, section 256B.49, is 
222.19  amended by adding a subdivision to read: 
222.20     Subd. 19.  [HEALTH AND WELFARE.] The commissioner of human 
222.21  services shall take the necessary safeguards to protect the 
222.22  health and welfare of individuals provided services under the 
222.23  waiver. 
222.24     Sec. 68.  Minnesota Statutes 2000, section 256B.49, is 
222.25  amended by adding a subdivision to read: 
222.26     Subd. 20.  [TRAUMATIC BRAIN INJURY AND RELATED CONDITIONS.] 
222.27  The commissioner shall seek to amend the traumatic brain injury 
222.28  waiver to include, as eligible persons, individuals with an 
222.29  acquired or degenerative disease diagnosis where cognitive 
222.30  impairment is present, such as multiple sclerosis. 
222.31     Sec. 69.  Minnesota Statutes 2000, section 256B.69, 
222.32  subdivision 23, is amended to read: 
222.33     Subd. 23.  [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 
222.34  ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 
222.35  implement demonstration projects to create alternative 
222.36  integrated delivery systems for acute and long-term care 
223.1   services to elderly persons and persons with disabilities as 
223.2   defined in section 256B.77, subdivision 7a, that provide 
223.3   increased coordination, improve access to quality services, and 
223.4   mitigate future cost increases.  The commissioner may seek 
223.5   federal authority to combine Medicare and Medicaid capitation 
223.6   payments for the purpose of such demonstrations.  Medicare funds 
223.7   and services shall be administered according to the terms and 
223.8   conditions of the federal waiver and demonstration provisions.  
223.9   For the purpose of administering medical assistance funds, 
223.10  demonstrations under this subdivision are subject to 
223.11  subdivisions 1 to 22.  The provisions of Minnesota Rules, parts 
223.12  9500.1450 to 9500.1464, apply to these demonstrations, with the 
223.13  exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 
223.14  subpart 1, items B and C, which do not apply to persons 
223.15  enrolling in demonstrations under this section.  An initial open 
223.16  enrollment period may be provided.  Persons who disenroll from 
223.17  demonstrations under this subdivision remain subject to 
223.18  Minnesota Rules, parts 9500.1450 to 9500.1464.  When a person is 
223.19  enrolled in a health plan under these demonstrations and the 
223.20  health plan's participation is subsequently terminated for any 
223.21  reason, the person shall be provided an opportunity to select a 
223.22  new health plan and shall have the right to change health plans 
223.23  within the first 60 days of enrollment in the second health 
223.24  plan.  Persons required to participate in health plans under 
223.25  this section who fail to make a choice of health plan shall not 
223.26  be randomly assigned to health plans under these demonstrations. 
223.27  Notwithstanding section 256L.12, subdivision 5, and Minnesota 
223.28  Rules, part 9505.5220, subpart 1, item A, if adopted, for the 
223.29  purpose of demonstrations under this subdivision, the 
223.30  commissioner may contract with managed care organizations, 
223.31  including counties, to serve only elderly persons eligible for 
223.32  medical assistance, elderly and disabled persons, or disabled 
223.33  persons only.  For persons with primary diagnoses of mental 
223.34  retardation or a related condition, serious and persistent 
223.35  mental illness, or serious emotional disturbance, the 
223.36  commissioner must ensure that the county authority has approved 
224.1   the demonstration and contracting design.  Enrollment in these 
224.2   projects for persons with disabilities shall be voluntary until 
224.3   July 1, 2001.  The commissioner shall not implement any 
224.4   demonstration project under this subdivision for persons with 
224.5   primary diagnoses of mental retardation or a related condition, 
224.6   serious and persistent mental illness, or serious emotional 
224.7   disturbance, without approval of the county board of the county 
224.8   in which the demonstration is being implemented. 
224.9      Before implementation of a demonstration project for 
224.10  disabled persons, the commissioner must provide information to 
224.11  appropriate committees of the house of representatives and 
224.12  senate and must involve representatives of affected disability 
224.13  groups in the design of the demonstration projects. 
224.14     (b) A nursing facility reimbursed under the alternative 
224.15  reimbursement methodology in section 256B.434 may, in 
224.16  collaboration with a hospital, clinic, or other health care 
224.17  entity provide services under paragraph (a).  The commissioner 
224.18  shall amend the state plan and seek any federal waivers 
224.19  necessary to implement this paragraph. 
224.20     Sec. 70.  Minnesota Statutes 2000, section 256D.35, is 
224.21  amended by adding a subdivision to read: 
224.22     Subd. 11a.  [INSTITUTION.] "Institution" means:  a 
224.23  hospital, consistent with Code of Federal Regulations, title 42, 
224.24  section 440.10; regional treatment center inpatient services; a 
224.25  nursing facility; and an intermediate care facility for persons 
224.26  with mental retardation. 
224.27     Sec. 71.  Minnesota Statutes 2000, section 256D.35, is 
224.28  amended by adding a subdivision to read: 
224.29     Subd. 18a.  [SHELTER COSTS.] "Shelter costs" means:  rent, 
224.30  manufactured home lot rentals; monthly principal, interest, 
224.31  insurance premiums, and property taxes due for mortgages or 
224.32  contract for deed costs; costs for utilities, including heating, 
224.33  cooling, electricity, water, and sewerage; garbage collection 
224.34  fees; and the basic service fee for one telephone. 
224.35     Sec. 72.  Minnesota Statutes 2000, section 256D.44, 
224.36  subdivision 5, is amended to read: 
225.1      Subd. 5.  [SPECIAL NEEDS.] In addition to the state 
225.2   standards of assistance established in subdivisions 1 to 4, 
225.3   payments are allowed for the following special needs of 
225.4   recipients of Minnesota supplemental aid who are not residents 
225.5   of a nursing home, a regional treatment center, or a group 
225.6   residential housing facility. 
225.7      (a) The county agency shall pay a monthly allowance for 
225.8   medically prescribed diets payable under the Minnesota family 
225.9   investment program if the cost of those additional dietary needs 
225.10  cannot be met through some other maintenance benefit.  
225.11     (b) Payment for nonrecurring special needs must be allowed 
225.12  for necessary home repairs or necessary repairs or replacement 
225.13  of household furniture and appliances using the payment standard 
225.14  of the AFDC program in effect on July 16, 1996, for these 
225.15  expenses, as long as other funding sources are not available.  
225.16     (c) A fee for guardian or conservator service is allowed at 
225.17  a reasonable rate negotiated by the county or approved by the 
225.18  court.  This rate shall not exceed five percent of the 
225.19  assistance unit's gross monthly income up to a maximum of $100 
225.20  per month.  If the guardian or conservator is a member of the 
225.21  county agency staff, no fee is allowed. 
225.22     (d) The county agency shall continue to pay a monthly 
225.23  allowance of $68 for restaurant meals for a person who was 
225.24  receiving a restaurant meal allowance on June 1, 1990, and who 
225.25  eats two or more meals in a restaurant daily.  The allowance 
225.26  must continue until the person has not received Minnesota 
225.27  supplemental aid for one full calendar month or until the 
225.28  person's living arrangement changes and the person no longer 
225.29  meets the criteria for the restaurant meal allowance, whichever 
225.30  occurs first. 
225.31     (e) A fee of ten percent of the recipient's gross income or 
225.32  $25, whichever is less, is allowed for representative payee 
225.33  services provided by an agency that meets the requirements under 
225.34  SSI regulations to charge a fee for representative payee 
225.35  services.  This special need is available to all recipients of 
225.36  Minnesota supplemental aid regardless of their living 
226.1   arrangement.  
226.2      (f) Notwithstanding the language in this subdivision, an 
226.3   amount equal to the maximum allotment authorized by the federal 
226.4   Food Stamp Program for a single individual which is in effect on 
226.5   the first day of January of the previous year will be added to 
226.6   the standards of assistance established in subdivisions 1 to 4 
226.7   for individuals under the age of 65 who are relocating from an 
226.8   institution and who are shelter needy.  An eligible individual 
226.9   who receives this benefit prior to age 65 may continue to 
226.10  receive the benefit after the age of 65. 
226.11     "Shelter needy" means that the assistance unit incurs 
226.12  monthly shelter costs that exceed 40 percent of the assistance 
226.13  unit's gross income before the application of this special needs 
226.14  standard.  "Gross income" for the purposes of this section is 
226.15  the applicant's or recipient's income as defined in section 
226.16  256D.35, subdivision 10, or the standard specified in 
226.17  subdivision 3, whichever is greater.  A recipient of a federal 
226.18  or state housing subsidy, that limits shelter costs to a 
226.19  percentage of gross income, shall not be considered shelter 
226.20  needy for purposes of this paragraph. 
226.21     Sec. 73.  Minnesota Statutes 2000, section 256I.05, 
226.22  subdivision 1e, is amended to read: 
226.23     Subd. 1e.  [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 
226.24  Notwithstanding the provisions of subdivisions 1a and 1c, 
226.25  beginning July 1, 1999 2001, a county agency shall negotiate a 
226.26  supplementary rate in addition to the rate specified in 
226.27  subdivision 1, equal to 25 125 percent of the amount specified 
226.28  in subdivision 1a, including any legislatively authorized 
226.29  inflationary adjustments, for a group residential housing 
226.30  provider that: 
226.31     (1) is located in Hennepin county and has had a group 
226.32  residential housing contract with the county since June 1996; 
226.33     (2) operates in three separate locations a 56-bed 71-bed 
226.34  facility, a and two 40-bed facility, and a 30-bed facility 
226.35  facilities; and 
226.36     (3) serves a chemically dependent clientele, providing 24 
227.1   hours per day supervision and limiting a resident's maximum 
227.2   length of stay to 13 months out of a consecutive 24-month period.
227.3      Sec. 74.  [256I.07] [RESPITE CARE PILOT PROJECT FOR FAMILY 
227.4   ADULT FOSTER CARE PROVIDERS.] 
227.5      Subdivision 1.  [PROGRAM ESTABLISHED.] The state recognizes 
227.6   the importance of developing and maintaining quality family 
227.7   foster care resources.  In order to accomplish that goal, the 
227.8   commissioner shall establish a two-year respite care pilot 
227.9   project for family adult foster care providers in three 
227.10  counties.  This pilot project is intended to provide support to 
227.11  caregivers of adult foster care residents.  The commissioner 
227.12  shall establish a pilot project to accomplish the provisions in 
227.13  subdivisions 2 to 4. 
227.14     Subd. 2.  [ELIGIBILITY.] A family adult foster care home 
227.15  provider as defined under section 144D.01, subdivision 7, who 
227.16  has been licensed for six months is eligible for 30 days of 
227.17  respite care per calendar year.  In cases of emergency, a county 
227.18  social services agency may waive the six-month licensing 
227.19  requirement.  In order to be eligible to receive respite payment 
227.20  from group residential housing and alternative care, a provider 
227.21  must take time off away from their foster care residents.  
227.22     Subd. 3.  [PAYMENT STRUCTURE.] (a) The payment for respite 
227.23  care for an adult foster care resident eligible for only group 
227.24  residential housing shall be based on the current monthly group 
227.25  residential housing base room and board rate and the current 
227.26  maximum monthly group residential housing difficulty of care 
227.27  rate. 
227.28     (b) The payment for respite care for an adult foster care 
227.29  resident eligible for alternative care funds shall be based on 
227.30  the resident's alternative care foster care rate. 
227.31     (c) The payment for respite care for an adult foster care 
227.32  resident eligible for Medicaid home and community-based services 
227.33  waiver funds shall be based on the group residential housing 
227.34  base room and board rate. 
227.35     (d) The total amount available to pay for respite care for 
227.36  a family adult foster care provider shall be based on the number 
228.1   of residents currently served in the foster care home and the 
228.2   source of funding used to pay for each resident's foster care.  
228.3   Respite care must be paid for on a per diem basis and for a full 
228.4   day. 
228.5      Subd. 4.  [PRIVATE PAY RESIDENTS.] Payment for respite care 
228.6   for private pay foster care residents must be arranged between 
228.7   the provider and the resident or the resident's family. 
228.8      Sec. 75.  Laws 1999, chapter 152, section 1, is amended to 
228.9   read: 
228.10     Section 1.  [TASK FORCE.] 
228.11     A day training and habilitation task force is established.  
228.12  Task force membership shall consist of representatives of the 
228.13  commissioner of human services, counties, service consumers, and 
228.14  vendors of day training and habilitation as defined in Minnesota 
228.15  Statutes, section 252.41, subdivision 9, including at least one 
228.16  representative from each association representing day training 
228.17  and habilitation vendors.  Appointments to the task force shall 
228.18  be made by the commissioner of human services and technical 
228.19  assistance shall be provided by the department of human services.
228.20     Sec. 76.  Laws 1999, chapter 152, section 4, is amended to 
228.21  read: 
228.22     Sec. 4.  [REPORT.] 
228.23     The task force shall present a report recommending a new 
228.24  payment rate structure to the legislature by January 15, 2000, 
228.25  and shall make recommendations to the commissioner of human 
228.26  services regarding the implementation of the pilot project for 
228.27  the individualized payment rate structure, so the pilot project 
228.28  can be implemented by July 1, 2002, as required in section 77.  
228.29  The task force expires on March 15, 2000 December 30, 2003. 
228.30     Sec. 77.  [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE 
228.31  PILOT PROJECT.] 
228.32     Subdivision 1.  [INDIVIDUALIZED PAYMENT RATE 
228.33  STRUCTURE.] Notwithstanding Minnesota Statutes, sections 
228.34  252.451, subdivision 5; and 252.46; and Minnesota Rules, part 
228.35  9525.1290, subpart 1, items A and B, the commissioner of human 
228.36  services shall initiate a pilot project and phase-in for the 
229.1   individualized payment rate structure described in this section 
229.2   and section 78.  The pilot project shall include actual 
229.3   transfers of funds, not simulated transfers.  The pilot project 
229.4   may include all or some of the vendors in up to eight counties, 
229.5   with no more than two counties from the seven-county 
229.6   Minneapolis-St. Paul metropolitan area.  Following initiation of 
229.7   the pilot project, the commissioner shall phase in 
229.8   implementation of the individualized payment rate structure to 
229.9   the remaining counties and vendors according to the 
229.10  implementation plan developed by the task force.  The pilot and 
229.11  phase-in shall not extend over more than 18 months and shall be 
229.12  completed by December 31, 2003.  
229.13     Subd. 2.  [SUNSET.] The pilot project shall sunset upon 
229.14  implementation of a new statewide rate structure according to 
229.15  the implementation plan developed by the task force described in 
229.16  subdivision 3, in its report to the legislature on December 1, 
229.17  2001.  The rates of vendors participating in the pilot project 
229.18  must be modified to be consistent with the new statewide rate 
229.19  structure, as implemented. 
229.20     Subd. 3.  [TASK FORCE RESPONSIBILITIES.] The day training 
229.21  and habilitation task force established under Laws 1999, chapter 
229.22  152, section 4, shall evaluate the pilot project authorized 
229.23  under subdivision 1, and by December 1, 2001, shall report to 
229.24  the legislature with an implementation plan, which shall address 
229.25  how and when the pilot project individualized payment rate 
229.26  structure will be implemented statewide, shall ensure that 
229.27  vendors that wish to maintain their current per diem rate may do 
229.28  so within the new payment system, and shall identify criteria 
229.29  that would halt statewide implementation if vendors or clients 
229.30  were adversely affected by the new payment rate structure, and 
229.31  with recommendations for any amendments that should be made 
229.32  before statewide implementation.  These recommendations shall be 
229.33  made in a report to the chairs of the house health and human 
229.34  services policy and finance committees and the senate health and 
229.35  family security committee and finance division. 
229.36     Subd. 4.  [RATE SETTING.] (a) The rate structure under this 
230.1   section is intended to allow a county to authorize an individual 
230.2   rate for each client in the vendor's program based on the needs 
230.3   and expected outcomes of the individual client.  Rates shall be 
230.4   based on an authorized package of services for each individual 
230.5   over a typical time frame.  Rates may be established across 
230.6   multiple sites run by a single vendor. 
230.7      (b) With county concurrence, a vendor shall establish up to 
230.8   four levels of service, A through D, based on the intensity of 
230.9   services provided to an individual client of day training and 
230.10  habilitation services.  Service level A shall be the highest 
230.11  intensity of services, marked primarily, but not exclusively, by 
230.12  a one-to-one client-to-staff ratio.  Service level D shall be 
230.13  the lowest intensity of services.  The county shall document the 
230.14  vendor's description of the type and amount of services 
230.15  associated with each service level. 
230.16     (c) For each vendor, a county board shall establish a 
230.17  dollar value for one hour of service at each of the service 
230.18  levels defined in paragraph (b).  In establishing these values 
230.19  for existing vendors transitioning from the payment rate 
230.20  structure under Minnesota Statutes, section 252.46, subdivision 
230.21  1, the county board shall follow the formula and guidelines 
230.22  developed by the day training and habilitation task force under 
230.23  paragraph (e). 
230.24     (d) A vendor may elect to maintain a single transportation 
230.25  rate or may elect to establish up to five types of 
230.26  transportation services:  public transportation, public special 
230.27  transportation, nonambulatory transportation, out-of-service 
230.28  area transportation, and ambulatory transportation.  For vendors 
230.29  that elect to establish multiple transportation services, the 
230.30  county board shall establish a dollar value for a round trip on 
230.31  each type of transportation service offered through the vendor.  
230.32  With vendor concurrence, the county may also establish a uniform 
230.33  one-way trip value for some or all of the transportation service 
230.34  types. 
230.35     (e) The county board shall ensure that the vendor 
230.36  translates the vendor's existing program and transportation 
231.1   rates to the rates and values in the pilot project by using the 
231.2   conversion calculations for services and transportation approved 
231.3   by the day training and habilitation task force established 
231.4   under Laws 1999, chapter 152, and included in the task force's 
231.5   recommendations to the legislature.  The conversion calculation 
231.6   may be amended by the task force with the approval of the 
231.7   commissioner and any amendments shall become effective upon 
231.8   notification to the pilot project counties from the 
231.9   commissioner.  The calculation shall take the total 
231.10  reimbursement dollars available to the vendor and divide by the 
231.11  units of service expected at each service level and of each 
231.12  transportation type.  In determining the total reimbursement 
231.13  dollars available to a vendor, the vendor shall multiply the 
231.14  vendor's current per diem rate for both services and 
231.15  transportation, including any new rate increases, by the 
231.16  vendor's actual utilization for the year prior to implementation 
231.17  of the pilot project.  Vendors shall be allowed to allocate 
231.18  available reimbursement dollars between service and 
231.19  transportation before the vendor's service level and 
231.20  transportation values are calculated.  After translating its 
231.21  existing service and transportation rates to the service level 
231.22  and transportation values under the pilot, the vendor shall 
231.23  project its expected reimbursement income using the expected 
231.24  service and transportation packages for its existing clients, 
231.25  based on current service authorizations.  If the projected 
231.26  reimbursement income is less than the vendor would have received 
231.27  under the payment structure of Minnesota Statutes, section 
231.28  252.46, the vendor and the county, with the approval of the 
231.29  commissioner, shall adjust the vendor's service level and 
231.30  transportation values to eliminate the shortfall.  The 
231.31  commissioner shall report all adjustments to the day training 
231.32  and habilitation task force for consideration of possible 
231.33  modifications to the pilot project individualized payment rate 
231.34  structure.  
231.35     Subd. 5.  [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of 
231.36  its annual authorization of services for each client under 
232.1   Minnesota Statutes, section 252.44, paragraph (a), clause (1), 
232.2   and Minnesota Rules, part 9525.0016, subpart 12, the county 
232.3   shall authorize and document a service package and a 
232.4   transportation package as follows: 
232.5      (1) the service package shall include the amount and type 
232.6   of services at each applicable service level to be provided to 
232.7   the client over a package period.  An individual client may 
232.8   receive services at multiple service levels over the course of 
232.9   the package period.  The service package rate shall be the sum 
232.10  of the amount of services at each level over the package period, 
232.11  multiplied by the dollar value for each service level; 
232.12     (2) the transportation package shall include the amount and 
232.13  type of transportation services to be provided to the client 
232.14  over the package period.  The transportation package rate shall 
232.15  be the sum of the amount of transportation services, multiplied 
232.16  by the dollar value associated with the type of transportation 
232.17  service authorized for the client; 
232.18     (3) the package period shall be established by the county, 
232.19  and may be one week, two weeks, or one month; and 
232.20     (4) the individual rate authorization may be reviewed and 
232.21  modified by the county at any time and must be reviewed and 
232.22  reauthorized by the county at least annually. 
232.23     (b) For vendors with rates established under this section, 
232.24  a service day under Minnesota Statutes, sections 245B.06 and 
232.25  252.44, includes any day in which a client receives any 
232.26  reimbursable service from a vendor or attends employment 
232.27  arranged by the vendor. 
232.28     Subd. 6.  [BILLING FOR SERVICES.] The vendor shall bill 
232.29  for, and shall be reimbursed for, the service package rate and 
232.30  transportation package rate for the package period as authorized 
232.31  by the county for each client in the vendor's program.  The 
232.32  length of the package period shall not affect the timing or 
232.33  frequency of vendors' submissions of claims for payment under 
232.34  the Medicaid Management Information System II (MMIS) or its 
232.35  successors. 
232.36     Subd. 7.  [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The 
233.1   vendor shall notify an individual client's case manager if the 
233.2   vendor has knowledge of a material change in the client's needs 
233.3   that may indicate a need for a change in service authorization.  
233.4   Factors that would require such notice include, but are not 
233.5   limited to, significant changes in medical status, residential 
233.6   placement, attendance patterns, behavioral needs, or skill 
233.7   functioning.  The vendor shall notify the case manager as soon 
233.8   as possible but no later than 30 calendar days after becoming 
233.9   aware of the change in needs.  The service authorization for the 
233.10  client shall not change until the county authorizes a new 
233.11  service and transportation package for the client in accordance 
233.12  with the provisions in Minnesota Statutes, section 256B.092. 
233.13     Sec. 78.  [COUNTY BOARD RESPONSIBILITIES.] 
233.14     For each vendor with rates established under section 77, 
233.15  the county board shall document the vendor's description of the 
233.16  type and amount of services associated with each service level, 
233.17  the vendor's service level values, the vendor's transportation 
233.18  values, and the package period that will be used to determine 
233.19  the rate for each individual client.  The county shall establish 
233.20  a package period of one week, two weeks, or one month. 
233.21     Sec. 79.  [STUDY OF DAY TRAINING AND HABILITATION VENDOR 
233.22  RATES.] 
233.23     The commissioner shall identify the vendors with the lowest 
233.24  rates or underfunded programs in the state and make 
233.25  recommendations to reconcile the discrepancies prior to the 
233.26  implementation of the individualized payment rate structure 
233.27  described in sections 77 and 78. 
233.28     Sec. 80.  [FEDERAL APPROVAL.] 
233.29     The commissioner shall seek any amendments to the state 
233.30  Medicaid plan and any waivers necessary to permit implementation 
233.31  of section 77 within the timelines specified. 
233.32     Sec. 81.  [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.] 
233.33     The commissioner of human services, in consultation with 
233.34  county representatives and other interested persons, shall 
233.35  develop recommendations revising the funding methodology for 
233.36  SILS as defined in Minnesota Statutes, section 252.275, 
234.1   subdivisions 3, 4, 4b, and 4c, and report by January 15, 2002, 
234.2   to the chair of the house of representatives health and human 
234.3   services finance committee and the chairs of the senate health, 
234.4   human services, and corrections budget division. 
234.5      Sec. 82.  [WAIVER REQUEST REGARDING SPOUSAL INCOME.] 
234.6      By September 1, 2001, the commissioner of human services 
234.7   shall seek federal approval to allow recipients of home and 
234.8   community-based waivers authorized under Minnesota Statutes, 
234.9   section 256B.49, to choose either a waiver of deeming of spousal 
234.10  income or the spousal impoverishment protections authorized 
234.11  under United States Code, title 42, section 1396r-5, with the 
234.12  addition of the group residential housing rate set according to 
234.13  Minnesota Statutes, section 256I.03, subdivision 5, to the 
234.14  personal needs allowance authorized by Minnesota Statutes, 
234.15  section 256B.0575. 
234.16     Sec. 83.  [PROGRAM OPTIONS FOR CERTAIN PERSONS WITH 
234.17  DEVELOPMENTAL DISABILITIES.] 
234.18     (a) The commissioner of human services shall ensure that 
234.19  services continue to be available to persons with developmental 
234.20  disabilities who were covered by social services supplemental 
234.21  grants prior to July 1, 2001.  Services shall be provided in 
234.22  priority order as follows: 
234.23     (1) to the extent possible, the commissioner shall 
234.24  establish for these persons targeted slots under the home and 
234.25  community-based waivered services program for persons with 
234.26  mental retardation or related conditions; 
234.27     (2) persons accommodated under clause (1) shall, if 
234.28  eligible, receive room and board services through group 
234.29  residential housing under Minnesota Statutes, chapter 256I; and 
234.30     (3) any remaining persons shall continue to receive 
234.31  services through community social services supplemental grants 
234.32  to the affected counties. 
234.33     (b) This section applies only to individuals receiving 
234.34  services under social services supplemental grants as of June 
234.35  30, 2001. 
234.36     Sec. 84.  [FEDERAL APPROVAL.] 
235.1      The commissioner of human services, by September 1, 2001, 
235.2   shall request any federal approval and plan amendments necessary 
235.3   to implement the choice of case manager provision in section 
235.4   256B.092, subdivision 2a, paragraph (b). 
235.5      Sec. 85.  [FEDERAL WAIVER REQUESTS.] 
235.6      The commissioner of human services shall submit to the 
235.7   federal Health Care Financing Administration by September 1, 
235.8   2001, a request for a home and community-based services waiver 
235.9   for day services, including:  community inclusion, supported 
235.10  employment, and day training and habilitation services defined 
235.11  in Minnesota Statutes, section 252.41, subdivision 3, clause 
235.12  (1), for persons eligible for the waiver under Minnesota 
235.13  Statutes, section 256B.092. 
235.14     Sec. 86. [REPEALER.] 
235.15     (a) Minnesota Statutes 2000, sections 256B.0951, 
235.16  subdivision 6; and 256E.06, subdivision 2b, are repealed. 
235.17     (b) Minnesota Statutes 2000, sections 145.9245; 256.476, 
235.18  subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and 
235.19  3c; and 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10, 
235.20  are repealed. 
235.21     (c) Laws 1995, chapter 178, article 2, section 48, 
235.22  subdivision 6, is repealed. 
235.23     (d) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460; 
235.24  9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 
235.25  9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 
235.26  9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 
235.27  9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 
235.28  9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 
235.29  9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 
235.30  9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 
235.31  9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 
235.32  9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 
235.33  9505.3660; and 9505.3670, are repealed. 
235.34                             ARTICLE 4 
235.35                CONSUMER INFORMATION AND ASSISTANCE 
235.36                      AND COMMUNITY-BASED CARE 
236.1      Section 1.  [144A.35] [EXPANSION OF BED DISTRIBUTION STUDY 
236.2   AND CREATION OF CRITICAL ACCESS SITES.] 
236.3      Subdivision 1.  [OLDER ADULT SERVICES DISTRIBUTION 
236.4   STUDY.] The commissioner of health, in coordination with the 
236.5   commissioner of human services, shall monitor and analyze the 
236.6   distribution of older adult services, including, but not limited 
236.7   to, nursing home beds, senior housing, housing with services 
236.8   units, and home and community-based services in the different 
236.9   geographic areas of the state.  The study shall include an 
236.10  analysis of the impact of amendments to the nursing home 
236.11  moratorium law which would allow for transfers of nursing home 
236.12  beds within the state.  The commissioner of health shall submit 
236.13  to the legislature, beginning January 15, 2002, and each January 
236.14  15 thereafter, an assessment of the distribution of long-term 
236.15  health care services by geographic area, with particular 
236.16  attention to service deficits or problems, the designation of 
236.17  critical access service sites, and corrective action plans. 
236.18     Subd. 2.  [CRITICAL ACCESS SERVICE SITE.] "Critical access 
236.19  service site" shall include nursing homes, senior housing, 
236.20  housing with services, and home and community-based services 
236.21  that are certified by the state as necessary providers of health 
236.22  care services to a specific geographic area.  For purposes of 
236.23  this requirement, a "necessary provider of health care services" 
236.24  is a provider that is: 
236.25     (1) located more than 20 miles, defined as official mileage 
236.26  as reported by the Minnesota department of transportation, from 
236.27  the next nearest long-term health care provider; 
236.28     (2) the sole long-term health care provider in the county; 
236.29  or 
236.30     (3) a long-term health care provider located in a medically 
236.31  underserved area or health professional shortage area. 
236.32     Subd. 3.  [IDENTIFICATION OF CRITICAL ACCESS SERVICE 
236.33  SITES.] Based on the results of the analysis completed in 
236.34  subdivision 1, the commissioners of health and human services 
236.35  shall identify and designate long-term health care providers as 
236.36  critical access service sites. 
237.1      Subd. 4.  [CRITICAL ACCESS SERVICE SITES.] The commissioner 
237.2   of health, in consultation with the commissioner of human 
237.3   services, shall: 
237.4      (1) develop and implement specific waivers to regulations 
237.5   governing health care personnel scope of duties, physical plant 
237.6   requirements, and location of community-based services, to 
237.7   address critical access service site older adult service needs; 
237.8      (2) identify payment barriers to the continued operation of 
237.9   older adult services in critical access service sites, and 
237.10  provide recommendations on changes to reimbursement rates to 
237.11  facilitate the continued operation of these services. 
237.12     Sec. 2.  Minnesota Statutes 2000, section 256.973, is 
237.13  amended by adding a subdivision to read: 
237.14     Subd. 6.  [GRANTS FOR HOME-SHARING PROGRAMS.] Grants 
237.15  awarded for home-sharing programs under this section shall be 
237.16  awarded through a request for proposals process every two years 
237.17  according to criteria developed by the commissioner.  In 
237.18  awarding grants, the commissioner shall not give priority to an 
237.19  applicant solely because the applicant has previously received a 
237.20  grant under this section.  Nothing under this subdivision shall 
237.21  prohibit the commissioner from evaluating the performance of a 
237.22  home-sharing program receiving a grant under this section and 
237.23  allocating funds based on the evaluation. 
237.24     Sec. 3.  Minnesota Statutes 2000, section 256.975, is 
237.25  amended by adding a subdivision to read: 
237.26     Subd. 7.  [CONSUMER INFORMATION AND ASSISTANCE; SENIOR 
237.27  LINKAGE.] (a) The Minnesota board on aging shall operate a 
237.28  statewide information and assistance service to aid older 
237.29  Minnesotans and their families in making informed choices about 
237.30  long-term care options and health care benefits.  Language 
237.31  services to persons with limited English language skills may be 
237.32  made available.  The service, known as Senior LinkAge Line, must 
237.33  be available during business hours through a statewide toll-free 
237.34  number and must also be available through the Internet. 
237.35     (b) The service must assist older adults, caregivers, and 
237.36  providers in accessing information about choices in long-term 
238.1   care services that are purchased through private providers or 
238.2   available through public options.  The service must: 
238.3      (1) develop a comprehensive database that includes detailed 
238.4   listings in both consumer- and provider-oriented formats; 
238.5      (2) make the database accessible on the Internet and 
238.6   through other telecommunication and media-related tools; 
238.7      (3) link callers to interactive long-term care screening 
238.8   tools and make these tools available through the Internet by 
238.9   integrating the tools with the database; 
238.10     (4) develop community education materials with a focus on 
238.11  planning for long-term care and evaluating independent living, 
238.12  housing, and service options; 
238.13     (5) conduct an outreach campaign to assist older adults and 
238.14  their caregivers in finding information on the Internet and 
238.15  through other means of communication; 
238.16     (6) implement a messaging system for overflow callers and 
238.17  respond to these callers by the next business day; 
238.18     (7) link callers with county human services and other 
238.19  providers to receive more in-depth assistance and consultation 
238.20  related to long-term care options; and 
238.21     (8) link callers with quality profiles for nursing 
238.22  facilities and other providers developed by the commissioner of 
238.23  health. 
238.24     (c) The Minnesota board on aging shall conduct an 
238.25  evaluation of the effectiveness of the statewide information and 
238.26  assistance, and submit this evaluation to the legislature by 
238.27  December 1, 2002.  The evaluation must include an analysis of 
238.28  funding adequacy, gaps in service delivery, continuity in 
238.29  information between the service and identified linkages, and 
238.30  potential use of private funding to enhance the service. 
238.31     Sec. 4.  [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS 
238.32  PROGRAM.] 
238.33     Subdivision 1.  [DEFINITIONS.] For purposes of this 
238.34  section, the following terms have the meanings given. 
238.35     (a) "Community" means a town, township, city, or targeted 
238.36  neighborhood within a city, or a consortium of towns, townships, 
239.1   cities, or targeted neighborhoods within cities. 
239.2      (b) "Older adult services" means any services available 
239.3   under the elderly waiver program or alternative care grant 
239.4   programs; nursing facility services; transportation services; 
239.5   respite services; and other community-based services identified 
239.6   as necessary either to maintain lifestyle choices for older 
239.7   Minnesotans, or to promote independence. 
239.8      (c) "Older adult" refers to individuals 65 years of age and 
239.9   older. 
239.10     Subd. 2.  [CREATION.] The community services development 
239.11  grants program is created under the administration of the 
239.12  commissioner of human services.  
239.13     Subd. 3.  [PROVISION OF GRANTS.] The commissioner shall 
239.14  make grants available to communities, providers of older adult 
239.15  services identified in subdivision 1, or to a consortium of 
239.16  providers of older adult services, to establish older adult 
239.17  services.  Grants may be provided for capital and other costs 
239.18  including, but not limited to, start-up and training costs, 
239.19  equipment, and supplies related to older adult services or other 
239.20  residential or service alternatives to nursing facility care.  
239.21  Grants may also be made to renovate current buildings, provide 
239.22  transportation services, fund programs that would allow older 
239.23  adults or disabled individuals to stay in their own homes by 
239.24  sharing a home, fund programs that coordinate and manage formal 
239.25  and informal services to older adults in their homes to enable 
239.26  them to live as independently as possible in their own homes as 
239.27  an alternative to nursing home care, or expand state-funded 
239.28  programs in the area. 
239.29     Subd. 4.  [ELIGIBILITY.] Grants may be awarded only to 
239.30  communities and providers or to a consortium of providers that 
239.31  have a local match of 50 percent of the costs for the project in 
239.32  the form of donations, local tax dollars, in-kind donations, 
239.33  fundraising, or other local matches. 
239.34     Subd. 5.  [GRANT PREFERENCE.] The commissioner of human 
239.35  services may award grants to the extent grant funds are 
239.36  available and to the extent applications are approved by the 
240.1   commissioner.  Denial of approval of an application in one year 
240.2   does not preclude submission of an application in a subsequent 
240.3   year.  The maximum grant amount is limited to $750,000. 
240.4      Sec. 5.  Minnesota Statutes 2000, section 256B.0911, 
240.5   subdivision 1, is amended to read: 
240.6      Subdivision 1.  [PURPOSE AND GOAL.] (a) The purpose of the 
240.7   preadmission screening program long-term care consultation 
240.8   services is to assist persons with long-term or chronic care 
240.9   needs in making long-term care decisions and selecting options 
240.10  that meet their needs and reflect their preferences.  The 
240.11  availability of, and access to, information and other types of 
240.12  assistance is also intended to prevent or delay certified 
240.13  nursing facility placements by assessing applicants and 
240.14  residents and offering cost-effective alternatives appropriate 
240.15  for the person's needs and to provide transition assistance 
240.16  after admission.  Further, the goal of the program these 
240.17  services is to contain costs associated with unnecessary 
240.18  certified nursing facility admissions.  The commissioners of 
240.19  human services and health shall seek to maximize use of 
240.20  available federal and state funds and establish the broadest 
240.21  program possible within the funding available. 
240.22     (b) These services must be coordinated with services 
240.23  provided under sections 256.975, subdivision 7, and 256.9772, 
240.24  and with services provided by other public and private agencies 
240.25  in the community to offer a variety of cost-effective 
240.26  alternatives to persons with disabilities and elderly persons.  
240.27  The county agency providing long-term care consultation services 
240.28  shall encourage the use of volunteers from families, religious 
240.29  organizations, social clubs, and similar civic and service 
240.30  organizations to provide community-based services. 
240.31     Sec. 6.  Minnesota Statutes 2000, section 256B.0911, is 
240.32  amended by adding a subdivision to read: 
240.33     Subd. 1a.  [DEFINITIONS.] For purposes of this section, the 
240.34  following definitions apply: 
240.35     (a) "Long-term care consultation services" means: 
240.36     (1) providing information and education to the general 
241.1   public regarding availability of the services authorized under 
241.2   this section; 
241.3      (2) an intake process that provides access to the services 
241.4   described in this section; 
241.5      (3) assessment of the health, psychological, and social 
241.6   needs of referred individuals; 
241.7      (4) assistance in identifying services needed to maintain 
241.8   an individual in the least restrictive environment; 
241.9      (5) providing recommendations on cost-effective community 
241.10  services that are available to the individual; 
241.11     (6) development of an individual's community support plan; 
241.12     (7) providing information regarding eligibility for 
241.13  Minnesota health care programs; 
241.14     (8) preadmission screening to determine the need for a 
241.15  nursing facility level of care; 
241.16     (9) preliminary determination of Minnesota health care 
241.17  programs eligibility for individuals who need a nursing facility 
241.18  level of care, with appropriate referrals for final 
241.19  determination; 
241.20     (10) providing recommendations for nursing facility 
241.21  placement when there are no cost-effective community services 
241.22  available; and 
241.23     (11) assistance to transition people back to community 
241.24  settings after facility admission. 
241.25     (b) "Minnesota health care programs" means the medical 
241.26  assistance program under chapter 256B, the alternative care 
241.27  program under section 256B.0913, and the prescription drug 
241.28  program under section 256.955. 
241.29     Sec. 7.  Minnesota Statutes 2000, section 256B.0911, 
241.30  subdivision 3, is amended to read: 
241.31     Subd. 3.  [PERSONS RESPONSIBLE FOR CONDUCTING THE 
241.32  PREADMISSION SCREENING LONG-TERM CARE CONSULTATION TEAM.] (a) A 
241.33  local screening long-term care consultation team shall be 
241.34  established by the county board of commissioners.  Each local 
241.35  screening consultation team shall consist of screeners who are a 
241.36  at least one social worker and a at least one public health 
242.1   nurse from their respective county agencies.  The board may 
242.2   designate public health or social services as the lead agency 
242.3   for long-term care consultation services.  If a county does not 
242.4   have a public health nurse available, it may request approval 
242.5   from the commissioner to assign a county registered nurse with 
242.6   at least one year experience in home care to participate on the 
242.7   team.  The screening team members must confer regarding the most 
242.8   appropriate care for each individual screened.  Two or more 
242.9   counties may collaborate to establish a joint local screening 
242.10  consultation team or teams. 
242.11     (b) In assessing a person's needs, screeners shall have a 
242.12  physician available for consultation and shall consider the 
242.13  assessment of the individual's attending physician, if any.  The 
242.14  individual's physician shall be included if the physician 
242.15  chooses to participate.  Other personnel may be included on the 
242.16  team as deemed appropriate by the county agencies.  The team is 
242.17  responsible for providing long-term care consultation services 
242.18  to all persons located in the county who request the services, 
242.19  regardless of eligibility for Minnesota health care programs. 
242.20     Sec. 8.  Minnesota Statutes 2000, section 256B.0911, is 
242.21  amended by adding a subdivision to read: 
242.22     Subd. 3a.  [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 
242.23  requesting assessment, services planning, or other assistance 
242.24  intended to support community-based living must be visited by a 
242.25  long-term care consultation team within ten working days after 
242.26  the date on which an assessment was requested or recommended.  
242.27  Assessments must be conducted according to paragraphs (b) to (g).
242.28     (b) The county may utilize a team of either the social 
242.29  worker or public health nurse, or both, to conduct the 
242.30  assessment in a face-to-face interview.  The consultation team 
242.31  members must confer regarding the most appropriate care for each 
242.32  individual screened or assessed. 
242.33     (c) The long-term care consultation team must assess the 
242.34  health and social needs of the person, using an assessment form 
242.35  provided by the commissioner of human services. 
242.36     (d) The team must conduct the assessment in a face-to-face 
243.1   interview with the person being assessed and the person's legal 
243.2   representative, if applicable. 
243.3      (e) The team must provide the person, or the person's legal 
243.4   representative, with written recommendations for facility- or 
243.5   community-based services.  The team must document that the most 
243.6   cost-effective alternatives available were offered to the 
243.7   individual.  For purposes of this requirement, "cost-effective 
243.8   alternatives" means community services and living arrangements 
243.9   that cost the same as or less than nursing facility care. 
243.10     (f) If the person chooses to use community-based services, 
243.11  the team must provide the person or the person's legal 
243.12  representative with a written community support plan, regardless 
243.13  of whether the individual is eligible for Minnesota health care 
243.14  programs.  The person may request assistance in developing a 
243.15  community support plan without participating in a complete 
243.16  assessment. 
243.17     (g) The team must give the person receiving assessment or 
243.18  support planning, or the person's legal representative, 
243.19  materials supplied by the commissioner of human services 
243.20  containing the following information: 
243.21     (1) the purpose of preadmission screening and assessment; 
243.22     (2) information about Minnesota health care programs; 
243.23     (3) the person's freedom to accept or reject the 
243.24  recommendations of the team; 
243.25     (4) the person's right to confidentiality under the 
243.26  Minnesota Government Data Practices Act, chapter 13; and 
243.27     (5) the person's right to appeal the decision regarding the 
243.28  need for nursing facility level of care or the county's final 
243.29  decisions regarding public programs eligibility according to 
243.30  section 256.045, subdivision 3. 
243.31     Sec. 9.  Minnesota Statutes 2000, section 256B.0911, is 
243.32  amended by adding a subdivision to read: 
243.33     Subd. 3b.  [TRANSITION ASSISTANCE.] (a) A long-term care 
243.34  consultation team shall provide assistance to persons residing 
243.35  in a nursing facility, hospital, regional treatment center, or 
243.36  intermediate care facility for persons with mental retardation 
244.1   who request or are referred for such assistance.  Transition 
244.2   assistance must include assessment, community support plan 
244.3   development, referrals to Minnesota health care programs, and 
244.4   referrals to programs that provide assistance with housing. 
244.5      (b) The county shall develop transition processes with 
244.6   institutional social workers and discharge planners to ensure 
244.7   that: 
244.8      (1) persons admitted to facilities receive information 
244.9   about transition assistance that is available; 
244.10     (2) the assessment is completed for persons within ten 
244.11  working days of the date of request or recommendation for 
244.12  assessment; and 
244.13     (3) there is a plan for transition and follow-up for the 
244.14  individual's return to the community.  The plan must require 
244.15  notification of other local agencies when a person who may 
244.16  require assistance is screened by one county for admission to a 
244.17  facility located in another county. 
244.18     (c) If a person who is eligible for a Minnesota health care 
244.19  program is admitted to a nursing facility, the nursing facility 
244.20  must include a consultation team member or the case manager in 
244.21  the discharge planning process. 
244.22     Sec. 10.  Minnesota Statutes 2000, section 256B.0911, is 
244.23  amended by adding a subdivision to read: 
244.24     Subd. 4a.  [PREADMISSION SCREENING ACTIVITIES RELATED TO 
244.25  NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 
244.26  certified nursing facilities, including certified boarding care 
244.27  facilities, must be screened prior to admission regardless of 
244.28  income, assets, or funding sources for nursing facility care, 
244.29  except as described in subdivision 4b.  The purpose of the 
244.30  screening is to determine the need for nursing facility level of 
244.31  care as described in paragraph (d) and to complete activities 
244.32  required under federal law related to mental illness and mental 
244.33  retardation as outlined in paragraph (b). 
244.34     (b) A person who has a diagnosis or possible diagnosis of 
244.35  mental illness, mental retardation, or a related condition must 
244.36  receive a preadmission screening before admission regardless of 
245.1   the exemptions outlined in subdivision 4b, paragraph (b), to 
245.2   identify the need for further evaluation and specialized 
245.3   services, unless the admission prior to screening is authorized 
245.4   by the local mental health authority or the local developmental 
245.5   disabilities case manager, or unless authorized by the county 
245.6   agency according to Public Law Number 101-508.  
245.7      The following criteria apply to the preadmission screening: 
245.8      (1) the county must use forms and criteria developed by the 
245.9   commissioner of human services to identify persons who require 
245.10  referral for further evaluation and determination of the need 
245.11  for specialized services; and 
245.12     (2) the evaluation and determination of the need for 
245.13  specialized services must be done by: 
245.14     (i) a qualified independent mental health professional, for 
245.15  persons with a primary or secondary diagnosis of a serious 
245.16  mental illness; or 
245.17     (ii) a qualified mental retardation professional, for 
245.18  persons with a primary or secondary diagnosis of mental 
245.19  retardation or related conditions.  For purposes of this 
245.20  requirement, a qualified mental retardation professional must 
245.21  meet the standards for a qualified mental retardation 
245.22  professional under Code of Federal Regulations, title 42, 
245.23  section 483.430. 
245.24     (c) The local county mental health authority or the state 
245.25  mental retardation authority under Public Laws Numbers 100-203 
245.26  and 101-508 may prohibit admission to a nursing facility if the 
245.27  individual does not meet the nursing facility level of care 
245.28  criteria or needs specialized services as defined in Public Laws 
245.29  Numbers 100-203 and 101-508.  For purposes of this section, 
245.30  "specialized services" for a person with mental retardation or a 
245.31  related condition means active treatment as that term is defined 
245.32  under Code of Federal Regulations, title 42, section 483.440, 
245.33  paragraph (a), clause (1). 
245.34     (d) The determination of the need for nursing facility 
245.35  level of care must be made according to criteria developed by 
245.36  the commissioner of human services.  In assessing a person's 
246.1   needs, consultation team members shall have a physician 
246.2   available for consultation and shall consider the assessment of 
246.3   the individual's attending physician, if any.  The individual's 
246.4   physician must be included if the physician chooses to 
246.5   participate.  Other personnel may be included on the team as 
246.6   deemed appropriate by the county. 
246.7      Sec. 11.  Minnesota Statutes 2000, section 256B.0911, is 
246.8   amended by adding a subdivision to read: 
246.9      Subd. 4b.  [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 
246.10  Exemptions from the federal screening requirements outlined in 
246.11  subdivision 4a, paragraphs (b) and (c), are limited to: 
246.12     (1) a person who, having entered an acute care facility 
246.13  from a certified nursing facility, is returning to a certified 
246.14  nursing facility; and 
246.15     (2) a person transferring from one certified nursing 
246.16  facility in Minnesota to another certified nursing facility in 
246.17  Minnesota. 
246.18     (b) Persons who are exempt from preadmission screening for 
246.19  purposes of level of care determination include: 
246.20     (1) persons described in paragraph (a); 
246.21     (2) an individual who has a contractual right to have 
246.22  nursing facility care paid for indefinitely by the veterans' 
246.23  administration; 
246.24     (3) an individual enrolled in a demonstration project under 
246.25  section 256B.69, subdivision 8, at the time of application to a 
246.26  nursing facility; 
246.27     (4) an individual currently being served under the 
246.28  alternative care program or under a home and community-based 
246.29  services waiver authorized under section 1915(c) of the federal 
246.30  Social Security Act; and 
246.31     (5) individuals admitted to a certified nursing facility 
246.32  for a short-term stay, which is expected to be 14 days or less 
246.33  in duration based upon a physician's certification, and who have 
246.34  been assessed and approved for nursing facility admission within 
246.35  the previous six months.  This exemption applies only if the 
246.36  consultation team member determines at the time of the initial 
247.1   assessment of the six-month period that it is appropriate to use 
247.2   the nursing facility for short-term stays and that there is an 
247.3   adequate plan of care for return to the home or community-based 
247.4   setting.  If a stay exceeds 14 days, the individual must be 
247.5   referred no later than the first county working day following 
247.6   the 14th resident day for a screening, which must be completed 
247.7   within five working days of the referral.  The payment 
247.8   limitations in subdivision 7 apply to an individual found at 
247.9   screening to not meet the level of care criteria for admission 
247.10  to a certified nursing facility. 
247.11     (c) Persons admitted to a Medicaid-certified nursing 
247.12  facility from the community on an emergency basis as described 
247.13  in paragraph (d) or from an acute care facility on a nonworking 
247.14  day must be screened the first working day after admission. 
247.15     (d) Emergency admission to a nursing facility prior to 
247.16  screening is permitted when all of the following conditions are 
247.17  met: 
247.18     (1) a person is admitted from the community to a certified 
247.19  nursing or certified boarding care facility during county 
247.20  nonworking hours; 
247.21     (2) a physician has determined that delaying admission 
247.22  until preadmission screening is completed would adversely affect 
247.23  the person's health and safety; 
247.24     (3) there is a recent precipitating event that precludes 
247.25  the client from living safely in the community, such as 
247.26  sustaining an injury, sudden onset of acute illness, or a 
247.27  caregiver's inability to continue to provide care; 
247.28     (4) the attending physician has authorized the emergency 
247.29  placement and has documented the reason that the emergency 
247.30  placement is recommended; and 
247.31     (5) the county is contacted on the first working day 
247.32  following the emergency admission. 
247.33  Transfer of a patient from an acute care hospital to a nursing 
247.34  facility is not considered an emergency except for a person who 
247.35  has received hospital services in the following situations: 
247.36  hospital admission for observation, care in an emergency room 
248.1   without hospital admission, or following hospital 24-hour bed 
248.2   care. 
248.3      Sec. 12.  Minnesota Statutes 2000, section 256B.0911, is 
248.4   amended by adding a subdivision to read: 
248.5      Subd. 4c.  [SCREENING REQUIREMENTS.] (a) A person may be 
248.6   screened for nursing facility admission by telephone or in a 
248.7   face-to-face screening interview.  Consultation team members 
248.8   shall identify each individual's needs using the following 
248.9   categories: 
248.10     (1) the person needs no face-to-face screening interview to 
248.11  determine the need for nursing facility level of care based on 
248.12  information obtained from other health care professionals; 
248.13     (2) the person needs an immediate face-to-face screening 
248.14  interview to determine the need for nursing facility level of 
248.15  care and complete activities required under subdivision 4a; or 
248.16     (3) the person may be exempt from screening requirements as 
248.17  outlined in subdivision 4b, but will need transitional 
248.18  assistance after admission or in-person follow-along after a 
248.19  return home. 
248.20     (b) Persons admitted on a nonemergency basis to a 
248.21  Medicaid-certified nursing facility must be screened prior to 
248.22  admission. 
248.23     (c) The long-term care consultation team shall recommend a 
248.24  case mix classification for persons admitted to a certified 
248.25  nursing facility when sufficient information is received to make 
248.26  that classification.  The nursing facility is authorized to 
248.27  conduct all case mix assessments for persons who have been 
248.28  screened prior to admission for whom the county did not 
248.29  recommend a case mix classification.  The nursing facility is 
248.30  authorized to conduct all case mix assessments for persons 
248.31  admitted to the facility prior to a preadmission screening.  The 
248.32  county retains the responsibility of distributing appropriate 
248.33  case mix forms to the nursing facility. 
248.34     (d) The county screening or intake activity must include 
248.35  processes to identify persons who may require transition 
248.36  assistance as described in subdivision 3b. 
249.1      Sec. 13.  Minnesota Statutes 2000, section 256B.0911, 
249.2   subdivision 5, is amended to read: 
249.3      Subd. 5.  [SIMPLIFICATION OF FORMS ADMINISTRATIVE 
249.4   ACTIVITY.] The commissioner shall minimize the number of forms 
249.5   required in the preadmission screening process provision of 
249.6   long-term care consultation services and shall limit the 
249.7   screening document to items necessary for care community support 
249.8   plan approval, reimbursement, program planning, evaluation, and 
249.9   policy development. 
249.10     Sec. 14.  Minnesota Statutes 2000, section 256B.0911, 
249.11  subdivision 6, is amended to read: 
249.12     Subd. 6.  [PAYMENT FOR PREADMISSION SCREENING LONG-TERM 
249.13  CARE CONSULTATION SERVICES.] (a) The total screening payment for 
249.14  each county must be paid monthly by certified nursing facilities 
249.15  in the county.  The monthly amount to be paid by each nursing 
249.16  facility for each fiscal year must be determined by dividing the 
249.17  county's annual allocation for screenings long-term care 
249.18  consultation services by 12 to determine the monthly payment and 
249.19  allocating the monthly payment to each nursing facility based on 
249.20  the number of licensed beds in the nursing facility.  Payments 
249.21  to counties in which there is no certified nursing facility must 
249.22  be made by increasing the payment rate of the two facilities 
249.23  located nearest to the county seat. 
249.24     (b) The commissioner shall include the total annual payment 
249.25  for screening determined under paragraph (a) for each nursing 
249.26  facility according to section 256B.431, subdivision 2b, 
249.27  paragraph (g), 256B.434, or 256B.435. 
249.28     (c) Payments for screening activities long-term care 
249.29  consultation services are available to the county or counties to 
249.30  cover staff salaries and expenses to provide the screening 
249.31  function services described in subdivision 1a.  The lead agency 
249.32  county shall employ, or contract with other agencies to employ, 
249.33  within the limits of available funding, sufficient personnel 
249.34  to conduct the preadmission screening activity provide long-term 
249.35  care consultation services while meeting the state's long-term 
249.36  care outcomes and objectives as defined in section 256B.0917, 
250.1   subdivision 1.  The local agency county shall be accountable for 
250.2   meeting local objectives as approved by the commissioner in the 
250.3   CSSA biennial plan. 
250.4      (d) Notwithstanding section 256B.0641, overpayments 
250.5   attributable to payment of the screening costs under the medical 
250.6   assistance program may not be recovered from a facility.  
250.7      (e) The commissioner of human services shall amend the 
250.8   Minnesota medical assistance plan to include reimbursement for 
250.9   the local screening consultation teams. 
250.10     (f) The county may bill, as case management services, 
250.11  assessments, support planning, and follow-along provided to 
250.12  persons determined to be eligible for case management under 
250.13  Minnesota health care programs.  No individual or family member 
250.14  shall be charged for an initial assessment or initial support 
250.15  plan development provided under subdivision 3a or 3b. 
250.16     Sec. 15.  Minnesota Statutes 2000, section 256B.0911, 
250.17  subdivision 7, is amended to read: 
250.18     Subd. 7.  [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 
250.19  (a) Medical assistance reimbursement for nursing facilities 
250.20  shall be authorized for a medical assistance recipient only if a 
250.21  preadmission screening has been conducted prior to admission or 
250.22  the local county agency has authorized an exemption.  Medical 
250.23  assistance reimbursement for nursing facilities shall not be 
250.24  provided for any recipient who the local screener has determined 
250.25  does not meet the level of care criteria for nursing facility 
250.26  placement or, if indicated, has not had a level II PASARR OBRA 
250.27  evaluation as required under the federal Omnibus Reconciliation 
250.28  Act of 1987 completed unless an admission for a recipient with 
250.29  mental illness is approved by the local mental health authority 
250.30  or an admission for a recipient with mental retardation or 
250.31  related condition is approved by the state mental retardation 
250.32  authority. 
250.33     (b) The nursing facility must not bill a person who is not 
250.34  a medical assistance recipient for resident days that preceded 
250.35  the date of completion of screening activities as required under 
250.36  subdivisions 4a, 4b, and 4c.  The nursing facility must include 
251.1   unreimbursed resident days in the nursing facility resident day 
251.2   totals reported to the commissioner. 
251.3      (c) The commissioner shall make a request to the health 
251.4   care financing administration for a waiver allowing screening 
251.5   team approval of Medicaid payments for certified nursing 
251.6   facility care.  An individual has a choice and makes the final 
251.7   decision between nursing facility placement and community 
251.8   placement after the screening team's recommendation, except as 
251.9   provided in paragraphs (b) and (c) subdivision 4a, paragraph (c).
251.10     (c) The local county mental health authority or the state 
251.11  mental retardation authority under Public Law Numbers 100-203 
251.12  and 101-508 may prohibit admission to a nursing facility, if the 
251.13  individual does not meet the nursing facility level of care 
251.14  criteria or needs specialized services as defined in Public Law 
251.15  Numbers 100-203 and 101-508.  For purposes of this section, 
251.16  "specialized services" for a person with mental retardation or a 
251.17  related condition means "active treatment" as that term is 
251.18  defined in Code of Federal Regulations, title 42, section 
251.19  483.440(a)(1). 
251.20     (e) Appeals from the screening team's recommendation or the 
251.21  county agency's final decision shall be made according to 
251.22  section 256.045, subdivision 3. 
251.23     Sec. 16.  Minnesota Statutes 2000, section 256B.0913, 
251.24  subdivision 1, is amended to read: 
251.25     Subdivision 1.  [PURPOSE AND GOALS.] The purpose of the 
251.26  alternative care program is to provide funding for or access to 
251.27  home and community-based services for frail elderly persons, in 
251.28  order to limit nursing facility placements.  The program is 
251.29  designed to support frail elderly persons in their desire to 
251.30  remain in the community as independently and as long as possible 
251.31  and to support informal caregivers in their efforts to provide 
251.32  care for frail elderly people.  Further, the goals of the 
251.33  program are: 
251.34     (1) to contain medical assistance expenditures by providing 
251.35  funding care in the community at a cost the same or less than 
251.36  nursing facility costs; and 
252.1      (2) to maintain the moratorium on new construction of 
252.2   nursing home beds. 
252.3      Sec. 17.  Minnesota Statutes 2000, section 256B.0913, 
252.4   subdivision 2, is amended to read: 
252.5      Subd. 2.  [ELIGIBILITY FOR SERVICES.] Alternative care 
252.6   services are available to all frail older Minnesotans.  This 
252.7   includes: 
252.8      (1) persons who are receiving medical assistance and served 
252.9   under the medical assistance program or the Medicaid waiver 
252.10  program; 
252.11     (2) persons age 65 or older who are not eligible for 
252.12  medical assistance without a spenddown or waiver obligation but 
252.13  who would be eligible for medical assistance within 180 days of 
252.14  admission to a nursing facility and served under subject to 
252.15  subdivisions 4 to 13; and 
252.16     (3) persons who are paying for their services out-of-pocket.
252.17     Sec. 18.  Minnesota Statutes 2000, section 256B.0913, 
252.18  subdivision 4, is amended to read: 
252.19     Subd. 4.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 
252.20  NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 
252.21  under the alternative care program is available to persons who 
252.22  meet the following criteria: 
252.23     (1) the person has been screened by the county screening 
252.24  team or, if previously screened and served under the alternative 
252.25  care program, assessed by the local county social worker or 
252.26  public health nurse determined by a community assessment under 
252.27  section 256B.0911, to be a person who would require the level of 
252.28  care provided in a nursing facility, but for the provision of 
252.29  services under the alternative care program; 
252.30     (2) the person is age 65 or older; 
252.31     (3) the person would be financially eligible for medical 
252.32  assistance within 180 days of admission to a nursing facility; 
252.33     (4) the person meets the asset transfer requirements of is 
252.34  not ineligible for the medical assistance program due to an 
252.35  asset transfer penalty; 
252.36     (5) the screening team would recommend nursing facility 
253.1   admission or continued stay for the person if alternative care 
253.2   services were not available; 
253.3      (6) the person needs services that are not available at 
253.4   that time in the county funded through other county, state, or 
253.5   federal funding sources; and 
253.6      (7) (6) the monthly cost of the alternative care services 
253.7   funded by the program for this person does not exceed 75 percent 
253.8   of the statewide average monthly medical assistance payment for 
253.9   nursing facility care at the individual's case mix 
253.10  classification weighted average monthly nursing facility rate of 
253.11  the case mix resident class to which the individual alternative 
253.12  care client would be assigned under Minnesota Rules, parts 
253.13  9549.0050 to 9549.0059, less the recipient's maintenance needs 
253.14  allowance as described in section 256B.0915, subdivision 1d, 
253.15  paragraph (a), until the first day of the state fiscal year in 
253.16  which the resident assessment system, under section 256B.437, 
253.17  for nursing home rate determination is implemented.  Effective 
253.18  on the first day of the state fiscal year in which a resident 
253.19  assessment system, under section 256B.437, for nursing home rate 
253.20  determination is implemented and the first day of each 
253.21  subsequent state fiscal year, the monthly cost of alternative 
253.22  care services for this person shall not exceed the alternative 
253.23  care monthly cap for the case mix resident class to which the 
253.24  alternative care client would be assigned under Minnesota Rules, 
253.25  parts 9549.0050 to 9549.0059, which was in effect on the last 
253.26  day of the previous state fiscal year, and adjusted by the 
253.27  greater of any legislatively adopted home and community-based 
253.28  services cost-of-living percentage increase or any legislatively 
253.29  adopted statewide percent rate increase for nursing facilities.  
253.30  This monthly limit does not prohibit the alternative care client 
253.31  from payment for additional services, but in no case may the 
253.32  cost of additional services purchased under this section exceed 
253.33  the difference between the client's monthly service limit 
253.34  defined under section 256B.0915, subdivision 3, and the 
253.35  alternative care program monthly service limit defined in this 
253.36  paragraph.  If medical supplies and equipment or adaptations 
254.1   environmental modifications are or will be purchased for an 
254.2   alternative care services recipient, the costs may be prorated 
254.3   on a monthly basis throughout the year in which they are 
254.4   purchased for up to 12 consecutive months beginning with the 
254.5   month of purchase.  If the monthly cost of a recipient's other 
254.6   alternative care services exceeds the monthly limit established 
254.7   in this paragraph, the annual cost of the alternative care 
254.8   services shall be determined.  In this event, the annual cost of 
254.9   alternative care services shall not exceed 12 times the monthly 
254.10  limit calculated described in this paragraph. 
254.11     (b) Individuals who meet the criteria in paragraph (a) and 
254.12  who have been approved for alternative care funding are called 
254.13  180-day eligible clients. 
254.14     (c) The statewide average payment for nursing facility care 
254.15  is the statewide average monthly nursing facility rate in effect 
254.16  on July 1 of the fiscal year in which the cost is incurred, less 
254.17  the statewide average monthly income of nursing facility 
254.18  residents who are age 65 or older and who are medical assistance 
254.19  recipients in the month of March of the previous fiscal year.  
254.20  This monthly limit does not prohibit the 180-day eligible client 
254.21  from paying for additional services needed or desired.  
254.22     (d) In determining the total costs of alternative care 
254.23  services for one month, the costs of all services funded by the 
254.24  alternative care program, including supplies and equipment, must 
254.25  be included. 
254.26     (e) Alternative care funding under this subdivision is not 
254.27  available for a person who is a medical assistance recipient or 
254.28  who would be eligible for medical assistance without a 
254.29  spenddown, unless authorized by the commissioner or waiver 
254.30  obligation.  A person whose initial application for medical 
254.31  assistance is being processed may be served under the 
254.32  alternative care program for a period up to 60 days.  If the 
254.33  individual is found to be eligible for medical assistance, the 
254.34  county must bill medical assistance must be billed for services 
254.35  payable under the federally approved elderly waiver plan and 
254.36  delivered from the date the individual was found eligible 
255.1   for services reimbursable under the federally approved elderly 
255.2   waiver program plan.  Notwithstanding this provision, upon 
255.3   federal approval, alternative care funds may not be used to pay 
255.4   for any service the cost of which is payable by medical 
255.5   assistance or which is used by a recipient to meet a medical 
255.6   assistance income spenddown or waiver obligation.  
255.7      (f) (c) Alternative care funding is not available for a 
255.8   person who resides in a licensed nursing home or, certified 
255.9   boarding care home, hospital, or intermediate care facility, 
255.10  except for case management services which are being provided in 
255.11  support of the discharge planning process to a nursing home 
255.12  resident or certified boarding care home resident who is 
255.13  ineligible for case management funded by medical assistance. 
255.14     Sec. 19.  Minnesota Statutes 2000, section 256B.0913, 
255.15  subdivision 5, is amended to read: 
255.16     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
255.17  Alternative care funding may be used for payment of costs of: 
255.18     (1) adult foster care; 
255.19     (2) adult day care; 
255.20     (3) home health aide; 
255.21     (4) homemaker services; 
255.22     (5) personal care; 
255.23     (6) case management; 
255.24     (7) respite care; 
255.25     (8) assisted living; 
255.26     (9) residential care services; 
255.27     (10) care-related supplies and equipment; 
255.28     (11) meals delivered to the home; 
255.29     (12) transportation; 
255.30     (13) skilled nursing; 
255.31     (14) chore services; 
255.32     (15) companion services; 
255.33     (16) nutrition services; 
255.34     (17) training for direct informal caregivers; 
255.35     (18) telemedicine devices to monitor recipients in their 
255.36  own homes as an alternative to hospital care, nursing home care, 
256.1   or home visits; and 
256.2      (19) other services including which includes discretionary 
256.3   funds and direct cash payments to clients, approved by the 
256.4   county agency following approval by the commissioner, subject to 
256.5   the provisions of paragraph (m) (j).  Total annual payments for "
256.6   other services" for all clients within a county may not exceed 
256.7   either ten percent of that county's annual alternative care 
256.8   program base allocation or $5,000, whichever is greater.  In no 
256.9   case shall this amount exceed the county's total annual 
256.10  alternative care program base allocation; and 
256.11     (20) environmental modifications. 
256.12     (b) The county agency must ensure that the funds are not 
256.13  used only to supplement and not to supplant services available 
256.14  through other public assistance or services programs. 
256.15     (c) Unless specified in statute, the service definitions 
256.16  and standards for alternative care services shall be the same as 
256.17  the service definitions and standards defined specified in the 
256.18  federally approved elderly waiver plan.  Except for the county 
256.19  agencies' approval of direct cash payments to clients as 
256.20  described in paragraph (j) or for a provider of supplies and 
256.21  equipment when the monthly cost of the supplies and equipment is 
256.22  less than $250, persons or agencies must be employed by or under 
256.23  a contract with the county agency or the public health nursing 
256.24  agency of the local board of health in order to receive funding 
256.25  under the alternative care program.  Supplies and equipment may 
256.26  be purchased from a non-Medicaid certified vendor if the cost 
256.27  for the item is less than that of a Medicaid vendor.  
256.28     (d) The adult foster care rate shall be considered a 
256.29  difficulty of care payment and shall not include room and 
256.30  board.  The adult foster care daily rate shall be negotiated 
256.31  between the county agency and the foster care provider.  The 
256.32  rate established under this section shall not exceed 75 percent 
256.33  of the state average monthly nursing home payment for the case 
256.34  mix classification to which the individual receiving foster care 
256.35  is assigned, and it must allow for other alternative care 
256.36  services to be authorized by the case manager.  The alternative 
257.1   care payment for the foster care service in combination with the 
257.2   payment for other alternative care services, including case 
257.3   management, must not exceed the limit specified in subdivision 
257.4   4, paragraph (a), clause (6). 
257.5      (e) Personal care services may be provided by a personal 
257.6   care provider organization. must meet the service standards 
257.7   defined in the federally approved elderly waiver plan, except 
257.8   that a county agency may contract with a client's relative of 
257.9   the client who meets the relative hardship waiver requirement as 
257.10  defined in section 256B.0627, subdivision 4, paragraph (b), 
257.11  clause (10), to provide personal care services, but must ensure 
257.12  nursing if the county agency ensures supervision of this service 
257.13  by a registered nurse or mental health practitioner.  Covered 
257.14  personal care services defined in section 256B.0627, subdivision 
257.15  4, must meet applicable standards in Minnesota Rules, part 
257.16  9505.0335. 
257.17     (f) A county may use alternative care funds to purchase 
257.18  medical supplies and equipment without prior approval from the 
257.19  commissioner when:  (1) there is no other funding source; (2) 
257.20  the supplies and equipment are specified in the individual's 
257.21  care plan as medically necessary to enable the individual to 
257.22  remain in the community according to the criteria in Minnesota 
257.23  Rules, part 9505.0210, item A; and (3) the supplies and 
257.24  equipment represent an effective and appropriate use of 
257.25  alternative care funds.  A county may use alternative care funds 
257.26  to purchase supplies and equipment from a non-Medicaid certified 
257.27  vendor if the cost for the items is less than that of a Medicaid 
257.28  vendor.  A county is not required to contract with a provider of 
257.29  supplies and equipment if the monthly cost of the supplies and 
257.30  equipment is less than $250.  
257.31     (g) For purposes of this section, residential care services 
257.32  are services which are provided to individuals living in 
257.33  residential care homes.  Residential care homes are currently 
257.34  licensed as board and lodging establishments and are registered 
257.35  with the department of health as providing special 
257.36  services under section 157.17 and are not subject to 
258.1   registration under chapter 144D.  Residential care services are 
258.2   defined as "supportive services" and "health-related services."  
258.3   "Supportive services" means the provision of up to 24-hour 
258.4   supervision and oversight.  Supportive services includes:  (1) 
258.5   transportation, when provided by the residential care center 
258.6   home only; (2) socialization, when socialization is part of the 
258.7   plan of care, has specific goals and outcomes established, and 
258.8   is not diversional or recreational in nature; (3) assisting 
258.9   clients in setting up meetings and appointments; (4) assisting 
258.10  clients in setting up medical and social services; (5) providing 
258.11  assistance with personal laundry, such as carrying the client's 
258.12  laundry to the laundry room.  Assistance with personal laundry 
258.13  does not include any laundry, such as bed linen, that is 
258.14  included in the room and board rate.  "Health-related services" 
258.15  are limited to minimal assistance with dressing, grooming, and 
258.16  bathing and providing reminders to residents to take medications 
258.17  that are self-administered or providing storage for medications, 
258.18  if requested.  Individuals receiving residential care services 
258.19  cannot receive homemaking services funded under this section.  
258.20     (h) (g) For the purposes of this section, "assisted living" 
258.21  refers to supportive services provided by a single vendor to 
258.22  clients who reside in the same apartment building of three or 
258.23  more units which are not subject to registration under chapter 
258.24  144D and are licensed by the department of health as a class A 
258.25  home care provider or a class E home care provider.  Assisted 
258.26  living services are defined as up to 24-hour supervision, and 
258.27  oversight, supportive services as defined in clause (1), 
258.28  individualized home care aide tasks as defined in clause (2), 
258.29  and individualized home management tasks as defined in clause 
258.30  (3) provided to residents of a residential center living in 
258.31  their units or apartments with a full kitchen and bathroom.  A 
258.32  full kitchen includes a stove, oven, refrigerator, food 
258.33  preparation counter space, and a kitchen utensil storage 
258.34  compartment.  Assisted living services must be provided by the 
258.35  management of the residential center or by providers under 
258.36  contract with the management or with the county. 
259.1      (1) Supportive services include:  
259.2      (i) socialization, when socialization is part of the plan 
259.3   of care, has specific goals and outcomes established, and is not 
259.4   diversional or recreational in nature; 
259.5      (ii) assisting clients in setting up meetings and 
259.6   appointments; and 
259.7      (iii) providing transportation, when provided by the 
259.8   residential center only.  
259.9      Individuals receiving assisted living services will not 
259.10  receive both assisted living services and homemaking services.  
259.11  Individualized means services are chosen and designed 
259.12  specifically for each resident's needs, rather than provided or 
259.13  offered to all residents regardless of their illnesses, 
259.14  disabilities, or physical conditions.  
259.15     (2) Home care aide tasks means:  
259.16     (i) preparing modified diets, such as diabetic or low 
259.17  sodium diets; 
259.18     (ii) reminding residents to take regularly scheduled 
259.19  medications or to perform exercises; 
259.20     (iii) household chores in the presence of technically 
259.21  sophisticated medical equipment or episodes of acute illness or 
259.22  infectious disease; 
259.23     (iv) household chores when the resident's care requires the 
259.24  prevention of exposure to infectious disease or containment of 
259.25  infectious disease; and 
259.26     (v) assisting with dressing, oral hygiene, hair care, 
259.27  grooming, and bathing, if the resident is ambulatory, and if the 
259.28  resident has no serious acute illness or infectious disease.  
259.29  Oral hygiene means care of teeth, gums, and oral prosthetic 
259.30  devices.  
259.31     (3) Home management tasks means:  
259.32     (i) housekeeping; 
259.33     (ii) laundry; 
259.34     (iii) preparation of regular snacks and meals; and 
259.35     (iv) shopping.  
259.36     Individuals receiving assisted living services shall not 
260.1   receive both assisted living services and homemaking services.  
260.2   Individualized means services are chosen and designed 
260.3   specifically for each resident's needs, rather than provided or 
260.4   offered to all residents regardless of their illnesses, 
260.5   disabilities, or physical conditions.  Assisted living services 
260.6   as defined in this section shall not be authorized in boarding 
260.7   and lodging establishments licensed according to sections 
260.8   157.011 and 157.15 to 157.22. 
260.9      (i) (h) For establishments registered under chapter 144D, 
260.10  assisted living services under this section means either the 
260.11  services described and licensed in paragraph (g) and delivered 
260.12  by a class E home care provider licensed by the department of 
260.13  health or the services described under section 144A.4605 and 
260.14  delivered by an assisted living home care provider or a class A 
260.15  home care provider licensed by the commissioner of health. 
260.16     (j) For the purposes of this section, reimbursement (i) 
260.17  Payment for assisted living services and residential care 
260.18  services shall be a monthly rate negotiated and authorized by 
260.19  the county agency based on an individualized service plan for 
260.20  each resident and may not cover direct rent or food costs.  The 
260.21  rate 
260.22     (1) The individualized monthly negotiated payment for 
260.23  assisted living services as described in paragraph (g) or (h), 
260.24  and residential care services as described in paragraph (f), 
260.25  shall not exceed the nonfederal share in effect on July 1 of the 
260.26  state fiscal year for which the rate limit is being calculated 
260.27  of the greater of either the statewide or any of the geographic 
260.28  groups' weighted average monthly medical assistance nursing 
260.29  facility payment rate of the case mix resident class to which 
260.30  the 180-day alternative care eligible client would be assigned 
260.31  under Minnesota Rules, parts 9549.0050 to 9549.0059, unless the 
260.32  less the maintenance needs allowance as described in subdivision 
260.33  1d, paragraph (a), until the first day of the state fiscal year 
260.34  in which a resident assessment system, under section 256B.437, 
260.35  of nursing home rate determination is implemented.  Effective on 
260.36  the first day of the state fiscal year in which a resident 
261.1   assessment system, under section 256B.437, of nursing home rate 
261.2   determination is implemented and the first day of each 
261.3   subsequent state fiscal year, the individualized monthly 
261.4   negotiated payment for the services described in this clause 
261.5   shall not exceed the limit described in this clause which was in 
261.6   effect on the last day of the previous state fiscal year and 
261.7   which has been adjusted by the greater of any legislatively 
261.8   adopted home and community-based services cost-of-living 
261.9   percentage increase or any legislatively adopted statewide 
261.10  percent rate increase for nursing facilities. 
261.11     (2) The individualized monthly negotiated payment for 
261.12  assisted living services are provided by a home care described 
261.13  under section 144A.4605 and delivered by a provider licensed by 
261.14  the department of health as a class A home care provider or an 
261.15  assisted living home care provider and are provided in a 
261.16  building that is registered as a housing with services 
261.17  establishment under chapter 144D and that provides 24-hour 
261.18  supervision in combination with the payment for other 
261.19  alternative care services, including case management, must not 
261.20  exceed the limit specified in subdivision 4, paragraph (a), 
261.21  clause (6). 
261.22     (k) For purposes of this section, companion services are 
261.23  defined as nonmedical care, supervision and oversight, provided 
261.24  to a functionally impaired adult.  Companions may assist the 
261.25  individual with such tasks as meal preparation, laundry and 
261.26  shopping, but do not perform these activities as discrete 
261.27  services.  The provision of companion services does not entail 
261.28  hands-on medical care.  Providers may also perform light 
261.29  housekeeping tasks which are incidental to the care and 
261.30  supervision of the recipient.  This service must be approved by 
261.31  the case manager as part of the care plan.  Companion services 
261.32  must be provided by individuals or organizations who are under 
261.33  contract with the local agency to provide the service.  Any 
261.34  person related to the waiver recipient by blood, marriage or 
261.35  adoption cannot be reimbursed under this service.  Persons 
261.36  providing companion services will be monitored by the case 
262.1   manager. 
262.2      (l) For purposes of this section, training for direct 
262.3   informal caregivers is defined as a classroom or home course of 
262.4   instruction which may include:  transfer and lifting skills, 
262.5   nutrition, personal and physical cares, home safety in a home 
262.6   environment, stress reduction and management, behavioral 
262.7   management, long-term care decision making, care coordination 
262.8   and family dynamics.  The training is provided to an informal 
262.9   unpaid caregiver of a 180-day eligible client which enables the 
262.10  caregiver to deliver care in a home setting with high levels of 
262.11  quality.  The training must be approved by the case manager as 
262.12  part of the individual care plan.  Individuals, agencies, and 
262.13  educational facilities which provide caregiver training and 
262.14  education will be monitored by the case manager. 
262.15     (m) (j) A county agency may make payment from their 
262.16  alternative care program allocation for "other services" 
262.17  provided to an alternative care program recipient if those 
262.18  services prevent, shorten, or delay institutionalization.  These 
262.19  services may which include use of "discretionary funds" for 
262.20  services that are not otherwise defined in this section and 
262.21  direct cash payments to the recipient client for the purpose of 
262.22  purchasing the recipient's services.  The following provisions 
262.23  apply to payments under this paragraph: 
262.24     (1) a cash payment to a client under this provision cannot 
262.25  exceed 80 percent of the monthly payment limit for that client 
262.26  as specified in subdivision 4, paragraph (a), clause (7) (6); 
262.27     (2) a county may not approve any cash payment for a client 
262.28  who meets either of the following: 
262.29     (i) has been assessed as having a dependency in 
262.30  orientation, unless the client has an authorized 
262.31  representative under section 256.476, subdivision 2, paragraph 
262.32  (g), or for a client who.  An "authorized representative" means 
262.33  an individual who is at least 18 years of age and is designated 
262.34  by the person or the person's legal representative to act on the 
262.35  person's behalf.  This individual may be a family member, 
262.36  guardian, representative payee, or other individual designated 
263.1   by the person or the person's legal representative, if any, to 
263.2   assist in purchasing and arranging for supports; or 
263.3      (ii) is concurrently receiving adult foster care, 
263.4   residential care, or assisted living services; 
263.5      (3) any service approved under this section must be a 
263.6   service which meets the purpose and goals of the program as 
263.7   listed in subdivision 1; 
263.8      (4) cash payments must also meet the criteria of and are 
263.9   governed by the procedures and liability protection established 
263.10  in section 256.476, subdivision 4, paragraphs (b) through (h), 
263.11  and recipients of cash grants must meet the requirements in 
263.12  section 256.476, subdivision 10; and cash payments to a person 
263.13  or a person's family will be provided through a monthly payment 
263.14  and be in the form of cash, voucher, or direct county payment to 
263.15  vendor.  Fees or premiums assessed to the person for eligibility 
263.16  for health and human services are not reimbursable through this 
263.17  service option.  Services and goods purchased through cash 
263.18  payments must be identified in the person's individualized care 
263.19  plan and must meet all of the following criteria: 
263.20     (i) they must be over and above the normal cost of caring 
263.21  for the person if the person did not have functional 
263.22  limitations; 
263.23     (ii) they must be directly attributable to the person's 
263.24  functional limitations; 
263.25     (iii) they must have the potential to be effective at 
263.26  meeting the goals of the program; 
263.27     (iv) they must be consistent with the needs identified in 
263.28  the individualized service plan.  The service plan shall specify 
263.29  the needs of the person and family, the form and amount of 
263.30  payment, the items and services to be reimbursed, and the 
263.31  arrangements for management of the individual grant; and 
263.32     (v) the person, the person's family, or the legal 
263.33  representative shall be provided sufficient information to 
263.34  ensure an informed choice of alternatives.  The local agency 
263.35  shall document this information in the person's care plan, 
263.36  including the type and level of expenditures to be reimbursed; 
264.1      (4) the county, lead agency under contract, or tribal 
264.2   government under contract to administer the alternative care 
264.3   program shall not be liable for damages, injuries, or 
264.4   liabilities sustained through the purchase of direct supports or 
264.5   goods by the person, the person's family, or the authorized 
264.6   representative with funds received through the cash payments 
264.7   under this section.  Liabilities include, but are not limited 
264.8   to, workers' compensation, the Federal Insurance Contributions 
264.9   Act (FICA), or the Federal Unemployment Tax Act (FUTA); 
264.10     (5) persons receiving grants under this section shall have 
264.11  the following responsibilities: 
264.12     (i) spend the grant money in a manner consistent with their 
264.13  individualized service plan with the local agency; 
264.14     (ii) notify the local agency of any necessary changes in 
264.15  the grant-expenditures; 
264.16     (iii) arrange and pay for supports; and 
264.17     (iv) inform the local agency of areas where they have 
264.18  experienced difficulty securing or maintaining supports; and 
264.19     (5) (6) the county shall report client outcomes, services, 
264.20  and costs under this paragraph in a manner prescribed by the 
264.21  commissioner. 
264.22     (k) Upon implementation of direct cash payments to clients 
264.23  under this section, any person determined eligible for the 
264.24  alternative care program who chooses a cash payment approved by 
264.25  the county agency shall receive the cash payment under this 
264.26  section and not under section 256.476 unless the person was 
264.27  receiving a consumer support grant under section 256.476 before 
264.28  implementation of direct cash payments under this section. 
264.29     Sec. 20.  Minnesota Statutes 2000, section 256B.0913, 
264.30  subdivision 6, is amended to read: 
264.31     Subd. 6.  [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 
264.32  alternative care program is administered by the county agency.  
264.33  This agency is the lead agency responsible for the local 
264.34  administration of the alternative care program as described in 
264.35  this section.  However, it may contract with the public health 
264.36  nursing service to be the lead agency.  The commissioner may 
265.1   contract with federally recognized Indian tribes with a 
265.2   reservation in Minnesota to serve as the lead agency responsible 
265.3   for the local administration of the alternative care program as 
265.4   described in the contract. 
265.5      Sec. 21.  Minnesota Statutes 2000, section 256B.0913, 
265.6   subdivision 7, is amended to read: 
265.7      Subd. 7.  [CASE MANAGEMENT.] Providers of case management 
265.8   services for persons receiving services funded by the 
265.9   alternative care program must meet the qualification 
265.10  requirements and standards specified in section 256B.0915, 
265.11  subdivision 1b.  The case manager must ensure the health and 
265.12  safety of the individual client and not approve alternative care 
265.13  funding for a client in any setting in which the case manager 
265.14  cannot reasonably ensure the client's health and safety.  The 
265.15  case manager is responsible for the cost-effectiveness of the 
265.16  alternative care individual care plan and must not approve any 
265.17  care plan in which the cost of services funded by alternative 
265.18  care and client contributions exceeds the limit specified in 
265.19  section 256B.0915, subdivision 3, paragraph (b).  The county may 
265.20  allow a case manager employed by the county to delegate certain 
265.21  aspects of the case management activity to another individual 
265.22  employed by the county provided there is oversight of the 
265.23  individual by the case manager.  The case manager may not 
265.24  delegate those aspects which require professional judgment 
265.25  including assessments, reassessments, and care plan development. 
265.26     Sec. 22.  Minnesota Statutes 2000, section 256B.0913, 
265.27  subdivision 8, is amended to read: 
265.28     Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 
265.29  case manager shall implement the plan of care for each 180-day 
265.30  eligible alternative care client and ensure that a client's 
265.31  service needs and eligibility are reassessed at least every 12 
265.32  months.  The plan shall include any services prescribed by the 
265.33  individual's attending physician as necessary to allow the 
265.34  individual to remain in a community setting.  In developing the 
265.35  individual's care plan, the case manager should include the use 
265.36  of volunteers from families and neighbors, religious 
266.1   organizations, social clubs, and civic and service organizations 
266.2   to support the formal home care services.  The county shall be 
266.3   held harmless for damages or injuries sustained through the use 
266.4   of volunteers under this subdivision including workers' 
266.5   compensation liability.  The lead agency shall provide 
266.6   documentation to the commissioner verifying that the 
266.7   individual's alternative care is not available at that time 
266.8   through any other public assistance or service program.  The 
266.9   lead agency shall provide documentation in each individual's 
266.10  plan of care and, if requested, to the commissioner that the 
266.11  most cost-effective alternatives available have been offered to 
266.12  the individual and that the individual was free to choose among 
266.13  available qualified providers, both public and private.  The 
266.14  case manager must give the individual a ten-day written notice 
266.15  of any decrease in or termination of alternative care services. 
266.16     (b) If the county administering alternative care services 
266.17  is different than the county of financial responsibility, the 
266.18  care plan may be implemented without the approval of the county 
266.19  of financial responsibility. 
266.20     Sec. 23.  Minnesota Statutes 2000, section 256B.0913, 
266.21  subdivision 9, is amended to read: 
266.22     Subd. 9.  [CONTRACTING PROVISIONS FOR PROVIDERS.] The lead 
266.23  agency shall document to the commissioner that the agency made 
266.24  reasonable efforts to inform potential providers of the 
266.25  anticipated need for services under the alternative care program 
266.26  or waiver programs under sections 256B.0915 and 256B.49, 
266.27  including a minimum of 14 days' written advance notice of the 
266.28  opportunity to be selected as a service provider and an annual 
266.29  public meeting with providers to explain and review the criteria 
266.30  for selection.  The lead agency shall also document to the 
266.31  commissioner that the agency allowed potential providers an 
266.32  opportunity to be selected to contract with the county agency.  
266.33  Funds reimbursed to counties under this subdivision Alternative 
266.34  care funds paid to service providers are subject to audit by the 
266.35  commissioner for fiscal and utilization control.  
266.36     The lead agency must select providers for contracts or 
267.1   agreements using the following criteria and other criteria 
267.2   established by the county: 
267.3      (1) the need for the particular services offered by the 
267.4   provider; 
267.5      (2) the population to be served, including the number of 
267.6   clients, the length of time services will be provided, and the 
267.7   medical condition of clients; 
267.8      (3) the geographic area to be served; 
267.9      (4) quality assurance methods, including appropriate 
267.10  licensure, certification, or standards, and supervision of 
267.11  employees when needed; 
267.12     (5) rates for each service and unit of service exclusive of 
267.13  county administrative costs; 
267.14     (6) evaluation of services previously delivered by the 
267.15  provider; and 
267.16     (7) contract or agreement conditions, including billing 
267.17  requirements, cancellation, and indemnification. 
267.18     The county must evaluate its own agency services under the 
267.19  criteria established for other providers.  The county shall 
267.20  provide a written statement of the reasons for not selecting 
267.21  providers. 
267.22     Sec. 24.  Minnesota Statutes 2000, section 256B.0913, 
267.23  subdivision 10, is amended to read: 
267.24     Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
267.25  appropriation for fiscal years 1992 and beyond shall cover 
267.26  only 180-day alternative care eligible clients.  Prior to July 1 
267.27  of each year, the commissioner shall allocate to county agencies 
267.28  the state funds available for alternative care for persons 
267.29  eligible under subdivision 2. 
267.30     (b) Prior to July 1 of each year, the commissioner shall 
267.31  allocate to county agencies the state funds available for 
267.32  alternative care for persons eligible under subdivision 2.  The 
267.33  allocation for fiscal year 1992 shall be calculated using a base 
267.34  that is adjusted to exclude the medical assistance share of 
267.35  alternative care expenditures.  The adjusted base is calculated 
267.36  by multiplying each county's allocation for fiscal year 1991 by 
268.1   the percentage of county alternative care expenditures for 
268.2   180-day eligible clients.  The percentage is determined based on 
268.3   expenditures for services rendered in fiscal year 1989 or 
268.4   calendar year 1989, whichever is greater.  The adjusted base for 
268.5   each county is the county's current fiscal year base allocation 
268.6   plus any targeted funds approved during the current fiscal 
268.7   year.  Calculations for paragraphs (c) and (d) are to be made as 
268.8   follows:  for each county, the determination of alternative care 
268.9   program expenditures shall be based on payments for services 
268.10  rendered from April 1 through March 31 in the base year, to the 
268.11  extent that claims have been submitted and paid by June 1 of 
268.12  that year.  
268.13     (c) If the county alternative care program expenditures for 
268.14  180-day eligible clients as defined in paragraph (b) are 95 
268.15  percent or more of its the county's adjusted base allocation, 
268.16  the allocation for the next fiscal year is 100 percent of the 
268.17  adjusted base, plus inflation to the extent that inflation is 
268.18  included in the state budget. 
268.19     (d) If the county alternative care program expenditures for 
268.20  180-day eligible clients as defined in paragraph (b) are less 
268.21  than 95 percent of its the county's adjusted base allocation, 
268.22  the allocation for the next fiscal year is the adjusted base 
268.23  allocation less the amount of unspent funds below the 95 percent 
268.24  level. 
268.25     (e) For fiscal year 1992 only, a county may receive an 
268.26  increased allocation if annualized service costs for the month 
268.27  of May 1991 for 180-day eligible clients are greater than the 
268.28  allocation otherwise determined.  A county may apply for this 
268.29  increase by reporting projected expenditures for May to the 
268.30  commissioner by June 1, 1991.  The amount of the allocation may 
268.31  exceed the amount calculated in paragraph (b).  The projected 
268.32  expenditures for May must be based on actual 180-day eligible 
268.33  client caseload and the individual cost of clients' care plans.  
268.34  If a county does not report its expenditures for May, the amount 
268.35  in paragraph (c) or (d) shall be used. 
268.36     (f) Calculations for paragraphs (c) and (d) are to be made 
269.1   as follows:  for each county, the determination of expenditures 
269.2   shall be based on payments for services rendered from April 1 
269.3   through March 31 in the base year, to the extent that claims 
269.4   have been submitted by June 1 of that year.  Calculations for 
269.5   paragraphs (c) and (d) must also include the funds transferred 
269.6   to the consumer support grant program for clients who have 
269.7   transferred to that program from April 1 through March 31 in the 
269.8   base year.  
269.9      (g) For the biennium ending June 30, 2001, the allocation 
269.10  of state funds to county agencies shall be calculated as 
269.11  described in paragraphs (c) and (d).  If the annual legislative 
269.12  appropriation for the alternative care program is inadequate to 
269.13  fund the combined county allocations for fiscal year 2000 or 
269.14  2001 a biennium, the commissioner shall distribute to each 
269.15  county the entire annual appropriation as that county's 
269.16  percentage of the computed base as calculated in paragraph 
269.17  (f) paragraphs (c) and (d). 
269.18     Sec. 25.  Minnesota Statutes 2000, section 256B.0913, 
269.19  subdivision 11, is amended to read: 
269.20     Subd. 11.  [TARGETED FUNDING.] (a) The purpose of targeted 
269.21  funding is to make additional money available to counties with 
269.22  the greatest need.  Targeted funds are not intended to be 
269.23  distributed equitably among all counties, but rather, allocated 
269.24  to those with long-term care strategies that meet state goals. 
269.25     (b) The funds available for targeted funding shall be the 
269.26  total appropriation for each fiscal year minus county 
269.27  allocations determined under subdivision 10 as adjusted for any 
269.28  inflation increases provided in appropriations for the biennium. 
269.29     (c) The commissioner shall allocate targeted funds to 
269.30  counties that demonstrate to the satisfaction of the 
269.31  commissioner that they have developed feasible plans to increase 
269.32  alternative care spending.  In making targeted funding 
269.33  allocations, the commissioner shall use the following priorities:
269.34     (1) counties that received a lower allocation in fiscal 
269.35  year 1991 than in fiscal year 1990.  Counties remain in this 
269.36  priority until they have been restored to their fiscal year 1990 
270.1   level plus inflation; 
270.2      (2) counties that sustain a base allocation reduction for 
270.3   failure to spend 95 percent of the allocation if they 
270.4   demonstrate that the base reduction should be restored; 
270.5      (3) counties that propose projects to divert community 
270.6   residents from nursing home placement or convert nursing home 
270.7   residents to community living; and 
270.8      (4) counties that can otherwise justify program growth by 
270.9   demonstrating the existence of waiting lists, demographically 
270.10  justified needs, or other unmet needs. 
270.11     (d) Counties that would receive targeted funds according to 
270.12  paragraph (c) must demonstrate to the commissioner's 
270.13  satisfaction that the funds would be appropriately spent by 
270.14  showing how the funds would be used to further the state's 
270.15  alternative care goals as described in subdivision 1, and that 
270.16  the county has the administrative and service delivery 
270.17  capability to use them.  
270.18     (e) The commissioner shall request applications by June 1 
270.19  each year, for county agencies to apply for targeted funds by 
270.20  November 1 of each year.  The counties selected for targeted 
270.21  funds shall be notified of the amount of their additional 
270.22  funding by August 1 of each year.  Targeted funds allocated to a 
270.23  county agency in one year shall be treated as part of the 
270.24  county's base allocation for that year in determining 
270.25  allocations for subsequent years.  No reallocations between 
270.26  counties shall be made. 
270.27     (f) The allocation for each year after fiscal year 1992 
270.28  shall be determined using the previous fiscal year's allocation, 
270.29  including any targeted funds, as the base and then applying the 
270.30  criteria under subdivision 10, paragraphs (c), (d), and (f), to 
270.31  the current year's expenditures. 
270.32     Sec. 26.  Minnesota Statutes 2000, section 256B.0913, 
270.33  subdivision 12, is amended to read: 
270.34     Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
270.35  all 180-day alternative care eligible clients to help pay for 
270.36  the cost of participating in the program.  The amount of the 
271.1   premium for the alternative care client shall be determined as 
271.2   follows: 
271.3      (1) when the alternative care client's income less 
271.4   recurring and predictable medical expenses is greater than the 
271.5   medical assistance income standard recipient's maintenance needs 
271.6   allowance as defined in section 256B.0915, subdivision 1d, 
271.7   paragraph (a), but less than 150 percent of the federal poverty 
271.8   guideline effective on July 1 of the state fiscal year in which 
271.9   the premium is being computed, and total assets are less than 
271.10  $10,000, the fee is zero; 
271.11     (2) when the alternative care client's income less 
271.12  recurring and predictable medical expenses is greater than 150 
271.13  percent of the federal poverty guideline effective on July 1 of 
271.14  the state fiscal year in which the premium is being computed, 
271.15  and total assets are less than $10,000, the fee is 25 percent of 
271.16  the cost of alternative care services or the difference between 
271.17  150 percent of the federal poverty guideline effective on July 1 
271.18  of the state fiscal year in which the premium is being computed 
271.19  and the client's income less recurring and predictable medical 
271.20  expenses, whichever is less; and 
271.21     (3) when the alternative care client's total assets are 
271.22  greater than $10,000, the fee is 25 percent of the cost of 
271.23  alternative care services.  
271.24     For married persons, total assets are defined as the total 
271.25  marital assets less the estimated community spouse asset 
271.26  allowance, under section 256B.059, if applicable.  For married 
271.27  persons, total income is defined as the client's income less the 
271.28  monthly spousal allotment, under section 256B.058. 
271.29     All alternative care services except case management shall 
271.30  be included in the estimated costs for the purpose of 
271.31  determining 25 percent of the costs. 
271.32     The monthly premium shall be calculated based on the cost 
271.33  of the first full month of alternative care services and shall 
271.34  continue unaltered until the next reassessment is completed or 
271.35  at the end of 12 months, whichever comes first.  Premiums are 
271.36  due and payable each month alternative care services are 
272.1   received unless the actual cost of the services is less than the 
272.2   premium. 
272.3      (b) The fee shall be waived by the commissioner when: 
272.4      (1) a person who is residing in a nursing facility is 
272.5   receiving case management only; 
272.6      (2) a person is applying for medical assistance; 
272.7      (3) a married couple is requesting an asset assessment 
272.8   under the spousal impoverishment provisions; 
272.9      (4) a person is a medical assistance recipient, but has 
272.10  been approved for alternative care-funded assisted living 
272.11  services; 
272.12     (5) a person is found eligible for alternative care, but is 
272.13  not yet receiving alternative care services; or 
272.14     (6) (5) a person's fee under paragraph (a) is less than $25.
272.15     (c) The county agency must record in the state's receivable 
272.16  system the client's assessed premium amount or the reason the 
272.17  premium has been waived.  The commissioner will bill and collect 
272.18  the premium from the client and forward the amounts collected to 
272.19  the commissioner in the manner and at the times prescribed by 
272.20  the commissioner.  Money collected must be deposited in the 
272.21  general fund and is appropriated to the commissioner for the 
272.22  alternative care program.  The client must supply the county 
272.23  with the client's social security number at the time of 
272.24  application.  If a client fails or refuses to pay the premium 
272.25  due, The county shall supply the commissioner with the client's 
272.26  social security number and other information the commissioner 
272.27  requires to collect the premium from the client.  The 
272.28  commissioner shall collect unpaid premiums using the Revenue 
272.29  Recapture Act in chapter 270A and other methods available to the 
272.30  commissioner.  The commissioner may require counties to inform 
272.31  clients of the collection procedures that may be used by the 
272.32  state if a premium is not paid.  
272.33     (d) The commissioner shall begin to adopt emergency or 
272.34  permanent rules governing client premiums within 30 days after 
272.35  July 1, 1991, including criteria for determining when services 
272.36  to a client must be terminated due to failure to pay a premium.  
273.1      Sec. 27.  Minnesota Statutes 2000, section 256B.0913, 
273.2   subdivision 13, is amended to read: 
273.3      Subd. 13.  [COUNTY BIENNIAL PLAN.] The county biennial plan 
273.4   for the preadmission screening program long-term care 
273.5   consultation under section 256B.0911, the alternative care 
273.6   program under this section, and waivers for the elderly under 
273.7   section 256B.0915, and waivers for the disabled under section 
273.8   256B.49, shall be incorporated into the biennial Community 
273.9   Social Services Act plan and shall meet the regulations and 
273.10  timelines of that plan.  This county biennial plan shall include:
273.11     (1) information on the administration of the preadmission 
273.12  screening program; 
273.13     (2) information on the administration of the home and 
273.14  community-based services waivers for the elderly under section 
273.15  256B.0915, and for the disabled under section 256B.49; and 
273.16     (3) information on the administration of the alternative 
273.17  care program. 
273.18     Sec. 28.  Minnesota Statutes 2000, section 256B.0913, 
273.19  subdivision 14, is amended to read: 
273.20     Subd. 14.  [REIMBURSEMENT PAYMENT AND RATE ADJUSTMENTS.] (a)
273.21  Reimbursement Payment for expenditures for the provided 
273.22  alternative care services as approved by the client's case 
273.23  manager shall be through the invoice processing procedures of 
273.24  the department's Medicaid Management Information System (MMIS).  
273.25  To receive reimbursement payment, the county or vendor must 
273.26  submit invoices within 12 months following the date of service.  
273.27  The county agency and its vendors under contract shall not be 
273.28  reimbursed for services which exceed the county allocation. 
273.29     (b) If a county collects less than 50 percent of the client 
273.30  premiums due under subdivision 12, the commissioner may withhold 
273.31  up to three percent of the county's final alternative care 
273.32  program allocation determined under subdivisions 10 and 11. 
273.33     (c) The county shall negotiate individual rates with 
273.34  vendors and may be reimbursed authorize service payment for 
273.35  actual costs up to the greater of the county's current approved 
273.36  rate or 60 percent of the maximum rate in fiscal year 1994 and 
274.1   65 percent of the maximum rate in fiscal year 1995 for each 
274.2   alternative care service.  Notwithstanding any other rule or 
274.3   statutory provision to the contrary, the commissioner shall not 
274.4   be authorized to increase rates by an annual inflation factor, 
274.5   unless so authorized by the legislature. 
274.6      (d) (c) On July 1, 1993, the commissioner shall increase 
274.7   the maximum rate for home delivered meals to $4.50 per meal.  To 
274.8   improve access to community services and eliminate payment 
274.9   disparities between the alternative care program and the elderly 
274.10  waiver program, the commissioner shall establish statewide 
274.11  maximum service rate limits and eliminate county-specific 
274.12  service rate limits. 
274.13     (1) Effective July 1, 2001, for service rate limits, except 
274.14  those in subdivision 5, paragraphs (d) and (j), the rate limit 
274.15  for each service shall be the greater of the alternative care 
274.16  statewide maximum rate or the elderly waiver statewide maximum 
274.17  rate. 
274.18     (2) Counties may negotiate individual service rates with 
274.19  vendors for actual costs up to the statewide maximum service 
274.20  rate limit. 
274.21     Sec. 29.  Minnesota Statutes 2000, section 256B.0915, 
274.22  subdivision 1d, is amended to read: 
274.23     Subd. 1d.  [POSTELIGIBILITY TREATMENT OF INCOME AND 
274.24  RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 
274.25  provisions of section 256B.056, the commissioner shall make the 
274.26  following amendment to the medical assistance elderly waiver 
274.27  program effective July 1, 1999, or upon federal approval, 
274.28  whichever is later. 
274.29     A recipient's maintenance needs will be an amount equal to 
274.30  the Minnesota supplemental aid equivalent rate as defined in 
274.31  section 256I.03, subdivision 5, plus the medical assistance 
274.32  personal needs allowance as defined in section 256B.35, 
274.33  subdivision 1, paragraph (a), when applying posteligibility 
274.34  treatment of income rules to the gross income of elderly waiver 
274.35  recipients, except for individuals whose income is in excess of 
274.36  the special income standard according to Code of Federal 
275.1   Regulations, title 42, section 435.236.  Recipient maintenance 
275.2   needs shall be adjusted under this provision each July 1. 
275.3      (b) The commissioner of human services shall secure 
275.4   approval of additional elderly waiver slots sufficient to serve 
275.5   persons who will qualify under the revised income standard 
275.6   described in paragraph (a) before implementing section 
275.7   256B.0913, subdivision 16. 
275.8      (c) In implementing this subdivision, the commissioner 
275.9   shall consider allowing persons who would otherwise be eligible 
275.10  for the alternative care program but would qualify for the 
275.11  elderly waiver with a spenddown to remain on the alternative 
275.12  care program. 
275.13     Sec. 30.  Minnesota Statutes 2000, section 256B.0915, 
275.14  subdivision 3, is amended to read: 
275.15     Subd. 3.  [LIMITS OF CASES, RATES, REIMBURSEMENT PAYMENTS, 
275.16  AND FORECASTING.] (a) The number of medical assistance waiver 
275.17  recipients that a county may serve must be allocated according 
275.18  to the number of medical assistance waiver cases open on July 1 
275.19  of each fiscal year.  Additional recipients may be served with 
275.20  the approval of the commissioner. 
275.21     (b) The monthly limit for the cost of waivered services to 
275.22  an individual elderly waiver client shall be the statewide 
275.23  average payment weighted average monthly nursing facility rate 
275.24  of the case mix resident class to which the elderly waiver 
275.25  client would be assigned under the medical assistance case mix 
275.26  reimbursement system.  Minnesota Rules, parts 9549.0050 to 
275.27  9549.0059, less the recipient's maintenance needs allowance as 
275.28  described in subdivision 1d, paragraph (a), until the first day 
275.29  of the state fiscal year in which the resident assessment system 
275.30  as described in section 256B.437 for nursing home rate 
275.31  determination is implemented.  Effective on the first day of the 
275.32  state fiscal year in which the resident assessment system as 
275.33  described in section 256B.437 for nursing home rate 
275.34  determination is implemented and the first day of each 
275.35  subsequent state fiscal year, the monthly limit for the cost of 
275.36  waivered services to an individual elderly waiver client shall 
276.1   be the rate of the case mix resident class to which the waiver 
276.2   client would be assigned under Minnesota Rules, parts 9549.0050 
276.3   to 9549.0059, in effect on the last day of the previous state 
276.4   fiscal year, adjusted by the greater of any legislatively 
276.5   adopted home and community-based services cost-of-living 
276.6   percentage increase or any legislatively adopted statewide 
276.7   percent rate increase for nursing facilities. 
276.8      (c) If extended medical supplies and equipment or 
276.9   adaptations environmental modifications are or will be purchased 
276.10  for an elderly waiver services recipient client, the costs may 
276.11  be prorated on a monthly basis throughout the year in which they 
276.12  are purchased for up to 12 consecutive months beginning with the 
276.13  month of purchase.  If the monthly cost of a recipient's other 
276.14  waivered services exceeds the monthly limit established in this 
276.15  paragraph (b), the annual cost of the all waivered services 
276.16  shall be determined.  In this event, the annual cost of all 
276.17  waivered services shall not exceed 12 times the monthly 
276.18  limit calculated in this paragraph.  The statewide average 
276.19  payment rate is calculated by determining the statewide average 
276.20  monthly nursing home rate, effective July 1 of the fiscal year 
276.21  in which the cost is incurred, less the statewide average 
276.22  monthly income of nursing home residents who are age 65 or 
276.23  older, and who are medical assistance recipients in the month of 
276.24  March of the previous state fiscal year.  The annual cost 
276.25  divided by 12 of elderly or disabled waivered services of 
276.26  waivered services as described in paragraph (b).  
276.27     (d) For a person who is a nursing facility resident at the 
276.28  time of requesting a determination of eligibility for elderly or 
276.29  disabled waivered services shall be the greater of the monthly 
276.30  payment for:  (i), a monthly conversion limit for the cost of 
276.31  elderly waivered services may be requested.  The monthly 
276.32  conversion limit for the cost of elderly waiver services shall 
276.33  be the resident class assigned under Minnesota Rules, parts 
276.34  9549.0050 to 9549.0059, for that resident in the nursing 
276.35  facility where the resident currently resides; or (ii) the 
276.36  statewide average payment of the case mix resident class to 
277.1   which the resident would be assigned under the medical 
277.2   assistance case mix reimbursement system, provided that until 
277.3   July 1 of the state fiscal year in which the resident assessment 
277.4   system as described in section 256B.437 for nursing home rate 
277.5   determination is implemented.  Effective on July 1 of the state 
277.6   fiscal year in which the resident assessment system as described 
277.7   in section 256B.437 for nursing home rate determination is 
277.8   implemented, the monthly conversion limit for the cost of 
277.9   elderly waiver services shall be the per diem nursing facility 
277.10  rate as determined by the resident assessment system as 
277.11  described in section 256B.437 for that resident in the nursing 
277.12  facility where the resident currently resides multiplied by 365 
277.13  and divided by 12, less the recipient's maintenance needs 
277.14  allowance as described in subdivision 1d.  The limit under this 
277.15  clause only applies to persons discharged from a nursing 
277.16  facility after a minimum 30-day stay and found eligible for 
277.17  waivered services on or after July 1, 1997.  The following costs 
277.18  must be included in determining the total monthly costs for the 
277.19  waiver client: 
277.20     (1) cost of all waivered services, including extended 
277.21  medical supplies and equipment and environmental modifications; 
277.22  and 
277.23     (2) cost of skilled nursing, home health aide, and personal 
277.24  care services reimbursable by medical assistance.  
277.25     (c) (e) Medical assistance funding for skilled nursing 
277.26  services, private duty nursing, home health aide, and personal 
277.27  care services for waiver recipients must be approved by the case 
277.28  manager and included in the individual care plan. 
277.29     (d) For both the elderly waiver and the nursing facility 
277.30  disabled waiver, a county may purchase extended supplies and 
277.31  equipment without prior approval from the commissioner when 
277.32  there is no other funding source and the supplies and equipment 
277.33  are specified in the individual's care plan as medically 
277.34  necessary to enable the individual to remain in the community 
277.35  according to the criteria in Minnesota Rules, part 9505.0210, 
277.36  items A and B.  (f) A county is not required to contract with a 
278.1   provider of supplies and equipment if the monthly cost of the 
278.2   supplies and equipment is less than $250.  
278.3      (e) (g) The adult foster care daily rate for the elderly 
278.4   and disabled waivers shall be considered a difficulty of care 
278.5   payment and shall not include room and board.  The adult foster 
278.6   care service rate shall be negotiated between the county agency 
278.7   and the foster care provider.  The rate established under this 
278.8   section shall not exceed the state average monthly nursing home 
278.9   payment for the case mix classification to which the individual 
278.10  receiving foster care is assigned; the rate must allow for other 
278.11  waiver and medical assistance home care services to be 
278.12  authorized by the case manager.  The elderly waiver payment for 
278.13  the foster care service in combination with the payment for all 
278.14  other elderly waiver services, including case management, must 
278.15  not exceed the limit specified in paragraph (b). 
278.16     (f) The assisted living and residential care service rates 
278.17  for elderly and community alternatives for disabled individuals 
278.18  (CADI) waivers shall be made to the vendor as a monthly rate 
278.19  negotiated with the county agency based on an individualized 
278.20  service plan for each resident.  The rate shall not exceed the 
278.21  nonfederal share of the greater of either the statewide or any 
278.22  of the geographic groups' weighted average monthly medical 
278.23  assistance nursing facility payment rate of the case mix 
278.24  resident class to which the elderly or disabled client would be 
278.25  assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
278.26  unless the services are provided by a home care provider 
278.27  licensed by the department of health and are provided in a 
278.28  building that is registered as a housing with services 
278.29  establishment under chapter 144D and that provides 24-hour 
278.30  supervision.  For alternative care assisted living projects 
278.31  established under Laws 1988, chapter 689, article 2, section 
278.32  256, monthly rates may not exceed 65 percent of the greater of 
278.33  either the statewide or any of the geographic groups' weighted 
278.34  average monthly medical assistance nursing facility payment rate 
278.35  for the case mix resident class to which the elderly or disabled 
278.36  client would be assigned under Minnesota Rules, parts 9549.0050 
279.1   to 9549.0059.  The rate may not cover direct rent or food costs. 
279.2      (h) Payment for assisted living service shall be a monthly 
279.3   rate negotiated and authorized by the county agency based on an 
279.4   individualized service plan for each resident and may not cover 
279.5   direct rent or food costs. 
279.6      (1) The individualized monthly negotiated payment for 
279.7   assisted living services as described in section 256B.0913, 
279.8   subdivision 5, paragraph (g) or (h), and residential care 
279.9   services as described in section 256B.0913, subdivision 5, 
279.10  paragraph (f), shall not exceed the nonfederal share, in effect 
279.11  on July 1 of the state fiscal year for which the rate limit is 
279.12  being calculated, of the greater of either the statewide or any 
279.13  of the geographic groups' weighted average monthly nursing 
279.14  facility rate of the case mix resident class to which the 
279.15  elderly waiver eligible client would be assigned under Minnesota 
279.16  Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 
279.17  allowance as described in subdivision 1d, paragraph (a), until 
279.18  the July 1 of the state fiscal year in which the resident 
279.19  assessment system as described in section 256B.437 for nursing 
279.20  home rate determination is implemented.  Effective on July 1 of 
279.21  the state fiscal year in which the resident assessment system as 
279.22  described in section 256B.437 for nursing home rate 
279.23  determination is implemented and July 1 of each subsequent state 
279.24  fiscal year, the individualized monthly negotiated payment for 
279.25  the services described in this clause shall not exceed the limit 
279.26  described in this clause which was in effect on June 30 of the 
279.27  previous state fiscal year and which has been adjusted by the 
279.28  greater of any legislatively adopted home and community-based 
279.29  services cost-of-living percentage increase or any legislatively 
279.30  adopted statewide percent rate increase for nursing facilities. 
279.31     (2) The individualized monthly negotiated payment for 
279.32  assisted living services described in section 144A.4605 and 
279.33  delivered by a provider licensed by the department of health as 
279.34  a class A home care provider or an assisted living home care 
279.35  provider and provided in a building that is registered as a 
279.36  housing with services establishment under chapter 144D and that 
280.1   provides 24-hour supervision in combination with the payment for 
280.2   other elderly waiver services, including case management, must 
280.3   not exceed the limit specified in paragraph (b). 
280.4      (g) (i) The county shall negotiate individual service rates 
280.5   with vendors and may be reimbursed authorize payment for actual 
280.6   costs up to the greater of the county's current approved rate or 
280.7   60 percent of the maximum rate in fiscal year 1994 and 65 
280.8   percent of the maximum rate in fiscal year 1995 for each service 
280.9   within each program.  Persons or agencies must be employed by or 
280.10  under a contract with the county agency or the public health 
280.11  nursing agency of the local board of health in order to receive 
280.12  funding under the elderly waiver program, except as a provider 
280.13  of supplies and equipment when the monthly cost of the supplies 
280.14  and equipment is less than $250.  
280.15     (h) On July 1, 1993, the commissioner shall increase the 
280.16  maximum rate for home-delivered meals to $4.50 per meal. 
280.17     (i) (j) Reimbursement for the medical assistance recipients 
280.18  under the approved waiver shall be made from the medical 
280.19  assistance account through the invoice processing procedures of 
280.20  the department's Medicaid Management Information System (MMIS), 
280.21  only with the approval of the client's case manager.  The budget 
280.22  for the state share of the Medicaid expenditures shall be 
280.23  forecasted with the medical assistance budget, and shall be 
280.24  consistent with the approved waiver.  
280.25     (k) To improve access to community services and eliminate 
280.26  payment disparities between the alternative care program and the 
280.27  elderly waiver, the commissioner shall establish statewide 
280.28  maximum service rate limits and eliminate county-specific 
280.29  service rate limits. 
280.30     (1) Effective July 1, 2001, for service rate limits, except 
280.31  those described or defined in paragraphs (g) and (h), the rate 
280.32  limit for each service shall be the greater of the alternative 
280.33  care statewide maximum rate or the elderly waiver statewide 
280.34  maximum rate. 
280.35     (2) Counties may negotiate individual service rates with 
280.36  vendors for actual costs up to the statewide maximum service 
281.1   rate limit. 
281.2      (j) (l) Beginning July 1, 1991, the state shall reimburse 
281.3   counties according to the payment schedule in section 256.025 
281.4   for the county share of costs incurred under this subdivision on 
281.5   or after January 1, 1991, for individuals who are receiving 
281.6   medical assistance. 
281.7      (k) For the community alternatives for disabled individuals 
281.8   waiver, and nursing facility disabled waivers, county may use 
281.9   waiver funds for the cost of minor adaptations to a client's 
281.10  residence or vehicle without prior approval from the 
281.11  commissioner if there is no other source of funding and the 
281.12  adaptation: 
281.13     (1) is necessary to avoid institutionalization; 
281.14     (2) has no utility apart from the needs of the client; and 
281.15     (3) meets the criteria in Minnesota Rules, part 9505.0210, 
281.16  items A and B.  
281.17  For purposes of this subdivision, "residence" means the client's 
281.18  own home, the client's family residence, or a family foster 
281.19  home.  For purposes of this subdivision, "vehicle" means the 
281.20  client's vehicle, the client's family vehicle, or the client's 
281.21  family foster home vehicle. 
281.22     (l) The commissioner shall establish a maximum rate unit 
281.23  for baths provided by an adult day care provider that are not 
281.24  included in the provider's contractual daily or hourly rate. 
281.25  This maximum rate must equal the home health aide extended rate 
281.26  and shall be paid for baths provided to clients served under the 
281.27  elderly and disabled waivers. 
281.28     Sec. 31.  Minnesota Statutes 2000, section 256B.0915, 
281.29  subdivision 5, is amended to read: 
281.30     Subd. 5.  [REASSESSMENTS FOR WAIVER CLIENTS.] A 
281.31  reassessment of a client served under the elderly or disabled 
281.32  waiver must be conducted at least every 12 months and at other 
281.33  times when the case manager determines that there has been 
281.34  significant change in the client's functioning.  This may 
281.35  include instances where the client is discharged from the 
281.36  hospital.  
282.1      Sec. 32.  Minnesota Statutes 2000, section 256B.0917, 
282.2   subdivision 7, is amended to read: 
282.3      Subd. 7.  [CONTRACT.] (a) The commissioner of human 
282.4   services shall execute a contract with Living at Home/Block 
282.5   Nurse Program, Inc. (LAH/BN, Inc.).  The contract shall require 
282.6   LAH/BN, Inc. to: 
282.7      (1) develop criteria for and award grants to establish 
282.8   community-based organizations that will implement 
282.9   living-at-home/block nurse programs throughout the state; 
282.10     (2) award grants to enable current living-at-home/block 
282.11  nurse programs to continue to implement the combined 
282.12  living-at-home/block nurse program model; 
282.13     (3) serve as a state technical assistance center to assist 
282.14  and coordinate the living-at-home/block nurse programs 
282.15  established; and 
282.16     (4) manage contracts with individual living-at-home/block 
282.17  nurse programs. 
282.18     (b) The contract shall be effective July 1, 1997, and 
282.19  section 16B.17 shall not apply. 
282.20     Sec. 33.  [256B.0918] [DEVELOPMENT AND PURPOSE OF MEDICAL 
282.21  ASSISTANCE PILOT PROJECT ON SENIOR SERVICES.] 
282.22     Subdivision 1.  [DEVELOPMENT AND PURPOSE.] The commissioner 
282.23  of human services shall develop a medical assistance pilot 
282.24  project on senior services to determine how converting the 
282.25  delivery of housing, supportive services, and health care for 
282.26  seniors into a flexible voucher program will impact public 
282.27  expenditures for older adult service care and provide an 
282.28  alternative way to purchase services based on consumer choice. 
282.29     Subd. 2.  [FEDERAL WAIVER AUTHORITY.] The commissioner 
282.30  shall apply for any necessary federal waivers or approvals to 
282.31  implement this pilot project.  The commissioner shall submit the 
282.32  waiver request no later than April 15, 2002.  
282.33     Subd. 3.  [REPORT.] The commissioner shall report to the 
282.34  legislature by January 15, 2003, on approval of waivers 
282.35  requested.  Upon federal approval, the commissioner shall seek 
282.36  legislative authorization to implement the pilot project.  Once 
283.1   the pilot project is implemented, participating communities and 
283.2   the commissioner of human services shall collaborate to prepare 
283.3   and issue an annual report each December 1 to the appropriate 
283.4   committee chairs in the senate and house on:  (1) the use of 
283.5   state resources, including other funds leveraged for this 
283.6   initiative; (2) the status of individuals being served in the 
283.7   pilot project; and (3) the cost-effectiveness of the pilot 
283.8   project.  The commissioner shall provide data that may be needed 
283.9   to evaluate the pilot project to communities that request the 
283.10  data. 
283.11     Subd. 4.  [SUNSET.] This section sunsets June 30, 2008. 
283.12     Sec. 34.  [SERVICE ACCESS STUDY.] 
283.13     By February 15, 2002, the commissioner of human services 
283.14  shall submit to the legislature recommendations for creating 
283.15  coordinated service access at the county agency level for both 
283.16  publicly subsidized and nonsubsidized long-term care services 
283.17  and housing options.  The report must: 
283.18     (1) include a plan to coordinate public funding streams to 
283.19  allow low-income, privately paying consumers to purchase 
283.20  services through a sliding fee scale; and 
283.21     (2) evaluate the feasibility of statewide implementation, 
283.22  based upon an evaluation of public cost, consumer preferences 
283.23  and satisfaction, and other relevant factors. 
283.24     Sec. 35.  [RESPITE CARE.] 
283.25     The Minnesota board on aging shall report to the 
283.26  legislature by February 1, 2002, on the provision of in-home and 
283.27  out-of-home respite care services on a sliding scale basis under 
283.28  the federal Older Americans Act. 
283.29     Sec. 36.  [REPEALER.] 
283.30     Minnesota Statutes 2000, sections 256B.0911, subdivisions 
283.31  2, 2a, 4, 8, and 9; and 256B.0913, subdivisions 3, 15a, 15b, 
283.32  15c, and 16; Minnesota Rules, parts 9505.2390; 9505.2395; 
283.33  9505.2396; 9505.2400; 9505.2405; 9505.2410; 9505.2413; 
283.34  9505.2415; 9505.2420; 9505.2425; 9505.2426; 9505.2430; 
283.35  9505.2435; 9505.2440; 9505.2445; 9505.2450; 9505.2455; 
283.36  9505.2458; 9505.2460; 9505.2465; 9505.2470; 9505.2473; 
284.1   9505.2475; 9505.2480; 9505.2485; 9505.2486; 9505.2490; 
284.2   9505.2495; 9505.2496; and 9505.2500, are repealed. 
284.3                              ARTICLE 5 
284.4               LONG-TERM CARE REFORM AND REIMBURSEMENT 
284.5      Section 1.  [144.0724] [RESIDENT REIMBURSEMENT 
284.6   CLASSIFICATION.] 
284.7      Subdivision 1.  [RESIDENT REIMBURSEMENT 
284.8   CLASSIFICATIONS.] The commissioner of health shall establish 
284.9   resident reimbursement classifications based upon the 
284.10  assessments of residents of nursing homes and boarding care 
284.11  homes conducted under this section and according to section 
284.12  256B.437.  The reimbursement classifications established under 
284.13  this section shall be implemented after June 30, 2002, but no 
284.14  later than January 1, 2003. 
284.15     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
284.16  following terms have the meanings given. 
284.17     (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 
284.18  date" means the last day of the minimum data set observation 
284.19  period.  The date sets the designated endpoint of the common 
284.20  observation period, and all minimum data set items refer back in 
284.21  time from that point. 
284.22     (b) [CASE MIX INDEX.] "Case mix index" means the weighting 
284.23  factors assigned to the RUG-III classifications. 
284.24     (c) [INDEX MAXIMIZATION.] "Index maximization" means 
284.25  classifying a resident who could be assigned to more than one 
284.26  category, to the category with the highest case mix index. 
284.27     (d) [MINIMUM DATA SET.] "Minimum data set" means the 
284.28  assessment instrument specified by the Health Care Financing 
284.29  Administration and designated by the Minnesota department of 
284.30  health. 
284.31     (e) [REPRESENTATIVE.] "Representative" means a person who 
284.32  is the resident's guardian or conservator, the person authorized 
284.33  to pay the nursing home expenses of the resident, a 
284.34  representative of the nursing home ombudsman's office whose 
284.35  assistance has been requested, or any other individual 
284.36  designated by the resident. 
285.1      (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 
285.2   utilization groups" or "RUG" means the system for grouping a 
285.3   nursing facility's residents according to their clinical and 
285.4   functional status identified in data supplied by the facility's 
285.5   minimum data set. 
285.6      Subd. 3.  [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) 
285.7   Resident reimbursement classifications shall be based on the 
285.8   minimum data set, version 2.0 assessment instrument, or its 
285.9   successor version mandated by the Health Care Financing 
285.10  Administration that nursing facilities are required to complete 
285.11  for all residents.  The commissioner of health shall establish 
285.12  resident classes according to the 34 group, resource utilization 
285.13  groups, version III or RUG-III model.  Resident classes must be 
285.14  established based on the individual items on the minimum data 
285.15  set and must be completed according to the facility manual for 
285.16  case mix classification issued by the Minnesota department of 
285.17  health.  The facility manual for case mix classification shall 
285.18  be drafted by the Minnesota department of health and presented 
285.19  to the chairs of health and human services legislative 
285.20  committees by December 31, 2001. 
285.21     (b) Each resident must be classified based on the 
285.22  information from the minimum data set according to general 
285.23  domains in clauses (1) to (7): 
285.24     (1) extensive services where a resident requires 
285.25  intravenous feeding or medications, suctioning, tracheostomy 
285.26  care, or is on a ventilator or respirator; 
285.27     (2) rehabilitation where a resident requires physical, 
285.28  occupational, or speech therapy; 
285.29     (3) special care where a resident has cerebral palsy; 
285.30  quadriplegia; multiple sclerosis; pressure ulcers; fever with 
285.31  vomiting, weight loss, or dehydration; tube feeding and aphasia; 
285.32  or is receiving radiation therapy; 
285.33     (4) clinically complex status where a resident has burns, 
285.34  coma, septicemia, pneumonia, internal bleeding, chemotherapy, 
285.35  wounds, kidney failure, urinary tract infections, oxygen, or 
285.36  transfusions; 
286.1      (5) impaired cognition where a resident has poor cognitive 
286.2   performance; 
286.3      (6) behavior problems where a resident exhibits wandering, 
286.4   has hallucinations, or is physically or verbally abusive toward 
286.5   others, unless the resident's other condition would place the 
286.6   resident in other categories; and 
286.7      (7) reduced physical functioning where a resident has no 
286.8   special clinical conditions. 
286.9      (c) The commissioner of health shall establish resident 
286.10  classification according to a 34 group model based on the 
286.11  information on the minimum data set and within the general 
286.12  domains listed in paragraph (b), clauses (1) to (7).  Detailed 
286.13  descriptions of each resource utilization group shall be defined 
286.14  in the facility manual for case mix classification issued by the 
286.15  Minnesota department of health.  The 34 groups are described as 
286.16  follows: 
286.17     (1) SE3:  requires four or five extensive services; 
286.18     (2) SE2:  requires two or three extensive services; 
286.19     (3) SE1:  requires one extensive service; 
286.20     (4) RAD:  requires rehabilitation services and is dependent 
286.21  in activity of daily living (ADL) at a count of 17 or 18; 
286.22     (5) RAC:  requires rehabilitation services and ADL count is 
286.23  14 to 16; 
286.24     (6) RAB:  requires rehabilitation services and ADL count is 
286.25  ten to 13; 
286.26     (7) RAA:  requires rehabilitation services and ADL count is 
286.27  four to nine; 
286.28     (8) SSC:  requires special care and ADL count is 17 or 18; 
286.29     (9) SSB:  requires special care and ADL count is 15 or 16; 
286.30     (10) SSA:  requires special care and ADL count is seven to 
286.31  14; 
286.32     (11) CC2:  clinically complex with depression and ADL count 
286.33  is 17 or 18; 
286.34     (12) CC1:  clinically complex with no depression and ADL 
286.35  count is 17 or 18; 
286.36     (13) CB2:  clinically complex with depression and ADL count 
287.1   is 12 to 16; 
287.2      (14) CB1:  clinically complex with no depression and ADL 
287.3   count is 12 to 16; 
287.4      (15) CA2:  clinically complex with depression and ADL count 
287.5   is four to 11; 
287.6      (16) CA1:  clinically complex with no depression and ADL 
287.7   count is four to 11; 
287.8      (17) IB2:  impaired cognition with nursing rehabilitation 
287.9   and ADL count is six to ten; 
287.10     (18) IB1:  impaired cognition with no nursing 
287.11  rehabilitation and ADL count is six to ten; 
287.12     (19) IA2:  impaired cognition with nursing rehabilitation 
287.13  and ADL count is four or five; 
287.14     (20) IA1:  impaired cognition with no nursing 
287.15  rehabilitation and ADL count is four or five; 
287.16     (21) BB2:  behavior problems with nursing rehabilitation 
287.17  and ADL count is six to ten; 
287.18     (22) BB1:  behavior problems with no nursing rehabilitation 
287.19  and ADL count is six to ten; 
287.20     (23) BA2:  behavior problems with nursing rehabilitation 
287.21  and ADL count is four to five; 
287.22     (24) BA1:  behavior problems with no nursing rehabilitation 
287.23  and ADL count is four to five; 
287.24     (25) PE2:  reduced physical functioning with nursing 
287.25  rehabilitation and ADL count is 16 to 18; 
287.26     (26) PE1:  reduced physical functioning with no nursing 
287.27  rehabilitation and ADL count is 16 to 18; 
287.28     (27) PD2:  reduced physical functioning with nursing 
287.29  rehabilitation and ADL count is 11 to 15; 
287.30     (28) PD1:  reduced physical functioning with no nursing 
287.31  rehabilitation and ADL count is 11 to 15; 
287.32     (29) PC2:  reduced physical functioning with nursing 
287.33  rehabilitation and ADL count is nine or ten; 
287.34     (30) PC1:  reduced physical functioning with no nursing 
287.35  rehabilitation and ADL count is nine or ten; 
287.36     (31) PB2:  reduced physical functioning with nursing 
288.1   rehabilitation and ADL count is six to eight; 
288.2      (32) PB1:  reduced physical functioning with no nursing 
288.3   rehabilitation and ADL count is six to eight; 
288.4      (33) PA2:  reduced physical functioning with nursing 
288.5   rehabilitation and ADL count is four or five; and 
288.6      (34) PA1:  reduced physical functioning with no nursing 
288.7   rehabilitation and ADL count is four or five. 
288.8      Subd. 4.  [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility 
288.9   must conduct and electronically submit to the commissioner of 
288.10  health case mix assessments that conform with the assessment 
288.11  schedule defined by the Code of Federal Regulations, title 42, 
288.12  section 483.20, and published by the United States Department of 
288.13  Health and Human Services, Health Care Financing Administration, 
288.14  in the Long Term Care Assessment Instrument User's Manual, 
288.15  version 2.0, October 1995, and subsequent clarifications made in 
288.16  the Long-Term Care Assessment Instrument Questions and Answers, 
288.17  version 2.0, August 1996.  The commissioner of health may 
288.18  substitute successor manuals or question and answer documents 
288.19  published by the United States Department of Health and Human 
288.20  Services, Health Care Financing Administration, to replace or 
288.21  supplement the current version of the manual or document. 
288.22     (b) The assessments used to determine a case mix 
288.23  classification for reimbursement include the following: 
288.24     (1) a new admission assessment must be completed by day 14 
288.25  following admission; 
288.26     (2) an annual assessment must be completed within 366 days 
288.27  of the last comprehensive assessment; 
288.28     (3) a significant change assessment must be completed 
288.29  within 14 days of the identification of a significant change; 
288.30  and 
288.31     (4) the second quarterly assessment following either a new 
288.32  admission assessment, an annual assessment, or a significant 
288.33  change assessment.  Each quarterly assessment must be completed 
288.34  within 92 days of the previous assessment. 
288.35     Subd. 5.  [SHORT STAYS.] (a) A facility must submit to the 
288.36  commissioner of health an initial admission assessment for all 
289.1   residents who stay in the facility less than 14 days. 
289.2      (b) Notwithstanding the admission assessment requirements 
289.3   of paragraph (a), a facility may elect to accept a default rate 
289.4   with a case mix index of 1.0 for all facility residents who stay 
289.5   less than 14 days in lieu of submitting an initial assessment.  
289.6   Facilities may make this election to be effective on the day of 
289.7   implementation of the revised case mix system. 
289.8      (c) After implementation of the revised case mix system, 
289.9   nursing facilities must elect one of the options described in 
289.10  paragraphs (a) and (b) on the annual report to the commissioner 
289.11  of human services filed for each report year ending September 
289.12  30.  The election shall be effective on the following July 1. 
289.13     (d) For residents who are admitted or readmitted and leave 
289.14  the facility on a frequent basis and for whom readmission is 
289.15  expected, the resident may be discharged on an extended leave 
289.16  status.  This status does not require reassessment each time the 
289.17  resident returns to the facility unless a significant change in 
289.18  the resident's status has occurred since the last assessment.  
289.19  The case mix classification for these residents is determined by 
289.20  the facility election made in paragraphs (a) and (b). 
289.21     Subd. 6.  [PENALTIES FOR LATE OR NONSUBMISSION.] A facility 
289.22  that fails to complete or submit an assessment for a RUG-III 
289.23  classification within seven days of the time requirements in 
289.24  subdivisions 4 and 5 is subject to a reduced rate for that 
289.25  resident.  The reduced rate shall be the lowest rate for that 
289.26  facility.  The reduced rate is effective on the day of admission 
289.27  for new admission assessments or on the day that the assessment 
289.28  was due for all other assessments and continues in effect until 
289.29  the first day of the month following the date of submission of 
289.30  the resident's assessment. 
289.31     Subd. 7.  [NOTICE OF RESIDENT REIMBURSEMENT 
289.32  CLASSIFICATION.] (a) A facility must elect between the options 
289.33  in clauses (1) and (2) to provide notice to a resident of the 
289.34  resident's case mix classification. 
289.35     (1) The commissioner of health shall provide to a nursing 
289.36  facility a notice for each resident of the reimbursement 
290.1   classification established under subdivision 1.  The notice must 
290.2   inform the resident of the classification that was assigned, the 
290.3   opportunity to review the documentation supporting the 
290.4   classification, the opportunity to obtain clarification from the 
290.5   commissioner, and the opportunity to request a reconsideration 
290.6   of the classification.  The commissioner must send notice of 
290.7   resident classification by first class mail.  A nursing facility 
290.8   is responsible for the distribution of the notice to each 
290.9   resident, to the person responsible for the payment of the 
290.10  resident's nursing home expenses, or to another person 
290.11  designated by the resident.  This notice must be distributed 
290.12  within three working days after the facility's receipt of the 
290.13  notice from the commissioner of health. 
290.14     (2) A facility may choose to provide a classification 
290.15  notice, as prescribed by the commissioner of health, to a 
290.16  resident upon receipt of the confirmation of the case mix 
290.17  classification calculated by a facility or a corrected case mix 
290.18  classification as indicated on the final validation report from 
290.19  the commissioner.  A nursing facility is responsible for the 
290.20  distribution of the notice to each resident, to the person 
290.21  responsible for the payment of the resident's nursing home 
290.22  expenses, or to another person designated by the resident.  This 
290.23  notice must be distributed within three working days after the 
290.24  facility's receipt of the validation report from the 
290.25  commissioner.  If a facility elects this option, the 
290.26  commissioner of health shall provide the facility with a list of 
290.27  residents and their case mix classifications as determined by 
290.28  the commissioner.  A nursing facility may make this election to 
290.29  be effective on the day of implementation of the revised case 
290.30  mix system. 
290.31     (3) After implementation of the revised case mix system, a 
290.32  nursing facility shall elect a notice of resident reimbursement 
290.33  classification procedure as described in clause (1) or (2) on 
290.34  the annual report to the commissioner of human services filed 
290.35  for each report year ending September 30.  The election will be 
290.36  effective the following July 1. 
291.1      (b) If a facility submits a correction to an assessment 
291.2   conducted under subdivision 3 that results in a change in case 
291.3   mix classification, the facility shall give written notice to 
291.4   the resident or the resident's representative about the item 
291.5   that was corrected and the reason for the correction.  The 
291.6   notice of corrected assessment may be provided at the same time 
291.7   that the resident or resident's representative is provided the 
291.8   resident's corrected notice of classification. 
291.9      Subd. 8.  [REQUEST FOR RECONSIDERATION OF RESIDENT 
291.10  CLASSIFICATIONS.] (a) The resident, or resident's 
291.11  representative, or the nursing facility or boarding care home 
291.12  may request that the commissioner of health reconsider the 
291.13  assigned reimbursement classification.  The request for 
291.14  reconsideration must be submitted in writing to the commissioner 
291.15  within 30 days of the day the resident or the resident's 
291.16  representative receives the resident classification notice.  The 
291.17  request for reconsideration must include the name of the 
291.18  resident, the name and address of the facility in which the 
291.19  resident resides, the reasons for the reconsideration, the 
291.20  requested classification changes, and documentation supporting 
291.21  the requested classification.  The documentation accompanying 
291.22  the reconsideration request is limited to documentation which 
291.23  establishes that the needs of the resident at the time of the 
291.24  assessment justify a classification which is different than the 
291.25  classification established by the commissioner of health. 
291.26     (b) Upon request, the nursing facility must give the 
291.27  resident or the resident's representative a copy of the 
291.28  assessment form and the other documentation that was given to 
291.29  the commissioner of health to support the assessment findings.  
291.30  The nursing facility shall also provide access to and a copy of 
291.31  other information from the resident's record that has been 
291.32  requested by or on behalf of the resident to support a 
291.33  resident's reconsideration request.  A copy of any requested 
291.34  material must be provided within three working days of receipt 
291.35  of a written request for the information.  If a facility fails 
291.36  to provide the material within this time, it is subject to the 
292.1   issuance of a correction order and penalty assessment under 
292.2   sections 144.653 and 144A.10.  Notwithstanding those sections, 
292.3   any correction order issued under this subdivision must require 
292.4   that the nursing facility immediately comply with the request 
292.5   for information and that as of the date of the issuance of the 
292.6   correction order, the facility shall forfeit to the state a $100 
292.7   fine for the first day of noncompliance, and an increase in the 
292.8   $100 fine by $50 increments for each day the noncompliance 
292.9   continues. 
292.10     (c) In addition to the information required under 
292.11  paragraphs (a) and (b), a reconsideration request from a nursing 
292.12  facility must contain the following information:  (i) the date 
292.13  the reimbursement classification notices were received by the 
292.14  facility; (ii) the date the classification notices were 
292.15  distributed to the resident or the resident's representative; 
292.16  and (iii) a copy of a notice sent to the resident or to the 
292.17  resident's representative.  This notice must inform the resident 
292.18  or the resident's representative that a reconsideration of the 
292.19  resident's classification is being requested, the reason for the 
292.20  request, that the resident's rate will change if the request is 
292.21  approved by the commissioner, the extent of the change, that 
292.22  copies of the facility's request and supporting documentation 
292.23  are available for review, and that the resident also has the 
292.24  right to request a reconsideration.  If the facility fails to 
292.25  provide the required information with the reconsideration 
292.26  request, the request must be denied, and the facility may not 
292.27  make further reconsideration requests on that specific 
292.28  reimbursement classification. 
292.29     (d) Reconsideration by the commissioner must be made by 
292.30  individuals not involved in reviewing the assessment, audit, or 
292.31  reconsideration that established the disputed classification.  
292.32  The reconsideration must be based upon the initial assessment 
292.33  and upon the information provided to the commissioner under 
292.34  paragraphs (a) and (b).  If necessary for evaluating the 
292.35  reconsideration request, the commissioner may conduct on-site 
292.36  reviews.  Within 15 working days of receiving the request for 
293.1   reconsideration, the commissioner shall affirm or modify the 
293.2   original resident classification.  The original classification 
293.3   must be modified if the commissioner determines that the 
293.4   assessment resulting in the classification did not accurately 
293.5   reflect the needs or assessment characteristics of the resident 
293.6   at the time of the assessment.  The resident and the nursing 
293.7   facility or boarding care home shall be notified within five 
293.8   working days after the decision is made.  A decision by the 
293.9   commissioner under this subdivision is the final administrative 
293.10  decision of the agency for the party requesting reconsideration. 
293.11     (e) The resident classification established by the 
293.12  commissioner shall be the classification that applies to the 
293.13  resident while the request for reconsideration is pending. 
293.14     (f) The commissioner may request additional documentation 
293.15  regarding a reconsideration necessary to make an accurate 
293.16  reconsideration determination. 
293.17     Subd. 9.  [AUDIT AUTHORITY.] (a) The commissioner shall 
293.18  audit the accuracy of resident assessments performed under 
293.19  section 256B.437 through desk audits, on-site review of 
293.20  residents and their records, and interviews with staff and 
293.21  families.  The commissioner shall reclassify a resident if the 
293.22  commissioner determines that the resident was incorrectly 
293.23  classified. 
293.24     (b) The commissioner is authorized to conduct on-site 
293.25  audits on an unannounced basis. 
293.26     (c) A facility must grant the commissioner access to 
293.27  examine the medical records relating to the resident assessments 
293.28  selected for audit under this subdivision.  The commissioner may 
293.29  also observe and speak to facility staff and residents. 
293.30     (d) The commissioner shall consider documentation under the 
293.31  time frames for coding items on the minimum data set as set out 
293.32  in the Resident Assessment Instrument Manual published by the 
293.33  Health Care Financing Administration. 
293.34     (e) The commissioner shall develop an audit selection 
293.35  procedure that includes the following factors: 
293.36     (1) The commissioner may target facilities that demonstrate 
294.1   an atypical pattern of scoring minimum data set items, 
294.2   nonsubmission of assessments, late submission of assessments, or 
294.3   a previous history of audit changes of greater than 35 percent.  
294.4   The commissioner shall select at least 20 percent of the most 
294.5   current assessments submitted to the state for audit.  Audits of 
294.6   assessments selected in the targeted facilities must focus on 
294.7   the factors leading to the audit.  If the number of targeted 
294.8   assessments selected does not meet the threshold of 20 percent 
294.9   of the facility residents, then a stratified sample of the 
294.10  remainder of assessments shall be drawn to meet the quota.  If 
294.11  the total change exceeds 35 percent, the commissioner may 
294.12  conduct an expanded audit up to 100 percent of the remaining 
294.13  current assessments. 
294.14     (2) Facilities that are not a part of the targeted group 
294.15  shall be placed in a general pool from which facilities will be 
294.16  selected on a random basis for audit.  Every facility shall be 
294.17  audited annually.  If a facility has two successive audits in 
294.18  which the percentage of change is five percent or less and the 
294.19  facility has not been the subject of a targeted audit in the 
294.20  past 36 months, the facility may be audited biannually.  A 
294.21  stratified sample of 15 percent of the most current assessments 
294.22  shall be selected for audit.  If more than 20 percent of the 
294.23  RUGS-III classifications after the audit are changed, the audit 
294.24  shall be expanded to a second 15 percent sample.  If the total 
294.25  change between the first and second samples exceed 35 percent, 
294.26  the commissioner may expand the audit to all of the remaining 
294.27  assessments. 
294.28     (3) If a facility qualifies for an expanded audit, the 
294.29  commissioner may audit the facility again within six months.  If 
294.30  a facility has two expanded audits within a 24-month period, 
294.31  that facility will be audited at least every six months for the 
294.32  next 18 months. 
294.33     (4) The commissioner may conduct special audits if the 
294.34  commissioner determines that circumstances exist that could 
294.35  alter or affect the validity of case mix classifications of 
294.36  residents.  These circumstances include, but are not limited to, 
295.1   the following:  
295.2      (i) frequent changes in the administration or management of 
295.3   the facility; 
295.4      (ii) an unusually high percentage of residents in a 
295.5   specific case mix classification; 
295.6      (iii) a high frequency in the number of reconsideration 
295.7   requests received from a facility; 
295.8      (iv) frequent adjustments of case mix classifications as 
295.9   the result of reconsiderations or audits; 
295.10     (v) a criminal indictment alleging provider fraud; or 
295.11     (vi) other similar factors that relate to a facility's 
295.12  ability to conduct accurate assessments. 
295.13     (f) Within 15 working days of completing the audit process, 
295.14  the commissioner shall mail the written results of the audit to 
295.15  the facility, along with a written notice for each resident 
295.16  affected to be forwarded by the facility.  The notice must 
295.17  contain the resident's classification and a statement informing 
295.18  the resident, the resident's authorized representative, and the 
295.19  facility of their right to review the commissioner's documents 
295.20  supporting the classification and to request a reconsideration 
295.21  of the classification.  This notice must also include the 
295.22  address and telephone number of the area nursing home ombudsman. 
295.23     Subd. 10.  [TRANSITION.] After implementation of this 
295.24  section, reconsiderations requested for classifications made 
295.25  under section 144.0722, subdivision 1, shall be determined under 
295.26  section 144.0722, subdivision 3. 
295.27     Sec. 2.  Minnesota Statutes 2000, section 144A.071, 
295.28  subdivision 1, is amended to read: 
295.29     Subdivision 1.  [FINDINGS.] The legislature declares that a 
295.30  moratorium on the licensure and medical assistance certification 
295.31  of new nursing home beds and construction projects that 
295.32  exceed $750,000 $1,000,000 is necessary to control nursing home 
295.33  expenditure growth and enable the state to meet the needs of its 
295.34  elderly by providing high quality services in the most 
295.35  appropriate manner along a continuum of care.  
295.36     Sec. 3.  Minnesota Statutes 2000, section 144A.071, 
296.1   subdivision 1a, is amended to read: 
296.2      Subd. 1a.  [DEFINITIONS.] For purposes of sections 144A.071 
296.3   to 144A.073, the following terms have the meanings given them: 
296.4      (a) "attached fixtures" has the meaning given in Minnesota 
296.5   Rules, part 9549.0020, subpart 6. 
296.6      (b) "buildings" has the meaning given in Minnesota Rules, 
296.7   part 9549.0020, subpart 7. 
296.8      (c) "capital assets" has the meaning given in section 
296.9   256B.421, subdivision 16. 
296.10     (d) "commenced construction" means that all of the 
296.11  following conditions were met:  the final working drawings and 
296.12  specifications were approved by the commissioner of health; the 
296.13  construction contracts were let; a timely construction schedule 
296.14  was developed, stipulating dates for beginning, achieving 
296.15  various stages, and completing construction; and all zoning and 
296.16  building permits were applied for. 
296.17     (e) "completion date" means the date on which a certificate 
296.18  of occupancy is issued for a construction project, or if a 
296.19  certificate of occupancy is not required, the date on which the 
296.20  construction project is available for facility use. 
296.21     (f) "construction" means any erection, building, 
296.22  alteration, reconstruction, modernization, or improvement 
296.23  necessary to comply with the nursing home licensure rules. 
296.24     (g) "construction project" means: 
296.25     (1) a capital asset addition to, or replacement of a 
296.26  nursing home or certified boarding care home that results in new 
296.27  space or the remodeling of or renovations to existing facility 
296.28  space; 
296.29     (2) the remodeling or renovation of existing facility space 
296.30  the use of which is modified as a result of the project 
296.31  described in clause (1).  This existing space and the project 
296.32  described in clause (1) must be used for the functions as 
296.33  designated on the construction plans on completion of the 
296.34  project described in clause (1) for a period of not less than 24 
296.35  months; or 
296.36     (3) capital asset additions or replacements that are 
297.1   completed within 12 months before or after the completion date 
297.2   of the project described in clause (1). 
297.3      (h) "new licensed" or "new certified beds" means: 
297.4      (1) newly constructed beds in a facility or the 
297.5   construction of a new facility that would increase the total 
297.6   number of licensed nursing home beds or certified boarding care 
297.7   or nursing home beds in the state; or 
297.8      (2) newly licensed nursing home beds or newly certified 
297.9   boarding care or nursing home beds that result from remodeling 
297.10  of the facility that involves relocation of beds but does not 
297.11  result in an increase in the total number of beds, except when 
297.12  the project involves the upgrade of boarding care beds to 
297.13  nursing home beds, as defined in section 144A.073, subdivision 
297.14  1.  "Remodeling" includes any of the type of conversion, 
297.15  renovation, replacement, or upgrading projects as defined in 
297.16  section 144A.073, subdivision 1. 
297.17     (i) "project construction costs" means the cost of the 
297.18  facility capital asset additions, replacements, renovations, or 
297.19  remodeling projects, construction site preparation costs, and 
297.20  related soft costs.  Project construction costs also include the 
297.21  cost of any remodeling or renovation of existing facility space 
297.22  which is modified as a result of the construction 
297.23  project.  Project construction costs also includes the cost of 
297.24  new technology implemented as part of the construction project. 
297.25     (j) "technology" means information systems or devices that 
297.26  make documentation, charting, and staff time more efficient or 
297.27  encourage and allow for care through alternative settings 
297.28  including, but not limited to, touch screens, monitors, 
297.29  hand-helds, swipe cards, motion detectors, pagers, telemedicine, 
297.30  medication dispensers, and equipment to monitor vital signs and 
297.31  self-injections, and to observe skin and other conditions. 
297.32     Sec. 4.  Minnesota Statutes 2000, section 144A.071, 
297.33  subdivision 2, is amended to read: 
297.34     Subd. 2.  [MORATORIUM.] The commissioner of health, in 
297.35  coordination with the commissioner of human services, shall deny 
297.36  each request for new licensed or certified nursing home or 
298.1   certified boarding care beds except as provided in subdivision 3 
298.2   or 4a, or section 144A.073.  "Certified bed" means a nursing 
298.3   home bed or a boarding care bed certified by the commissioner of 
298.4   health for the purposes of the medical assistance program, under 
298.5   United States Code, title 42, sections 1396 et seq.  
298.6      The commissioner of human services, in coordination with 
298.7   the commissioner of health, shall deny any request to issue a 
298.8   license under section 252.28 and chapter 245A to a nursing home 
298.9   or boarding care home, if that license would result in an 
298.10  increase in the medical assistance reimbursement amount.  
298.11     In addition, the commissioner of health must not approve 
298.12  any construction project whose cost exceeds $750,000 $1,000,000 
298.13  unless: 
298.14     (a) any construction costs exceeding $750,000 $1,000,000 
298.15  are not added to the facility's appraised value and are not 
298.16  included in the facility's payment rate for reimbursement under 
298.17  the medical assistance program; or 
298.18     (b) the project: 
298.19     (1) has been approved through the process described in 
298.20  section 144A.073; 
298.21     (2) meets an exception in subdivision 3 or 4a; 
298.22     (3) is necessary to correct violations of state or federal 
298.23  law issued by the commissioner of health; 
298.24     (4) is necessary to repair or replace a portion of the 
298.25  facility that was damaged by fire, lightning, groundshifts, or 
298.26  other such hazards, including environmental hazards, provided 
298.27  that the provisions of subdivision 4a, clause (a), are met; 
298.28     (5) as of May 1, 1992, the facility has submitted to the 
298.29  commissioner of health written documentation evidencing that the 
298.30  facility meets the "commenced construction" definition as 
298.31  specified in subdivision 1a, clause (d), or that substantial 
298.32  steps have been taken prior to April 1, 1992, relating to the 
298.33  construction project.  "Substantial steps" require that the 
298.34  facility has made arrangements with outside parties relating to 
298.35  the construction project and include the hiring of an architect 
298.36  or construction firm, submission of preliminary plans to the 
299.1   department of health or documentation from a financial 
299.2   institution that financing arrangements for the construction 
299.3   project have been made; or 
299.4      (6) is being proposed by a licensed nursing facility that 
299.5   is not certified to participate in the medical assistance 
299.6   program and will not result in new licensed or certified beds. 
299.7      Prior to the final plan approval of any construction 
299.8   project, the commissioner of health shall be provided with an 
299.9   itemized cost estimate for the project construction costs.  If a 
299.10  construction project is anticipated to be completed in phases, 
299.11  the total estimated cost of all phases of the project shall be 
299.12  submitted to the commissioner and shall be considered as one 
299.13  construction project.  Once the construction project is 
299.14  completed and prior to the final clearance by the commissioner, 
299.15  the total project construction costs for the construction 
299.16  project shall be submitted to the commissioner.  If the final 
299.17  project construction cost exceeds the dollar threshold in this 
299.18  subdivision, the commissioner of human services shall not 
299.19  recognize any of the project construction costs or the related 
299.20  financing costs in excess of this threshold in establishing the 
299.21  facility's property-related payment rate. 
299.22     The dollar thresholds for construction projects are as 
299.23  follows:  for construction projects other than those authorized 
299.24  in clauses (1) to (6), the dollar threshold 
299.25  is $750,000 $1,000,000.  For projects authorized after July 1, 
299.26  1993, under clause (1), the dollar threshold is the cost 
299.27  estimate submitted with a proposal for an exception under 
299.28  section 144A.073, plus inflation as calculated according to 
299.29  section 256B.431, subdivision 3f, paragraph (a).  For projects 
299.30  authorized under clauses (2) to (4), the dollar threshold is the 
299.31  itemized estimate project construction costs submitted to the 
299.32  commissioner of health at the time of final plan approval, plus 
299.33  inflation as calculated according to section 256B.431, 
299.34  subdivision 3f, paragraph (a). 
299.35     The commissioner of health shall adopt rules to implement 
299.36  this section or to amend the emergency rules for granting 
300.1   exceptions to the moratorium on nursing homes under section 
300.2   144A.073.  
300.3      Sec. 5.  Minnesota Statutes 2000, section 144A.071, 
300.4   subdivision 4a, is amended to read: 
300.5      Subd. 4a.  [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 
300.6   best interest of the state to ensure that nursing homes and 
300.7   boarding care homes continue to meet the physical plant 
300.8   licensing and certification requirements by permitting certain 
300.9   construction projects.  Facilities should be maintained in 
300.10  condition to satisfy the physical and emotional needs of 
300.11  residents while allowing the state to maintain control over 
300.12  nursing home expenditure growth. 
300.13     The commissioner of health in coordination with the 
300.14  commissioner of human services, may approve the renovation, 
300.15  replacement, upgrading, or relocation of a nursing home or 
300.16  boarding care home, under the following conditions: 
300.17     (a) to license or certify beds in a new facility 
300.18  constructed to replace a facility or to make repairs in an 
300.19  existing facility that was destroyed or damaged after June 30, 
300.20  1987, by fire, lightning, or other hazard provided:  
300.21     (i) destruction was not caused by the intentional act of or 
300.22  at the direction of a controlling person of the facility; 
300.23     (ii) at the time the facility was destroyed or damaged the 
300.24  controlling persons of the facility maintained insurance 
300.25  coverage for the type of hazard that occurred in an amount that 
300.26  a reasonable person would conclude was adequate; 
300.27     (iii) the net proceeds from an insurance settlement for the 
300.28  damages caused by the hazard are applied to the cost of the new 
300.29  facility or repairs; 
300.30     (iv) the new facility is constructed on the same site as 
300.31  the destroyed facility or on another site subject to the 
300.32  restrictions in section 144A.073, subdivision 5; 
300.33     (v) the number of licensed and certified beds in the new 
300.34  facility does not exceed the number of licensed and certified 
300.35  beds in the destroyed facility; and 
300.36     (vi) the commissioner determines that the replacement beds 
301.1   are needed to prevent an inadequate supply of beds. 
301.2   Project construction costs incurred for repairs authorized under 
301.3   this clause shall not be considered in the dollar threshold 
301.4   amount defined in subdivision 2; 
301.5      (b) to license or certify beds that are moved from one 
301.6   location to another within a nursing home facility, provided the 
301.7   total costs of remodeling performed in conjunction with the 
301.8   relocation of beds does not exceed $750,000 $1,000,000; 
301.9      (c) to license or certify beds in a project recommended for 
301.10  approval under section 144A.073; 
301.11     (d) to license or certify beds that are moved from an 
301.12  existing state nursing home to a different state facility, 
301.13  provided there is no net increase in the number of state nursing 
301.14  home beds; 
301.15     (e) to certify and license as nursing home beds boarding 
301.16  care beds in a certified boarding care facility if the beds meet 
301.17  the standards for nursing home licensure, or in a facility that 
301.18  was granted an exception to the moratorium under section 
301.19  144A.073, and if the cost of any remodeling of the facility does 
301.20  not exceed $750,000 $1,000,000.  If boarding care beds are 
301.21  licensed as nursing home beds, the number of boarding care beds 
301.22  in the facility must not increase beyond the number remaining at 
301.23  the time of the upgrade in licensure.  The provisions contained 
301.24  in section 144A.073 regarding the upgrading of the facilities do 
301.25  not apply to facilities that satisfy these requirements; 
301.26     (f) to license and certify up to 40 beds transferred from 
301.27  an existing facility owned and operated by the Amherst H. Wilder 
301.28  Foundation in the city of St. Paul to a new unit at the same 
301.29  location as the existing facility that will serve persons with 
301.30  Alzheimer's disease and other related disorders.  The transfer 
301.31  of beds may occur gradually or in stages, provided the total 
301.32  number of beds transferred does not exceed 40.  At the time of 
301.33  licensure and certification of a bed or beds in the new unit, 
301.34  the commissioner of health shall delicense and decertify the 
301.35  same number of beds in the existing facility.  As a condition of 
301.36  receiving a license or certification under this clause, the 
302.1   facility must make a written commitment to the commissioner of 
302.2   human services that it will not seek to receive an increase in 
302.3   its property-related payment rate as a result of the transfers 
302.4   allowed under this paragraph; 
302.5      (g) to license and certify nursing home beds to replace 
302.6   currently licensed and certified boarding care beds which may be 
302.7   located either in a remodeled or renovated boarding care or 
302.8   nursing home facility or in a remodeled, renovated, newly 
302.9   constructed, or replacement nursing home facility within the 
302.10  identifiable complex of health care facilities in which the 
302.11  currently licensed boarding care beds are presently located, 
302.12  provided that the number of boarding care beds in the facility 
302.13  or complex are decreased by the number to be licensed as nursing 
302.14  home beds and further provided that, if the total costs of new 
302.15  construction, replacement, remodeling, or renovation exceed ten 
302.16  percent of the appraised value of the facility or $200,000, 
302.17  whichever is less, the facility makes a written commitment to 
302.18  the commissioner of human services that it will not seek to 
302.19  receive an increase in its property-related payment rate by 
302.20  reason of the new construction, replacement, remodeling, or 
302.21  renovation.  The provisions contained in section 144A.073 
302.22  regarding the upgrading of facilities do not apply to facilities 
302.23  that satisfy these requirements; 
302.24     (h) to license as a nursing home and certify as a nursing 
302.25  facility a facility that is licensed as a boarding care facility 
302.26  but not certified under the medical assistance program, but only 
302.27  if the commissioner of human services certifies to the 
302.28  commissioner of health that licensing the facility as a nursing 
302.29  home and certifying the facility as a nursing facility will 
302.30  result in a net annual savings to the state general fund of 
302.31  $200,000 or more; 
302.32     (i) to certify, after September 30, 1992, and prior to July 
302.33  1, 1993, existing nursing home beds in a facility that was 
302.34  licensed and in operation prior to January 1, 1992; 
302.35     (j) to license and certify new nursing home beds to replace 
302.36  beds in a facility acquired by the Minneapolis community 
303.1   development agency as part of redevelopment activities in a city 
303.2   of the first class, provided the new facility is located within 
303.3   three miles of the site of the old facility.  Operating and 
303.4   property costs for the new facility must be determined and 
303.5   allowed under section 256B.431 or 256B.434; 
303.6      (k) to license and certify up to 20 new nursing home beds 
303.7   in a community-operated hospital and attached convalescent and 
303.8   nursing care facility with 40 beds on April 21, 1991, that 
303.9   suspended operation of the hospital in April 1986.  The 
303.10  commissioner of human services shall provide the facility with 
303.11  the same per diem property-related payment rate for each 
303.12  additional licensed and certified bed as it will receive for its 
303.13  existing 40 beds; 
303.14     (l) to license or certify beds in renovation, replacement, 
303.15  or upgrading projects as defined in section 144A.073, 
303.16  subdivision 1, so long as the cumulative total costs of the 
303.17  facility's remodeling projects do not 
303.18  exceed $750,000 $1,000,000; 
303.19     (m) to license and certify beds that are moved from one 
303.20  location to another for the purposes of converting up to five 
303.21  four-bed wards to single or double occupancy rooms in a nursing 
303.22  home that, as of January 1, 1993, was county-owned and had a 
303.23  licensed capacity of 115 beds; 
303.24     (n) to allow a facility that on April 16, 1993, was a 
303.25  106-bed licensed and certified nursing facility located in 
303.26  Minneapolis to layaway all of its licensed and certified nursing 
303.27  home beds.  These beds may be relicensed and recertified in a 
303.28  newly-constructed teaching nursing home facility affiliated with 
303.29  a teaching hospital upon approval by the legislature.  The 
303.30  proposal must be developed in consultation with the interagency 
303.31  committee on long-term care planning.  The beds on layaway 
303.32  status shall have the same status as voluntarily delicensed and 
303.33  decertified beds, except that beds on layaway status remain 
303.34  subject to the surcharge in section 256.9657.  This layaway 
303.35  provision expires July 1, 1998; 
303.36     (o) to allow a project which will be completed in 
304.1   conjunction with an approved moratorium exception project for a 
304.2   nursing home in southern Cass county and which is directly 
304.3   related to that portion of the facility that must be repaired, 
304.4   renovated, or replaced, to correct an emergency plumbing problem 
304.5   for which a state correction order has been issued and which 
304.6   must be corrected by August 31, 1993; 
304.7      (p) to allow a facility that on April 16, 1993, was a 
304.8   368-bed licensed and certified nursing facility located in 
304.9   Minneapolis to layaway, upon 30 days prior written notice to the 
304.10  commissioner, up to 30 of the facility's licensed and certified 
304.11  beds by converting three-bed wards to single or double 
304.12  occupancy.  Beds on layaway status shall have the same status as 
304.13  voluntarily delicensed and decertified beds except that beds on 
304.14  layaway status remain subject to the surcharge in section 
304.15  256.9657, remain subject to the license application and renewal 
304.16  fees under section 144A.07 and shall be subject to a $100 per 
304.17  bed reactivation fee.  In addition, at any time within three 
304.18  years of the effective date of the layaway, the beds on layaway 
304.19  status may be: 
304.20     (1) relicensed and recertified upon relocation and 
304.21  reactivation of some or all of the beds to an existing licensed 
304.22  and certified facility or facilities located in Pine River, 
304.23  Brainerd, or International Falls; provided that the total 
304.24  project construction costs related to the relocation of beds 
304.25  from layaway status for any facility receiving relocated beds 
304.26  may not exceed the dollar threshold provided in subdivision 2 
304.27  unless the construction project has been approved through the 
304.28  moratorium exception process under section 144A.073; 
304.29     (2) relicensed and recertified, upon reactivation of some 
304.30  or all of the beds within the facility which placed the beds in 
304.31  layaway status, if the commissioner has determined a need for 
304.32  the reactivation of the beds on layaway status. 
304.33     The property-related payment rate of a facility placing 
304.34  beds on layaway status must be adjusted by the incremental 
304.35  change in its rental per diem after recalculating the rental per 
304.36  diem as provided in section 256B.431, subdivision 3a, paragraph 
305.1   (c).  The property-related payment rate for a facility 
305.2   relicensing and recertifying beds from layaway status must be 
305.3   adjusted by the incremental change in its rental per diem after 
305.4   recalculating its rental per diem using the number of beds after 
305.5   the relicensing to establish the facility's capacity day 
305.6   divisor, which shall be effective the first day of the month 
305.7   following the month in which the relicensing and recertification 
305.8   became effective.  Any beds remaining on layaway status more 
305.9   than three years after the date the layaway status became 
305.10  effective must be removed from layaway status and immediately 
305.11  delicensed and decertified; 
305.12     (q) to license and certify beds in a renovation and 
305.13  remodeling project to convert 12 four-bed wards into 24 two-bed 
305.14  rooms, expand space, and add improvements in a nursing home 
305.15  that, as of January 1, 1994, met the following conditions:  the 
305.16  nursing home was located in Ramsey county; had a licensed 
305.17  capacity of 154 beds; and had been ranked among the top 15 
305.18  applicants by the 1993 moratorium exceptions advisory review 
305.19  panel.  The total project construction cost estimate for this 
305.20  project must not exceed the cost estimate submitted in 
305.21  connection with the 1993 moratorium exception process; 
305.22     (r) to license and certify up to 117 beds that are 
305.23  relocated from a licensed and certified 138-bed nursing facility 
305.24  located in St. Paul to a hospital with 130 licensed hospital 
305.25  beds located in South St. Paul, provided that the nursing 
305.26  facility and hospital are owned by the same or a related 
305.27  organization and that prior to the date the relocation is 
305.28  completed the hospital ceases operation of its inpatient 
305.29  hospital services at that hospital.  After relocation, the 
305.30  nursing facility's status under section 256B.431, subdivision 
305.31  2j, shall be the same as it was prior to relocation.  The 
305.32  nursing facility's property-related payment rate resulting from 
305.33  the project authorized in this paragraph shall become effective 
305.34  no earlier than April 1, 1996.  For purposes of calculating the 
305.35  incremental change in the facility's rental per diem resulting 
305.36  from this project, the allowable appraised value of the nursing 
306.1   facility portion of the existing health care facility physical 
306.2   plant prior to the renovation and relocation may not exceed 
306.3   $2,490,000; 
306.4      (s) to license and certify two beds in a facility to 
306.5   replace beds that were voluntarily delicensed and decertified on 
306.6   June 28, 1991; 
306.7      (t) to allow 16 licensed and certified beds located on July 
306.8   1, 1994, in a 142-bed nursing home and 21-bed boarding care home 
306.9   facility in Minneapolis, notwithstanding the licensure and 
306.10  certification after July 1, 1995, of the Minneapolis facility as 
306.11  a 147-bed nursing home facility after completion of a 
306.12  construction project approved in 1993 under section 144A.073, to 
306.13  be laid away upon 30 days' prior written notice to the 
306.14  commissioner.  Beds on layaway status shall have the same status 
306.15  as voluntarily delicensed or decertified beds except that they 
306.16  shall remain subject to the surcharge in section 256.9657.  The 
306.17  16 beds on layaway status may be relicensed as nursing home beds 
306.18  and recertified at any time within five years of the effective 
306.19  date of the layaway upon relocation of some or all of the beds 
306.20  to a licensed and certified facility located in Watertown, 
306.21  provided that the total project construction costs related to 
306.22  the relocation of beds from layaway status for the Watertown 
306.23  facility may not exceed the dollar threshold provided in 
306.24  subdivision 2 unless the construction project has been approved 
306.25  through the moratorium exception process under section 144A.073. 
306.26     The property-related payment rate of the facility placing 
306.27  beds on layaway status must be adjusted by the incremental 
306.28  change in its rental per diem after recalculating the rental per 
306.29  diem as provided in section 256B.431, subdivision 3a, paragraph 
306.30  (c).  The property-related payment rate for the facility 
306.31  relicensing and recertifying beds from layaway status must be 
306.32  adjusted by the incremental change in its rental per diem after 
306.33  recalculating its rental per diem using the number of beds after 
306.34  the relicensing to establish the facility's capacity day 
306.35  divisor, which shall be effective the first day of the month 
306.36  following the month in which the relicensing and recertification 
307.1   became effective.  Any beds remaining on layaway status more 
307.2   than five years after the date the layaway status became 
307.3   effective must be removed from layaway status and immediately 
307.4   delicensed and decertified; 
307.5      (u) to license and certify beds that are moved within an 
307.6   existing area of a facility or to a newly constructed addition 
307.7   which is built for the purpose of eliminating three- and 
307.8   four-bed rooms and adding space for dining, lounge areas, 
307.9   bathing rooms, and ancillary service areas in a nursing home 
307.10  that, as of January 1, 1995, was located in Fridley and had a 
307.11  licensed capacity of 129 beds; 
307.12     (v) to relocate 36 beds in Crow Wing county and four beds 
307.13  from Hennepin county to a 160-bed facility in Crow Wing county, 
307.14  provided all the affected beds are under common ownership; 
307.15     (w) to license and certify a total replacement project of 
307.16  up to 49 beds located in Norman county that are relocated from a 
307.17  nursing home destroyed by flood and whose residents were 
307.18  relocated to other nursing homes.  The operating cost payment 
307.19  rates for the new nursing facility shall be determined based on 
307.20  the interim and settle-up payment provisions of Minnesota Rules, 
307.21  part 9549.0057, and the reimbursement provisions of section 
307.22  256B.431, except that subdivision 26, paragraphs (a) and (b), 
307.23  shall not apply until the second rate year after the settle-up 
307.24  cost report is filed.  Property-related reimbursement rates 
307.25  shall be determined under section 256B.431, taking into account 
307.26  any federal or state flood-related loans or grants provided to 
307.27  the facility; 
307.28     (x) to license and certify a total replacement project of 
307.29  up to 129 beds located in Polk county that are relocated from a 
307.30  nursing home destroyed by flood and whose residents were 
307.31  relocated to other nursing homes.  The operating cost payment 
307.32  rates for the new nursing facility shall be determined based on 
307.33  the interim and settle-up payment provisions of Minnesota Rules, 
307.34  part 9549.0057, and the reimbursement provisions of section 
307.35  256B.431, except that subdivision 26, paragraphs (a) and (b), 
307.36  shall not apply until the second rate year after the settle-up 
308.1   cost report is filed.  Property-related reimbursement rates 
308.2   shall be determined under section 256B.431, taking into account 
308.3   any federal or state flood-related loans or grants provided to 
308.4   the facility; 
308.5      (y) to license and certify beds in a renovation and 
308.6   remodeling project to convert 13 three-bed wards into 13 two-bed 
308.7   rooms and 13 single-bed rooms, expand space, and add 
308.8   improvements in a nursing home that, as of January 1, 1994, met 
308.9   the following conditions:  the nursing home was located in 
308.10  Ramsey county, was not owned by a hospital corporation, had a 
308.11  licensed capacity of 64 beds, and had been ranked among the top 
308.12  15 applicants by the 1993 moratorium exceptions advisory review 
308.13  panel.  The total project construction cost estimate for this 
308.14  project must not exceed the cost estimate submitted in 
308.15  connection with the 1993 moratorium exception process; 
308.16     (z) to license and certify up to 150 nursing home beds to 
308.17  replace an existing 285 bed nursing facility located in St. 
308.18  Paul.  The replacement project shall include both the renovation 
308.19  of existing buildings and the construction of new facilities at 
308.20  the existing site.  The reduction in the licensed capacity of 
308.21  the existing facility shall occur during the construction 
308.22  project as beds are taken out of service due to the construction 
308.23  process.  Prior to the start of the construction process, the 
308.24  facility shall provide written information to the commissioner 
308.25  of health describing the process for bed reduction, plans for 
308.26  the relocation of residents, and the estimated construction 
308.27  schedule.  The relocation of residents shall be in accordance 
308.28  with the provisions of law and rule; 
308.29     (aa) to allow the commissioner of human services to license 
308.30  an additional 36 beds to provide residential services for the 
308.31  physically handicapped under Minnesota Rules, parts 9570.2000 to 
308.32  9570.3400, in a 198-bed nursing home located in Red Wing, 
308.33  provided that the total number of licensed and certified beds at 
308.34  the facility does not increase; 
308.35     (bb) to license and certify a new facility in St. Louis 
308.36  county with 44 beds constructed to replace an existing facility 
309.1   in St. Louis county with 31 beds, which has resident rooms on 
309.2   two separate floors and an antiquated elevator that creates 
309.3   safety concerns for residents and prevents nonambulatory 
309.4   residents from residing on the second floor.  The project shall 
309.5   include the elimination of three- and four-bed rooms; 
309.6      (cc) to license and certify four beds in a 16-bed certified 
309.7   boarding care home in Minneapolis to replace beds that were 
309.8   voluntarily delicensed and decertified on or before March 31, 
309.9   1992.  The licensure and certification is conditional upon the 
309.10  facility periodically assessing and adjusting its resident mix 
309.11  and other factors which may contribute to a potential 
309.12  institution for mental disease declaration.  The commissioner of 
309.13  human services shall retain the authority to audit the facility 
309.14  at any time and shall require the facility to comply with any 
309.15  requirements necessary to prevent an institution for mental 
309.16  disease declaration, including delicensure and decertification 
309.17  of beds, if necessary; or 
309.18     (dd) to license and certify 72 beds in an existing facility 
309.19  in Mille Lacs county with 80 beds as part of a renovation 
309.20  project.  The renovation must include construction of an 
309.21  addition to accommodate ten residents with beginning and 
309.22  midstage dementia in a self-contained living unit; creation of 
309.23  three resident households where dining, activities, and support 
309.24  spaces are located near resident living quarters; designation of 
309.25  four beds for rehabilitation in a self-contained area; 
309.26  designation of 30 private rooms; and other improvements.; 
309.27     (ee) to license and certify beds in a facility that has 
309.28  undergone replacement or remodeling as part of a planned closure 
309.29  under section 256B.437; 
309.30     (ff) to license and certify a total replacement project of 
309.31  up to 124 beds located in Wilkin county that are in need of 
309.32  relocation from a nursing home substantially destroyed by 
309.33  flood.  The operating cost payment rates for the new nursing 
309.34  facility shall be determined based on the interim and settle-up 
309.35  payment provisions of Minnesota Rules, part 9549.0057, and the 
309.36  reimbursement provisions of section 256B.431, except that 
310.1   section 256B.431, subdivision 26, paragraphs (a) and (b), shall 
310.2   not apply until the second rate year after the settle-up cost 
310.3   report is filed.  Property-related reimbursement rates shall be 
310.4   determined under section 256B.431, taking into account any 
310.5   federal or state flood-related loans or grants provided to the 
310.6   facility; 
310.7      (gg) to allow the commissioner of human services to license 
310.8   an additional nine beds to provide residential services for the 
310.9   physically handicapped under Minnesota Rules, parts 9570.2000 to 
310.10  9570.3400, in a 215-bed nursing home located in Duluth, provided 
310.11  that the total number of licensed and certified beds at the 
310.12  facility does not increase; 
310.13     (hh) to license and certify up to 120 new nursing facility 
310.14  beds to replace beds in a facility in Anoka county, which was 
310.15  licensed for 98 beds as of July 1, 2000, provided the new 
310.16  facility is located within four miles of the existing facility 
310.17  and is in Anoka county.  Operating and property rates shall be 
310.18  determined and allowed under section 256B.431 and Minnesota 
310.19  Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 
310.20  256B.435.  The provisions of section 256B.431, subdivision 26, 
310.21  paragraphs (a) and (b), do not apply until the second rate year 
310.22  following settle-up; or 
310.23     (ii) to transfer up to 98 beds of a 129-licensed bed 
310.24  facility located in Anoka county that, as of March 25, 2001, is 
310.25  in the active process of closing, to a 122-licensed bed 
310.26  nonprofit nursing facility located in the city of Columbia 
310.27  Heights or its affiliate.  The transfer is effective when the 
310.28  receiving facility notifies the commissioner in writing of the 
310.29  number of beds accepted.  The commissioner shall place all 
310.30  transferred beds on layaway status held in the name of the 
310.31  receiving facility.  The layaway adjustment provisions of 
310.32  section 256B.431, subdivision 30, do not apply to this layaway.  
310.33  The receiving facility may only remove the beds from layaway for 
310.34  recertification and relicensure at the receiving facility's 
310.35  current site, or at a newly constructed facility located in 
310.36  Anoka county.  The receiving facility must receive statutory 
311.1   authorization before removing these beds from layaway. 
311.2      Sec. 6.  Minnesota Statutes 2000, section 144A.073, 
311.3   subdivision 2, is amended to read: 
311.4      Subd. 2.  [REQUEST FOR PROPOSALS.] At the authorization by 
311.5   the legislature of additional medical assistance expenditures 
311.6   for exceptions to the moratorium on nursing homes, the 
311.7   interagency committee shall publish in the State Register a 
311.8   request for proposals for nursing home projects to be licensed 
311.9   or certified under section 144A.071, subdivision 4a, clause 
311.10  (c).  The public notice of this funding and the request for 
311.11  proposals must specify how the approval criteria will be 
311.12  prioritized by the advisory review panel, the interagency 
311.13  long-term care planning committee, and the commissioner.  The 
311.14  notice must describe the information that must accompany a 
311.15  request and state that proposals must be submitted to the 
311.16  interagency committee within 90 days of the date of 
311.17  publication.  The notice must include the amount of the 
311.18  legislative appropriation available for the additional costs to 
311.19  the medical assistance program of projects approved under this 
311.20  section.  If no money is appropriated for a year, the 
311.21  interagency committee shall publish a notice to that effect, and 
311.22  no proposals shall be requested.  If money is appropriated, the 
311.23  interagency committee shall initiate the application and review 
311.24  process described in this section at least twice each biennium 
311.25  and up to four times each biennium, according to dates 
311.26  established by rule.  Authorized funds shall be allocated 
311.27  proportionally to the number of processes.  Funds not encumbered 
311.28  by an earlier process within a biennium shall carry forward to 
311.29  subsequent iterations of the process.  Authorization for 
311.30  expenditures does not carry forward into the following 
311.31  biennium.  To be considered for approval, a proposal must 
311.32  include the following information: 
311.33     (1) whether the request is for renovation, replacement, 
311.34  upgrading, conversion, or relocation; 
311.35     (2) a description of the problem the project is designed to 
311.36  address; 
312.1      (3) a description of the proposed project; 
312.2      (4) an analysis of projected costs of the nursing facility 
312.3   proposal, which are not required to exceed the cost threshold 
312.4   referred to in section 144A.071, subdivision 1, to be considered 
312.5   under this section, including initial construction and 
312.6   remodeling costs; site preparation costs; technology costs; 
312.7   financing costs, including the current estimated long-term 
312.8   financing costs of the proposal, which consists of estimates of 
312.9   the amount and sources of money, reserves if required under the 
312.10  proposed funding mechanism, annual payments schedule, interest 
312.11  rates, length of term, closing costs and fees, insurance costs, 
312.12  and any completed marketing study or underwriting review; and 
312.13  estimated operating costs during the first two years after 
312.14  completion of the project; 
312.15     (5) for proposals involving replacement of all or part of a 
312.16  facility, the proposed location of the replacement facility and 
312.17  an estimate of the cost of addressing the problem through 
312.18  renovation; 
312.19     (6) for proposals involving renovation, an estimate of the 
312.20  cost of addressing the problem through replacement; 
312.21     (7) the proposed timetable for commencing construction and 
312.22  completing the project; 
312.23     (8) a statement of any licensure or certification issues, 
312.24  such as certification survey deficiencies; 
312.25     (9) the proposed relocation plan for current residents if 
312.26  beds are to be closed so that the department of human services 
312.27  can estimate the total costs of a proposal; and 
312.28     (10) other information required by permanent rule of the 
312.29  commissioner of health in accordance with subdivisions 4 and 8. 
312.30     Sec. 7.  Minnesota Statutes 2000, section 144A.073, 
312.31  subdivision 4, is amended to read: 
312.32     Subd. 4.  [CRITERIA FOR REVIEW.] The following criteria 
312.33  shall be used in a consistent manner to compare, evaluate, and 
312.34  rank all proposals submitted.  Except for the criteria specified 
312.35  in clause (3), the application of criteria listed under this 
312.36  subdivision shall not reflect any distinction based on the 
313.1   geographic location of the proposed project: 
313.2      (1) the extent to which the proposal furthers state 
313.3   long-term care goals, including the goals stated in section 
313.4   144A.31, and including the goal of enhancing the availability 
313.5   and use of alternative care services and the goal of reducing 
313.6   the number of long-term care resident rooms with more than two 
313.7   beds; 
313.8      (2) the proposal's long-term effects on state costs 
313.9   including the cost estimate of the project according to section 
313.10  144A.071, subdivision 5a; 
313.11     (3) the extent to which the proposal promotes equitable 
313.12  access to long-term care services in nursing homes through 
313.13  redistribution of the nursing home bed supply, as measured by 
313.14  the number of beds relative to the population 85 or older, 
313.15  projected to the year 2000 by the state demographer, and 
313.16  according to items (i) to (iv): 
313.17     (i) reduce beds in counties where the supply is high, 
313.18  relative to the statewide mean, and increase beds in counties 
313.19  where the supply is low, relative to the statewide mean; 
313.20     (ii) adjust the bed supply so as to create the greatest 
313.21  benefits in improving the distribution of beds; 
313.22     (iii) adjust the existing bed supply in counties so that 
313.23  the bed supply in a county moves toward the statewide mean; and 
313.24     (iv) adjust the existing bed supply so that the 
313.25  distribution of beds as projected for the year 2020 would be 
313.26  consistent with projected need, based on the methodology 
313.27  outlined in the interagency long-term care committee's 1993 
313.28  nursing home bed distribution study; 
313.29     (4) the extent to which the project improves conditions 
313.30  that affect the health or safety of residents, such as narrow 
313.31  corridors, narrow door frames, unenclosed fire exits, and wood 
313.32  frame construction, and similar provisions contained in fire and 
313.33  life safety codes and licensure and certification rules; 
313.34     (5) the extent to which the project improves conditions 
313.35  that affect the comfort or quality of life of residents in a 
313.36  facility or the ability of the facility to provide efficient 
314.1   care, such as a relatively high number of residents in a room; 
314.2   inadequate lighting or ventilation; poor access to bathing or 
314.3   toilet facilities; a lack of available ancillary space for 
314.4   dining rooms, day rooms, or rooms used for other activities; 
314.5   problems relating to heating, cooling, or energy efficiency; 
314.6   inefficient location of nursing stations; narrow corridors; or 
314.7   other provisions contained in the licensure and certification 
314.8   rules; 
314.9      (6) the extent to which the applicant demonstrates the 
314.10  delivery of quality care, as defined in state and federal 
314.11  statutes and rules, to residents as evidenced by the two most 
314.12  recent state agency certification surveys and the applicants' 
314.13  response to those surveys; 
314.14     (7) the extent to which the project removes the need for 
314.15  waivers or variances previously granted by either the licensing 
314.16  agency, certifying agency, fire marshal, or local government 
314.17  entity; and 
314.18     (8) the extent to which the project increases the number of 
314.19  private or single bed rooms; and 
314.20     (9) other factors that may be developed in permanent rule 
314.21  by the commissioner of health that evaluate and assess how the 
314.22  proposed project will further promote or protect the health, 
314.23  safety, comfort, treatment, or well-being of the facility's 
314.24  residents. 
314.25     Sec. 8.  [144A.185] [DEFINITIONS.] 
314.26     Subdivision 1.  [APPLICABILITY.] For purposes of sections 
314.27  144A.185 to 144A.1887, the terms defined in this section have 
314.28  the meanings given them.  
314.29     Subd. 2.  [CLOSURE.] "Closure" means the cessation of 
314.30  operations of a nursing home and the delicensure or 
314.31  decertification of all beds within the facility.  
314.32     Subd. 3.  [CURTAILMENT, REDUCTION, OR CHANGE IN 
314.33  OPERATIONS.] "Curtailment, reduction, or change in operations" 
314.34  means any change in operations or services that would result in 
314.35  or encourage the relocation of residents. 
314.36     Subd. 4.  [FACILITY.] "Facility" means a licensed nursing 
315.1   home or a certified boarding care home licensed according to 
315.2   sections 144.50 to 144.56. 
315.3      Subd. 5.  [LICENSEE.] "Licensee" means the owner of the 
315.4   facility or the owner's designee or the commissioner of health 
315.5   for a facility in receivership. 
315.6      Subd. 6.  [LOCAL AGENCY.] "Local agency" means a county or 
315.7   a multicounty social service agency authorized under section 
315.8   393.01 as the agency responsible for providing social services 
315.9   for the county in which the facility is located.  
315.10     Subd. 7.  [PLAN.] "Plan" means a process developed under 
315.11  section 144A.186 for the closure or curtailment, reduction, or 
315.12  change in operations of a facility and for the subsequent 
315.13  relocation of residents.  
315.14     Subd. 8.  [RELOCATION.] "Relocation" means the discharge of 
315.15  a resident and movement of the resident to another facility or 
315.16  living arrangement as a result of a closure or curtailment, 
315.17  reduction, or change in operations of a facility. 
315.18     Sec. 9.  [144A.1855] [INITIAL NOTICE.] 
315.19     Subdivision 1.  [NOTIFICATION; PARTIES.] A licensee shall 
315.20  notify the following parties in writing when there is an intent 
315.21  to close or curtail, reduce, or change operations which would 
315.22  result in or encourage the relocation of residents:  
315.23     (1) the commissioner of health; 
315.24     (2) the commissioner of human services; 
315.25     (3) the local agency; 
315.26     (4) the office of the ombudsman for older Minnesotans; and 
315.27     (5) the office of the ombudsman for mental health and 
315.28  mental retardation.  
315.29     Subd. 2.  [NOTICE REQUIREMENTS.] The written notice shall 
315.30  include the names, telephone numbers, fax numbers, and e-mail 
315.31  addresses of the persons in the facility who are responsible for 
315.32  coordinating the facility's efforts in the planning process and 
315.33  the number of residents potentially affected by the closure or 
315.34  curtailment, reduction, or change in operations.  
315.35     Sec. 10.  [144A.186] [PLANNING PROCESS.] 
315.36     Subdivision 1.  [LOCAL AGENCY REQUIREMENTS.] (a) A local 
316.1   agency, within five working days of receiving an initial notice 
316.2   from a licensee according to section 144A.1855, shall provide 
316.3   all parties identified in section 144A.1855, subdivision 1, with 
316.4   the names, telephone numbers, fax numbers, and e-mail addresses 
316.5   of those persons who are responsible for coordinating local 
316.6   agency efforts in the planning process. 
316.7      (b) Within ten working days of receipt of the notice under 
316.8   paragraph (a), the local agency and licensee shall meet to 
316.9   develop the relocation plan under subdivision 2.  The local 
316.10  agency shall inform the departments of health and human 
316.11  services, the office of the ombudsman for older Minnesotans, and 
316.12  the office of the ombudsman for mental health and mental 
316.13  retardation of the date, time, and location of the meeting so 
316.14  that their representatives may attend.  The relocation plan must 
316.15  be completed within 45 days, but may be completed earlier 
316.16  according to a schedule agreed to by all parties. 
316.17     Subd. 2.  [RELOCATION PLAN.] (a) The plan shall: 
316.18     (1) identify the expected date of closure or curtailment, 
316.19  reduction, or change in operations; 
316.20     (2) outline the process for public notification of the 
316.21  closure or curtailment, reduction, or change in operations; 
316.22     (3) outline the process to ensure 60-day advance written 
316.23  notice to residents, family members, and designated 
316.24  representatives of residents; 
316.25     (4) present an aggregate description of the resident 
316.26  population remaining to be relocated and the population's needs; 
316.27     (5) outline the individual resident assessment process to 
316.28  be used; 
316.29     (6) identify an inventory of available relocation options, 
316.30  including home and community-based services; 
316.31     (7) identify a timeline for submission of the list required 
316.32  under section 144A.1865, subdivision 3; and 
316.33     (8) identify a schedule for each element of the plan.  
316.34     (b) All parties to the plan shall refrain from any public 
316.35  notification of the intent to close or curtail, reduce, or 
316.36  change operations until a relocation plan has been established.  
317.1      Sec. 11.  [144A.1865] [REQUIREMENTS OF LICENSEE.] 
317.2      Subdivision 1.  [RELOCATION.] The licensee shall provide 
317.3   for the safe, orderly, and appropriate relocation of residents.  
317.4   The licensee and facility staff shall cooperate with 
317.5   representatives from the local agency, the departments of health 
317.6   and human services, the office of the ombudsman for older 
317.7   Minnesotans, and the office of the ombudsman for mental health 
317.8   and mental retardation in planning for and implementing the 
317.9   relocation of residents.  
317.10     Subd. 2.  [INTERDISCIPLINARY TEAM.] The licensee shall 
317.11  establish an interdisciplinary team responsible for coordinating 
317.12  and implementing the plan under section 144A.186, subdivision 
317.13  2.  The interdisciplinary team shall include representatives 
317.14  from the local agency, the office of the ombudsman for older 
317.15  Minnesotans, facility staff who provide direct care services to 
317.16  the residents, and the facility administration.  
317.17     Subd. 3.  [RESIDENT LISTS.] The licensee shall provide a 
317.18  list to the local agency that includes the following information 
317.19  on each resident to be relocated:  
317.20     (1) name; 
317.21     (2) date of birth; 
317.22     (3) social security number; 
317.23     (4) medical assistance ID number; 
317.24     (5) all diagnoses; and 
317.25     (6) name of and contact information for the resident's 
317.26  family or other designated representative.  
317.27     Subd. 4.  [CONSULTATION WITH LOCAL AGENCY.] The licensee 
317.28  shall consult with the local agency on the availability and 
317.29  development of resources and in the resident relocation process. 
317.30     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
317.31  following final enactment. 
317.32     Sec. 12.  [144A.187] [RESIDENT AND PHYSICIAN NOTICE.] 
317.33     Subdivision 1.  [RESIDENT NOTICE REQUIRED.] (a) At least 60 
317.34  days before the proposed date of closure or curtailment, 
317.35  reduction, or change in operations as agreed to in the plan 
317.36  under section 144A.186, the licensee shall send a written notice 
318.1   of closure or curtailment, reduction, or change in operations to 
318.2   each resident being relocated, the resident's family member or 
318.3   designated representative, and the resident's attending 
318.4   physician. 
318.5      (b) The notice must include: 
318.6      (1) the date of the proposed closure or curtailment, 
318.7   reduction, or change in operations; 
318.8      (2) the name, address, telephone number, fax number, and 
318.9   e-mail address of the individuals in the facility responsible 
318.10  for providing assistance and information; 
318.11     (3) a notice of upcoming meetings for residents, families 
318.12  and designated representatives, and resident and family councils 
318.13  to discuss the relocation of residents; 
318.14     (4) the name, address, and telephone number of the local 
318.15  agency contact person; 
318.16     (5) the name, address, and telephone number of the office 
318.17  of the ombudsman for older Minnesotans and the office of the 
318.18  ombudsman for mental health and mental retardation; and 
318.19     (6) a notice of resident rights during discharge and 
318.20  relocation. 
318.21     (c) The notice to residents must comply with all applicable 
318.22  state and federal requirements for notice of transfer or 
318.23  discharge of nursing home residents.  
318.24     Subd. 2.  [MEDICAL INFORMATION REQUEST.] The licensee shall 
318.25  request the attending physician to furnish the licensee with, or 
318.26  arrange for the release of, any medical information needed to 
318.27  update a resident's medical records and to prepare transfer 
318.28  forms and discharge summaries.  
318.29     Sec. 13.  [144A.1875] [RELOCATION OF RESIDENTS.] 
318.30     Subdivision 1.  [PREPARATION; PLACEMENT INFORMATION.] A 
318.31  licensee shall provide sufficient preparation to residents to 
318.32  ensure safe, orderly, and appropriate discharge and relocation.  
318.33  The facility is responsible for assisting residents in finding 
318.34  placement within the resident's desired geographic location 
318.35  using the Senior LinkAge database of the department of human 
318.36  services.  By January 1, 2002, Senior LinkAge line shall make 
319.1   available via a Web site the name, address, and telephone and 
319.2   fax numbers of each facility with available beds, the 
319.3   certification level of the available beds, the types of services 
319.4   available, and the number of beds that are available as updated 
319.5   daily by the licensee.  The Web site shall include the 
319.6   information required by section 256.975, subdivision 7, 
319.7   paragraph (b), clause (1), and home and community-based services 
319.8   and other options for individuals with special needs.  The 
319.9   licensee must provide residents, their families or designated 
319.10  representatives, the office of the ombudsman for older 
319.11  Minnesotans, the office of the ombudsman for mental health and 
319.12  mental retardation, and the local agency with the toll-free 
319.13  number and Web site address for the Senior LinkAge line.  
319.14     Subd. 2.  [RESIDENT AND FAMILY MEETINGS.] After preparing 
319.15  the plan according to section 144A.186, the licensee shall 
319.16  conduct meetings with residents, families and designated 
319.17  representatives, and resident and family councils to notify them 
319.18  of the process for resident relocation.  Representatives from 
319.19  the local agency, the office of the ombudsman for older 
319.20  Minnesotans, the office of the ombudsman for mental health and 
319.21  mental retardation, the departments of health and human services 
319.22  shall receive advance notice of these meetings. 
319.23     Subd. 3.  [PERSONAL PROPERTY.] (a) The licensee shall 
319.24  update the inventory of residents' personal possessions and 
319.25  provide a copy of the final inventory to each resident and the 
319.26  resident's family or designated representative prior to the 
319.27  relocation of the resident.  The licensee is responsible for the 
319.28  timely transfer of a resident's possessions for all relocations 
319.29  within the state and within a 50-mile radius of the facility for 
319.30  relocations outside the state. 
319.31     (b) The licensee shall complete a final accounting of 
319.32  personal funds held in trust by the licensee and provide a copy 
319.33  of the accounting to each resident and the resident's family or 
319.34  designated representative.  The licensee is responsible for the 
319.35  timely transfer of all personal funds held in trust by the 
319.36  licensee. 
320.1      Subd. 4.  [SITE VISITS.] The licensee is responsible for 
320.2   assisting residents desiring to make site visits to facilities 
320.3   or other placements to which the resident may be relocated, 
320.4   unless it is medically inadvisable, as documented by the 
320.5   attending physician in the resident's care record.  The licensee 
320.6   shall provide, or make arrangements for, transportation for site 
320.7   visits to facilities or other placements within a 50-mile radius.
320.8      Subd. 5.  [FINAL NOTICE OF RELOCATION.] (a) Before 
320.9   relocating a resident, the licensee shall provide a final 
320.10  written notice to the resident, the resident's family or 
320.11  designated representative, and the resident's attending 
320.12  physician. 
320.13     (b) The final written notice shall: 
320.14     (1) be provided seven days before the relocation of a 
320.15  resident, unless the resident agrees to waive the resident's 
320.16  right to advance notice; and 
320.17     (2) identify the date of the anticipated relocation and the 
320.18  location to which the resident is being relocated.  
320.19     Subd. 6.  [ADMINISTRATIVE DUTIES.] (a) All administrative 
320.20  duties of the licensee under subdivisions 1, 2, 4, and 5 must be 
320.21  completed before relocation of a resident.  
320.22     (b) The licensee is responsible for providing the receiving 
320.23  facility or other health, housing, or care entity with a 
320.24  complete and accurate resident record, including information on 
320.25  family members, designated representatives, guardians, social 
320.26  service caseworkers, and other contact information.  The record 
320.27  must also include all information necessary to provide 
320.28  appropriate medical care and social services, including, but not 
320.29  limited to, information on preadmission screening, Level I and 
320.30  Level II screening, minimum data set and all other assessments, 
320.31  resident diagnosis, behavior, and medication.  
320.32     (c) For residents with special care needs, the licensee 
320.33  shall consult with the receiving facility or other placement 
320.34  entity and provide staff training or other preparation as needed 
320.35  to assist in providing for the special needs.  
320.36     (d) The licensee shall assist residents with the transfer 
321.1   or reconnection of telephone service.  The licensee shall bear 
321.2   all costs associated with reestablishing telephone service.  
321.3      Subd. 7.  [TRANSPORTATION; CONTINUITY OF CARE.] The 
321.4   licensee shall make arrangements or provide for the 
321.5   transportation of residents to the new facility or placement 
321.6   within the state or within a 50-mile radius for relocations 
321.7   outside the state.  The licensee shall provide a staff person to 
321.8   accompany the resident during transportation, upon request of 
321.9   the resident, the resident's family, or designated 
321.10  representative.  The discharge and relocation of residents must 
321.11  comply with all applicable state and federal requirements and 
321.12  must be conducted in a safe, orderly, and appropriate manner.  
321.13  The licensee must ensure that there is no disruption in 
321.14  providing meals, medications, or treatments of a resident during 
321.15  the relocation process.  
321.16     Sec. 14.  [144A.1885] [RELOCATION REPORTS.] 
321.17     (a) Beginning the week following development of the initial 
321.18  relocation plan under section 144A.186, the licensee shall 
321.19  submit weekly status reports to the commissioners of health and 
321.20  human services, or their designees, and to the local agency. 
321.21     (b) The first status report must identify the relocation 
321.22  plan developed under section 144A.186, the interdisciplinary 
321.23  team members, and the number of residents to be relocated.  
321.24     (c) Subsequent status reports must note any modifications 
321.25  to the relocation plan, any change of interdisciplinary team 
321.26  members or number of residents relocated, the placement 
321.27  destination to which residents have been relocated, and the 
321.28  number of residents remaining to be relocated.  Subsequent 
321.29  status reports must also identify issues or problems encountered 
321.30  during the relocation process and the resolution of these issues.
321.31     Sec. 15.  [144A.1886] [REQUIREMENTS OF LOCAL AGENCY.] 
321.32     Subdivision 1.  [MEETING; REPRESENTATION.] (a) The local 
321.33  agency with the licensee shall convene a meeting to develop a 
321.34  plan according to section 144A.186, subdivision 1, paragraph (b).
321.35     (b) The local agency shall designate a representative to 
321.36  the interdisciplinary team established by the licensee 
322.1   responsible for coordinating the relocation efforts.  
322.2      Subd. 2.  [RESOURCE.] (a) The local agency shall serve as a 
322.3   resource in the relocation process.  
322.4      (b) Concurrent with the notice sent to residents from the 
322.5   licensee according to section 144A.187, subdivision 1, the local 
322.6   agency shall provide written notice to residents, family 
322.7   members, and designated representatives describing: 
322.8      (1) the local agency's role in the relocation process and 
322.9   in the follow-up to relocation; 
322.10     (2) a local agency contact name, address, and telephone 
322.11  number; and 
322.12     (3) the name, address, and telephone number of the office 
322.13  of the ombudsman for older Minnesotans and the office of the 
322.14  ombudsman for mental health and mental retardation.  
322.15     (c) The local agency is responsible for the safe and 
322.16  orderly relocation of residents in cases where an emergent need 
322.17  arises or when the licensee has abrogated the licensee's 
322.18  responsibilities under the relocation plan.  
322.19     Subd. 3.  [COORDINATION; OVERSIGHT.] (a) The local agency 
322.20  shall meet with appropriate facility staff to coordinate any 
322.21  assistance.  Coordination shall include participating in group 
322.22  meetings with residents, family members, and designated 
322.23  representatives to explain the transfer or relocation process.  
322.24     (b) The local agency shall monitor compliance with all 
322.25  components of the relocation plan.  When the licensee is not in 
322.26  compliance, the local agency shall notify the commissioners of 
322.27  health and human services.  
322.28     (c) Except as requested by the resident, family member, or 
322.29  designated representative and within the parameters of the 
322.30  Vulnerable Adults Act, the local agency may halt a relocation 
322.31  that it deems inappropriate or dangerous to the health or safety 
322.32  of a resident. 
322.33     Subd. 4.  [FOLLOW-UP REVIEW.] (a) A member of the local 
322.34  agency staff shall visit residents relocated within 100 miles of 
322.35  the county within 30 days after a relocation.  Local agency 
322.36  staff shall interview the resident and family member or 
323.1   designated representative or shall observe the resident on-site, 
323.2   or both, and review and discuss pertinent medical or social 
323.3   records with appropriate facility staff to assess the adjustment 
323.4   of the resident to the new placement, recommend services or 
323.5   methods to meet any special needs of the resident, and identify 
323.6   residents at risk.  
323.7      (b) The local agency may conduct subsequent follow-up 
323.8   visits in cases where the adjustment of the resident to the new 
323.9   placement is in question.  
323.10     (c) Within 60 days of the completion of the follow-up 
323.11  visits, the local agency shall submit a written summary of the 
323.12  follow-up work to the commissioners of health and human 
323.13  services, in a manner approved by the commissioners.  
323.14     (d) The local agency shall submit a report of any issues 
323.15  that may require further review or monitoring to the 
323.16  commissioner of health. 
323.17     Sec. 16.  [144A.1887] [FUNDING.] 
323.18     (a) Within 60 days of a nursing home ceasing operations, 
323.19  the commissioner of human services shall reimburse nursing homes 
323.20  that are reimbursed under sections 256B.431, 256B.434, and 
323.21  256B.435 for operating costs incurred by the nursing home during 
323.22  the closure process.  The amount to be reimbursed to the nursing 
323.23  home shall be determined by applying paragraphs (b) to (f). 
323.24     (b) The facility shall provide the commissioner of human 
323.25  services with the nursing home's operating costs for the time 
323.26  period of 30 days prior to the notice specified under section 
323.27  144A.16, to 30 days after the nursing home's closure. 
323.28     (c) The nursing home shall provide the commissioner of 
323.29  human services with the number of medical assistance, Medicare, 
323.30  private pay, and other resident days for the period referenced 
323.31  in paragraph (b) by the 11 case mix categories. 
323.32     (d) The commissioner of human services shall calculate a 
323.33  nursing home closure rate by dividing the facility operating 
323.34  costs in paragraph (b) by the total resident days in paragraph 
323.35  (c). 
323.36     (e) The total closure costs attributable to medical 
324.1   assistance shall be determined by multiplying the nursing home 
324.2   closure rate in paragraph (d) by the medical assistance days 
324.3   provided by the nursing facility in paragraph (c). 
324.4      (f) The amount to be reimbursed to the nursing home is 
324.5   equal to the total closure costs in paragraph (e) minus the sum 
324.6   of the nursing facility's 11 operating rates times their 
324.7   respective number of medical assistance days by case mix as 
324.8   referenced in paragraph (c). 
324.9      Sec. 17.  [144A.36] [TRANSITION PLANNING GRANTS.] 
324.10     Subdivision 1.  [DEFINITIONS.] "Eligible nursing home" 
324.11  means any nursing home licensed under sections 144A.01 to 
324.12  144A.16 and certified by the appropriate authority under United 
324.13  States Code, title 42, sections 1396-1396p, to participate as a 
324.14  vendor in the medical assistance program established under 
324.15  chapter 256B. 
324.16     Subd. 2.  [GRANTS AUTHORIZED.] (a) The commissioner shall 
324.17  establish a program of transition planning grants to assist 
324.18  eligible nursing homes in implementing the provisions in 
324.19  paragraphs (b) and (c).  
324.20     (b) Transition planning grants may be used by nursing homes 
324.21  to develop strategic plans which identify the appropriate 
324.22  institutional and noninstitutional settings necessary to meet 
324.23  the older adult service needs of the community.  
324.24     (c) At a minimum, a strategic plan must consist of: 
324.25     (1) a needs assessment to determine what older adult 
324.26  services are needed and desired by the community; 
324.27     (2) an assessment of the appropriate settings in which to 
324.28  provide needed older adult services; 
324.29     (3) an assessment identifying currently available services 
324.30  and their settings in the community; and 
324.31     (4) a transition plan to achieve the needed outcome 
324.32  identified by the assessment. 
324.33     Subd. 3.  [ALLOCATION OF GRANTS.] (a) Eligible nursing 
324.34  homes must apply to the commissioner no later than September 1 
324.35  of each fiscal year for grants awarded in that fiscal year.  A 
324.36  grant shall be awarded upon signing of a grant contract. 
325.1      (b) The commissioner must make a final decision on the 
325.2   funding of each application within 60 days of the deadline for 
325.3   receiving applications. 
325.4      Subd. 4.  [EVALUATION.] The commissioner shall evaluate the 
325.5   overall effectiveness of the grant program.  The commissioner 
325.6   may collect, from the nursing homes receiving grants, the 
325.7   information necessary to evaluate the grant program.  
325.8   Information related to the financial condition of individual 
325.9   nursing homes shall be classified as nonpublic data. 
325.10     Sec. 18.  [144A.37] [ALTERNATIVE NURSING HOME SURVEY 
325.11  PROCESS.] 
325.12     Subdivision 1.  [ALTERNATIVE NURSING HOME SURVEY 
325.13  SCHEDULES.] (a) The commissioner of health shall implement 
325.14  alternative procedures for the nursing home survey process as 
325.15  authorized under this section.  
325.16     (b) These alternative survey process procedures seek to:  
325.17  (1) use department resources more effectively and efficiently to 
325.18  target problem areas; (2) use other existing or new mechanisms 
325.19  to provide objective assessments of quality and to measure 
325.20  quality improvement; (3) provide for frequent collaborative 
325.21  interaction of facility staff and surveyors rather than a 
325.22  punitive approach; and (4) reward a nursing home that has 
325.23  performed very well by extending intervals between full surveys. 
325.24     (c) The commissioner shall pursue changes in federal law 
325.25  necessary to accomplish this process and shall apply for any 
325.26  necessary federal waivers or approval.  If a federal waiver is 
325.27  approved, the commissioner shall promptly submit, to the house 
325.28  and senate committees with jurisdiction over health and human 
325.29  services policy and finance, fiscal estimates for implementing 
325.30  the alternative survey process waiver.  The commissioner shall 
325.31  also pursue any necessary federal law changes during the 107th 
325.32  Congress. 
325.33     (d) The alternative nursing home survey schedule and 
325.34  related educational activities shall not be implemented until 
325.35  funding is appropriated by the legislature. 
325.36     Subd. 2.  [SURVEY INTERVALS.] The commissioner of health 
326.1   must extend the time period between standard surveys up to 30 
326.2   months based on the criteria established in subdivision 4.  In 
326.3   using the alternative survey schedule, the requirement for the 
326.4   statewide average to not exceed 12 months does not apply. 
326.5      Subd. 3.  [COMPLIANCE HISTORY.] The commissioner shall 
326.6   develop a process for identifying the survey cycles for skilled 
326.7   nursing facilities based upon the compliance history of the 
326.8   facility.  This process can use a range of months for survey 
326.9   intervals.  At a minimum, the process must be based on 
326.10  information from the last two survey cycles and shall take into 
326.11  consideration any deficiencies issued as the result of a survey 
326.12  or a complaint investigation during the interval.  A skilled 
326.13  nursing facility with a finding of substandard quality of care 
326.14  or a finding of immediate jeopardy is not entitled to a survey 
326.15  interval greater than 12 months.  The commissioner shall alter 
326.16  the survey cycle for a specific skilled nursing facility based 
326.17  on findings identified through the completion of a survey, a 
326.18  monitoring visit, or a complaint investigation.  The 
326.19  commissioner must also take into consideration information other 
326.20  than the facility's compliance history. 
326.21     Subd. 4.  [CRITERIA FOR SURVEY INTERVAL 
326.22  CLASSIFICATION.] (a) The commissioner shall provide public 
326.23  notice of the classification process and shall identify the 
326.24  selected survey cycles for each skilled nursing facility.  The 
326.25  classification system must be based on an analysis of the 
326.26  findings made during the past two standard survey intervals, but 
326.27  it only takes one survey or complaint finding to modify the 
326.28  interval. 
326.29     (b) The commissioner shall also take into consideration 
326.30  information obtained from residents and family members in each 
326.31  skilled nursing facility and from other sources such as 
326.32  employees and ombudsmen in determining the appropriate survey 
326.33  intervals for facilities. 
326.34     Subd. 5.  [REQUIRED MONITORING.] (a) The commissioner shall 
326.35  conduct at least one monitoring visit on an annual basis for 
326.36  every skilled nursing facility which has been selected for a 
327.1   survey cycle greater than 12 months.  The commissioner shall 
327.2   develop protocols for the monitoring visits which shall be less 
327.3   extensive than the requirements for a standard survey.  The 
327.4   commissioner shall use the criteria in paragraph (b) to 
327.5   determine whether additional monitoring visits to a facility 
327.6   will be required.  
327.7      (b) The criteria shall include, but not be limited to, the 
327.8   following: 
327.9      (1) changes in ownership, administration of the facility, 
327.10  or direction of the facility's nursing service; 
327.11     (2) changes in the facility's quality indicators which 
327.12  might evidence a decline in the facility's quality of care; 
327.13     (3) reductions in staffing or an increase in the 
327.14  utilization of temporary nursing personnel; and 
327.15     (4) complaint information or other information that 
327.16  identifies potential concerns for the quality of the care and 
327.17  services provided in the skilled nursing facility. 
327.18     Subd. 6.  [SURVEY REQUIREMENTS FOR FACILITIES NOT APPROVED 
327.19  FOR EXTENDED SURVEY INTERVALS.] The commissioner shall establish 
327.20  a process for surveying and monitoring of facilities which 
327.21  require a survey interval of less than 15 months.  This 
327.22  information shall identify the steps that the commissioner must 
327.23  take to monitor the facility in addition to the standard survey. 
327.24     Subd. 7.  [IMPACT ON SURVEY AGENCY'S BUDGET.] The 
327.25  implementation of an alternative survey process for the state 
327.26  must not result in any reduction of funding that would have been 
327.27  provided to the state survey agency for survey and enforcement 
327.28  activity based upon the completion of full standard surveys for 
327.29  each skilled nursing facility in the state. 
327.30     Subd. 8.  [EDUCATIONAL ACTIVITIES.] The commissioner shall 
327.31  expand the state survey agency's ability to conduct training and 
327.32  educational efforts for skilled nursing facilities, residents 
327.33  and family members, residents and family councils, long-term 
327.34  care ombudsman programs, and the general public. 
327.35     Subd. 9.  [EVALUATION.] The commissioner shall develop a 
327.36  process for the evaluation of the effectiveness of an 
328.1   alternative survey process conducted under this section. 
328.2      <h>[EFFECTIVE DATE.]</h> This section is effective the day 
328.3   following final enactment. 
328.4      Sec. 19.  [144A.38] [INNOVATIONS IN QUALITY DEMONSTRATION 
328.5   GRANTS.] 
328.6      Subdivision 1.  [PROGRAM ESTABLISHED.] The commissioner of 
328.7   health and the commissioner of human services shall establish a 
328.8   long-term care grant program that demonstrates best practices 
328.9   and innovation for long-term care service delivery and housing.  
328.10  The grants must fund demonstrations that create new means and 
328.11  models for serving the elderly or demonstrate creativity in 
328.12  service provision through the scope of their program or service. 
328.13     Subd. 2.  [ELIGIBILITY.] Grants may only be made to those 
328.14  who provide direct service or housing to the elderly within the 
328.15  state.  Grants may only be made for projects that show 
328.16  innovations and measurable improvement in resident care, quality 
328.17  of life, use of technology, or customer satisfaction. 
328.18     Subd. 3.  [AWARDING OF GRANTS.] (a) Applications for grants 
328.19  must be made to the commissioners on forms prescribed by the 
328.20  commissioners. 
328.21     (b) The commissioners shall review applications and award 
328.22  grants based on the following criteria: 
328.23     (1) improvement in direct care to residents; 
328.24     (2) increase in efficiency through the use of technology; 
328.25     (3) increase in quality of care through the use of 
328.26  technology; 
328.27     (4) increase in the access and delivery of service; 
328.28     (5) enhancement of nursing staff training; 
328.29     (6) the effectiveness of the project as a demonstration; 
328.30  and 
328.31     (7) the immediate transferability of the project to scale. 
328.32     (c) In reviewing applications and awarding grants, the 
328.33  commissioners shall consult with long-term care providers, 
328.34  consumers of long-term care, long-term care researchers, and 
328.35  staff of other state agencies. 
328.36     (d) Grants for eligible projects may not exceed $100,000. 
329.1      Sec. 20.  [144A.39] [LONG-TERM CARE QUALITY PROFILES.] 
329.2      Subdivision l.  [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 
329.3   PROFILES.] (a) The commissioner of health and the commissioner 
329.4   of human services shall develop and implement a quality profile 
329.5   system for nursing facilities and, beginning not later than July 
329.6   1, 2003, other providers of long-term care services, except when 
329.7   the quality profile system would duplicate requirements under 
329.8   sections 256B.5011 and 256B.5013.  The system must be developed 
329.9   and implemented to the extent possible without the collection of 
329.10  new data.  To the extent possible, the system must incorporate 
329.11  or be coordinated with information on quality maintained by area 
329.12  agencies on aging, long-term care trade associations, and other 
329.13  entities.  The system must be designed to provide information on 
329.14  quality: 
329.15     (1) to consumers and their families to facilitate informed 
329.16  choices of service providers; 
329.17     (2) to providers to enable them to measure the results of 
329.18  their quality improvement efforts and compare quality 
329.19  achievements with other service providers; and 
329.20     (3) to public and private purchasers of long-term care 
329.21  services to enable them to purchase high-quality care. 
329.22     (b) The system must be developed in consultation with the 
329.23  long-term care task force, area agencies on aging, and 
329.24  representatives of consumers, providers, and labor unions.  
329.25  Within the limits of available appropriations, the commissioners 
329.26  may employ consultants to assist with this project. 
329.27     Subd. 2.  [QUALITY MEASUREMENT TOOLS.] The commissioners 
329.28  shall identify and apply existing quality measurement tools to: 
329.29     (1) emphasize quality of care and its relationship to 
329.30  quality of life; and 
329.31     (2) address the needs of various users of long-term care 
329.32  services, including, but not limited to, short-stay residents, 
329.33  persons with behavioral problems, persons with dementia, and 
329.34  persons who are members of minority groups. 
329.35  The tools must be identified and applied, to the extent 
329.36  possible, without requiring providers to supply information 
330.1   beyond current state and federal requirements. 
330.2      Subd. 3.  [CONSUMER SURVEYS.] Following identification of 
330.3   the quality measurement tool, the commissioners shall conduct 
330.4   surveys of long-term care service consumers to develop quality 
330.5   profiles of providers.  To the extent possible, surveys must be 
330.6   conducted face-to-face by state employees or contractors.  At 
330.7   the discretion of the commissioners, surveys may be conducted by 
330.8   telephone or by provider staff.  Surveys must be conducted 
330.9   periodically to update quality profiles of individual service 
330.10  providers. 
330.11     Subd. 4.  [DISSEMINATION OF QUALITY PROFILES.] By July 1, 
330.12  2002, the commissioners shall implement a system to disseminate 
330.13  the quality profiles developed from consumer surveys using the 
330.14  quality measurement tool.  Profiles must be disseminated to the 
330.15  Senior LinkAge line and to consumers, providers, and purchasers 
330.16  of long-term care services through all feasible printed and 
330.17  electronic outlets.  The commissioners shall conduct a public 
330.18  awareness campaign to inform potential users regarding profile 
330.19  contents and potential uses. 
330.20     Sec. 21.  Minnesota Statutes 2000, section 256B.431, 
330.21  subdivision 17, is amended to read: 
330.22     Subd. 17.  [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 
330.23  (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 
330.24  for rate periods beginning on October 1, 1992, and for rate 
330.25  years beginning after June 30, 1993, a nursing facility that (1) 
330.26  has completed a construction project approved under section 
330.27  144A.071, subdivision 4a, clause (m); (2) has completed a 
330.28  construction project approved under section 144A.071, 
330.29  subdivision 4a, and effective after June 30, 1995; or (3) has 
330.30  completed a renovation, replacement, or upgrading project 
330.31  approved under the moratorium exception process in section 
330.32  144A.073 shall be reimbursed for costs directly identified to 
330.33  that project as provided in subdivision 16 and this subdivision. 
330.34     (b) Notwithstanding Minnesota Rules, part 9549.0060, 
330.35  subparts 5, item A, subitems (1) and (3), and 7, item D, 
330.36  allowable interest expense on debt shall include: 
331.1      (1) interest expense on debt related to the cost of 
331.2   purchasing or replacing depreciable equipment, excluding 
331.3   vehicles, not to exceed six percent of the total historical cost 
331.4   of the project; and 
331.5      (2) interest expense on debt related to financing or 
331.6   refinancing costs, including costs related to points, loan 
331.7   origination fees, financing charges, legal fees, and title 
331.8   searches; and issuance costs including bond discounts, bond 
331.9   counsel, underwriter's counsel, corporate counsel, printing, and 
331.10  financial forecasts.  Allowable debt related to items in this 
331.11  clause shall not exceed seven percent of the total historical 
331.12  cost of the project.  To the extent these costs are financed, 
331.13  the straight-line amortization of the costs in this clause is 
331.14  not an allowable cost; and 
331.15     (3) interest on debt incurred for the establishment of a 
331.16  debt reserve fund, net of the interest earned on the debt 
331.17  reserve fund. 
331.18     (c) Debt incurred for costs under paragraph (b) is not 
331.19  subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 
331.20  subitem (5) or (6). 
331.21     (d) The incremental increase in a nursing facility's rental 
331.22  rate, determined under Minnesota Rules, parts 9549.0010 to 
331.23  9549.0080, and this section, resulting from the acquisition of 
331.24  allowable capital assets, and allowable debt and interest 
331.25  expense under this subdivision shall be added to its 
331.26  property-related payment rate and shall be effective on the 
331.27  first day of the month following the month in which the 
331.28  moratorium project was completed. 
331.29     (e) Notwithstanding subdivision 3f, paragraph (a), for rate 
331.30  periods beginning on October 1, 1992, and for rate years 
331.31  beginning after June 30, 1993, the replacement-costs-new per bed 
331.32  limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 
331.33  item B, for a nursing facility that has completed a renovation, 
331.34  replacement, or upgrading project that has been approved under 
331.35  the moratorium exception process in section 144A.073, or that 
331.36  has completed an addition to or replacement of buildings, 
332.1   attached fixtures, or land improvements for which the total 
332.2   historical cost exceeds the lesser of $150,000 or ten percent of 
332.3   the most recent appraised value, must be $47,500 per licensed 
332.4   bed in multiple-bed rooms and $71,250 per licensed bed in a 
332.5   single-bed room.  These amounts must be adjusted annually as 
332.6   specified in subdivision 3f, paragraph (a), beginning January 1, 
332.7   1993. 
332.8      (f) For purposes of this paragraph, a total replacement 
332.9   means the complete replacement of the nursing facility's 
332.10  physical plant through the construction of a new physical plant, 
332.11  the transfer of the nursing facility's license from one physical 
332.12  plant location to another, or a new building addition to 
332.13  relocate beds from three- and four-bed wards.  For total 
332.14  replacement projects completed on or after July 1, 1992, the 
332.15  commissioner shall compute the incremental change in the nursing 
332.16  facility's rental per diem, for rate years beginning on or after 
332.17  July 1, 1995, by replacing its appraised value, including the 
332.18  historical capital asset costs, and the capital debt and 
332.19  interest costs with the new nursing facility's allowable capital 
332.20  asset costs and the related allowable capital debt and interest 
332.21  costs.  If the new nursing facility has decreased its licensed 
332.22  capacity, the aggregate investment per bed limit in subdivision 
332.23  3a, paragraph (c), shall apply.  If the new nursing facility has 
332.24  retained a portion of the original physical plant for nursing 
332.25  facility usage, then a portion of the appraised value prior to 
332.26  the replacement must be retained and included in the calculation 
332.27  of the incremental change in the nursing facility's rental per 
332.28  diem.  For purposes of this part, the original nursing facility 
332.29  means the nursing facility prior to the total replacement 
332.30  project.  The portion of the appraised value to be retained 
332.31  shall be calculated according to clauses (1) to (3): 
332.32     (1) The numerator of the allocation ratio shall be the 
332.33  square footage of the area in the original physical plant which 
332.34  is being retained for nursing facility usage. 
332.35     (2) The denominator of the allocation ratio shall be the 
332.36  total square footage of the original nursing facility physical 
333.1   plant. 
333.2      (3) Each component of the nursing facility's allowable 
333.3   appraised value prior to the total replacement project shall be 
333.4   multiplied by the allocation ratio developed by dividing clause 
333.5   (1) by clause (2). 
333.6      In the case of either type of total replacement as 
333.7   authorized under section 144A.071 or 144A.073, the provisions of 
333.8   this subdivision shall also apply.  For purposes of the 
333.9   moratorium exception authorized under section 144A.071, 
333.10  subdivision 4a, paragraph (s), if the total replacement involves 
333.11  the renovation and use of an existing health care facility 
333.12  physical plant, the new allowable capital asset costs and 
333.13  related debt and interest costs shall include first the 
333.14  allowable capital asset costs and related debt and interest 
333.15  costs of the renovation, to which shall be added the allowable 
333.16  capital asset costs of the existing physical plant prior to the 
333.17  renovation, and if reported by the facility, the related 
333.18  allowable capital debt and interest costs. 
333.19     (g) Notwithstanding Minnesota Rules, part 9549.0060, 
333.20  subpart 11, item C, subitem (2), for a total replacement, as 
333.21  defined in paragraph (f), authorized under section 144A.071 or 
333.22  144A.073 after July 1, 1999, or any building project that is a 
333.23  relocation, renovation, upgrading, or conversion authorized 
333.24  under section 144A.073, completed on or after July 1, 2001, the 
333.25  replacement-costs-new per bed limit shall be $74,280 per 
333.26  licensed bed in multiple-bed rooms, $92,850 per licensed bed in 
333.27  semiprivate rooms with a fixed partition separating the resident 
333.28  beds, and $111,420 per licensed bed in single rooms.  Minnesota 
333.29  Rules, part 9549.0060, subpart 11, item C, subitem (2), does not 
333.30  apply.  These amounts must be adjusted annually as specified in 
333.31  subdivision 3f, paragraph (a), beginning January 1, 2000.  
333.32     (h) For a total replacement, as defined in paragraph (f), 
333.33  authorized under section 144A.073 for a 96-bed nursing home in 
333.34  Carlton county, the replacement-costs-new per bed limit shall be 
333.35  $74,280 per licensed bed in multiple-bed rooms, $92,850 per 
333.36  licensed bed in semiprivate rooms with a fixed partition 
334.1   separating the resident's beds, and $111,420 per licensed bed in 
334.2   a single room.  Minnesota Rules, part 9549.0060, subpart 11, 
334.3   item C, subitem (2), does not apply.  The resulting maximum 
334.4   allowable replacement-costs-new multiplied by 1.25 shall 
334.5   constitute the project's dollar threshold for purposes of 
334.6   application of the limit set forth in section 144A.071, 
334.7   subdivision 2.  The commissioner of health may waive the 
334.8   requirements of section 144A.073, subdivision 3b, paragraph (b), 
334.9   clause (2), on the condition that the other requirements of that 
334.10  paragraph are met. 
334.11     (i) For a renovation authorized under section 144A.073 for 
334.12  a 65-bed nursing home in St. Louis county, the incremental 
334.13  increase in rental rate for purposes of paragraph (d) shall be 
334.14  $8.16, and the total replacement cost, allowable appraised 
334.15  value, allowable debt, and allowable interest shall be increased 
334.16  according to the incremental increase. 
334.17     (j) For a total replacement, as defined in paragraph (f), 
334.18  authorized under section 144A.073 involving a new building 
334.19  addition that relocates beds from three-bed wards for an 80-bed 
334.20  nursing home in Redwood county, the replacement-costs-new per 
334.21  bed limit shall be $74,280 per licensed bed for multiple-bed 
334.22  rooms; $92,850 per licensed bed for semiprivate rooms with a 
334.23  fixed partition separating the beds; and $111,420 per licensed 
334.24  bed for single rooms.  These amounts shall be adjusted annually, 
334.25  beginning January 1, 2001.  Minnesota Rules, part 9549.0060, 
334.26  subpart 11, item C, subitem (2), does not apply.  The resulting 
334.27  maximum allowable replacement-costs-new multiplied by 1.25 shall 
334.28  constitute the project's dollar threshold for purposes of 
334.29  application of the limit set forth in section 144A.071, 
334.30  subdivision 2.  The commissioner of health may waive the 
334.31  requirements of section 144A.073, subdivision 3b, paragraph (b), 
334.32  clause (2), on the condition that the other requirements of that 
334.33  paragraph are met. 
334.34     Sec. 22.  Minnesota Statutes 2000, section 256B.431, is 
334.35  amended by adding a subdivision to read: 
334.36     Subd. 31.  [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 
335.1   years beginning on or after July 1, 2001, the total payment rate 
335.2   for a facility reimbursed under this section, section 256B.434, 
335.3   or any other section for the first 90 days after admission shall 
335.4   be: 
335.5      (1) for the first 30 paid days, the rate shall be 120 
335.6   percent of the facility's medical assistance rate for each case 
335.7   mix class; and 
335.8      (2) for the next 60 days after the first 30 paid days, the 
335.9   rate shall be 110 percent of the facility's medical assistance 
335.10  rate for each case mix class. 
335.11     (b) Beginning with the 91st paid day after admission, the 
335.12  payment rate shall be the rate otherwise determined under this 
335.13  section, section 256B.434, or any other section. 
335.14     (c) This subdivision applies to admissions occurring on or 
335.15  after July 1, 2001. 
335.16     Sec. 23.  Minnesota Statutes 2000, section 256B.431, is 
335.17  amended by adding a subdivision to read: 
335.18     Subd. 32.  [NURSING FACILITY RATE INCREASES BEGINNING JULY 
335.19  1, 2001, AND JULY 1, 2002.] For the rate years beginning July 1, 
335.20  2001, and July 1, 2002, the commissioner shall provide to each 
335.21  nursing facility reimbursed under this section or section 
335.22  256B.434 an adjustment equal to 3.0 percent of the total 
335.23  operating payment rate.  The operating payment rates in effect 
335.24  on June 30, 2001, and June 30, 2002, respectively, shall include 
335.25  the adjustment in subdivision 2i, paragraph (c). 
335.26     Sec. 24.  Minnesota Statutes 2000, section 256B.431, is 
335.27  amended by adding a subdivision to read: 
335.28     Subd. 33.  [ADDITIONAL INCREASES FOR LOW RATE METROPOLITAN 
335.29  AREA FACILITIES.] After the calculation of the increase for the 
335.30  rate year beginning July 1, 2001, in subdivision 32, the 
335.31  commissioner must provide for special increases to facilities 
335.32  determined to be the lowest rate facilities in state development 
335.33  region 11, as defined in section 462.385.  Within this region, 
335.34  the commissioner shall identify the median nursing facility rate 
335.35  by case mix category for all nursing facilities under section 
335.36  256B.431 or 256B.434.  Nursing home rates that are below the 
336.1   median for case mix class A must be adjusted to the set of case 
336.2   mix rates for the facility at the median for case mix class A.  
336.3      Sec. 25.  Minnesota Statutes 2000, section 256B.431, is 
336.4   amended by adding a subdivision to read: 
336.5      Subd. 34.  [RATE FLOOR FOR FACILITIES LOCATED OUTSIDE THE 
336.6   METROPOLITAN AREA.] (a) For the rate year beginning July 1, 
336.7   2001, the commissioner shall adjust operating costs per diem for 
336.8   nursing facilities located outside of state development region 
336.9   11, as defined in section 462.385, reimbursed under this section 
336.10  and sections 256B.434 and 256B.435, as provided in this 
336.11  subdivision. 
336.12     (b) For each nursing facility, the commissioner shall 
336.13  compare the operating costs per diem listed in this paragraph to 
336.14  the operating costs per diem the facility would otherwise 
336.15  receive for the July 1, 2001, rate year after provision of any 
336.16  other rate increases required by this chapter. 
336.17       Case mix classification     Operating costs per diem
336.18                 A                         $ 67.02
336.19                 B                         $ 73.00
336.20                 C                         $ 79.77
336.21                 D                         $ 85.94
336.22                 E                         $ 92.32
336.23                 F                         $ 92.72
336.24                 G                         $ 98.13
336.25                 H                         $108.40
336.26                 I                         $112.03
336.27                 J                         $117.67
336.28                 K                         $129.55
336.29     (c) If a facility's total reimbursement for operating 
336.30  costs, using the case mix classification operating costs per 
336.31  diem listed in paragraph (b), is greater than the total 
336.32  reimbursement for operating costs the facility would otherwise 
336.33  receive, the commissioner shall calculate operating costs per 
336.34  diem for that facility for the rate year beginning July 1, 2001, 
336.35  using the case mix classification operating costs per diem 
336.36  listed in paragraph (b). 
337.1      (d) If a facility's total reimbursement for operating 
337.2   costs, using the case mix classification costs per diem listed 
337.3   in paragraph (b), is less than the total reimbursement for 
337.4   operating costs the facility would otherwise receive, the 
337.5   commissioner shall reimburse that facility for the rate year 
337.6   beginning July 1, 2001, as provided in this section, section 
337.7   256B.434, or 256B.435, whichever is applicable, and shall not 
337.8   calculate operating costs per diem for that facility using the 
337.9   case mix classification operating costs per diem listed in 
337.10  paragraph (b). 
337.11     Sec. 26.  Minnesota Statutes 2000, section 256B.431, is 
337.12  amended by adding a subdivision to read: 
337.13     Subd. 35.  [EXCLUSION OF RAW FOOD COST ADJUSTMENT.] For 
337.14  rate years beginning on or after July 1, 2001, in calculating a 
337.15  nursing facility's operating cost per diem for the purposes of 
337.16  constructing an array, determining a median, or otherwise 
337.17  performing a statistical measure of nursing facility payment 
337.18  rates to be used to determine future rate increases under this 
337.19  section, section 256B.434, or any other section, the 
337.20  commissioner shall exclude adjustments for raw food costs under 
337.21  subdivision 2b, paragraph (h), that are related to providing 
337.22  special diets based on religious beliefs. 
337.23     Sec. 27.  Minnesota Statutes 2000, section 256B.434, 
337.24  subdivision 4, is amended to read: 
337.25     Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
337.26  nursing facilities which have their payment rates determined 
337.27  under this section rather than section 256B.431, the 
337.28  commissioner shall establish a rate under this subdivision.  The 
337.29  nursing facility must enter into a written contract with the 
337.30  commissioner. 
337.31     (b) A nursing facility's case mix payment rate for the 
337.32  first rate year of a facility's contract under this section is 
337.33  the payment rate the facility would have received under section 
337.34  256B.431. 
337.35     (c) A nursing facility's case mix payment rates for the 
337.36  second and subsequent years of a facility's contract under this 
338.1   section are the previous rate year's contract payment rates plus 
338.2   an inflation adjustment and, for facilities reimbursed under 
338.3   this section or section 256B.431, an adjustment to include the 
338.4   cost of any increase in health department licensing fees for the 
338.5   facility taking effect on or after July 1, 2001.  The index for 
338.6   the inflation adjustment must be based on the change in the 
338.7   Consumer Price Index-All Items (United States City average) 
338.8   (CPI-U) forecasted by Data Resources, Inc., as forecasted in the 
338.9   fourth quarter of the calendar year preceding the rate year.  
338.10  The inflation adjustment must be based on the 12-month period 
338.11  from the midpoint of the previous rate year to the midpoint of 
338.12  the rate year for which the rate is being determined.  For the 
338.13  rate years beginning on July 1, 1999, and July 1, 2000, July 1, 
338.14  2001, and July 1, 2002, this paragraph shall apply only to the 
338.15  property-related payment rate, except that adjustments to 
338.16  include the cost of any increase in health department licensing 
338.17  fees taking effect on or after July 1, 2001, shall be provided.  
338.18  In determining the amount of the property-related payment rate 
338.19  adjustment under this paragraph, the commissioner shall 
338.20  determine the proportion of the facility's rates that are 
338.21  property-related based on the facility's most recent cost report.
338.22     (d) The commissioner shall develop additional 
338.23  incentive-based payments of up to five percent above the 
338.24  standard contract rate for achieving outcomes specified in each 
338.25  contract.  The specified facility-specific outcomes must be 
338.26  measurable and approved by the commissioner.  The commissioner 
338.27  may establish, for each contract, various levels of achievement 
338.28  within an outcome.  After the outcomes have been specified the 
338.29  commissioner shall assign various levels of payment associated 
338.30  with achieving the outcome.  Any incentive-based payment cancels 
338.31  if there is a termination of the contract.  In establishing the 
338.32  specified outcomes and related criteria the commissioner shall 
338.33  consider the following state policy objectives: 
338.34     (1) improved cost effectiveness and quality of life as 
338.35  measured by improved clinical outcomes; 
338.36     (2) successful diversion or discharge to community 
339.1   alternatives; 
339.2      (3) decreased acute care costs; 
339.3      (4) improved consumer satisfaction; 
339.4      (5) the achievement of quality; or 
339.5      (6) any additional outcomes proposed by a nursing facility 
339.6   that the commissioner finds desirable. 
339.7      Sec. 28.  Minnesota Statutes 2000, section 256B.434, is 
339.8   amended by adding a subdivision to read: 
339.9      Subd. 4c.  [FACILITY RATE INCREASES EFFECTIVE JANUARY 1, 
339.10  2002.] For the rate period beginning January 1, 2002, and for 
339.11  the rate year beginning July 1, 2002, a nursing facility in 
339.12  Morrison county licensed for 83 beds shall receive an increase 
339.13  of $2.54 in each case mix payment rate to offset property tax 
339.14  payments due as a result of the facility's conversion from 
339.15  nonprofit to for-profit status.  The increases under this 
339.16  subdivision shall be added following the determination under 
339.17  this chapter of the payment rate for the rate year beginning 
339.18  July 1, 2001, and shall be included in the facility's total 
339.19  payment rates for the purposes of determining future rates under 
339.20  this section or any other section. 
339.21     Sec. 29.  Minnesota Statutes 2000, section 256B.434, is 
339.22  amended by adding a subdivision to read: 
339.23     Subd. 4d.  [FACILITY RATE INCREASES EFFECTIVE JULY 1, 
339.24  2001.] For the rate year beginning July 1, 2001, a nursing 
339.25  facility in Hennepin county licensed for 302 beds shall receive 
339.26  an increase of 29 cents in each case mix payment rate to correct 
339.27  an error in the cost-reporting system that occurred prior to the 
339.28  date that the facility entered the alternative payment 
339.29  demonstration project.  The increases under this subdivision 
339.30  shall be added following the determination under this chapter of 
339.31  the payment rate for the rate year beginning July 1, 2001, and 
339.32  shall be included in the facility's total payment rates for the 
339.33  purposes of determining future rates under this section or any 
339.34  other section. 
339.35     Sec. 30.  Minnesota Statutes 2000, section 256B.434, is 
339.36  amended by adding a subdivision to read: 
340.1      Subd. 4e.  [RATE INCREASE EFFECTIVE JULY 1, 2001.] A 
340.2   nursing facility in Anoka county licensed for 98 beds as of July 
340.3   1, 2000, shall receive an increase of $10 in each case mix rate 
340.4   for the rate year beginning July 1, 2001.  The increases under 
340.5   this subdivision shall be added following the determination 
340.6   under this chapter of the payment rate for the rate year 
340.7   beginning July 1, 2001, and shall be included in the facility's 
340.8   total payment rate for purposes of determining future rates 
340.9   under this section or any other section through June 30, 2004. 
340.10     Sec. 31.  [256B.437] [IMPLEMENTATION OF A CASE MIX SYSTEM 
340.11  FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.] 
340.12     Subdivision 1.  [SCOPE.] This section establishes the 
340.13  method and criteria used to determine resident reimbursement 
340.14  classifications based upon the assessments of residents of 
340.15  nursing homes and boarding care homes whose payment rates are 
340.16  established under section 256B.431, 256B.434, or 256B.435.  
340.17  Resident reimbursement classifications shall be established 
340.18  according to the 34 group, resource utilization groups, version 
340.19  III or RUG-III model as described in section 144.0724.  
340.20  Reimbursement classifications established under this section 
340.21  shall be implemented after June 30, 2002, but no later than 
340.22  January 1, 2003. 
340.23     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
340.24  following terms have the meanings given. 
340.25     (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 
340.26  date" has the meaning given in section 144.0724, subdivision 2, 
340.27  paragraph (a). 
340.28     (b) [CASE MIX INDEX.] "Case mix index" has the meaning 
340.29  given in section 144.0724, subdivision 2, paragraph (b). 
340.30     (c) [INDEX MAXIMIZATION.] "Index maximization" has the 
340.31  meaning given in section 144.0724, subdivision 2, paragraph (c). 
340.32     (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning 
340.33  given in section 144.0724, subdivision 2, paragraph (d). 
340.34     (e) [REPRESENTATIVE.] "Representative" has the meaning 
340.35  given in section 144.0724, subdivision 2, paragraph (e). 
340.36     (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 
341.1   utilization groups" or "RUG" has the meaning given in section 
341.2   144.0724, subdivision 2, paragraph (f). 
341.3      Subd. 3.  [CASE MIX INDICES.] (a) The commissioner of human 
341.4   services shall assign a case mix index to each resident class 
341.5   based on the Health Care Financing Administration's staff time 
341.6   measurement study and adjusted for Minnesota-specific wage 
341.7   indices.  The case mix indices assigned to each resident class 
341.8   shall be published in the Minnesota State Register at least 120 
341.9   days prior to the implementation of the 34 group, RUG-III 
341.10  resident classification system. 
341.11     (b) An index maximization approach shall be used to 
341.12  classify residents. 
341.13     (c) After implementation of the revised case mix system, 
341.14  the commissioner of human services may annually rebase case mix 
341.15  indices and base rates using more current data on average wage 
341.16  rates and staff time measurement studies.  This rebasing shall 
341.17  be calculated under subdivision 7, paragraph (b).  The 
341.18  commissioner shall publish in the Minnesota State Register 
341.19  adjusted case mix indices at least 45 days prior to the 
341.20  effective date of the adjusted case mix indices. 
341.21     Subd. 4.  [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing 
341.22  facilities shall conduct and submit case mix assessments 
341.23  according to the schedule established by the commissioner of 
341.24  health under section 144.0724, subdivisions 4 and 5. 
341.25     (b) The resident reimbursement classifications established 
341.26  under section 144.0724, subdivision 3, shall be effective the 
341.27  day of admission for new admission assessments.  The effective 
341.28  date for significant change assessments shall be the assessment 
341.29  reference date.  The effective date for annual and second 
341.30  quarterly assessments shall be the first day of the month 
341.31  following assessment reference date. 
341.32     Subd. 5.  [NOTICE OF RESIDENT REIMBURSEMENT 
341.33  CLASSIFICATION.] Nursing facilities shall provide notice to a 
341.34  resident of the resident's case mix classification according to 
341.35  procedures established by the commissioner of health under 
341.36  section 144.0724, subdivision 7. 
342.1      Subd. 6.  [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any 
342.2   request for reconsideration of a resident classification must be 
342.3   made under section 144.0724, subdivision 8. 
342.4      Subd. 7.  [RATE DETERMINATION UPON TRANSITION TO RUG-III 
342.5   PAYMENT RATES.] (a) The commissioner of human services shall 
342.6   determine payment rates at the time of transition to the RUG 
342.7   based payment model in a facility-specific, budget-neutral 
342.8   manner.  The case mix indices as defined in subdivision 3 shall 
342.9   be used to allocate the case mix adjusted component of total 
342.10  payment across all case mix groups.  To transition from the 
342.11  current calculation methodology to the RUG based methodology, 
342.12  the commissioner of health shall report to the commissioner of 
342.13  human services the resident days classified according to the 
342.14  categories defined in subdivision 3 for the 12-month reporting 
342.15  period ending September 30, 2001, for each nursing facility.  
342.16  The commissioner of human services shall use this data to 
342.17  compute the standardized days for the reporting period under the 
342.18  RUG system. 
342.19     (b) The commissioner of human services shall determine the 
342.20  case mix adjusted component of the rate as follows: 
342.21     (1) determine the case mix portion of the 11 case mix rates 
342.22  in effect on June 30, 2002, or the 34 case mix rates in effect 
342.23  on or after June 30, 2003; 
342.24     (2) multiply each amount in clause (1) by the number of 
342.25  resident days assigned to each group for the reporting period 
342.26  ending September 30, 2001, or the most recent year for which 
342.27  data is available; 
342.28     (3) compute the sum of the amounts in clause (2); 
342.29     (4) determine the total RUG standardized days for the 
342.30  reporting period ending September 30, 2001, or the most recent 
342.31  year for which data is available using new indices calculated 
342.32  under subdivision 3, paragraph (c); 
342.33     (5) divide the amount in clause (3) by the amount in clause 
342.34  (4) which shall be the average case mix adjusted component of 
342.35  the rate under the RUG method; and 
342.36     (6) multiply this average rate by the case mix weight in 
343.1   subdivision 3 for each RUG group. 
343.2      (c) The noncase mix component will be allocated to each RUG 
343.3   group as a constant amount to determine the transition payment 
343.4   rate.  Any other rate adjustments that are effective on or after 
343.5   July 1, 2002, shall be applied to the transition rates 
343.6   determined under this section. 
343.7      Sec. 32.  [256B.4371] [NURSING FACILITY VOLUNTARY CLOSURES 
343.8   AND PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.] 
343.9      Subdivision 1.  [DEFINITIONS.] (a) The definitions in this 
343.10  subdivision apply to subdivisions 2 to 9. 
343.11     (b) "Closure" means the cessation of operations of a 
343.12  nursing facility and delicensure and decertification of all beds 
343.13  within the facility. 
343.14     (c) "Commencement of closure" means the date on which 
343.15  residents and designated representatives are notified of a 
343.16  planned closure according to sections 144A.185 to 144A.1887 as 
343.17  part of an approved closure plan. 
343.18     (d) "Completion of closure" means the date on which the 
343.19  final resident of the nursing facility or nursing facilities 
343.20  designated for closure in an approved closure plan is discharged 
343.21  from the facility or facilities. 
343.22     (e) "Closure plan" means a plan to close a nursing facility 
343.23  and reallocate the resulting savings to provide planned closure 
343.24  rate adjustments at other facilities. 
343.25     (f) "Partial closure" means the delicensure and 
343.26  decertification of a portion of the beds within the facility. 
343.27     (g) "Planned closure rate adjustment" means an increase in 
343.28  a nursing facility's operating rates resulting from a partial 
343.29  planned closure of a facility or a planned closure of another 
343.30  facility.  
343.31     Subd. 2.  [PLANNING AND DEVELOPMENT OF COMMUNITY BASED 
343.32  SERVICES.] (a) The commissioner of human services shall 
343.33  establish a process to adjust the capacity and distribution of 
343.34  long-term care services to equalize the supply and demand for 
343.35  different types of services.  This process must include 
343.36  community planning, expansion or establishment of needed 
344.1   services, and analysis of voluntary nursing facility closures. 
344.2      (b) The purpose of this process is to support the planning 
344.3   and development of community-based services.  This process must 
344.4   support early intervention, advocacy, and consumer protection 
344.5   while providing resources and incentives for expanded county 
344.6   planning and for nursing facilities to transition to meet 
344.7   community needs. 
344.8      (c) The process shall support and facilitate expansion of 
344.9   community-based services under the county-administered 
344.10  alternative care program under section 256B.0913 and waivers for 
344.11  elderly under section 256B.0915, including the development of 
344.12  supportive services such as housing and transportation.  The 
344.13  process shall utilize community assessments and planning 
344.14  developed for the community health services plan and plan update 
344.15  and for the community social services act plan. 
344.16     (d) The addendum to the biennial plan shall be submitted 
344.17  annually, beginning in 2001, and shall include recommendations 
344.18  for development of community-based services.  Both planning and 
344.19  implementation shall be implemented within the amount of funding 
344.20  made available to the county board for these purposes. 
344.21     (e) The commissioner of health and the commissioner of 
344.22  human services, as appropriate, shall provide available data 
344.23  necessary for the county, including but not limited to data on 
344.24  nursing facility bed distribution, housing with services 
344.25  options, the closure of nursing facilities that occur outside of 
344.26  the planned closure process, and approval of planned closures in 
344.27  the county and contiguous counties. 
344.28     (f) The plan, within the funding allocated, shall: 
344.29     (1) identify the need for services based on demographic 
344.30  data, service availability, caseload information, and provider 
344.31  information; 
344.32     (2) involve providers, consumers, cities, townships, 
344.33  businesses, and area agencies on aging in the planning process; 
344.34     (3) address the availability of alternative care and 
344.35  elderly waiver services for eligible recipients; 
344.36     (4) address the development of other supportive services, 
345.1   such as transit, housing, and workforce and economic 
345.2   development; and 
345.3      (5) estimate the cost and timelines for development. 
345.4      (g) The biennial plan addendum shall be coordinated with 
345.5   the county mental health plan for inclusion in the community 
345.6   health services plan and included as an addendum to the 
345.7   community social services plan. 
345.8      (h) The county board having financial responsibility for 
345.9   persons present in another county shall cooperate with that 
345.10  county for planning and development of services. 
345.11     (i) The county board shall cooperate in planning and 
345.12  development of community based services with other counties, as 
345.13  necessary, and coordinate planning for long-term care services 
345.14  that involve more than one county, within the funding allocated 
345.15  for these purposes. 
345.16     (j) The commissioners of health and human services, in 
345.17  cooperation with county boards, shall report to the legislature 
345.18  by February 1 of each year, beginning February 1, 2002, 
345.19  regarding the development of community based services, 
345.20  transition or closure of nursing facilities, and consumer 
345.21  outcomes achieved, as documented by each county and reported to 
345.22  the commissioner by December 31 of each year. 
345.23     (k) The process established by the commissioner of human 
345.24  services shall ensure: 
345.25     (1) that counties consider multicounty service areas in 
345.26  developing services that may impact delivery efficiencies; and 
345.27     (2) review and comment by the area agencies on aging, 
345.28  regional development commissions, where they exist, and other 
345.29  planning agencies of the biennial plan addendum. 
345.30     Subd. 3.  [REQUEST FOR APPLICATIONS FOR PLANNED CLOSURE OF 
345.31  NURSING FACILITIES.] (a) By July 15, 2001, the commissioner of 
345.32  human services shall implement and announce a program for 
345.33  closure or partial closure of nursing facilities.  Names and 
345.34  identifying information provided in response to the announcement 
345.35  shall remain private unless approved, according to the timelines 
345.36  established in the plan.  The announcement must specify: 
346.1      (1) the criteria that will be used by the interagency 
346.2   long-term care planning committee established under section 
346.3   144A.31 and the commissioner to approve or reject applications; 
346.4      (2) a requirement for the submission of a letter of intent 
346.5   before the submission of an application; 
346.6      (3) the information that must accompany an application; 
346.7      (4) a schedule for letters of intent, applications, and 
346.8   consideration of applications for a minimum of four review 
346.9   processes to be conducted before June 30, 2003; and 
346.10     (5) that applications may combine planned closure rate 
346.11  adjustments with moratorium exception funding, in which case a 
346.12  single application may serve both purposes. 
346.13  Between October 1, 2001, and June 30, 2003, the commissioner 
346.14  shall approve planned closures of at least 5,140 nursing 
346.15  facility beds, with no more than 2,070 approved for closure 
346.16  prior to July 1, 2002, less the number of licensed beds in 
346.17  facilities that close during the same time period without 
346.18  approved closure plans or have notified the commissioner of 
346.19  health of their intent to close without an approved closure plan.
346.20     (b) A facility or facilities reimbursed under section 
346.21  256B.431, 256B.434, or 256B.435 with a closure plan approved by 
346.22  the commissioner under subdivision 6 may assign a planned 
346.23  closure rate adjustment to another facility that is not closing 
346.24  or facilities that are not closing, or in the case of a partial 
346.25  closure, to the facility undertaking the partial closure.  A 
346.26  facility may also elect to have a planned closure rate 
346.27  adjustment shared equally by the five nursing facilities with 
346.28  the lowest total operating payment rates in the state 
346.29  development region, designated under section 462.385, in which 
346.30  the facility receiving the planned closure rate adjustment is 
346.31  located.  The planned closure rate adjustment must be calculated 
346.32  under subdivision 7.  A planned closure rate adjustment under 
346.33  this section is effective on the first day of the month 
346.34  following completion of closure of all facilities designated for 
346.35  closure in the application and becomes part of the nursing 
346.36  facility's total operating payment rate. 
347.1      Applicants may use the planned closure rate adjustment to 
347.2   allow for a property payment for a new nursing facility or an 
347.3   addition to an existing nursing facility.  Applications approved 
347.4   under this paragraph are exempt from other requirements for 
347.5   moratorium exceptions under section 144A.073, subdivisions 2 and 
347.6   3.  
347.7      Facilities without a closure plan, or whose closure plan is 
347.8   not approved by the commissioner, are not eligible for a planned 
347.9   closure rate adjustment under subdivision 7.  However, the 
347.10  commissioner shall calculate the amount the facility would have 
347.11  received under subdivision 7 and shall use this amount to 
347.12  provide equal rate adjustments to the five nursing facilities 
347.13  with the lowest total operating payment rates in the state 
347.14  development region, designated under section 462.385, in which 
347.15  the facility is located. 
347.16     (c) To be considered for approval, an application must 
347.17  include: 
347.18     (1) a description of the proposed closure plan, which must 
347.19  include identification of the facility or facilities to receive 
347.20  a planned closure rate adjustment and the amount and timing of a 
347.21  planned closure rate adjustment proposed for each facility; 
347.22     (2) the proposed timetable for any proposed closure, 
347.23  including the proposed dates for announcement to residents, 
347.24  commencement of closure, and completion of closure; 
347.25     (3) the proposed relocation plan for current residents of 
347.26  any facility designated for closure.  The proposed relocation 
347.27  plan must be designed to comply with all applicable state and 
347.28  federal statutes and regulations, including, but not limited to, 
347.29  section 144A.16 and Minnesota Rules, parts 4655.6810 to 
347.30  4655.6830, 4658.1600 to 4658.1690, and 9546.0010 to 9546.0060; 
347.31     (4) a description of the relationship between the nursing 
347.32  facility that is proposed for closure and the nursing facility 
347.33  or facilities proposed to receive the planned closure rate 
347.34  adjustment.  If these facilities are not under common ownership, 
347.35  copies of any contracts, purchase agreements, or other documents 
347.36  establishing a relationship or proposed relationship must be 
348.1   provided; 
348.2      (5) documentation, in a format approved by the 
348.3   commissioner, that all the nursing facilities receiving a 
348.4   planned closure rate adjustment under the plan have accepted 
348.5   joint and several liability for recovery of overpayments under 
348.6   section 256B.0641, subdivision 2, for the facilities designated 
348.7   for closure under the plan; and 
348.8      (6) an explanation of how the application coordinates with 
348.9   planning efforts under subdivision 2. 
348.10     (d) The application must address the criteria listed in 
348.11  subdivision 4. 
348.12     Subd. 4.  [CRITERIA FOR REVIEW OF APPLICATION.] In 
348.13  reviewing and approving closure proposals, the commissioner 
348.14  shall consider, but not be limited to, the following criteria: 
348.15     (1) improved quality of care and quality of life for 
348.16  consumers; 
348.17     (2) closure of a nursing facility that has a poor physical 
348.18  plant; 
348.19     (3) the existence of excess nursing facility beds, measured 
348.20  in terms of beds per thousand persons aged 85 or older.  The 
348.21  excess must be measured in reference to: 
348.22     (i) the county in which the facility is located; 
348.23     (ii) the county and all contiguous counties; 
348.24     (iii) the region in which the facility is located; or 
348.25     (iv) the facility's service area. 
348.26  The facility shall indicate in its proposal the area it believes 
348.27  is appropriate for this measurement.  A facility in a county 
348.28  that is in the lowest quartile of counties with reference to 
348.29  beds per thousand persons aged 85 or older is not in an area of 
348.30  excess capacity; 
348.31     (4) low-occupancy rates, provided that the unoccupied beds 
348.32  are not the result of a personnel shortage.  In analyzing 
348.33  occupancy rates, the commissioner shall examine waiting lists in 
348.34  the applicant facility and at facilities in the surrounding 
348.35  area, as determined under clause (3); 
348.36     (5) evidence of a community planning process to determine 
349.1   what services are needed and ensure that needed services are 
349.2   established; 
349.3      (6) innovative use of reinvestment funds; 
349.4      (7) innovative use planned for the closed facility's 
349.5   physical plant; 
349.6      (8) evidence that the proposal serves the interests of the 
349.7   state; and 
349.8      (9) evidence of other factors that affect the viability of 
349.9   the facility, including excessive nursing pool costs. 
349.10     Subd. 5.  [REVIEW AND APPROVAL OF PROPOSALS.] (a) The 
349.11  interagency long-term care planning committee may recommend that 
349.12  the commissioner of human services grant approval, within the 
349.13  limits established in subdivision 3, paragraph (a), to 
349.14  applications that satisfy the requirements of this section.  The 
349.15  interagency committee may appoint an advisory review panel 
349.16  composed of representatives of counties, SAIL projects, 
349.17  consumers, and providers to review proposals and provide 
349.18  comments and recommendations to the committee.  The 
349.19  commissioners of human services and health shall provide staff 
349.20  and technical assistance to the committee for the review and 
349.21  analysis of proposals.  The commissioners of human services and 
349.22  health shall jointly approve or disapprove an application within 
349.23  30 days after receiving the committee's recommendations. 
349.24     (b) Approval of a planned closure expires 18 months after 
349.25  approval by the commissioner of human services, unless 
349.26  commencement of closure has begun. 
349.27     (c) The commissioner of human services may change any 
349.28  provision of the application to which all parties agree. 
349.29     Subd. 6.  [PLANNED CLOSURE RATE ADJUSTMENT.] The 
349.30  commissioner of human services shall calculate the amount of the 
349.31  planned closure rate adjustment available under subdivision 3, 
349.32  paragraph (b), according to clauses (1) to (4): 
349.33     (1) the amount available is the net reduction of nursing 
349.34  facility beds multiplied by $2,080; 
349.35     (2) the total number of beds in the nursing facility 
349.36  receiving the planned closure rate adjustment must be 
350.1   identified; 
350.2      (3) capacity days are determined by multiplying the number 
350.3   determined under clause (2) by 365; and 
350.4      (4) the planned closure rate adjustment is the amount 
350.5   available in clause (1), divided by capacity days determined 
350.6   under clause (3). 
350.7      Subd. 7.  [OTHER RATE ADJUSTMENTS.] Facilities receiving 
350.8   planned closure rate adjustments remain eligible for any 
350.9   applicable rate adjustments provided under section 256B.431, 
350.10  256B.434, or any other section. 
350.11     Subd. 8.  [COUNTY COSTS.] The commissioner of human 
350.12  services shall allocate up to $500 per nursing facility bed that 
350.13  is closing, within the limits of the appropriation specified for 
350.14  this purpose, to be used for relocation costs incurred by 
350.15  counties for planned closures under this section or resident 
350.16  relocation under sections 144A.185 to 144A.1887.  To be eligible 
350.17  for this allocation, a county in which a nursing facility closes 
350.18  must provide to the commissioner a detailed statement in a form 
350.19  provided by the commissioner of additional costs, not to exceed 
350.20  $500 per bed closed, that are directly incurred related to the 
350.21  county's required role in the relocation process. 
350.22     Sec. 33.  Minnesota Statutes 2000, section 256B.501, is 
350.23  amended by adding a subdivision to read: 
350.24     Subd. 14.  [ICF/MR RATE INCREASES BEGINNING JULY 1, 2001, 
350.25  AND JULY 1, 2002.] (a) For the rate periods beginning July 1, 
350.26  2001, and July 1, 2002, the commissioner shall make available to 
350.27  each facility reimbursed under this section, section 256B.5011, 
350.28  and Laws 1993, First Special Session chapter 1, article 4, 
350.29  section 11, an adjustment to the total operating payment rate of 
350.30  3.0 percent. 
350.31     (b) For each facility, the commissioner shall determine the 
350.32  payment rate adjustment using the percentage specified in 
350.33  paragraph (a) multiplied by the total operating payment rate in 
350.34  effect on the last day of the prior rate year, and dividing the 
350.35  resulting amount by the facility's actual resident days.  The 
350.36  total operating payment rate shall include the adjustment 
351.1   provided in subdivision 12. 
351.2      (c) Any facility whose payment rates are governed by 
351.3   closure agreements, receivership agreements, or Minnesota Rules, 
351.4   part 9553.0075, is not eligible for an adjustment otherwise 
351.5   granted under this subdivision.  
351.6      Sec. 34.  Minnesota Statutes 2000, section 256B.76, is 
351.7   amended to read: 
351.8      256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
351.9      (a) Effective for services rendered on or after October 1, 
351.10  1992, the commissioner shall make payments for physician 
351.11  services as follows: 
351.12     (1) payment for level one Health Care Finance 
351.13  Administration's common procedural coding system (HCPCS) codes 
351.14  titled "office and other outpatient services," "preventive 
351.15  medicine new and established patient," "delivery, antepartum, 
351.16  and postpartum care," "critical care," Caesarean cesarean 
351.17  delivery and pharmacologic management provided to psychiatric 
351.18  patients, and HCPCS level three codes for enhanced services for 
351.19  prenatal high risk, shall be paid at the lower of (i) submitted 
351.20  charges, or (ii) 25 percent above the rate in effect on June 30, 
351.21  1992.  If the rate on any procedure code within these categories 
351.22  is different than the rate that would have been paid under the 
351.23  methodology in section 256B.74, subdivision 2, then the larger 
351.24  rate shall be paid; 
351.25     (2) payments for all other services shall be paid at the 
351.26  lower of (i) submitted charges, or (ii) 15.4 percent above the 
351.27  rate in effect on June 30, 1992; 
351.28     (3) all physician rates shall be converted from the 50th 
351.29  percentile of 1982 to the 50th percentile of 1989, less the 
351.30  percent in aggregate necessary to equal the above increases 
351.31  except that payment rates for home health agency services shall 
351.32  be the rates in effect on September 30, 1992; 
351.33     (4) effective for services rendered on or after January 1, 
351.34  2000, payment rates for physician and professional services 
351.35  shall be increased by three percent over the rates in effect on 
351.36  December 31, 1999, except for home health agency and family 
352.1   planning agency services; and 
352.2      (5) the increases in clause (4) shall be implemented 
352.3   January 1, 2000, for managed care. 
352.4      (b) Effective for services rendered on or after October 1, 
352.5   1992, the commissioner shall make payments for dental services 
352.6   as follows: 
352.7      (1) dental services shall be paid at the lower of (i) 
352.8   submitted charges, or (ii) 25 percent above the rate in effect 
352.9   on June 30, 1992; 
352.10     (2) dental rates shall be converted from the 50th 
352.11  percentile of 1982 to the 50th percentile of 1989, less the 
352.12  percent in aggregate necessary to equal the above increases; 
352.13     (3) effective for services rendered on or after January 1, 
352.14  2000, payment rates for dental services shall be increased by 
352.15  three percent over the rates in effect on December 31, 1999; 
352.16     (4) the commissioner shall award grants to community 
352.17  clinics or other nonprofit community organizations, political 
352.18  subdivisions, professional associations, or other organizations 
352.19  that demonstrate the ability to provide dental services 
352.20  effectively to public program recipients.  Grants may be used to 
352.21  fund the costs related to coordinating access for recipients, 
352.22  developing and implementing patient care criteria, upgrading or 
352.23  establishing new facilities, acquiring furnishings or equipment, 
352.24  recruiting new providers, or other development costs that will 
352.25  improve access to dental care in a region.  In awarding grants, 
352.26  the commissioner shall give priority to applicants that plan to 
352.27  serve areas of the state in which the number of dental providers 
352.28  is not currently sufficient to meet the needs of recipients of 
352.29  public programs or uninsured individuals.  The commissioner 
352.30  shall consider the following in awarding the grants:  (i) 
352.31  potential to successfully increase access to an underserved 
352.32  population; (ii) the ability to raise matching funds; (iii) the 
352.33  long-term viability of the project to improve access beyond the 
352.34  period of initial funding; (iv) the efficiency in the use of the 
352.35  funding; and (v) the experience of the proposers in providing 
352.36  services to the target population. 
353.1      The commissioner shall monitor the grants and may terminate 
353.2   a grant if the grantee does not increase dental access for 
353.3   public program recipients.  The commissioner shall consider 
353.4   grants for the following: 
353.5      (i) implementation of new programs or continued expansion 
353.6   of current access programs that have demonstrated success in 
353.7   providing dental services in underserved areas; 
353.8      (ii) a pilot program for utilizing hygienists outside of a 
353.9   traditional dental office to provide dental hygiene services; 
353.10  and 
353.11     (iii) a program that organizes a network of volunteer 
353.12  dentists, establishes a system to refer eligible individuals to 
353.13  volunteer dentists, and through that network provides donated 
353.14  dental care services to public program recipients or uninsured 
353.15  individuals. 
353.16     (5) beginning October 1, 1999, the payment for tooth 
353.17  sealants and fluoride treatments shall be the lower of (i) 
353.18  submitted charge, or (ii) 80 percent of median 1997 charges; and 
353.19     (6) the increases listed in clauses (3) and (5) shall be 
353.20  implemented January 1, 2000, for managed care. 
353.21     (c) An entity that operates both a Medicare certified 
353.22  comprehensive outpatient rehabilitation facility and a facility 
353.23  which was certified prior to January 1, 1993, that is licensed 
353.24  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
353.25  whom at least 33 percent of the clients receiving rehabilitation 
353.26  services and mental health services in the most recent calendar 
353.27  year are medical assistance recipients, shall be reimbursed by 
353.28  the commissioner for rehabilitation services and mental health 
353.29  services at rates that are 38 percent greater than the maximum 
353.30  reimbursement rate allowed under paragraph (a), clause (2), when 
353.31  those services are (1) provided within the comprehensive 
353.32  outpatient rehabilitation facility and (2) provided to residents 
353.33  of nursing facilities owned by the entity. 
353.34     Sec. 35.  Laws 1995, chapter 207, article 3, section 21, as 
353.35  amended by Laws 1999, chapter 245, article 3, section 43, is 
353.36  amended to read:  
354.1      Sec. 21.  [FACILITY CERTIFICATION.] 
354.2      (a) Notwithstanding Minnesota Statutes, section 252.291, 
354.3   subdivisions 1 and 2, the commissioner of health shall inspect 
354.4   to certify a large community-based facility currently licensed 
354.5   under Minnesota Rules, parts 9525.0215 to 9525.0355, for more 
354.6   than 16 beds and located in Northfield.  The facility may be 
354.7   certified for up to 44 beds.  The commissioner of health must 
354.8   inspect to certify the facility as soon as possible after the 
354.9   effective date of this section.  The commissioner of human 
354.10  services shall work with the facility and affected counties to 
354.11  relocate any current residents of the facility who do not meet 
354.12  the admission criteria for an ICF/MR.  Until January 1, 1999, in 
354.13  order to fund the ICF/MR services and relocations of current 
354.14  residents authorized, the commissioner of human services may 
354.15  transfer on a quarterly basis to the medical assistance account 
354.16  from each affected county's community social service allocation, 
354.17  an amount equal to the state share of medical assistance 
354.18  reimbursement for the residential and day habilitation services 
354.19  funded by medical assistance and provided to clients for whom 
354.20  the county is financially responsible.  
354.21     (b) After January 1, 1999, the commissioner of human 
354.22  services shall fund the services under the state medical 
354.23  assistance program and may transfer on a quarterly basis to the 
354.24  medical assistance account from each affected county's community 
354.25  social service allocation, an amount equal to one-half of the 
354.26  state share of medical assistance reimbursement for the 
354.27  residential and day habilitation services funded by medical 
354.28  assistance and provided to clients for whom the county is 
354.29  financially responsible.  
354.30     (c) Effective July 1, 2001, the commissioner of human 
354.31  services shall fund the entire state share of medical assistance 
354.32  reimbursement for the residential and day habilitation services 
354.33  funded by medical assistance and provided to clients for whom 
354.34  counties are financially responsible from the medical assistance 
354.35  account, and shall not make any transfer from the community 
354.36  social service allocations of affected counties.  
355.1      (d) For nonresidents of Minnesota seeking admission to the 
355.2   facility, Rice county shall be notified in order to assure that 
355.3   appropriate funding is guaranteed from their state or country of 
355.4   residence. 
355.5      Sec. 36.  Laws 1999, chapter 245, article 3, section 45, as 
355.6   amended by Laws 2000, chapter 312, section 3, is amended to read:
355.7      Sec. 45.  [STATE LICENSURE CONFLICTS WITH FEDERAL 
355.8   REGULATIONS.] 
355.9      (a) Notwithstanding the provisions of Minnesota Rules, part 
355.10  4658.0520, an incontinent resident must be checked according to 
355.11  a specific time interval written in the resident's care plan.  
355.12  The resident's attending physician must authorize in writing any 
355.13  interval longer than two hours unless the resident, if 
355.14  competent, or a family member or legally appointed conservator, 
355.15  guardian, or health care agent of a resident who is not 
355.16  competent, agrees in writing to waive physician involvement in 
355.17  determining this interval. 
355.18     (b) This section expires July 1, 2001 2003. 
355.19     Sec. 37.  [DEVELOPMENT OF NEW NURSING FACILITY 
355.20  REIMBURSEMENT SYSTEM.] 
355.21     (a) The commissioner of human services shall develop and 
355.22  report to the legislature by January 15, 2003, a system to 
355.23  replace the current nursing facility reimbursement system 
355.24  established under Minnesota Statutes, sections 256B.431, 
355.25  256B.434, and 256B.435. 
355.26     (b) The system must be developed in consultation with the 
355.27  long-term care task force and with representatives of consumers, 
355.28  providers, and labor unions.  Within the limits of available 
355.29  appropriations, the commissioner may employ consultants to 
355.30  assist with this project. 
355.31     (c) The new reimbursement system must: 
355.32     (1) provide incentives to enhance quality of life and 
355.33  quality of care; 
355.34     (2) recognize cost differences in the care of different 
355.35  types of populations, including subacute care and dementia care; 
355.36     (3) establish rates that are sufficient without being 
356.1   excessive; 
356.2      (4) be affordable for the state and for private-pay 
356.3   residents; 
356.4      (5) be sensitive to changing conditions in the long-term 
356.5   care environment; 
356.6      (6) avoid creating access problems related to insufficient 
356.7   funding; 
356.8      (7) allow providers maximum flexibility in their business 
356.9   operations; 
356.10     (8) recognize the need for capital investment to improve 
356.11  physical plants; and 
356.12     (9) provide incentives for the development and use of 
356.13  private rooms. 
356.14     (d) Notwithstanding Minnesota Statutes, section 256B.435, 
356.15  the commissioner must not implement a performance-based 
356.16  contracting system for nursing facilities prior to July 1, 2003. 
356.17  The commissioner shall continue to reimburse nursing facilities 
356.18  under Minnesota Statutes, section 256B.431 or 256B.434, until 
356.19  otherwise directed by law. 
356.20     (e) The commissioner of human services, in consultation 
356.21  with the commissioner of health, shall conduct or contract for a 
356.22  time study to determine staff time being spent on various case 
356.23  mix categories; recommend adjustments to the case mix weights 
356.24  based on the time study data; and determine whether current 
356.25  staffing standards are adequate for providing quality care based 
356.26  on professional best practice and consumer experience.  If the 
356.27  commissioner determines the current standards are inadequate, 
356.28  the commissioner shall determine an appropriate staffing 
356.29  standard for the various case mix categories and the financial 
356.30  implications of phasing into this standard over the next four 
356.31  years. 
356.32     Sec. 38.  [REPORT ON STANDARDS FOR SUBACUTE CARE FACILITY 
356.33  LICENSURE.] 
356.34     By January 15, 2003, the commissioner of health shall 
356.35  submit a report to the legislature on implementation of a 
356.36  licensure program for subacute care.  This report must include: 
357.1      (1) definitions of subacute care and applicability of the 
357.2   proposed licensure program to various types of licensed 
357.3   facilities; 
357.4      (2) an analysis of whether specific standards for subacute 
357.5   levels of care need to be developed and the potential for 
357.6   increased costs for existing providers of subacute care; 
357.7      (3) recommendations on the applicability of the nursing 
357.8   home moratorium law to the licensure of subacute care facilities 
357.9   or programs; 
357.10     (4) identification of federal regulations guiding the 
357.11  provision of subacute care and whether further state standards 
357.12  are needed; and 
357.13     (5) identification of current and potential reimbursement 
357.14  for subacute care under Medicare, Medicaid, or managed care 
357.15  programs. 
357.16     Sec. 39.  [REGULATORY FLEXIBILITY.] 
357.17     (a) By July 1, 2001, the commissioners of health and human 
357.18  services shall: 
357.19     (1) develop a summary of federal nursing facility and 
357.20  community long-term care regulations that hamper state 
357.21  flexibility and place burdens on the goal of achieving 
357.22  high-quality care and optimum outcomes for consumers of 
357.23  services; and 
357.24     (2) share this summary with the legislature, other states, 
357.25  national groups that advocate for state interests with Congress, 
357.26  and the Minnesota congressional delegation. 
357.27     (b) The commissioners shall conduct ongoing follow-up with 
357.28  the entities to which this summary is provided and with the 
357.29  health care financing administration to achieve maximum 
357.30  regulatory flexibility, including the possibility of pilot 
357.31  projects to demonstrate regulatory flexibility on less than a 
357.32  statewide basis. 
357.33     Sec. 40.  [REPORT.] 
357.34     By January 15, 2003, the commissioner of health and the 
357.35  commissioner of human services shall report to the senate health 
357.36  and family security committee and the house health and human 
358.1   services policy committee on the number of closures that have 
358.2   taken place under Minnesota Statutes, section 256B.437, and any 
358.3   other nursing facility closures that may have taken place, 
358.4   alternatives to nursing facility care that have been developed, 
358.5   any problems with access to long-term care services that have 
358.6   resulted, and any recommendations for continuation of the 
358.7   regional long-term care planning process and the closure process 
358.8   after June 30, 2003. 
358.9      Sec. 41.  [NURSING ASSISTANT; HOME HEALTH AIDE CURRICULUM.] 
358.10     By January 1, 2003, the commissioner of health, in 
358.11  consultation with long-term care consumers, advocates, unions, 
358.12  and trade associations, shall present to the chairs of the 
358.13  legislative committees dealing with health care policy 
358.14  recommendations for updating the nursing assistant and home 
358.15  health aide curriculum (1998 edition) to help students learn 
358.16  front-line survival skills that support job motivation and 
358.17  satisfaction.  These skills include, but are not limited to, 
358.18  working with challenging behaviors, communication skills, stress 
358.19  management including the impact of personal life stress in the 
358.20  work setting, building relationships with families, cultural 
358.21  competencies, and working with death and dying. 
358.22     Sec. 42.  [EVALUATION OF REPORTING REQUIREMENTS.] 
358.23     The commissioners of human services and health, in 
358.24  consultation with interested parties, shall evaluate long-term 
358.25  care provider reporting requirements, balancing the need for 
358.26  public accountability with the need to reduce unnecessary 
358.27  paperwork, and shall eliminate unnecessary reporting 
358.28  requirements, seeking any necessary changes in federal and state 
358.29  law.  The commissioners shall present a progress report by 
358.30  February 1, 2002, to the chairs of the house and senate 
358.31  committees with jurisdiction over health and human services 
358.32  policy and finance. 
358.33     Sec. 43.  [NURSING FACILITY MULTIPLE SCLEROSIS PILOT 
358.34  PROJECT.] 
358.35     (a) For the period from July 1, 2001, to June 30, 2003, the 
358.36  commissioner of human services shall establish and implement a 
359.1   pilot project to contract with nursing facilities eligible to 
359.2   receive medical assistance payments that, at the time of 
359.3   enrollment in the pilot project, serve ten or more persons with 
359.4   a diagnosis of multiple sclerosis.  The commissioner shall 
359.5   negotiate a payment rate with eligible facilities to provide 
359.6   services to persons with multiple sclerosis that must not exceed 
359.7   150 percent of the person's case mix classification payment rate 
359.8   for that facility.  The commissioner may contract with up to six 
359.9   nursing facilities. 
359.10     (b) Facilities may enroll in the pilot project between July 
359.11  1, 2001, and December 31, 2001. 
359.12     (c) The commissioner shall evaluate the additional payments 
359.13  made under the pilot project to determine if the adjustment 
359.14  enables participating facilities to adequately meet the needs 
359.15  for individual care and specialized programming, including 
359.16  programs to meet psychosocial, physiological, and case 
359.17  management needs, without incurring financial losses.  The 
359.18  commissioner of human services, in consultation with the 
359.19  commissioner of health, shall report to the legislature by 
359.20  January 15, 2003, on the results of the project and with a 
359.21  recommendation on whether the project should be made permanent. 
359.22     (d) The negotiated adjustment shall not affect the payment 
359.23  rate charged to private paying residents under the provisions of 
359.24  Minnesota Statutes, section 256B.48, subdivision 1. 
359.25     Sec. 44.  [MINIMUM STAFFING STANDARDS REPORT.] 
359.26     By January 15, 2002, the commissioner of health and the 
359.27  commissioner of human services shall report to the legislature 
359.28  on whether they should translate the minimum nurse staffing 
359.29  requirement in Minnesota Statutes, section 144A.04, subdivision 
359.30  7, paragraph (a), upon the transition to the RUG-III 
359.31  classification system, or whether they should establish 
359.32  different time-based standards, and how to accomplish either. 
359.33     Sec. 45.  [REPEALER.] 
359.34     Minnesota Statutes 2000, sections 144.0721, subdivision 1, 
359.35  and 256B.434, subdivision 5, are repealed. 
359.36                             ARTICLE 6 
360.1                              WORK FORCE 
360.2      Section 1.  Minnesota Statutes 2000, section 144.1464, is 
360.3   amended to read: 
360.4      144.1464 [SUMMER HEALTH CARE INTERNS.] 
360.5      Subdivision 1.  [SUMMER INTERNSHIPS.] The commissioner of 
360.6   health, through a contract with a nonprofit organization as 
360.7   required by subdivision 4, shall award grants to hospitals and, 
360.8   clinics, nursing facilities, and home care providers to 
360.9   establish a secondary and post-secondary summer health care 
360.10  intern program.  The purpose of the program is to expose 
360.11  interested secondary and post-secondary pupils to various 
360.12  careers within the health care profession. 
360.13     Subd. 2.  [CRITERIA.] (a) The commissioner, through the 
360.14  organization under contract, shall award grants to 
360.15  hospitals and, clinics, nursing facilities, and home care 
360.16  providers that agree to:  
360.17     (1) provide secondary and post-secondary summer health care 
360.18  interns with formal exposure to the health care profession; 
360.19     (2) provide an orientation for the secondary and 
360.20  post-secondary summer health care interns; 
360.21     (3) pay one-half the costs of employing the secondary and 
360.22  post-secondary summer health care intern, based on an overall 
360.23  hourly wage that is at least the minimum wage but does not 
360.24  exceed $6 an hour; 
360.25     (4) interview and hire secondary and post-secondary pupils 
360.26  for a minimum of six weeks and a maximum of 12 weeks; and 
360.27     (5) employ at least one secondary student for each 
360.28  post-secondary student employed, to the extent that there are 
360.29  sufficient qualifying secondary student applicants. 
360.30     (b) In order to be eligible to be hired as a secondary 
360.31  summer health intern by a hospital or, clinic, nursing facility, 
360.32  or home care provider, a pupil must: 
360.33     (1) intend to complete high school graduation requirements 
360.34  and be between the junior and senior year of high school; and 
360.35     (2) be from a school district in proximity to the facility; 
360.36  and 
361.1      (3) provide the facility with a letter of recommendation 
361.2   from a health occupations or science educator. 
361.3      (c) In order to be eligible to be hired as a post-secondary 
361.4   summer health care intern by a hospital or clinic, a pupil must: 
361.5      (1) intend to complete a health care training program or a 
361.6   two-year or four-year degree program and be planning on 
361.7   enrolling in or be enrolled in that training program or degree 
361.8   program; and 
361.9      (2) be enrolled in a Minnesota educational institution or 
361.10  be a resident of the state of Minnesota; priority must be given 
361.11  to applicants from a school district or an educational 
361.12  institution in proximity to the facility; and 
361.13     (3) provide the facility with a letter of recommendation 
361.14  from a health occupations or science educator. 
361.15     (d) Hospitals and, clinics, nursing facilities, and home 
361.16  care providers awarded grants may employ pupils as secondary and 
361.17  post-secondary summer health care interns beginning on or after 
361.18  June 15, 1993, if they agree to pay the intern, during the 
361.19  period before disbursement of state grant money, with money 
361.20  designated as the facility's 50 percent contribution towards 
361.21  internship costs.  
361.22     Subd. 3.  [GRANTS.] The commissioner, through the 
361.23  organization under contract, shall award separate grants to 
361.24  hospitals and, clinics, nursing facilities, and home care 
361.25  providers meeting the requirements of subdivision 2.  The grants 
361.26  must be used to pay one-half of the costs of employing secondary 
361.27  and post-secondary pupils in a hospital or, clinic, nursing 
361.28  facility, or home care setting during the course of the 
361.29  program.  No more than 50 percent of the participants may be 
361.30  post-secondary students, unless the program does not receive 
361.31  enough qualified secondary applicants per fiscal year.  No more 
361.32  than five pupils may be selected from any secondary or 
361.33  post-secondary institution to participate in the program and no 
361.34  more than one-half of the number of pupils selected may be from 
361.35  the seven-county metropolitan area. 
361.36     Subd. 4.  [CONTRACT.] The commissioner shall contract with 
362.1   a statewide, nonprofit organization representing facilities at 
362.2   which secondary and post-secondary summer health care interns 
362.3   will serve, to administer the grant program established by this 
362.4   section.  Grant funds that are not used in one fiscal year may 
362.5   be carried over to the next fiscal year.  The organization 
362.6   awarded the grant shall provide the commissioner with any 
362.7   information needed by the commissioner to evaluate the program, 
362.8   in the form and at the times specified by the commissioner. 
362.9      Sec. 2.  [144.1499] [PROMOTION OF HEALTH CARE AND LONG-TERM 
362.10  CARE CAREERS.] 
362.11     The commissioner of health, in consultation with an 
362.12  organization representing health care employers, long-term care 
362.13  employers, and educational institutions, may make grants to 
362.14  qualifying consortia as defined in section 116L.11, subdivision 
362.15  4, for intergenerational programs to encourage middle and high 
362.16  school students to work and volunteer in health care and 
362.17  long-term care settings.  To qualify for a grant under this 
362.18  section, a consortium shall: 
362.19     (1) develop a health and long-term care careers curriculum 
362.20  that provides career exploration and training in national skill 
362.21  standards for health care and long-term care and that is 
362.22  consistent with Minnesota graduation standards and other related 
362.23  requirements; 
362.24     (2) offer programs for high school students that provide 
362.25  training in health and long-term care careers with credits that 
362.26  articulate into post-secondary programs; and 
362.27     (3) provide technical support to the participating health 
362.28  care and long-term care employer to enable the use of the 
362.29  employer's facilities and programs for K-12 health and long-term 
362.30  care careers education. 
362.31     Sec. 3.  Minnesota Statutes 2000, section 144A.62, 
362.32  subdivision 1, is amended to read: 
362.33     Subdivision 1.  [ASSISTANCE WITH EATING AND DRINKING.] (a) 
362.34  Upon federal approval, a nursing home may employ resident 
362.35  attendants to assist with the activities authorized under 
362.36  subdivision 2.  The resident attendant will not shall be counted 
363.1   in the minimum staffing requirements under section 144A.04, 
363.2   subdivision 7. 
363.3      (b) The commissioner shall submit by May July 15, 2000 
363.4   2001, a new request for a federal waiver necessary to implement 
363.5   this section. 
363.6      Sec. 4.  Minnesota Statutes 2000, section 144A.62, 
363.7   subdivision 2, is amended to read: 
363.8      Subd. 2.  [DEFINITION.] (a) "Resident attendant" means an 
363.9   individual who assists residents in a nursing home with the one 
363.10  or more of the following activities of eating and drinking: 
363.11     (1) eating and drinking; and 
363.12     (2) transporting. 
363.13     (b) A resident attendant does not include an individual who:
363.14     (1) is a licensed health professional or a registered 
363.15  dietitian; 
363.16     (2) volunteers without monetary compensation; or 
363.17     (3) is a registered nursing assistant. 
363.18     Sec. 5.  Minnesota Statutes 2000, section 144A.62, 
363.19  subdivision 3, is amended to read: 
363.20     Subd. 3.  [REQUIREMENTS.] (a) A nursing home may not use on 
363.21  a full-time or other paid basis any individual as a resident 
363.22  attendant in the nursing home unless the individual: 
363.23     (1) has completed a training and competency evaluation 
363.24  program encompassing the tasks activities in subdivision 2 that 
363.25  the individual provides; 
363.26     (2) is competent to provide feeding and hydration services 
363.27  those activities; and 
363.28     (3) is under the supervision of the director of nursing. 
363.29     (b) A nursing home may not use a current employee as a 
363.30  resident attendant unless the employee satisfies the 
363.31  requirements of paragraph (a) and volunteers to be used in that 
363.32  capacity. 
363.33     Sec. 6.  Minnesota Statutes 2000, section 144A.62, 
363.34  subdivision 4, is amended to read: 
363.35     Subd. 4.  [EVALUATION.] The training and competency 
363.36  evaluation program may be facility based.  It must include, at a 
364.1   minimum, the training and competency standards for eating and 
364.2   drinking assistance the specific activities the attendant will 
364.3   be conducting contained in the nursing assistant training 
364.4   curriculum. 
364.5      Sec. 7.  Minnesota Statutes 2000, section 148.212, is 
364.6   amended to read: 
364.7      148.212 [TEMPORARY PERMIT.] 
364.8      Upon receipt of the applicable licensure or reregistration 
364.9   fee and permit fee, and in accordance with rules of the board, 
364.10  the board may issue a nonrenewable temporary permit to practice 
364.11  professional or practical nursing to an applicant for licensure 
364.12  or reregistration who is not the subject of a pending 
364.13  investigation or disciplinary action, nor disqualified for any 
364.14  other reason, under the following circumstances: 
364.15     (a) The applicant for licensure by examination under 
364.16  section 148.211, subdivision 1, has graduated from an approved 
364.17  nursing program within the 60 days preceding board receipt of an 
364.18  affidavit of graduation or transcript and has been authorized by 
364.19  the board to write the licensure examination for the first time 
364.20  in the United States.  The permit holder must practice 
364.21  professional or practical nursing under the direct supervision 
364.22  of a registered nurse.  The permit is valid from the date of 
364.23  issue until the date the board takes action on the application 
364.24  or for 60 days whichever occurs first. 
364.25     (b) The applicant for licensure by endorsement under 
364.26  section 148.211, subdivision 2, is currently licensed to 
364.27  practice professional or practical nursing in another state, 
364.28  territory, or Canadian province.  The permit is valid from 
364.29  submission of a proper request until the date of board action on 
364.30  the application. 
364.31     (c) The applicant for licensure by endorsement under 
364.32  section 148.211, subdivision 2, or for reregistration under 
364.33  section 148.231, subdivision 5, is currently registered in a 
364.34  formal, structured refresher course or its equivalent for nurses 
364.35  that includes clinical practice. 
364.36     (d) The applicant for licensure by examination under 
365.1   section 148.211, subdivision 1, as a registered nurse has been 
365.2   issued a commission on graduates of foreign nurse schools 
365.3   certificate, has completed all requirements for licensure except 
365.4   the licensing examination, and has been authorized by the board 
365.5   to write the licensure examination for the first time in the 
365.6   United States.  The permit holder must practice professional 
365.7   nursing under the direct supervision of a registered nurse.  The 
365.8   permit is valid from the date of issue until the date the board 
365.9   takes action on the application or for 60 days, whichever occurs 
365.10  first. 
365.11                             ARTICLE 7 
365.12                     REGULATION OF SUPPLEMENTAL 
365.13                     NURSING SERVICES AGENCIES
365.14     Section 1.  [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 
365.15  SERVICES AGENCIES; DEFINITIONS.] 
365.16     Subdivision 1.  [SCOPE.] As used in sections 144A.70 to 
365.17  144A.74, the terms defined in this section have the meanings 
365.18  given them. 
365.19     Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
365.20  commissioner of health. 
365.21     Subd. 3.  [CONTROLLING PERSON.] "Controlling person" means 
365.22  a business entity, officer, program administrator, or director 
365.23  whose responsibilities include the direction of the management 
365.24  or policies of a supplemental nursing services agency.  
365.25  Controlling person also means an individual who, directly or 
365.26  indirectly, beneficially owns an interest in a corporation, 
365.27  partnership, or other business association that is a controlling 
365.28  person. 
365.29     Subd. 4.  [HEALTH CARE FACILITY.] "Health care facility" 
365.30  means a hospital, boarding care home, or outpatient surgical 
365.31  center licensed under sections 144.50 to 144.58, a nursing home 
365.32  or home care agency licensed under this chapter, a residential 
365.33  care home, or a board and lodging establishment that is 
365.34  registered to provide supportive or health supervision services 
365.35  under section 157.17. 
365.36     Subd. 5.  [PERSON.] "Person" includes an individual, firm, 
366.1   corporation, partnership, or association. 
366.2      Subd. 6.  [SUPPLEMENTAL NURSING SERVICES 
366.3   AGENCY.] "Supplemental nursing services agency" means a person, 
366.4   firm, corporation, partnership, or association engaged for hire 
366.5   in the business of providing or procuring temporary employment 
366.6   in health care facilities for nurses, nursing assistants, nurse 
366.7   aides, and orderlies.  Supplemental nursing services agency does 
366.8   not include an individual who only engages in providing the 
366.9   individual's services on a temporary basis to health care 
366.10  facilities.  Supplemental nursing services agency also does not 
366.11  include any nursing services agency that is limited to providing 
366.12  temporary nursing personnel solely to one or more health care 
366.13  facilities owned or operated by the same person, firm, 
366.14  corporation, or partnership. 
366.15     Sec. 2.  [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 
366.16  REGISTRATION.] 
366.17     Subdivision 1.  [DUTY TO REGISTER.] A person who operates a 
366.18  supplemental nursing services agency shall register the agency 
366.19  with the commissioner.  Each separate location of the business 
366.20  of a supplemental nursing services agency shall register the 
366.21  agency with the commissioner.  Each separate location of the 
366.22  business of a supplemental nursing services agency shall have a 
366.23  separate registration. 
366.24     Subd. 2.  [APPLICATION INFORMATION AND FEE.] The 
366.25  commissioner shall establish forms and procedures for processing 
366.26  each supplemental nursing services agency registration 
366.27  application.  An application for a supplemental nursing services 
366.28  agency registration must include at least the following: 
366.29     (1) the names and addresses of the owner or owners of the 
366.30  supplemental nursing services agency; 
366.31     (2) if the owner is a corporation, copies of its articles 
366.32  of incorporation and current bylaws, together with the names and 
366.33  addresses of its officers and directors; 
366.34     (3) any other relevant information that the commissioner 
366.35  determines is necessary to properly evaluate an application for 
366.36  registration; and 
367.1      (4) the annual registration fee for a supplemental nursing 
367.2   services agency, which is $891. 
367.3      Subd. 3.  [REGISTRATION NOT TRANSFERABLE.] A registration 
367.4   issued by the commissioner according to this section is 
367.5   effective for a period of one year from the date of its issuance 
367.6   unless the registration is revoked or suspended under section 
367.7   144A.72, subdivision 2, or unless the supplemental nursing 
367.8   services agency is sold or ownership or management is 
367.9   transferred.  When a supplemental nursing services agency is 
367.10  sold or ownership or management is transferred, the registration 
367.11  of the agency must be voided and the new owner or operator may 
367.12  apply for a new registration. 
367.13     Sec. 3.  [144A.72] [REGISTRATION REQUIREMENTS.] 
367.14     The commissioner shall require that, as a condition of 
367.15  registration: 
367.16     (1) the supplemental nursing services agency shall document 
367.17  that each temporary employee provided to health care facilities 
367.18  currently meets the minimum licensing, training, and continuing 
367.19  education standards for the position in which the employee will 
367.20  be working; 
367.21     (2) the supplemental nursing services agency shall comply 
367.22  with all pertinent requirements relating to the health and other 
367.23  qualifications of personnel employed in health care facilities; 
367.24     (3) the supplemental nursing services agency must not 
367.25  restrict in any manner the employment opportunities of its 
367.26  employees; 
367.27     (4) the supplemental nursing services agency, when 
367.28  supplying temporary employees to a health care facility, and 
367.29  when requested by the facility to do so, shall agree that at 
367.30  least 30 percent of the total personnel hours supplied are 
367.31  during night, holiday, or weekend shifts; 
367.32     (5) the supplemental nursing services agency shall carry 
367.33  medical malpractice insurance to insure against the loss, 
367.34  damage, or expense incident to a claim arising out of the death 
367.35  or injury of any person as the result of negligence or 
367.36  malpractice in the provision of health care services by the 
368.1   supplemental nursing services agency or by any employee of the 
368.2   agency; and 
368.3      (6) the supplemental nursing services agency must not, in 
368.4   any contract with any employee or health care facility, require 
368.5   the payment of liquidated damages, employment fees, or other 
368.6   compensation should the employee be hired as a permanent 
368.7   employee of a health care facility. 
368.8      Sec. 4.  [144A.73] [COMPLAINT SYSTEM.] 
368.9      The commissioner shall establish a system for reporting 
368.10  complaints against a supplemental nursing services agency or its 
368.11  employees.  Complaints may be made by any member of the public.  
368.12  Written complaints must be forwarded to the employer of each 
368.13  person against whom a complaint is made.  The employer shall 
368.14  promptly report to the commissioner any corrective action taken. 
368.15     Sec. 5.  [144A.74] [MAXIMUM CHARGES.] 
368.16     A supplemental nursing services agency must not bill or 
368.17  receive payments from a nursing home licensed under this chapter 
368.18  at a rate higher than 150 percent of the weighted average wage 
368.19  rate for the applicable employee classification for the 
368.20  geographic group to which the nursing home is assigned under 
368.21  chapter 256B.  The weighted average wage rates must be 
368.22  determined by the commissioner of human services and reported to 
368.23  the commissioner of health on an annual basis.  Facilities shall 
368.24  provide information necessary to determine weighted average wage 
368.25  rates to the commissioner of human services in a format 
368.26  requested by the commissioner.  The maximum rate must include 
368.27  all charges for administrative fees, contract fees, or other 
368.28  special charges in addition to the hourly rates for the 
368.29  temporary nursing pool personnel supplied to a nursing home. 
368.30     Sec. 6.  Minnesota Statutes 2000, section 245A.04, 
368.31  subdivision 3, is amended to read: 
368.32     Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
368.33  (a) Before the commissioner issues a license, the commissioner 
368.34  shall conduct a study of the individuals specified in paragraph 
368.35  (c) (d), clauses (1) to (5), according to rules of the 
368.36  commissioner. 
369.1      Beginning January 1, 1997, the commissioner shall also 
369.2   conduct a study of employees providing direct contact services 
369.3   for nonlicensed personal care provider organizations described 
369.4   in paragraph (c) (d), clause (5). 
369.5      The commissioner shall recover the cost of these background 
369.6   studies through a fee of no more than $12 per study charged to 
369.7   the personal care provider organization.  The fees collected 
369.8   under this paragraph are appropriated to the commissioner for 
369.9   the purpose of conducting background studies. 
369.10     Beginning August 1, 1997, the commissioner shall conduct 
369.11  all background studies required under this chapter for adult 
369.12  foster care providers who are licensed by the commissioner of 
369.13  human services and registered under chapter 144D.  The 
369.14  commissioner shall conduct these background studies in 
369.15  accordance with this chapter.  The commissioner shall initiate a 
369.16  pilot project to conduct up to 5,000 background studies under 
369.17  this chapter in programs with joint licensure as home and 
369.18  community-based services and adult foster care for people with 
369.19  developmental disabilities when the license holder does not 
369.20  reside in the foster care residence. 
369.21     (b) Beginning July 1, 1998, the commissioner shall conduct 
369.22  a background study on individuals specified in 
369.23  paragraph (c) (d), clauses (1) to (5), who perform direct 
369.24  contact services in a nursing home or a home care agency 
369.25  licensed under chapter 144A or a boarding care home licensed 
369.26  under sections 144.50 to 144.58, when the subject of the study 
369.27  resides outside Minnesota; the study must be at least as 
369.28  comprehensive as that of a Minnesota resident and include a 
369.29  search of information from the criminal justice data 
369.30  communications network in the state where the subject of the 
369.31  study resides. 
369.32     (c) Beginning August 1, 2001, the commissioner shall 
369.33  conduct all background studies required under this chapter and 
369.34  initiated by supplemental nursing services agencies registered 
369.35  under chapter 144A.  Studies for the agencies must be initiated 
369.36  annually by each agency.  The commissioner shall conduct the 
370.1   background studies according to this chapter.  The commissioner 
370.2   shall recover the cost of the background studies through a fee 
370.3   of no more than $8 per study, charged to the supplemental 
370.4   nursing services agency.  The fees collected under this 
370.5   paragraph are appropriated to the commissioner for the purpose 
370.6   of conducting background studies. 
370.7      (d) The applicant, license holder, the registrant, bureau 
370.8   of criminal apprehension, the commissioner of health, and county 
370.9   agencies, after written notice to the individual who is the 
370.10  subject of the study, shall help with the study by giving the 
370.11  commissioner criminal conviction data and reports about the 
370.12  maltreatment of adults substantiated under section 626.557 and 
370.13  the maltreatment of minors in licensed programs substantiated 
370.14  under section 626.556.  The individuals to be studied shall 
370.15  include: 
370.16     (1) the applicant; 
370.17     (2) persons over the age of 13 living in the household 
370.18  where the licensed program will be provided; 
370.19     (3) current employees or contractors of the applicant who 
370.20  will have direct contact with persons served by the facility, 
370.21  agency, or program; 
370.22     (4) volunteers or student volunteers who have direct 
370.23  contact with persons served by the program to provide program 
370.24  services, if the contact is not directly supervised by the 
370.25  individuals listed in clause (1) or (3); and 
370.26     (5) any person who, as an individual or as a member of an 
370.27  organization, exclusively offers, provides, or arranges for 
370.28  personal care assistant services under the medical assistance 
370.29  program as authorized under sections 256B.04, subdivision 16, 
370.30  and 256B.0625, subdivision 19a. 
370.31     The juvenile courts shall also help with the study by 
370.32  giving the commissioner existing juvenile court records on 
370.33  individuals described in clause (2) relating to delinquency 
370.34  proceedings held within either the five years immediately 
370.35  preceding the application or the five years immediately 
370.36  preceding the individual's 18th birthday, whichever time period 
371.1   is longer.  The commissioner shall destroy juvenile records 
371.2   obtained pursuant to this subdivision when the subject of the 
371.3   records reaches age 23.  
371.4      For purposes of this section and Minnesota Rules, part 
371.5   9543.3070, a finding that a delinquency petition is proven in 
371.6   juvenile court shall be considered a conviction in state 
371.7   district court. 
371.8      For purposes of this subdivision, "direct contact" means 
371.9   providing face-to-face care, training, supervision, counseling, 
371.10  consultation, or medication assistance to persons served by a 
371.11  program.  For purposes of this subdivision, "directly supervised"
371.12  means an individual listed in clause (1), (3), or (5) is within 
371.13  sight or hearing of a volunteer to the extent that the 
371.14  individual listed in clause (1), (3), or (5) is capable at all 
371.15  times of intervening to protect the health and safety of the 
371.16  persons served by the program who have direct contact with the 
371.17  volunteer. 
371.18     A study of an individual in clauses (1) to (5) shall be 
371.19  conducted at least upon application for initial license or 
371.20  registration and reapplication for a license or registration.  
371.21  The commissioner is not required to conduct a study of an 
371.22  individual at the time of reapplication for a license or if the 
371.23  individual has been continuously affiliated with a foster care 
371.24  provider licensed by the commissioner of human services and 
371.25  registered under chapter 144D, other than a family day care or 
371.26  foster care license, if:  (i) a study of the individual was 
371.27  conducted either at the time of initial licensure or when the 
371.28  individual became affiliated with the license holder; (ii) the 
371.29  individual has been continuously affiliated with the license 
371.30  holder since the last study was conducted; and (iii) the 
371.31  procedure described in paragraph (d) (e) has been implemented 
371.32  and was in effect continuously since the last study was 
371.33  conducted.  For the purposes of this section, a physician 
371.34  licensed under chapter 147 is considered to be continuously 
371.35  affiliated upon the license holder's receipt from the 
371.36  commissioner of health or human services of the physician's 
372.1   background study results.  For individuals who are required to 
372.2   have background studies under clauses (1) to (5) and who have 
372.3   been continuously affiliated with a foster care provider that is 
372.4   licensed in more than one county, criminal conviction data may 
372.5   be shared among those counties in which the foster care programs 
372.6   are licensed.  A county agency's receipt of criminal conviction 
372.7   data from another county agency shall meet the criminal data 
372.8   background study requirements of this section. 
372.9      The commissioner may also conduct studies on individuals 
372.10  specified in clauses (3) and (4) when the studies are initiated 
372.11  by: 
372.12     (i) personnel pool agencies; 
372.13     (ii) temporary personnel agencies; 
372.14     (iii) educational programs that train persons by providing 
372.15  direct contact services in licensed programs; and 
372.16     (iv) professional services agencies that are not licensed 
372.17  and which contract with licensed programs to provide direct 
372.18  contact services or individuals who provide direct contact 
372.19  services. 
372.20     Studies on individuals in items (i) to (iv) must be 
372.21  initiated annually by these agencies, programs, and 
372.22  individuals.  Except for personal care provider 
372.23  organizations and supplemental nursing services agencies, no 
372.24  applicant, license holder, or individual who is the subject of 
372.25  the study shall pay any fees required to conduct the study. 
372.26     (1) At the option of the licensed facility, rather than 
372.27  initiating another background study on an individual required to 
372.28  be studied who has indicated to the licensed facility that a 
372.29  background study by the commissioner was previously completed, 
372.30  the facility may make a request to the commissioner for 
372.31  documentation of the individual's background study status, 
372.32  provided that: 
372.33     (i) the facility makes this request using a form provided 
372.34  by the commissioner; 
372.35     (ii) in making the request the facility informs the 
372.36  commissioner that either: 
373.1      (A) the individual has been continuously affiliated with a 
373.2   licensed facility since the individual's previous background 
373.3   study was completed, or since October 1, 1995, whichever is 
373.4   shorter; or 
373.5      (B) the individual is affiliated only with a personnel pool 
373.6   agency, a temporary personnel agency, an educational program 
373.7   that trains persons by providing direct contact services in 
373.8   licensed programs, or a professional services agency that is not 
373.9   licensed and which contracts with licensed programs to provide 
373.10  direct contact services or individuals who provide direct 
373.11  contact services; and 
373.12     (iii) the facility provides notices to the individual as 
373.13  required in paragraphs (a) to (d) (e), and that the facility is 
373.14  requesting written notification of the individual's background 
373.15  study status from the commissioner.  
373.16     (2) The commissioner shall respond to each request under 
373.17  paragraph (1) with a written or electronic notice to the 
373.18  facility and the study subject.  If the commissioner determines 
373.19  that a background study is necessary, the study shall be 
373.20  completed without further request from a licensed agency or 
373.21  notifications to the study subject.  
373.22     (3) When a background study is being initiated by a 
373.23  licensed facility or a foster care provider that is also 
373.24  registered under chapter 144D, a study subject affiliated with 
373.25  multiple licensed facilities may attach to the background study 
373.26  form a cover letter indicating the additional facilities' names, 
373.27  addresses, and background study identification numbers.  When 
373.28  the commissioner receives such notices, each facility identified 
373.29  by the background study subject shall be notified of the study 
373.30  results.  The background study notice sent to the subsequent 
373.31  agencies shall satisfy those facilities' responsibilities for 
373.32  initiating a background study on that individual. 
373.33     (d) (e) If an individual who is affiliated with a program 
373.34  or facility regulated by the department of human services or 
373.35  department of health or who is affiliated with a nonlicensed 
373.36  personal care provider organization, is convicted of a crime 
374.1   constituting a disqualification under subdivision 3d, the 
374.2   probation officer or corrections agent shall notify the 
374.3   commissioner of the conviction.  The commissioner, in 
374.4   consultation with the commissioner of corrections, shall develop 
374.5   forms and information necessary to implement this paragraph and 
374.6   shall provide the forms and information to the commissioner of 
374.7   corrections for distribution to local probation officers and 
374.8   corrections agents.  The commissioner shall inform individuals 
374.9   subject to a background study that criminal convictions for 
374.10  disqualifying crimes will be reported to the commissioner by the 
374.11  corrections system.  A probation officer, corrections agent, or 
374.12  corrections agency is not civilly or criminally liable for 
374.13  disclosing or failing to disclose the information required by 
374.14  this paragraph.  Upon receipt of disqualifying information, the 
374.15  commissioner shall provide the notifications required in 
374.16  subdivision 3a, as appropriate to agencies on record as having 
374.17  initiated a background study or making a request for 
374.18  documentation of the background study status of the individual.  
374.19  This paragraph does not apply to family day care and child 
374.20  foster care programs. 
374.21     (e) (f) The individual who is the subject of the study must 
374.22  provide the applicant or license holder with sufficient 
374.23  information to ensure an accurate study including the 
374.24  individual's first, middle, and last name; home address, city, 
374.25  county, and state of residence for the past five years; zip 
374.26  code; sex; date of birth; and driver's license number.  The 
374.27  applicant or license holder shall provide this information about 
374.28  an individual in paragraph (c) (d), clauses (1) to (5), on forms 
374.29  prescribed by the commissioner.  By January 1, 2000, for 
374.30  background studies conducted by the department of human 
374.31  services, the commissioner shall implement a system for the 
374.32  electronic transmission of:  (1) background study information to 
374.33  the commissioner; and (2) background study results to the 
374.34  license holder.  The commissioner may request additional 
374.35  information of the individual, which shall be optional for the 
374.36  individual to provide, such as the individual's social security 
375.1   number or race. 
375.2      (f) (g) Except for child foster care, adult foster care, 
375.3   and family day care homes, a study must include information 
375.4   related to names of substantiated perpetrators of maltreatment 
375.5   of vulnerable adults that has been received by the commissioner 
375.6   as required under section 626.557, subdivision 9c, paragraph 
375.7   (i), and the commissioner's records relating to the maltreatment 
375.8   of minors in licensed programs, information from juvenile courts 
375.9   as required in paragraph (c) (d) for persons listed in paragraph 
375.10  (c) (d), clause (2), and information from the bureau of criminal 
375.11  apprehension.  For child foster care, adult foster care, and 
375.12  family day care homes, the study must include information from 
375.13  the county agency's record of substantiated maltreatment of 
375.14  adults, and the maltreatment of minors, information from 
375.15  juvenile courts as required in paragraph (c) (d) for persons 
375.16  listed in paragraph (c) (d), clause (2), and information from 
375.17  the bureau of criminal apprehension.  The commissioner may also 
375.18  review arrest and investigative information from the bureau of 
375.19  criminal apprehension, the commissioner of health, a county 
375.20  attorney, county sheriff, county agency, local chief of police, 
375.21  other states, the courts, or the Federal Bureau of Investigation 
375.22  if the commissioner has reasonable cause to believe the 
375.23  information is pertinent to the disqualification of an 
375.24  individual listed in paragraph (c) (d), clauses (1) to (5).  The 
375.25  commissioner is not required to conduct more than one review of 
375.26  a subject's records from the Federal Bureau of Investigation if 
375.27  a review of the subject's criminal history with the Federal 
375.28  Bureau of Investigation has already been completed by the 
375.29  commissioner and there has been no break in the subject's 
375.30  affiliation with the license holder who initiated the background 
375.31  studies. 
375.32     When the commissioner has reasonable cause to believe that 
375.33  further pertinent information may exist on the subject, the 
375.34  subject shall provide a set of classifiable fingerprints 
375.35  obtained from an authorized law enforcement agency.  For 
375.36  purposes of requiring fingerprints, the commissioner shall be 
376.1   considered to have reasonable cause under, but not limited to, 
376.2   the following circumstances: 
376.3      (1) information from the bureau of criminal apprehension 
376.4   indicates that the subject is a multistate offender; 
376.5      (2) information from the bureau of criminal apprehension 
376.6   indicates that multistate offender status is undetermined; or 
376.7      (3) the commissioner has received a report from the subject 
376.8   or a third party indicating that the subject has a criminal 
376.9   history in a jurisdiction other than Minnesota. 
376.10     (g) (h) An applicant's or, license holder's, or 
376.11  registrant's failure or refusal to cooperate with the 
376.12  commissioner is reasonable cause to disqualify a subject, deny a 
376.13  license application or immediately suspend, suspend, or revoke a 
376.14  license or registration.  Failure or refusal of an individual to 
376.15  cooperate with the study is just cause for denying or 
376.16  terminating employment of the individual if the individual's 
376.17  failure or refusal to cooperate could cause the applicant's 
376.18  application to be denied or the license holder's license to be 
376.19  immediately suspended, suspended, or revoked. 
376.20     (h) (i) The commissioner shall not consider an application 
376.21  to be complete until all of the information required to be 
376.22  provided under this subdivision has been received.  
376.23     (i) (j) No person in paragraph (c) (d), clause (1), (2), 
376.24  (3), (4), or (5), who is disqualified as a result of this 
376.25  section may be retained by the agency in a position involving 
376.26  direct contact with persons served by the program. 
376.27     (j) (k) Termination of persons in paragraph (c) (d), clause 
376.28  (1), (2), (3), (4), or (5), made in good faith reliance on a 
376.29  notice of disqualification provided by the commissioner shall 
376.30  not subject the applicant or license holder to civil liability. 
376.31     (k) (l) The commissioner may establish records to fulfill 
376.32  the requirements of this section. 
376.33     (l) (m) The commissioner may not disqualify an individual 
376.34  subject to a study under this section because that person has, 
376.35  or has had, a mental illness as defined in section 245.462, 
376.36  subdivision 20. 
377.1      (m) (n) An individual subject to disqualification under 
377.2   this subdivision has the applicable rights in subdivision 3a, 
377.3   3b, or 3c. 
377.4      (n) (o) For the purposes of background studies completed by 
377.5   tribal organizations performing licensing activities otherwise 
377.6   required of the commissioner under this chapter, after obtaining 
377.7   consent from the background study subject, tribal licensing 
377.8   agencies shall have access to criminal history data in the same 
377.9   manner as county licensing agencies and private licensing 
377.10  agencies under this chapter. 
377.11     Sec. 7.  [REPORT ON SUPPLEMENTAL NURSING SERVICES AGENCY 
377.12  USE.] 
377.13     Beginning July 1, 2001, through June 30, 2003, the 
377.14  commissioner of human services shall require nursing facilities 
377.15  and other providers of long-term care services to report 
377.16  semiannually on the use of supplemental nursing services, in the 
377.17  form and manner specified by the commissioner.  The information 
377.18  reported must include, but is not limited to: 
377.19     (1) number of hours worked by supplemental nursing services 
377.20  personnel, by job classification, for each month; 
377.21     (2) payments to supplemental nursing services agencies, on 
377.22  a per hour worked basis, by job classification, for each month; 
377.23  and 
377.24     (3) percentage of total monthly work hours provided by 
377.25  supplemental nursing services agency personnel, by job 
377.26  classification, for each shift and for weekdays and weekends. 
377.27                             ARTICLE 8 
377.28                      LONG-TERM CARE INSURANCE 
377.29     Section 1.  Minnesota Statutes 2000, section 62A.48, 
377.30  subdivision 4, is amended to read: 
377.31     Subd. 4.  [LOSS RATIO.] The anticipated loss ratio for 
377.32  long-term care policies must not be less than 65 percent for 
377.33  policies issued on a group basis or 60 percent for policies 
377.34  issued on an individual or mass-market basis.  This subdivision 
377.35  does not apply to policies issued on or after January 1, 2002, 
377.36  that comply with sections 62S.021 and 62S.081. 
378.1      <h>[EFFECTIVE DATE.]</h> This section is effective the day 
378.2   following final enactment. 
378.3      Sec. 2.  Minnesota Statutes 2000, section 62A.48, is 
378.4   amended by adding a subdivision to read: 
378.5      Subd. 10.  [REGULATION OF PREMIUMS AND PREMIUM 
378.6   INCREASES.] Policies issued under sections 62A.46 to 62A.56 on 
378.7   or after January 1, 2002, must comply with sections 62S.021, 
378.8   62S.081, 62S.265, and 62S.266 to the same extent as policies 
378.9   issued under chapter 62S. 
378.10     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
378.11  following final enactment. 
378.12     Sec. 3.  Minnesota Statutes 2000, section 62A.48, is 
378.13  amended by adding a subdivision to read: 
378.14     Subd. 11.  [NONFORFEITURE BENEFITS.] Policies issued under 
378.15  sections 62A.46 to 62A.56 on or after January 1, 2002, must 
378.16  comply with section 62S.02, subdivision 2, to the same extent as 
378.17  policies issued under chapter 62S. 
378.18     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
378.19  following final enactment. 
378.20     Sec. 4.  Minnesota Statutes 2000, section 62S.01, is 
378.21  amended by adding a subdivision to read: 
378.22     Subd. 13a.  [EXCEPTIONAL INCREASE.] (a) "Exceptional 
378.23  increase" means only those premium rate increases filed by an 
378.24  insurer as exceptional for which the commissioner determines 
378.25  that the need for the premium rate increase is justified due to 
378.26  changes in laws or rules applicable to long-term care coverage 
378.27  in this state, or due to increased and unexpected utilization 
378.28  that affects the majority of insurers of similar products. 
378.29     (b) Except as provided in section 62S.265, exceptional 
378.30  increases are subject to the same requirements as other premium 
378.31  rate schedule increases.  The commissioner may request a review 
378.32  by an independent actuary or a professional actuarial body of 
378.33  the basis for a request that an increase be considered an 
378.34  exceptional increase.  The commissioner, in determining that the 
378.35  necessary basis for an exceptional increase exists, shall also 
378.36  determine any potential offsets to higher claims costs. 
379.1      <h>[EFFECTIVE DATE.]</h> This section is effective the day 
379.2   following final enactment. 
379.3      Sec. 5.  Minnesota Statutes 2000, section 62S.01, is 
379.4   amended by adding a subdivision to read: 
379.5      Subd. 17a.  [INCIDENTAL.] "Incidental," as used in section 
379.6   62S.265, subdivision 10, means that the value of the long-term 
379.7   care benefits provided is less than ten percent of the total 
379.8   value of the benefits provided over the life of the policy.  
379.9   These values must be measured as of the date of issue. 
379.10     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
379.11  following final enactment. 
379.12     Sec. 6.  Minnesota Statutes 2000, section 62S.01, is 
379.13  amended by adding a subdivision to read: 
379.14     Subd. 23a.  [QUALIFIED ACTUARY.] "Qualified actuary" means 
379.15  a member in good standing of the American Academy of Actuaries. 
379.16     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
379.17  following final enactment. 
379.18     Sec. 7.  Minnesota Statutes 2000, section 62S.01, is 
379.19  amended by adding a subdivision to read: 
379.20     Subd. 25a.  [SIMILAR POLICY FORMS.] "Similar policy forms" 
379.21  means all of the long-term care insurance policies and 
379.22  certificates issued by an insurer in the same long-term care 
379.23  benefit classification as the policy form being considered.  
379.24  Certificates of groups that meet the definition in section 
379.25  62S.01, subdivision 15, clause (1), are not considered similar 
379.26  to certificates or policies otherwise issued as long-term care 
379.27  insurance, but are similar to other comparable certificates with 
379.28  the same long-term care benefit classifications.  For purposes 
379.29  of determining similar policy forms, long-term care benefit 
379.30  classifications are defined as follows:  institutional long-term 
379.31  care benefits only, noninstitutional long-term care benefits 
379.32  only, or comprehensive long-term care benefits. 
379.33     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
379.34  following final enactment. 
379.35     Sec. 8.  [62S.021] [LONG-TERM CARE INSURANCE; INITIAL 
379.36  FILING.] 
380.1      Subdivision 1.  [APPLICABILITY.] This section applies to 
380.2   any long-term care policy issued in this state on or after 
380.3   January 1, 2002, under this chapter or sections 62A.46 to 62A.56.
380.4      Subd. 2.  [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer 
380.5   shall provide the following information to the commissioner 30 
380.6   days prior to making a long-term care insurance form available 
380.7   for sale: 
380.8      (1) a copy of the disclosure documents required in section 
380.9   62S.081; and 
380.10     (2) an actuarial certification consisting of at least the 
380.11  following: 
380.12     (i) a statement that the initial premium rate schedule is 
380.13  sufficient to cover anticipated costs under moderately adverse 
380.14  experience and that the premium rate schedule is reasonably 
380.15  expected to be sustainable over the life of the form with no 
380.16  future premium increases anticipated; 
380.17     (ii) a statement that the policy design and coverage 
380.18  provided have been reviewed and taken into consideration; 
380.19     (iii) a statement that the underwriting and claims 
380.20  adjudication processes have been reviewed and taken into 
380.21  consideration; and 
380.22     (iv) a complete description of the basis for contract 
380.23  reserves that are anticipated to be held under the form, to 
380.24  include: 
380.25     (A) sufficient detail or sample calculations provided so as 
380.26  to have a complete depiction of the reserve amounts to be held; 
380.27     (B) a statement that the assumptions used for reserves 
380.28  contain reasonable margins for adverse experience; 
380.29     (C) a statement that the net valuation premium for renewal 
380.30  years does not increase, except for attained-age rating where 
380.31  permitted; 
380.32     (D) a statement that the difference between the gross 
380.33  premium and the net valuation premium for renewal years is 
380.34  sufficient to cover expected renewal expenses, or if such a 
380.35  statement cannot be made, a complete description of the 
380.36  situations in which this does not occur.  An aggregate 
381.1   distribution of anticipated issues may be used as long as the 
381.2   underlying gross premiums maintain a reasonably consistent 
381.3   relationship.  If the gross premiums for certain age groups 
381.4   appear to be inconsistent with this requirement, the 
381.5   commissioner may request a demonstration under item (i) based on 
381.6   a standard age distribution; and 
381.7      (E) either a statement that the premium rate schedule is 
381.8   not less than the premium rate schedule for existing similar 
381.9   policy forms also available from the insurer except for 
381.10  reasonable differences attributable to benefits, or a comparison 
381.11  of the premium schedules for similar policy forms that are 
381.12  currently available from the insurer with an explanation of the 
381.13  differences. 
381.14     Subd. 3.  [ACTUARIAL DEMONSTRATION.] The commissioner may 
381.15  request an actuarial demonstration that benefits are reasonable 
381.16  in relation to premiums.  The actuarial demonstration must 
381.17  include either premium and claim experience on similar policy 
381.18  forms, adjusted for any premium or benefit differences, relevant 
381.19  and credible data from other studies, or both.  If the 
381.20  commissioner asks for additional information under this 
381.21  subdivision, the 30-day time limit in subdivision 2 does not 
381.22  include the time during which the insurer is preparing the 
381.23  requested information. 
381.24     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
381.25  following final enactment. 
381.26     Sec. 9.  [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES 
381.27  TO CONSUMERS.] 
381.28     Subdivision 1.  [APPLICATION.] This section applies as 
381.29  follows: 
381.30     (a) Except as provided in paragraph (b), this section 
381.31  applies to any long-term care policy or certificate issued in 
381.32  this state on or after January 1, 2002. 
381.33     (b) For certificates issued on or after the effective date 
381.34  of this section under a policy of group long-term care insurance 
381.35  as defined in section 62S.01, subdivision 15, that was in force 
381.36  on the effective date of this section, this section applies on 
382.1   the policy anniversary following June 30, 2002. 
382.2      Subd. 2.  [REQUIRED DISCLOSURES.] Other than policies for 
382.3   which no applicable premium rate or rate schedule increases can 
382.4   be made, insurers shall provide all of the information listed in 
382.5   this subdivision to the applicant at the time of application or 
382.6   enrollment, unless the method of application does not allow for 
382.7   delivery at that time; in this case, an insurer shall provide 
382.8   all of the information listed in this subdivision to the 
382.9   applicant no later than at the time of delivery of the policy or 
382.10  certificate: 
382.11     (1) a statement that the policy may be subject to rate 
382.12  increases in the future; 
382.13     (2) an explanation of potential future premium rate 
382.14  revisions and the policyholder's or certificate holder's option 
382.15  in the event of a premium rate revision; 
382.16     (3) the premium rate or rate schedules applicable to the 
382.17  applicant that will be in effect until a request is made for an 
382.18  increase; 
382.19     (4) a general explanation of applying premium rate or rate 
382.20  schedule adjustments that must include: 
382.21     (i) a description of when premium rate or rate schedule 
382.22  adjustments will be effective, for example the next anniversary 
382.23  date or the next billing date; and 
382.24     (ii) the right to a revised premium rate or rate schedule 
382.25  as provided in clause (3) if the premium rate or rate schedule 
382.26  is changed; and 
382.27     (5)(i) information regarding each premium rate increase on 
382.28  this policy form or similar policy forms over the past ten years 
382.29  for this state or any other state that, at a minimum, identifies:
382.30     (A) the policy forms for which premium rates have been 
382.31  increased; 
382.32     (B) the calendar years when the form was available for 
382.33  purchase; and 
382.34     (C) the amount or percent of each increase.  The percentage 
382.35  may be expressed as a percentage of the premium rate prior to 
382.36  the increase and may also be expressed as minimum and maximum 
383.1   percentages if the rate increase is variable by rating 
383.2   characteristics; 
383.3      (ii) the insurer may, in a fair manner, provide additional 
383.4   explanatory information related to the rate increases; 
383.5      (iii) an insurer has the right to exclude from the 
383.6   disclosure premium rate increases that apply only to blocks of 
383.7   business acquired from other nonaffiliated insurers or the 
383.8   long-term care policies acquired from other nonaffiliated 
383.9   insurers when those increases occurred prior to the acquisition; 
383.10     (iv) if an acquiring insurer files for a rate increase on a 
383.11  long-term care policy form acquired from nonaffiliated insurers 
383.12  or a block of policy forms acquired from nonaffiliated insurers 
383.13  on or before the later of the effective date of this section, or 
383.14  the end of a 24-month period following the acquisition of the 
383.15  block of policies, the acquiring insurer may exclude that rate 
383.16  increase from the disclosure.  However, the nonaffiliated 
383.17  selling company must include the disclosure of that rate 
383.18  increase according to item (i); and 
383.19     (v) if the acquiring insurer in item (iv) files for a 
383.20  subsequent rate increase, even within the 24-month period, on 
383.21  the same policy form acquired from nonaffiliated insurers or 
383.22  block of policy forms acquired from nonaffiliated insurers 
383.23  referenced in item (iv), the acquiring insurer shall make all 
383.24  disclosures required by this subdivision, including disclosure 
383.25  of the earlier rate increase referenced in item (iv). 
383.26     Subd. 3.  [ACKNOWLEDGMENT.] An applicant shall sign an 
383.27  acknowledgment at the time of application, unless the method of 
383.28  application does not allow for signature at that time, that the 
383.29  insurer made the disclosure required under subdivision 2.  If, 
383.30  due to the method of application, the applicant cannot sign an 
383.31  acknowledgment at the time of application, the applicant shall 
383.32  sign no later than at the time of delivery of the policy or 
383.33  certificate. 
383.34     Subd. 4.  [FORMS.] An insurer shall use the forms in 
383.35  Appendices B and F of the Long-term Care Insurance Model 
383.36  Regulation adopted by the National Association of Insurance 
384.1   Commissioners to comply with the requirements of subdivisions 1 
384.2   and 2. 
384.3      Subd. 5.  [NOTICE OF INCREASE.] An insurer shall provide 
384.4   notice of an upcoming premium rate schedule increase, after the 
384.5   increase has been approved by the commissioner, to all 
384.6   policyholders or certificate holders, if applicable, at least 45 
384.7   days prior to the implementation of the premium rate schedule 
384.8   increase by the insurer.  The notice must include the 
384.9   information required by subdivision 2 when the rate increase is 
384.10  implemented. 
384.11     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
384.12  following final enactment. 
384.13     Sec. 10.  Minnesota Statutes 2000, section 62S.26, is 
384.14  amended to read: 
384.15     62S.26 [LOSS RATIO.] 
384.16     (a) The minimum loss ratio must be at least 60 percent, 
384.17  calculated in a manner which provides for adequate reserving of 
384.18  the long-term care insurance risk.  In evaluating the expected 
384.19  loss ratio, the commissioner shall give consideration to all 
384.20  relevant factors, including: 
384.21     (1) statistical credibility of incurred claims experience 
384.22  and earned premiums; 
384.23     (2) the period for which rates are computed to provide 
384.24  coverage; 
384.25     (3) experienced and projected trends; 
384.26     (4) concentration of experience within early policy 
384.27  duration; 
384.28     (5) expected claim fluctuation; 
384.29     (6) experience refunds, adjustments, or dividends; 
384.30     (7) renewability features; 
384.31     (8) all appropriate expense factors; 
384.32     (9) interest; 
384.33     (10) experimental nature of the coverage; 
384.34     (11) policy reserves; 
384.35     (12) mix of business by risk classification; and 
384.36     (13) product features such as long elimination periods, 
385.1   high deductibles, and high maximum limits. 
385.2      (b) This section does not apply to policies or certificates 
385.3   that are subject to sections 62S.021, 62S.081, and 62S.265, and 
385.4   that comply with those sections. 
385.5      <h>[EFFECTIVE DATE.]</h> This section is effective the day 
385.6   following final enactment. 
385.7      Sec. 11.  [62S.265] [PREMIUM RATE SCHEDULE INCREASES.] 
385.8      Subdivision 1.  [APPLICABILITY.] (a) Except as provided in 
385.9   paragraph (b), this section applies to any long-term care policy 
385.10  or certificate issued in this state on or after January 1, 2002, 
385.11  under this chapter or sections 62A.46 to 62A.56. 
385.12     (b) For certificates issued on or after the effective date 
385.13  of this section under a group long-term care insurance policy as 
385.14  defined in section 62S.01, subdivision 15, issued under this 
385.15  chapter, that was in force on the effective date of this 
385.16  section, this section applies on the policy anniversary 
385.17  following June 30, 2002. 
385.18     Subd. 2.  [NOTICE.] An insurer shall file a requested 
385.19  premium rate schedule increase, including an exceptional 
385.20  increase, to the commissioner for prior approval at least 60 
385.21  days prior to the notice to the policyholders and shall include: 
385.22     (1) all information required by section 62S.081; 
385.23     (2) certification by a qualified actuary that: 
385.24     (i) if the requested premium rate schedule increase is 
385.25  implemented and the underlying assumptions, which reflect 
385.26  moderately adverse conditions, are realized, no further premium 
385.27  rate schedule increases are anticipated; and 
385.28     (ii) the premium rate filing complies with this section; 
385.29     (3) an actuarial memorandum justifying the rate schedule 
385.30  change request that includes: 
385.31     (i) lifetime projections of earned premiums and incurred 
385.32  claims based on the filed premium rate schedule increase and the 
385.33  method and assumptions used in determining the projected values, 
385.34  including reflection of any assumptions that deviate from those 
385.35  used for pricing other forms currently available for sale; 
385.36     (A) annual values for the five years preceding and the 
386.1   three years following the valuation date must be provided 
386.2   separately; 
386.3      (B) the projections must include the development of the 
386.4   lifetime loss ratio, unless the rate increase is an exceptional 
386.5   increase; 
386.6      (C) the projections must demonstrate compliance with 
386.7   subdivision 3; and 
386.8      (D) for exceptional increases, the projected experience 
386.9   must be limited to the increases in claims expenses attributable 
386.10  to the approved reasons for the exceptional increase and, if the 
386.11  commissioner determines that offsets to higher claim costs may 
386.12  exist, the insurer shall use appropriate net projected 
386.13  experience; 
386.14     (ii) disclosure of how reserves have been incorporated in 
386.15  this rate increase whenever the rate increase will trigger 
386.16  contingent benefit upon lapse; 
386.17     (iii) disclosure of the analysis performed to determine why 
386.18  a rate adjustment is necessary, which pricing assumptions were 
386.19  not realized and why, and what other actions taken by the 
386.20  company have been relied upon by the actuary; 
386.21     (iv) a statement that policy design, underwriting, and 
386.22  claims adjudication practices have been taken into 
386.23  consideration; and 
386.24     (v) if it is necessary to maintain consistent premium rates 
386.25  for new certificates and certificates receiving a rate increase, 
386.26  the insurer shall file composite rates reflecting projections of 
386.27  new certificates; 
386.28     (4) a statement that renewal premium rate schedules are not 
386.29  greater than new business premium rate schedules except for 
386.30  differences attributable to benefits, unless sufficient 
386.31  justification is provided to the commissioner; and 
386.32     (5) sufficient information for review and approval of the 
386.33  premium rate schedule increase by the commissioner. 
386.34     Subd. 3.  [REQUIREMENTS PERTAINING TO RATE INCREASES.] All 
386.35  premium rate schedule increases must be determined according to 
386.36  the following requirements: 
387.1      (1) exceptional increases must provide that 70 percent of 
387.2   the present value of projected additional premiums from the 
387.3   exceptional increase will be returned to policyholders in 
387.4   benefits; 
387.5      (2) premium rate schedule increases must be calculated so 
387.6   that the sum of the accumulated value of incurred claims, 
387.7   without the inclusion of active life reserves, and the present 
387.8   value of future projected incurred claims, without the inclusion 
387.9   of active life reserves, will not be less than the sum of the 
387.10  following: 
387.11     (i) the accumulated value of the initial earned premium 
387.12  times 58 percent; 
387.13     (ii) 85 percent of the accumulated value of prior premium 
387.14  rate schedule increases on an earned basis; 
387.15     (iii) the present value of future projected initial earned 
387.16  premiums times 58 percent; and 
387.17     (iv) 85 percent of the present value of future projected 
387.18  premiums not in item (iii) on an earned basis; 
387.19     (3) if a policy form has both exceptional and other 
387.20  increases, the values in clause (2), items (ii) and (iv), must 
387.21  also include 70 percent for exceptional rate increase amounts; 
387.22  and 
387.23     (4) all present and accumulated values used to determine 
387.24  rate increases must use the maximum valuation interest rate for 
387.25  contract reserves permitted for valuation of whole life 
387.26  insurance policies issued in this state on the same date.  The 
387.27  actuary shall disclose as part of the actuarial memorandum the 
387.28  use of any appropriate averages. 
387.29     Subd. 4.  [PROJECTIONS.] For each rate increase that is 
387.30  implemented, the insurer shall file for approval by the 
387.31  commissioner updated projections, as described in subdivision 2, 
387.32  clause (3), item (i), annually for the next three years and 
387.33  include a comparison of actual results to projected values.  The 
387.34  commissioner may extend the period to greater than three years 
387.35  if actual results are not consistent with projected values from 
387.36  prior projections.  For group insurance policies that meet the 
388.1   conditions in subdivision 11, the projections required by this 
388.2   subdivision must be provided to the policyholder in lieu of 
388.3   filing with the commissioner. 
388.4      Subd. 5.  [LIFETIME PROJECTIONS.] If any premium rate in 
388.5   the revised premium rate schedule is greater than 200 percent of 
388.6   the comparable rate in the initial premium schedule, lifetime 
388.7   projections, as described in subdivision 2, clause (3), item 
388.8   (i), must be filed for approval by the commissioner every five 
388.9   years following the end of the required period in subdivision 
388.10  4.  For group insurance policies that meet the conditions in 
388.11  subdivision 11, the projections required by this subdivision 
388.12  must be provided to the policyholder in lieu of filing with the 
388.13  commissioner. 
388.14     Subd. 6.  [EFFECT OF ACTUAL EXPERIENCE.] (a) If the 
388.15  commissioner has determined that the actual experience following 
388.16  a rate increase does not adequately match the projected 
388.17  experience and that the current projections under moderately 
388.18  adverse conditions demonstrate that incurred claims will not 
388.19  exceed proportions of premiums specified in subdivision 3, the 
388.20  commissioner may require the insurer to implement any of the 
388.21  following: 
388.22     (1) premium rate schedule adjustments; or 
388.23     (2) other measures to reduce the difference between the 
388.24  projected and actual experience. 
388.25     (b) In determining whether the actual experience adequately 
388.26  matches the projected experience, consideration must be given to 
388.27  subdivision 2, clause (3), item (v), if applicable. 
388.28     Subd. 7.  [CONTINGENT BENEFIT UPON LAPSE.] If the majority 
388.29  of the policies or certificates to which the increase is 
388.30  applicable are eligible for the contingent benefit upon lapse, 
388.31  the insurer shall file: 
388.32     (1) a plan, subject to commissioner approval, for improved 
388.33  administration or claims processing designed to eliminate the 
388.34  potential for further deterioration of the policy form requiring 
388.35  further premium rate schedule increases, or both, or a 
388.36  demonstration that appropriate administration and claims 
389.1   processing have been implemented or are in effect; otherwise, 
389.2   the commissioner may impose the condition in subdivision 8, 
389.3   paragraph (b); and 
389.4      (2) the original anticipated lifetime loss ratio, and the 
389.5   premium rate schedule increase that would have been calculated 
389.6   according to subdivision 3 had the greater of the original 
389.7   anticipated lifetime loss ratio or 58 percent been used in the 
389.8   calculations described in subdivision 3, clause (2), items (i) 
389.9   and (iii). 
389.10     Subd. 8.  [PROJECTED LAPSE RATES.] (a) For a rate increase 
389.11  filing that meets the following criteria, the commissioner shall 
389.12  review, for all policies included in the filing, the projected 
389.13  lapse rates and past lapse rates during the 12 months following 
389.14  each increase to determine if significant adverse lapsation has 
389.15  occurred or is anticipated: 
389.16     (1) the rate increase is not the first rate increase 
389.17  requested for the specific policy form or forms; 
389.18     (2) the rate increase is not an exceptional increase; and 
389.19     (3) the majority of the policies or certificates to which 
389.20  the increase is applicable are eligible for the contingent 
389.21  benefit upon lapse. 
389.22     (b) If significant adverse lapsation has occurred, is 
389.23  anticipated in the filing, or is evidenced in the actual results 
389.24  as presented in the updated projections provided by the insurer 
389.25  following the requested rate increase, the commissioner may 
389.26  determine that a rate spiral exists.  Following the 
389.27  determination that a rate spiral exists, the commissioner may 
389.28  require the insurer to offer, without underwriting, to all 
389.29  in-force insureds subject to the rate increase, the option to 
389.30  replace existing coverage with one or more reasonably comparable 
389.31  products being offered by the insurer or its affiliates.  The 
389.32  offer must: 
389.33     (1) be subject to the approval of the commissioner; 
389.34     (2) be based upon actuarially sound principles, but not be 
389.35  based upon attained age; and 
389.36     (3) provide that maximum benefits under any new policy 
390.1   accepted by an insured will be reduced by comparable benefits 
390.2   already paid under the existing policy. 
390.3      (c) The insurer shall maintain the experience of all the 
390.4   replacement insureds separate from the experience of insureds 
390.5   originally issued the policy forms.  In the event of a request 
390.6   for a rate increase on the policy form, the rate increase must 
390.7   be limited to the lesser of the maximum rate increase determined 
390.8   based on the combined experience and the maximum rate increase 
390.9   determined based only upon the experience of the insureds 
390.10  originally issued the form plus ten percent. 
390.11     Subd. 9.  [PERSISTENT PRACTICE OF INADEQUATE INITIAL 
390.12  RATES.] If the commissioner determines that the insurer has 
390.13  exhibited a persistent practice of filing inadequate initial 
390.14  premium rates for long-term care insurance, the commissioner 
390.15  may, in addition to the provisions of subdivision 8, take either 
390.16  of the following actions: 
390.17     (1) prohibit the insurer from filing and marketing 
390.18  comparable coverage for a period of up to five years; or 
390.19     (2) prohibit the insurer from offering all other similar 
390.20  coverages and limit the insurer's marketing of new applications 
390.21  for the products that are subject to recent premium rate 
390.22  schedule increases. 
390.23     Subd. 10.  [INCIDENTAL LONG-TERM CARE 
390.24  BENEFITS.] Subdivisions 1 to 9 do not apply to policies for 
390.25  which the long-term care benefits provided by the policy are 
390.26  incidental, as defined in section 62S.01, subdivision 17a, if 
390.27  the policy complies with all of the following provisions: 
390.28     (1) the interest credited internally to determine cash 
390.29  value accumulations, including long-term care, if any, are 
390.30  guaranteed not to be less than the minimum guaranteed interest 
390.31  rate for cash value accumulations without long-term care set 
390.32  forth in the policy; 
390.33     (2) the portion of the policy that provides insurance 
390.34  benefits other than long-term care coverage meets the 
390.35  nonforfeiture requirements as applicable in any of the following:
390.36     (i) for life insurance, section 61A.25; 
391.1      (ii) for individual deferred annuities, section 61A.245; 
391.2   and 
391.3      (iii) for variable annuities, section 61A.21; 
391.4      (3) the policy meets the disclosure requirements of 
391.5   sections 62S.10 and 62S.11 if the policy is governed by chapter 
391.6   62S and of section 62A.50 if the policy is governed by sections 
391.7   62A.46 to 62A.56; 
391.8      (4) the portion of the policy that provides insurance 
391.9   benefits other than long-term care coverage meets the 
391.10  requirements as applicable in the following: 
391.11     (i) policy illustrations to the extent required by state 
391.12  law applicable to life insurance; 
391.13     (ii) disclosure requirements in state law applicable to 
391.14  annuities; and 
391.15     (iii) disclosure requirements applicable to variable 
391.16  annuities; and 
391.17     (5) an actuarial memorandum is filed with the commissioner 
391.18  that includes: 
391.19     (i) a description of the basis on which the long-term care 
391.20  rates were determined; 
391.21     (ii) a description of the basis for the reserves; 
391.22     (iii) a summary of the type of policy, benefits, 
391.23  renewability, general marketing method, and limits on ages of 
391.24  issuance; 
391.25     (iv) a description and a table of each actuarial assumption 
391.26  used.  For expenses, an insurer must include percent of premium 
391.27  dollars per policy and dollars per unit of benefits, if any; 
391.28     (v) a description and a table of the anticipated policy 
391.29  reserves and additional reserves to be held in each future year 
391.30  for active lives; 
391.31     (vi) the estimated average annual premium per policy and 
391.32  the average issue age; 
391.33     (vii) a statement as to whether underwriting is performed 
391.34  at the time of application.  The statement must indicate whether 
391.35  underwriting is used and, if used, the statement must include a 
391.36  description of the type or types of underwriting used, such as 
392.1   medical underwriting or functional assessment underwriting.  
392.2   Concerning a group policy, the statement must indicate whether 
392.3   the enrollee or any dependent will be underwritten and when 
392.4   underwriting occurs; and 
392.5      (viii) a description of the effect of the long-term care 
392.6   policy provision on the required premiums, nonforfeiture values, 
392.7   and reserves on the underlying insurance policy, both for active 
392.8   lives and those in long-term care claim status. 
392.9      Subd. 11.  [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do 
392.10  not apply to group long-term care insurance policies as defined 
392.11  in section 62S.01, subdivision 15, where: 
392.12     (1) the policies insure 250 or more persons, and the 
392.13  policyholder has 5,000 or more eligible employees of a single 
392.14  employer; or 
392.15     (2) the policyholder, and not the certificate holders, pays 
392.16  a material portion of the premium, which is not less than 20 
392.17  percent of the total premium for the group in the calendar year 
392.18  prior to the year in which a rate increase is filed. 
392.19     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
392.20  following final enactment. 
392.21     Sec. 12.  [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.] 
392.22     Subdivision 1.  [APPLICABILITY.] This section does not 
392.23  apply to life insurance policies or riders containing 
392.24  accelerated long-term care benefits. 
392.25     Subd. 2.  [REQUIREMENT.] An insurer must offer each 
392.26  prospective policyholder a nonforfeiture benefit in compliance 
392.27  with the following requirements: 
392.28     (1) a policy or certificate offered with nonforfeiture 
392.29  benefits must have coverage elements, eligibility, benefit 
392.30  triggers, and benefit length that are the same as coverage to be 
392.31  issued without nonforfeiture benefits.  The nonforfeiture 
392.32  benefit included in the offer must be the benefit described in 
392.33  subdivision 5; and 
392.34     (2) the offer must be in writing if the nonforfeiture 
392.35  benefit is not otherwise described in the outline of coverage or 
392.36  other materials given to the prospective policyholder. 
393.1      Subd. 3.  [EFFECT OF REJECTION OF OFFER.] If the offer 
393.2   required to be made under subdivision 2 is rejected, the insurer 
393.3   shall provide the contingent benefit upon lapse described in 
393.4   this section. 
393.5      Subd. 4.  [CONTINGENT BENEFIT UPON LAPSE.] (a) After 
393.6   rejection of the offer required under subdivision 2, for 
393.7   individual and group policies without nonforfeiture benefits 
393.8   issued after the effective date of this section, the insurer 
393.9   shall provide a contingent benefit upon lapse. 
393.10     (b) If a group policyholder elects to make the 
393.11  nonforfeiture benefit an option to the certificate holder, a 
393.12  certificate shall provide either the nonforfeiture benefit or 
393.13  the contingent benefit upon lapse. 
393.14     (c) The contingent benefit on lapse must be triggered every 
393.15  time an insurer increases the premium rates to a level which 
393.16  results in a cumulative increase of the annual premium equal to 
393.17  or exceeding the percentage of the insured's initial annual 
393.18  premium based on the insured's issue age provided in this 
393.19  paragraph, and the policy or certificate lapses within 120 days 
393.20  of the due date of the premium increase.  Unless otherwise 
393.21  required, policyholders shall be notified at least 30 days prior 
393.22  to the due date of the premium reflecting the rate increase. 
393.23           Triggers for a Substantial Premium Increase 
393.24                      Percent Increase
393.25       Issue Age      Over Initial Premium
393.26       29 and Under            200
393.27          30-34                190
393.28          35-39                170
393.29          40-44                150
393.30          45-49                130
393.31          50-54                110
393.32          55-59                 90
393.33             60                 70
393.34             61                 66
393.35             62                 62
393.36             63                 58
394.1              64                 54
394.2              65                 50
394.3              66                 48
394.4              67                 46
394.5              68                 44
394.6              69                 42
394.7              70                 40
394.8              71                 38
394.9              72                 36
394.10             73                 34
394.11             74                 32
394.12             75                 30
394.13             76                 28
394.14             77                 26
394.15             78                 24
394.16             79                 22
394.17             80                 20
394.18             81                 19
394.19             82                 18
394.20             83                 17
394.21             84                 16
394.22             85                 15
394.23             86                 14
394.24             87                 13
394.25             88                 12
394.26             89                 11
394.27         90 and over            10
394.28     (d) On or before the effective date of a substantial 
394.29  premium increase as defined in paragraph (c), the insurer shall: 
394.30     (1) offer to reduce policy benefits provided by the current 
394.31  coverage without the requirement of additional underwriting so 
394.32  that required premium payments are not increased; 
394.33     (2) offer to convert the coverage to a paid-up status with 
394.34  a shortened benefit period according to the terms of subdivision 
394.35  5.  This option may be elected at any time during the 120-day 
394.36  period referenced in paragraph (c); and 
395.1      (3) notify the policyholder or certificate holder that a 
395.2   default or lapse at any time during the 120-day period 
395.3   referenced in paragraph (c) is deemed to be the election of the 
395.4   offer to convert in clause (2). 
395.5      Subd. 5.  [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a) 
395.6   Benefits continued as nonforfeiture benefits, including 
395.7   contingent benefits upon lapse, must be as described in this 
395.8   subdivision. 
395.9      (b) For purposes of this subdivision, "attained age rating" 
395.10  is defined as a schedule of premiums starting from the issue 
395.11  date which increases with age at least one percent per year 
395.12  prior to age 50, and at least three percent per year beyond age 
395.13  50. 
395.14     (c) For purposes of this subdivision, the nonforfeiture 
395.15  benefit must be of a shortened benefit period providing paid-up, 
395.16  long-term care insurance coverage after lapse.  The same 
395.17  benefits, amounts, and frequency in effect at the time of lapse, 
395.18  but not increased thereafter, will be payable for a qualifying 
395.19  claim, but the lifetime maximum dollars or days of benefits must 
395.20  be determined as specified in paragraph (d). 
395.21     (d) The standard nonforfeiture credit is equal to 100 
395.22  percent of the sum of all premiums paid, including the premiums 
395.23  paid prior to any changes in benefits.  The insurer may offer 
395.24  additional shortened benefit period options, so long as the 
395.25  benefits for each duration equal or exceed the standard 
395.26  nonforfeiture credit for that duration.  However, the minimum 
395.27  nonforfeiture credit must not be less than 30 times the daily 
395.28  nursing home benefit at the time of lapse.  In either event, the 
395.29  calculation of the nonforfeiture credit is subject to the 
395.30  limitation of this subdivision. 
395.31     (e) The nonforfeiture benefit must begin not later than the 
395.32  end of the third year following the policy or certificate issue 
395.33  date.  The contingent benefit upon lapse must be effective 
395.34  during the first three years as well as thereafter. 
395.35     (f) Notwithstanding paragraph (e), for a policy or 
395.36  certificate with attained age rating, the nonforfeiture benefit 
396.1   must begin on the earlier of: 
396.2      (1) the end of the tenth year following the policy or 
396.3   certificate issue date; or 
396.4      (2) the end of the second year following the date the 
396.5   policy or certificate is no longer subject to attained age 
396.6   rating. 
396.7      (g) Nonforfeiture credits may be used for all care and 
396.8   services qualifying for benefits under the terms of the policy 
396.9   or certificate, up to the limits specified in the policy or 
396.10  certificate. 
396.11     Subd. 6.  [BENEFIT LIMIT.] All benefits paid by the insurer 
396.12  while the policy or certificate is in premium-paying status and 
396.13  in the paid-up status will not exceed the maximum benefits which 
396.14  would be payable if the policy or certificate had remained in 
396.15  premium-paying status. 
396.16     Subd. 7.  [MINIMUM BENEFITS; INDIVIDUAL AND GROUP 
396.17  POLICIES.] There must be no difference in the minimum 
396.18  nonforfeiture benefits as required under this section for group 
396.19  and individual policies. 
396.20     Subd. 8.  [APPLICATION; EFFECTIVE DATES.] This section 
396.21  becomes effective January 1, 2002, and applies as follows: 
396.22     (a) Except as provided in paragraph (b), this section 
396.23  applies to any long-term care policy issued in this state on or 
396.24  after the effective date of this section. 
396.25     (b) For certificates issued on or after the effective date 
396.26  of this section, under a group long-term care insurance policy 
396.27  that was in force on the effective date of this section, the 
396.28  provisions of this section do not apply. 
396.29     Subd. 9.  [EFFECT ON LOSS RATIO.] Premiums charged for a 
396.30  policy or certificate containing nonforfeiture benefits or a 
396.31  contingent benefit on lapse are subject to the loss ratio 
396.32  requirements of section 62A.48, subdivision 4, or 62S.26, 
396.33  treating the policy as a whole, except for policies or 
396.34  certificates that are subject to sections 62S.021, 62S.081, and 
396.35  62S.265 and that comply with those sections. 
396.36     Subd. 10.  [PURCHASED BLOCKS OF BUSINESS.] To determine 
397.1   whether contingent nonforfeiture upon lapse provisions are 
397.2   triggered under subdivision 4, paragraph (c), a replacing 
397.3   insurer that purchased or otherwise assumed a block or blocks of 
397.4   long-term care insurance policies from another insurer shall 
397.5   calculate the percentage increase based on the initial annual 
397.6   premium paid by the insured when the policy was first purchased 
397.7   from the original insurer. 
397.8      Subd. 11.  [LEVEL PREMIUM CONTRACTS.] A nonforfeiture 
397.9   benefit for qualified long-term care insurance contracts that 
397.10  are level premium contracts must be offered that meets the 
397.11  following requirements: 
397.12     (1) the nonforfeiture provision must be appropriately 
397.13  captioned; 
397.14     (2) the nonforfeiture provision must provide a benefit 
397.15  available in the event of a default in the payment of any 
397.16  premiums and must state that the amount of the benefit may be 
397.17  adjusted subsequent to being initially granted only as necessary 
397.18  to reflect changes in claims, persistency, and interest as 
397.19  reflected in changes in rates for premium paying contracts 
397.20  approved by the commissioner for the same contract form; and 
397.21     (3) the nonforfeiture provision must provide at least one 
397.22  of the following: 
397.23     (i) reduced paid-up insurance; 
397.24     (ii) extended term insurance; 
397.25     (iii) shortened benefit period; or 
397.26     (iv) other similar offerings approved by the commissioner. 
397.27     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
397.28  following final enactment. 
397.29     Sec. 13.  Minnesota Statutes 2000, section 256.975, is 
397.30  amended by adding a subdivision to read: 
397.31     Subd. 8.  [PROMOTION OF LONG-TERM CARE INSURANCE.] The 
397.32  Minnesota board on aging, either directly or through contract, 
397.33  shall promote the provision of employer-sponsored, long-term 
397.34  care insurance.  The board shall encourage private and public 
397.35  sector employers to make long-term care insurance available to 
397.36  employees, provide interested employers with information on the 
398.1   long-term care insurance product offered to state employees, and 
398.2   provide technical assistance to employers in designing long-term 
398.3   care insurance products and contacting companies offering 
398.4   long-term care insurance products. 
398.5      Sec. 14.  [256B.0571] [LONG-TERM CARE PARTNERSHIP.] 
398.6      Subdivision 1.  [DEFINITIONS.] For purposes of this 
398.7   section, the following terms have the meanings given them. 
398.8      (a) "Home care service" means care described in section 
398.9   144A.43. 
398.10     (b) "Long-term care insurance" means a policy described in 
398.11  section 62S.01. 
398.12     (c) "Medical assistance" means the program of medical 
398.13  assistance established under section 256B.01. 
398.14     (d) "Nursing home" means nursing home as described in 
398.15  section 144A.01. 
398.16     (e) "Partnership policy" means a long-term care insurance 
398.17  policy that meets the requirements under chapter 62S. 
398.18     (f) "Partnership program" means the Minnesota partnership 
398.19  for long-term care program established under this section. 
398.20     Subd. 2.  [PARTNERSHIP PROGRAM.] (a) Subject to federal 
398.21  waiver approval, the commissioner of human services, along with 
398.22  the commissioner of commerce, shall establish the Minnesota 
398.23  partnership for long-term care program to provide for the 
398.24  financing of long-term care through a combination of private 
398.25  insurance and medical assistance. 
398.26     (b) An individual who meets the requirements in paragraph 
398.27  (c) is eligible to participate in the partnership program. 
398.28     (c) The individual must: 
398.29     (1) be a Minnesota resident; 
398.30     (2) purchase a partnership policy that is delivered, issued 
398.31  for delivery, or renewed on or after the effective date of this 
398.32  section, and maintains the partnership policy in effect 
398.33  throughout the period of participation in the partnership 
398.34  program; and 
398.35     (3) exhaust the minimum benefits under the partnership 
398.36  policy as described in this section.  Benefits received under a 
399.1   long-term care insurance policy before the effective date of 
399.2   this section do not count toward the exhaustion of benefits 
399.3   required in this subdivision. 
399.4      Subd. 3.  [MEDICAL ASSISTANCE ELIGIBILITY.] (a) Upon 
399.5   application of an individual who meets the requirements 
399.6   described in subdivision 2, the commissioner of human services 
399.7   shall determine the individual's eligibility for medical 
399.8   assistance according to paragraphs (b) and (c). 
399.9      (b) After disregarding financial assets exempted under 
399.10  medical assistance eligibility requirements, the department 
399.11  shall disregard an additional amount of financial assets equal 
399.12  to the dollar amount of coverage under the partnership policy.  
399.13     (c) The department shall consider the individual's income 
399.14  according to medical assistance eligibility requirements. 
399.15     Subd. 4.  [FEDERAL APPROVAL.] (a) The commissioner of human 
399.16  services shall seek appropriate amendments to the medical 
399.17  assistance state plan and shall apply for any necessary waiver 
399.18  of medical assistance requirements by the federal Health Care 
399.19  Financing Administration to implement the partnership program.  
399.20  The state shall not implement the partnership program unless the 
399.21  provisions in paragraphs (b) and (c) apply. 
399.22     (b) The commissioner shall seek any necessary federal 
399.23  waiver of medical assistance requirements. 
399.24     (c) Individuals who receive medical assistance under this 
399.25  section are exempt from estate recovery requirements under 
399.26  section 1917, title XIX of the federal Social Security Act, 
399.27  United States Code, title 42, section 1396p. 
399.28     Subd. 5.  [APPROVED POLICIES.] (a) A partnership policy 
399.29  must meet all of the requirements in paragraphs (b) to (h). 
399.30     (b) Minimum coverage shall be for a period of not less than 
399.31  three years and for a dollar amount equal to 36 months of 
399.32  nursing home care at the minimum daily benefit rate determined 
399.33  and adjusted under paragraph (c).  The policy shall provide for 
399.34  home health care benefits to be substituted for nursing home 
399.35  care benefits on the basis of two home health care days for one 
399.36  nursing home care day. 
400.1      (c) Minimum daily benefits shall be $130 for nursing home 
400.2   care or $65 for home care.  These minimum daily benefit amounts 
400.3   shall be adjusted by the department on October 1 of each year, 
400.4   based on the health care index used under medical assistance for 
400.5   nursing home rate setting.  Adjusted minimum daily benefit 
400.6   amounts shall be rounded to the nearest whole dollar. 
400.7      (d) The insured shall be entitled to designate a third 
400.8   party to receive notice if the policy is about to lapse for 
400.9   nonpayment of premium, and an additional 30-day grace period for 
400.10  payment of premium shall be granted following notification to 
400.11  that person. 
400.12     (e) The policy must cover all of the following services: 
400.13     (1) nursing home stay; 
400.14     (2) home care service; 
400.15     (3) care management; and 
400.16     (4) up to 14 days of nursing care in a hospital while the 
400.17  individual is waiting for long-term care placement.  
400.18     (f) Payment for service under paragraph (e), clause (4), 
400.19  must not exceed the daily benefit amount for nursing home care. 
400.20     (g) A partnership policy must offer both options in 
400.21  paragraph (h) for an adjusted premium. 
400.22     (h) The options are: 
400.23     (1) an elimination period of not more than 100 days; and 
400.24     (2) nonforfeiture benefits for applicants between the ages 
400.25  of 18 and 75. 
400.26                             ARTICLE 9
400.27                 MENTAL HEALTH AND CIVIL COMMITMENT
400.28     Section 1.  [145.56] [SUICIDE PREVENTION.] 
400.29     Subdivision 1.  [PUBLIC HEALTH GOAL; SUICIDE PREVENTION 
400.30  PLAN.] The commissioner of health shall make suicide prevention 
400.31  an important public health goal of the state and shall conduct 
400.32  suicide prevention activities to accomplish that goal using an 
400.33  evidence-based, public health approach focused on prevention.  
400.34  The commissioner shall refine, coordinate, and implement the 
400.35  state's suicide prevention plan, in collaboration with assigned 
400.36  staff from the department of human services; the department of 
401.1   public safety; the department of children, families, and 
401.2   learning; and appropriate agencies, organizations, and 
401.3   institutions in the community. 
401.4      Subd. 2.  [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 
401.5   shall establish a grant program consistent with the policy goals 
401.6   of this section to fund: 
401.7      (1) community-based programs to provide education, 
401.8   outreach, and advocacy services to populations who may be at 
401.9   risk for suicide; 
401.10     (2) community-based programs that educate natural community 
401.11  helpers and gatekeepers, such as family members, spiritual 
401.12  leaders, coaches, and business owners, employers, and coworkers, 
401.13  on how to prevent suicide by encouraging help-seeking behaviors; 
401.14  and 
401.15     (3) community-based programs to provide evidence-based 
401.16  suicide prevention and intervention education to school staff, 
401.17  parents, and students in kindergarten through grade 12. 
401.18     (b) Education to populations at risk for suicide and to 
401.19  community helpers and gatekeepers must include information on 
401.20  the symptoms of depression and other psychiatric illnesses, the 
401.21  warning signs of suicide, skills for preventing suicides, and 
401.22  making or seeking effective referrals to intervention and 
401.23  community resources. 
401.24     Subd. 3.  [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The 
401.25  commissioner shall promote the use of employee assistance and 
401.26  workplace programs to support employees with depression and 
401.27  other psychiatric illnesses and substance abuse disorders, and 
401.28  refer them to services.  In promoting these programs, the 
401.29  commissioner shall collaborate with employer and professional 
401.30  associations, unions, and safety councils. 
401.31     (b) The commissioner shall provide training and technical 
401.32  assistance to local public health and other community-based 
401.33  professionals to provide for integrated implementation of best 
401.34  practices for preventing suicides. 
401.35     Subd. 4. [COLLECTING AND REPORTING SUICIDE DATA.] The 
401.36  commissioner shall coordinate with federal, regional, local, and 
402.1   other state agencies to collect, analyze, and annually issue a 
402.2   public report on Minnesota-specific data on suicide and suicidal 
402.3   behaviors. 
402.4      Subd. 5.  [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 
402.5   commissioner shall conduct periodic evaluations of the impact of 
402.6   and outcomes from implementation of the state's suicide 
402.7   prevention plan and each of the activities specified in this 
402.8   section.  By July 1, 2002, and July 1 of each even-numbered year 
402.9   thereafter, the commissioner shall report the results of these 
402.10  evaluations to the chairs of the policy and finance committees 
402.11  in the house and senate with jurisdiction over health and human 
402.12  services issues. 
402.13     Sec. 2.  Minnesota Statutes 2000, section 245.462, 
402.14  subdivision 8, is amended to read: 
402.15     Subd. 8.  [DAY TREATMENT SERVICES.] "Day treatment," "day 
402.16  treatment services," or "day treatment program" means a 
402.17  structured program of treatment and care provided to an adult in 
402.18  or by:  (1) a hospital accredited by the joint commission on 
402.19  accreditation of health organizations and licensed under 
402.20  sections 144.50 to 144.55; (2) a community mental health center 
402.21  under section 245.62; or (3) an entity that is under contract 
402.22  with the county board to operate a program that meets the 
402.23  requirements of section 245.4712, subdivision 2, and Minnesota 
402.24  Rules, parts 9505.0170 to 9505.0475.  Day treatment consists of 
402.25  group psychotherapy and other intensive therapeutic services 
402.26  that are provided at least one day a week by a multidisciplinary 
402.27  staff under the clinical supervision of a mental health 
402.28  professional.  Day treatment may include education and 
402.29  consultation provided to families and other individuals as part 
402.30  of the treatment process.  The services are aimed at stabilizing 
402.31  the adult's mental health status, providing mental health 
402.32  services, and developing and improving the adult's independent 
402.33  living and socialization skills.  The goal of day treatment is 
402.34  to reduce or relieve mental illness and to enable the adult to 
402.35  live in the community.  Day treatment services are not a part of 
402.36  inpatient or residential treatment services.  Day treatment 
403.1   services are distinguished from day care by their structured 
403.2   therapeutic program of psychotherapy services.  The commissioner 
403.3   may limit medical assistance reimbursement for day treatment to 
403.4   15 hours per week per person instead of the three hours per day 
403.5   per person specified in Minnesota Rules, part 9505.0323, subpart 
403.6   15. 
403.7      Sec. 3.  Minnesota Statutes 2000, section 245.462, 
403.8   subdivision 18, is amended to read: 
403.9      Subd. 18.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
403.10  professional" means a person providing clinical services in the 
403.11  treatment of mental illness who is qualified in at least one of 
403.12  the following ways:  
403.13     (1) in psychiatric nursing:  a registered nurse who is 
403.14  licensed under sections 148.171 to 148.285, and who is certified 
403.15  as a clinical specialist in adult psychiatric and mental health 
403.16  nursing by a national nurse certification organization or who 
403.17  has a master's degree in nursing or one of the behavioral 
403.18  sciences or related fields from an accredited college or 
403.19  university or its equivalent, with at least 4,000 hours of 
403.20  post-master's supervised experience in the delivery of clinical 
403.21  services in the treatment of mental illness; 
403.22     (2) in clinical social work:  a person licensed as an 
403.23  independent clinical social worker under section 148B.21, 
403.24  subdivision 6, or a person with a master's degree in social work 
403.25  from an accredited college or university, with at least 4,000 
403.26  hours of post-master's supervised experience in the delivery of 
403.27  clinical services in the treatment of mental illness; 
403.28     (3) in psychology:  a psychologist an individual licensed 
403.29  by the board of psychology under sections 148.88 to 148.98 who 
403.30  has stated to the board of psychology competencies in the 
403.31  diagnosis and treatment of mental illness; 
403.32     (4) in psychiatry:  a physician licensed under chapter 147 
403.33  and certified by the American board of psychiatry and neurology 
403.34  or eligible for board certification in psychiatry; 
403.35     (5) in marriage and family therapy:  the mental health 
403.36  professional must be a marriage and family therapist licensed 
404.1   under sections 148B.29 to 148B.39 with at least two years of 
404.2   post-master's supervised experience in the delivery of clinical 
404.3   services in the treatment of mental illness; or 
404.4      (6) in allied fields:  a person with a master's degree from 
404.5   an accredited college or university in one of the behavioral 
404.6   sciences or related fields, with at least 4,000 hours of 
404.7   post-master's supervised experience in the delivery of clinical 
404.8   services in the treatment of mental illness.  
404.9      Sec. 4.  Minnesota Statutes 2000, section 245.462, is 
404.10  amended by adding a subdivision to read: 
404.11     Subd. 25a.  [SIGNIFICANT IMPAIRMENT IN FUNCTIONING.] 
404.12  "Significant impairment in functioning" means a condition, 
404.13  including significant suicidal ideation or thoughts of harming 
404.14  self or others, which harmfully affects, recurrently or 
404.15  consistently, a person's activities of daily living in 
404.16  employment, housing, family, and social relationships, or 
404.17  education. 
404.18     Sec. 5.  Minnesota Statutes 2000, section 245.4871, 
404.19  subdivision 10, is amended to read: 
404.20     Subd. 10.  [DAY TREATMENT SERVICES.] "Day treatment," "day 
404.21  treatment services," or "day treatment program" means a 
404.22  structured program of treatment and care provided to a child in: 
404.23     (1) an outpatient hospital accredited by the joint 
404.24  commission on accreditation of health organizations and licensed 
404.25  under sections 144.50 to 144.55; 
404.26     (2) a community mental health center under section 245.62; 
404.27     (3) an entity that is under contract with the county board 
404.28  to operate a program that meets the requirements of section 
404.29  245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 
404.30  9505.0475; or 
404.31     (4) an entity that operates a program that meets the 
404.32  requirements of section 245.4884, subdivision 2, and Minnesota 
404.33  Rules, parts 9505.0170 to 9505.0475, that is under contract with 
404.34  an entity that is under contract with a county board. 
404.35     Day treatment consists of group psychotherapy and other 
404.36  intensive therapeutic services that are provided for a minimum 
405.1   three-hour time block by a multidisciplinary staff under the 
405.2   clinical supervision of a mental health professional.  Day 
405.3   treatment may include education and consultation provided to 
405.4   families and other individuals as an extension of the treatment 
405.5   process.  The services are aimed at stabilizing the child's 
405.6   mental health status, and developing and improving the child's 
405.7   daily independent living and socialization skills.  Day 
405.8   treatment services are distinguished from day care by their 
405.9   structured therapeutic program of psychotherapy services.  Day 
405.10  treatment services are not a part of inpatient hospital or 
405.11  residential treatment services.  Day treatment services for a 
405.12  child are an integrated set of education, therapy, and family 
405.13  interventions. 
405.14     A day treatment service must be available to a child at 
405.15  least five days a week throughout the year and must be 
405.16  coordinated with, integrated with, or part of an education 
405.17  program offered by the child's school. 
405.18     Sec. 6.  Minnesota Statutes 2000, section 245.4871, 
405.19  subdivision 27, is amended to read: 
405.20     Subd. 27.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
405.21  professional" means a person providing clinical services in the 
405.22  diagnosis and treatment of children's emotional disorders.  A 
405.23  mental health professional must have training and experience in 
405.24  working with children consistent with the age group to which the 
405.25  mental health professional is assigned.  A mental health 
405.26  professional must be qualified in at least one of the following 
405.27  ways:  
405.28     (1) in psychiatric nursing, the mental health professional 
405.29  must be a registered nurse who is licensed under sections 
405.30  148.171 to 148.285 and who is certified as a clinical specialist 
405.31  in child and adolescent psychiatric or mental health nursing by 
405.32  a national nurse certification organization or who has a 
405.33  master's degree in nursing or one of the behavioral sciences or 
405.34  related fields from an accredited college or university or its 
405.35  equivalent, with at least 4,000 hours of post-master's 
405.36  supervised experience in the delivery of clinical services in 
406.1   the treatment of mental illness; 
406.2      (2) in clinical social work, the mental health professional 
406.3   must be a person licensed as an independent clinical social 
406.4   worker under section 148B.21, subdivision 6, or a person with a 
406.5   master's degree in social work from an accredited college or 
406.6   university, with at least 4,000 hours of post-master's 
406.7   supervised experience in the delivery of clinical services in 
406.8   the treatment of mental disorders; 
406.9      (3) in psychology, the mental health professional must be a 
406.10  psychologist an individual licensed by the board of psychology 
406.11  under sections 148.88 to 148.98 who has stated to the board of 
406.12  psychology competencies in the diagnosis and treatment of mental 
406.13  disorders; 
406.14     (4) in psychiatry, the mental health professional must be a 
406.15  physician licensed under chapter 147 and certified by the 
406.16  American board of psychiatry and neurology or eligible for board 
406.17  certification in psychiatry; 
406.18     (5) in marriage and family therapy, the mental health 
406.19  professional must be a marriage and family therapist licensed 
406.20  under sections 148B.29 to 148B.39 with at least two years of 
406.21  post-master's supervised experience in the delivery of clinical 
406.22  services in the treatment of mental disorders or emotional 
406.23  disturbances; or 
406.24     (6) in allied fields, the mental health professional must 
406.25  be a person with a master's degree from an accredited college or 
406.26  university in one of the behavioral sciences or related fields, 
406.27  with at least 4,000 hours of post-master's supervised experience 
406.28  in the delivery of clinical services in the treatment of 
406.29  emotional disturbances. 
406.30     Sec. 7.  Minnesota Statutes 2000, section 245.4876, 
406.31  subdivision 1, is amended to read: 
406.32     Subdivision 1.  [CRITERIA.] Children's mental health 
406.33  services required by sections 245.487 to 245.4888 must be:  
406.34     (1) based, when feasible, on research findings; 
406.35     (2) based on individual clinical, cultural, and ethnic 
406.36  needs, and other special needs of the children being served; 
407.1      (3) delivered in a manner that improves family functioning 
407.2   when clinically appropriate; 
407.3      (4) provided in the most appropriate, least restrictive 
407.4   setting that meets the requirements in subdivision 1a, and that 
407.5   is available to the county board to meet the child's treatment 
407.6   needs; 
407.7      (5) accessible to all age groups of children; 
407.8      (6) appropriate to the developmental age of the child being 
407.9   served; 
407.10     (7) delivered in a manner that provides accountability to 
407.11  the child for the quality of service delivered and continuity of 
407.12  services to the child during the years the child needs services 
407.13  from the local system of care; 
407.14     (8) provided by qualified individuals as required in 
407.15  sections 245.487 to 245.4888; 
407.16     (9) coordinated with children's mental health services 
407.17  offered by other providers; 
407.18     (10) provided under conditions that protect the rights and 
407.19  dignity of the individuals being served; and 
407.20     (11) provided in a manner and setting most likely to 
407.21  facilitate progress toward treatment goals. 
407.22     Sec. 8.  Minnesota Statutes 2000, section 245.4876, is 
407.23  amended by adding a subdivision to read: 
407.24     Subd. 1a.  [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 
407.25  child must be provided with mental health services in the least 
407.26  restrictive setting that is appropriate to the needs and current 
407.27  condition of the individual child.  For a child to receive 
407.28  mental health services in a residential treatment or acute care 
407.29  hospital inpatient setting, the family may not be required to 
407.30  demonstrate that services were first provided in a less 
407.31  restrictive setting and that the child failed to make progress 
407.32  toward or meet treatment goals in the less restrictive setting. 
407.33     Sec. 9.  Minnesota Statutes 2000, section 245.4885, 
407.34  subdivision 1, is amended to read: 
407.35     Subdivision 1.  [SCREENING REQUIRED.] The county board 
407.36  shall, prior to admission, except in the case of emergency 
408.1   admission, screen all children referred for treatment of severe 
408.2   emotional disturbance to a residential treatment facility or 
408.3   informally admitted to a regional treatment center if public 
408.4   funds are used to pay for the services.  The county board shall 
408.5   also screen all children admitted to an acute care hospital for 
408.6   treatment of severe emotional disturbance if public funds other 
408.7   than reimbursement under chapters 256B and 256D are used to pay 
408.8   for the services.  If a child is admitted to a residential 
408.9   treatment facility or acute care hospital for emergency 
408.10  treatment or held for emergency care by a regional treatment 
408.11  center under section 253B.05, subdivision 1, screening must 
408.12  occur within three working days of admission.  Screening shall 
408.13  determine whether the proposed treatment:  
408.14     (1) is necessary; 
408.15     (2) is appropriate to the child's individual treatment 
408.16  needs; 
408.17     (3) cannot be effectively provided in the child's home; and 
408.18     (4) provides a length of stay as short as possible 
408.19  consistent with the individual child's need. 
408.20     When a screening is conducted, the county board may not 
408.21  determine that referral or admission to a residential treatment 
408.22  facility or acute care hospital is not appropriate solely 
408.23  because services were not first provided to the child in a less 
408.24  restrictive setting and the child failed to make progress toward 
408.25  or meet treatment goals in the less restrictive setting.  
408.26  Screening shall include both a diagnostic assessment and a 
408.27  functional assessment which evaluates family, school, and 
408.28  community living situations.  If a diagnostic assessment or 
408.29  functional assessment has been completed by a mental health 
408.30  professional within 180 days, a new diagnostic or functional 
408.31  assessment need not be completed unless in the opinion of the 
408.32  current treating mental health professional the child's mental 
408.33  health status has changed markedly since the assessment was 
408.34  completed.  The child's parent shall be notified if an 
408.35  assessment will not be completed and of the reasons.  A copy of 
408.36  the notice shall be placed in the child's file.  Recommendations 
409.1   developed as part of the screening process shall include 
409.2   specific community services needed by the child and, if 
409.3   appropriate, the child's family, and shall indicate whether or 
409.4   not these services are available and accessible to the child and 
409.5   family.  
409.6      During the screening process, the child, child's family, or 
409.7   child's legal representative, as appropriate, must be informed 
409.8   of the child's eligibility for case management services and 
409.9   family community support services and that an individual family 
409.10  community support plan is being developed by the case manager, 
409.11  if assigned.  
409.12     Screening shall be in compliance with section 256F.07 or 
409.13  260C.212, whichever applies.  Wherever possible, the parent 
409.14  shall be consulted in the screening process, unless clinically 
409.15  inappropriate.  
409.16     The screening process, and placement decision, and 
409.17  recommendations for mental health services must be documented in 
409.18  the child's record.  
409.19     An alternate review process may be approved by the 
409.20  commissioner if the county board demonstrates that an alternate 
409.21  review process has been established by the county board and the 
409.22  times of review, persons responsible for the review, and review 
409.23  criteria are comparable to the standards in clauses (1) to (4). 
409.24     Sec. 10.  Minnesota Statutes 2000, section 245.4886, 
409.25  subdivision 1, is amended to read: 
409.26     Subdivision 1.  [STATEWIDE PROGRAM; ESTABLISHMENT.] The 
409.27  commissioner shall establish a statewide program to assist 
409.28  counties in providing services to children with severe emotional 
409.29  disturbance as defined in section 245.4871, subdivision 15, and 
409.30  their families; and to young adults meeting the criteria for 
409.31  transition services in section 245.4875, subdivision 8, and 
409.32  their families.  Services must be designed to help each child to 
409.33  function and remain with the child's family in the community.  
409.34  Transition services to eligible young adults must be designed to 
409.35  foster independent living in the community.  The commissioner 
409.36  shall make grants to counties to establish, operate, or contract 
410.1   with private providers to provide the following services in the 
410.2   following order of priority when these cannot be reimbursed 
410.3   under section 256B.0625: 
410.4      (1) family community support services including crisis 
410.5   placement and crisis respite care as specified in section 
410.6   245.4871, subdivision 17; 
410.7      (2) case management services as specified in section 
410.8   245.4871, subdivision 3; 
410.9      (3) day treatment services as specified in section 
410.10  245.4871, subdivision 10; 
410.11     (4) professional home-based family treatment as specified 
410.12  in section 245.4871, subdivision 31; and 
410.13     (5) therapeutic support of foster care as specified in 
410.14  section 245.4871, subdivision 34. 
410.15     Funding appropriated beginning July 1, 1991, must be used 
410.16  by county boards to provide family community support services 
410.17  and case management services.  Additional services shall be 
410.18  provided in the order of priority as identified in this 
410.19  subdivision. 
410.20     Sec. 11.  Minnesota Statutes 2000, section 245.99, 
410.21  subdivision 4, is amended to read: 
410.22     Subd. 4.  [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.] 
410.23  The commissioner may contract with organizations or government 
410.24  units experienced in housing assistance to operate the program 
410.25  under this section.  This program is not an entitlement.  The 
410.26  commissioner may take any of the following steps whenever the 
410.27  commissioner projects that funds will be inadequate to meet 
410.28  demand in a given fiscal year: 
410.29     (1) transfer funds from mental health grants in the same 
410.30  appropriation; and 
410.31     (2) impose statewide restrictions as to the type and amount 
410.32  of assistance available to each recipient under this program 
410.33  including reducing the income eligibility level, limiting 
410.34  reimbursement to a percentage of each recipient's costs, 
410.35  limiting housing assistance to 60 days per recipient, or closing 
410.36  the program for the remainder of the fiscal year. 
411.1      Sec. 12.  Minnesota Statutes 2000, section 256.969, 
411.2   subdivision 3a, is amended to read: 
411.3      Subd. 3a.  [PAYMENTS.] Acute care hospital billings under 
411.4   the medical assistance program must not be submitted until the 
411.5   recipient is discharged.  However, the commissioner shall 
411.6   establish monthly interim payments for inpatient hospitals that 
411.7   have individual patient lengths of stay over 30 days regardless 
411.8   of diagnostic category.  Except as provided in section 256.9693, 
411.9   medical assistance reimbursement for treatment of mental illness 
411.10  shall be reimbursed based on diagnostic classifications.  The 
411.11  commissioner may selectively contract with hospitals for 
411.12  services within the diagnostic categories relating to mental 
411.13  illness and chemical dependency under competitive bidding when 
411.14  reasonable geographic access by recipients can be assured.  No 
411.15  physician shall be denied the privilege of treating a recipient 
411.16  required to use a hospital under contract with the commissioner, 
411.17  as long as the physician meets credentialing standards of the 
411.18  individual hospital.  Individual hospital payments established 
411.19  under this section and sections 256.9685, 256.9686, and 
411.20  256.9695, in addition to third party and recipient liability, 
411.21  for discharges occurring during the rate year shall not exceed, 
411.22  in aggregate, the charges for the medical assistance covered 
411.23  inpatient services paid for the same period of time to the 
411.24  hospital.  This payment limitation shall be calculated 
411.25  separately for medical assistance and general assistance medical 
411.26  care services.  The limitation on general assistance medical 
411.27  care shall be effective for admissions occurring on or after 
411.28  July 1, 1991.  Services that have rates established under 
411.29  subdivision 11 or 12, must be limited separately from other 
411.30  services.  After consulting with the affected hospitals, the 
411.31  commissioner may consider related hospitals one entity and may 
411.32  merge the payment rates while maintaining separate provider 
411.33  numbers.  The operating and property base rates per admission or 
411.34  per day shall be derived from the best Medicare and claims data 
411.35  available when rates are established.  The commissioner shall 
411.36  determine the best Medicare and claims data, taking into 
412.1   consideration variables of recency of the data, audit 
412.2   disposition, settlement status, and the ability to set rates in 
412.3   a timely manner.  The commissioner shall notify hospitals of 
412.4   payment rates by December 1 of the year preceding the rate 
412.5   year.  The rate setting data must reflect the admissions data 
412.6   used to establish relative values.  Base year changes from 1981 
412.7   to the base year established for the rate year beginning January 
412.8   1, 1991, and for subsequent rate years, shall not be limited to 
412.9   the limits ending June 30, 1987, on the maximum rate of increase 
412.10  under subdivision 1.  The commissioner may adjust base year 
412.11  cost, relative value, and case mix index data to exclude the 
412.12  costs of services that have been discontinued by the October 1 
412.13  of the year preceding the rate year or that are paid separately 
412.14  from inpatient services.  Inpatient stays that encompass 
412.15  portions of two or more rate years shall have payments 
412.16  established based on payment rates in effect at the time of 
412.17  admission unless the date of admission preceded the rate year in 
412.18  effect by six months or more.  In this case, operating payment 
412.19  rates for services rendered during the rate year in effect and 
412.20  established based on the date of admission shall be adjusted to 
412.21  the rate year in effect by the hospital cost index. 
412.22     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
412.23     Sec. 13.  [256.9693] [CONTINUING CARE PROGRAM FOR PERSONS 
412.24  WITH MENTAL ILLNESS.] 
412.25     The commissioner shall establish a continuing care benefit 
412.26  program for persons with mental illness, in which persons with 
412.27  mental illness may obtain acute care hospital inpatient 
412.28  treatment for mental illness for up to 45 days beyond that 
412.29  allowed by section 256.969.  Persons with mental illness who are 
412.30  eligible for medical assistance may obtain inpatient treatment 
412.31  under this program in hospital beds for which the commissioner 
412.32  contracts under this section.  The commissioner may selectively 
412.33  contract with hospitals to provide this benefit through 
412.34  competitive bidding when reasonable geographic access by 
412.35  recipients can be assured.  Payments under this section shall 
412.36  not affect payments under section 256.969.  The commissioner may 
413.1   contract externally with a utilization review organization to 
413.2   authorize persons with mental illness to access the continuing 
413.3   care benefit program.  The commissioner, as part of the 
413.4   contracts with hospitals, shall establish admission criteria to 
413.5   allow persons with mental illness to access the continuing care 
413.6   benefit program.  If a court orders acute care hospital 
413.7   inpatient treatment for mental illness for a person, the person 
413.8   may obtain the treatment under the continuing care benefit 
413.9   program.  The commissioner shall not require, as part of the 
413.10  admission criteria, any commitment or petition under chapter 
413.11  253B as a condition of accessing the program.  This benefit is 
413.12  not available for people who are also eligible for Medicare and 
413.13  who have not exhausted their annual or lifetime inpatient 
413.14  psychiatric benefit under Medicare.  If a recipient is enrolled 
413.15  in a prepaid plan, this program is included in the plan's 
413.16  coverage.  
413.17     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
413.18     Sec. 14.  [256B.0623] [ADULT REHABILITATIVE MENTAL HEALTH 
413.19  SERVICES.] 
413.20     Subdivision 1.  [SCOPE.] Medical assistance covers adult 
413.21  rehabilitative mental health services as defined in subdivision 
413.22  2, subject to federal approval, if provided to recipients as 
413.23  defined in subdivision 3 and provided by a qualified provider 
413.24  entity meeting the standards in this section and by a qualified 
413.25  individual provider working within the provider's scope of 
413.26  practice and identified in the recipient's individual treatment 
413.27  plan as defined in section 245.462, subdivision 14, and if 
413.28  determined to be medically necessary according to section 62Q.53.
413.29     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
413.30  following terms have the meanings given them. 
413.31     (a) "Adult rehabilitative mental health services" means 
413.32  mental health services which are rehabilitative and enable the 
413.33  recipient to develop and enhance psychiatric stability, social 
413.34  competencies, personal and emotional adjustment, and independent 
413.35  living and community skills, when these abilities are impaired 
413.36  by the symptoms of mental illness.  Adult rehabilitative mental 
414.1   health services are also appropriate when provided to enable a 
414.2   recipient to retain stability and functioning, if the recipient 
414.3   would be at risk of significant functional decompensation or 
414.4   more restrictive service settings without these services. 
414.5      (1) Adult rehabilitative mental health services instruct, 
414.6   assist, and support the recipient in areas such as:  
414.7   interpersonal communication skills, community resource 
414.8   utilization and integration skills, crisis assistance, relapse 
414.9   prevention skills, health care directives, budgeting and 
414.10  shopping skills, healthy lifestyle skills and practices, cooking 
414.11  and nutrition skills, transportation skills, medication 
414.12  education and monitoring, mental illness symptom management 
414.13  skills, household management skills, employment-related skills, 
414.14  and transition to community living services. 
414.15     (2) These services shall be provided to the recipient on a 
414.16  one-to-one basis in the recipient's home or another community 
414.17  setting or in groups. 
414.18     (b) "Medication education services" means services provided 
414.19  individually or in groups which focus on educating the recipient 
414.20  about mental illness and symptoms; the role and effects of 
414.21  medications in treating symptoms of mental illness; and the side 
414.22  effects of medications.  Medication education is coordinated 
414.23  with medication management services, and does not duplicate it.  
414.24  Medication education services are provided by physicians, 
414.25  pharmacists, or registered nurses. 
414.26     (c) "Transition to community living services" means 
414.27  services which maintain continuity of contact between the 
414.28  rehabilitation services provider and the recipient and which 
414.29  facilitate discharge from a hospital, residential treatment 
414.30  program under Minnesota Rules, chapter 9505, board and lodging 
414.31  facility, or nursing home. Transition to community living 
414.32  services are not intended to provide other areas of adult 
414.33  rehabilitative mental health services.  
414.34     Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
414.35  individual who: 
414.36     (1) is age 18 or older; 
415.1      (2) is diagnosed with a medical condition, such as mental 
415.2   illness or traumatic brain injury, for which adult 
415.3   rehabilitative mental health services are needed; 
415.4      (3) has substantial disability and functional impairment in 
415.5   three or more of the areas listed in section 245.462, 
415.6   subdivision 11a, so that self-sufficiency is markedly reduced; 
415.7   and 
415.8      (4) has had a recent diagnostic assessment by a qualified 
415.9   professional that documents adult rehabilitative mental health 
415.10  services are medically necessary to address identified 
415.11  disability and functional impairments and individual recipient 
415.12  goals. 
415.13     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) The provider 
415.14  entity must be: 
415.15     (1) a county operated entity certified by the state; or 
415.16     (2) a noncounty entity certified by the entity's host 
415.17  county. 
415.18     (b) The certification process is a determination as to 
415.19  whether the entity meets the standards in this subdivision.  The 
415.20  certification must specify which adult rehabilitative mental 
415.21  health services the entity is qualified to provide. 
415.22     (c) If an entity seeks to provide services outside its host 
415.23  county, it must obtain additional certification from each county 
415.24  in which it will provide services.  The additional certification 
415.25  must be based on the adequacy of the entity's knowledge of that 
415.26  county's local health and human service system, and the ability 
415.27  of the entity to coordinate its services with the other services 
415.28  available in that county. 
415.29     (d) Recertification must occur at least every two years. 
415.30     (e) The commissioner may intervene at any time and 
415.31  decertify providers with cause.  The decertification is subject 
415.32  to appeal to the state.  A county board may recommend that the 
415.33  state decertify a provider for cause. 
415.34     (f) The adult rehabilitative mental health services 
415.35  provider entity must meet the following standards: 
415.36     (1) have capacity to recruit, hire, manage, and train 
416.1   mental health professionals, mental health practitioners, and 
416.2   mental health rehabilitation workers; 
416.3      (2) have adequate administrative ability to ensure 
416.4   availability of services; 
416.5      (3) ensure adequate preservice and inservice training for 
416.6   staff; 
416.7      (4) ensure that mental health professionals, mental health 
416.8   practitioners, and mental health rehabilitation workers are 
416.9   skilled in the delivery of the specific adult rehabilitative 
416.10  mental health services provided to the individual eligible 
416.11  recipient; 
416.12     (5) ensure that staff is capable of implementing culturally 
416.13  specific services that are culturally competent and appropriate 
416.14  as determined by the recipient's culture, beliefs, values, and 
416.15  language as identified in the individual treatment plan; 
416.16     (6) ensure enough flexibility in service delivery to 
416.17  respond to the changing and intermittent care needs of a 
416.18  recipient as identified by the recipient and the individual 
416.19  treatment plan; 
416.20     (7) ensure that the mental health professional or mental 
416.21  health practitioner, who is under the clinical supervision of a 
416.22  mental health professional, involved in a recipient's services 
416.23  participates in the development of the individual treatment 
416.24  plan; 
416.25     (8) assist the recipient in arranging needed crisis 
416.26  assessment, intervention, and stabilization services; 
416.27     (9) ensure that services are coordinated with other 
416.28  recipient mental health services providers and the county mental 
416.29  health authority and the federally recognized American Indian 
416.30  authority and necessary others after obtaining the consent of 
416.31  the recipient.  Services must also be coordinated with the 
416.32  recipient's case manager or care coordinator, if the recipient 
416.33  is receiving case management or care coordination services; 
416.34     (10) develop and maintain recipient files, individual 
416.35  treatment plans, and contact charting; 
416.36     (11) develop and maintain staff training and personnel 
417.1   files; 
417.2      (12) submit information as required by the state; 
417.3      (13) establish and maintain a quality assurance plan to 
417.4   evaluate the outcome of services provided; 
417.5      (14) keep all necessary records required by law; 
417.6      (15) deliver services as required by section 245.461; 
417.7      (16) comply with all applicable laws; 
417.8      (17) be an enrolled Medicaid provider; 
417.9      (18) maintain a quality assurance plan to determine 
417.10  specific service outcomes and the recipient's satisfaction with 
417.11  services; and 
417.12     (19) develop and maintain written policies and procedures 
417.13  regarding service provision and administration of the provider 
417.14  entity. 
417.15     (g) The commissioner shall develop statewide procedures for 
417.16  provider certification, including timelines for counties to 
417.17  certify qualified providers. 
417.18     Subd. 5.  [QUALIFICATIONS OF PROVIDER STAFF.] Adult 
417.19  rehabilitative mental health services must be provided by 
417.20  qualified individual provider staff of a certified provider 
417.21  entity.  Individual provider staff must be qualified under one 
417.22  of the following criteria: 
417.23     (1) a mental health professional as defined in section 
417.24  245.462, subdivision 18, clauses (1) to (5); 
417.25     (2) a mental health practitioner as defined in section 
417.26  245.462, subdivision 17.  The mental health practitioner must 
417.27  work under the clinical supervision of a mental health 
417.28  professional; or 
417.29     (3) a mental health rehabilitation worker.  A mental health 
417.30  rehabilitation worker means a staff person working under the 
417.31  direction of a mental health practitioner or mental health 
417.32  professional, and under the clinical supervision of a mental 
417.33  health professional in the implementation of rehabilitative 
417.34  mental health services as identified in the recipient's 
417.35  individual treatment plan; and who: 
417.36     (i) is at least 21 years of age; 
418.1      (ii) has a high school diploma or equivalent; 
418.2      (iii) has successfully completed 30 hours of training 
418.3   during the past two years in all of the following areas:  
418.4   recipient rights, recipient-centered individual treatment 
418.5   planning, behavioral terminology, mental illness, co-occurring 
418.6   mental illness and substance abuse, psychotropic medications and 
418.7   side effects, functional assessment, local community resources, 
418.8   adult vulnerability, recipient confidentiality; and 
418.9      (iv) meets the qualifications in (A) or (B): 
418.10     (A) has an associate of arts degree in one of the 
418.11  behavioral sciences or human services, or is a registered nurse 
418.12  without a bachelor's degree, or who within the previous ten 
418.13  years has:  
418.14     (1) three years of personal life experience with serious 
418.15  and persistent mental illness; 
418.16     (2) three years of life experience as a primary caregiver 
418.17  to an adult with a serious mental illness or traumatic brain 
418.18  injury; or 
418.19     (3) 4,000 hours of supervised paid work experience in the 
418.20  delivery of mental health services to adults with a serious 
418.21  mental illness or traumatic brain injury; or 
418.22     (B)(1) be fluent in the non-English language or competent 
418.23  in the culture of the ethnic group to which at least 50 percent 
418.24  of the mental health rehabilitation worker's clients belong; 
418.25     (2) receives during the first 2,000 hours of work, monthly 
418.26  documented individual clinical supervision by a mental health 
418.27  professional; 
418.28     (3) has 18 hours of documented field supervision by a 
418.29  mental health professional or practitioner during the first 160 
418.30  hours of contact work with recipients, and at least six hours of 
418.31  field supervision quarterly during the following year; 
418.32     (4) has review and cosignature of charting of recipient 
418.33  contacts during field supervision by a mental health 
418.34  professional or practitioner; and 
418.35     (5) has 40 hours of additional continuing education on 
418.36  mental health topics during the first year of employment. 
419.1      Subd. 6.  [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 
419.2   health rehabilitation workers must receive ongoing continuing 
419.3   education training of at least 30 hours every two years in areas 
419.4   of mental illness and mental health services and other areas 
419.5   specific to the population being served.  Mental health 
419.6   rehabilitation workers must also be subject to the ongoing 
419.7   direction and clinical supervision standards in paragraphs (c) 
419.8   and (d). 
419.9      (b) Mental health practitioners must receive ongoing 
419.10  continuing education training as required by their professional 
419.11  license; or if the practitioner is not licensed, the 
419.12  practitioner must receive ongoing continuing education training 
419.13  of at least 30 hours every two years in areas of mental illness 
419.14  and mental health services.  Mental health practitioners must 
419.15  meet the ongoing clinical supervision standards in paragraph (c).
419.16     (c) A mental health professional providing clinical 
419.17  supervision of staff delivering adult rehabilitative mental 
419.18  health services must provide the following guidance: 
419.19     (1) review the information in the recipient's file; 
419.20     (2) review and approve initial and updates of individual 
419.21  treatment plans; 
419.22     (3) meet with mental health rehabilitation workers and 
419.23  practitioners, individually or in small groups, at least monthly 
419.24  to discuss treatment topics of interest to the workers and 
419.25  practitioners; 
419.26     (4) meet with mental health rehabilitation workers and 
419.27  practitioners, individually or in small groups, at least monthly 
419.28  to discuss treatment plans of recipients, and approve by 
419.29  signature and document in the recipient's file any resulting 
419.30  plan updates; 
419.31     (5) meet at least twice a month with the directing mental 
419.32  health practitioner, if there is one, to review needs of the 
419.33  adult rehabilitative mental health services program, review 
419.34  staff on-site observations and evaluate mental health 
419.35  rehabilitation workers, plan staff training, review program 
419.36  evaluation and development, and consult with the directing 
420.1   practitioner; 
420.2      (6) be available for urgent consultation as the individual 
420.3   recipient needs or the situation necessitates; and 
420.4      (7) provide clinical supervision by full- or part-time 
420.5   mental health professionals employed by or under contract with 
420.6   the provider entity. 
420.7      (d) An adult rehabilitative mental health services provider 
420.8   entity must have a treatment director who is a mental health 
420.9   practitioner or mental health professional.  The treatment 
420.10  director must ensure the following: 
420.11     (1) while delivering direct services to recipients, a newly 
420.12  hired mental health rehabilitation worker must be directly 
420.13  observed delivering services to recipients by the mental health 
420.14  practitioner or mental health professional for at least six 
420.15  hours per 40 hours worked during the first 160 hours that the 
420.16  mental health rehabilitation worker works; 
420.17     (2) the mental health rehabilitation worker must receive 
420.18  ongoing on-site direct service observation by a mental health 
420.19  professional or mental health practitioner for at least six 
420.20  hours for every six months of employment; 
420.21     (3) progress notes are reviewed from on-site service 
420.22  observation prepared by the mental health rehabilitation worker 
420.23  and mental health practitioner for accuracy and consistency with 
420.24  actual recipient contact and the individual treatment plan and 
420.25  goals; 
420.26     (4) immediate availability by phone or in person for 
420.27  consultation by a mental health professional or a mental health 
420.28  practitioner to the mental health rehabilitation services worker 
420.29  during service provision; 
420.30     (5) oversee the identification of changes in individual 
420.31  recipient treatment strategies, revise the plan and communicate 
420.32  treatment instructions and methodologies as appropriate to 
420.33  ensure that treatment is implemented correctly; 
420.34     (6) model service practices which:  respect the recipient, 
420.35  include the recipient in planning and implementation of the 
420.36  individual treatment plan, recognize the recipient's strengths, 
421.1   collaborate and coordinate with other involved parties and 
421.2   providers; 
421.3      (7) ensure that mental health practitioners and mental 
421.4   health rehabilitation workers are able to effectively 
421.5   communicate with the recipients, significant others, and 
421.6   providers; and 
421.7      (8) oversee the record of the results of on-site 
421.8   observation and charting evaluation and corrective actions taken 
421.9   to modify the work of the mental health practitioners and mental 
421.10  health rehabilitation workers. 
421.11     (e) A mental health practitioner who is providing treatment 
421.12  direction for a provider entity must receive supervision at 
421.13  least monthly from a mental health professional to: 
421.14     (1) identify and plan for general needs of the recipient 
421.15  population served; 
421.16     (2) identify and plan to address provider entity program 
421.17  needs and effectiveness; 
421.18     (3) identify and plan provider entity staff training and 
421.19  personnel needs and issues; and 
421.20     (4) plan, implement, and evaluate provider entity quality 
421.21  improvement programs.  
421.22     Subd. 7.  [PERSONNEL FILE.] The adult rehabilitative mental 
421.23  health services provider entity must maintain a personnel file 
421.24  on each staff.  Each file must contain: 
421.25     (1) an annual performance review; 
421.26     (2) a summary of on-site service observations and charting 
421.27  review; 
421.28     (3) a criminal background check of all direct service 
421.29  staff; 
421.30     (4) evidence of academic degree and qualifications; 
421.31     (5) a copy of professional license; 
421.32     (6) any job performance recognition and disciplinary 
421.33  actions; 
421.34     (7) any individual staff written input into own personnel 
421.35  file; 
421.36     (8) all clinical supervision provided; and 
422.1      (9) documentation of compliance with continuing education 
422.2   requirements. 
422.3      Subd. 8.  [DIAGNOSTIC ASSESSMENT.] Providers of adult 
422.4   rehabilitative mental health services must complete a diagnostic 
422.5   assessment as defined in section 245.462, subdivision 9, within 
422.6   five days after the recipient's second visit or within 30 days 
422.7   after intake, whichever occurs first.  In cases where a 
422.8   diagnostic assessment is available that reflects the recipient's 
422.9   current status, and has been completed within 180 days preceding 
422.10  admission, an update must be completed.  An update shall include 
422.11  a written summary by a mental health professional of the 
422.12  recipient's current mental health status and service needs.  If 
422.13  the recipient's mental health status has changed significantly 
422.14  since the adult's most recent diagnostic assessment, a new 
422.15  diagnostic assessment is required. 
422.16     Subd. 9.  [FUNCTIONAL ASSESSMENT.] Providers of adult 
422.17  rehabilitative mental health services must complete a written 
422.18  functional assessment as defined in section 245.462, subdivision 
422.19  11a, for each recipient.  The functional assessment must be 
422.20  completed within 30 days of intake, and reviewed and updated at 
422.21  least every six months after it is developed, unless there is a 
422.22  significant change in the functioning of the recipient.  If 
422.23  there is a significant change in functioning, the assessment 
422.24  must be updated.  A single functional assessment can meet case 
422.25  management and adult rehabilitative mental health services 
422.26  requirements, if agreed to by the recipient.  Unless the 
422.27  recipient refuses, the recipient must have significant 
422.28  participation in the development of the functional assessment. 
422.29     Subd. 10.  [INDIVIDUAL TREATMENT PLAN.] All providers of 
422.30  adult rehabilitative mental health services must develop and 
422.31  implement an individual treatment plan for each recipient.  The 
422.32  provisions in clauses (1) and (2) apply: 
422.33     (1) Individual treatment plan means a plan of intervention, 
422.34  treatment, and services for an individual recipient written by a 
422.35  mental health professional or by a mental health practitioner 
422.36  under the clinical supervision of a mental health professional.  
423.1   The individual treatment plan must be based on diagnostic and 
423.2   functional assessments.  To the extent possible, the development 
423.3   and implementation of a treatment plan must be a collaborative 
423.4   process involving the recipient, and with the permission of the 
423.5   recipient, the recipient's family and others in the recipient's 
423.6   support system.  Providers of adult rehabilitative mental health 
423.7   services must develop the individual treatment plan within 30 
423.8   calendar days of intake.  The treatment plan must be updated at 
423.9   least every six months thereafter, or more often when there is 
423.10  significant change in the recipient's situation or functioning, 
423.11  or in services or service methods to be used, or at the request 
423.12  of the recipient or the recipient's legal guardian. 
423.13     (2) The individual treatment plan must include: 
423.14     (i) a list of problems identified in the assessment; 
423.15     (ii) the recipient's strengths and resources; 
423.16     (iii) concrete, measurable goals to be achieved, including 
423.17  time frames for achievement; 
423.18     (iv) specific objectives directed toward the achievement of 
423.19  each one of the goals; 
423.20     (v) documentation of participants in the treatment planning.
423.21  The recipient, if possible, must be a participant.  The 
423.22  recipient or the recipient's legal guardian must sign the 
423.23  treatment plan, or documentation must be provided why this was 
423.24  not possible.  A copy of the plan must be given to the recipient 
423.25  or legal guardian.  Referral to formal services must be 
423.26  arranged, including specific providers where applicable; 
423.27     (vi) cultural considerations, resources, and needs of the 
423.28  recipient must be included; 
423.29     (vii) planned frequency and type of services must be 
423.30  initiated; and 
423.31     (viii) clear progress notes on outcome of goals. 
423.32     (3) The individual community support plan defined in 
423.33  section 245.462, subdivision 12, may serve as the individual 
423.34  treatment plan if there is involvement of a mental health case 
423.35  manager, and with the approval of the recipient.  The individual 
423.36  community support plan must include the criteria in clause (2). 
424.1      Subd. 11.  [RECIPIENT FILE.] Providers of adult 
424.2   rehabilitative mental health services must maintain a file for 
424.3   each recipient that contains the following information: 
424.4      (1) diagnostic assessment or verification of its location, 
424.5   that is current and that was reviewed by a mental health 
424.6   professional who is employed by or under contract with the 
424.7   provider entity; 
424.8      (2) functional assessments; 
424.9      (3) individual treatment plans signed by the recipient and 
424.10  the mental health professional, or if the recipient refused to 
424.11  sign the plan, the date and reason stated by the recipient as to 
424.12  why the recipient would not sign the plan; 
424.13     (4) recipient history; 
424.14     (5) signed release forms; 
424.15     (6) recipient health information and current medications; 
424.16     (7) emergency contacts for the recipient; 
424.17     (8) case records which document the date of service, the 
424.18  place of service delivery, signature of the person providing the 
424.19  service, nature, extent and units of service, and place of 
424.20  service delivery; 
424.21     (9) contacts, direct or by telephone, with recipient's 
424.22  family or others, other providers, or other resources for 
424.23  service coordination; 
424.24     (10) summary of recipient case reviews by staff; and 
424.25     (11) written information by the recipient that the 
424.26  recipient requests be included in the file. 
424.27     Subd. 12.  [ADDITIONAL REQUIREMENTS.] (a) Providers of 
424.28  adult rehabilitative mental health services must comply with the 
424.29  requirements relating to referrals for case management in 
424.30  section 245.467, subdivision 4. 
424.31     (b) Adult rehabilitative mental health services are 
424.32  provided for most recipients in the recipient's home and 
424.33  community.  Services may also be provided at the home of a 
424.34  relative or significant other, job site, psychosocial clubhouse, 
424.35  drop-in center, social setting, classroom, or other places in 
424.36  the community.  Except for "transition to community services," 
425.1   the place of service does not include a regional treatment 
425.2   center, nursing home, residential treatment facility licensed 
425.3   under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), 
425.4   or an acute care hospital. 
425.5      (c) Adult rehabilitative mental health services may be 
425.6   provided in group settings if appropriate to each participating 
425.7   recipient's needs and treatment plan.  A group is defined as two 
425.8   to ten clients, at least one of whom is a recipient, who is 
425.9   concurrently receiving a service which is identified in this 
425.10  section.  The service and group must be specified in the 
425.11  recipient's treatment plan.  No more than two qualified staff 
425.12  may bill Medicaid for services provided to the same group of 
425.13  recipients.  If two adult rehabilitative mental health workers 
425.14  bill for recipients in the same group session, they must each 
425.15  bill for different recipients. 
425.16     Subd. 13.  [EXCLUDED SERVICES.] The following services are 
425.17  excluded from reimbursement as adult rehabilitative mental 
425.18  health services: 
425.19     (1) recipient transportation services; 
425.20     (2) a service provided and billed by a provider who is not 
425.21  enrolled to provide adult rehabilitative mental health service; 
425.22     (3) adult rehabilitative mental health services performed 
425.23  by volunteers; 
425.24     (4) provider performance of household tasks, chores, or 
425.25  related activities, such as laundering clothes, moving the 
425.26  recipient's household, housekeeping, and grocery shopping for 
425.27  the recipient; 
425.28     (5) direct billing of time spent "on call" when not 
425.29  delivering services to recipients; 
425.30     (6) activities which are primarily social or recreational 
425.31  in nature, rather than rehabilitative, for the individual 
425.32  recipient, as determined by the individual's needs and treatment 
425.33  plan; 
425.34     (7) job-specific skills services, such as on-the-job 
425.35  training; 
425.36     (8) provider service time included in case management 
426.1   reimbursement; 
426.2      (9) outreach services to potential recipients; 
426.3      (10) a mental health service that is not medically 
426.4   necessary; and 
426.5      (11) any services provided by a hospital, board and 
426.6   lodging, or residential facility to an individual who is a 
426.7   patient in or resident of that facility. 
426.8      Subd. 14.  [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED 
426.9   STATE STAFF.] When rehabilitative services are provided by 
426.10  qualified state staff who are assigned to pilot projects under 
426.11  section 245.4661, the county or other local entity to which the 
426.12  qualified state staff are assigned may consider these staff part 
426.13  of the local provider entity for which certification is sought 
426.14  under this section, and may bill the medical assistance program 
426.15  for qualifying services provided by the qualified state staff.  
426.16  Notwithstanding section 256.025, subdivision 2, payments for 
426.17  services provided by state staff who are assigned to adult 
426.18  mental health initiatives shall only be made from federal funds. 
426.19     Sec. 15.  [256B.0624] [ADULT MENTAL HEALTH CRISIS RESPONSE 
426.20  SERVICES.] 
426.21     Subdivision 1.  [SCOPE.] Medical assistance covers adult 
426.22  mental health crisis response services as defined in subdivision 
426.23  2, paragraphs (c) to (e), subject to federal approval, if 
426.24  provided to a recipient as defined in subdivision 3 and provided 
426.25  by a qualified provider entity as defined in this section and by 
426.26  a qualified individual provider working within the provider's 
426.27  scope of practice and as defined in this subdivision and 
426.28  identified in the recipient's individual crisis treatment plan 
426.29  as defined in subdivision 10 and if determined to be medically 
426.30  necessary.  
426.31     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
426.32  following terms have the meanings given them. 
426.33     (a) "Mental health crisis" is an adult behavioral, 
426.34  emotional, or psychiatric situation which, but for the provision 
426.35  of crisis response services, would likely result in 
426.36  significantly reduced levels of functioning in primary 
427.1   activities of daily living, or in an emergency situation, or in 
427.2   the placement of the recipient in a more restrictive setting, 
427.3   including, but not limited to, inpatient hospitalization.  
427.4      (b) "Mental health emergency" is an adult behavioral, 
427.5   emotional, or psychiatric situation which causes an immediate 
427.6   need for mental health services and is consistent with section 
427.7   62Q.55. 
427.8      A mental health crisis or emergency is determined for 
427.9   medical assistance service reimbursement by a physician, a 
427.10  mental health professional, or crisis mental health practitioner 
427.11  with input from the recipient whenever possible. 
427.12     (c) "Mental health crisis assessment" means an immediate 
427.13  face-to-face assessment by a physician, a mental health 
427.14  professional, or mental health practitioner under the clinical 
427.15  supervision of a mental health professional, following a 
427.16  screening that suggests that the adult may be experiencing a 
427.17  mental health crisis or mental health emergency situation. 
427.18     (d) "Mental health mobile crisis intervention services" 
427.19  means face-to-face, short-term intensive mental health services 
427.20  initiated during a mental health crisis or mental health 
427.21  emergency to help the recipient cope with immediate stressors, 
427.22  identify and utilize available resources and strengths, and 
427.23  begin to return to the recipient's baseline level of functioning.
427.24     (1) This service is provided on-site by a mobile crisis 
427.25  intervention team outside of an inpatient hospital setting.  
427.26  Mental health mobile crisis intervention services must be 
427.27  available 24 hours a day, seven days a week.  
427.28     (2) The initial screening must consider other available 
427.29  services to determine which service intervention would best 
427.30  address the recipient's needs and circumstances.  
427.31     (3) The mobile crisis intervention team must be available 
427.32  to meet promptly face-to-face with a person in mental health 
427.33  crisis or emergency in a community setting.  
427.34     (4) The intervention must consist of a mental health crisis 
427.35  assessment and a crisis treatment plan.  
427.36     (5) The treatment plan must include recommendations for any 
428.1   needed crisis stabilization services for the recipient. 
428.2      (e) "Mental health crisis stabilization services" means 
428.3   individualized mental health services provided to a recipient 
428.4   following crisis intervention services which are designed to 
428.5   restore the recipient to the recipient's prior functional 
428.6   level.  Mental health crisis stabilization services may be 
428.7   provided in the recipient's home, the home of a family member or 
428.8   friend of the recipient, another community setting, or a 
428.9   short-term supervised, licensed residential program.  Mental 
428.10  health crisis stabilization does not include partial 
428.11  hospitalization or day treatment. 
428.12     Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
428.13  individual who: 
428.14     (1) is age 18 or older; 
428.15     (2) is screened as possibly experiencing a mental health 
428.16  crisis or emergency where a mental health crisis assessment is 
428.17  needed; and 
428.18     (3) is assessed as experiencing a mental health crisis or 
428.19  emergency, and mental health crisis intervention or crisis 
428.20  intervention and stabilization services are determined to be 
428.21  medically necessary.  
428.22     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) A provider 
428.23  entity is an entity that meets the standards listed in paragraph 
428.24  (b) and: 
428.25     (1) is a county board operated entity; or 
428.26     (2) is a provider entity that is under contract with the 
428.27  county board in the county where the potential crisis or 
428.28  emergency is occurring.  To provide services under this section, 
428.29  the provider entity must directly provide the services; or if 
428.30  services are subcontracted, the provider entity must maintain 
428.31  responsibility for services and billing. 
428.32     (b) The adult mental health crisis response services 
428.33  provider entity must meet the following standards: 
428.34     (1) has the capacity to recruit, hire, and manage and train 
428.35  mental health professionals, practitioners, and rehabilitation 
428.36  workers; 
429.1      (2) has adequate administrative ability to ensure 
429.2   availability of services; 
429.3      (3) is able to ensure adequate preservice and in-service 
429.4   training; 
429.5      (4) is able to ensure that staff providing these services 
429.6   are skilled in the delivery of mental health crisis response 
429.7   services to recipients; 
429.8      (5) is able to ensure that staff are capable of 
429.9   implementing culturally specific treatment identified in the 
429.10  individual treatment plan that is meaningful and appropriate as 
429.11  determined by the recipient's culture, beliefs, values, and 
429.12  language; 
429.13     (6) is able to ensure enough flexibility to respond to the 
429.14  changing intervention and care needs of a recipient as 
429.15  identified by the recipient during the service partnership 
429.16  between the recipient and providers; 
429.17     (7) is able to ensure that mental health professionals and 
429.18  mental health practitioners have the communication tools and 
429.19  procedures to communicate and consult promptly about crisis 
429.20  assessment and interventions as services occur; 
429.21     (8) is able to coordinate these services with county 
429.22  emergency services and mental health crisis services; 
429.23     (9) is able to ensure that mental health crisis assessment 
429.24  and mobile crisis intervention services are available 24 hours a 
429.25  day, seven days a week; 
429.26     (10) is able to ensure that services are coordinated with 
429.27  other mental health service providers, county mental health 
429.28  authorities, or federally recognized American Indian authorities 
429.29  and others as necessary, with the consent of the adult.  
429.30  Services must also be coordinated with the recipient's case 
429.31  manager if the adult is receiving case management services; 
429.32     (11) is able to ensure that crisis intervention services 
429.33  are provided in a manner consistent with sections 245.461 to 
429.34  245.486; 
429.35     (12) is able to submit information as required by the 
429.36  state; 
430.1      (13) maintains staff training and personnel files; 
430.2      (14) is able to establish and maintain a quality assurance 
430.3   and evaluation plan to evaluate the outcomes of services and 
430.4   recipient satisfaction; 
430.5      (15) is able to keep records as required by applicable 
430.6   laws; 
430.7      (16) is able to comply with all applicable laws and 
430.8   statutes; 
430.9      (17) is an enrolled medical assistance provider; and 
430.10     (18) develops and maintains written policies and procedures 
430.11  regarding service provision and administration of the provider 
430.12  entity including safety of staff and recipients in high risk 
430.13  situations.  
430.14     Subd. 5.  [MOBILE CRISIS INTERVENTION STAFF 
430.15  QUALIFICATIONS.] For provision of adult mental health mobile 
430.16  crisis intervention services, a mobile crisis intervention team 
430.17  is comprised of at least two mental health professionals as 
430.18  defined in section 245.462, subdivision 18, clauses (1) to (5), 
430.19  or a combination of at least one mental health professional and 
430.20  one mental health practitioner as defined in section 245.462, 
430.21  subdivision 17, with the required mental health crisis training 
430.22  and under the clinical supervision of a mental health 
430.23  professional on the team.  The team must have at least two 
430.24  people with at least one member providing on-site crisis 
430.25  intervention services when needed.  Team members must be 
430.26  experienced in mental health assessment, crisis intervention 
430.27  techniques, and clinical decision-making under emergency 
430.28  conditions and have knowledge of local services and resources.  
430.29  The team must recommend and coordinate the team's services with 
430.30  appropriate local resources such as the county social services 
430.31  agency, mental health services, and local law enforcement when 
430.32  necessary. 
430.33     Subd. 6.  [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 
430.34  INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 
430.35  crisis intervention services, a screening of the potential 
430.36  crisis situation must be conducted.  The screening may use the 
431.1   resources of crisis assistance and emergency services as defined 
431.2   in sections 245.462, subdivision 6, and 245.469, subdivisions 1 
431.3   and 2.  The screening must gather information, determine whether 
431.4   a crisis situation exists, identify parties involved, and 
431.5   determine an appropriate response. 
431.6      (b) If a crisis exists, a crisis assessment must be 
431.7   completed.  A crisis assessment evaluates any immediate needs 
431.8   for which emergency services are needed and, as time permits, 
431.9   the recipient's current life situation, sources of stress, 
431.10  mental health problems and symptoms, strengths, cultural 
431.11  considerations, support network, vulnerabilities, and current 
431.12  functioning. 
431.13     (c) If the crisis assessment determines mobile crisis 
431.14  intervention services are needed, the intervention services must 
431.15  be provided promptly.  As opportunity presents during the 
431.16  intervention, at least two members of the mobile crisis 
431.17  intervention team must confer directly or by telephone about the 
431.18  assessment, treatment plan, and actions taken and needed.  At 
431.19  least one of the team members must be on-site providing crisis 
431.20  intervention services.  If providing on-site crisis intervention 
431.21  services, a mental health practitioner must seek clinical 
431.22  supervision as required in subdivision 8. 
431.23     (d) The mobile crisis intervention team must develop an 
431.24  initial, brief crisis treatment plan as soon as appropriate but 
431.25  no later than 24 hours after the initial face-to-face 
431.26  intervention.  The plan must address the needs and problems 
431.27  noted in the crisis assessment and include measurable short-term 
431.28  goals, cultural considerations, and frequency and type of 
431.29  services to be provided to achieve the goals and reduce or 
431.30  eliminate the crisis.  The treatment plan must be updated as 
431.31  needed to reflect current goals and services. 
431.32     (e) The team must document which short-term goals have been 
431.33  met, and when no further crisis intervention services are 
431.34  required. 
431.35     (f) If the recipient's crisis is stabilized, but the 
431.36  recipient needs a referral to other services, the team must 
432.1   provide referrals to these services.  If the recipient has a 
432.2   case manager, planning for other services must be coordinated 
432.3   with the case manager. 
432.4      Subd. 7.  [CRISIS STABILIZATION SERVICES.] (a) Crisis 
432.5   stabilization services must be provided by qualified staff of a 
432.6   crisis stabilization services provider entity and must meet the 
432.7   following standards: 
432.8      (1) a crisis stabilization treatment plan must be developed 
432.9   which meets the criteria in subdivision 11; 
432.10     (2) staff must be qualified as defined in subdivision 8; 
432.11  and 
432.12     (3) services must be delivered according to the treatment 
432.13  plan and include face-to-face contact with the recipient by 
432.14  qualified staff for further assessment, help with referrals, 
432.15  updating of the crisis stabilization treatment plan, supportive 
432.16  counseling, skills training, and collaboration with other 
432.17  service providers in the community. 
432.18     (b) If crisis stabilization services are provided in a 
432.19  supervised, licensed residential setting, the recipient must be 
432.20  contacted face-to-face daily by a qualified mental health 
432.21  practitioner or mental health professional.  The program must 
432.22  have 24-hour-a-day residential staffing which may include staff 
432.23  who do not meet the qualifications in subdivision 8.  The 
432.24  residential staff must have 24-hour-a-day immediate direct or 
432.25  telephone access to a qualified mental health professional or 
432.26  practitioner. 
432.27     (c) If crisis stabilization services are provided in a 
432.28  supervised, licensed residential setting that serves no more 
432.29  than four adult residents, and no more than two are recipients 
432.30  of crisis stabilization services, the residential staff must 
432.31  include, for at least eight hours per day, at least one 
432.32  individual who meets the qualifications in subdivision 8. 
432.33     (d) If crisis stabilization services are provided in a 
432.34  supervised, licensed residential setting that serves more than 
432.35  four adult residents, and one or more are recipients of crisis 
432.36  stabilization services, the residential staff must include, for 
433.1   24 hours a day, at least one individual who meets the 
433.2   qualifications in subdivision 8.  During the first 48 hours that 
433.3   a recipient is in the residential program, the residential 
433.4   program must have at least two staff working 24 hours a day.  
433.5   Staffing levels may be adjusted thereafter according to the 
433.6   needs of the recipient as specified in the crisis stabilization 
433.7   treatment plan. 
433.8      Subd. 8.  [ADULT CRISIS STABILIZATION STAFF 
433.9   QUALIFICATIONS.] (a) Adult mental health crisis stabilization 
433.10  services must be provided by qualified individual staff of a 
433.11  qualified provider entity.  Individual provider staff must have 
433.12  the following qualifications: 
433.13     (1) be a mental health professional as defined in section 
433.14  245.462, subdivision 18, clauses (1) to (5); 
433.15     (2) be a mental health practitioner as defined in section 
433.16  245.462, subdivision 17.  The mental health practitioner must 
433.17  work under the clinical supervision of a mental health 
433.18  professional; or 
433.19     (3) be a mental health rehabilitation worker who meets the 
433.20  criteria in section 256B.0623, subdivision 5, clause (3); works 
433.21  under the direction of a mental health practitioner as defined 
433.22  in section 245.462, subdivision 17, or under direction of a 
433.23  mental health professional; and works under the clinical 
433.24  supervision of a mental health professional. 
433.25     (b) Mental health practitioners and mental health 
433.26  rehabilitation workers must have completed at least 30 hours of 
433.27  training in crisis intervention and stabilization during the 
433.28  past two years. 
433.29     Subd. 9.  [SUPERVISION.] Mental health practitioners may 
433.30  provide crisis assessment and mobile crisis intervention 
433.31  services if the following clinical supervision requirements are 
433.32  met: 
433.33     (1) the mental health provider entity must accept full 
433.34  responsibility for the services provided; 
433.35     (2) the mental health professional of the provider entity, 
433.36  who is an employee or under contract with the provider entity, 
434.1   must be available by phone or in person for clinical 
434.2   supervision; 
434.3      (3) the mental health professional is consulted, in person 
434.4   or by phone, during the first three hours when a mental health 
434.5   practitioner provides on-site service; 
434.6      (4) the mental health professional must: 
434.7      (i) review and approve of the tentative crisis assessment 
434.8   and crisis treatment plan; 
434.9      (ii) document the consultation; and 
434.10     (iii) sign the crisis assessment and treatment plan within 
434.11  the next business day; 
434.12     (5) if the mobile crisis intervention services continue 
434.13  into a second calendar day, a mental health professional must 
434.14  contact the recipient face-to-face on the second day to provide 
434.15  services and update the crisis treatment plan; and 
434.16     (6) the on-site observation must be documented in the 
434.17  recipient's record and signed by the mental health professional. 
434.18     Subd. 10.  [RECIPIENT FILE.] Providers of mobile crisis 
434.19  intervention or crisis stabilization services must maintain a 
434.20  file for each recipient containing the following information: 
434.21     (1) individual crisis treatment plans signed by the 
434.22  recipient, mental health professional, and mental health 
434.23  practitioner who developed the crisis treatment plan, or if the 
434.24  recipient refused to sign the plan, the date and reason stated 
434.25  by the recipient as to why the recipient would not sign the 
434.26  plan; 
434.27     (2) signed release forms; 
434.28     (3) recipient health information and current medications; 
434.29     (4) emergency contacts for the recipient; 
434.30     (5) case records which document the date of service, place 
434.31  of service delivery, signature of the person providing the 
434.32  service, and the nature, extent, and units of service.  Direct 
434.33  or telephone contact with the recipient's family or others 
434.34  should be documented; 
434.35     (6) required clinical supervision by mental health 
434.36  professionals; 
435.1      (7) summary of the recipient's case reviews by staff; and 
435.2      (8) any written information by the recipient that the 
435.3   recipient wants in the file. 
435.4   Documentation in the file must comply with all requirements of 
435.5   the commissioner. 
435.6      Subd. 11.  [TREATMENT PLAN.] The individual crisis 
435.7   stabilization treatment plan must include, at a minimum: 
435.8      (1) a list of problems identified in the assessment; 
435.9      (2) a list of the recipient's strengths and resources; 
435.10     (3) concrete, measurable short-term goals and tasks to be 
435.11  achieved, including time frames for achievement; 
435.12     (4) specific objectives directed toward the achievement of 
435.13  each one of the goals; 
435.14     (5) documentation of the participants involved in the 
435.15  service planning.  The recipient, if possible, must be a 
435.16  participant.  The recipient or the recipient's legal guardian 
435.17  must sign the service plan or documentation must be provided why 
435.18  this was not possible.  A copy of the plan must be given to the 
435.19  recipient and the recipient's legal guardian.  The plan should 
435.20  include services arranged, including specific providers where 
435.21  applicable; 
435.22     (6) planned frequency and type of services initiated; 
435.23     (7) a crisis response action plan if a crisis should occur; 
435.24     (8) clear progress notes on outcome of goals; 
435.25     (9) a written plan must be completed within 24 hours of 
435.26  beginning services with the recipient; and 
435.27     (10) a treatment plan must be developed by a mental health 
435.28  professional or mental health practitioner under the clinical 
435.29  supervision of a mental health professional.  The mental health 
435.30  professional must approve and sign all treatment plans. 
435.31     Subd. 12.  [EXCLUDED SERVICES.] The following services are 
435.32  excluded from reimbursement under this section: 
435.33     (1) room and board services; 
435.34     (2) services delivered to a recipient while admitted to an 
435.35  inpatient hospital; 
435.36     (3) recipient transportation costs may be covered under 
436.1   other medical assistance provisions, but transportation services 
436.2   are not an adult mental health crisis response service; 
436.3      (4) services provided and billed by a provider who is not 
436.4   enrolled under medical assistance to provide adult mental health 
436.5   crisis response services; 
436.6      (5) services performed by volunteers; 
436.7      (6) direct billing of time spent "on call" when not 
436.8   delivering services to a recipient; 
436.9      (7) provider service time included in case management 
436.10  reimbursement.  When a provider is eligible to provide more than 
436.11  one type of medical assistance service, the recipient must have 
436.12  a choice of provider for each service, unless otherwise provided 
436.13  for by law; 
436.14     (8) outreach services to potential recipients; and 
436.15     (9) a mental health service that is not medically necessary.
436.16     Sec. 16.  Minnesota Statutes 2000, section 256B.0625, 
436.17  subdivision 20, is amended to read: 
436.18     Subd. 20.  [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 
436.19  extent authorized by rule of the state agency, medical 
436.20  assistance covers case management services to persons with 
436.21  serious and persistent mental illness and children with severe 
436.22  emotional disturbance.  Services provided under this section 
436.23  must meet the relevant standards in sections 245.461 to 
436.24  245.4888, the Comprehensive Adult and Children's Mental Health 
436.25  Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 
436.26  9505.0322, excluding subpart 10. 
436.27     (b) Entities meeting program standards set out in rules 
436.28  governing family community support services as defined in 
436.29  section 245.4871, subdivision 17, are eligible for medical 
436.30  assistance reimbursement for case management services for 
436.31  children with severe emotional disturbance when these services 
436.32  meet the program standards in Minnesota Rules, parts 9520.0900 
436.33  to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
436.34     (c) Medical assistance and MinnesotaCare payment for mental 
436.35  health case management shall be made on a monthly basis.  In 
436.36  order to receive payment for an eligible child, the provider 
437.1   must document at least a face-to-face contact with the child, 
437.2   the child's parents, or the child's legal representative.  To 
437.3   receive payment for an eligible adult, the provider must 
437.4   document: 
437.5      (1) at least a face-to-face contact with the adult or the 
437.6   adult's legal representative; or 
437.7      (2) at least a telephone contact with the adult or the 
437.8   adult's legal representative and document a face-to-face contact 
437.9   with the adult or the adult's legal representative within the 
437.10  preceding two months. 
437.11     (d) Payment for mental health case management provided by 
437.12  county or state staff shall be based on the monthly rate 
437.13  methodology under section 256B.094, subdivision 6, paragraph 
437.14  (b), with separate rates calculated for child welfare and mental 
437.15  health, and within mental health, separate rates for children 
437.16  and adults. 
437.17     (e) Payment for mental health case management provided by 
437.18  Indian health services or by agencies operated by Indian tribes 
437.19  may be made according to this section or other relevant 
437.20  federally approved rate setting methodology. 
437.21     (f) Payment for mental health case management provided by 
437.22  county-contracted vendors who contract with a county or Indian 
437.23  tribe shall be based on a monthly rate negotiated by the host 
437.24  county or tribe.  The negotiated rate must not exceed the rate 
437.25  charged by the vendor for the same service to other payers.  If 
437.26  the service is provided by a team of contracted vendors, the 
437.27  county or tribe may negotiate a team rate with a vendor who is a 
437.28  member of the team.  The team shall determine how to distribute 
437.29  the rate among its members.  No reimbursement received by 
437.30  contracted vendors shall be returned to the county or tribe, 
437.31  except to reimburse the county or tribe for advance funding 
437.32  provided by the county or tribe to the vendor. 
437.33     (f) (g) If the service is provided by a team which includes 
437.34  contracted vendors, tribal staff, and county or state staff, the 
437.35  costs for county or state staff participation in the team shall 
437.36  be included in the rate for county-provided services.  In this 
438.1   case, the contracted vendor, the tribal agency, and the county 
438.2   may each receive separate payment for services provided by each 
438.3   entity in the same month.  In order to prevent duplication of 
438.4   services, the county each entity must document, in the 
438.5   recipient's file, the need for team case management and a 
438.6   description of the roles of the team members. 
438.7      (g) (h) The commissioner shall calculate the nonfederal 
438.8   share of actual medical assistance and general assistance 
438.9   medical care payments for each county, based on the higher of 
438.10  calendar year 1995 or 1996, by service date, project that amount 
438.11  forward to 1999, and transfer one-half of the result from 
438.12  medical assistance and general assistance medical care to each 
438.13  county's mental health grants under sections 245.4886 and 
438.14  256E.12 for calendar year 1999.  The annualized minimum amount 
438.15  added to each county's mental health grant shall be $3,000 per 
438.16  year for children and $5,000 per year for adults.  The 
438.17  commissioner may reduce the statewide growth factor in order to 
438.18  fund these minimums.  The annualized total amount transferred 
438.19  shall become part of the base for future mental health grants 
438.20  for each county. 
438.21     (h) (i) Any net increase in revenue to the county or tribe 
438.22  as a result of the change in this section must be used to 
438.23  provide expanded mental health services as defined in sections 
438.24  245.461 to 245.4888, the Comprehensive Adult and Children's 
438.25  Mental Health Acts, excluding inpatient and residential 
438.26  treatment.  For adults, increased revenue may also be used for 
438.27  services and consumer supports which are part of adult mental 
438.28  health projects approved under Laws 1997, chapter 203, article 
438.29  7, section 25.  For children, increased revenue may also be used 
438.30  for respite care and nonresidential individualized 
438.31  rehabilitation services as defined in section 245.492, 
438.32  subdivisions 17 and 23.  "Increased revenue" has the meaning 
438.33  given in Minnesota Rules, part 9520.0903, subpart 3.  
438.34     (i) (j) Notwithstanding section 256B.19, subdivision 1, the 
438.35  nonfederal share of costs for mental health case management 
438.36  shall be provided by the recipient's county of responsibility, 
439.1   as defined in sections 256G.01 to 256G.12, from sources other 
439.2   than federal funds or funds used to match other federal 
439.3   funds.  If the service is provided by a tribal agency, the 
439.4   nonfederal share, if any, shall be provided by the recipient's 
439.5   tribe.  
439.6      (j) (k) The commissioner may suspend, reduce, or terminate 
439.7   the reimbursement to a provider that does not meet the reporting 
439.8   or other requirements of this section.  The county of 
439.9   responsibility, as defined in sections 256G.01 to 256G.12, or, 
439.10  if applicable, the tribal agency, is responsible for any federal 
439.11  disallowances.  The county or tribe may share this 
439.12  responsibility with its contracted vendors.  
439.13     (k) (l) The commissioner shall set aside a portion of the 
439.14  federal funds earned under this section to repay the special 
439.15  revenue maximization account under section 256.01, subdivision 
439.16  2, clause (15).  The repayment is limited to: 
439.17     (1) the costs of developing and implementing this section; 
439.18  and 
439.19     (2) programming the information systems. 
439.20     (l) (m) Notwithstanding section 256.025, subdivision 2, 
439.21  payments to counties and tribal agencies for case management 
439.22  expenditures under this section shall only be made from federal 
439.23  earnings from services provided under this section.  Payments to 
439.24  contracted county-contracted vendors shall include both the 
439.25  federal earnings and the county share. 
439.26     (m) (n) Notwithstanding section 256B.041, county payments 
439.27  for the cost of mental health case management services provided 
439.28  by county or state staff shall not be made to the state 
439.29  treasurer.  For the purposes of mental health case management 
439.30  services provided by county or state staff under this section, 
439.31  the centralized disbursement of payments to counties under 
439.32  section 256B.041 consists only of federal earnings from services 
439.33  provided under this section. 
439.34     (n) (o) Case management services under this subdivision do 
439.35  not include therapy, treatment, legal, or outreach services. 
439.36     (o) (p) If the recipient is a resident of a nursing 
440.1   facility, intermediate care facility, or hospital, and the 
440.2   recipient's institutional care is paid by medical assistance, 
440.3   payment for case management services under this subdivision is 
440.4   limited to the last 30 days of the recipient's residency in that 
440.5   facility and may not exceed more than two months in a calendar 
440.6   year. 
440.7      (p) (q) Payment for case management services under this 
440.8   subdivision shall not duplicate payments made under other 
440.9   program authorities for the same purpose. 
440.10     (q) (r) By July 1, 2000, the commissioner shall evaluate 
440.11  the effectiveness of the changes required by this section, 
440.12  including changes in number of persons receiving mental health 
440.13  case management, changes in hours of service per person, and 
440.14  changes in caseload size. 
440.15     (r) (s) For each calendar year beginning with the calendar 
440.16  year 2001, the annualized amount of state funds for each county 
440.17  determined under paragraph (g) (h) shall be adjusted by the 
440.18  county's percentage change in the average number of clients per 
440.19  month who received case management under this section during the 
440.20  fiscal year that ended six months prior to the calendar year in 
440.21  question, in comparison to the prior fiscal year. 
440.22     (s) (t) For counties receiving the minimum allocation of 
440.23  $3,000 or $5,000 described in paragraph (g) (h), the adjustment 
440.24  in paragraph (r) (s) shall be determined so that the county 
440.25  receives the higher of the following amounts: 
440.26     (1) a continuation of the minimum allocation in paragraph 
440.27  (g) (h); or 
440.28     (2) an amount based on that county's average number of 
440.29  clients per month who received case management under this 
440.30  section during the fiscal year that ended six months prior to 
440.31  the calendar year in question, in comparison to the prior fiscal 
440.32  year, times the average statewide grant per person per month for 
440.33  counties not receiving the minimum allocation. 
440.34     (t) (u) The adjustments in paragraphs (r) and (s) and (t) 
440.35  shall be calculated separately for children and adults. 
440.36     Sec. 17.  Minnesota Statutes 2000, section 256B.0625, is 
441.1   amended by adding a subdivision to read: 
441.2      Subd. 43.  [APPEAL PROCESS.] If a county contract or 
441.3   certification is required to enroll as an authorized provider of 
441.4   mental health services under medical assistance, and if a county 
441.5   refuses to grant the necessary contract or certification, the 
441.6   provider may appeal the county decision to the commissioner.  A 
441.7   recipient may initiate an appeal on behalf of a provider who has 
441.8   been denied certification.  The commissioner shall determine 
441.9   whether the provider meets applicable standards under state laws 
441.10  and rules based on an independent review of the facts, including 
441.11  comments from the county review.  If the commissioner finds that 
441.12  the provider meets the applicable standards, the commissioner 
441.13  shall enroll the provider as an authorized provider.  The 
441.14  commissioner shall develop procedures for providers and 
441.15  recipients to appeal a county decision to refuse to enroll a 
441.16  provider.  After the commissioner makes a decision regarding an 
441.17  appeal, the county, provider, or recipient may request that the 
441.18  commissioner reconsider the commissioner's initial decision. The 
441.19  commissioner's reconsideration decision is final and not subject 
441.20  to further appeal. 
441.21     Sec. 18.  Minnesota Statutes 2000, section 256B.0625, is 
441.22  amended by adding a subdivision to read: 
441.23     Subd. 44.  [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical 
441.24  assistance covers provider travel time if a recipient's 
441.25  individual treatment plan requires the provision of mental 
441.26  health services outside of the provider's normal place of 
441.27  business.  This does not include any travel time which is 
441.28  included in other billable services, and is only covered when 
441.29  the mental health service being provided to a recipient is 
441.30  covered under medical assistance. 
441.31     Sec. 19.  [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 
441.32  SERVICES.] 
441.33     Payment for medication management provided to psychiatric 
441.34  patients, outpatient mental health services, day treatment 
441.35  services, home-based mental health services, and family 
441.36  community support services shall be paid at: 
442.1      (1) for services rendered on or after July 1, 2001, and 
442.2   before July 1, 2002, the lower of (i) submitted charges, or (ii) 
442.3   the 73rd percentile of the 50th percentile of 1999 charges; and 
442.4      (2) for services rendered on or after July 1, 2002, the 
442.5   lower of (i) submitted charges, or (ii) the 75th percentile of 
442.6   the 50th percentile of 1999 charges. 
442.7      Sec. 20.  [299A.76] [SUICIDE STATISTICS.] 
442.8      (a) The commissioner of public safety shall not: 
442.9      (1) include any statistics on committing suicide or 
442.10  attempting suicide in any compilation of crime statistics 
442.11  published by the commissioner; or 
442.12     (2) label as a crime statistic, any data on committing 
442.13  suicide or attempting suicide. 
442.14     (b) This section does not apply to the crimes of aiding 
442.15  suicide under section 609.215, subdivision 1, or aiding 
442.16  attempted suicide under section 609.215, subdivision 2, or to 
442.17  statistics directly related to the commission of a crime. 
442.18     Sec. 21.  [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 
442.19  CARE BENEFIT PROGRAM.] 
442.20     When the continuing care benefit program for persons with 
442.21  mental illness under Minnesota Statutes, section 256.9693 is 
442.22  established, the commissioner of human services shall notify 
442.23  counties, health plan companies with prepaid medical assistance 
442.24  contracts, health care providers, and enrollees of the benefit 
442.25  program through bulletins, workshops, and other meetings. 
442.26     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2002. 
442.27     Sec. 22.  [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 
442.28  PERSONS.] 
442.29     The commissioner of human services shall study and make 
442.30  recommendations on how Medicare-eligible persons with mental 
442.31  illness may obtain acute care hospital inpatient treatment for 
442.32  mental illness for a length of stay beyond that allowed by the 
442.33  diagnostic classifications for mental illness according to 
442.34  Minnesota Statutes, section 256.969, subdivision 3a.  The study 
442.35  and recommendations shall be reported to the legislature by 
442.36  January 15, 2002. 
443.1      Sec. 23.  [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 
443.2   RESIDENTIAL SERVICES GRANTS.] 
443.3      The commissioner of human services shall review funding 
443.4   methods for adult residential services grants under Minnesota 
443.5   Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 
443.6   system that takes into account client difficulty of care as 
443.7   manifested by client physical, mental, or behavioral 
443.8   conditions.  The payment system must provide reimbursement for 
443.9   education, consultation, and support services provided to 
443.10  families and other individuals as an extension of the treatment 
443.11  process.  The commissioner shall present recommendations and 
443.12  draft legislation for an adult residential services payment 
443.13  system to the legislature by January 15, 2002.  The 
443.14  recommendations must address whether additional funding for 
443.15  adult residential services grants is necessary for the provision 
443.16  of high quality services under a payment reimbursement system. 
443.17                             ARTICLE 10 
443.18                        ASSISTANCE PROGRAMS 
443.19     Section 1.  Minnesota Statutes 2000, section 256.01, 
443.20  subdivision 18, is amended to read: 
443.21     Subd. 18.  [IMMIGRATION STATUS VERIFICATIONS.] (a) 
443.22  Notwithstanding any waiver of this requirement by the secretary 
443.23  of the United States Department of Health and Human Services, 
443.24  effective July 1, 2001, the commissioner shall utilize the 
443.25  Systematic Alien Verification for Entitlements (SAVE) program to 
443.26  conduct immigration status verifications: 
443.27     (1) as required under United States Code, title 8, section 
443.28  1642; 
443.29     (2) for all applicants for food assistance benefits, 
443.30  whether under the federal food stamp program, the MFIP or work 
443.31  first program, or the Minnesota food assistance program; 
443.32     (3) for all applicants for general assistance medical care, 
443.33  except assistance for an emergency medical condition, for 
443.34  immunization with respect to an immunizable disease, or for 
443.35  testing and treatment of symptoms of a communicable disease; and 
443.36     (4) for all applicants for general assistance, Minnesota 
444.1   supplemental aid, MinnesotaCare, or group residential housing, 
444.2   when the benefits provided by these programs would fall under 
444.3   the definition of "federal public benefit" under United States 
444.4   Code, title 8, section 1642, if federal funds were used to pay 
444.5   for all or part of the benefits.  
444.6      The commissioner shall report to the Immigration and 
444.7   Naturalization Service all undocumented persons who have been 
444.8   identified through application verification procedures or by the 
444.9   self-admission of an applicant for assistance.  Reports made 
444.10  under this subdivision must comply with the requirements of 
444.11  section 411A of the Social Security Act, as amended, and United 
444.12  States Code, title 8, section 1644. 
444.13     (b) The commissioner shall comply with the reporting 
444.14  requirements under United States Code, title 42, section 611a, 
444.15  and any federal regulation or guidance adopted under that law. 
444.16     Sec. 2.  [256J.021] [SEPARATE STATE PROGRAM FOR USE OF 
444.17  STATE MONEY.] 
444.18     Beginning October 1, 2001, and each year thereafter, the 
444.19  commissioner of human services must treat financial assistance 
444.20  expenditures made to or on behalf of any minor child under 
444.21  section 256J.02, subdivision 2, clause (1), who is a resident of 
444.22  this state under section 256J.12, and who is part of a 
444.23  two-parent eligible household as expenditures under a separately 
444.24  funded state program and report those expenditures to the 
444.25  federal Department of Health and Human Services as separate 
444.26  state program expenditures under Code of Federal Regulations, 
444.27  title 45, section 263.5. 
444.28     Sec. 3.  Minnesota Statutes 2000, section 256J.09, 
444.29  subdivision 1, is amended to read: 
444.30     Subdivision 1.  [WHERE TO APPLY.] To apply for assistance a 
444.31  person must apply for assistance at submit a signed application 
444.32  to the county agency in the county where that person lives. 
444.33     Sec. 4.  Minnesota Statutes 2000, section 256J.09, 
444.34  subdivision 2, is amended to read: 
444.35     Subd. 2.  [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 
444.36  INFORMATION.] When a person inquires about assistance, a county 
445.1   agency must inform a person who inquires about assistance about: 
445.2      (1) explain the eligibility requirements for assistance of, 
445.3   and how to apply for, diversionary assistance, including 
445.4   diversionary assistance and as provided in section 256J.47; 
445.5   emergency assistance. as provided in section 256J.48; MFIP as 
445.6   provided in section 256J.10; or any other assistance for which 
445.7   the person may be eligible; and 
445.8      A county agency must (2) offer the person brochures 
445.9   developed or approved by the commissioner that describe how to 
445.10  apply for assistance. 
445.11     Sec. 5.  Minnesota Statutes 2000, section 256J.09, 
445.12  subdivision 3, is amended to read: 
445.13     Subd. 3.  [SUBMITTING THE APPLICATION FORM.] (a) A county 
445.14  agency must offer, in person or by mail, the application forms 
445.15  prescribed by the commissioner as soon as a person makes a 
445.16  written or oral inquiry.  At that time, the county agency must: 
445.17     (1) inform the person that assistance begins with the date 
445.18  the signed application is received by the county agency or the 
445.19  date all eligibility criteria are met, whichever is later.  The 
445.20  county agency must; 
445.21     (2) inform the applicant person that any delay in 
445.22  submitting the application will reduce the amount of assistance 
445.23  paid for the month of application.  A county agency must; 
445.24     (3) inform a person that the person may submit the 
445.25  application before an interview appointment.  To apply for 
445.26  assistance, a person must submit a signed application to the 
445.27  county agency.; 
445.28     (4) explain the information that will be verified during 
445.29  the application process by the county agency as provided in 
445.30  section 256J.32; 
445.31     (5) inform a person about the county agency's average 
445.32  application processing time and explain how the application will 
445.33  be processed under subdivision 5; 
445.34     (6) explain how to contact the county agency if a person's 
445.35  application information changes and how to withdraw the 
445.36  application; 
446.1      (7) inform a person that the next step in the application 
446.2   process is an interview and what a person must do if the 
446.3   application is approved including, but not limited to, attending 
446.4   orientation under section 256J.45 and complying with employment 
446.5   and training services requirements in sections 256J.52 to 
446.6   256J.55; 
446.7      (8) explain the child care and transportation services that 
446.8   are available under paragraph (c) to enable caregivers to attend 
446.9   the interview, screening, and orientation; and 
446.10     (9) identify any language barriers and arrange for 
446.11  translation assistance during appointments, including, but not 
446.12  limited to, screening under subdivision 3a, orientation under 
446.13  section 256J.45, and the initial assessment under section 
446.14  256J.52.  
446.15     (b) Upon receipt of a signed application, the county agency 
446.16  must stamp the date of receipt on the face of the application.  
446.17  The county agency must process the application within the time 
446.18  period required under subdivision 5.  An applicant may withdraw 
446.19  the application at any time by giving written or oral notice to 
446.20  the county agency.  The county agency must issue a written 
446.21  notice confirming the withdrawal.  The notice must inform the 
446.22  applicant of the county agency's understanding that the 
446.23  applicant has withdrawn the application and no longer wants to 
446.24  pursue it.  When, within ten days of the date of the agency's 
446.25  notice, an applicant informs a county agency, in writing, that 
446.26  the applicant does not wish to withdraw the application, the 
446.27  county agency must reinstate the application and finish 
446.28  processing the application. 
446.29     (c) Upon a participant's request, the county agency must 
446.30  arrange for transportation and child care or reimburse the 
446.31  participant for transportation and child care expenses necessary 
446.32  to enable participants to attend the screening under subdivision 
446.33  3a and orientation under section 256J.45.  
446.34     Sec. 6.  Minnesota Statutes 2000, section 256J.09, is 
446.35  amended by adding a subdivision to read: 
446.36     Subd. 3a.  [SCREENING.] The county agency, or at county 
447.1   option, the county's employment and training service provider as 
447.2   defined in section 256J.49, must screen each applicant to 
447.3   determine immediate needs and to determine if the applicant may 
447.4   be eligible for: 
447.5      (1) another program that is not partially funded through 
447.6   the federal temporary assistance to needy families block grant 
447.7   under Title I of Public Law Number 104-193, including the 
447.8   expedited issuance of food stamps under section 256J.28, 
447.9   subdivision 1.  If the applicant may be eligible for another 
447.10  program, a county caseworker must provide the appropriate 
447.11  referral to the program; 
447.12     (2) the diversionary assistance program under section 
447.13  256J.47; or 
447.14     (3) the emergency assistance program under section 256J.48. 
447.15     Sec. 7.  Minnesota Statutes 2000, section 256J.09, is 
447.16  amended by adding a subdivision to read: 
447.17     Subd. 3b.  [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 
447.18  If the applicant is not diverted from applying for MFIP, and if 
447.19  the applicant meets the MFIP eligibility requirements, then a 
447.20  county agency must: 
447.21     (1) identify an applicant who is under the age of 20 and 
447.22  explain to the applicant the assessment procedures and 
447.23  employment plan requirements for minor parents under section 
447.24  256J.54; 
447.25     (2) explain to the applicant the eligibility criteria for 
447.26  an exemption under the family violence provisions in section 
447.27  256J.52, subdivision 6, and explain what an applicant should do 
447.28  to develop an alternative employment plan; 
447.29     (3) determine if an applicant qualifies for an exemption 
447.30  under section 256J.56 from employment and training services 
447.31  requirements, explain how a person should report to the county 
447.32  agency any status changes, and explain that an applicant who is 
447.33  exempt may volunteer to participate in employment and training 
447.34  services; 
447.35     (4) for applicants who are not exempt from the requirement 
447.36  to attend orientation, arrange for an orientation under section 
448.1   256J.45 and an initial assessment under section 256J.52; 
448.2      (5) inform an applicant who is not exempt from the 
448.3   requirement to attend orientation that failure to attend the 
448.4   orientation is considered an occurrence of noncompliance with 
448.5   program requirements and will result in an imposition of a 
448.6   sanction under section 256J.46; and 
448.7      (6) explain how to contact the county agency if an 
448.8   applicant has questions about compliance with program 
448.9   requirements. 
448.10     Sec. 8.  Minnesota Statutes 2000, section 256J.15, is 
448.11  amended by adding a subdivision to read: 
448.12     Subd. 3.  [ELIGIBILITY AFTER DISQUALIFICATION DUE TO 
448.13  NONCOMPLIANCE.] (a) An applicant who is a member of an 
448.14  assistance unit that was disqualified from receiving MFIP under 
448.15  section 256J.46, subdivision 1, paragraph (d), clause (3), and 
448.16  who applies for MFIP assistance within six months of the date of 
448.17  the disqualification is considered to be a new applicant for 
448.18  purposes of the property limitations under section 256J.20 and, 
448.19  at county option, the payment of assistance provisions under 
448.20  section 256J.24, subdivision 8.  The county agency must also use 
448.21  the initial income test under section 256J.21, subdivision 3, in 
448.22  determining the applicant's eligibility for assistance. 
448.23     (b) Notwithstanding section 256J.24, subdivisions 5 to 7 
448.24  and 9, for an applicant who is eligible for MFIP under this 
448.25  subdivision, the residual amount of the grant, after making any 
448.26  applicable vendor payments for shelter and utility costs, if 
448.27  any, must be reduced by ten percent of the applicable MFIP 
448.28  standard of need for an assistance unit of the same size for 
448.29  each of the first six months on MFIP before the residual amount 
448.30  of the grant is paid to the assistance unit. 
448.31     (c) A participant who is disqualified from MFIP a second or 
448.32  subsequent time and who is eligible for MFIP under this 
448.33  subdivision is considered to have a third occurrence of 
448.34  noncompliance and must be sanctioned under section 256J.46, 
448.35  subdivision 1, paragraph (d), clause (2), for the first six 
448.36  months on MFIP under this subdivision. 
449.1      Sec. 9.  Minnesota Statutes 2000, section 256J.24, 
449.2   subdivision 10, is amended to read: 
449.3      Subd. 10.  [MFIP EXIT LEVEL.] (a) In state fiscal years 
449.4   2000 and 2001, The commissioner shall adjust the MFIP earned 
449.5   income disregard to ensure that most participants do not lose 
449.6   eligibility for MFIP until their income reaches at least 120 
449.7   percent of the federal poverty guidelines in effect in October 
449.8   of each fiscal year.  The adjustment to the disregard shall be 
449.9   based on a household size of three, and the resulting earned 
449.10  income disregard percentage must be applied to all household 
449.11  sizes.  The adjustment under this subdivision must be 
449.12  implemented at the same time as the October food stamp 
449.13  cost-of-living adjustment is reflected in the food portion of 
449.14  MFIP transitional standard as required under subdivision 5a. 
449.15     (b) In state fiscal year 2002 and thereafter, the earned 
449.16  income disregard percentage must be the same as the percentage 
449.17  implemented in October 2000. 
449.18     Sec. 10.  Minnesota Statutes 2000, section 256J.26, 
449.19  subdivision 1, is amended to read: 
449.20     Subdivision 1.  [PERSON CONVICTED OF DRUG OFFENSES.] (a) 
449.21  Applicants or participants who have been convicted of a drug 
449.22  offense committed after July 1, 1997, may, if otherwise 
449.23  eligible, receive MFIP benefits subject to the following 
449.24  conditions: 
449.25     (1) Benefits for the entire assistance unit must be paid in 
449.26  vendor form for shelter and utilities during any time the 
449.27  applicant is part of the assistance unit. 
449.28     (2) The convicted applicant or participant shall be subject 
449.29  to random drug testing as a condition of continued eligibility 
449.30  and following any positive test for an illegal controlled 
449.31  substance is subject to the following sanctions: 
449.32     (i) for failing a drug test the first time, the 
449.33  participant's grant shall be reduced by ten percent of the MFIP 
449.34  standard of need, prior to making vendor payments for shelter 
449.35  and utility costs; or 
449.36     (ii) for failing a drug test two or more times, the 
450.1   residual amount of the participant's grant after making vendor 
450.2   payments for shelter and utility costs, if any, must be reduced 
450.3   by an amount equal to 30 percent of the MFIP standard of 
450.4   need for an assistance unit of the same size.  When a sanction 
450.5   under this subdivision is in effect, the job counselor must 
450.6   attempt to meet with the person face-to-face.  During the 
450.7   face-to-face meeting, the job counselor must explain the 
450.8   consequences of a subsequent drug test failure and inform the 
450.9   participant of the right to appeal the sanction under section 
450.10  256J.40.  If a face-to-face meeting is not possible, the county 
450.11  agency must send the participant a notice of adverse action as 
450.12  provided in section 256J.31, subdivisions 4 and 5, and must 
450.13  include the information required in the face-to-face meeting; or 
450.14     (ii) for failing a drug test two times, the participant is 
450.15  permanently disqualified from receiving MFIP assistance, both 
450.16  the cash and food portions.  The assistance unit's MFIP grant 
450.17  must be reduced by the amount which would have otherwise been 
450.18  made available to the disqualified participant.  
450.19  Disqualification under this item does not make a participant 
450.20  ineligible for food stamps.  Before a disqualification under 
450.21  this provision is imposed, the job counselor must attempt to 
450.22  meet with the participant face-to-face.  During the face-to-face 
450.23  meeting, the job counselor must identify other resources that 
450.24  may be available to the participant to meet the needs of the 
450.25  family and inform the participant of the right to appeal the 
450.26  disqualification under section 256J.40.  If a face-to-face 
450.27  meeting is not possible, the county agency must send the 
450.28  participant a notice of adverse action as provided in section 
450.29  256J.31, subdivisions 4 and 5, and must include the information 
450.30  required in the face-to-face meeting. 
450.31     (3) A participant who fails an initial a drug test the 
450.32  first time and is under a sanction due to other MFIP program 
450.33  requirements is considered to have more than one occurrence of 
450.34  noncompliance and is subject to the applicable level of sanction 
450.35  in clause (2)(ii) as specified under section 256J.46, 
450.36  subdivision 1, paragraph (d). 
451.1      (b) Applicants requesting only food stamps or participants 
451.2   receiving only food stamps, who have been convicted of a drug 
451.3   offense that occurred after July 1, 1997, may, if otherwise 
451.4   eligible, receive food stamps if the convicted applicant or 
451.5   participant is subject to random drug testing as a condition of 
451.6   continued eligibility.  Following a positive test for an illegal 
451.7   controlled substance, the applicant is subject to the following 
451.8   sanctions: 
451.9      (1) for failing a drug test the first time, food stamps 
451.10  shall be reduced by ten percent of the applicable food stamp 
451.11  allotment; and 
451.12     (2) for failing a drug test two or more times, food stamps 
451.13  shall be reduced by an amount equal to 30 percent of the 
451.14  applicable food stamp allotment.  When a sanction under this 
451.15  clause is in effect, a job counselor must attempt to meet with 
451.16  the person face-to-face.  During the face-to-face meeting, a job 
451.17  counselor must explain the consequences of a subsequent drug 
451.18  test failure and inform the participant of the right to appeal 
451.19  the sanction under section 256J.40.  If a face-to-face meeting 
451.20  is not possible, a county agency must send the participant a 
451.21  notice of adverse action as provided in section 256J.31, 
451.22  subdivisions 4 and 5, and must include the information required 
451.23  in the face-to-face meeting; and 
451.24     (2) for failing a drug test two times, the participant is 
451.25  permanently disqualified from receiving food stamps.  Before a 
451.26  disqualification under this provision is imposed, a job 
451.27  counselor must attempt to meet with the participant 
451.28  face-to-face.  During the face-to-face meeting, the job 
451.29  counselor must identify other resources that may be available to 
451.30  the participant to meet the needs of the family and inform the 
451.31  participant of the right to appeal the disqualification under 
451.32  section 256J.40.  If a face-to-face meeting is not possible, a 
451.33  county agency must send the participant a notice of adverse 
451.34  action as provided in section 256J.31, subdivisions 4 and 5, and 
451.35  must include the information required in the face-to-face 
451.36  meeting. 
452.1      (c) For the purposes of this subdivision, "drug offense" 
452.2   means an offense that occurred after July 1, 1997, of sections 
452.3   152.021 to 152.025, 152.0261, or 152.096.  Drug offense also 
452.4   means a conviction in another jurisdiction of the possession, 
452.5   use, or distribution of a controlled substance, or conspiracy to 
452.6   commit any of these offenses, if the offense occurred after July 
452.7   1, 1997, and the conviction is a felony offense in that 
452.8   jurisdiction, or in the case of New Jersey, a high misdemeanor. 
452.9      Sec. 11.  Minnesota Statutes 2000, section 256J.31, 
452.10  subdivision 4, is amended to read: 
452.11     Subd. 4.  [PARTICIPANT'S RIGHT TO NOTICE.] A county agency 
452.12  must give a participant written notice of all adverse actions 
452.13  affecting the participant including payment reductions, 
452.14  suspensions, terminations, and use of protective, vendor, or 
452.15  two-party payments.  The notice of adverse action must be on a 
452.16  form prescribed or approved by the commissioner, must be 
452.17  understandable at a seventh grade reading level, and must be 
452.18  mailed to the last known mailing address provided by the 
452.19  participant.  A notice written in English must include the 
452.20  department of human services language block and must be sent to 
452.21  every applicable participant.  The county agency must state on 
452.22  the notice of adverse action the action it intends to take, the 
452.23  reasons for the action, the participant's right to appeal the 
452.24  action, the conditions under which assistance can be continued 
452.25  pending an appeal decision, and the related consequences of the 
452.26  action. 
452.27     Sec. 12.  Minnesota Statutes 2000, section 256J.32, 
452.28  subdivision 7a, is amended to read: 
452.29     Subd. 7a.  [REQUIREMENT TO REPORT TO IMMIGRATION AND 
452.30  NATURALIZATION SERVICES.] Notwithstanding subdivision 7, 
452.31  effective July 1, 2001, the commissioner shall report to the 
452.32  Immigration and Naturalization Services all undocumented persons 
452.33  who have been identified through application verification 
452.34  procedures or by the self-admission of an applicant for 
452.35  assistance.  Reports made under this subdivision must comply 
452.36  with the requirements of section 411A of the Social Security 
453.1   Act, as amended, and United States Code, title 8, section 1644.  
453.2   The commissioner shall comply with the reporting requirements 
453.3   under United States Code, title 42, section 611a, and any 
453.4   federal regulation or guidance adopted under that law. 
453.5      Sec. 13.  Minnesota Statutes 2000, section 256J.42, is 
453.6   amended by adding a subdivision to read: 
453.7      Subd. 6.  [CASE REVIEW.] (a) Within 180 days before the end 
453.8   of the participant's 60th month on MFIP, the county agency or 
453.9   job counselor must review the participant's case to determine if 
453.10  the employment plan is still appropriate, or if the participant 
453.11  is exempt under section 256J.56 from the employment and training 
453.12  services component, and attempt to meet with the participant 
453.13  face-to-face. 
453.14     (b) During the face-to-face meeting, a county agency or the 
453.15  job counselor must: 
453.16     (1) inform the participant how many months of counted 
453.17  assistance the participant has accrued and when the participant 
453.18  is expected to reach the 60th month; 
453.19     (2) explain the hardship extension criteria under section 
453.20  256J.425 and what the participant should do if the participant 
453.21  thinks a hardship extension applies; 
453.22     (3) identify other resources that may be available to the 
453.23  participant to meet the needs of the family; and 
453.24     (4) inform the participant of the right to appeal the case 
453.25  closure under section 256J.40. 
453.26     (c) If a face-to-face meeting is not possible, the county 
453.27  agency must send the participant a notice of adverse action as 
453.28  provided in section 256J.31, subdivisions 4 and 5. 
453.29     (d) Before a participant's case is closed under this 
453.30  section, the county must ensure that: 
453.31     (1) the case has been reviewed by the job counselor's 
453.32  supervisor or the review team designated in the county's 
453.33  approved local service unit plan to determine if the criteria 
453.34  for a hardship extension, if requested, were applied 
453.35  appropriately; and 
453.36     (2) the county agency or the job counselor attempted to 
454.1   meet with the participant face-to-face. 
454.2      Sec. 14.  [256J.425] [HARDSHIP EXTENSIONS.] 
454.3      Subdivision 1.  [ELIGIBILITY.] An assistance unit subject 
454.4   to the time limit under section 256J.42, subdivision 1, in which 
454.5   any participant has received 60 counted months of assistance is 
454.6   not eligible to receive months of assistance beyond the first 60 
454.7   months under a hardship extension, if the participant is not in 
454.8   compliance.  If there is more than one participant in the 
454.9   household, each participant must be in compliance to be eligible 
454.10  for a hardship extension.  For purposes of determining 
454.11  eligibility for a hardship extension, a participant is in 
454.12  compliance in any month that the participant has not been 
454.13  sanctioned under section 256J.46, subdivision 1, or under 
454.14  256J.26, subdivision 1. 
454.15     Subd. 2.  [ILL OR INCAPACITATED PARTICIPANTS; DEPENDENT 
454.16  HOUSEHOLD MEMBER.] (a) An assistance unit subject to the time 
454.17  limit in section 256J.42, subdivision 1, in which any 
454.18  participant has received 60 counted months of assistance, is 
454.19  eligible to receive months of assistance under a hardship 
454.20  extension if the participant belongs to any of the following 
454.21  groups: 
454.22     (1) participants who are suffering from a professionally 
454.23  certified illness, injury, or incapacity which is expected to 
454.24  continue for more than 30 days and which prevents the person 
454.25  from obtaining or retaining employment and who are following the 
454.26  treatment recommendations of the health care provider certifying 
454.27  the illness, injury, or incapacity; 
454.28     (2) participants whose presence in the home is required 
454.29  because of the professionally certified illness or incapacity of 
454.30  another member in the assistance unit, a relative in the 
454.31  household, or a foster child in the household and the illness or 
454.32  incapacity is expected to continue for more than 30 days; or 
454.33     (3) caregivers with a child or an adult in the household 
454.34  who meets the disability or medical criteria for home care 
454.35  services under section 256B.0627, subdivision 1, paragraph (c), 
454.36  or a home and community-based waiver services program under 
455.1   chapter 256B, or meets the criteria for severe emotional 
455.2   disturbance under section 245.4871, subdivision 6, or for 
455.3   serious and persistent mental illness under section 245.462, 
455.4   subdivision 20, paragraph (c).  Caregivers in this category are 
455.5   presumed to be prevented from obtaining or retaining employment. 
455.6      (b) An assistance unit receiving assistance under a 
455.7   hardship extension under this subdivision may continue to 
455.8   receive assistance under MFIP as long as the participant meets 
455.9   the criteria in paragraph (a), clause (1), (2), or (3).  A 
455.10  county agency or job counselor must, on a quarterly basis, 
455.11  review the case file of an assistance unit receiving assistance 
455.12  under this subdivision to determine if the participant still 
455.13  meets the criteria in paragraph (a), clause (1), (2), or (3). 
455.14     Subd. 3.  [CERTAIN HARD-TO-EMPLOY PARTICIPANTS.] (a) An 
455.15  assistance unit subject to the time limit in section 256J.42, 
455.16  subdivision 1, in which any participant has received 60 counted 
455.17  months of assistance, is eligible to receive months of 
455.18  assistance under a hardship extension if the participant belongs 
455.19  to any of the following groups: 
455.20     (1) a person who is diagnosed by a licensed physician, 
455.21  psychological practitioner, or other qualified professional, as 
455.22  mentally retarded or mentally ill, and that condition prevents 
455.23  the person from obtaining or retaining employment; 
455.24     (2) a person who has been assessed by a vocational 
455.25  specialist, job counselor, or the county agency to be 
455.26  unemployable for purposes of this subdivision; a person is 
455.27  considered employable if positions of employment in the local 
455.28  labor market exist, regardless of the current availability of 
455.29  openings for those positions, that the person is capable of 
455.30  performing.  The person's eligibility under this category must 
455.31  be reassessed at least annually; or 
455.32     (3) a person who is determined by the county agency, 
455.33  according to Minnesota Rules, part 9500.1251, subpart 2, item I, 
455.34  to be learning disabled, provided that if a rehabilitation plan 
455.35  for the person is developed or approved by the county agency, 
455.36  the person is following the plan.  A rehabilitation plan does 
456.1   not replace the requirement to develop and comply with an 
456.2   employment plan under section 256J.52. 
456.3      (b) An assistance unit receiving assistance under a 
456.4   hardship extension under this subdivision may continue to 
456.5   receive assistance under MFIP as long as the participant meets 
456.6   the criteria in paragraph (a), clause (1), (2), or (3), and all 
456.7   participants in the assistance unit remain in compliance with, 
456.8   or are exempt from, the employment and training services 
456.9   requirements in sections 256J.52 to 256J.55. 
456.10     Subd. 4.  [VICTIMS OF FAMILY VIOLENCE.] A participant who 
456.11  received TANF assistance that counted towards the federal 
456.12  60-month time limit while the participant complied with a safety 
456.13  plan or, after October 1, 2001, an alternative employment plan 
456.14  under the MFIP employment and training component is eligible for 
456.15  assistance under a hardship extension for a period of time equal 
456.16  to the number of months that were counted toward the federal 
456.17  60-month time limit while the participant complied with a safety 
456.18  plan or, after October 1, 2001, an alternative employment plan 
456.19  under the MFIP employment and training component. 
456.20     Subd. 5.  [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a) A 
456.21  participant who received TANF assistance that counted towards 
456.22  the federal 60-month time limit while the participant was or 
456.23  would have been exempt under section 256J.56, paragraph (a), 
456.24  clause (7), from employment and training services requirements 
456.25  and who is no longer eligible for assistance under a hardship 
456.26  extension under subdivision 2, paragraph (a), clause (3), is 
456.27  eligible for assistance under a hardship extension for a period 
456.28  of time equal to the number of months that were counted toward 
456.29  the federal 60-month time limit while the participant was or 
456.30  would have been exempt under section 256J.56, paragraph (a), 
456.31  clause (7), from the employment and training services 
456.32  requirements. 
456.33     (b) A participant who received TANF assistance that counted 
456.34  towards the federal 60-month time limit while the participant 
456.35  met the state time limit exemption criteria under section 
456.36  256J.42, subdivision 5, is eligible for assistance under a 
457.1   hardship extension for a period of time equal to the number of 
457.2   months that were counted toward the federal 60-month time limit 
457.3   while the participant met the state time limit exemption 
457.4   criteria under section 256J.42, subdivision 5. 
457.5      Sec. 15.  Minnesota Statutes 2000, section 256J.45, 
457.6   subdivision 1, is amended to read: 
457.7      Subdivision 1.  [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 
457.8   county agency must provide a face-to-face orientation to each 
457.9   MFIP caregiver who is not exempt under section 256J.56, 
457.10  paragraph (a), clause (6) or (8), with a face-to-face 
457.11  orientation unless the caregiver is: 
457.12     (1) a single parent, or one parent in a two-parent family, 
457.13  employed at least 35 hours per week; or 
457.14     (2) a second parent in a two-parent family who is employed 
457.15  for 20 or more hours per week provided the first parent is 
457.16  employed at least 35 hours per week. 
457.17  The county agency must inform caregivers who are not exempt 
457.18  under section 256J.56, paragraph (a), clause (6) or (8), clause 
457.19  (1) or (2) that failure to attend the orientation is considered 
457.20  an occurrence of noncompliance with program requirements, and 
457.21  will result in the imposition of a sanction under section 
457.22  256J.46.  If the client complies with the orientation 
457.23  requirement prior to the first day of the month in which the 
457.24  grant reduction is proposed to occur, the orientation sanction 
457.25  shall be lifted. 
457.26     Sec. 16.  Minnesota Statutes 2000, section 256J.46, 
457.27  subdivision 1, is amended to read: 
457.28     Subdivision 1.  [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 
457.29  WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 
457.30  good cause to comply with the requirements of this chapter, and 
457.31  who is not subject to a sanction under subdivision 2, shall be 
457.32  subject to a sanction as provided in this subdivision.  Prior to 
457.33  the imposition of a sanction, a county agency shall provide a 
457.34  notice of intent to sanction under section 256J.57, subdivision 
457.35  2, and, when applicable, a notice of adverse action as provided 
457.36  in section 256J.31. 
458.1      (b) A participant who fails to comply with an alternative 
458.2   employment plan must have the plan reviewed by a person trained 
458.3   in domestic violence and a job counselor to determine if 
458.4   components of the alternative employment plan are still 
458.5   appropriate.  If the activities are no longer appropriate, the 
458.6   plan must be revised with a person trained in domestic violence 
458.7   and approved by a job counselor.  A participant who fails to 
458.8   comply with a plan that is determined not to need revision will 
458.9   lose their exemption and be required to comply with regular 
458.10  employment services activities.  
458.11     (c) A sanction under this subdivision becomes effective the 
458.12  month following the month in which a required notice is given.  
458.13  A sanction must not be imposed when a participant comes into 
458.14  compliance with the requirements for orientation under section 
458.15  256J.45 or third-party liability for medical services under 
458.16  section 256J.30, subdivision 10, prior to the effective date of 
458.17  the sanction.  A sanction must not be imposed when a participant 
458.18  comes into compliance with the requirements for employment and 
458.19  training services under sections 256J.49 to 256J.72 256J.55 ten 
458.20  days prior to the effective date of the sanction.  For purposes 
458.21  of this subdivision, each month that a participant fails to 
458.22  comply with a requirement of this chapter shall be considered a 
458.23  separate occurrence of noncompliance.  A participant who has had 
458.24  one or more sanctions imposed must remain in compliance with the 
458.25  provisions of this chapter for six months in order for a 
458.26  subsequent occurrence of noncompliance to be considered a first 
458.27  occurrence.  
458.28     (b) (d) Sanctions for noncompliance shall be imposed as 
458.29  follows: 
458.30     (1) For the first occurrence of noncompliance by a 
458.31  participant in a single-parent household or by one participant 
458.32  in a two-parent household an assistance unit, the assistance 
458.33  unit's grant shall be reduced by ten percent of the MFIP 
458.34  standard of need for an assistance unit of the same size with 
458.35  the residual grant paid to the participant.  The reduction in 
458.36  the grant amount must be in effect for a minimum of one month 
459.1   and shall be removed in the month following the month that the 
459.2   participant returns to compliance.  
459.3      (2) For a second or subsequent and third occurrence of 
459.4   noncompliance by a participant in an assistance unit, or 
459.5   when both each of the participants in a two-parent household are 
459.6   out of compliance assistance unit have a first occurrence of 
459.7   noncompliance at the same time, the assistance unit's shelter 
459.8   costs shall be vendor paid up to the amount of the cash portion 
459.9   of the MFIP grant for which the participant's assistance unit is 
459.10  eligible.  At county option, the assistance unit's utilities may 
459.11  also be vendor paid up to the amount of the cash portion of the 
459.12  MFIP grant remaining after vendor payment of the assistance 
459.13  unit's shelter costs.  The residual amount of the grant after 
459.14  vendor payment, if any, must be reduced by an amount equal to 30 
459.15  percent of the MFIP standard of need for an assistance unit of 
459.16  the same size before the residual grant is paid to the 
459.17  assistance unit.  The reduction in the grant amount must be in 
459.18  effect for a minimum of one month and shall be removed in the 
459.19  month following the month that a the participant in a one-parent 
459.20  household assistance unit returns to compliance.  In a 
459.21  two-parent household assistance unit, the grant reduction must 
459.22  be in effect for a minimum of one month and shall be removed in 
459.23  the month following the month both participants return to 
459.24  compliance.  The vendor payment of shelter costs and, if 
459.25  applicable, utilities shall be removed six months after the 
459.26  month in which the participant or participants return to 
459.27  compliance.  If an assistance unit is sanctioned under this 
459.28  clause, the participant's case file must be reviewed as required 
459.29  under paragraph (e). 
459.30     (3) For a fourth occurrence of noncompliance, the 
459.31  assistance unit is disqualified from receiving MFIP assistance, 
459.32  both the cash and food portions.  This disqualification must be 
459.33  in effect for a minimum of one full month.  Disqualification 
459.34  under this clause does not make a participant ineligible for 
459.35  food stamps.  Before an assistance unit is disqualified under 
459.36  this clause, the county must ensure that: 
460.1      (i) the case has been reviewed by the job counselor's 
460.2   supervisor or the review team designated in the county's 
460.3   approved local service unit plan to determine if the review 
460.4   required under paragraph (e) has occurred; and 
460.5      (ii) the job counselor attempted to meet with the 
460.6   participant face-to-face. 
460.7      (c) No later than during the second month that (e) When a 
460.8   sanction under paragraph (b) (d), clause (2), is in effect due 
460.9   to noncompliance with employment services, the participant's 
460.10  case file must be reviewed to determine if, the county agency or 
460.11  job counselor must review the participant's case to determine if 
460.12  the employment plan is still appropriate and attempt to meet 
460.13  with the participant face-to-face.  If a face-to-face meeting is 
460.14  not possible, the county agency must send the participant a 
460.15  notice of adverse action as provided in section 256J.31, 
460.16  subdivisions 4 and 5. 
460.17     (1) During the face-to-face meeting, the job counselor must:
460.18     (i) determine whether the continued noncompliance can be 
460.19  explained and mitigated by providing a needed preemployment 
460.20  activity, as defined in section 256J.49, subdivision 13, clause 
460.21  (16), or services under a local intervention grant for 
460.22  self-sufficiency under section 256J.625; 
460.23     (ii) determine whether the participant qualifies for a good 
460.24  cause exception under section 256J.57; or 
460.25     (iii) determine whether the participant qualifies for an 
460.26  exemption under section 256J.56; 
460.27     (iv) determine whether the participant qualifies for an 
460.28  exemption for victims of family violence under section 256J.52, 
460.29  subdivision 6; 
460.30     (v) inform the participant of the participant's sanction 
460.31  status and explain the consequences of continuing noncompliance; 
460.32     (vi) identify other resources that may be available to the 
460.33  participant to meet the needs of the family if the participant 
460.34  is sanctioned and disqualified from MFIP under paragraph (d), 
460.35  clause (3); and 
460.36     (vii) inform the participant of the right to appeal under 
461.1   section 256J.40. 
461.2      (2) If the lack of an identified activity can explain the 
461.3   noncompliance, the county must work with the participant to 
461.4   provide the identified activity, and the county must restore the 
461.5   participant's grant amount to the full amount for which the 
461.6   assistance unit is eligible.  The grant must be restored 
461.7   retroactively to the first day of the month in which the 
461.8   participant was found to lack preemployment activities or to 
461.9   qualify for an exemption or under section 256J.56, a good cause 
461.10  exception under section 256J.57, or an exemption for victims of 
461.11  family violence under section 256J.52, subdivision 6. 
461.12     (3) If the participant is found to qualify for a good cause 
461.13  exception or an exemption, the county must restore the 
461.14  participant's grant to the full amount for which the assistance 
461.15  unit is eligible.  
461.16     <h>[EFFECTIVE DATE.]</h> The family violence provisions in 
461.17  paragraph (e) are effective October 1, 2001, if the alternative 
461.18  employment plan and family violence provisions in section 
461.19  256J.52, subdivision 6, are enacted during the 2001 session. 
461.20     Sec. 17.  Minnesota Statutes 2000, section 256J.46, 
461.21  subdivision 2a, is amended to read: 
461.22     Subd. 2a.  [DUAL SANCTIONS.] (a) Notwithstanding the 
461.23  provisions of subdivisions 1 and 2, for a participant subject to 
461.24  a sanction for refusal to comply with child support requirements 
461.25  under subdivision 2 and subject to a concurrent sanction for 
461.26  refusal to cooperate with other program requirements under 
461.27  subdivision 1, sanctions shall be imposed in the manner 
461.28  prescribed in this subdivision. 
461.29     A participant who has had one or more sanctions imposed 
461.30  under this subdivision must remain in compliance with the 
461.31  provisions of this chapter for six months in order for a 
461.32  subsequent occurrence of noncompliance to be considered a first 
461.33  occurrence.  Any vendor payment of shelter costs or utilities 
461.34  under this subdivision must remain in effect for six months 
461.35  after the month in which the participant is no longer subject to 
461.36  sanction under subdivision 1. 
462.1      (b) If the participant was subject to sanction for: 
462.2      (i) noncompliance under subdivision 1 before being subject 
462.3   to sanction for noncooperation under subdivision 2; or 
462.4      (ii) noncooperation under subdivision 2 before being 
462.5   subject to sanction for noncompliance under subdivision 1; under 
462.6   subdivision 1 or 2 before being subject to sanction under the 
462.7   other of those subdivisions, the participant shall be sanctioned 
462.8   as provided in subdivision 1, paragraph (b) (d), clause 
462.9   clauses (2) and (3), and the requirement that the county conduct 
462.10  a review as specified in subdivision 1, paragraph (c) (e), 
462.11  remains in effect. 
462.12     (c) A participant who first becomes subject to sanction 
462.13  under both subdivisions 1 and 2 in the same month is subject to 
462.14  sanction as follows: 
462.15     (i) in the first month of noncompliance and noncooperation, 
462.16  the participant's grant must be reduced by 25 percent of the 
462.17  applicable MFIP standard of need, with any residual amount paid 
462.18  to the participant; 
462.19     (ii) in the second and subsequent months of noncompliance 
462.20  and noncooperation, the participant shall be sanctioned as 
462.21  provided in subdivision 1, paragraph (b) (d), clause clauses (2) 
462.22  and (3). 
462.23     The requirement that the county conduct a review as 
462.24  specified in subdivision 1, paragraph (c) (e), remains in effect.
462.25     (d) A participant remains subject to sanction under 
462.26  subdivision 2 if the participant: 
462.27     (i) returns to compliance and is no longer subject to 
462.28  sanction under subdivision 1; or 
462.29     (ii) has the sanction under subdivision 1, 
462.30  paragraph (b) (d), removed upon completion of the review under 
462.31  subdivision 1, paragraph (c) (e). 
462.32     A participant remains subject to sanction under subdivision 
462.33  1, paragraph (b) (d), if the participant cooperates and is no 
462.34  longer subject to sanction under subdivision 2. 
462.35     Sec. 18.  Minnesota Statutes 2000, section 256J.46, is 
462.36  amended by adding a subdivision to read: 
463.1      Subd. 3.  [SANCTION STATUS AFTER DISQUALIFICATION.] An 
463.2   applicant who is a member of an assistance unit that was 
463.3   disqualified from receiving MFIP under subdivision 1, paragraph 
463.4   (d), clause (3), who applies for MFIP assistance within six 
463.5   months of the date of the disqualification, and who is 
463.6   determined to be eligible for MFIP assistance, is considered to 
463.7   have a first occurrence of noncompliance.  An applicant who is a 
463.8   member of an assistance unit that was disqualified from MFIP 
463.9   under subdivision 1, paragraph (d), clause (3), a second or 
463.10  subsequent time, who applies for assistance within six months of 
463.11  the date of disqualification, and who is determined to be 
463.12  eligible for MFIP assistance, is considered to have a third 
463.13  occurrence of noncompliance.  The applicant must remain in 
463.14  compliance with the provisions of this chapter for six months in 
463.15  order for a subsequent occurrence of noncompliance to be 
463.16  considered a first occurrence. 
463.17     Sec. 19.  Minnesota Statutes 2000, section 256J.50, 
463.18  subdivision 1, is amended to read: 
463.19     Subdivision 1.  [EMPLOYMENT AND TRAINING SERVICES COMPONENT 
463.20  OF MFIP.] (a) By January 1, 1998, each county must develop and 
463.21  implement an employment and training services component of MFIP 
463.22  which is designed to put participants on the most direct path to 
463.23  unsubsidized employment.  Participation in these services is 
463.24  mandatory for all MFIP caregivers, unless the caregiver is 
463.25  exempt under section 256J.56. 
463.26     (b) A county must provide employment and training services 
463.27  under sections 256J.515 to 256J.74 within 30 days after the 
463.28  caregiver's participation becomes mandatory under subdivision 
463.29  5 or within 30 days of receipt of a request for services from a 
463.30  caregiver who under section 256J.42 is no longer eligible to 
463.31  receive MFIP but whose income is below 120 percent of the 
463.32  federal poverty guidelines for a family of the same size.  The 
463.33  request must be made within 12 months of the date the 
463.34  caregivers' MFIP case was closed. 
463.35     Sec. 20.  Minnesota Statutes 2000, section 256J.50, 
463.36  subdivision 7, is amended to read: 
464.1      Subd. 7.  [LOCAL SERVICE UNIT PLAN.] (a) Each local or 
464.2   county service unit shall prepare and submit a plan as specified 
464.3   in section 268.88. 
464.4      (b) The plan must include a description of how projects 
464.5   funded under the local intervention grants for self-sufficiency 
464.6   in section 256J.625, subdivisions 2 and 3, operate in the local 
464.7   service unit, including: 
464.8      (1) the target populations of hard-to-employ participants 
464.9   and, working participants in need of job retention and wage 
464.10  advancement services, and caregivers who, within the last 12 
464.11  months, have been determined under section 256J.42 to no longer 
464.12  be eligible to receive MFIP and whose income is below 120 
464.13  percent of the federal poverty guidelines for a family of the 
464.14  same size, with a description of how individual participant 
464.15  needs will be met; 
464.16     (2) services that will be provided which may include paid 
464.17  work experience, enhanced mental health services, outreach to 
464.18  sanctioned families and to caregivers who, within the last 12 
464.19  months, have been determined under section 256J.42 to no longer 
464.20  be eligible to receive MFIP but whose income is below 120 
464.21  percent of the federal poverty guidelines for a family of the 
464.22  same size, child care for social services, child care transition 
464.23  year set-aside, homeless and housing advocacy, and 
464.24  transportation; 
464.25     (3) projected expenditures by activity; 
464.26     (4) anticipated program outcomes including the anticipated 
464.27  impact the intervention efforts will have on performance 
464.28  measures under section 256J.751 and on reducing the number of 
464.29  MFIP participants expected to reach their 60-month time limit; 
464.30  and 
464.31     (5) a description of services that are provided or will be 
464.32  provided to MFIP participants affected by chemical dependency, 
464.33  mental health issues, learning disabilities, or family violence. 
464.34     Each plan must demonstrate how the county or tribe is 
464.35  working within its organization and with other organizations in 
464.36  the community to serve hard-to-employ populations, including how 
465.1   organizations in the community were engaged in planning for use 
465.2   of these funds, services other entities will provide under the 
465.3   plan, and whether multicounty or regional strategies are being 
465.4   implemented as part of this plan. 
465.5      (c) Activities and expenditures in the plan must enhance or 
465.6   supplement MFIP activities without supplanting existing 
465.7   activities and expenditures.  However, this paragraph does not 
465.8   require a county to maintain either:  
465.9      (1) its current provision of child care assistance to MFIP 
465.10  families through the expenditure of county resources under 
465.11  chapter 256E for social services child care assistance if funds 
465.12  are appropriated by another law for an MFIP social services 
465.13  child care pool; 
465.14     (2) its current provision of transition-year child care 
465.15  assistance through the expenditure of county resources if funds 
465.16  are appropriated by another law for this purpose; or 
465.17     (3) its current provision of intensive ESL programs through 
465.18  the expenditure of county resources if funds are appropriated by 
465.19  another law for intensive ESL grants. 
465.20     (d) The plan required under this subdivision must be 
465.21  approved before the local or county service unit is eligible to 
465.22  receive funds under section 256J.625, subdivisions 2 and 3. 
465.23     Sec. 21.  Minnesota Statutes 2000, section 256J.56, is 
465.24  amended to read: 
465.25     256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 
465.26  EXEMPTIONS.] 
465.27     (a) An MFIP caregiver participant is exempt from the 
465.28  requirements of sections 256J.52 to 256J.55 if the caregiver 
465.29  participant belongs to any of the following groups: 
465.30     (1) individuals participants who are age 60 or older; 
465.31     (2) individuals participants who are suffering from a 
465.32  professionally certified permanent or temporary illness, injury, 
465.33  or incapacity which is expected to continue for more than 30 
465.34  days and which prevents the person from obtaining or retaining 
465.35  employment.  Persons in this category with a temporary illness, 
465.36  injury, or incapacity must be reevaluated at least quarterly; 
466.1      (3) caregivers participants whose presence in the home is 
466.2   required because of the professionally certified illness or 
466.3   incapacity of another member in the assistance unit, a relative 
466.4   in the household, or a foster child in the household and the 
466.5   illness or incapacity is expected to continue for more than 30 
466.6   days; 
466.7      (4) women who are pregnant, if the pregnancy has resulted 
466.8   in a professionally certified incapacity that prevents the woman 
466.9   from obtaining or retaining employment; 
466.10     (5) caregivers of a child under the age of one year who 
466.11  personally provide full-time care for the child.  This exemption 
466.12  may be used for only 12 months in a lifetime.  In two-parent 
466.13  households, only one parent or other relative may qualify for 
466.14  this exemption; 
466.15     (6) individuals who are single parents, or one parent in a 
466.16  two-parent family, employed at least 35 hours per week; 
466.17     (7) individuals (6) participants experiencing a personal or 
466.18  family crisis that makes them incapable of participating in the 
466.19  program, as determined by the county agency.  If the participant 
466.20  does not agree with the county agency's determination, the 
466.21  participant may seek professional certification, as defined in 
466.22  section 256J.08, that the participant is incapable of 
466.23  participating in the program. 
466.24     Persons in this exemption category must be reevaluated 
466.25  every 60 days; or 
466.26     (8) second parents in two-parent families employed for 20 
466.27  or more hours per week, provided the first parent is employed at 
466.28  least 35 hours per week; or 
466.29     (9) (7) caregivers with a child or an adult in the 
466.30  household who meets the disability or medical criteria for home 
466.31  care services under section 256B.0627, subdivision 1, paragraph 
466.32  (c), or a home and community-based waiver services program under 
466.33  chapter 256B, or meets the criteria for severe emotional 
466.34  disturbance under section 245.4871, subdivision 6, or for 
466.35  serious and persistent mental illness under section 245.462, 
466.36  subdivision 20, paragraph (c).  Caregivers in this exemption 
467.1   category are presumed to be prevented from obtaining or 
467.2   retaining employment. 
467.3      A caregiver who is exempt under clause (5) must enroll in 
467.4   and attend an early childhood and family education class, a 
467.5   parenting class, or some similar activity, if available, during 
467.6   the period of time the caregiver is exempt under this section.  
467.7   Notwithstanding section 256J.46, failure to attend the required 
467.8   activity shall not result in the imposition of a sanction. 
467.9      (b) The county agency must provide employment and training 
467.10  services to MFIP caregivers participants who are exempt under 
467.11  this section, but who volunteer to participate.  Exempt 
467.12  volunteers may request approval for any work activity under 
467.13  section 256J.49, subdivision 13.  The hourly participation 
467.14  requirements for nonexempt caregivers participants under section 
467.15  256J.50, subdivision 5, do not apply to exempt caregivers 
467.16  participants who volunteer to participate. 
467.17     Sec. 22.  Minnesota Statutes 2000, section 256J.57, 
467.18  subdivision 2, is amended to read: 
467.19     Subd. 2.  [NOTICE OF INTENT TO SANCTION.] (a) When a 
467.20  participant fails without good cause to comply with the 
467.21  requirements of sections 256J.52 to 256J.55, the job counselor 
467.22  or the county agency must provide a notice of intent to sanction 
467.23  to the participant specifying the program requirements that were 
467.24  not complied with, informing the participant that the county 
467.25  agency will impose the sanctions specified in section 256J.46, 
467.26  and informing the participant of the opportunity to request a 
467.27  conciliation conference as specified in paragraph (b).  The 
467.28  notice must also state that the participant's continuing 
467.29  noncompliance with the specified requirements will result in 
467.30  additional sanctions under section 256J.46, without the need for 
467.31  additional notices or conciliation conferences under this 
467.32  subdivision.  The notice, written in English, must include the 
467.33  department of human services language block, and must be sent to 
467.34  every applicable participant.  If the participant does not 
467.35  request a conciliation conference within ten calendar days of 
467.36  the mailing of the notice of intent to sanction, the job 
468.1   counselor must notify the county agency that the assistance 
468.2   payment should be reduced.  The county must then send a notice 
468.3   of adverse action to the participant informing the participant 
468.4   of the sanction that will be imposed, the reasons for the 
468.5   sanction, the effective date of the sanction, and the 
468.6   participant's right to have a fair hearing under section 256J.40.
468.7      (b) The participant may request a conciliation conference 
468.8   by sending a written request, by making a telephone request, or 
468.9   by making an in-person request.  The request must be received 
468.10  within ten calendar days of the date the county agency mailed 
468.11  the ten-day notice of intent to sanction.  If a timely request 
468.12  for a conciliation is received, the county agency's service 
468.13  provider must conduct the conference within five days of the 
468.14  request.  The job counselor's supervisor, or a designee of the 
468.15  supervisor, must review the outcome of the conciliation 
468.16  conference.  If the conciliation conference resolves the 
468.17  noncompliance, the job counselor must promptly inform the county 
468.18  agency and request withdrawal of the sanction notice. 
468.19     (c) Upon receiving a sanction notice, the participant may 
468.20  request a fair hearing under section 256J.40, without exercising 
468.21  the option of a conciliation conference.  In such cases, the 
468.22  county agency shall not require the participant to engage in a 
468.23  conciliation conference prior to the fair hearing. 
468.24     (d) If the participant requests a fair hearing or a 
468.25  conciliation conference, sanctions will not be imposed until 
468.26  there is a determination of noncompliance.  Sanctions must be 
468.27  imposed as provided in section 256J.46. 
468.28     Sec. 23.  Minnesota Statutes 2000, section 256J.62, 
468.29  subdivision 9, is amended to read: 
468.30     Subd. 9.  [CONTINUATION OF CERTAIN SERVICES.] At the 
468.31  request of the caregiver participant, the county may continue to 
468.32  provide case management, counseling, or other support services 
468.33  to a participant following the participant's achievement of: 
468.34     (a) who has achieved the employment goal,; or 
468.35     (b) who under section 256J.42 is no longer eligible to 
468.36  receive MFIP. 
469.1      These services may be provided for up to 12 months 
469.2   following termination of the participant's eligibility for MFIP. 
469.3      A county may expend funds for a specific employment and 
469.4   training service for the duration of that service to a 
469.5   participant if the funds are obligated or expended prior to the 
469.6   participant losing MFIP eligibility. 
469.7      Sec. 24.  Minnesota Statutes 2000, section 256J.625, 
469.8   subdivision 1, is amended to read: 
469.9      Subdivision 1.  [ESTABLISHMENT; GUARANTEED MINIMUM 
469.10  ALLOCATION.] (a) The commissioner shall make grants under this 
469.11  subdivision to assist county and tribal TANF programs to more 
469.12  effectively serve hard-to-employ MFIP participants and 
469.13  participants who, within the last 12 months, have been 
469.14  determined under section 256J.42 to no longer be eligible to 
469.15  receive MFIP but whose income is below 120 percent of the 
469.16  federal poverty guidelines for a family of the same size.  Funds 
469.17  appropriated for local intervention grants for self-sufficiency 
469.18  must be allocated first in amounts equal to the guaranteed 
469.19  minimum in paragraph (b), and second according to the provisions 
469.20  of subdivision 2.  Any remaining funds must be allocated 
469.21  according to the formula in subdivision 3.  Counties or tribes 
469.22  must have an approved local service unit plan under section 
469.23  256J.50, subdivision 7, paragraph (b), in order to receive and 
469.24  expend funds under subdivisions 2 and 3.  
469.25     (b) Each county or tribal program shall receive a 
469.26  guaranteed minimum annual allocation of $25,000. 
469.27     Sec. 25.  Minnesota Statutes 2000, section 256J.625, 
469.28  subdivision 2, is amended to read: 
469.29     Subd. 2.  [SET-ASIDE FUNDS.] (a) Of the funds appropriated 
469.30  for grants under this section, after the allocation in 
469.31  subdivision 1, paragraph (b), is made, 20 percent of the 
469.32  remaining funds each year shall be retained by the commissioner 
469.33  and awarded to counties or tribes whose approved plans 
469.34  demonstrate additional need based on their identification of 
469.35  hard-to-employ families and, working participants in need of job 
469.36  retention and wage advancement services, and participants who 
470.1   within the last 12 months, have been determined under section 
470.2   256J.42 to no longer be eligible to receive MFIP but whose 
470.3   income is below 120 percent of the federal poverty guidelines 
470.4   for a family of same size, strong anticipated outcomes for 
470.5   families and an effective plan for monitoring performance, or, 
470.6   use of a multicounty, multi-entity or regional approach to serve 
470.7   hard-to-employ families and, working participants in need of job 
470.8   retention and wage advancement services, and participants who, 
470.9   within the last 12 months, have been determined under section 
470.10  256J.42 to no longer be eligible to receive MFIP but whose 
470.11  income is below 120 percent of the federal poverty guidelines 
470.12  for a family of the same size, who are identified as a target 
470.13  population to be served in the plan submitted under section 
470.14  256J.50, subdivision 7, paragraph (b).  In distributing funds 
470.15  under this paragraph, the commissioner must achieve a geographic 
470.16  balance.  The commissioner may award funds under this paragraph 
470.17  to other public, private, or nonprofit entities to deliver 
470.18  services in a county or region where the entity or entities 
470.19  submit a plan that demonstrates a strong capability to fulfill 
470.20  the terms of the plan and where the plan shows an innovative or 
470.21  multi-entity approach. 
470.22     (b) For fiscal year 2001 only, of the funds available under 
470.23  this subdivision the commissioner must allocate funding in the 
470.24  amounts specified in article 1, section 2, subdivision 7, for an 
470.25  intensive intervention transitional employment training project 
470.26  and for nontraditional career assistance and training programs.  
470.27  These allocations must occur before any set-aside funds are 
470.28  allocated under paragraph (a). 
470.29     Sec. 26.  Minnesota Statutes 2000, section 256J.625, 
470.30  subdivision 4, is amended to read: 
470.31     Subd. 4.  [USE OF FUNDS.] (a) A county or tribal program 
470.32  may use funds allocated under this subdivision to provide 
470.33  services to MFIP participants who are hard-to-employ and their 
470.34  families.  Services provided must be intended to reduce the 
470.35  number of MFIP participants who are expected to reach the 
470.36  60-month time limit under section 256J.42.  Counties, tribes, 
471.1   and other entities receiving funds under subdivision 2 or 3 must 
471.2   submit semiannual progress reports to the commissioner which 
471.3   detail program outcomes. 
471.4      (b) Funds allocated under this section may not be used to 
471.5   provide benefits that are defined as "assistance" in Code of 
471.6   Federal Regulations, title 45, section 260.31, to an assistance 
471.7   unit that is only receiving the food portion of MFIP benefits or 
471.8   under section 256J.42 is no longer eligible to receive MFIP. 
471.9      (c) A county may use funds allocated under this section for 
471.10  that part of the match for federal access to jobs transportation 
471.11  funds that is TANF-eligible.  A county may also use funds 
471.12  allocated under this section to enhance transportation choices 
471.13  for eligible recipients up to 150 percent of the federal poverty 
471.14  guidelines. 
471.15     Sec. 27.  Minnesota Statutes 2000, section 256J.751, is 
471.16  amended to read: 
471.17     256J.751 [COUNTY PERFORMANCE MANAGEMENT.] 
471.18     (a) Subdivision 1.  [QUARTERLY COUNTY CASELOAD REPORT.] The 
471.19  commissioner shall report quarterly to all counties each county 
471.20  on the county's performance on the following measures: 
471.21     (1) percent of MFIP caseload working in paid employment; 
471.22     (2) percent number of MFIP caseload cases receiving only 
471.23  the food portion of assistance; 
471.24     (2) number of child-only cases; 
471.25     (3) number of minor caregivers; 
471.26     (4) number of cases that are exempt from the 60-month time 
471.27  limit by the exemption category under section 256J.42; 
471.28     (5) number of participants who are exempt from employment 
471.29  and training services requirements by the exemption category 
471.30  under section 256J.56; 
471.31     (6) number of assistance units receiving assistance under a 
471.32  hardship extension under section 256J.425; 
471.33     (7) number of participants and number of months spent in 
471.34  each level of sanction under section 256J.46, subdivision 1; 
471.35     (3) (8) number of MFIP cases that have left assistance; 
471.36     (4) (9) federal participation requirements as specified in 
472.1   title 1 of Public Law Number 104-193; and 
472.2      (5) (10) median placement wage rate.; and 
472.3      (b) (11) of each county's total MFIP caseload less the 
472.4   number of cases in clauses (1) to (6): 
472.5      (i) number of one-parent cases; 
472.6      (ii) number of two-parent cases; 
472.7      (iii) percent of one-parent cases that are working more 
472.8   than 20 hours per week; 
472.9      (iv) percent of two-parent cases that are working more than 
472.10  20 hours per week; and 
472.11     (v) percent of cases that have received more than 36 months 
472.12  of assistance. 
472.13     Subd. 2.  [QUARTERLY COMPARISON REPORT.] The commissioner 
472.14  shall report quarterly to all counties on each county's 
472.15  performance on the following measures: 
472.16     (1) percent of MFIP caseload working in paid employment; 
472.17     (2) percent of MFIP caseload receiving only the food 
472.18  portion of assistance; 
472.19     (3) number of MFIP cases that have left assistance; 
472.20     (4) federal participation requirements as specified in 
472.21  Title 1 of Public Law Number 104-193; 
472.22     (5) median placement wage rate; and 
472.23     (6) caseload by months of TANF assistance. 
472.24     Subd. 3.  [ANNUAL REPORT.] The commissioner must report to 
472.25  all counties and to the legislature on each county's annual 
472.26  performance on the measures required under subdivision 1 by 
472.27  racial and ethnic group and, to the extent consistent with state 
472.28  and federal law, must include each county's performance on: 
472.29     (1) the number of out-of-wedlock births and births to teen 
472.30  mothers; and 
472.31     (2) number of cases by racial and ethnic group. 
472.32     The report must be completed by January 1, 2002, and 
472.33  January 1 of each year thereafter and must comply with sections 
472.34  3.195 and 3.197. 
472.35     Subd. 4.  [DEVELOPMENT OF PERFORMANCE MEASURES.] By January 
472.36  1, 2002, the commissioner shall, in consultation with counties, 
473.1   develop measures for county performance in addition to those in 
473.2   paragraph (a) subdivision 1 and 2.  In developing these 
473.3   measures, the commissioner must consider: 
473.4      (1) a measure for MFIP cases that leave assistance due to 
473.5   employment; 
473.6      (2) job retention after participants leave MFIP; and 
473.7      (3) participant's earnings at a follow-up point after the 
473.8   participant has left MFIP; and 
473.9      (4) the appropriateness of services provided to minority 
473.10  groups. 
473.11     (c) Subd. 5.  [FAILURE TO MEET FEDERAL PERFORMANCE 
473.12  STANDARDS.] (a) If sanctions occur for failure to meet the 
473.13  performance standards specified in title 1 of Public Law Number 
473.14  104-193 of the Personal Responsibility and Work Opportunity Act 
473.15  of 1996, the state shall pay 88 percent of the sanction.  The 
473.16  remaining 12 percent of the sanction will be paid by the 
473.17  counties.  The county portion of the sanction will be 
473.18  distributed across all counties in proportion to each county's 
473.19  percentage of the MFIP average monthly caseload during the 
473.20  period for which the sanction was applied. 
473.21     (d) (b) If a county fails to meet the performance standards 
473.22  specified in title 1 of Public Law Number 104-193 of the 
473.23  Personal Responsibility and Work Opportunity Act of 1996 for any 
473.24  year, the commissioner shall work with counties to organize a 
473.25  joint state-county technical assistance team to work with the 
473.26  county.  The commissioner shall coordinate any technical 
473.27  assistance with other departments and agencies including the 
473.28  departments of economic security and children, families, and 
473.29  learning as necessary to achieve the purpose of this paragraph. 
473.30     Sec. 28.  Minnesota Statutes 2000, section 256K.25, 
473.31  subdivision 1, is amended to read: 
473.32     Subdivision 1.  [ESTABLISHMENT AND PURPOSE.] (a) The 
473.33  commissioner shall establish a supportive housing and managed 
473.34  care pilot project in two counties, one within the seven-county 
473.35  metropolitan area and one outside of that area, to determine 
473.36  whether the integrated delivery of employment services, 
474.1   supportive services, housing, and health care into a single, 
474.2   flexible program will: 
474.3      (1) reduce public expenditures on homeless families with 
474.4   minor children, homeless noncustodial parents, and other 
474.5   homeless individuals; 
474.6      (2) increase the employment rates of these persons; and 
474.7      (3) provide a new alternative to providing services to this 
474.8   hard-to-serve population. 
474.9      (b) The commissioner shall create a program for counties 
474.10  for the purpose of providing integrated intensive and 
474.11  individualized case management services, employment services, 
474.12  health care services, rent subsidies or other short- or 
474.13  medium-term housing assistance, and other supportive services to 
474.14  eligible families and individuals.  Minimum project and 
474.15  application requirements shall be developed by the commissioner 
474.16  in cooperation with counties and their nonprofit partners with 
474.17  the goal to provide the maximum flexibility in program design. 
474.18     (c) Services available under this project must be 
474.19  coordinated with available health care services for an eligible 
474.20  project participant. 
474.21     Sec. 29.  Minnesota Statutes 2000, section 256K.25, 
474.22  subdivision 3, is amended to read: 
474.23     Subd. 3.  [COUNTY ELIGIBILITY.] (a) A county may request 
474.24  funding under this pilot project if the county: 
474.25     (1) agrees to develop, in cooperation with nonprofit 
474.26  partners, a supportive housing and managed care pilot project 
474.27  that integrates the delivery of employment services, supportive 
474.28  services, housing and health care for eligible families and 
474.29  individuals, or agrees to contract with an existing integrated 
474.30  program; 
474.31     (2) for eligible participants who are also MFIP recipients, 
474.32  agrees to develop, in cooperation with nonprofit partners, 
474.33  procedures to ensure that the services provided under the pilot 
474.34  project are closely coordinated with the services provided under 
474.35  MFIP; and 
474.36     (3) develops a method for evaluating the quality of the 
475.1   integrated services provided and the amount of any resulting 
475.2   cost savings to the county and state.; and 
475.3      (4) addresses in the pilot design the prevalence in the 
475.4   homeless population served those individuals with mental 
475.5   illness, a history of substance abuse, or HIV. 
475.6      (b) Preference may be given to counties that cooperate with 
475.7   other counties participating in the pilot project for purposes 
475.8   of evaluation and counties that provide additional funding. 
475.9      Sec. 30.  Minnesota Statutes 2000, section 256K.25, 
475.10  subdivision 4, is amended to read: 
475.11     Subd. 4.  [PARTICIPANT ELIGIBILITY.] (a) In order to be 
475.12  eligible meet initial eligibility criteria for the pilot 
475.13  project, the county must determine that a participant is 
475.14  homeless or is at risk of homelessness; has a mental illness, a 
475.15  history of substance abuse, or HIV; and is a family that meets 
475.16  the criteria in paragraph (b) or is an individual who meets the 
475.17  criteria in paragraph (c). 
475.18     (b) An eligible family must include a minor child or a 
475.19  pregnant woman, and: 
475.20     (1) be receiving or be eligible for MFIP assistance under 
475.21  chapter 256J; or 
475.22     (2) include an adult caregiver who is employed or is 
475.23  receiving employment and training services, and have household 
475.24  income below the MFIP exit level in section 256J.24, subdivision 
475.25  10.  
475.26     (c) An eligible individual must: 
475.27     (1) meet the eligibility requirements of the group 
475.28  residential housing program under section 256I.04, subdivision 
475.29  1; or 
475.30     (2) be a noncustodial parent who is employed or is 
475.31  receiving employment and training services, and have household 
475.32  income below the MFIP exit level in section 256J.24, subdivision 
475.33  10.  
475.34     (d) Counties participating in the pilot project may develop 
475.35  and initiate disenrollment criteria, subject to approval by the 
475.36  commissioner of human services. 
476.1      Sec. 31.  Minnesota Statutes 2000, section 256K.25, 
476.2   subdivision 5, is amended to read: 
476.3      Subd. 5.  [FUNDING.] A county may request funding from the 
476.4   commissioner for a specified number of TANF-eligible project 
476.5   participants.  The commissioner shall review the request for 
476.6   compliance with subdivisions 1 to 4 and may approve or 
476.7   disapprove the request.  If other funds are available, the 
476.8   commissioner may allocate funding for project participants who 
476.9   meet the eligibility requirements of subdivision 4, paragraph 
476.10  (c).  The commissioner may also redirect funds to the pilot 
476.11  project. 
476.12     Sec. 32.  Minnesota Statutes 2000, section 256K.25, 
476.13  subdivision 6, is amended to read: 
476.14     Subd. 6.  [REPORT.] Participating counties and the 
476.15  commissioner shall collaborate to prepare and issue an annual 
476.16  report, beginning December 1, 2001, to the chairs of the 
476.17  appropriate legislative committees on the pilot project's use of 
476.18  public resources, including other funds leveraged for this 
476.19  initiative, and an assessment of the feasibility of financing 
476.20  the pilot through other health and human services programs, the 
476.21  employment and housing status of the families and individuals 
476.22  served in the project, and the cost-effectiveness of the 
476.23  project.  The annual report must also evaluate the pilot project 
476.24  with respect to the following project goals:  that participants 
476.25  will lead more productive, healthier, more stable and better 
476.26  quality lives; that the teams created under the project to 
476.27  deliver services for each project participant will be 
476.28  accountable for ensuring that services are more appropriate, 
476.29  cost-effective and well-coordinated; and that the system-wide 
476.30  costs of serving this population, and the inappropriate use of 
476.31  emergency, crisis-oriented or institutional services, will be 
476.32  materially reduced.  The commissioner shall provide data that 
476.33  may be needed to evaluate the project to participating counties 
476.34  that request the data. 
476.35     Sec. 33.  Minnesota Statutes 2000, section 261.062, is 
476.36  amended to read: 
477.1      261.062 [TAX FOR SUPPORT OF POOR.] 
477.2      The county board shall may levy a tax annually sufficient 
477.3   to defray the estimated expenses of supporting and relieving the 
477.4   poor therein during the succeeding year, and to make up any 
477.5   deficiency in the fund raised for that purpose during the 
477.6   preceding year. 
477.7      Sec. 34.  Minnesota Statutes 2000, section 268.0122, 
477.8   subdivision 2, is amended to read: 
477.9      Subd. 2.  [SPECIFIC POWERS.] The commissioner of economic 
477.10  security shall: 
477.11     (1) administer and supervise all forms of unemployment 
477.12  benefits provided for under federal and state laws that are 
477.13  vested in the commissioner, including make investigations and 
477.14  audits, secure and transmit information, and make available 
477.15  services and facilities as the commissioner considers necessary 
477.16  or appropriate to facilitate the administration of any other 
477.17  states, or the federal Economic Security Law, and accept and use 
477.18  information, services, and facilities made available by other 
477.19  states or the federal government; 
477.20     (2) administer and supervise all employment and training 
477.21  services assigned to the department under federal or state law; 
477.22     (3) review and comment on local service unit plans and 
477.23  community investment program plans and approve or disapprove the 
477.24  plans; 
477.25     (4) establish and maintain administrative units necessary 
477.26  to perform administrative functions common to all divisions of 
477.27  the department; 
477.28     (5) supervise the county boards of commissioners, local 
477.29  service units, and any other units of government designated in 
477.30  federal or state law as responsible for employment and training 
477.31  programs; 
477.32     (6) establish administrative standards and payment 
477.33  conditions for providers of employment and training services; 
477.34     (7) act as the agent of, and cooperate with, the federal 
477.35  government in matters of mutual concern, including the 
477.36  administration of any federal funds granted to the state to aid 
478.1   in the performance of functions of the commissioner; 
478.2      (8) obtain reports from local service units and service 
478.3   providers for the purpose of evaluating the performance of 
478.4   employment and training services; and 
478.5      (9) review and comment on plans for Indian tribe employment 
478.6   and training services and approve or disapprove the plans; and 
478.7      (10) require all general employment and training programs 
478.8   that receive state funds to make available information about 
478.9   opportunities for women in nontraditional careers in the trades 
478.10  and technical occupations. 
478.11     Sec. 35.  Laws 1997, chapter 203, article 9, section 21, as 
478.12  amended by Laws 1998, chapter 407, article 6, section 111, and 
478.13  Laws 2000, chapter 488, article 10, section 28, is amended to 
478.14  read: 
478.15     Sec. 21.  [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 
478.16     (a) Effective on the date specified, the following persons 
478.17  will be ineligible for general assistance and general assistance 
478.18  medical care under Minnesota Statutes, chapter 256D, group 
478.19  residential housing under Minnesota Statutes, chapter 256I, and 
478.20  MFIP assistance under Minnesota Statutes, chapter 256J, funded 
478.21  with state money: 
478.22     (1) Beginning July 1, 2002, persons who are terminated from 
478.23  or denied Supplemental Security Income due to the 1996 changes 
478.24  in the federal law making persons whose alcohol or drug 
478.25  addiction is a material factor contributing to the person's 
478.26  disability ineligible for Supplemental Security Income, and are 
478.27  eligible for general assistance under Minnesota Statutes, 
478.28  section 256D.05, subdivision 1, paragraph (a), clause (15), 
478.29  general assistance medical care under Minnesota Statutes, 
478.30  chapter 256D, or group residential housing under Minnesota 
478.31  Statutes, chapter 256I; 
478.32     (2) Beginning July 1, 2002, legal noncitizens who are 
478.33  ineligible for Supplemental Security Income due to the 1996 
478.34  changes in federal law making certain noncitizens ineligible for 
478.35  these programs due to their noncitizen status; and 
478.36     (3) Beginning July 1, 2001 2002, legal noncitizens who are 
479.1   eligible for MFIP assistance, either the cash assistance portion 
479.2   or the food assistance portion, funded entirely with state money.
479.3      (b) State money that remains unspent due to changes in 
479.4   federal law enacted after May 12, 1997, that reduce state 
479.5   spending for legal noncitizens or for persons whose alcohol or 
479.6   drug addiction is a material factor contributing to the person's 
479.7   disability, or enacted after February 1, 1998, that reduce state 
479.8   spending for food benefits for legal noncitizens shall not 
479.9   cancel and shall be deposited in the TANF reserve account. 
479.10     Sec. 36.  [REPORT ON ASSESSMENT OF COUNTY PERFORMANCE.] 
479.11     By January 15, 2003, the commissioner, in consultation with 
479.12  counties, must report to the chairs of the house and senate 
479.13  committees having jurisdiction over human services, on a 
479.14  proposal for assessing county performance using a methodology 
479.15  that controls for demographic, economic, and other variables 
479.16  that may impact county achievement of MFIP performance 
479.17  outcomes.  The proposal must recommend how state and federal 
479.18  funds may be allocated to counties to encourage and reward high 
479.19  performance. 
479.20     Sec. 37.  [REPEALER.] 
479.21     Minnesota Statutes 2000, sections 256J.42, subdivision 4; 
479.22  256J.44; and 256J.46, subdivision 1a, are repealed. 
479.23                             ARTICLE 11
479.24                           DHS LICENSING
479.25     Section 1.  Minnesota Statutes 2000, section 13.46, 
479.26  subdivision 4, is amended to read: 
479.27     Subd. 4.  [LICENSING DATA.] (a) As used in this subdivision:
479.28     (1) "licensing data" means all data collected, maintained, 
479.29  used, or disseminated by the welfare system pertaining to 
479.30  persons licensed or registered or who apply for licensure or 
479.31  registration or who formerly were licensed or registered under 
479.32  the authority of the commissioner of human services; 
479.33     (2) "client" means a person who is receiving services from 
479.34  a licensee or from an applicant for licensure; and 
479.35     (3) "personal and personal financial data" means social 
479.36  security numbers, identity of and letters of reference, 
480.1   insurance information, reports from the bureau of criminal 
480.2   apprehension, health examination reports, and social/home 
480.3   studies. 
480.4      (b)(1) Except as provided in paragraph (c), the following 
480.5   data on current and former licensees are public:  name, address, 
480.6   telephone number of licensees, licensed capacity, type of client 
480.7   preferred, variances granted, type of dwelling, name and 
480.8   relationship of other family members, previous license history, 
480.9   class of license, and the existence and status of complaints.  
480.10  When disciplinary action has been taken against a licensee or 
480.11  the complaint is resolved, the following data are public:  the 
480.12  substance of the complaint, the findings of the investigation of 
480.13  the complaint, the record of informal resolution of a licensing 
480.14  violation, orders of hearing, findings of fact, conclusions of 
480.15  law, and specifications of the final disciplinary action 
480.16  contained in the record of disciplinary action.  
480.17     (2) The following data on persons subject to 
480.18  disqualification under section 245A.04 in connection with a 
480.19  license to provide family day care for children, child care 
480.20  center services, foster care for children in the provider's 
480.21  home, or foster care or day care services for adults in the 
480.22  provider's home, are public:  the nature of any disqualification 
480.23  set aside under section 245A.04, subdivision 3b, and the reasons 
480.24  for setting aside the disqualification; and the reasons for 
480.25  granting any variance under section 245A.04, subdivision 9. 
480.26     (3) When maltreatment is substantiated under section 
480.27  626.556 or 626.557 and the victim and the substantiated 
480.28  perpetrator are affiliated with a program licensed under chapter 
480.29  245A, the commissioner of human services, local social services 
480.30  agency, or county welfare agency may inform the license holder 
480.31  where the maltreatment occurred of the identity of the 
480.32  substantiated perpetrator and the victim. 
480.33     (c) The following are private data on individuals under 
480.34  section 13.02, subdivision 12, or nonpublic data under section 
480.35  13.02, subdivision 9:  personal and personal financial data on 
480.36  family day care program and family foster care program 
481.1   applicants and licensees and their family members who provide 
481.2   services under the license. 
481.3      (d) The following are private data on individuals:  the 
481.4   identity of persons who have made reports concerning licensees 
481.5   or applicants that appear in inactive investigative data, and 
481.6   the records of clients or employees of the licensee or applicant 
481.7   for licensure whose records are received by the licensing agency 
481.8   for purposes of review or in anticipation of a contested 
481.9   matter.  The names of reporters under sections 626.556 and 
481.10  626.557 may be disclosed only as provided in section 626.556, 
481.11  subdivision 11, or 626.557, subdivision 12b. 
481.12     (e) Data classified as private, confidential, nonpublic, or 
481.13  protected nonpublic under this subdivision become public data if 
481.14  submitted to a court or administrative law judge as part of a 
481.15  disciplinary proceeding in which there is a public hearing 
481.16  concerning the disciplinary action. 
481.17     (f) Data generated in the course of licensing 
481.18  investigations that relate to an alleged violation of law are 
481.19  investigative data under subdivision 3. 
481.20     (g) Data that are not public data collected, maintained, 
481.21  used, or disseminated under this subdivision that relate to or 
481.22  are derived from a report as defined in section 626.556, 
481.23  subdivision 2, are subject to the destruction provisions of 
481.24  section 626.556, subdivision 11.  
481.25     (h) Upon request, not public data collected, maintained, 
481.26  used, or disseminated under this subdivision that relate to or 
481.27  are derived from a report of substantiated maltreatment as 
481.28  defined in section 626.556 or 626.557 may be exchanged with the 
481.29  department of health for purposes of completing background 
481.30  studies pursuant to section 144.057. 
481.31     (i) Data on individuals collected according to licensing 
481.32  activities under chapter 245A, and data on individuals collected 
481.33  by the commissioner of human services according to maltreatment 
481.34  investigations under sections 626.556 and 626.557, may be shared 
481.35  with the department of human rights, the department of health, 
481.36  the department of corrections, the ombudsman for mental health 
482.1   and retardation, and the individual's professional regulatory 
482.2   board when there is reason to believe that laws or standards 
482.3   under the jurisdiction of those agencies may have been violated. 
482.4      (j) In addition to the notice of determinations required 
482.5   under section 626.556, subdivision 10f, if the commissioner or 
482.6   the local social services agency has determined that an 
482.7   individual is a substantiated perpetrator of maltreatment of a 
482.8   child based on sexual abuse, as defined in section 626.556, 
482.9   subdivision 2, and the commissioner or local social services 
482.10  agency knows that the individual is a person responsible for a 
482.11  child's care in another facility, the commissioner or local 
482.12  social services agency shall notify the head of that facility of 
482.13  this determination.  The notification must include an 
482.14  explanation of the individual's available appeal rights and the 
482.15  status of any appeal.  If a notice is given under this 
482.16  paragraph, the government entity making the notification shall 
482.17  provide a copy of the notice to the individual who is the 
482.18  subject of the notice. 
482.19     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
482.20     Sec. 2.  Minnesota Statutes 2000, section 13.461, 
482.21  subdivision 17, is amended to read: 
482.22     Subd. 17.  [VULNERABLE ADULT MALTREATMENT REVIEW PANEL 
482.23  PANELS.] Data of the vulnerable adult maltreatment review 
482.24  panel or the child maltreatment review panel are classified 
482.25  under section 256.021 or section 256.022. 
482.26     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
482.27     Sec. 3.  Minnesota Statutes 2000, section 144.057, is 
482.28  amended to read: 
482.29     144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 
482.30  NURSING SERVICES AGENCY PERSONNEL.] 
482.31     Subdivision 1.  [BACKGROUND STUDIES REQUIRED.] The 
482.32  commissioner of health shall contract with the commissioner of 
482.33  human services to conduct background studies of: 
482.34     (1) individuals providing services which have direct 
482.35  contact, as defined under section 245A.04, subdivision 3, with 
482.36  patients and residents in hospitals, boarding care homes, 
483.1   outpatient surgical centers licensed under sections 144.50 to 
483.2   144.58; nursing homes and home care agencies licensed under 
483.3   chapter 144A; residential care homes licensed under chapter 
483.4   144B, and board and lodging establishments that are registered 
483.5   to provide supportive or health supervision services under 
483.6   section 157.17; and 
483.7      (2) beginning July 1, 1999, all other employees in nursing 
483.8   homes licensed under chapter 144A, and boarding care homes 
483.9   licensed under sections 144.50 to 144.58.  A disqualification of 
483.10  an individual in this section shall disqualify the individual 
483.11  from positions allowing direct contact or access to patients or 
483.12  residents receiving services; 
483.13     (3) individuals employed by a supplemental nursing services 
483.14  agency, as defined under section 144A.70, who are providing 
483.15  services in health care facilities; and 
483.16     (4) controlling persons of a supplemental nursing services 
483.17  agency, as defined under section 144A.70. 
483.18     If a facility or program is licensed by the department of 
483.19  human services and subject to the background study provisions of 
483.20  chapter 245A and is also licensed by the department of health, 
483.21  the department of human services is solely responsible for the 
483.22  background studies of individuals in the jointly licensed 
483.23  programs. 
483.24     Subd. 2.  [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 
483.25  SERVICES.] The department of human services shall conduct the 
483.26  background studies required by subdivision 1 in compliance with 
483.27  the provisions of chapter 245A and Minnesota Rules, parts 
483.28  9543.3000 to 9543.3090.  For the purpose of this section, the 
483.29  term "residential program" shall include all facilities 
483.30  described in subdivision 1.  The department of human services 
483.31  shall provide necessary forms and instructions, shall conduct 
483.32  the necessary background studies of individuals, and shall 
483.33  provide notification of the results of the studies to the 
483.34  facilities, supplemental nursing services agencies, individuals, 
483.35  and the commissioner of health.  Individuals shall be 
483.36  disqualified under the provisions of chapter 245A and Minnesota 
484.1   Rules, parts 9543.3000 to 9543.3090.  If an individual is 
484.2   disqualified, the department of human services shall notify the 
484.3   facility, the supplemental nursing services agency, and the 
484.4   individual and shall inform the individual of the right to 
484.5   request a reconsideration of the disqualification by submitting 
484.6   the request to the department of health. 
484.7      Subd. 3.  [RECONSIDERATIONS.] The commissioner of health 
484.8   shall review and decide reconsideration requests, including the 
484.9   granting of variances, in accordance with the procedures and 
484.10  criteria contained in chapter 245A and Minnesota Rules, parts 
484.11  9543.3000 to 9543.3090.  The commissioner's decision shall be 
484.12  provided to the individual and to the department of human 
484.13  services.  The commissioner's decision to grant or deny a 
484.14  reconsideration of disqualification is the final administrative 
484.15  agency action, except for the provisions under section 245A.04, 
484.16  subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a). 
484.17     <h>[EFFECTIVE DATE.]</h> This subdivision is effective January 1, 
484.18  2002. 
484.19     Subd. 4.  [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 
484.20  Facilities and agencies described in subdivision 1 shall be 
484.21  responsible for cooperating with the departments in implementing 
484.22  the provisions of this section.  The responsibilities imposed on 
484.23  applicants and licensees under chapter 245A and Minnesota Rules, 
484.24  parts 9543.3000 to 9543.3090, shall apply to these 
484.25  facilities and supplemental nursing services agencies.  The 
484.26  provision of section 245A.04, subdivision 3, paragraph (e), 
484.27  shall apply to applicants, licensees, registrants, or an 
484.28  individual's refusal to cooperate with the completion of the 
484.29  background studies.  Supplemental nursing services agencies 
484.30  subject to the registration requirements in section 144A.71 must 
484.31  maintain records verifying compliance with the background study 
484.32  requirements under this section. 
484.33     Sec. 4.  Minnesota Statutes 2000, section 214.104, is 
484.34  amended to read: 
484.35     214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS 
484.36  REGARDING DISQUALIFICATIONS FOR MALTREATMENT.] 
485.1      (a) A health-related licensing board shall make 
485.2   determinations as to whether licensees regulated persons who are 
485.3   under the board's jurisdiction should be disqualified under 
485.4   section 245A.04, subdivision 3d, from positions allowing direct 
485.5   contact with persons receiving services the subject of 
485.6   disciplinary or corrective action because of substantiated 
485.7   maltreatment under section 626.556 or 626.557.  A determination 
485.8   under this section may be done as part of an investigation under 
485.9   section 214.103.  The board shall make a determination within 90 
485.10  days of upon receipt, and after the review, of an investigation 
485.11  memorandum or other notice of substantiated maltreatment under 
485.12  section 626.556 or 626.557, or of a notice from the commissioner 
485.13  of human services that a background study of a licensee 
485.14  regulated person shows substantiated maltreatment.  The board 
485.15  shall also make a determination under this section upon 
485.16  consideration of the licensure of an individual who was subject 
485.17  to disqualification before licensure because of substantiated 
485.18  maltreatment. 
485.19     (b) In making a determination under this section, the board 
485.20  shall consider the nature and extent of any injury or harm 
485.21  resulting from the conduct that would constitute grounds for 
485.22  disqualification, the seriousness of the misconduct, the extent 
485.23  that disqualification is necessary to protect persons receiving 
485.24  services or the public, and other factors specified in section 
485.25  245A.04, subdivision 3b, paragraph (b). 
485.26     (c) The board shall determine the duration and extent of 
485.27  the disqualification or may establish conditions under which the 
485.28  licensee may hold a position allowing direct contact with 
485.29  persons receiving services or in a licensed facility.  
485.30     (b) Upon completion of its review of a report of 
485.31  substantiated maltreatment, the board shall notify the 
485.32  commissioner of human services and the lead agency that 
485.33  conducted an investigation under section 626.556 or 626.557, as 
485.34  applicable, of its determination.  The board shall notify the 
485.35  commissioner of human services if, following a review of the 
485.36  report of substantiated maltreatment, the board determines that 
486.1   it does not have jurisdiction in the matter and the commissioner 
486.2   shall make the appropriate disqualification decision regarding 
486.3   the regulated person as otherwise provided in chapter 245A.  The 
486.4   board shall also notify the commissioner of health or the 
486.5   commissioner of human services immediately upon receipt of 
486.6   knowledge of a facility or program allowing a regulated person 
486.7   to provide direct contact services at the facility or program 
486.8   while not complying with requirements placed on the regulated 
486.9   person. 
486.10     (c) In addition to any other remedy provided by law, the 
486.11  board may, through its designated board member, temporarily 
486.12  suspend the license of a licensee; deny a credential to an 
486.13  applicant; or require the regulated person to be continuously 
486.14  supervised, if the board finds there is probable cause to 
486.15  believe the regulated person referred to the board according to 
486.16  paragraph (a) poses an immediate risk of harm to vulnerable 
486.17  persons.  The board shall consider all relevant information 
486.18  available, which may include but is not limited to: 
486.19     (1) the extent the action is needed to protect persons 
486.20  receiving services or the public; 
486.21     (2) the recency of the maltreatment; 
486.22     (3) the number of incidents of maltreatment; 
486.23     (4) the intrusiveness or violence of the maltreatment; and 
486.24     (5) the vulnerability of the victim of maltreatment.  
486.25  The action shall take effect upon written notice to the 
486.26  regulated person, served by certified mail, specifying the 
486.27  statute violated.  The board shall notify the commissioner of 
486.28  health or the commissioner of human services of the suspension 
486.29  or denial of a credential.  The action shall remain in effect 
486.30  until the board issues a temporary stay or a final order in the 
486.31  matter after a hearing or upon agreement between the board and 
486.32  the regulated person.  At the time the board issues the notice, 
486.33  the regulated person shall inform the board of all settings in 
486.34  which the regulated person is employed or practices and the 
486.35  board shall inform all known employment and practice settings of 
486.36  the board action and schedule a disciplinary hearing to be held 
487.1   under chapter 14.  The board shall provide the regulated person 
487.2   with at least 30 days' notice of the hearing, unless the parties 
487.3   agree to a hearing date that provides less than 30 days notice, 
487.4   and shall schedule the hearing to begin no later than 90 days 
487.5   after issuance of the notice of hearing. 
487.6      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
487.7      Sec. 5.  Minnesota Statutes 2000, section 245A.03, 
487.8   subdivision 2b, is amended to read: 
487.9      Subd. 2b.  [EXCEPTION.] The provision in subdivision 2, 
487.10  clause (2), does not apply to: 
487.11     (1) a child care provider who as an applicant for licensure 
487.12  or as a license holder has received a license denial under 
487.13  section 245A.05, a fine conditional license under section 
487.14  245A.06, or a sanction under section 245A.07 from the 
487.15  commissioner that has not been reversed on appeal; or 
487.16     (2) a child care provider, or a child care provider who has 
487.17  a household member who, as a result of a licensing process, has 
487.18  a disqualification under this chapter that has not been set 
487.19  aside by the commissioner. 
487.20     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
487.21     Sec. 6.  Minnesota Statutes 2000, section 245A.04, 
487.22  subdivision 3a, is amended to read: 
487.23     Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
487.24  STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 
487.25  commissioner shall notify the applicant or, license holder, or 
487.26  registrant and the individual who is the subject of the study, 
487.27  in writing or by electronic transmission, of the results of the 
487.28  study.  When the study is completed, a notice that the study was 
487.29  undertaken and completed shall be maintained in the personnel 
487.30  files of the program.  For studies on individuals pertaining to 
487.31  a license to provide family day care or group family day care, 
487.32  foster care for children in the provider's own home, or foster 
487.33  care or day care services for adults in the provider's own home, 
487.34  the commissioner is not required to provide a separate notice of 
487.35  the background study results to the individual who is the 
487.36  subject of the study unless the study results in a 
488.1   disqualification of the individual. 
488.2      The commissioner shall notify the individual studied if the 
488.3   information in the study indicates the individual is 
488.4   disqualified from direct contact with persons served by the 
488.5   program.  The commissioner shall disclose the information 
488.6   causing disqualification and instructions on how to request a 
488.7   reconsideration of the disqualification to the individual 
488.8   studied.  An applicant or license holder who is not the subject 
488.9   of the study shall be informed that the commissioner has found 
488.10  information that disqualifies the subject from direct contact 
488.11  with persons served by the program.  However, only the 
488.12  individual studied must be informed of the information contained 
488.13  in the subject's background study unless the only basis for the 
488.14  disqualification is failure to cooperate, substantiated 
488.15  maltreatment under section 626.556 or 626.557, the Data 
488.16  Practices Act provides for release of the information, or the 
488.17  individual studied authorizes the release of the 
488.18  information.  When a disqualification is based on the subject's 
488.19  failure to cooperate with the background study or substantiated 
488.20  maltreatment under section 626.556 or 626.557, the agency that 
488.21  initiated the study shall be informed by the commissioner of the 
488.22  reason for the disqualification. 
488.23     (b) Except as provided in subdivision 3d, paragraph (b), if 
488.24  the commissioner determines that the individual studied has a 
488.25  disqualifying characteristic, the commissioner shall review the 
488.26  information immediately available and make a determination as to 
488.27  the subject's immediate risk of harm to persons served by the 
488.28  program where the individual studied will have direct contact.  
488.29  The commissioner shall consider all relevant information 
488.30  available, including the following factors in determining the 
488.31  immediate risk of harm:  the recency of the disqualifying 
488.32  characteristic; the recency of discharge from probation for the 
488.33  crimes; the number of disqualifying characteristics; the 
488.34  intrusiveness or violence of the disqualifying characteristic; 
488.35  the vulnerability of the victim involved in the disqualifying 
488.36  characteristic; and the similarity of the victim to the persons 
489.1   served by the program where the individual studied will have 
489.2   direct contact.  The commissioner may determine that the 
489.3   evaluation of the information immediately available gives the 
489.4   commissioner reason to believe one of the following: 
489.5      (1) The individual poses an imminent risk of harm to 
489.6   persons served by the program where the individual studied will 
489.7   have direct contact.  If the commissioner determines that an 
489.8   individual studied poses an imminent risk of harm to persons 
489.9   served by the program where the individual studied will have 
489.10  direct contact, the individual and the license holder must be 
489.11  sent a notice of disqualification.  The commissioner shall order 
489.12  the license holder to immediately remove the individual studied 
489.13  from direct contact.  The notice to the individual studied must 
489.14  include an explanation of the basis of this determination. 
489.15     (2) The individual poses a risk of harm requiring 
489.16  continuous supervision while providing direct contact services 
489.17  during the period in which the subject may request a 
489.18  reconsideration.  If the commissioner determines that an 
489.19  individual studied poses a risk of harm that requires continuous 
489.20  supervision, the individual and the license holder must be sent 
489.21  a notice of disqualification.  The commissioner shall order the 
489.22  license holder to immediately remove the individual studied from 
489.23  direct contact services or assure that the individual studied is 
489.24  within sight or hearing of another staff person when providing 
489.25  direct contact services during the period in which the 
489.26  individual may request a reconsideration of the 
489.27  disqualification.  If the individual studied does not submit a 
489.28  timely request for reconsideration, or the individual submits a 
489.29  timely request for reconsideration, but the disqualification is 
489.30  not set aside for that license holder, the license holder will 
489.31  be notified of the disqualification and ordered to immediately 
489.32  remove the individual from any position allowing direct contact 
489.33  with persons receiving services from the license holder. 
489.34     (3) The individual does not pose an imminent risk of harm 
489.35  or a risk of harm requiring continuous supervision while 
489.36  providing direct contact services during the period in which the 
490.1   subject may request a reconsideration.  If the commissioner 
490.2   determines that an individual studied does not pose a risk of 
490.3   harm that requires continuous supervision, only the individual 
490.4   must be sent a notice of disqualification.  The license holder 
490.5   must be sent a notice that more time is needed to complete the 
490.6   individual's background study.  If the individual studied 
490.7   submits a timely request for reconsideration, and if the 
490.8   disqualification is set aside for that license holder, the 
490.9   license holder will receive the same notification received by 
490.10  license holders in cases where the individual studied has no 
490.11  disqualifying characteristic.  If the individual studied does 
490.12  not submit a timely request for reconsideration, or the 
490.13  individual submits a timely request for reconsideration, but the 
490.14  disqualification is not set aside for that license holder, the 
490.15  license holder will be notified of the disqualification and 
490.16  ordered to immediately remove the individual from any position 
490.17  allowing direct contact with persons receiving services from the 
490.18  license holder.  
490.19     (c) County licensing agencies performing duties under this 
490.20  subdivision may develop an alternative system for determining 
490.21  the subject's immediate risk of harm to persons served by the 
490.22  program, providing the notices under paragraph (b), and 
490.23  documenting the action taken by the county licensing agency.  
490.24  Each county licensing agency's implementation of the alternative 
490.25  system is subject to approval by the commissioner.  
490.26  Notwithstanding this alternative system, county licensing 
490.27  agencies shall complete the requirements of paragraph (a). 
490.28     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
490.29     Sec. 7.  Minnesota Statutes 2000, section 245A.04, 
490.30  subdivision 3b, is amended to read: 
490.31     Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
490.32  individual who is the subject of the disqualification may 
490.33  request a reconsideration of the disqualification.  
490.34     The individual must submit the request for reconsideration 
490.35  to the commissioner in writing.  A request for reconsideration 
490.36  for an individual who has been sent a notice of disqualification 
491.1   under subdivision 3a, paragraph (b), clause (1) or (2), must be 
491.2   submitted within 30 calendar days of the disqualified 
491.3   individual's receipt of the notice of disqualification.  A 
491.4   request for reconsideration for an individual who has been sent 
491.5   a notice of disqualification under subdivision 3a, paragraph 
491.6   (b), clause (3), must be submitted within 15 calendar days of 
491.7   the disqualified individual's receipt of the notice of 
491.8   disqualification.  An individual who was determined to have 
491.9   maltreated a child under section 626.556 or a vulnerable adult 
491.10  under section 626.557, and who was disqualified under this 
491.11  section on the basis of serious or recurring maltreatment, may 
491.12  request reconsideration of both the maltreatment and the 
491.13  disqualification determinations.  The request for 
491.14  reconsideration of the maltreatment determination and the 
491.15  disqualification must be submitted within 30 calendar days of 
491.16  the individual's receipt of the notice of disqualification.  
491.17  Removal of a disqualified individual from direct contact shall 
491.18  be ordered if the individual does not request reconsideration 
491.19  within the prescribed time, and for an individual who submits a 
491.20  timely request for reconsideration, if the disqualification is 
491.21  not set aside.  The individual must present information showing 
491.22  that: 
491.23     (1) the information the commissioner relied upon is 
491.24  incorrect or inaccurate.  If the basis of a reconsideration 
491.25  request is that a maltreatment determination or disposition 
491.26  under section 626.556 or 626.557 is incorrect, and the 
491.27  commissioner has issued a final order in an appeal of that 
491.28  determination or disposition under section 256.045 or 245A.08, 
491.29  subdivision 5, the commissioner's order is conclusive on the 
491.30  issue of maltreatment.  If the individual did not request 
491.31  reconsideration of the maltreatment determination, the 
491.32  maltreatment determination is deemed conclusive; or 
491.33     (2) the subject of the study does not pose a risk of harm 
491.34  to any person served by the applicant or, license holder, or 
491.35  registrant. 
491.36     (b) The commissioner shall rescind the disqualification if 
492.1   the commissioner finds that the information relied on to 
492.2   disqualify the subject is incorrect.  The commissioner may set 
492.3   aside the disqualification under this section if the 
492.4   commissioner finds that the information the commissioner relied 
492.5   upon is incorrect or the individual does not pose a risk of harm 
492.6   to any person served by the applicant or, license holder, or 
492.7   registrant.  In determining that an individual does not pose a 
492.8   risk of harm, the commissioner shall consider the consequences 
492.9   of the event or events that lead to disqualification, whether 
492.10  there is more than one disqualifying event, the vulnerability of 
492.11  the victim at the time of the event, the time elapsed without a 
492.12  repeat of the same or similar event, documentation of successful 
492.13  completion by the individual studied of training or 
492.14  rehabilitation pertinent to the event, and any other information 
492.15  relevant to reconsideration.  In reviewing a disqualification 
492.16  under this section, the commissioner shall give preeminent 
492.17  weight to the safety of each person to be served by the license 
492.18  holder or, applicant, or registrant over the interests of the 
492.19  license holder or, applicant, or registrant. 
492.20     (c) Unless the information the commissioner relied on in 
492.21  disqualifying an individual is incorrect, the commissioner may 
492.22  not set aside the disqualification of an individual in 
492.23  connection with a license to provide family day care for 
492.24  children, foster care for children in the provider's own home, 
492.25  or foster care or day care services for adults in the provider's 
492.26  own home if: 
492.27     (1) less than ten years have passed since the discharge of 
492.28  the sentence imposed for the offense; and the individual has 
492.29  been convicted of a violation of any offense listed in sections 
492.30  609.20 (manslaughter in the first degree), 609.205 (manslaughter 
492.31  in the second degree), criminal vehicular homicide under 609.21 
492.32  (criminal vehicular homicide and injury), 609.215 (aiding 
492.33  suicide or aiding attempted suicide), felony violations under 
492.34  609.221 to 609.2231 (assault in the first, second, third, or 
492.35  fourth degree), 609.713 (terroristic threats), 609.235 (use of 
492.36  drugs to injure or to facilitate crime), 609.24 (simple 
493.1   robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 
493.2   609.255 (false imprisonment), 609.561 or 609.562 (arson in the 
493.3   first or second degree), 609.71 (riot), burglary in the first or 
493.4   second degree under 609.582 (burglary), 609.66 (dangerous 
493.5   weapon), 609.665 (spring guns), 609.67 (machine guns and 
493.6   short-barreled shotguns), 609.749 (harassment; stalking), 
493.7   152.021 or 152.022 (controlled substance crime in the first or 
493.8   second degree), 152.023, subdivision 1, clause (3) or (4), or 
493.9   subdivision 2, clause (4) (controlled substance crime in the 
493.10  third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
493.11  (controlled substance crime in the fourth degree), 609.224, 
493.12  subdivision 2, paragraph (c) (fifth-degree assault by a 
493.13  caregiver against a vulnerable adult), 609.228 (great bodily 
493.14  harm caused by distribution of drugs), 609.23 (mistreatment of 
493.15  persons confined), 609.231 (mistreatment of residents or 
493.16  patients), 609.2325 (criminal abuse of a vulnerable adult), 
493.17  609.233 (criminal neglect of a vulnerable adult), 609.2335 
493.18  (financial exploitation of a vulnerable adult), 609.234 (failure 
493.19  to report), 609.265 (abduction), 609.2664 to 609.2665 
493.20  (manslaughter of an unborn child in the first or second degree), 
493.21  609.267 to 609.2672 (assault of an unborn child in the first, 
493.22  second, or third degree), 609.268 (injury or death of an unborn 
493.23  child in the commission of a crime), 617.293 (disseminating or 
493.24  displaying harmful material to minors), a gross misdemeanor 
493.25  offense under 609.324, subdivision 1 (other prohibited acts), a 
493.26  gross misdemeanor offense under 609.378 (neglect or endangerment 
493.27  of a child), a gross misdemeanor offense under 609.377 
493.28  (malicious punishment of a child), 609.72, subdivision 3 
493.29  (disorderly conduct against a vulnerable adult); or an attempt 
493.30  or conspiracy to commit any of these offenses, as each of these 
493.31  offenses is defined in Minnesota Statutes; or an offense in any 
493.32  other state, the elements of which are substantially similar to 
493.33  the elements of any of the foregoing offenses; 
493.34     (2) regardless of how much time has passed since the 
493.35  discharge of the sentence imposed for the offense, the 
493.36  individual was convicted of a violation of any offense listed in 
494.1   sections 609.185 to 609.195 (murder in the first, second, or 
494.2   third degree), 609.2661 to 609.2663 (murder of an unborn child 
494.3   in the first, second, or third degree), a felony offense under 
494.4   609.377 (malicious punishment of a child), a felony offense 
494.5   under 609.324, subdivision 1 (other prohibited acts), a felony 
494.6   offense under 609.378 (neglect or endangerment of a child), 
494.7   609.322 (solicitation, inducement, and promotion of 
494.8   prostitution), 609.342 to 609.345 (criminal sexual conduct in 
494.9   the first, second, third, or fourth degree), 609.352 
494.10  (solicitation of children to engage in sexual conduct), 617.246 
494.11  (use of minors in a sexual performance), 617.247 (possession of 
494.12  pictorial representations of a minor), 609.365 (incest), a 
494.13  felony offense under sections 609.2242 and 609.2243 (domestic 
494.14  assault), a felony offense of spousal abuse, a felony offense of 
494.15  child abuse or neglect, a felony offense of a crime against 
494.16  children, or an attempt or conspiracy to commit any of these 
494.17  offenses as defined in Minnesota Statutes, or an offense in any 
494.18  other state, the elements of which are substantially similar to 
494.19  any of the foregoing offenses; 
494.20     (3) within the seven years preceding the study, the 
494.21  individual committed an act that constitutes maltreatment of a 
494.22  child under section 626.556, subdivision 10e, and that resulted 
494.23  in substantial bodily harm as defined in section 609.02, 
494.24  subdivision 7a, or substantial mental or emotional harm as 
494.25  supported by competent psychological or psychiatric evidence; or 
494.26     (4) within the seven years preceding the study, the 
494.27  individual was determined under section 626.557 to be the 
494.28  perpetrator of a substantiated incident of maltreatment of a 
494.29  vulnerable adult that resulted in substantial bodily harm as 
494.30  defined in section 609.02, subdivision 7a, or substantial mental 
494.31  or emotional harm as supported by competent psychological or 
494.32  psychiatric evidence. 
494.33     In the case of any ground for disqualification under 
494.34  clauses (1) to (4), if the act was committed by an individual 
494.35  other than the applicant or, license holder, or registrant 
494.36  residing in the applicant's or, license holder's, or 
495.1   registrant's home, the applicant or, license holder, or 
495.2   registrant may seek reconsideration when the individual who 
495.3   committed the act no longer resides in the home.  
495.4      The disqualification periods provided under clauses (1), 
495.5   (3), and (4) are the minimum applicable disqualification 
495.6   periods.  The commissioner may determine that an individual 
495.7   should continue to be disqualified from licensure or 
495.8   registration because the license holder or, applicant, or 
495.9   registrant poses a risk of harm to a person served by that 
495.10  individual after the minimum disqualification period has passed. 
495.11     (d) The commissioner shall respond in writing or by 
495.12  electronic transmission to all reconsideration requests for 
495.13  which the basis for the request is that the information relied 
495.14  upon by the commissioner to disqualify is incorrect or 
495.15  inaccurate within 30 working days of receipt of a request and 
495.16  all relevant information.  If the basis for the request is that 
495.17  the individual does not pose a risk of harm, the commissioner 
495.18  shall respond to the request within 15 working days after 
495.19  receiving the request for reconsideration and all relevant 
495.20  information.  If the request is based on both the correctness or 
495.21  accuracy of the information relied on to disqualify the 
495.22  individual and the risk of harm, the commissioner shall respond 
495.23  to the request within 45 working days after receiving the 
495.24  request for reconsideration and all relevant information.  If 
495.25  the disqualification is set aside, the commissioner shall notify 
495.26  the applicant or license holder in writing or by electronic 
495.27  transmission of the decision. 
495.28     (e) Except as provided in subdivision 3c, the 
495.29  commissioner's decision to disqualify an individual, including 
495.30  the decision to grant or deny a rescission or set aside a 
495.31  disqualification under this section, is the final administrative 
495.32  agency action and shall not be subject to further review in a 
495.33  contested case under chapter 14 involving a negative licensing 
495.34  appeal taken in response to the disqualification or involving an 
495.35  accuracy and completeness appeal under section 13.04. if a 
495.36  disqualification is not set aside or is not rescinded, an 
496.1   individual who was disqualified on the basis of a preponderance 
496.2   of evidence that the individual committed an act or acts that 
496.3   meet the definition of any of the crimes lists in subdivision 
496.4   3d, paragraph (a), clauses (1) to (4); or for failure to make 
496.5   required reports under section 626.556, subdivision 3, or 
496.6   626.557, subdivision 3, pursuant to subdivision 3d, paragraph 
496.7   (a), clause (4), may request a fair hearing under section 
496.8   256.045.  Except as provided under subdivision 3c, the 
496.9   commissioner's final order for an individual under this 
496.10  paragraph is conclusive on the issue of disqualification, 
496.11  including for purposes of subsequent studies conducted under 
496.12  section 245A.04, subdivision 3, and is the only administrative 
496.13  appeal of the final agency determination, specifically, 
496.14  including a challenge to the accuracy and completeness of data 
496.15  under section 13.04. 
496.16     (f) Except as provided under subdivision 3c, if an 
496.17  individual was disqualified on the basis of a determination of 
496.18  maltreatment under section 626.556 or 626.557, which was serious 
496.19  or recurring, and the individual has requested reconsideration 
496.20  of the maltreatment determination under section 626.556, 
496.21  subdivision 10i, or 626.557, subdivision 9d, and also requested 
496.22  reconsideration of the disqualification under this subdivision, 
496.23  reconsideration of the maltreatment determination and 
496.24  reconsideration of the disqualification shall be consolidated 
496.25  into a single reconsideration.  For maltreatment and 
496.26  disqualification determinations made by county agencies, the 
496.27  consolidated reconsideration shall be conducted by the county 
496.28  agency.  Except as provided under subdivision 3c, if an 
496.29  individual who was disqualified on the basis of serious or 
496.30  recurring maltreatment requests a fair hearing on the 
496.31  maltreatment determination under section 626.556, subdivision 
496.32  10i, or 626.557, subdivision 9d, the scope of the fair hearing 
496.33  under section 256.045 shall include the maltreatment 
496.34  determination and the disqualification.  Except as provided 
496.35  under subdivision 3c, the commissioner's final order for an 
496.36  individual under this paragraph is conclusive on the issue of 
497.1   maltreatment and disqualification, including for purposes of 
497.2   subsequent studies conducted under subdivision 3, and is the 
497.3   only administrative appeal of the final agency determination, 
497.4   specifically, including a challenge to the accuracy and 
497.5   completeness of data under section 13.04. 
497.6      <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
497.7      Sec. 8.  Minnesota Statutes 2000, section 245A.04, 
497.8   subdivision 3c, is amended to read: 
497.9      Subd. 3c.  [CONTESTED CASE.] (a) Notwithstanding 
497.10  subdivision 3b, paragraphs (e) and (f), if a disqualification is 
497.11  not set aside, a person who is an employee of an employer, as 
497.12  defined in section 179A.03, subdivision 15, may request a 
497.13  contested case hearing under chapter 14.  If the 
497.14  disqualification which was not set aside or was not rescinded 
497.15  was based on a maltreatment determination, the scope of the 
497.16  contested case hearing shall include the maltreatment 
497.17  determination and the disqualification.  In such cases, a fair 
497.18  hearing shall not be conducted under section 256.045.  Rules 
497.19  adopted under this chapter may not preclude an employee in a 
497.20  contested case hearing for disqualification from submitting 
497.21  evidence concerning information gathered under subdivision 3, 
497.22  paragraph (e). 
497.23     (b) If a disqualification for which reconsideration was 
497.24  requested and which was not set aside or was not rescinded under 
497.25  subdivision 3b is the basis for a denial of a license under 
497.26  section 245A.05 or a licensing sanction under section 245A.07, 
497.27  the license holder has the right to a contested case hearing 
497.28  under chapter 14 and Minnesota Rules, parts 1400.8510 to 
497.29  1400.8612 and successor rules.  The appeal must be submitted in 
497.30  accordance with section 245A.05 or 245A.07, subdivision 3.  As 
497.31  provided for under section 245A.08, subdivision 2a, the scope of 
497.32  the consolidated contested case hearing shall include the 
497.33  disqualification and the licensing sanction or denial of a 
497.34  license.  If the disqualification was based on a determination 
497.35  of substantiated serious or recurring maltreatment under section 
497.36  626.556 or 626.557, the appeal must be submitted in accordance 
498.1   with sections 245A.07, subdivision 3, and 626.556, subdivision 
498.2   10i, or 626.557, subdivision 9d.  As provided for under section 
498.3   245A.08, subdivision 2a, the scope of the contested case hearing 
498.4   shall include the maltreatment determination, the 
498.5   disqualification, and the licensing sanction or denial of a 
498.6   license.  In such cases, a fair hearing shall not be conducted 
498.7   under section 256.045. 
498.8      (c) If a maltreatment determination or disqualification, 
498.9   which was not set aside or was not rescinded under subdivision 
498.10  3b, is the basis for a denial of a license under section 245A.05 
498.11  or a licensing sanction under section 245A.07, and the 
498.12  disqualified subject is an individual other than the license 
498.13  holder and upon whom a background study must be conducted under 
498.14  subdivision 3, the hearing of all parties may be consolidated 
498.15  into a single contested case hearing upon consent of all parties 
498.16  and the administrative law judge.  
498.17     (d) The commissioner's final order under section 245A.08, 
498.18  subdivision 5, is conclusive on the issue of maltreatment and 
498.19  disqualification, including for purposes of subsequent 
498.20  background studies.  The contested case hearing under this 
498.21  subdivision is the only administrative appeal of the final 
498.22  agency determination, specifically, including a challenge to the 
498.23  accuracy and completeness of data under section 13.04. 
498.24     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
498.25     Sec. 9.  Minnesota Statutes 2000, section 245A.04, 
498.26  subdivision 3d, is amended to read: 
498.27     Subd. 3d.  [DISQUALIFICATION.] (a) Except as provided in 
498.28  paragraph (b), when a background study completed under 
498.29  subdivision 3 shows any of the following:  a conviction of one 
498.30  or more crimes listed in clauses (1) to (4); the individual has 
498.31  admitted to or a preponderance of the evidence indicates the 
498.32  individual has committed an act or acts that meet the definition 
498.33  of any of the crimes listed in clauses (1) to (4); or an 
498.34  investigation results in an administrative determination listed 
498.35  under clause (4), the individual shall be disqualified from any 
498.36  position allowing direct contact with persons receiving services 
499.1   from the license holder, registrant and for individuals studied 
499.2   under section 245A.04, subdivision 3, paragraph (c), clauses 
499.3   (2), (6), and (7), in H.F. 1381, if enacted, the individual 
499.4   shall also be disqualified from access to persons receiving 
499.5   services from the license holder: 
499.6      (1) regardless of how much time has passed since the 
499.7   discharge of the sentence imposed for the offense, and unless 
499.8   otherwise specified, regardless of the level of the conviction, 
499.9   the individual was convicted of any of the following offenses:  
499.10  sections 609.185 (murder in the first degree); 609.19 (murder in 
499.11  the second degree); 609.195 (murder in the third degree); 
499.12  609.2661 (murder of an unborn child in the first degree); 
499.13  609.2662 (murder of an unborn child in the second degree); 
499.14  609.2663 (murder of an unborn child in the third degree); 
499.15  609.322 (solicitation, inducement, and promotion of 
499.16  prostitution); 609.342 (criminal sexual conduct in the first 
499.17  degree); 609.343 (criminal sexual conduct in the second degree); 
499.18  609.344 (criminal sexual conduct in the third degree); 609.345 
499.19  (criminal sexual conduct in the fourth degree); 609.352 
499.20  (solicitation of children to engage in sexual conduct); 609.365 
499.21  (incest); felony offense under 609.377 (malicious punishment of 
499.22  a child); a felony offense under 609.378 (neglect or 
499.23  endangerment of a child); a felony offense under 609.324, 
499.24  subdivision 1 (other prohibited acts); 617.246 (use of minors in 
499.25  sexual performance prohibited); 617.247 (possession of pictorial 
499.26  representations of minors); a felony offense under sections 
499.27  609.2242 and 609.2243 (domestic assault), a felony offense of 
499.28  spousal abuse, a felony offense of child abuse or neglect, a 
499.29  felony offense of a crime against children; or attempt or 
499.30  conspiracy to commit any of these offenses as defined in 
499.31  Minnesota Statutes, or an offense in any other state or country, 
499.32  where the elements are substantially similar to any of the 
499.33  offenses listed in this clause; 
499.34     (2) if less than 15 years have passed since the discharge 
499.35  of the sentence imposed for the offense; and the individual has 
499.36  received a felony conviction for a violation of any of these 
500.1   offenses:  sections 609.20 (manslaughter in the first degree); 
500.2   609.205 (manslaughter in the second degree); 609.21 (criminal 
500.3   vehicular homicide and injury); 609.215 (suicide); 609.221 to 
500.4   609.2231 (assault in the first, second, third, or fourth 
500.5   degree); repeat offenses under 609.224 (assault in the fifth 
500.6   degree); repeat offenses under 609.3451 (criminal sexual conduct 
500.7   in the fifth degree); 609.713 (terroristic threats); 609.235 
500.8   (use of drugs to injure or facilitate crime); 609.24 (simple 
500.9   robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 
500.10  609.255 (false imprisonment); 609.561 (arson in the first 
500.11  degree); 609.562 (arson in the second degree); 609.563 (arson in 
500.12  the third degree); repeat offenses under 617.23 (indecent 
500.13  exposure; penalties); repeat offenses under 617.241 (obscene 
500.14  materials and performances; distribution and exhibition 
500.15  prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 
500.16  609.67 (machine guns and short-barreled shotguns); 609.749 
500.17  (harassment; stalking; penalties); 609.228 (great bodily harm 
500.18  caused by distribution of drugs); 609.2325 (criminal abuse of a 
500.19  vulnerable adult); 609.2664 (manslaughter of an unborn child in 
500.20  the first degree); 609.2665 (manslaughter of an unborn child in 
500.21  the second degree); 609.267 (assault of an unborn child in the 
500.22  first degree); 609.2671 (assault of an unborn child in the 
500.23  second degree); 609.268 (injury or death of an unborn child in 
500.24  the commission of a crime); 609.52 (theft); 609.2335 (financial 
500.25  exploitation of a vulnerable adult); 609.521 (possession of 
500.26  shoplifting gear); 609.582 (burglary); 609.625 (aggravated 
500.27  forgery); 609.63 (forgery); 609.631 (check forgery; offering a 
500.28  forged check); 609.635 (obtaining signature by false pretense); 
500.29  609.27 (coercion); 609.275 (attempt to coerce); 609.687 
500.30  (adulteration); 260C.301 (grounds for termination of parental 
500.31  rights); and chapter 152 (drugs; controlled substance).  An 
500.32  attempt or conspiracy to commit any of these offenses, as each 
500.33  of these offenses is defined in Minnesota Statutes; or an 
500.34  offense in any other state or country, the elements of which are 
500.35  substantially similar to the elements of the offenses in this 
500.36  clause.  If the individual studied is convicted of one of the 
501.1   felonies listed in this clause, but the sentence is a gross 
501.2   misdemeanor or misdemeanor disposition, the lookback period for 
501.3   the conviction is the period applicable to the disposition, that 
501.4   is the period for gross misdemeanors or misdemeanors; 
501.5      (3) if less than ten years have passed since the discharge 
501.6   of the sentence imposed for the offense; and the individual has 
501.7   received a gross misdemeanor conviction for a violation of any 
501.8   of the following offenses:  sections 609.224 (assault in the 
501.9   fifth degree); 609.2242 and 609.2243 (domestic assault); 
501.10  violation of an order for protection under 518B.01, subdivision 
501.11  14; 609.3451 (criminal sexual conduct in the fifth degree); 
501.12  repeat offenses under 609.746 (interference with privacy); 
501.13  repeat offenses under 617.23 (indecent exposure); 617.241 
501.14  (obscene materials and performances); 617.243 (indecent 
501.15  literature, distribution); 617.293 (harmful materials; 
501.16  dissemination and display to minors prohibited); 609.71 (riot); 
501.17  609.66 (dangerous weapons); 609.749 (harassment; stalking; 
501.18  penalties); 609.224, subdivision 2, paragraph (c) (assault in 
501.19  the fifth degree by a caregiver against a vulnerable adult); 
501.20  609.23 (mistreatment of persons confined); 609.231 (mistreatment 
501.21  of residents or patients); 609.2325 (criminal abuse of a 
501.22  vulnerable adult); 609.233 (criminal neglect of a vulnerable 
501.23  adult); 609.2335 (financial exploitation of a vulnerable adult); 
501.24  609.234 (failure to report maltreatment of a vulnerable adult); 
501.25  609.72, subdivision 3 (disorderly conduct against a vulnerable 
501.26  adult); 609.265 (abduction); 609.378 (neglect or endangerment of 
501.27  a child); 609.377 (malicious punishment of a child); 609.324, 
501.28  subdivision 1a (other prohibited acts; minor engaged in 
501.29  prostitution); 609.33 (disorderly house); 609.52 (theft); 
501.30  609.582 (burglary); 609.631 (check forgery; offering a forged 
501.31  check); 609.275 (attempt to coerce); or an attempt or conspiracy 
501.32  to commit any of these offenses, as each of these offenses is 
501.33  defined in Minnesota Statutes; or an offense in any other state 
501.34  or country, the elements of which are substantially similar to 
501.35  the elements of any of the offenses listed in this clause.  If 
501.36  the defendant is convicted of one of the gross misdemeanors 
502.1   listed in this clause, but the sentence is a misdemeanor 
502.2   disposition, the lookback period for the conviction is the 
502.3   period applicable to misdemeanors; or 
502.4      (4) if less than seven years have passed since the 
502.5   discharge of the sentence imposed for the offense; and the 
502.6   individual has received a misdemeanor conviction for a violation 
502.7   of any of the following offenses:  sections 609.224 (assault in 
502.8   the fifth degree); 609.2242 (domestic assault); violation of an 
502.9   order for protection under 518B.01 (Domestic Abuse Act); 
502.10  violation of an order for protection under 609.3232 (protective 
502.11  order authorized; procedures; penalties); 609.746 (interference 
502.12  with privacy); 609.79 (obscene or harassing phone calls); 
502.13  609.795 (letter, telegram, or package; opening; harassment); 
502.14  617.23 (indecent exposure; penalties); 609.2672 (assault of an 
502.15  unborn child in the third degree); 617.293 (harmful materials; 
502.16  dissemination and display to minors prohibited); 609.66 
502.17  (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 
502.18  exploitation of a vulnerable adult); 609.234 (failure to report 
502.19  maltreatment of a vulnerable adult); 609.52 (theft); 609.27 
502.20  (coercion); or an attempt or conspiracy to commit any of these 
502.21  offenses, as each of these offenses is defined in Minnesota 
502.22  Statutes; or an offense in any other state or country, the 
502.23  elements of which are substantially similar to the elements of 
502.24  any of the offenses listed in this clause; failure to make 
502.25  required reports under section 626.556, subdivision 3, or 
502.26  626.557, subdivision 3, for incidents in which:  (i) the final 
502.27  disposition under section 626.556 or 626.557 was substantiated 
502.28  maltreatment, and (ii) the maltreatment was recurring or 
502.29  serious; or substantiated serious or recurring maltreatment of a 
502.30  minor under section 626.556 or of a vulnerable adult under 
502.31  section 626.557 for which there is a preponderance of evidence 
502.32  that the maltreatment occurred, and that the subject was 
502.33  responsible for the maltreatment. 
502.34     For the purposes of this section, "serious maltreatment" 
502.35  means sexual abuse; maltreatment resulting in death; or 
502.36  maltreatment resulting in serious injury which reasonably 
503.1   requires the care of a physician whether or not the care of a 
503.2   physician was sought; or abuse resulting in serious injury.  For 
503.3   purposes of this section, "abuse resulting in serious injury" 
503.4   means:  bruises, bites, skin laceration or tissue damage; 
503.5   fractures; dislocations; evidence of internal injuries; head 
503.6   injuries with loss of consciousness; extensive second-degree or 
503.7   third-degree burns and other burns for which complications are 
503.8   present; extensive second-degree or third-degree frostbite, and 
503.9   others for which complications are present; irreversible 
503.10  mobility or avulsion of teeth; injuries to the eyeball; 
503.11  ingestion of foreign substances and objects that are harmful; 
503.12  near drowning; and heat exhaustion or sunstroke.  For purposes 
503.13  of this section, "care of a physician" is treatment received or 
503.14  ordered by a physician, but does not include diagnostic testing, 
503.15  assessment, or observation.  For the purposes of this section, 
503.16  "recurring maltreatment" means more than one incident of 
503.17  maltreatment for which there is a preponderance of evidence that 
503.18  the maltreatment occurred, and that the subject was responsible 
503.19  for the maltreatment.  For purposes of this section, "access" 
503.20  means physical access to an individual receiving services or the 
503.21  individual's personal property without continuous, direct 
503.22  supervision as defined in section 245A.04, subdivision 3.  
503.23     (b) If Except for background studies related to child 
503.24  foster care, adult foster care, or family child care licensure, 
503.25  when the subject of a background study is licensed regulated by 
503.26  a health-related licensing board as defined in chapter 214, and 
503.27  the regulated person has been determined to have been 
503.28  responsible for substantiated maltreatment under section 626.556 
503.29  or 626.557, instead of the commissioner making a decision 
503.30  regarding disqualification, the board shall make the a 
503.31  determination regarding a disqualification under this 
503.32  subdivision based on a finding of substantiated maltreatment 
503.33  under section 626.556 or 626.557.  The commissioner shall notify 
503.34  the health-related licensing board if a background study shows 
503.35  that a licensee would be disqualified because of substantiated 
503.36  maltreatment and the board shall make a determination under 
504.1   section 214.104. whether to impose disciplinary or corrective 
504.2   action under chapter 214. 
504.3      (1) The commissioner shall notify the health-related 
504.4   licensing board: 
504.5      (i) upon completion of a background study that produces a 
504.6   record showing that the individual was determined to have been 
504.7   responsible for substantiated maltreatment; 
504.8      (ii) upon the commissioner's completion of an investigation 
504.9   that determined the individual was responsible for substantiated 
504.10  maltreatment; or 
504.11     (iii) upon receipt from another agency of a finding of 
504.12  substantiated maltreatment for which the individual was 
504.13  responsible. 
504.14     (2) The commissioner's notice shall indicate whether the 
504.15  individual would have been disqualified by the commissioner for 
504.16  the substantiated maltreatment if the individual were not 
504.17  regulated by the board.  The commissioner shall concurrently 
504.18  send a copy of this notice to the individual.  
504.19     (3) Notwithstanding the exclusion from this subdivision for 
504.20  individuals who provide child foster care, adult foster care, or 
504.21  family child care, when the commissioner or a local agency has 
504.22  reason to believe that the direct contact services provided by 
504.23  the individual may fall within the jurisdiction of a 
504.24  health-related licensing board, a referral shall be made to the 
504.25  board as provided in this section. 
504.26     (4) If, upon review of the information provided by the 
504.27  commissioner, a health-related licensing board informs the 
504.28  commissioner that the board does not have jurisdiction to take 
504.29  disciplinary or corrective action, the commissioner shall make 
504.30  the appropriate disqualification decision regarding the 
504.31  individual as otherwise provided in this chapter. 
504.32     (5) The commissioner has the authority to monitor the 
504.33  facility's compliance with any requirements that the 
504.34  health-related licensing board places on regulated persons 
504.35  practicing in a facility either during the period pending a 
504.36  final decision on a disciplinary or corrective action or as a 
505.1   result of a disciplinary or corrective action.  The commissioner 
505.2   has the authority to order the immediate removal of a regulated 
505.3   person from direct contact or access when a board issues an 
505.4   order of temporary suspension based on a determination that the 
505.5   regulated person poses an immediate risk of harm to persons 
505.6   receiving services in a licensed facility. 
505.7      (6) A facility that allows a regulated person to provide 
505.8   direct contact services while not complying with the 
505.9   requirements imposed by the health-related licensing board is 
505.10  subject to action by the commissioner as specified under 
505.11  sections 245A.06 and 245A.07. 
505.12     (7) The commissioner shall notify a health-related 
505.13  licensing board immediately upon receipt of knowledge of 
505.14  noncompliance with requirements placed on a facility or upon a 
505.15  person regulated by the board. 
505.16     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
505.17     Sec. 10.  Minnesota Statutes 2000, section 245A.05, is 
505.18  amended to read: 
505.19     245A.05 [DENIAL OF APPLICATION.] 
505.20     The commissioner may deny a license if an applicant fails 
505.21  to comply with applicable laws or rules, or knowingly withholds 
505.22  relevant information from or gives false or misleading 
505.23  information to the commissioner in connection with an 
505.24  application for a license or during an investigation.  An 
505.25  applicant whose application has been denied by the commissioner 
505.26  must be given notice of the denial.  Notice must be given by 
505.27  certified mail.  The notice must state the reasons the 
505.28  application was denied and must inform the applicant of the 
505.29  right to a contested case hearing under chapter 14 and Minnesota 
505.30  Rules, parts 1400.8510 to 1400.8612 and successor rules.  The 
505.31  applicant may appeal the denial by notifying the commissioner in 
505.32  writing by certified mail within 20 calendar days after 
505.33  receiving notice that the application was denied.  Section 
505.34  245A.08 applies to hearings held to appeal the commissioner's 
505.35  denial of an application. 
505.36     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
506.1      Sec. 11.  Minnesota Statutes 2000, section 245A.06, is 
506.2   amended to read: 
506.3      245A.06 [CORRECTION ORDER AND FINES CONDITIONAL LICENSE.] 
506.4      Subdivision 1.  [CONTENTS OF CORRECTION ORDERS OR FINES AND 
506.5   CONDITIONAL LICENSES.] (a) If the commissioner finds that the 
506.6   applicant or license holder has failed to comply with an 
506.7   applicable law or rule and this failure does not imminently 
506.8   endanger the health, safety, or rights of the persons served by 
506.9   the program, the commissioner may issue a correction order and 
506.10  an order of conditional license to or impose a fine on the 
506.11  applicant or license holder.  When issuing a conditional 
506.12  license, the commissioner shall consider the nature, chronicity, 
506.13  or severity of the violation of law or rule and the effect of 
506.14  the violation on the health, safety, or rights of persons served 
506.15  by the program.  The correction order or fine conditional 
506.16  license must state: 
506.17     (1) the conditions that constitute a violation of the law 
506.18  or rule; 
506.19     (2) the specific law or rule violated; 
506.20     (3) the time allowed to correct each violation; and 
506.21     (4) if a fine is imposed, the amount of the fine license is 
506.22  made conditional, the length and terms of the conditional 
506.23  license. 
506.24     (b) Nothing in this section prohibits the commissioner from 
506.25  proposing a sanction as specified in section 245A.07, prior to 
506.26  issuing a correction order or fine conditional license. 
506.27     Subd. 2.  [RECONSIDERATION OF CORRECTION ORDERS.] If the 
506.28  applicant or license holder believes that the contents of the 
506.29  commissioner's correction order are in error, the applicant or 
506.30  license holder may ask the department of human services to 
506.31  reconsider the parts of the correction order that are alleged to 
506.32  be in error.  The request for reconsideration must be in writing 
506.33  and received by the commissioner within 20 calendar days after 
506.34  receipt of the correction order by the applicant or license 
506.35  holder, and: 
506.36     (1) specify the parts of the correction order that are 
507.1   alleged to be in error; 
507.2      (2) explain why they are in error; and 
507.3      (3) include documentation to support the allegation of 
507.4   error. 
507.5      A request for reconsideration does not stay any provisions 
507.6   or requirements of the correction order.  The commissioner's 
507.7   disposition of a request for reconsideration is final and not 
507.8   subject to appeal under chapter 14. 
507.9      Subd. 3.  [FAILURE TO COMPLY.] If the commissioner finds 
507.10  that the applicant or license holder has not corrected the 
507.11  violations specified in the correction order or conditional 
507.12  license, the commissioner may impose a fine and order other 
507.13  licensing sanctions pursuant to section 245A.07.  If a fine was 
507.14  imposed and the violation was not corrected, the commissioner 
507.15  may impose an additional fine.  This section does not prohibit 
507.16  the commissioner from seeking a court order, denying an 
507.17  application, or suspending, revoking, or making conditional the 
507.18  license in addition to imposing a fine. 
507.19     Subd. 4.  [NOTICE OF FINE CONDITIONAL LICENSE; 
507.20  RECONSIDERATION OF FINE CONDITIONAL LICENSE.] A license holder 
507.21  who is ordered to pay a fine If a license is made conditional, 
507.22  the license holder must be notified of the order by certified 
507.23  mail.  The notice must be mailed to the address shown on the 
507.24  application or the last known address of the license holder.  
507.25  The notice must state the reasons the fine conditional license 
507.26  was ordered and must inform the license holder of the 
507.27  responsibility for payment of fines in subdivision 7 and the 
507.28  right to request reconsideration of the fine conditional license 
507.29  by the commissioner.  The license holder may request 
507.30  reconsideration of the order to forfeit a fine of conditional 
507.31  license by notifying the commissioner by certified mail within 
507.32  20 calendar days after receiving the order.  The request must be 
507.33  in writing and must be received by the commissioner within ten 
507.34  calendar days after the license holder received the order.  The 
507.35  license holder may submit with the request for reconsideration 
507.36  written argument or evidence in support of the request for 
508.1   reconsideration.  A timely request for reconsideration shall 
508.2   stay forfeiture of the fine imposition of the terms of the 
508.3   conditional license until the commissioner issues a decision on 
508.4   the request for reconsideration.  The request for 
508.5   reconsideration must be in writing and: 
508.6      (1) specify the parts of the violation that are alleged to 
508.7   be in error; 
508.8      (2) explain why they are in error; 
508.9      (3) include documentation to support the allegation of 
508.10  error; and 
508.11     (4) any other information relevant to the fine or the 
508.12  amount of the fine. 
508.13     The commissioner's disposition of a request for 
508.14  reconsideration is final and not subject to appeal under chapter 
508.15  14. 
508.16     Subd. 5.  [FORFEITURE OF FINES.] The license holder shall 
508.17  pay the fines assessed on or before the payment date specified 
508.18  in the commissioner's order.  If the license holder fails to 
508.19  fully comply with the order, the commissioner shall issue a 
508.20  second fine or suspend the license until the license holder 
508.21  complies.  If the license holder receives state funds, the 
508.22  state, county, or municipal agencies or departments responsible 
508.23  for administering the funds shall withhold payments and recover 
508.24  any payments made while the license is suspended for failure to 
508.25  pay a fine.  
508.26     Subd. 5a.  [ACCRUAL OF FINES.] A license holder shall 
508.27  promptly notify the commissioner of human services, in writing, 
508.28  when a violation specified in an order to forfeit is corrected.  
508.29  If upon reinspection the commissioner determines that a 
508.30  violation has not been corrected as indicated by the order to 
508.31  forfeit, the commissioner may issue a second fine.  The 
508.32  commissioner shall notify the license holder by certified mail 
508.33  that a second fine has been assessed.  The license holder may 
508.34  request reconsideration of the second fine under the provisions 
508.35  of subdivision 4. 
508.36     Subd. 6.  [AMOUNT OF FINES.] Fines shall be assessed as 
509.1   follows: 
509.2      (1) the license holder shall forfeit $1,000 for each 
509.3   occurrence of violation of law or rule prohibiting the 
509.4   maltreatment of children or the maltreatment of vulnerable 
509.5   adults, including but not limited to corporal punishment, 
509.6   illegal or unauthorized use of physical, mechanical, or chemical 
509.7   restraints, and illegal or unauthorized use of aversive or 
509.8   deprivation procedures; 
509.9      (2) the license holder shall forfeit $200 for each 
509.10  occurrence of a violation of law or rule governing matters of 
509.11  health, safety, or supervision, including but not limited to the 
509.12  provision of adequate staff to child or adult ratios; and 
509.13     (3) the license holder shall forfeit $100 for each 
509.14  occurrence of a violation of law or rule other than those 
509.15  included in clauses (1) and (2). 
509.16     For the purposes of this section, "occurrence" means each 
509.17  violation identified in the commissioner's forfeiture order. 
509.18     Subd. 7.  [RESPONSIBILITY FOR PAYMENT OF FINES.] When a 
509.19  fine has been assessed, the license holder may not avoid payment 
509.20  by closing, selling, or otherwise transferring the licensed 
509.21  program to a third party.  In such an event, the license holder 
509.22  will be personally liable for payment.  In the case of a 
509.23  corporation, each controlling individual is personally and 
509.24  jointly liable for payment. 
509.25     Fines for child care centers must be assessed according to 
509.26  this section. 
509.27     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
509.28     Sec. 12.  Minnesota Statutes 2000, section 245A.07, is 
509.29  amended to read: 
509.30     245A.07 [SANCTIONS.] 
509.31     Subdivision 1.  [SANCTIONS AVAILABLE.] In addition to 
509.32  ordering forfeiture of fines making a license conditional under 
509.33  section 245A.06, the commissioner may propose to suspend, or 
509.34  revoke, or make conditional the license, impose a fine, or 
509.35  secure an injunction against the continuing operation of the 
509.36  program of a license holder who does not comply with applicable 
510.1   law or rule.  When applying sanctions authorized under this 
510.2   section, the commissioner shall consider the nature, chronicity, 
510.3   or severity of the violation of law or rule and the effect of 
510.4   the violation on the health, safety, or rights of persons served 
510.5   by the program. 
510.6      Subd. 2.  [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER 
510.7   TO HEALTH, SAFETY, OR RIGHTS TEMPORARY IMMEDIATE SUSPENSION.] (a)
510.8   If the license holder's actions or failure to comply with 
510.9   applicable law or rule has placed poses an imminent risk of harm 
510.10  to the health, safety, or rights of persons served by the 
510.11  program in imminent danger, the commissioner shall act 
510.12  immediately to temporarily suspend the license.  No state funds 
510.13  shall be made available or be expended by any agency or 
510.14  department of state, county, or municipal government for use by 
510.15  a license holder regulated under this chapter while a license is 
510.16  under immediate suspension.  A notice stating the reasons for 
510.17  the immediate suspension and informing the license holder of the 
510.18  right to a contested case an expedited hearing under chapter 
510.19  14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 
510.20  successor rules, must be delivered by personal service to the 
510.21  address shown on the application or the last known address of 
510.22  the license holder.  The license holder may appeal an order 
510.23  immediately suspending a license.  The appeal of an order 
510.24  immediately suspending a license must be made in writing by 
510.25  certified mail and must be received by the commissioner within 
510.26  five calendar days after the license holder receives notice that 
510.27  the license has been immediately suspended.  A license holder 
510.28  and any controlling individual shall discontinue operation of 
510.29  the program upon receipt of the commissioner's order to 
510.30  immediately suspend the license. 
510.31     (b) The commissioner is liable to the license holder for 
510.32  actual damages for days of lost service in an amount not more 
510.33  than $50,000 when: 
510.34     (1) the commissioner immediately suspends a license under 
510.35  paragraph (a); and 
510.36     (2) the administrative law judge recommends, after a review 
511.1   of the facts in an expedited hearing under chapter 14 and 
511.2   Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 
511.3   rules, that reasonable cause did not exist at the time the 
511.4   commissioner issued the immediate suspension.  
511.5      (c) If the commissioner immediately suspends a license 
511.6   under paragraph (a) and the administrative law judge recommends 
511.7   that reasonable cause exists for the immediate suspension, the 
511.8   commissioner is not liable to the license holder. 
511.9      Subd. 2a.  [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 
511.10  Within five working days of receipt of the license holder's 
511.11  timely appeal, the commissioner shall request assignment of an 
511.12  administrative law judge.  The request must include a proposed 
511.13  date, time, and place of a hearing.  A hearing must be conducted 
511.14  by an administrative law judge within 30 calendar days of the 
511.15  request for assignment, unless an extension is requested by 
511.16  either party and granted by the administrative law judge for 
511.17  good cause.  The commissioner shall issue a notice of hearing by 
511.18  certified mail at least ten working days before the hearing.  
511.19  The scope of the hearing shall be limited solely to the issue of 
511.20  whether the temporary immediate suspension should remain in 
511.21  effect pending the commissioner's final order under section 
511.22  245A.08, regarding a licensing sanction issued under subdivision 
511.23  3 following the immediate suspension.  The burden of proof in 
511.24  expedited hearings under this subdivision shall be limited to 
511.25  the commissioner's demonstration that reasonable cause exists to 
511.26  believe that the license holder's actions or failure to comply 
511.27  with applicable law or rule poses an imminent risk of harm to 
511.28  the health, safety, or rights of persons served by the program.  
511.29     (b) The administrative law judge shall issue findings of 
511.30  fact, conclusions, and a recommendation within ten working days 
511.31  from the date of hearing.  The commissioner's final order shall 
511.32  be issued within ten working days from receipt of the 
511.33  recommendation of the administrative law judge.  Within 90 
511.34  calendar days after a final order affirming an immediate 
511.35  suspension, the commissioner shall make a determination 
511.36  regarding whether a final licensing sanction shall be issued 
512.1   under subdivision 3.  The license holder shall continue to be 
512.2   prohibited from operation of the program during this 90-day 
512.3   period. 
512.4      Subd. 3.  [LICENSE SUSPENSION, REVOCATION, DENIAL OR 
512.5   CONDITIONAL LICENSE FINE.] The commissioner may suspend, or 
512.6   revoke, make conditional, or deny a license, or impose a fine if 
512.7   an applicant or a license holder fails to comply fully with 
512.8   applicable laws or rules, or knowingly withholds relevant 
512.9   information from or gives false or misleading information to the 
512.10  commissioner in connection with an application for a license or 
512.11  during an investigation.  A license holder who has had a license 
512.12  suspended, revoked, or made conditional has been ordered to pay 
512.13  a fine must be given notice of the action by certified mail.  
512.14  The notice must be mailed to the address shown on the 
512.15  application or the last known address of the license holder.  
512.16  The notice must state the reasons the license was suspended, 
512.17  revoked, or made conditional a fine was ordered. 
512.18     (a) If the license was suspended or revoked, the notice 
512.19  must inform the license holder of the right to a contested case 
512.20  hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
512.21  1400.8612 and successor rules.  The license holder may appeal an 
512.22  order suspending or revoking a license.  The appeal of an order 
512.23  suspending or revoking a license must be made in writing by 
512.24  certified mail and must be received by the commissioner within 
512.25  ten calendar days after the license holder receives notice that 
512.26  the license has been suspended or revoked.  
512.27     (b) If the license was made conditional, the notice must 
512.28  inform the license holder of the right to request a 
512.29  reconsideration by the commissioner.  The request for 
512.30  reconsideration must be made in writing by certified mail and 
512.31  must be received by the commissioner within ten calendar days 
512.32  after the license holder receives notice that the license has 
512.33  been made conditional.  The license holder may submit with the 
512.34  request for reconsideration written argument or evidence in 
512.35  support of the request for reconsideration.  The commissioner's 
512.36  disposition of a request for reconsideration is final and is not 
513.1   subject to appeal under chapter 14. (1) If the license holder 
513.2   was ordered to pay a fine, the notice must inform the license 
513.3   holder of the responsibility for payment of fines and the right 
513.4   to a contested case hearing under chapter 14 and Minnesota 
513.5   Rules, parts 1400.8510 to 1400.8612 and successor rules.  The 
513.6   appeal of an order to pay a fine must be made in writing by 
513.7   certified mail and must be received by the commissioner within 
513.8   ten calendar days after the license holder receives notice that 
513.9   the fine has been ordered.  
513.10     (2) The license holder shall pay the fines assessed on or 
513.11  before the payment date specified.  If the license holder fails 
513.12  to fully comply with the order, the commissioner may issue a 
513.13  second fine or suspend the license until the license holder 
513.14  complies.  If the license holder receives state funds, the 
513.15  state, county, or municipal agencies or departments responsible 
513.16  for administering the funds shall withhold payments and recover 
513.17  any payments made while the license is suspended for failure to 
513.18  pay a fine.  A timely appeal shall stay payment of the fine 
513.19  until the commissioner issues a final order.  
513.20     (3) A license holder shall promptly notify the commissioner 
513.21  of human services, in writing, when a violation specified in the 
513.22  order to forfeit a fine is corrected.  If upon reinspection the 
513.23  commissioner determines that a violation has not been corrected 
513.24  as indicated by the order to forfeit a fine, the commissioner 
513.25  may issue a second fine.  The commissioner shall notify the 
513.26  license holder by certified mail that a second fine has been 
513.27  assessed.  The license holder may appeal the second fine as 
513.28  provided under this subdivision. 
513.29     (4) Fines shall be assessed as follows:  the license holder 
513.30  shall forfeit $1,000 for each determination of maltreatment of a 
513.31  child under section 626.556 or the maltreatment of a vulnerable 
513.32  adult under section 626.557; the license holder shall forfeit 
513.33  $200 for each occurrence of a violation of law or rule governing 
513.34  matters of health, safety, or supervision, including but not 
513.35  limited to the provision of adequate staff to child or adult 
513.36  ratios, and failure to submit a background study; and the 
514.1   license holder shall forfeit $100 for each occurrence of a 
514.2   violation of law or rule other than those subject to a $1,000 or 
514.3   $200 fine above.  For purposes of this section, "occurrence" 
514.4   means each violation identified in the commissioner's fine order.
514.5      (5) When a fine has been assessed, the license holder may 
514.6   not avoid payment by closing, selling, or otherwise transferring 
514.7   the licensed program to a third party.  In such an event, the 
514.8   license holder will be personally liable for payment.  In the 
514.9   case of a corporation, each controlling individual is personally 
514.10  and jointly liable for payment. 
514.11     Subd. 4.  [ADOPTION AGENCY VIOLATIONS.] If a license holder 
514.12  licensed to place children for adoption fails to provide 
514.13  services as described in the disclosure form required by section 
514.14  259.37, subdivision 2, the sanctions under this section may be 
514.15  imposed. 
514.16     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
514.17     Sec. 13.  Minnesota Statutes 2000, section 245A.08, is 
514.18  amended to read: 
514.19     245A.08 [HEARINGS.] 
514.20     Subdivision 1.  [RECEIPT OF APPEAL; CONDUCT OF HEARING.] 
514.21  Upon receiving a timely appeal or petition pursuant to 
514.22  section 245A.04, subdivision 3c, 245A.05, or 245A.07, 
514.23  subdivision 3, the commissioner shall issue a notice of and 
514.24  order for hearing to the appellant under chapter 14 and 
514.25  Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 
514.26  rules. 
514.27     Subd. 2.  [CONDUCT OF HEARINGS.] At any hearing provided 
514.28  for by section 245A.04, subdivision 3c, 245A.05, or 245A.07, 
514.29  subdivision 3, the appellant may be represented by counsel and 
514.30  has the right to call, examine, and cross-examine witnesses.  
514.31  The administrative law judge may require the presence of 
514.32  witnesses and evidence by subpoena on behalf of any party.  
514.33     Subd. 2a.  [CONSOLIDATED CONTESTED CASE HEARINGS FOR 
514.34  SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND 
514.35  DISQUALIFICATIONS.] (a) When a denial of a license under section 
514.36  245A.05 or a licensing sanction under section 245A.07, 
515.1   subdivision 3, is based on a disqualification for which 
515.2   reconsideration was requested and which was not set aside or was 
515.3   not rescinded under section 245A.04, subdivision 3b, the scope 
515.4   of the contested case hearing shall include the disqualification 
515.5   and the licensing sanction or denial of a license.  When the 
515.6   licensing sanction or denial of a license is based on a 
515.7   determination of maltreatment under section 626.556 or 626.557, 
515.8   or a disqualification for serious or recurring maltreatment 
515.9   which was not set aside or was not rescinded, the scope of the 
515.10  contested case hearing shall include the maltreatment 
515.11  determination, disqualification, and the licensing sanction or 
515.12  denial of a license.  In such cases, a fair hearing under 
515.13  section 256.045 shall not be conducted as provided for in 
515.14  sections 626.556, subdivision 10i, and 626.557, subdivision 9d. 
515.15     (b) In consolidated contested case hearings regarding 
515.16  sanctions issued in family child care, child foster care, and 
515.17  adult foster care, the county attorney shall defend the 
515.18  commissioner's orders in accordance with section 245A.16, 
515.19  subdivision 4. 
515.20     (c) The commissioner's final order under subdivision 5 is 
515.21  the final agency action on the issue of maltreatment and 
515.22  disqualification, including for purposes of subsequent 
515.23  background studies under section 245A.04, subdivision 3, and is 
515.24  the only administrative appeal of the final agency 
515.25  determination, specifically, including a challenge to the 
515.26  accuracy and completeness of data under section 13.04. 
515.27     (d) When consolidated hearings under this subdivision 
515.28  involve a licensing sanction based on a previous maltreatment 
515.29  determination for which the commissioner has issued a final 
515.30  order in an appeal of that determination under section 256.045, 
515.31  or the individual failed to exercise the right to appeal the 
515.32  previous maltreatment determination under section 626.556, 
515.33  subdivision 10i, or 626.557, subdivision 9d, the commissioner's 
515.34  order is conclusive on the issue of maltreatment.  In such 
515.35  cases, the scope of the administrative law judge's review shall 
515.36  be limited to the disqualification and the licensing sanction or 
516.1   denial of a license.  In the case of a denial of a license or a 
516.2   licensing sanction issued to a facility based on a maltreatment 
516.3   determination regarding an individual who is not the license 
516.4   holder or a household member, the scope of the administrative 
516.5   law judge's review includes the maltreatment determination. 
516.6      (e) If a maltreatment determination or disqualification, 
516.7   which was not set aside or was not rescinded under section 
516.8   245A.04, subdivision 3b, is the basis for a denial of a license 
516.9   under section 245A.05 or a licensing sanction under section 
516.10  245A.07, and the disqualified subject is an individual other 
516.11  than the license holder and upon whom a background study must be 
516.12  conducted under section 245A.04, subdivision 3, the hearings of 
516.13  all parties may be consolidated into a single contested case 
516.14  hearing upon consent of all parties and the administrative law 
516.15  judge.  
516.16     Subd. 3.  [BURDEN OF PROOF.] (a) At a hearing regarding 
516.17  suspension, immediate suspension, or revocation of a license for 
516.18  family day care or foster care a licensing sanction under 
516.19  section 245A.07, including consolidated hearings under 
516.20  subdivision 2a, the commissioner may demonstrate reasonable 
516.21  cause for action taken by submitting statements, reports, or 
516.22  affidavits to substantiate the allegations that the license 
516.23  holder failed to comply fully with applicable law or rule.  If 
516.24  the commissioner demonstrates that reasonable cause existed, the 
516.25  burden of proof in hearings involving suspension, immediate 
516.26  suspension, or revocation of a family day care or foster care 
516.27  license shifts to the license holder to demonstrate by a 
516.28  preponderance of the evidence that the license holder was in 
516.29  full compliance with those laws or rules that the commissioner 
516.30  alleges the license holder violated, at the time that the 
516.31  commissioner alleges the violations of law or rules occurred. 
516.32     (b) At a hearing on denial of an application, the applicant 
516.33  bears the burden of proof to demonstrate by a preponderance of 
516.34  the evidence that the appellant has complied fully with sections 
516.35  245A.01 to 245A.15 this chapter and other applicable law or rule 
516.36  and that the application should be approved and a license 
517.1   granted. 
517.2      (c) At all other hearings under this section, the 
517.3   commissioner bears the burden of proof to demonstrate, by a 
517.4   preponderance of the evidence, that the violations of law or 
517.5   rule alleged by the commissioner occurred. 
517.6      Subd. 4.  [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The 
517.7   administrative law judge shall recommend whether or not the 
517.8   commissioner's order should be affirmed.  The recommendations 
517.9   must be consistent with this chapter and the rules of the 
517.10  commissioner.  The recommendations must be in writing and 
517.11  accompanied by findings of fact and conclusions and must be 
517.12  mailed to the parties by certified mail to their last known 
517.13  addresses as shown on the license or application. 
517.14     Subd. 5.  [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 
517.15  considering the findings of fact, conclusions, and 
517.16  recommendations of the administrative law judge, the 
517.17  commissioner shall issue a final order.  The commissioner shall 
517.18  consider, but shall not be bound by, the recommendations of the 
517.19  administrative law judge.  The appellant must be notified of the 
517.20  commissioner's final order as required by chapter 14 and 
517.21  Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 
517.22  rules.  The notice must also contain information about the 
517.23  appellant's rights under chapter 14 and Minnesota Rules, parts 
517.24  1400.8510 to 1400.8612 and successor rules.  The institution of 
517.25  proceedings for judicial review of the commissioner's final 
517.26  order shall not stay the enforcement of the final order except 
517.27  as provided in section 14.65.  A license holder and each 
517.28  controlling individual of a license holder whose license has 
517.29  been revoked because of noncompliance with applicable law or 
517.30  rule must not be granted a license for five years following the 
517.31  revocation.  An applicant whose application was denied must not 
517.32  be granted a license for two years following a denial, unless 
517.33  the applicant's subsequent application contains new information 
517.34  which constitutes a substantial change in the conditions that 
517.35  caused the previous denial. 
517.36     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
518.1      Sec. 14.  Minnesota Statutes 2000, section 245A.16, 
518.2   subdivision 1, is amended to read: 
518.3      Subdivision 1.  [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 
518.4   County agencies and private agencies that have been designated 
518.5   or licensed by the commissioner to perform licensing functions 
518.6   and activities under section 245A.04, to recommend denial of 
518.7   applicants under section 245A.05, to issue correction orders, to 
518.8   issue variances, and recommend fines a conditional license under 
518.9   section 245A.06, or to recommend suspending, or revoking, and 
518.10  making licenses probationary a license or issuing a fine under 
518.11  section 245A.07, shall comply with rules and directives of the 
518.12  commissioner governing those functions and with this section. 
518.13     (b) For family day care programs, the commissioner may 
518.14  authorize licensing reviews every two years after a licensee has 
518.15  had at least one annual review. 
518.16     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
518.17     Sec. 15.  Minnesota Statutes 2000, section 245B.08, 
518.18  subdivision 3, is amended to read: 
518.19     Subd. 3.  [SANCTIONS AVAILABLE.] Nothing in this 
518.20  subdivision shall be construed to limit the commissioner's 
518.21  authority to suspend, or revoke a license, or make conditional 
518.22  issue a fine at any time a license under section 245A.07; make 
518.23  correction orders and require fines make a license conditional 
518.24  for failure to comply with applicable laws or rules under 
518.25  section 245A.06; or deny an application for license under 
518.26  section 245A.05. 
518.27     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
518.28     Sec. 16.  [256.022] [CHILD MALTREATMENT REVIEW PANEL.] 
518.29     Subdivision 1.  [CREATION.] The commissioner of human 
518.30  services shall establish a review panel for purposes of 
518.31  reviewing investigating agency determinations regarding 
518.32  maltreatment of a child in a facility in response to requests 
518.33  received under section 626.556, subdivision 10i, paragraph (b).  
518.34  The review panel consists of the commissioners of health; human 
518.35  services; children, families, and learning; and corrections; the 
518.36  ombudsman for crime victims; and the ombudsman for mental health 
519.1   and mental retardation; or their designees.  
519.2      Subd. 2.  [REVIEW PROCEDURE.] (a) The panel shall hold 
519.3   quarterly meetings for purposes of conducting reviews under this 
519.4   section.  If an interested person acting on behalf of a child 
519.5   requests a review under this section, the panel shall review the 
519.6   request at its next quarterly meeting.  If the next quarterly 
519.7   meeting is within ten days of the panel's receipt of the request 
519.8   for review, the review may be delayed until the next subsequent 
519.9   meeting.  The panel shall review the request and the final 
519.10  determination regarding maltreatment made by the investigating 
519.11  agency and may review any other data on the investigation 
519.12  maintained by the agency that are pertinent and necessary to its 
519.13  review of the determination.  If more than one person requests a 
519.14  review under this section with respect to the same 
519.15  determination, the review panel shall combine the requests into 
519.16  one review.  Upon receipt of a request for a review, the panel 
519.17  shall notify the alleged perpetrator of maltreatment that a 
519.18  review has been requested and provide an approximate timeline 
519.19  for conducting the review.  
519.20     (b) Within 30 days of the review under this section, the 
519.21  panel shall notify the investigating agency and the interested 
519.22  person who requested the review as to whether the panel agrees 
519.23  with the determination or whether the investigating agency must 
519.24  reconsider the determination.  If the panel determines that the 
519.25  agency must reconsider the determination, the panel must make 
519.26  specific investigative recommendations to the agency.  Within 30 
519.27  days the investigating agency shall conduct a review and report 
519.28  back to the panel with its reconsidered determination and the 
519.29  specific rationale for its determination. 
519.30     Subd. 3.  [REPORT.] By January 15 of each year, the panel 
519.31  shall submit a report to the committees of the legislature with 
519.32  jurisdiction over section 626.556 regarding the number of 
519.33  requests for review it receives under this section, the number 
519.34  of cases where the panel requires the investigating agency to 
519.35  reconsider its final determination, the number of cases where 
519.36  the final determination is changed, and any recommendations to 
520.1   improve the review or investigative process.  
520.2      Subd. 4.  [DATA.] Data of the review panel created as part 
520.3   of a review under this section are private data on individuals 
520.4   as defined in section 13.02. 
520.5      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
520.6      Sec. 17.  Minnesota Statutes 2000, section 256.045, 
520.7   subdivision 3, is amended to read: 
520.8      Subd. 3.  [STATE AGENCY HEARINGS.] (a) State agency 
520.9   hearings are available for the following:  (1) any person 
520.10  applying for, receiving or having received public assistance, 
520.11  medical care, or a program of social services granted by the 
520.12  state agency or a county agency or the federal Food Stamp Act 
520.13  whose application for assistance is denied, not acted upon with 
520.14  reasonable promptness, or whose assistance is suspended, 
520.15  reduced, terminated, or claimed to have been incorrectly paid; 
520.16  (2) any patient or relative aggrieved by an order of the 
520.17  commissioner under section 252.27; (3) a party aggrieved by a 
520.18  ruling of a prepaid health plan; (4) except as provided under 
520.19  chapter 245A, any individual or facility determined by a lead 
520.20  agency to have maltreated a vulnerable adult under section 
520.21  626.557 after they have exercised their right to administrative 
520.22  reconsideration under section 626.557; (5) any person whose 
520.23  claim for foster care payment according to a placement of the 
520.24  child resulting from a child protection assessment under section 
520.25  626.556 is denied or not acted upon with reasonable promptness, 
520.26  regardless of funding source; (6) any person to whom a right of 
520.27  appeal according to this section is given by other provision of 
520.28  law; (7) an applicant aggrieved by an adverse decision to an 
520.29  application for a hardship waiver under section 
520.30  256B.15; or (8) except as provided under chapter 245A, an 
520.31  individual or facility determined to have maltreated a minor 
520.32  under section 626.556, after the individual or facility has 
520.33  exercised the right to administrative reconsideration under 
520.34  section 626.556; or (9) except as provided under chapter 245A, 
520.35  an individual disqualified under section 245A.04, subdivision 
520.36  3d, on the basis of serious or recurring maltreatment; a 
521.1   preponderance of the evidence that the individual has committed 
521.2   an act or acts that meet the definition of any of the crimes 
521.3   listed in section 245A.04, subdivision 3d, paragraph (a), 
521.4   clauses (1) to (4); or for failing to make reports required 
521.5   under section 626.556, subdivision 3, or 626.557, subdivision 
521.6   3.  Hearings regarding a maltreatment determination under clause 
521.7   (4) or (8) and a disqualification under this clause in which the 
521.8   basis for a disqualification is serious or recurring 
521.9   maltreatment, which has not been set aside or rescinded under 
521.10  section 245A.04, subdivision 3b, shall be consolidated into a 
521.11  single fair hearing.  In such cases, the scope of review by the 
521.12  human services referee shall include both the maltreatment 
521.13  determination and the disqualification.  The failure to exercise 
521.14  the right to an administrative reconsideration shall not be a 
521.15  bar to a hearing under this section if federal law provides an 
521.16  individual the right to a hearing to dispute a finding of 
521.17  maltreatment.  Individuals and organizations specified in this 
521.18  section may contest the specified action, decision, or final 
521.19  disposition before the state agency by submitting a written 
521.20  request for a hearing to the state agency within 30 days after 
521.21  receiving written notice of the action, decision, or final 
521.22  disposition, or within 90 days of such written notice if the 
521.23  applicant, recipient, patient, or relative shows good cause why 
521.24  the request was not submitted within the 30-day time limit. 
521.25     The hearing for an individual or facility under clause 
521.26  (4) or, (8), or (9) is the only administrative appeal to the 
521.27  final agency determination specifically, including a challenge 
521.28  to the accuracy and completeness of data under section 13.04.  
521.29  Hearings requested under clause (4) apply only to incidents of 
521.30  maltreatment that occur on or after October 1, 1995.  Hearings 
521.31  requested by nursing assistants in nursing homes alleged to have 
521.32  maltreated a resident prior to October 1, 1995, shall be held as 
521.33  a contested case proceeding under the provisions of chapter 14.  
521.34  Hearings requested under clause (8) apply only to incidents of 
521.35  maltreatment that occur on or after July 1, 1997.  A hearing for 
521.36  an individual or facility under clause (8) is only available 
522.1   when there is no juvenile court or adult criminal action 
522.2   pending.  If such action is filed in either court while an 
522.3   administrative review is pending, the administrative review must 
522.4   be suspended until the judicial actions are completed.  If the 
522.5   juvenile court action or criminal charge is dismissed or the 
522.6   criminal action overturned, the matter may be considered in an 
522.7   administrative hearing. 
522.8      For purposes of this section, bargaining unit grievance 
522.9   procedures are not an administrative appeal. 
522.10     The scope of hearings involving claims to foster care 
522.11  payments under clause (5) shall be limited to the issue of 
522.12  whether the county is legally responsible for a child's 
522.13  placement under court order or voluntary placement agreement 
522.14  and, if so, the correct amount of foster care payment to be made 
522.15  on the child's behalf and shall not include review of the 
522.16  propriety of the county's child protection determination or 
522.17  child placement decision. 
522.18     (b) A vendor of medical care as defined in section 256B.02, 
522.19  subdivision 7, or a vendor under contract with a county agency 
522.20  to provide social services under section 256E.08, subdivision 4, 
522.21  is not a party and may not request a hearing under this section, 
522.22  except if assisting a recipient as provided in subdivision 4. 
522.23     (c) An applicant or recipient is not entitled to receive 
522.24  social services beyond the services included in the amended 
522.25  community social services plan developed under section 256E.081, 
522.26  subdivision 3, if the county agency has met the requirements in 
522.27  section 256E.081. 
522.28     (d) The commissioner may summarily affirm the county or 
522.29  state agency's proposed action without a hearing when the sole 
522.30  issue is an automatic change due to a change in state or federal 
522.31  law. 
522.32     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
522.33     Sec. 18.  Minnesota Statutes 2000, section 256.045, 
522.34  subdivision 3b, is amended to read: 
522.35     Subd. 3b.  [STANDARD OF EVIDENCE FOR MALTREATMENT AND 
522.36  DISQUALIFICATION HEARINGS.] The state human services referee 
523.1   shall determine that maltreatment has occurred if a 
523.2   preponderance of evidence exists to support the final 
523.3   disposition under sections 626.556 and 626.557.  For purposes of 
523.4   hearings regarding disqualification, the state human services 
523.5   referee shall affirm the proposed disqualification in an appeal 
523.6   under subdivision 3, paragraph (a), clause (9), if a 
523.7   preponderance of the evidence shows the individual has:  
523.8      (1) committed maltreatment under section 626.556 or 
523.9   626.557, which is serious or recurring; 
523.10     (2) committed an act or acts meeting the definition of any 
523.11  of the crimes listed in section 245A.04, subdivision 3d, 
523.12  paragraph (a), clauses (1) to (4); or 
523.13     (3) failed to make required reports under section 626.556 
523.14  or 626.557 for incidents in which:  
523.15     (i) the final disposition under section 626.556 or 626.557 
523.16  was substantiated maltreatment; and 
523.17     (ii) the maltreatment was recurring or serious; or 
523.18  substantiated serious or recurring maltreatment of a minor under 
523.19  section 626.556 or of a vulnerable adult under section 626.557 
523.20  for which there is a preponderance of evidence that the 
523.21  maltreatment occurred, and that the subject was responsible for 
523.22  the maltreatment.  If the disqualification is affirmed, the 
523.23  state human services referee shall determine whether the 
523.24  individual poses a risk of harm in accordance with the 
523.25  requirements of section 245A.04, subdivision 3b. 
523.26     The state human services referee shall recommend an order 
523.27  to the commissioner of health or human services, as applicable, 
523.28  who shall issue a final order.  The commissioner shall affirm, 
523.29  reverse, or modify the final disposition.  Any order of the 
523.30  commissioner issued in accordance with this subdivision is 
523.31  conclusive upon the parties unless appeal is taken in the manner 
523.32  provided in subdivision 7.  Except as provided under section 
523.33  245A.04, subdivisions 3b, paragraphs (e) and (f); and 3c, in any 
523.34  licensing appeal under chapter 245A and sections 144.50 to 
523.35  144.58 and 144A.02 to 144A.46, the commissioner's determination 
523.36  as to maltreatment is conclusive. 
524.1      <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
524.2      Sec. 19.  Minnesota Statutes 2000, section 256.045, 
524.3   subdivision 4, is amended to read: 
524.4      Subd. 4.  [CONDUCT OF HEARINGS.] (a) All hearings held 
524.5   pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 
524.6   according to the provisions of the federal Social Security Act 
524.7   and the regulations implemented in accordance with that act to 
524.8   enable this state to qualify for federal grants-in-aid, and 
524.9   according to the rules and written policies of the commissioner 
524.10  of human services.  County agencies shall install equipment 
524.11  necessary to conduct telephone hearings.  A state human services 
524.12  referee may schedule a telephone conference hearing when the 
524.13  distance or time required to travel to the county agency offices 
524.14  will cause a delay in the issuance of an order, or to promote 
524.15  efficiency, or at the mutual request of the parties.  Hearings 
524.16  may be conducted by telephone conferences unless the applicant, 
524.17  recipient, former recipient, person, or facility contesting 
524.18  maltreatment objects.  The hearing shall not be held earlier 
524.19  than five days after filing of the required notice with the 
524.20  county or state agency.  The state human services referee shall 
524.21  notify all interested persons of the time, date, and location of 
524.22  the hearing at least five days before the date of the hearing.  
524.23  Interested persons may be represented by legal counsel or other 
524.24  representative of their choice, including a provider of therapy 
524.25  services, at the hearing and may appear personally, testify and 
524.26  offer evidence, and examine and cross-examine witnesses.  The 
524.27  applicant, recipient, former recipient, person, or facility 
524.28  contesting maltreatment shall have the opportunity to examine 
524.29  the contents of the case file and all documents and records to 
524.30  be used by the county or state agency at the hearing at a 
524.31  reasonable time before the date of the hearing and during the 
524.32  hearing.  In hearings under subdivision 3, paragraph (a), 
524.33  clauses (4) and, (8), and (9), either party may subpoena the 
524.34  private data relating to the investigation prepared by the 
524.35  agency under section 626.556 or 626.557 that is not otherwise 
524.36  accessible under section 13.04, provided the identity of the 
525.1   reporter may not be disclosed. 
525.2      (b) The private data obtained by subpoena in a hearing 
525.3   under subdivision 3, paragraph (a), clause (4) or, (8), or (9), 
525.4   must be subject to a protective order which prohibits its 
525.5   disclosure for any other purpose outside the hearing provided 
525.6   for in this section without prior order of the district court.  
525.7   Disclosure without court order is punishable by a sentence of 
525.8   not more than 90 days imprisonment or a fine of not more than 
525.9   $700, or both.  These restrictions on the use of private data do 
525.10  not prohibit access to the data under section 13.03, subdivision 
525.11  6.  Except for appeals under subdivision 3, paragraph (a), 
525.12  clauses (4), (5), and (8), and (9), upon request, the county 
525.13  agency shall provide reimbursement for transportation, child 
525.14  care, photocopying, medical assessment, witness fee, and other 
525.15  necessary and reasonable costs incurred by the applicant, 
525.16  recipient, or former recipient in connection with the appeal.  
525.17  All evidence, except that privileged by law, commonly accepted 
525.18  by reasonable people in the conduct of their affairs as having 
525.19  probative value with respect to the issues shall be submitted at 
525.20  the hearing and such hearing shall not be "a contested case" 
525.21  within the meaning of section 14.02, subdivision 3.  The agency 
525.22  must present its evidence prior to or at the hearing, and may 
525.23  not submit evidence after the hearing except by agreement of the 
525.24  parties at the hearing, provided the petitioner has the 
525.25  opportunity to respond. 
525.26     <h>[EFFECTIVE DATE.]</h> This section is effective January 1, 2002.
525.27     Sec. 20.  Minnesota Statutes 2000, section 626.556, is 
525.28  amended by adding a subdivision to read: 
525.29     Subd. 2a.  [DEFINITION; THREATENED INJURY.] As used in this 
525.30  section, "threatened injury," as defined in subdivision 2, 
525.31  paragraph (l)  includes, but is not limited to, exposing a child 
525.32  to a person responsible for the child's care, as defined in 
525.33  paragraph (b), clause (1), who has: 
525.34     (1) subjected a child to, or failed to protect a child 
525.35  from, an overt act or condition that constitutes egregious harm, 
525.36  as defined in section 260C.007, subdivision 26, or a similar law 
526.1   of another jurisdiction; 
526.2      (2) been found to be palpably unfit under section 260C.301, 
526.3   paragraph (b), clause (4), or a similar law of another 
526.4   jurisdiction; 
526.5      (3) committed an act that has resulted in an involuntary 
526.6   termination of parental rights under section 260C.301, or a 
526.7   similar law of another jurisdiction; or 
526.8      (4) committed an act that has resulted in the involuntary 
526.9   transfer of permanent legal and physical custody of a child to a 
526.10  relative under section 260C.201, subdivision 11, paragraph (e), 
526.11  clause (1), or a similar law of another jurisdiction. 
526.12     Sec. 21.  Minnesota Statutes 2000, section 626.556, 
526.13  subdivision 3, is amended to read: 
526.14     Subd. 3.  [PERSONS MANDATED TO REPORT.] (a) A person who 
526.15  knows or has reason to believe a child is being neglected or 
526.16  physically or sexually abused, as defined in subdivision 2, or 
526.17  has been neglected or physically or sexually abused within the 
526.18  preceding three years, shall immediately report the information 
526.19  to the local welfare agency, agency responsible for assessing or 
526.20  investigating the report, police department, or the county 
526.21  sheriff if the person is:  
526.22     (1) a professional or professional's delegate who is 
526.23  engaged in the practice of the healing arts, social services, 
526.24  hospital administration, psychological or psychiatric treatment, 
526.25  child care, education, or law enforcement; or 
526.26     (2) employed as a member of the clergy and received the 
526.27  information while engaged in ministerial duties, provided that a 
526.28  member of the clergy is not required by this subdivision to 
526.29  report information that is otherwise privileged under section 
526.30  595.02, subdivision 1, paragraph (c).  
526.31     The police department or the county sheriff, upon receiving 
526.32  a report, shall immediately notify the local welfare agency or 
526.33  agency responsible for assessing or investigating the report, 
526.34  orally and in writing.  The local welfare agency, or agency 
526.35  responsible for assessing or investigating the report, upon 
526.36  receiving a report, shall immediately notify the local police 
527.1   department or the county sheriff orally and in writing.  The 
527.2   county sheriff and the head of every local welfare agency, 
527.3   agency responsible for assessing or investigating reports, and 
527.4   police department shall each designate a person within their 
527.5   agency, department, or office who is responsible for ensuring 
527.6   that the notification duties of this paragraph and paragraph (b) 
527.7   are carried out.  Nothing in this subdivision shall be construed 
527.8   to require more than one report from any institution, facility, 
527.9   school, or agency. 
527.10     (b) Any person may voluntarily report to the local welfare 
527.11  agency, agency responsible for assessing or investigating the 
527.12  report, police department, or the county sheriff if the person 
527.13  knows, has reason to believe, or suspects a child is being or 
527.14  has been neglected or subjected to physical or sexual abuse.  
527.15  The police department or the county sheriff, upon receiving a 
527.16  report, shall immediately notify the local welfare agency or 
527.17  agency responsible for assessing or investigating the report, 
527.18  orally and in writing.  The local welfare agency or agency 
527.19  responsible for assessing or investigating the report, upon 
527.20  receiving a report, shall immediately notify the local police 
527.21  department or the county sheriff orally and in writing. 
527.22     (c) A person mandated to report physical or sexual child 
527.23  abuse or neglect occurring within a licensed facility shall 
527.24  report the information to the agency specified under 
527.25  subdivisions 3b and 3c as responsible for licensing 
527.26  the assessing or investigating a facility licensed under 
527.27  sections 144.50 to 144.58; a facility licensed under section 
527.28  241.021; 245A.01 to 245A.16; or 245B, or a facility licensed 
527.29  under chapter 245A; a school as defined in sections section 
527.30  120A.05, subdivisions 9, 11, and 13; and, or section 124D.10; or 
527.31  a nonlicensed personal care provider organization as defined 
527.32  in sections section 256B.04, subdivision 16; and, or section 
527.33  256B.0625, subdivision 19.  A health or corrections An agency 
527.34  receiving a report may request the local welfare agency to 
527.35  provide assistance pursuant to subdivisions 10, 10a, and 10b. 
527.36     (d) Any person mandated to report shall receive a summary 
528.1   of the disposition of any report made by that reporter, 
528.2   including whether the case has been opened for child protection 
528.3   or other services, or if a referral has been made to a community 
528.4   organization, unless release would be detrimental to the best 
528.5   interests of the child.  Any person who is not mandated to 
528.6   report shall, upon request to the local welfare agency, receive 
528.7   a concise summary of the disposition of any report made by that 
528.8   reporter, unless release would be detrimental to the best 
528.9   interests of the child. 
528.10     (e) For purposes of this subdivision, "immediately" means 
528.11  as soon as possible but in no event longer than 24 hours. 
528.12     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
528.13     Sec. 22.  Minnesota Statutes 2000, section 626.556, 
528.14  subdivision 3c, is amended to read: 
528.15     Subd. 3c.  [AGENCY RESPONSIBLE FOR ASSESSING OR 
528.16  INVESTIGATING REPORTS OF MALTREATMENT.] The following agencies 
528.17  are the administrative agencies responsible for assessing or 
528.18  investigating reports of alleged child maltreatment in 
528.19  facilities made under this section: 
528.20     (1) the county local welfare agency is the agency 
528.21  responsible for assessing or investigating allegations of 
528.22  maltreatment in child foster care, family child care, and 
528.23  legally unlicensed child care and; 
528.24     (2) the department of human services is the agency 
528.25  responsible for assessing or investigating allegations of 
528.26  maltreatment in juvenile correctional facilities licensed under 
528.27  section 241.021 located in the local welfare agency's county; 
528.28     (2) (3) the department of human services is the agency 
528.29  responsible for assessing or investigating allegations of 
528.30  maltreatment in facilities licensed under chapters 245A and 
528.31  245B, except for child foster care and family child care; and 
528.32     (3) (4) the department of health is the agency responsible 
528.33  for assessing or investigating allegations of child maltreatment 
528.34  in facilities licensed under sections 144.50 to 144.58, and in 
528.35  unlicensed home health care. 
528.36     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
529.1      Sec. 23.  Minnesota Statutes, section 626.556, is amended 
529.2   by adding a subdivision to read: 
529.3      Subd. 3d.  [COMMISSIONER OF HEALTH; 
529.4   DUTIES.] Notwithstanding the designation of certain data as 
529.5   confidential under section 144.225, subdivision 2 or private 
529.6   under section 144.225, subdivision 2a, the commissioner shall 
529.7   give the commissioner of human services access to birth record 
529.8   data and data contained in recognitions of parentage prepared 
529.9   according to section 257.75 necessary to enable the commissioner 
529.10  of human services to identify a child who is subject to 
529.11  threatened injury, as defined in subdivision 2, paragraph (l), 
529.12  by a person responsible for the child's care, as defined in 
529.13  subdivision 2, paragraph (b), clause (1).  The commissioner 
529.14  shall be given access to all data included on official birth 
529.15  certificates. 
529.16     Sec. 24.  Minnesota Statutes 2000, section 626.556, 
529.17  subdivision 10, is amended to read: 
529.18     Subd. 10.  [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 
529.19  ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 
529.20  alleges neglect, physical abuse, or sexual abuse by a parent, 
529.21  guardian, or individual functioning within the family unit as a 
529.22  person responsible for the child's care, the local welfare 
529.23  agency shall immediately conduct an assessment including 
529.24  gathering information on the existence of substance abuse and 
529.25  offer protective social services for purposes of preventing 
529.26  further abuses, safeguarding and enhancing the welfare of the 
529.27  abused or neglected minor, and preserving family life whenever 
529.28  possible.  If the report alleges a violation of a criminal 
529.29  statute involving sexual abuse, physical abuse, or neglect or 
529.30  endangerment, under section 609.378, the local law enforcement 
529.31  agency and local welfare agency shall coordinate the planning 
529.32  and execution of their respective investigation and assessment 
529.33  efforts to avoid a duplication of fact-finding efforts and 
529.34  multiple interviews.  Each agency shall prepare a separate 
529.35  report of the results of its investigation.  In cases of alleged 
529.36  child maltreatment resulting in death, the local agency may rely 
530.1   on the fact-finding efforts of a law enforcement investigation 
530.2   to make a determination of whether or not maltreatment 
530.3   occurred.  When necessary the local welfare agency shall seek 
530.4   authority to remove the child from the custody of a parent, 
530.5   guardian, or adult with whom the child is living.  In performing 
530.6   any of these duties, the local welfare agency shall maintain 
530.7   appropriate records.  
530.8      If the assessment indicates there is a potential for abuse 
530.9   of alcohol or other drugs by the parent, guardian, or person 
530.10  responsible for the child's care, the local welfare agency shall 
530.11  conduct a chemical use assessment pursuant to Minnesota Rules, 
530.12  part 9530.6615.  The local welfare agency shall report the 
530.13  determination of the chemical use assessment, and the 
530.14  recommendations and referrals for alcohol and other drug 
530.15  treatment services to the state authority on alcohol and drug 
530.16  abuse. 
530.17     (b) When a local agency receives a report or otherwise has 
530.18  information indicating that a child who is a client, as defined 
530.19  in section 245.91, has been the subject of physical abuse, 
530.20  sexual abuse, or neglect at an agency, facility, or program as 
530.21  defined in section 245.91, it shall, in addition to its other 
530.22  duties under this section, immediately inform the ombudsman 
530.23  established under sections 245.91 to 245.97. 
530.24     (c) Authority of the local welfare agency responsible for 
530.25  assessing the child abuse or neglect report and of the local law 
530.26  enforcement agency for investigating the alleged abuse or 
530.27  neglect includes, but is not limited to, authority to interview, 
530.28  without parental consent, the alleged victim and any other 
530.29  minors who currently reside with or who have resided with the 
530.30  alleged offender.  The interview may take place at school or at 
530.31  any facility or other place where the alleged victim or other 
530.32  minors might be found or the child may be transported to, and 
530.33  the interview conducted at, a place appropriate for the 
530.34  interview of a child designated by the local welfare agency or 
530.35  law enforcement agency.  The interview may take place outside 
530.36  the presence of the alleged offender or parent, legal custodian, 
531.1   guardian, or school official.  Except as provided in this 
531.2   paragraph, the parent, legal custodian, or guardian shall be 
531.3   notified by the responsible local welfare or law enforcement 
531.4   agency no later than the conclusion of the investigation or 
531.5   assessment that this interview has occurred.  Notwithstanding 
531.6   rule 49.02 of the Minnesota rules of procedure for juvenile 
531.7   courts, the juvenile court may, after hearing on an ex parte 
531.8   motion by the local welfare agency, order that, where reasonable 
531.9   cause exists, the agency withhold notification of this interview 
531.10  from the parent, legal custodian, or guardian.  If the interview 
531.11  took place or is to take place on school property, the order 
531.12  shall specify that school officials may not disclose to the 
531.13  parent, legal custodian, or guardian the contents of the 
531.14  notification of intent to interview the child on school 
531.15  property, as provided under this paragraph, and any other 
531.16  related information regarding the interview that may be a part 
531.17  of the child's school record.  A copy of the order shall be sent 
531.18  by the local welfare or law enforcement agency to the 
531.19  appropriate school official. 
531.20     (d) When the local welfare or local law enforcement agency 
531.21  determines that an interview should take place on school 
531.22  property, written notification of intent to interview the child 
531.23  on school property must be received by school officials prior to 
531.24  the interview.  The notification shall include the name of the 
531.25  child to be interviewed, the purpose of the interview, and a 
531.26  reference to the statutory authority to conduct an interview on 
531.27  school property.  For interviews conducted by the local welfare 
531.28  agency, the notification shall be signed by the chair of the 
531.29  local social services agency or the chair's designee.  The 
531.30  notification shall be private data on individuals subject to the 
531.31  provisions of this paragraph.  School officials may not disclose 
531.32  to the parent, legal custodian, or guardian the contents of the 
531.33  notification or any other related information regarding the 
531.34  interview until notified in writing by the local welfare or law 
531.35  enforcement agency that the investigation or assessment has been 
531.36  concluded.  Until that time, the local welfare or law 
532.1   enforcement agency shall be solely responsible for any 
532.2   disclosures regarding the nature of the assessment or 
532.3   investigation.  
532.4      Except where the alleged offender is believed to be a 
532.5   school official or employee, the time and place, and manner of 
532.6   the interview on school premises shall be within the discretion 
532.7   of school officials, but the local welfare or law enforcement 
532.8   agency shall have the exclusive authority to determine who may 
532.9   attend the interview.  The conditions as to time, place, and 
532.10  manner of the interview set by the school officials shall be 
532.11  reasonable and the interview shall be conducted not more than 24 
532.12  hours after the receipt of the notification unless another time 
532.13  is considered necessary by agreement between the school 
532.14  officials and the local welfare or law enforcement agency.  
532.15  Where the school fails to comply with the provisions of this 
532.16  paragraph, the juvenile court may order the school to comply.  
532.17  Every effort must be made to reduce the disruption of the 
532.18  educational program of the child, other students, or school 
532.19  staff when an interview is conducted on school premises.  
532.20     (e) Where the alleged offender or a person responsible for 
532.21  the care of the alleged victim or other minor prevents access to 
532.22  the victim or other minor by the local welfare agency, the 
532.23  juvenile court may order the parents, legal custodian, or 
532.24  guardian to produce the alleged victim or other minor for 
532.25  questioning by the local welfare agency or the local law 
532.26  enforcement agency outside the presence of the alleged offender 
532.27  or any person responsible for the child's care at reasonable 
532.28  places and times as specified by court order.  
532.29     (f) Before making an order under paragraph (e), the court 
532.30  shall issue an order to show cause, either upon its own motion 
532.31  or upon a verified petition, specifying the basis for the 
532.32  requested interviews and fixing the time and place of the 
532.33  hearing.  The order to show cause shall be served personally and 
532.34  shall be heard in the same manner as provided in other cases in 
532.35  the juvenile court.  The court shall consider the need for 
532.36  appointment of a guardian ad litem to protect the best interests 
533.1   of the child.  If appointed, the guardian ad litem shall be 
533.2   present at the hearing on the order to show cause.  
533.3      (g) The commissioner, the ombudsman for mental health and 
533.4   mental retardation, the local welfare agencies responsible for 
533.5   investigating reports, and the local law enforcement agencies 
533.6   have the right to enter facilities as defined in subdivision 2 
533.7   and to inspect and copy the facility's records, including 
533.8   medical records, as part of the investigation.  Notwithstanding 
533.9   the provisions of chapter 13, they also have the right to inform 
533.10  the facility under investigation that they are conducting an 
533.11  investigation, to disclose to the facility the names of the 
533.12  individuals under investigation for abusing or neglecting a 
533.13  child, and to provide the facility with a copy of the report and 
533.14  the investigative findings. 
533.15     (h) The local welfare agency shall collect available and 
533.16  relevant information to ascertain whether maltreatment occurred 
533.17  and whether protective services are needed.  Information 
533.18  collected includes, when relevant, information with regard to 
533.19  the person reporting the alleged maltreatment, including the 
533.20  nature of the reporter's relationship to the child and to the 
533.21  alleged offender, and the basis of the reporter's knowledge for 
533.22  the report; the child allegedly being maltreated; the alleged 
533.23  offender; the child's caretaker; and other collateral sources 
533.24  having relevant information related to the alleged 
533.25  maltreatment.  The local welfare agency may make a determination 
533.26  of no maltreatment early in an assessment, and close the case 
533.27  and retain immunity, if the collected information shows no basis 
533.28  for a full assessment or investigation. 
533.29     Information relevant to the assessment or investigation 
533.30  must be asked for, and may include: 
533.31     (1) the child's sex and age, prior reports of maltreatment, 
533.32  information relating to developmental functioning, credibility 
533.33  of the child's statement, and whether the information provided 
533.34  under this clause is consistent with other information collected 
533.35  during the course of the assessment or investigation; 
533.36     (2) the alleged offender's age, a record check for prior 
534.1   reports of maltreatment, and criminal charges and convictions.  
534.2   The local welfare agency must provide the alleged offender with 
534.3   an opportunity to make a statement.  The alleged offender may 
534.4   submit supporting documentation relevant to the assessment or 
534.5   investigation; 
534.6      (3) collateral source information regarding the alleged 
534.7   maltreatment and care of the child.  Collateral information 
534.8   includes, when relevant:  (i) a medical examination of the 
534.9   child; (ii) prior medical records relating to the alleged 
534.10  maltreatment or the care of the child maintained by any 
534.11  facility, clinic, or health care professional and an interview 
534.12  with the treating professionals; and (iii) interviews with the 
534.13  child's caretakers, including the child's parent, guardian, 
534.14  foster parent, child care provider, teachers, counselors, family 
534.15  members, relatives, and other persons who may have knowledge 
534.16  regarding the alleged maltreatment and the care of the child; 
534.17  and 
534.18     (4) information on the existence of domestic abuse and 
534.19  violence in the home of the child, and substance abuse. 
534.20     Nothing in this paragraph precludes the local welfare 
534.21  agency from collecting other relevant information necessary to 
534.22  conduct the assessment or investigation.  Notwithstanding 
534.23  section 13.384 or 144.335, the local welfare agency has access 
534.24  to medical data and records for purposes of clause (3).  
534.25  Notwithstanding the data's classification in the possession of 
534.26  any other agency, data acquired by the local welfare agency 
534.27  during the course of the assessment or investigation are private 
534.28  data on individuals and must be maintained in accordance with 
534.29  subdivision 11. 
534.30     (i) In the initial stages of an assessment or 
534.31  investigation, the local welfare agency shall conduct a 
534.32  face-to-face observation of the child reported to be maltreated 
534.33  and a face-to-face interview of the alleged offender.  The 
534.34  interview with the alleged offender may be postponed if it would 
534.35  jeopardize an active law enforcement investigation. 
534.36     (j) The local welfare agency shall use a question and 
535.1   answer interviewing format with questioning as nondirective as 
535.2   possible to elicit spontaneous responses.  The following 
535.3   interviewing methods and procedures must be used whenever 
535.4   possible when collecting information: 
535.5      (1) audio recordings of all interviews with witnesses and 
535.6   collateral sources; and 
535.7      (2) in cases of alleged sexual abuse, audio-video 
535.8   recordings of each interview with the alleged victim and child 
535.9   witnesses. 
535.10     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
535.11     Sec. 25.  Minnesota Statutes 2000, section 626.556, 
535.12  subdivision 10b, is amended to read: 
535.13     Subd. 10b.  [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 
535.14  FACILITY.] (a) This section applies to the commissioners of 
535.15  human services, health, and children, families, and learning.  
535.16  The commissioner of the agency responsible for assessing or 
535.17  investigating the report shall immediately investigate if the 
535.18  report alleges that: 
535.19     (1) a child who is in the care of a facility as defined in 
535.20  subdivision 2 is neglected, physically abused, or sexually 
535.21  abused, or is the victim of maltreatment in a facility by an 
535.22  individual in that facility, or has been so neglected or abused, 
535.23  or been the victim of maltreatment in a facility by an 
535.24  individual in that facility within the three years preceding the 
535.25  report; or 
535.26     (2) a child was neglected, physically abused, or sexually 
535.27  abused, or is the victim of maltreatment in a facility by an 
535.28  individual in a facility defined in subdivision 2, while in the 
535.29  care of that facility within the three years preceding the 
535.30  report.  
535.31     The commissioner of the agency responsible for assessing or 
535.32  investigating the report shall arrange for the transmittal to 
535.33  the commissioner of reports received by local agencies and may 
535.34  delegate to a local welfare agency the duty to investigate 
535.35  reports.  In conducting an investigation under this section, the 
535.36  commissioner has the powers and duties specified for local 
536.1   welfare agencies under this section.  The commissioner of the 
536.2   agency responsible for assessing or investigating the report or 
536.3   local welfare agency may interview any children who are or have 
536.4   been in the care of a facility under investigation and their 
536.5   parents, guardians, or legal custodians. 
536.6      (b) Prior to any interview, the commissioner of the agency 
536.7   responsible for assessing or investigating the report or local 
536.8   welfare agency shall notify the parent, guardian, or legal 
536.9   custodian of a child who will be interviewed in the manner 
536.10  provided for in subdivision 10d, paragraph (a).  If reasonable 
536.11  efforts to reach the parent, guardian, or legal custodian of a 
536.12  child in an out-of-home placement have failed, the child may be 
536.13  interviewed if there is reason to believe the interview is 
536.14  necessary to protect the child or other children in the 
536.15  facility.  The commissioner of the agency responsible for 
536.16  assessing or investigating the report or local agency must 
536.17  provide the information required in this subdivision to the 
536.18  parent, guardian, or legal custodian of a child interviewed 
536.19  without parental notification as soon as possible after the 
536.20  interview.  When the investigation is completed, any parent, 
536.21  guardian, or legal custodian notified under this subdivision 
536.22  shall receive the written memorandum provided for in subdivision 
536.23  10d, paragraph (c). 
536.24     (c) In conducting investigations under this subdivision the 
536.25  commissioner or local welfare agency responsible for assessing 
536.26  or investigating the report shall obtain be given access to 
536.27  information consistent with subdivision 10, paragraphs (g), (h), 
536.28  (i), and (j), and shall be granted the same access to the 
536.29  facility as the facility's licensing agency under the 
536.30  corresponding facility licensing statute.  A facility that 
536.31  denies the investigating agency access to this information shall 
536.32  be subject to a negative licensing action by the appropriate 
536.33  licensing agency.  When the agency responsible for assessing or 
536.34  investigating a report under this section and the licensing 
536.35  agency for the facility involved are not the same agency, the 
536.36  investigating agency and the licensing agency may share not 
537.1   public data as necessary to complete the investigation or to 
537.2   determine appropriate licensing action. 
537.3      (d) Except for foster care and family child care, the 
537.4   commissioner has the primary responsibility for the 
537.5   investigations and notifications required under subdivisions 10d 
537.6   and 10f for reports that allege maltreatment related to the care 
537.7   provided by or in facilities licensed by the commissioner.  The 
537.8   commissioner may request assistance from the local social 
537.9   services agency. 
537.10     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
537.11     Sec. 26.  Minnesota Statutes 2000, section 626.556, 
537.12  subdivision 10d, is amended to read: 
537.13     Subd. 10d.  [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 
537.14  (a) When a report is received that alleges neglect, physical 
537.15  abuse, or sexual abuse, or maltreatment of a child while in the 
537.16  care of a licensed or unlicensed day care facility, residential 
537.17  facility, agency, hospital, sanitarium, or other facility or 
537.18  institution required to be licensed according to sections 144.50 
537.19  to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B, or a 
537.20  school as defined in sections 120A.05, subdivisions 9, 11, and 
537.21  13; and 124D.10; or a nonlicensed personal care provider 
537.22  organization as defined in section 256B.04, subdivision 16, and 
537.23  256B.0625, subdivision 19a, the commissioner of the agency 
537.24  responsible for assessing or investigating the report or local 
537.25  welfare agency investigating the report shall provide the 
537.26  following information to the parent, guardian, or legal 
537.27  custodian of a child alleged to have been neglected, physically 
537.28  abused, or sexually abused, or the victim of maltreatment of a 
537.29  child in the facility:  the name of the facility; the fact that 
537.30  a report alleging neglect, physical abuse, or sexual abuse, or 
537.31  maltreatment of a child in the facility has been received; the 
537.32  nature of the alleged neglect, physical abuse, or sexual abuse, 
537.33  or maltreatment of a child in the facility; that the agency is 
537.34  conducting an investigation; any protective or corrective 
537.35  measures being taken pending the outcome of the investigation; 
537.36  and that a written memorandum will be provided when the 
538.1   investigation is completed. 
538.2      (b) The commissioner of the agency responsible for 
538.3   assessing or investigating the report or local welfare agency 
538.4   may also provide the information in paragraph (a) to the parent, 
538.5   guardian, or legal custodian of any other child in the facility 
538.6   if the investigative agency knows or has reason to believe the 
538.7   alleged neglect, physical abuse, or sexual abuse, or 
538.8   maltreatment of a child in the facility has occurred.  In 
538.9   determining whether to exercise this authority, the commissioner 
538.10  of the agency responsible for assessing or investigating the 
538.11  report or local welfare agency shall consider the seriousness of 
538.12  the alleged neglect, physical abuse, or sexual abuse, or 
538.13  maltreatment of a child in the facility; the number of children 
538.14  allegedly neglected, physically abused, or sexually abused, or 
538.15  victims of maltreatment of a child in the facility; the number 
538.16  of alleged perpetrators; and the length of the investigation.  
538.17  The facility shall be notified whenever this discretion is 
538.18  exercised. 
538.19     (c) When the commissioner of the agency responsible for 
538.20  assessing or investigating the report or local welfare agency 
538.21  has completed its investigation, every parent, guardian, or 
538.22  legal custodian notified of the investigation by the 
538.23  commissioner or local welfare agency shall be provided with the 
538.24  following information in a written memorandum:  the name of the 
538.25  facility investigated; the nature of the alleged neglect, 
538.26  physical abuse, or sexual abuse, or maltreatment of a child in 
538.27  the facility; the investigator's name; a summary of the 
538.28  investigation findings; a statement whether maltreatment was 
538.29  found; and the protective or corrective measures that are being 
538.30  or will be taken.  The memorandum shall be written in a manner 
538.31  that protects the identity of the reporter and the child and 
538.32  shall not contain the name, or to the extent possible, reveal 
538.33  the identity of the alleged perpetrator or of those interviewed 
538.34  during the investigation.  If maltreatment is determined to 
538.35  exist, the commissioner or local welfare agency shall also 
538.36  provide the written memorandum to the parent, guardian, or legal 
539.1   custodian of each child in the facility if maltreatment is 
539.2   determined to exist who had contact with the individual 
539.3   responsible for the maltreatment.  When the facility is the 
539.4   responsible party for maltreatment, the commissioner or local 
539.5   welfare agency shall also provide the written memorandum to the 
539.6   parent, guardian, or legal custodian of each child who received 
539.7   services in the population of the facility where the 
539.8   maltreatment occurred.  This notification must be provided to 
539.9   the parent, guardian, or legal custodian of each child receiving 
539.10  services from the time the maltreatment occurred until either 
539.11  the individual responsible for maltreatment is no longer in 
539.12  contact with a child or children in the facility or the 
539.13  conclusion of the investigation. 
539.14     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
539.15     Sec. 27.  Minnesota Statutes 2000, section 626.556, 
539.16  subdivision 10e, is amended to read: 
539.17     Subd. 10e.  [DETERMINATIONS.] Upon the conclusion of every 
539.18  assessment or investigation it conducts, the local welfare 
539.19  agency shall make two determinations:  first, whether 
539.20  maltreatment has occurred; and second, whether child protective 
539.21  services are needed.  When maltreatment is determined in an 
539.22  investigation involving a facility, the investigating agency 
539.23  shall also determine whether the facility or individual was 
539.24  responsible for the maltreatment using the mitigating factors in 
539.25  paragraph (d).  Determinations under this subdivision must be 
539.26  made based on a preponderance of the evidence. 
539.27     (a) For the purposes of this subdivision, "maltreatment" 
539.28  means any of the following acts or omissions committed by a 
539.29  person responsible for the child's care: 
539.30     (1) physical abuse as defined in subdivision 2, paragraph 
539.31  (d); 
539.32     (2) neglect as defined in subdivision 2, paragraph (c); 
539.33     (3) sexual abuse as defined in subdivision 2, paragraph 
539.34  (a); or 
539.35     (4) mental injury as defined in subdivision 2, paragraph 
539.36  (k); or 
540.1      (5) maltreatment of a child in a facility as defined in 
540.2   subdivision 2, paragraph (f). 
540.3      (b) For the purposes of this subdivision, a determination 
540.4   that child protective services are needed means that the local 
540.5   welfare agency has documented conditions during the assessment 
540.6   or investigation sufficient to cause a child protection worker, 
540.7   as defined in section 626.559, subdivision 1, to conclude that a 
540.8   child is at significant risk of maltreatment if protective 
540.9   intervention is not provided and that the individuals 
540.10  responsible for the child's care have not taken or are not 
540.11  likely to take actions to protect the child from maltreatment or 
540.12  risk of maltreatment. 
540.13     (c) This subdivision does not mean that maltreatment has 
540.14  occurred solely because the child's parent, guardian, or other 
540.15  person responsible for the child's care in good faith selects 
540.16  and depends upon spiritual means or prayer for treatment or care 
540.17  of disease or remedial care of the child, in lieu of medical 
540.18  care.  However, if lack of medical care may result in serious 
540.19  danger to the child's health, the local welfare agency may 
540.20  ensure that necessary medical services are provided to the child.
540.21     (d) When determining whether the facility or individual is 
540.22  the responsible party for determined maltreatment in a facility, 
540.23  the investigating agency shall consider at least the following 
540.24  mitigating factors: 
540.25     (1) whether the actions of the facility or the individual 
540.26  caregivers were according to, and followed the terms of, an 
540.27  erroneous physician order, prescription, individual care plan, 
540.28  or directive; however, this is not a mitigating factor when the 
540.29  facility or caregiver was responsible for the issuance of the 
540.30  erroneous order, prescription, individual care plan, or 
540.31  directive or knew or should have known of the errors and took no 
540.32  reasonable measures to correct the defect before administering 
540.33  care; 
540.34     (2) comparative responsibility between the facility, other 
540.35  caregivers, and requirements placed upon an employee, including 
540.36  the facility's compliance with related regulatory standards and 
541.1   the adequacy of facility policies and procedures, facility 
541.2   training, an individual's participation in the training, the 
541.3   caregiver's supervision, and facility staffing levels and the 
541.4   scope of the individual employee's authority and discretion; and 
541.5      (3) whether the facility or individual followed 
541.6   professional standards in exercising professional judgment. 
541.7      Individual counties may implement more detailed definitions 
541.8   or criteria that indicate which allegations to investigate, as 
541.9   long as a county's policies are consistent with the definitions 
541.10  in the statutes and rules and are approved by the county board.  
541.11  Each local welfare agency shall periodically inform mandated 
541.12  reporters under subdivision 3 who work in the county of the 
541.13  definitions of maltreatment in the statutes and rules and any 
541.14  additional definitions or criteria that have been approved by 
541.15  the county board. 
541.16     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
541.17     Sec. 28.  Minnesota Statutes 2000, section 626.556, 
541.18  subdivision 10f, is amended to read: 
541.19     Subd. 10f.  [NOTICE OF DETERMINATIONS.] Within ten working 
541.20  days of the conclusion of an assessment, the local welfare 
541.21  agency or agency responsible for assessing or investigating the 
541.22  report shall notify the parent or guardian of the child, the 
541.23  person determined to be maltreating the child, and if 
541.24  applicable, the director of the facility, of the determination 
541.25  and a summary of the specific reasons for the determination.  
541.26  The notice must also include a certification that the 
541.27  information collection procedures under subdivision 10, 
541.28  paragraphs (h), (i), and (j), were followed and a notice of the 
541.29  right of a data subject to obtain access to other private data 
541.30  on the subject collected, created, or maintained under this 
541.31  section.  In addition, the notice shall include the length of 
541.32  time that the records will be kept under subdivision 11c.  The 
541.33  investigating agency shall notify the parent or guardian of the 
541.34  child who is the subject of the report, and any person or 
541.35  facility determined to have maltreated a child, of their 
541.36  appeal or review rights under this section or section 256.022. 
542.1      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
542.2      Sec. 29.  Minnesota Statutes 2000, section 626.556, 
542.3   subdivision 10i, is amended to read: 
542.4      Subd. 10i.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
542.5   DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
542.6   SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
542.7   provided under paragraph (e), an individual or facility that the 
542.8   commissioner or a local social service agency determines has 
542.9   maltreated a child, or the child's designee an interested person 
542.10  acting on behalf of the child, regardless of the determination, 
542.11  who contests the investigating agency's final determination 
542.12  regarding maltreatment, may request the investigating agency to 
542.13  reconsider its final determination regarding maltreatment.  The 
542.14  request for reconsideration must be submitted in writing to the 
542.15  investigating agency within 15 calendar days after receipt of 
542.16  notice of the final determination regarding maltreatment or, if 
542.17  the request is made by an interested person who is not entitled 
542.18  to notice, within 15 days after receipt of the notice by the 
542.19  parent or guardian of the child.  Effective January 1, 2002, an 
542.20  individual who was determined to have maltreated a child under 
542.21  this section and who was disqualified on the basis of serious or 
542.22  recurring maltreatment under section 245A.04, subdivision 3d, 
542.23  may request reconsideration of the maltreatment determination 
542.24  and the disqualification.  The request for reconsideration of 
542.25  the maltreatment determination and the disqualification must be 
542.26  submitted within 30 calendar days of the individual's receipt of 
542.27  the notice of disqualification under section 245A.04, 
542.28  subdivision 3a. 
542.29     (b) Except as provided under paragraphs (e) and (f), if the 
542.30  investigating agency denies the request or fails to act upon the 
542.31  request within 15 calendar days after receiving the request for 
542.32  reconsideration, the person or facility entitled to a fair 
542.33  hearing under section 256.045 may submit to the commissioner of 
542.34  human services a written request for a hearing under that 
542.35  section.  For reports involving maltreatment of a child in a 
542.36  facility, an interested person acting on behalf of the child may 
543.1   request a review by the child maltreatment review panel under 
543.2   section 256.022 if the investigating agency denies the request 
543.3   or fails to act upon the request or if the interested person 
543.4   contests a reconsidered determination.  The investigating agency 
543.5   shall notify persons who request reconsideration of their rights 
543.6   under this paragraph.  The request must be submitted in writing 
543.7   to the review panel and a copy sent to the investigating agency 
543.8   within 30 calendar days of receipt of notice of a denial of a 
543.9   request for reconsideration or of a reconsidered determination.  
543.10  The request must specifically identify the aspects of the agency 
543.11  determination with which the person is dissatisfied. 
543.12     (c) If, as a result of the a reconsideration or review, the 
543.13  investigating agency changes the final determination of 
543.14  maltreatment, that agency shall notify the parties specified in 
543.15  subdivisions 10b, 10d, and 10f. 
543.16     (d) Except as provided under paragraph (f), if an 
543.17  individual or facility contests the investigating agency's final 
543.18  determination regarding maltreatment by requesting a fair 
543.19  hearing under section 256.045, the commissioner of human 
543.20  services shall assure that the hearing is conducted and a 
543.21  decision is reached within 90 days of receipt of the request for 
543.22  a hearing.  The time for action on the decision may be extended 
543.23  for as many days as the hearing is postponed or the record is 
543.24  held open for the benefit of either party. 
543.25     (e) Effective January 1, 2002, if an individual was 
543.26  disqualified under section 245A.04, subdivision 3d, on the basis 
543.27  of a determination of maltreatment, which was serious or 
543.28  recurring, and the individual has requested reconsideration of 
543.29  the maltreatment determination under paragraph (a) and requested 
543.30  reconsideration of the disqualification under section 245A.04, 
543.31  subdivision 3b, reconsideration of the maltreatment 
543.32  determination and reconsideration of the disqualification shall 
543.33  be consolidated into a single reconsideration.  If an individual 
543.34  disqualified on the basis of a determination of maltreatment, 
543.35  which was serious or recurring requests a fair hearing under 
543.36  paragraph (b), the scope of the fair hearing shall include the 
544.1   maltreatment determination and the disqualification. 
544.2      (f) Effective January 1, 2002, if a maltreatment 
544.3   determination or a disqualification based on serious or 
544.4   recurring maltreatment is the basis for a denial of a license 
544.5   under section 245A.05 or a licensing sanction under section 
544.6   245A.07, the license holder has the right to a contested case 
544.7   hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
544.8   1400.8612 and successor rules.  As provided for under section 
544.9   245A.08, subdivision 2a, the scope of the contested case hearing 
544.10  shall include the maltreatment determination, disqualification, 
544.11  and licensing sanction or denial of a license.  In such cases, a 
544.12  fair hearing regarding the maltreatment determination shall not 
544.13  be conducted under paragraph (b).  If the disqualified subject 
544.14  is an individual other than the license holder and upon whom a 
544.15  background study must be conducted under section 245A.04, 
544.16  subdivision 3, the hearings of all parties may be consolidated 
544.17  into a single contested case hearing upon consent of all parties 
544.18  and the administrative law judge. 
544.19     (g) For purposes of this subdivision, "interested person 
544.20  acting on behalf of the child" means a parent or legal guardian; 
544.21  stepparent; grandparent; guardian ad litem; adult stepbrother, 
544.22  stepsister, or sibling; or adult aunt or uncle; unless the 
544.23  person has been determined to be the perpetrator of the 
544.24  maltreatment. 
544.25     Sec. 30.  Minnesota Statutes 2000, section 626.556, 
544.26  subdivision 11, is amended to read: 
544.27     Subd. 11.  [RECORDS.] (a) Except as provided in paragraph 
544.28  (b) or (c) and subdivisions 10b, 10d, 10g, and 11b, all records 
544.29  concerning individuals maintained by a local welfare agency or 
544.30  agency responsible for assessing or investigating the report 
544.31  under this section, including any written reports filed under 
544.32  subdivision 7, shall be private data on individuals, except 
544.33  insofar as copies of reports are required by subdivision 7 to be 
544.34  sent to the local police department or the county sheriff.  
544.35  Reports maintained by any police department or the county 
544.36  sheriff shall be private data on individuals except the reports 
545.1   shall be made available to the investigating, petitioning, or 
545.2   prosecuting authority, including county medical examiners or 
545.3   county coroners.  Section 13.82, subdivisions 7, 5a, and 5b, 
545.4   apply to law enforcement data other than the reports.  The local 
545.5   social services agency or agency responsible for assessing or 
545.6   investigating the report shall make available to the 
545.7   investigating, petitioning, or prosecuting authority, including 
545.8   county medical examiners or county coroners or their 
545.9   professional delegates, any records which contain information 
545.10  relating to a specific incident of neglect or abuse which is 
545.11  under investigation, petition, or prosecution and information 
545.12  relating to any prior incidents of neglect or abuse involving 
545.13  any of the same persons.  The records shall be collected and 
545.14  maintained in accordance with the provisions of chapter 13.  In 
545.15  conducting investigations and assessments pursuant to this 
545.16  section, the notice required by section 13.04, subdivision 2, 
545.17  need not be provided to a minor under the age of ten who is the 
545.18  alleged victim of abuse or neglect.  An individual subject of a 
545.19  record shall have access to the record in accordance with those 
545.20  sections, except that the name of the reporter shall be 
545.21  confidential while the report is under assessment or 
545.22  investigation except as otherwise permitted by this 
545.23  subdivision.  Any person conducting an investigation or 
545.24  assessment under this section who intentionally discloses the 
545.25  identity of a reporter prior to the completion of the 
545.26  investigation or assessment is guilty of a misdemeanor.  After 
545.27  the assessment or investigation is completed, the name of the 
545.28  reporter shall be confidential.  The subject of the report may 
545.29  compel disclosure of the name of the reporter only with the 
545.30  consent of the reporter or upon a written finding by the court 
545.31  that the report was false and that there is evidence that the 
545.32  report was made in bad faith.  This subdivision does not alter 
545.33  disclosure responsibilities or obligations under the rules of 
545.34  criminal procedure. 
545.35     (b) Upon request of the legislative auditor, data on 
545.36  individuals maintained under this section must be released to 
546.1   the legislative auditor in order for the auditor to fulfill the 
546.2   auditor's duties under section 3.971.  The auditor shall 
546.3   maintain the data in accordance with chapter 13. 
546.4      (c) The investigating agency shall exchange not public data 
546.5   with the child maltreatment review panel under section 256.022 
546.6   if the data are pertinent and necessary for a review requested 
546.7   under section 256.022.  Upon completion of the review, the not 
546.8   public data received by the review panel must be returned to the 
546.9   investigating agency.  
546.10     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
546.11     Sec. 31.  Minnesota Statutes 2000, section 626.556, 
546.12  subdivision 12, is amended to read: 
546.13     Subd. 12.  [DUTIES OF FACILITY OPERATORS.] Any operator, 
546.14  employee, or volunteer worker at any facility who intentionally 
546.15  neglects, physically abuses, or sexually abuses any child in the 
546.16  care of that facility may be charged with a violation of section 
546.17  609.255, 609.377, or 609.378.  Any operator of a facility who 
546.18  knowingly permits conditions to exist which result in neglect, 
546.19  physical abuse, or sexual abuse, or maltreatment of a child in a 
546.20  facility while in the care of that facility may be charged with 
546.21  a violation of section 609.378.  The facility operator shall 
546.22  inform all mandated reporters employed by or otherwise 
546.23  associated with the facility of the duties required of mandated 
546.24  reporters and shall inform all mandatory reporters of the 
546.25  prohibition against retaliation for reports made in good faith 
546.26  under this section. 
546.27     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
546.28     Sec. 32.  Minnesota Statutes 2000, section 626.557, 
546.29  subdivision 3, is amended to read: 
546.30     Subd. 3.  [TIMING OF REPORT.] (a) A mandated reporter who 
546.31  has reason to believe that a vulnerable adult is being or has 
546.32  been maltreated, or who has knowledge that a vulnerable adult 
546.33  has sustained a physical injury which is not reasonably 
546.34  explained shall immediately report the information to the common 
546.35  entry point.  If an individual is a vulnerable adult solely 
546.36  because the individual is admitted to a facility, a mandated 
547.1   reporter is not required to report suspected maltreatment of the 
547.2   individual that occurred prior to admission, unless: 
547.3      (1) the individual was admitted to the facility from 
547.4   another facility and the reporter has reason to believe the 
547.5   vulnerable adult was maltreated in the previous facility; or 
547.6      (2) the reporter knows or has reason to believe that the 
547.7   individual is a vulnerable adult as defined in section 626.5572, 
547.8   subdivision 21, clause (4).  
547.9      (b) A person not required to report under the provisions of 
547.10  this section may voluntarily report as described above.  
547.11     (c) Nothing in this section requires a report of known or 
547.12  suspected maltreatment, if the reporter knows or has reason to 
547.13  know that a report has been made to the common entry point. 
547.14     (d) Nothing in this section shall preclude a reporter from 
547.15  also reporting to a law enforcement agency.  
547.16     (e) A mandated reporter who knows or has reason to believe 
547.17  that an error under section 626.5572, subdivision 17, paragraph 
547.18  (c), clause (5), occurred must make a report under this 
547.19  subdivision.  If the reporter or a facility, at any time 
547.20  believes that an investigation by a lead agency will determine 
547.21  or should determine that the reported error was not neglect 
547.22  according to the criteria under section 626.5572, subdivision 
547.23  17, paragraph (c), clause (5), the reporter or facility may 
547.24  provide to the common entry point or directly to the lead agency 
547.25  information explaining how the event meets the criteria under 
547.26  section 626.5572, subdivision 17, paragraph (c), clause (5).  
547.27  The lead agency shall consider this information when making an 
547.28  initial disposition of the report under subdivision 9c. 
547.29     <h>[EFFECTIVE DATE.]</h> This section is effective August 1, 2001. 
547.30     Sec. 33.  Minnesota Statutes 2000, section 626.557, 
547.31  subdivision 9d, is amended to read: 
547.32     Subd. 9d.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
547.33  DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
547.34  SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
547.35  provided under paragraph (e), any individual or facility which a 
547.36  lead agency determines has maltreated a vulnerable adult, or the 
548.1   vulnerable adult or an interested person acting on behalf of the 
548.2   vulnerable adult, regardless of the lead agency's determination, 
548.3   who contests the lead agency's final disposition of an 
548.4   allegation of maltreatment, may request the lead agency to 
548.5   reconsider its final disposition.  The request for 
548.6   reconsideration must be submitted in writing to the lead agency 
548.7   within 15 calendar days after receipt of notice of final 
548.8   disposition or, if the request is made by an interested person 
548.9   who is not entitled to notice, within 15 days after receipt of 
548.10  the notice by the vulnerable adult or the vulnerable adult's 
548.11  legal guardian.  An individual who was determined to have 
548.12  maltreated a vulnerable adult under this section and who was 
548.13  disqualified on the basis of serious or recurring maltreatment 
548.14  under section 245A.04, subdivision 3d, may request 
548.15  reconsideration of the maltreatment determination and the 
548.16  disqualification.  The request for reconsideration of the 
548.17  maltreatment determination and the disqualification must be 
548.18  submitted within 30 calendar days of the individual's receipt of 
548.19  the notice of disqualification under section 245A.04, 
548.20  subdivision 3a. 
548.21     (b) Except as provided under paragraphs (e) and (f), if the 
548.22  lead agency denies the request or fails to act upon the request 
548.23  within 15 calendar days after receiving the request for 
548.24  reconsideration, the person or facility entitled to a fair 
548.25  hearing under section 256.045, may submit to the commissioner of 
548.26  human services a written request for a hearing under that 
548.27  statute.  The vulnerable adult, or an interested person acting 
548.28  on behalf of the vulnerable adult, may request a review by the 
548.29  vulnerable adult maltreatment review panel under section 256.021 
548.30  if the lead agency denies the request or fails to act upon the 
548.31  request, or if the vulnerable adult or interested person 
548.32  contests a reconsidered disposition.  The lead agency shall 
548.33  notify persons who request reconsideration of their rights under 
548.34  this paragraph.  The request must be submitted in writing to the 
548.35  review panel and a copy sent to the lead agency within 30 
548.36  calendar days of receipt of notice of a denial of a request for 
549.1   reconsideration or of a reconsidered disposition.  The request 
549.2   must specifically identify the aspects of the agency 
549.3   determination with which the person is dissatisfied.  
549.4      (c) If, as a result of a reconsideration or review, the 
549.5   lead agency changes the final disposition, it shall notify the 
549.6   parties specified in subdivision 9c, paragraph (d). 
549.7      (d) For purposes of this subdivision, "interested person 
549.8   acting on behalf of the vulnerable adult" means a person 
549.9   designated in writing by the vulnerable adult to act on behalf 
549.10  of the vulnerable adult, or a legal guardian or conservator or 
549.11  other legal representative, a proxy or health care agent 
549.12  appointed under chapter 145B or 145C, or an individual who is 
549.13  related to the vulnerable adult, as defined in section 245A.02, 
549.14  subdivision 13. 
549.15     (e) If an individual was disqualified under section 
549.16  245A.04, subdivision 3d, on the basis of a determination of 
549.17  maltreatment, which was serious or recurring, and the individual 
549.18  has requested reconsideration of the maltreatment determination 
549.19  under paragraph (a) and reconsideration of the disqualification 
549.20  under section 245A.04, subdivision 3b, reconsideration of the 
549.21  maltreatment determination and requested reconsideration of the 
549.22  disqualification shall be consolidated into a single 
549.23  reconsideration.  If an individual who was disqualified on the 
549.24  basis of serious or recurring maltreatment requests a fair 
549.25  hearing under paragraph (b), the scope of the fair hearing shall 
549.26  include the maltreatment determination and the disqualification. 
549.27     (f) If a maltreatment determination or a disqualification 
549.28  based on serious or recurring maltreatment is the basis for a 
549.29  denial of a license under section 245A.05 or a licensing 
549.30  sanction under section 245A.07, the license holder has the right 
549.31  to a contested case hearing under chapter 14 and Minnesota 
549.32  Rules, parts 1400.8510 to 1400.8612 and successor rules.  As 
549.33  provided for under section 245A.08, the scope of the contested 
549.34  case hearing shall include the maltreatment determination, 
549.35  disqualification, and licensing sanction or denial of a 
549.36  license.  In such cases, a fair hearing shall not be conducted 
550.1   under paragraph (b).  If the disqualified subject is an 
550.2   individual other than the license holder and upon whom a 
550.3   background study must be conducted under section 245A.04, 
550.4   subdivision 3, the hearings of all parties may be consolidated 
550.5   into a single contested case hearing upon consent of all parties 
550.6   and the administrative law judge. 
550.7      (g) Until August 1, 2002, an individual or facility that 
550.8   was determined by the commissioner of human services or the 
550.9   commissioner of health to be responsible for neglect under 
550.10  section 626.5572, subdivision 17, after October 1, 1995, and 
550.11  before August 1, 2001, that believes that the finding of neglect 
550.12  does not meet an amended definition of neglect may request a 
550.13  reconsideration of the determination of neglect.  The 
550.14  commissioner of human services or the commissioner of health 
550.15  shall mail a notice to the last known address of individuals who 
550.16  are eligible to seek this reconsideration.  The request for 
550.17  reconsideration must state how the established findings no 
550.18  longer meet the elements of the definition of neglect.  The 
550.19  commissioner shall review the request for reconsideration and 
550.20  make a determination within 15 calendar days.  The 
550.21  commissioner's decision on this reconsideration is the final 
550.22  agency action. 
550.23     (1) For purposes of compliance with the data destruction 
550.24  schedule under subdivision 12b, paragraph (d), when a finding of 
550.25  substantiated maltreatment has been changed as a result of a 
550.26  reconsideration under this paragraph, the date of the original 
550.27  finding of a substantiated maltreatment must be used to 
550.28  calculate the destruction date. 
550.29     (2) For purposes of any background studies under section 
550.30  245A.04, when a determination of substantiated maltreatment has 
550.31  been changed as a result of a reconsideration under this 
550.32  paragraph, any prior disqualification of the individual under 
550.33  section 245A.04 that was based on this determination of 
550.34  maltreatment shall be rescinded, and for future background 
550.35  studies under section 245A.04 the commissioner must not use the 
550.36  previous determination of substantiated maltreatment as a basis 
551.1   for disqualification or as a basis for referring the 
551.2   individual's maltreatment history to a health-related licensing 
551.3   board under section 245A.04, subdivision 3d, paragraph (b). 
551.4      <h>[EFFECTIVE DATE.]</h> Paragraph (g) of this section is 
551.5   effective the day following final enactment.  Paragraphs (a), 
551.6   (b), (e), and (f) are effective January 1, 2002. 
551.7      Sec. 34.  Minnesota Statutes 2000, section 626.5572, 
551.8   subdivision 17, is amended to read: 
551.9      Subd. 17.  [NEGLECT.] "Neglect" means:  
551.10     (a) The failure or omission by a caregiver to supply a 
551.11  vulnerable adult with care or services, including but not 
551.12  limited to, food, clothing, shelter, health care, or supervision 
551.13  which is: 
551.14     (1) reasonable and necessary to obtain or maintain the 
551.15  vulnerable adult's physical or mental health or safety, 
551.16  considering the physical and mental capacity or dysfunction of 
551.17  the vulnerable adult; and 
551.18     (2) which is not the result of an accident or therapeutic 
551.19  conduct. 
551.20     (b) The absence or likelihood of absence of care or 
551.21  services, including but not limited to, food, clothing, shelter, 
551.22  health care, or supervision necessary to maintain the physical 
551.23  and mental health of the vulnerable adult which a reasonable 
551.24  person would deem essential to obtain or maintain the vulnerable 
551.25  adult's health, safety, or comfort considering the physical or 
551.26  mental capacity or dysfunction of the vulnerable adult. 
551.27     (c) For purposes of this section, a vulnerable adult is not 
551.28  neglected for the sole reason that: 
551.29     (1) the vulnerable adult or a person with authority to make 
551.30  health care decisions for the vulnerable adult under sections 
551.31  144.651, 144A.44, chapter 145B, 145C, or 252A, or section 
551.32  253B.03, or 525.539 to 525.6199, refuses consent or withdraws 
551.33  consent, consistent with that authority and within the boundary 
551.34  of reasonable medical practice, to any therapeutic conduct, 
551.35  including any care, service, or procedure to diagnose, maintain, 
551.36  or treat the physical or mental condition of the vulnerable 
552.1   adult, or, where permitted under law, to provide nutrition and 
552.2   hydration parenterally or through intubation; this paragraph 
552.3   does not enlarge or diminish rights otherwise held under law by: 
552.4      (i) a vulnerable adult or a person acting on behalf of a 
552.5   vulnerable adult, including an involved family member, to 
552.6   consent to or refuse consent for therapeutic conduct; or 
552.7      (ii) a caregiver to offer or provide or refuse to offer or 
552.8   provide therapeutic conduct; or 
552.9      (2) the vulnerable adult, a person with authority to make 
552.10  health care decisions for the vulnerable adult, or a caregiver 
552.11  in good faith selects and depends upon spiritual means or prayer 
552.12  for treatment or care of disease or remedial care of the 
552.13  vulnerable adult in lieu of medical care, provided that this is 
552.14  consistent with the prior practice or belief of the vulnerable 
552.15  adult or with the expressed intentions of the vulnerable adult; 
552.16     (3) the vulnerable adult, who is not impaired in judgment 
552.17  or capacity by mental or emotional dysfunction or undue 
552.18  influence, engages in sexual contact with:  
552.19     (i) a person including a facility staff person when a 
552.20  consensual sexual personal relationship existed prior to the 
552.21  caregiving relationship; or 
552.22     (ii) a personal care attendant, regardless of whether the 
552.23  consensual sexual personal relationship existed prior to the 
552.24  caregiving relationship; or 
552.25     (4) an individual makes an error in the provision of 
552.26  therapeutic conduct to a vulnerable adult which:  (i) does not 
552.27  result in injury or harm which reasonably requires medical or 
552.28  mental health care; or, if it reasonably requires care, 
552.29     (5) an individual makes an error in the provision of 
552.30  therapeutic conduct to a vulnerable adult that results in injury 
552.31  or harm which reasonably requires the care of a physician; and: 
552.32     (i) the necessary care is sought and provided in a timely 
552.33  fashion as dictated by the condition of the vulnerable adult; 
552.34  and (ii) the injury or harm that required care does not result 
552.35  in substantial acute, or chronic injury or illness, or permanent 
552.36  disability above and beyond the vulnerable adult's preexisting 
553.1   condition; 
553.2      (ii) is (iii) the error is not part of a pattern of errors 
553.3   by the individual; 
553.4      (iv) if in a facility, the error is immediately reported as 
553.5   required under section 626.557, and recorded internally by the 
553.6   employee or person providing services in the facility in order 
553.7   to evaluate and identify corrective action; 
553.8      (v) if in a facility, the facility identifies and takes 
553.9   corrective action and implements measures designed to reduce the 
553.10  risk of further occurrence of this error and similar errors; and 
553.11     (iii) is (vi) if in a facility, the actions required under 
553.12  items (iv) and (v) are sufficiently documented for review and 
553.13  evaluation by the facility and any applicable licensing, 
553.14  certification, and ombudsman agency; and. 
553.15     (iv) is not part of a pattern of errors by the individual. 
553.16     (d) Nothing in this definition requires a caregiver, if 
553.17  regulated, to provide services in excess of those required by 
553.18  the caregiver's license, certification, registration, or other 
553.19  regulation. 
553.20     (e) If the findings of an investigation by a lead agency 
553.21  result in a determination of substantiated maltreatment for the 
553.22  sole reason that the actions required of a facility under 
553.23  paragraph (c), clause (5), item (iv), (v), or (vi), were not 
553.24  taken, then the facility is subject to a correction order.  This 
553.25  must not alter the lead agency's determination of mitigating 
553.26  factors under section 626.557, subdivision 9c, paragraph (c). 
553.27     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
553.28  following final enactment. 
553.29     Sec. 35.  Minnesota Statutes 2000, section 626.559, 
553.30  subdivision 2, is amended to read: 
553.31     Subd. 2.  [JOINT TRAINING.] The commissioners of human 
553.32  services and public safety shall cooperate in the development of 
553.33  a joint program for training child abuse services professionals 
553.34  in the appropriate techniques for child abuse assessment and 
553.35  investigation.  The program shall include but need not be 
553.36  limited to the following areas: 
554.1      (1) the public policy goals of the state as set forth in 
554.2   section 260C.001 and the role of the assessment or investigation 
554.3   in meeting these goals; 
554.4      (2) the special duties of child protection workers and law 
554.5   enforcement officers under section 626.556; 
554.6      (3) the appropriate methods for directing and managing 
554.7   affiliated professionals who may be utilized in providing 
554.8   protective services and strengthening family ties; 
554.9      (4) the appropriate methods for interviewing alleged 
554.10  victims of child abuse and other minors in the course of 
554.11  performing an assessment or an investigation; 
554.12     (5) the dynamics of child abuse and neglect within family 
554.13  systems and the appropriate methods for interviewing parents in 
554.14  the course of the assessment or investigation, including 
554.15  training in recognizing cases in which one of the parents is a 
554.16  victim of domestic abuse and in need of special legal or medical 
554.17  services; 
554.18     (6) the legal, evidentiary considerations that may be 
554.19  relevant to the conduct of an assessment or an investigation; 
554.20     (7) the circumstances under which it is appropriate to 
554.21  remove the alleged abuser or the alleged victim from the home; 
554.22     (8) the protective social services that are available to 
554.23  protect alleged victims from further abuse, to prevent child 
554.24  abuse and domestic abuse, and to preserve the family unit, and 
554.25  training in the preparation of case plans to coordinate services 
554.26  for the alleged child abuse victim with services for any parents 
554.27  who are victims of domestic abuse; and 
554.28     (9) the methods by which child protection workers and law 
554.29  enforcement workers cooperate in conducting assessments and 
554.30  investigations in order to avoid duplication of efforts; and 
554.31     (10) appropriate methods for interviewing alleged victims 
554.32  of child abuse and conducting investigations in cases where the 
554.33  alleged victim is developmentally, physically, or mentally 
554.34  disabled. 
554.35     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
554.36     Sec. 36.  [FEDERAL LAW CHANGE REQUEST OR WAIVER.] 
555.1      The commissioner of health or human services, whichever is 
555.2   appropriate, shall pursue changes to federal law necessary to 
555.3   allow greater discretion on disciplinary activities of 
555.4   unlicensed health care workers and apply for necessary federal 
555.5   waivers or approval that would allow for a set-aside process 
555.6   related to disqualifications for nurse aides in nursing homes by 
555.7   July 1, 2002. 
555.8      <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
555.9      Sec. 37.  [WAIVER FROM FEDERAL RULES AND REGULATIONS.] 
555.10     By January 2002, the commissioner of health shall work with 
555.11  providers to examine federal rules and regulations prohibiting 
555.12  neglect, abuse, and financial exploitation of residents in 
555.13  licensed nursing facilities and shall apply for federal waivers 
555.14  to: 
555.15     (1) allow the use of Minnesota Statutes, section 626.5572, 
555.16  to control the identification and prevention of maltreatment of 
555.17  residents in licensed nursing facilities, rather than the 
555.18  definitions under federal rules and regulations; and 
555.19     (2) allow the use of Minnesota Statutes, sections 214.104, 
555.20  245A.04, and 626.557 to control the disqualification or 
555.21  discipline of any persons providing services to residents in 
555.22  licensed nursing facilities, rather than the nurse aide registry 
555.23  or other exclusionary provisions of federal rules and 
555.24  regulations. 
555.25     <h>[EFFECTIVE DATE.]</h> This section is effective July 1, 2001. 
555.26                             ARTICLE 12 
555.27                           MISCELLANEOUS 
555.28     Section 1.  Minnesota Statutes 2000, section 144.1222, is 
555.29  amended by adding a subdivision to read: 
555.30     Subd. 2a.  [POOLS AT FAMILY DAY CARE OR GROUP FAMILY DAY 
555.31  CARE HOMES.] Notwithstanding Minnesota Rules, part 4717.0250, 
555.32  subpart 8, a pool that is located at a family day care or group 
555.33  family day care home licensed under Minnesota Rules, chapter 
555.34  9502, shall not be considered a public pool, and is exempt from 
555.35  the requirements for public pools in Minnesota Rules, parts 
555.36  4717.0150 to 4717.3975.  If the provider chooses to allow 
556.1   children cared for at the family day care or group family day 
556.2   care home to use the pool located at the home, the provider must 
556.3   satisfy the requirements in section 245A.14, subdivision 10.  
556.4      Sec. 2.  Minnesota Statutes 2000, section 148B.21, 
556.5   subdivision 6a, is amended to read: 
556.6      Subd. 6a.  [BACKGROUND CHECKS.] The board shall request a 
556.7   criminal history background check from the superintendent of the 
556.8   bureau of criminal apprehension on all applicants for initial 
556.9   licensure.  An application for a license under this section must 
556.10  be accompanied by an executed criminal history consent form and 
556.11  the fee for conducting the criminal history background 
556.12  check.  The board shall deposit all fees paid by applicants for 
556.13  criminal history background checks under this subdivision into 
556.14  the miscellaneous special revenue fund and shall reimburse the 
556.15  bureau of criminal apprehension for the cost of the background 
556.16  checks upon their completion. 
556.17     Sec. 3.  Minnesota Statutes 2000, section 148B.22, 
556.18  subdivision 3, is amended to read: 
556.19     Subd. 3.  [BACKGROUND CHECKS.] The board shall request a 
556.20  criminal history background check from the superintendent of the 
556.21  bureau of criminal apprehension on all licensees under its 
556.22  jurisdiction who did not complete a criminal history background 
556.23  check as part of an application for initial licensure.  This 
556.24  background check is a one-time requirement.  An application for 
556.25  a license under this section must be accompanied by an executed 
556.26  criminal history consent form and the fee for conducting the 
556.27  criminal history background check.  The board shall deposit all 
556.28  fees paid by licensees for criminal history background checks 
556.29  under this subdivision into the miscellaneous special revenue 
556.30  fund and shall reimburse the bureau of criminal apprehension for 
556.31  the cost of the background checks upon their completion. 
556.32     Sec. 4.  Minnesota Statutes 2000, section 245A.14, is 
556.33  amended by adding a subdivision to read: 
556.34     Subd. 10.  [SWIMMING POOLS; FAMILY DAY CARE AND GROUP 
556.35  FAMILY DAY CARE PROVIDERS.] (a) This subdivision governs pools 
556.36  located at family day care or group family day care homes 
557.1   licensed under Minnesota Rules, chapter 9502.  This subdivision 
557.2   does not apply to portable wading pools or whirlpools located at 
557.3   family day care or group family day care homes licensed under 
557.4   Minnesota Rules, chapter 9502.  For a provider to be eligible to 
557.5   allow a child cared for at the family day care or group family 
557.6   day care home to use the pool located at the home, the provider 
557.7   must not have had a licensing sanction under section 245A.07 or 
557.8   a correction order or fine under section 245A.06 relating to the 
557.9   supervision or health and safety of children substantiated by 
557.10  the county agency during the prior 24 months, and must satisfy 
557.11  the following requirements: 
557.12     (1) obtain written consent from a child's parent or legal 
557.13  guardian allowing the child to use the pool, and renew the 
557.14  parent's or legal guardian's written consent at least annually.  
557.15  The written consent must include a statement that the parent or 
557.16  legal guardian has received and read materials provided by the 
557.17  department of health to the department of human services for 
557.18  distribution to all family day care or group family day care 
557.19  homes related to the risk of disease transmission as well as 
557.20  other health risks associated with swimming pools.  The written 
557.21  consent must also include a statement that the department of 
557.22  health and county agency will not monitor or inspect the 
557.23  provider's swimming pool to ensure compliance with the 
557.24  requirements in this subdivision; 
557.25     (2) enter into a written contract with a child's parent or 
557.26  legal guardian, and renew the written contract annually.  The 
557.27  terms of the written contract must specify that the provider 
557.28  agrees to perform all of the requirements in this subdivision; 
557.29     (3) attend and successfully complete a pool operator 
557.30  training course once every five years.  Acceptable training 
557.31  courses are: 
557.32     (i) the National Swimming Pool Foundation Certified Pool 
557.33  Operator course; 
557.34     (ii) the National Spa and Pool Institute Tech I and Tech II 
557.35  courses (both required); or 
557.36     (iii) the National Recreation and Park Association Aquatic 
558.1   Facility Operator course; 
558.2      (4) require a caregiver trained in first aid and adult and 
558.3   child cardiopulmonary resuscitation to supervise and be present 
558.4   at the pool with any children in the pool; 
558.5      (5) toilet all potty-trained children before they enter the 
558.6   pool; 
558.7      (6) require all children who are not potty-trained to wear 
558.8   swim diapers while in the pool; 
558.9      (7) if fecal material enters the pool water, add three 
558.10  times the normal shock treatment to the pool water to raise the 
558.11  chlorine level to at least 20 parts per million, and close the 
558.12  pool to swimming for the 24 hours following the entrance of 
558.13  fecal material into the water or until the water pH and 
558.14  disinfectant concentration levels have returned to the standards 
558.15  specified in clause (9), whichever is later; 
558.16     (8) prevent any child from entering the pool who has an 
558.17  open wound or any child who has or is suspected of having a 
558.18  communicable disease; 
558.19     (9) maintain the pool water at a pH of not less than 7.2 
558.20  and not more than 8.0, maintain the disinfectant concentration 
558.21  between two and five parts per million for chlorine or between 
558.22  2.3 and 4.5 parts per million for bromine, and maintain a daily 
558.23  record of the pool's operation with pH and disinfectant 
558.24  concentration readings on days when children cared for at the 
558.25  family day care or group family day care home are present; 
558.26     (10) have a disinfectant feeder or feeders; 
558.27     (11) have a recirculation system that will clarify and 
558.28  disinfect the pool volume of water in ten hours or less; 
558.29     (12) maintain the pool's water clarity so that an object on 
558.30  the pool floor at the pool's deepest point is easily visible; 
558.31     (13) have two or more suction lines in the pool; 
558.32     (14) have in place and enforce written safety rules and 
558.33  pool policies; 
558.34     (15) prohibit diving; 
558.35     (16) prohibit pushing or rough play in the pool area; 
558.36     (17) have in place at all times a safety rope that divides 
559.1   the shallow and deep portions of the pool; 
559.2      (18) satisfy any existing local ordinances regarding pool 
559.3   installation, decks, and fencing; 
559.4      (19) maintain a water temperature of not more than 104 
559.5   degrees Fahrenheit and not less than 70 degrees Fahrenheit; and 
559.6      (20) for lifesaving equipment, have a United States Coast 
559.7   Guard-approved life ring attached to a rope, an exit ladder, and 
559.8   a shepherd's hook available at all times to the caregiver 
559.9   supervising the pool. 
559.10     (b) A violation of this subdivision is grounds for a 
559.11  sanction under section 245A.07, or a correction order or fine 
559.12  under section 245A.06.  If a provider under this subdivision 
559.13  receives a licensing sanction or a correction order or fine 
559.14  relating to the supervision or health and safety of children, 
559.15  the provider is prohibited from allowing a child cared for at 
559.16  the family day care or group family day care home to continue to 
559.17  use the pool located at the home. 
559.18     Sec. 5.  Minnesota Statutes 2000, section 246.57, is 
559.19  amended by adding a subdivision to read: 
559.20     Subd. 7.  [SHARED SERVICES ACCOUNT.] Notwithstanding 
559.21  subdivision 1, beginning July 1, 2001, $6,000,000 each biennium 
559.22  is transferred from the shared services account into which 
559.23  receipts for shared services under subdivision 1 are deposited 
559.24  to the general fund.  This subdivision expires June 30, 2005. 
559.25     Sec. 6.  Minnesota Statutes 2000, section 252A.02, is 
559.26  amended by adding a subdivision to read: 
559.27     Subd. 3a.  [GUARDIANSHIP SERVICE PROVIDERS.] "Guardianship 
559.28  service providers" are individuals or agencies that meet the 
559.29  ethical conduct and best practice standards of the National 
559.30  Guardianship Association, meet the criminal background check 
559.31  requirements of section 245A.04, and do not provide any other 
559.32  services to the individuals for whom guardianship services are 
559.33  provided. 
559.34     Sec. 7.  Minnesota Statutes 2000, section 252A.02, 
559.35  subdivision 12, is amended to read: 
559.36     Subd. 12.  [COMPREHENSIVE EVALUATION.] "Comprehensive 
560.1   evaluation" shall consist of: 
560.2      (1) a medical report on the health status and physical 
560.3   condition of the proposed ward, prepared under the direction of 
560.4   a licensed physician; 
560.5      (2) a report on the proposed ward's intellectual capacity 
560.6   and functional abilities, specifying the tests and other data 
560.7   used in reaching its conclusions, prepared by a psychologist who 
560.8   is qualified in the diagnosis of mental retardation; and 
560.9      (3) a report from the case manager that includes: 
560.10     (i) the most current assessment of individual service needs 
560.11  as described in rules of the commissioner; 
560.12     (ii) the most current individual service plan as described 
560.13  in rules of the commissioner under section 256B.092, subdivision 
560.14  1b; and 
560.15     (iii) a description of contacts with and responses of near 
560.16  relatives of the proposed ward notifying them that a nomination 
560.17  for public guardianship has been made and advising them that 
560.18  they may seek private guardianship.  
560.19     Each report shall contain recommendations as to the amount 
560.20  of assistance and supervision required by the proposed ward to 
560.21  function as independently as possible in society.  To be 
560.22  considered part of the comprehensive evaluation, reports must be 
560.23  completed no more than one year before filing the petition under 
560.24  section 252A.05.  
560.25     Sec. 8.  Minnesota Statutes 2000, section 252A.02, 
560.26  subdivision 13, is amended to read: 
560.27     Subd. 13.  [CASE MANAGER.] "Case manager" means the person 
560.28  designated by the county board under rules of the commissioner 
560.29  to provide case management services under section 256B.092. 
560.30     Sec. 9.  Minnesota Statutes 2000, section 252A.111, 
560.31  subdivision 6, is amended to read: 
560.32     Subd. 6.  [SPECIAL DUTIES.] In exercising powers and duties 
560.33  under this chapter, the commissioner shall: 
560.34     (1) maintain close contact with the ward, visiting at least 
560.35  twice a year; 
560.36     (2) prohibit filming a ward in any way that would reveal 
561.1   the identity of the ward unless the commissioner determines the 
561.2   filming to be in the best interests of the ward.  The 
561.3   commissioner may give written consent for filming of the ward 
561.4   after permitting and encouraging input by the nearest relative 
561.5   protect and exercise the legal rights of the ward; 
561.6      (3) take actions and make decisions on behalf of the ward 
561.7   that encourage and allow the maximum level of independent 
561.8   functioning in a manner least restrictive of the ward's personal 
561.9   freedom consistent with the need for supervision and protection; 
561.10  and 
561.11     (4) permit and encourage maximum self-reliance on the part 
561.12  of the ward and permit and encourage input by the nearest 
561.13  relative of the ward in planning and decision making on behalf 
561.14  of the ward. 
561.15     Sec. 10.  Minnesota Statutes 2000, section 252A.16, 
561.16  subdivision 1, is amended to read: 
561.17     Subdivision 1.  [REVIEW REQUIRED.] The commissioner 
561.18  shall provide require an annual review of the physical, mental, 
561.19  and social adjustment and progress of every ward and 
561.20  conservatee.  A copy of this review shall be kept on file at the 
561.21  department of human services and may be inspected by the ward or 
561.22  conservatee, the ward's or conservatee's parents, spouse, or 
561.23  relatives and other persons who receive the permission of the 
561.24  commissioner.  The review shall contain information required 
561.25  under rules of the commissioner Minnesota Rules, part 9525.3065, 
561.26  subpart 1.  
561.27     Sec. 11.  Minnesota Statutes 2000, section 252A.19, 
561.28  subdivision 2, is amended to read: 
561.29     Subd. 2.  [PETITION.] The commissioner, ward, or any 
561.30  interested person may petition the appointing court or the court 
561.31  to which venue has been transferred for an order to remove the 
561.32  guardianship or to limit or expand the powers of the 
561.33  conservatorship or to appoint a guardian or conservator under 
561.34  sections 525.539 to 525.705 or to restore the ward or 
561.35  conservatee to full legal capacity or to review de novo any 
561.36  decision made by the public guardian or public conservator for 
562.1   or on behalf of a ward or conservatee or for any other order as 
562.2   the court may deem just and equitable.  Section 525.61, 
562.3   subdivision 3, does not apply to a petition to remove a public 
562.4   guardian. 
562.5      Sec. 12.  Minnesota Statutes 2000, section 252A.20, 
562.6   subdivision 1, is amended to read: 
562.7      Subdivision 1.  [WITNESS AND ATTORNEY FEES.] In each 
562.8   proceeding under sections 252A.01 to 252A.21, the court shall 
562.9   allow and order paid to each witness subpoenaed the fees and 
562.10  mileage prescribed by law; to each physician, psychologist, or 
562.11  social worker who assists in the preparation of the 
562.12  comprehensive evaluation and who is not in the employ of the 
562.13  local agency, or the state department of human services, or area 
562.14  mental health-mental retardation board, a reasonable sum for 
562.15  services and for travel; and to the ward's counsel, when 
562.16  appointed by the court, a reasonable sum for travel and for each 
562.17  day or portion of a day actually employed in court or actually 
562.18  consumed in preparing for the hearing.  Upon order the county 
562.19  auditor shall issue a warrant on the county treasurer for 
562.20  payment of the amount allowed. 
562.21     Sec. 13.  Minnesota Statutes 2000, section 256.482, 
562.22  subdivision 8, is amended to read: 
562.23     Subd. 8.  [SUNSET.] Notwithstanding section 15.059, 
562.24  subdivision 5, the council on disability shall not sunset until 
562.25  June 30, 2001 2005. 
562.26     Sec. 14.  [260.0121] [PRIOR INVOLUNTARY TERMINATION OF 
562.27  PARENTAL RIGHTS.] 
562.28     In addition to the circumstances listed in section 260.012, 
562.29  paragraph (a), clause (1) under which reasonable efforts for 
562.30  rehabilitation and reunification are not required, reasonable 
562.31  efforts for rehabilitation and reunification are also not 
562.32  required upon a determination by the court that a termination of 
562.33  parental rights petition has been filed stating a prima facie 
562.34  case that the parent's custodial rights to another child have 
562.35  been involuntarily transferred to a relative under section 
562.36  260C.201, subdivision 11, paragraph (e), clause (1), or a 
563.1   similar law of another jurisdiction. 
563.2      Sec. 15.  Minnesota Statutes 2000, section 260C.307, 
563.3   subdivision 3, is amended to read: 
563.4      Subd. 3.  [NOTICE.] The court shall have notice of the 
563.5   time, place, and purpose of the hearing served on the parents, 
563.6   as defined in sections 257.51 to 257.74 or 259.49, subdivision 
563.7   1, clause (2), and upon the child's grandparent if the child has 
563.8   lived with the grandparent within the two years immediately 
563.9   preceding the filing of the petition.  Notice must be served in 
563.10  the manner provided in sections 260C.151 and 260C.152, except 
563.11  that personal service shall be made at least ten days before the 
563.12  day of the hearing.  Published notice shall be made for three 
563.13  weeks, the last publication to be at least ten days before the 
563.14  day of the hearing; and notice sent by certified mail shall be 
563.15  mailed at least 20 days before the day of the hearing.  A parent 
563.16  who consents to the termination of parental rights under the 
563.17  provisions of section 260C.301, subdivision 2, clause (a), may 
563.18  waive in writing the notice required by this subdivision; 
563.19  however, if the parent is a minor or incompetent the waiver 
563.20  shall be effective only if the parent's guardian ad litem 
563.21  concurs in writing. 
563.22     Sec. 16.  Minnesota Statutes 2000, section 260C.301, is 
563.23  amended by adding a subdivision to read: 
563.24     Subd. 3a.  ADDITIONAL GROUND FOR REQUIRED TERMINATION OF 
563.25  PARENTAL RIGHTS.] In addition to the grounds listed in 
563.26  subdivision 3, paragraph (a), the county attorney shall file a 
563.27  termination of parental rights petition within 30 days of the 
563.28  responsible social services agency determining that the parent 
563.29  has lost parental rights to another child through an order 
563.30  involuntarily terminating the parent's rights, or another child 
563.31  of the parent is the subject of an order transferring permanent 
563.32  legal and physical custody of the child to a relative under 
563.33  section 260C.201, subdivision 11, paragraph (e), clause (1), or 
563.34  a similar law of another jurisdiction.  
563.35     Sec. 17.  Minnesota Statutes 2000, section 260C.301, is 
563.36  amended by adding a subdivision to read: 
564.1      Subd. 1a.  [ADDITIONAL FACTOR UPON WHICH PARENTAL RIGHTS 
564.2   MAY BE TERMINATED.] In addition to the presumptions upon which 
564.3   parental rights may be terminated that are listed in subdivision 
564.4   1, paragraph (b), clause (4), it is presumed that a parent is 
564.5   palpably unfit to be a party to the parent and child 
564.6   relationship upon a showing that the parent's custodial rights 
564.7   to another child have been involuntarily transferred to a 
564.8   relative under section 260C.201, subdivision 11, paragraph (e), 
564.9   clause (1), or a similar law of another jurisdiction. 
564.10     Sec. 18.  Minnesota Statutes 2000, section 260C.317, is 
564.11  amended by adding a subdivision to read: 
564.12     Subd. 5.  [GRANDPARENT VISITATION.] In all proceedings for 
564.13  termination of parental rights, after notification of a 
564.14  grandparent under section 260C.307, subdivision 3, or at any 
564.15  time after completion of the proceeding and continuing during 
564.16  the minority of the child, a grandparent may seek an order of 
564.17  the court granting visitation rights to the grandparent under 
564.18  section 257.022, subdivision 2. 
564.19     <h>[EFFECTIVE DATE.]</h> This section applies to proceedings 
564.20  commenced or completed before the effective date of this section.
564.21     Sec. 19.  [PUBLIC GUARDIANSHIP ALTERNATIVES.] 
564.22     The commissioner of human services shall provide county 
564.23  agencies with funds up to the amount appropriated for public 
564.24  guardianship alternatives based on proposals by the counties to 
564.25  establish private alternatives.  
564.26     Sec. 20.  [AUTOMATIC DEFIBRILLATOR STUDY.] 
564.27     The emergency medical services regulatory board, in 
564.28  consultation with the department of public safety, shall study 
564.29  and report to the legislature by December 15, 2002, regarding 
564.30  the availability of automatic defibrillators outside the 
564.31  seven-county metropolitan area.  The report shall include 
564.32  recommendations to make these devices accessible within a 
564.33  reasonable distance throughout the nonmetropolitan area, 
564.34  including recommendations for funding their acquisition and 
564.35  distribution. 
564.36     Sec. 21.  [AH-GWAH-CHING CENTER.] 
565.1      The commissioner of human services and the Cass county 
565.2   board of commissioners, in consultation with the commissioner of 
565.3   administration, shall evaluate the feasibility of allowing Cass 
565.4   county to buy or lease unused portions of Ah-Gwah-Ching center.  
565.5   The commissioner shall present the results of this evaluation 
565.6   and recommendations to the chairs of the house and senate 
565.7   committees with jurisdiction over health and human services 
565.8   policy and finance. 
565.9      Sec. 22.  [STUDY OF OUTCOMES FOR CHILDREN IN THE CHILD 
565.10  PROTECTION SYSTEM.] 
565.11     (a) The commissioner of human services, in consultation 
565.12  with local social services agencies, councils of color, 
565.13  representatives of communities of color, and other interested 
565.14  parties, shall study why African American children in Minnesota 
565.15  are disproportionately represented in out-of-home placements.  
565.16  The commissioner also shall study each stage of the proceedings 
565.17  concerning children in need of protection or services, including 
565.18  the point at which children enter the child welfare system, each 
565.19  decision-making point in the child welfare system, and the 
565.20  outcomes for children in the child welfare system, to determine 
565.21  why outcomes for children differ by race.  The commissioner 
565.22  shall use child welfare performance and outcome indicators and 
565.23  data and other available data as part of this study.  The 
565.24  commissioner also shall study and determine if there are 
565.25  decision-making points in the child welfare system that lead to 
565.26  different outcomes for children and how those decision-making 
565.27  points affect outcomes for children.  The commissioner shall 
565.28  report and make legislative recommendations on the following: 
565.29     (1) amending the child welfare statutes to reduce any 
565.30  identified disparities in the child welfare system relating to 
565.31  outcomes for children of color, as compared to white children; 
565.32     (2) reducing any identified bias in the child welfare 
565.33  system; 
565.34     (3) reducing the number and duration of out-of-home 
565.35  placements for African American children; and 
565.36     (4) improving the long-term outcomes for African American 
566.1   children in out-of-home placements. 
566.2      (b) The commissioner of human services shall submit the 
566.3   report and recommended legislation to the chairs and ranking 
566.4   minority members of the committees in the house of 
566.5   representatives and senate with jurisdiction over child 
566.6   protection and out-of-home placement issues by January 15, 2002. 
566.7      Sec. 23.  [BOARD OF NURSING FEES.] 
566.8      Fee modifications proposed by the governor for the board of 
566.9   nursing in the 2002-2003 health and human services biennial 
566.10  budget document are approved. 
566.11     Sec. 24.  [BOARD OF MARRIAGE AND FAMILY THERAPY FEES.] 
566.12     Fee increases and new fees proposed by the governor for the 
566.13  board of marriage and family therapy in the 2002-2003 health and 
566.14  human services biennial budget document are approved. 
566.15     Sec. 25.  [REPEALER.] 
566.16     Minnesota Statutes 2000, section 252A.111, subdivision 3, 
566.17  is repealed. 
566.18                             ARTICLE 13 
566.19                           APPROPRIATIONS 
566.20  Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
566.21     The sums shown in the columns marked "APPROPRIATIONS" are 
566.22  appropriated from the general fund, or any other named fund, to 
566.23  the agencies and for the purposes specified in the following 
566.24  sections of this article, to be available for the fiscal years 
566.25  indicated for each purpose.  The figures "2002" and "2003" where 
566.26  used in this article, mean that the appropriation or 
566.27  appropriations listed under them are available for the fiscal 
566.28  year ending June 30, 2002, or June 30, 2003, respectively.  
566.29  Where a dollar amount appears in parentheses, it means a 
566.30  reduction of an appropriation.  
566.31                          SUMMARY BY FUND 
566.32  APPROPRIATIONS                                      BIENNIAL
566.33                            2002          2003           TOTAL
566.34  General          $3,083,463,000 $3,390,947,000 $6,474,410,000
566.35  State Government
566.36  Special Revenue      35,451,000     37,127,000     72,578,000
566.37  Health Care
567.1   Access              214,712,000    269,923,000    484,635,000
567.2   Federal TANF        318,103,000    277,420,000    595,523,000
567.3   Lottery Cash Flow     1,300,000      1,300,000      2,600,000
567.4   TOTAL            $3,653,029,000 $3,976,717,000 $7,629,746,000
567.5                                              APPROPRIATIONS 
567.6                                          Available for the Year 
567.7                                              Ending June 30 
567.8                                             2002         2003 
567.9   Sec. 2.  COMMISSIONER OF 
567.10  HUMAN SERVICES 
567.11  Subdivision 1.  Total 
567.12  Appropriation                     $3,475,621,000 $3,799,990,000
567.13                Summary by Fund
567.14  General           2,962,827,000 3,272,668,000
567.15  State Government
567.16  Special Revenue         507,000       507,000
567.17  Health Care 
567.18  Access              207,884,000   263,095,000
567.19  Federal TANF        303,103,000   262,420,000
567.20  Lottery Cash Flow     1,300,000     1,300,000
567.21  [APPROPRIATION FOR COURT-ORDERED MENTAL 
567.22  HEALTH TREATMENT.] Of the general fund 
567.23  appropriation, $2,289,000 in fiscal 
567.24  year 2002 and $2,289,000 in fiscal year 
567.25  2003 are for the cost of implementing 
567.26  H.F. 560, if enacted.  This 
567.27  appropriation is available only if H.F. 
567.28  560 is enacted. 
567.29  [APPROPRIATIONS FOR CIVIL COMMITMENT.] 
567.30  (a) Of the general fund appropriation, 
567.31  $3,386,000 in fiscal year 2003 is for 
567.32  the cost of implementing H.F. 281, if 
567.33  enacted.  This appropriation is 
567.34  available only if H.F. 281 is enacted. 
567.35  (b) Of the general fund appropriation, 
567.36  $155,000 in fiscal year 2003 is 
567.37  appropriated to the commissioner to be 
567.38  transferred to the Minnesota supreme 
567.39  court for costs associated with 
567.40  petitions filed for judicial 
567.41  commitment.  This appropriation is 
567.42  available only if H.F. 281 is enacted. 
567.43  [APPROPRIATIONS FOR CHILD SUPPORT.] (1) 
567.44  Of the general fund appropriation, 
567.45  $32,000 in fiscal year 2002 and $32,000 
567.46  in fiscal year 2003 are for the cost of 
567.47  implementing H.F. 1807, if enacted.  
567.48  This appropriation is available only if 
567.49  H.F. 1807 is enacted. 
567.50  (2) Of the general fund appropriation, 
567.51  $435,000 in fiscal year 2002 is for the 
567.52  cost of implementing H.F. 1446, if 
567.53  enacted.  This appropriation is 
567.54  available only if H.F. 1446 is enacted. 
568.1   [APPROPRIATION FOR PATIENT 
568.2   PROTECTIONS.] (a) Of the general fund 
568.3   appropriation, $248,000 in fiscal year 
568.4   2002 and $591,000 in fiscal year 2003 
568.5   are for the cost of implementing the 
568.6   patient protection provisions in H.F. 
568.7   560, if enacted.  This appropriation is 
568.8   available only if H.F. 560 is enacted. 
568.9   (b) Of the health care access fund 
568.10  appropriation, $106,000 in fiscal year 
568.11  2002 and $255,000 in fiscal year 2003 
568.12  are for the cost of implementing H.F. 
568.13  560, if enacted.  This appropriation is 
568.14  available only if H.F. 560 is enacted. 
568.15  [RECEIPTS FOR SYSTEMS PROJECTS.] 
568.16  Appropriations and federal receipts for 
568.17  information system projects for MAXIS, 
568.18  PRISM, MMIS, and SSIS must be deposited 
568.19  in the state system account authorized 
568.20  in Minnesota Statutes, section 
568.21  256.014.  Money appropriated for 
568.22  computer projects approved by the 
568.23  Minnesota office of technology, funded 
568.24  by the legislature, and approved by the 
568.25  commissioner of finance may be 
568.26  transferred from one project to another 
568.27  and from development to operations as 
568.28  the commissioner of human services 
568.29  considers necessary.  Any unexpended 
568.30  balance in the appropriation for these 
568.31  projects does not cancel but is 
568.32  available for ongoing development and 
568.33  operations. 
568.34  [GIFTS.] Notwithstanding Minnesota 
568.35  Statutes, chapter 7, the commissioner 
568.36  may accept on behalf of the state 
568.37  additional funding from sources other 
568.38  than state funds for the purpose of 
568.39  financing the cost of assistance 
568.40  program grants or nongrant 
568.41  administration.  All additional funding 
568.42  is appropriated to the commissioner for 
568.43  use as designated by the grantor of 
568.44  funding. 
568.45  [SYSTEMS CONTINUITY.] In the event of 
568.46  disruption of technical systems or 
568.47  computer operations, the commissioner 
568.48  may use available grant appropriations 
568.49  to ensure continuity of payments for 
568.50  maintaining the health, safety, and 
568.51  well-being of clients served by 
568.52  programs administered by the department 
568.53  of human services.  Grant funds must be 
568.54  used in a manner consistent with the 
568.55  original intent of the appropriation. 
568.56  [SPECIAL REVENUE FUND INFORMATION.] On 
568.57  December 1, 2001, and December 1, 2002, 
568.58  the commissioner shall provide the 
568.59  chairs of the house health and human 
568.60  services finance committee and the 
568.61  senate health, human services, and 
568.62  corrections budget division with 
568.63  detailed fund balance information for 
568.64  each special revenue fund account.  
568.65  [FEDERAL ADMINISTRATIVE REIMBURSEMENT.] 
569.1   Federal administrative reimbursement 
569.2   resulting from MinnesotaCare outreach 
569.3   grants and the Minnesota senior health 
569.4   options project are appropriated to the 
569.5   commissioner for these activities.  Any 
569.6   balance from this appropriation 
569.7   remaining at the end of the biennium 
569.8   shall be transferred to the general 
569.9   fund. 
569.10  [NONFEDERAL SHARE TRANSFERS.] The 
569.11  nonfederal share of activities for 
569.12  which federal administrative 
569.13  reimbursement is appropriated to the 
569.14  commissioner may be transferred to the 
569.15  special revenue fund.  Any balance from 
569.16  this appropriation remaining at the end 
569.17  of the biennium shall be transferred to 
569.18  the general fund. 
569.19  [MAJOR SYSTEMS TRANSFER.] (1) 
569.20  $21,550,000 of funds available in the 
569.21  state systems account authorized in 
569.22  Minnesota Statutes, section 256.014, is 
569.23  transferred to the general fund for the 
569.24  biennium ending June 30, 2003. 
569.25  (2) $2,450,000 of funds available in 
569.26  the state systems account authorized in 
569.27  Minnesota Statutes, section 256.014, is 
569.28  transferred to the general fund for the 
569.29  biennium ending June 30, 2005.  
569.30  Notwithstanding section 13 of this 
569.31  article, this rider does not expire on 
569.32  June 30, 2003. 
569.33  [TANF FUNDS APPROPRIATED TO OTHER 
569.34  ENTITIES.] Any expenditures from the 
569.35  TANF block grant shall be expended in 
569.36  accordance with the requirements and 
569.37  limitations of part A of title IV of 
569.38  the Social Security Act, as amended, 
569.39  and any other applicable federal 
569.40  requirement or limitation.  Prior to 
569.41  any expenditure of these funds, the 
569.42  commissioner shall assure that funds 
569.43  are expended in compliance with the 
569.44  requirements and limitations of federal 
569.45  law and that any reporting requirements 
569.46  of federal law are met.  It shall be 
569.47  the responsibility of any entity to 
569.48  which these funds are appropriated to 
569.49  implement a memorandum of understanding 
569.50  with the commissioner that provides the 
569.51  necessary assurance of compliance prior 
569.52  to any expenditure of funds.  The 
569.53  commissioner shall receipt TANF funds 
569.54  appropriated to other state agencies 
569.55  and coordinate all related interagency 
569.56  accounting transactions necessary to 
569.57  implement these appropriations.  
569.58  Unexpended TANF funds appropriated to 
569.59  any state, local, or nonprofit entity 
569.60  cancel at the end of the state fiscal 
569.61  year unless appropriating language 
569.62  permits otherwise. 
569.63  [TANF FUNDS TRANSFERRED TO OTHER 
569.64  FEDERAL GRANTS.] The commissioner must 
569.65  authorize transfers from TANF to other 
569.66  federal block grants so that funds are 
570.1   available to meet the annual 
570.2   expenditure needs as appropriated.  
570.3   Transfers may be authorized prior to 
570.4   the expenditure year with the agreement 
570.5   of the receiving entity.  Transferred 
570.6   funds must be expended in the year for 
570.7   which the funds were appropriated 
570.8   unless appropriation language permits 
570.9   otherwise.  In accelerating transfer 
570.10  authorizations, the commissioner must 
570.11  aim to preserve the future potential 
570.12  transfer capacity from TANF to other 
570.13  block grants. 
570.14  [TANF MAINTENANCE OF EFFORT.] (a) In 
570.15  order to meet the basic maintenance of 
570.16  effort (MOE) requirements of the TANF 
570.17  block grant specified under Code of 
570.18  Federal Regulations, title 45, section 
570.19  263.1, the commissioner may only report 
570.20  nonfederal money expended for allowable 
570.21  activities listed in the following 
570.22  clauses as TANF MOE expenditures: 
570.23  (1) MFIP cash and food assistance 
570.24  benefits under Minnesota Statutes, 
570.25  chapter 256J; 
570.26  (2) the child care assistance programs 
570.27  under Minnesota Statutes, sections 
570.28  119B.03 and 119B.05, and county child 
570.29  care administrative costs under 
570.30  Minnesota Statutes, section 119B.15; 
570.31  (3) state and county MFIP 
570.32  administrative costs under Minnesota 
570.33  Statutes, chapters 256J and 256K; 
570.34  (4) state, county, and tribal MFIP 
570.35  employment services under Minnesota 
570.36  Statutes, chapters 256J and 256K; and 
570.37  (5) expenditures made on behalf of 
570.38  noncitizen MFIP recipients who qualify 
570.39  for the medical assistance without 
570.40  federal financial participation program 
570.41  under Minnesota Statutes, section 
570.42  256B.06, subdivision 4, paragraphs (d), 
570.43  (e), and (j). 
570.44  (b) The commissioner shall ensure that 
570.45  sufficient qualified nonfederal 
570.46  expenditures are made each year to meet 
570.47  the state's TANF MOE requirements.  For 
570.48  the activities listed in paragraph (a), 
570.49  clauses (2) to (5), the commissioner 
570.50  may only report expenditures that are 
570.51  excluded from the definition of 
570.52  assistance under Code of Federal 
570.53  Regulations, title 45, section 260.31. 
570.54  (c) If nonfederal expenditures for the 
570.55  programs and purposes listed in 
570.56  paragraph (a) are insufficient to meet 
570.57  the state's TANF MOE requirements, the 
570.58  commissioner shall recommend additional 
570.59  allowable sources of nonfederal 
570.60  expenditures to the legislature, if the 
570.61  legislature is or will be in session to 
570.62  take action to specify additional 
570.63  sources of nonfederal expenditures for 
571.1   TANF MOE before a federal penalty is 
571.2   imposed.  The commissioner shall 
571.3   otherwise provide notice to the 
571.4   legislative commission on planning and 
571.5   fiscal policy under paragraph (e). 
571.6   (d) If the commissioner uses authority 
571.7   granted under Laws 1999, chapter 245, 
571.8   article 1, section 10, or similar 
571.9   authority granted by a subsequent 
571.10  legislature, to meet the state's TANF 
571.11  MOE requirements in a reporting period, 
571.12  the commissioner shall inform the 
571.13  chairs of the appropriate legislative 
571.14  committees about all transfers made 
571.15  under that authority for this purpose.  
571.16  (e) If the commissioner determines that 
571.17  nonfederal expenditures under paragraph 
571.18  (a) are insufficient to meet TANF MOE 
571.19  expenditure requirements, and if the 
571.20  legislature is not or will not be in 
571.21  session to take timely action to avoid 
571.22  a federal penalty, the commissioner may 
571.23  report nonfederal expenditures from 
571.24  other allowable sources as TANF MOE 
571.25  expenditures after the requirements of 
571.26  this paragraph are met.  The 
571.27  commissioner may report nonfederal 
571.28  expenditures in addition to those 
571.29  specified under paragraph (a) as 
571.30  nonfederal TANF MOE expenditures, but 
571.31  only ten days after the commissioner of 
571.32  finance has first submitted the 
571.33  commissioner's recommendations for 
571.34  additional allowable sources of 
571.35  nonfederal TANF MOE expenditures to the 
571.36  members of the legislative commission 
571.37  on planning and fiscal policy for their 
571.38  review. 
571.39  (f) The commissioner of finance shall 
571.40  not incorporate any changes in federal 
571.41  TANF expenditures or nonfederal 
571.42  expenditures for TANF MOE that may 
571.43  result from reporting additional 
571.44  allowable sources of nonfederal TANF 
571.45  MOE expenditures under the interim 
571.46  procedures in paragraph (e) into the 
571.47  February or November forecasts required 
571.48  under Minnesota Statutes, section 
571.49  16A.103, unless the commissioner of 
571.50  finance has approved the additional 
571.51  sources of expenditures under paragraph 
571.52  (e). 
571.53  (g) The provisions of Minnesota 
571.54  Statutes, section 256.011, subdivision 
571.55  3, which require that federal grants or 
571.56  aids secured or obtained under that 
571.57  subdivision be used to reduce any 
571.58  direct appropriations provided by law, 
571.59  do not apply if the grants or aids are 
571.60  federal TANF funds. 
571.61  (h) Notwithstanding section 14 of this 
571.62  article, paragraphs (a) to (h) expire 
571.63  June 30, 2005. 
571.64  Subd. 2.  Agency Management 
572.1   General              34,546,000    33,003,000
572.2   State Government
572.3   Special Revenue         392,000       392,000
572.4   Health Care 
572.5   Access                3,591,000     3,602,000
572.6   Federal TANF            546,000       454,000
572.7   The amounts that may be spent from the 
572.8   appropriation for each purpose are as 
572.9   follows: 
572.10  (a) Financial Operations 
572.11  General               6,708,000     6,708,000
572.12  Health Care
572.13  Access                  803,000       803,000
572.14  Federal TANF            546,000       454,000
572.15  (b) Legal and Regulation Operations 
572.16  General               8,728,000     8,337,000
572.17  State Government
572.18  Special Revenue         392,000       392,000
572.19  Health Care
572.20  Access                  233,000       244,000
572.21  [CORE LICENSING ACTIVITIES.] Of the 
572.22  general fund appropriation, $1,138,000 
572.23  in fiscal year 2002 and $923,000 in 
572.24  fiscal year 2003 is to support 14 new 
572.25  licensor positions.  Of this amount, 
572.26  $72,000 in fiscal year 2002 and 
572.27  $107,000 in fiscal year 2003 is to 
572.28  cover maintenance and operational costs 
572.29  for a new computer system, which will 
572.30  provide public access to licensing 
572.31  information. In order to receive 
572.32  continued appropriations for these 
572.33  purposes, by January 1, 2003, the 
572.34  commissioner shall: 
572.35  (1) reduce the average length of time 
572.36  to complete investigations of licensing 
572.37  complaints within 75 days; 
572.38  (2) complete all licensing reviews 
572.39  within the one-year and two-year 
572.40  intervals set forth in statutes; and 
572.41  (3) complete negative licensing action 
572.42  decisions within 45 days of county 
572.43  recommendations. 
572.44  [EXPEDITED MALTREATMENT 
572.45  INVESTIGATIONS.] Of the general fund 
572.46  appropriation, $359,000 in fiscal year 
572.47  2002 and $277,000 in fiscal year 2003 
572.48  are for one senior investigator 
572.49  position, three investigator positions, 
572.50  and one-half of a clerical position to 
572.51  achieve the goals for expedited 
572.52  maltreatment investigations.  In order 
572.53  to receive continued appropriations for 
572.54  this purpose, by January 1, 2003, the 
573.1   commissioner shall reduce the average 
573.2   length of time to complete maltreatment 
573.3   investigations to 60 days. 
573.4   [PUBLIC GUARDIANSHIP INCENTIVES.] Of 
573.5   the general fund appropriation, 
573.6   $250,000 in fiscal year 2002 and 
573.7   $250,000 in fiscal year 2003 is to be 
573.8   used for the purposes of providing 
573.9   fiscal incentives to encourage counties 
573.10  to establish private alternatives. 
573.11  [CHILD MALTREATMENT REVIEW PANEL.] Of 
573.12  the general fund appropriation, $46,000 
573.13  in fiscal year 2002 and $32,000 in 
573.14  fiscal year 2003 is to establish a 
573.15  review panel for purposes of reviewing 
573.16  investigating agency determinations 
573.17  regarding maltreatment of a child in a 
573.18  facility in response to requests 
573.19  received under Minnesota Statutes, 
573.20  section 626.556, subdivision 10i, 
573.21  paragraph (b). 
573.22  (c) Management Operations 
573.23  General              19,110,000    17,958,000
573.24  Health Care
573.25  Access                2,555,000     2,555,000
573.26  Subd. 3.  Administrative Reimbursement/
573.27  Pass Through
573.28  Federal TANF                               60,565         51,992
573.29  Subd. 4.  Children's Services Grants 
573.30  General              59,320,000    59,833,000
573.31  Federal TANF          6,290,000     6,290,000
573.32  [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 
573.33  Federal funds available during fiscal 
573.34  year 2002 and fiscal year 2003, for 
573.35  adoption incentive grants are 
573.36  appropriated to the commissioner for 
573.37  these purposes. 
573.38  [TANF TRANSFER TO SOCIAL SERVICES.] 
573.39  $4,650,000 is appropriated to the 
573.40  commissioner in fiscal year 2002 and in 
573.41  fiscal year 2003 for purposes of 
573.42  increasing services for families with 
573.43  children whose incomes are at or below 
573.44  200 percent of the federal poverty 
573.45  guidelines.  The commissioner shall 
573.46  authorize a sufficient transfer of 
573.47  funds from the state's federal TANF 
573.48  block grant to the state's federal 
573.49  social services block grant to meet 
573.50  this appropriation. 
573.51  [SOCIAL SERVICES BLOCK GRANT FUNDS FOR 
573.52  CONCURRENT PERMANENCY PLANNING.] 
573.53  Notwithstanding Minnesota Statutes, 
573.54  section 256E.07, $4,650,000 in fiscal 
573.55  year 2002 and $4,650,000 in fiscal year 
573.56  2003 in social services block grant 
573.57  funds allocated to the commissioner 
573.58  under title XX of the Social Security 
574.1   Act are available for distribution to 
574.2   counties under the formula in Minnesota 
574.3   Statutes, section 260C.213, for the 
574.4   purposes of concurrent permanency 
574.5   planning. 
574.6   Subd. 5.  Children's Services Management
574.7   General               4,880,000     4,252,000
574.8   Subd. 6.  Basic Health Care Grants
574.9                 Summary by Fund
574.10  General           1,114,020,000 1,317,641,000
574.11  Health Care
574.12  Access              189,392,000   244,592,000
574.13  The amounts that may be spent from this 
574.14  appropriation for each purpose are as 
574.15  follows: 
574.16  (a) MinnesotaCare Grants  
574.17  Health Care
574.18  Access              188,642,000   243,842,000
574.19  [MINNESOTACARE FEDERAL RECEIPTS.] 
574.20  Receipts received as a result of 
574.21  federal participation pertaining to 
574.22  administrative costs of the Minnesota 
574.23  health care reform waiver shall be 
574.24  deposited as nondedicated revenue in 
574.25  the health care access fund.  Receipts 
574.26  received as a result of federal 
574.27  participation pertaining to grants 
574.28  shall be deposited in the federal fund 
574.29  and shall offset health care access 
574.30  funds for payments to providers. 
574.31  [MINNESOTACARE FUNDING.] The 
574.32  commissioner may expend money 
574.33  appropriated from the health care 
574.34  access fund for MinnesotaCare in either 
574.35  fiscal year of the biennium. 
574.36  (b) MA Basic Health Care Grants -
574.37  Families and Children
574.38  General             433,298,000   517,563,000
574.39  (c) MA Basic Health Care Grants - 
574.40  Elderly and Disabled
574.41  General             511,946,000   604,451,000
574.42  [MEDICALLY NEEDY STANDARD AND FEDERAL 
574.43  AUTHORIZATION.] If federal 
574.44  authorization to use the medical 
574.45  assistance income standard in Minnesota 
574.46  Statutes, section 256B.056, subdivision 
574.47  4, as the medically needy standard is 
574.48  not obtained, the commissioner shall 
574.49  use all resulting savings to provide 
574.50  services under the home and 
574.51  community-based waiver for persons with 
574.52  mental retardation and related 
574.53  conditions. 
574.54  (d) General Assistance Medical Care
575.1   General             155,744,000   176,748,000
575.2   (e) Health Care Grants - Other Assistance  
575.3   General              13,032,000    18,879,000
575.4   Health Care             
575.5   Access                 750,000       750,000 
575.6   [PURCHASING ALLIANCE STOP-LOSS 
575.7   FUNDING.] Of the general fund 
575.8   appropriation, $150,000 in fiscal year 
575.9   2002 and $500,000 in fiscal year 2003 
575.10  are appropriated to the commissioner 
575.11  for the cost of establishing the 
575.12  Purchasing Alliance Stop-loss fund 
575.13  under Minnesota Statutes, section 
575.14  256.956. 
575.15  Subd. 7.  Basic Health Care Management
575.16  General              20,730,000    20,715,000
575.17  Health Care
575.18  Access               13,583,000    13,583,000
575.19  The amounts that may be spent from this 
575.20  appropriation for each purpose are as 
575.21  follows: 
575.22  (a) Health Care Policy Administration
575.23  General               2,822,000     2,862,000
575.24  Health Care 
575.25  Access                  562,000       562,000
575.26  (b) Health Care Operations
575.27  General              17,908,000    17,853,000
575.28  Health Care
575.29  Access               13,021,000    13,021,000
575.30  [PREPAID MEDICAL PROGRAMS.] The 
575.31  nonfederal share of the prepaid medical 
575.32  assistance program fund, which has been 
575.33  appropriated to fund county managed 
575.34  care advocacy and enrollment operating 
575.35  costs, shall be disbursed as grants 
575.36  using either a reimbursement or block 
575.37  grant mechanism. 
575.38  Subd. 8.  State-Operated Services
575.39  General             205,868,000   199,287,000
575.40  The amounts that may be spent from this 
575.41  appropriation for each purpose are as 
575.42  follows: 
575.43  [MITIGATION RELATED TO STATE-OPERATED 
575.44  SERVICES RESTRUCTURING.] Money 
575.45  appropriated to finance mitigation 
575.46  expenses related to restructuring 
575.47  state-operated services programs and 
575.48  administrative services may be 
575.49  transferred between fiscal years within 
575.50  the biennium. 
575.51  [STATE-OPERATED SERVICES CHEMICAL 
576.1   DEPENDENCY PROGRAMS.] When the 
576.2   operations of the state-operated 
576.3   services chemical dependency fund 
576.4   created in Minnesota Statutes, section 
576.5   246.18, subdivision 2, are impeded by 
576.6   projected cash deficiencies resulting 
576.7   from delays in the receipt of grants, 
576.8   dedicated income, or other similar 
576.9   receivables, and when the deficiencies 
576.10  would be corrected within the budget 
576.11  period involved, the commissioner of 
576.12  finance may transfer general fund cash 
576.13  reserves into this account as necessary 
576.14  to meet cash demands.  The cash flow 
576.15  transfers must be returned to the 
576.16  general fund in the fiscal year that 
576.17  the transfer was made.  Any interest 
576.18  earned on general fund cash flow 
576.19  transfers accrues to the general fund 
576.20  and not the state-operated services 
576.21  chemical dependency fund. 
576.22  [STATE-OPERATED SERVICES 
576.23  RESTRUCTURING.] For purposes of 
576.24  restructuring state-operated services, 
576.25  any state-operated services employee 
576.26  whose position is to be eliminated 
576.27  shall be afforded the options provided 
576.28  in applicable collective bargaining 
576.29  agreements.  All salary and mitigation 
576.30  allocations from fiscal year 2002 shall 
576.31  be carried forward into fiscal year 
576.32  2003.  Provided there is no conflict 
576.33  with any collective bargaining 
576.34  agreement, any state-operated services 
576.35  position reduction must only be 
576.36  accomplished through mitigation, 
576.37  attrition, transfer, and other measures 
576.38  as provided in state or applicable 
576.39  collective bargaining agreements and in 
576.40  Minnesota Statutes, section 252.50, 
576.41  subdivision 11, and not through layoff. 
576.42  [REPAIRS AND BETTERMENTS.] The 
576.43  commissioner may transfer unencumbered 
576.44  appropriation balances between fiscal 
576.45  years within the biennium for the state 
576.46  residential facilities repairs and 
576.47  betterments account and special 
576.48  equipment. 
576.49  Subd. 9.  Continuing Care Grants 
576.50  General           1,370,056,000 1,486,468,000
576.51  Lottery Cash Flow     1,158,000     1,158,000
576.52  The amounts that may be spent from this 
576.53  appropriation for each purpose are as 
576.54  follows: 
576.55  (a) Community Social Services
576.56  Block Grants
576.57      48,718,000     49,695,000 
576.58  [CSSA TRADITIONAL APPROPRIATION.] 
576.59  Notwithstanding Minnesota Statutes, 
576.60  section 256E.06, subdivisions 1 and 2, 
576.61  the appropriations available under that 
576.62  section in fiscal years 2002 and 2003 
577.1   must be distributed to each county 
577.2   proportionately to the aid received by 
577.3   the county in calendar year 2000.  
577.4   (b) Aging Adult Service Grants
577.5       13,500,000     13,732,000 
577.6   [COUNTY PLANNING AND SERVICE 
577.7   DEVELOPMENT.] Of this appropriation, 
577.8   $1,200,000 in fiscal year 2002 and 
577.9   $1,600,000 in fiscal year 2003 are for 
577.10  distribution to county boards for 
577.11  planning and development of community 
577.12  services for the elderly as required 
577.13  under Minnesota Statutes, section 
577.14  256B.437, subdivision 2.  For Phase I 
577.15  funding to develop the initial biennial 
577.16  plan addendum, the commissioner shall 
577.17  distribute a minimum of $10,000 to each 
577.18  county on July 1, 2001.  In a county 
577.19  with more than 10,000 persons over 65 
577.20  years, the funding allocation shall be 
577.21  $15,000; with more than 30,000 persons 
577.22  over 65 years - $20,000; with more than 
577.23  50,000 persons over 65 years - $25,000; 
577.24  and with more than 100,000 persons over 
577.25  65 years - $30,000.  Upon submission of 
577.26  the completed biennial plan addendum, 
577.27  the commissioner shall distribute Phase 
577.28  II funding to each county for 
577.29  development of community-based services 
577.30  no later than January 1, 2002.  For 
577.31  counties with less than 4,500 persons 
577.32  under 65 years, the Phase II allocation 
577.33  shall be $10,000.  For counties with 
577.34  more than 4,500 persons over 65 years, 
577.35  the Phase II allocation shall be $2.23 
577.36  per person over 65 years.  Any 
577.37  remaining funds shall be available as 
577.38  targeted funds distributed to counties 
577.39  with designated critical access sites.  
577.40  Phase I funding may be carried over by 
577.41  the county into 2002 and 2003 for the 
577.42  development of services. 
577.43  [GRANTS FOR SENIOR NUTRITION.] Of the 
577.44  general fund appropriation, $40,881 in 
577.45  fiscal year 2002 is appropriated to the 
577.46  commissioner for senior nutrition 
577.47  programs under Minnesota Statutes, 
577.48  section 256.9752 and shall be 
577.49  distributed as follows: 
577.50  (1) $12,023 is for development region 
577.51  6E; 
577.52  (2) $18,692 is for development region 
577.53  6W; and 
577.54  (3) $10,166 is for development region 8.
577.55  [MINNESOTA SENIOR SERVICE CORPS.] Of 
577.56  the general fund appropriation, 
577.57  $3,200,000 for fiscal year 2002 and 
577.58  fiscal year 2003 is for the following 
577.59  purposes: 
577.60  (a) $1,000,000 each year in fiscal year 
577.61  2002 and fiscal year 2003 is for the 
577.62  volunteer programs for retired senior 
578.1   citizens under Minnesota Statutes, 
578.2   section 256.9753, to expand the seniors 
578.3   in schools initiative, provide travel 
578.4   reimbursement to volunteers, and to 
578.5   continue community outreach and the 
578.6   expansion of the program. 
578.7   (b) $200,000 each year in fiscal year 
578.8   2002 and fiscal year 2003 is for the 
578.9   foster grandparents program under 
578.10  Minnesota Statutes, section 256.976, to 
578.11  assist with necessary extensive 
578.12  training expenses and travel 
578.13  reimbursement for volunteers. 
578.14  (c) $400,000 each year in fiscal year 
578.15  2002 and fiscal year 2003 is for the 
578.16  senior companion program under 
578.17  Minnesota Statutes, section 256.977, to 
578.18  expand the program, assist with travel 
578.19  reimbursement for volunteers, and 
578.20  continue the experience corps for 
578.21  independent living. 
578.22  (c) Deaf and Hard-of-Hearing 
578.23  Services Grants
578.24       1,923,000      1,825,000 
578.25  [SERVICES TO DEAF PERSONS WITH MENTAL 
578.26  ILLNESS.] Of this appropriation, 
578.27  $100,000 in fiscal year 2002 and 
578.28  $100,000 in fiscal year 2003 is for a 
578.29  grant to a nonprofit agency that 
578.30  currently serves deaf and 
578.31  hard-of-hearing adults with mental 
578.32  illness through residential programs 
578.33  and supportive housing outreach 
578.34  activities.  The grant must be used to 
578.35  continue and maintain community support 
578.36  services for deaf and hard-of-hearing 
578.37  adults with mental illness who use or 
578.38  wish to use sign language as their 
578.39  primary means of communication. 
578.40  (d) Mental Health Grants 
578.41  General              50,014,000    51,525,000
578.42  Lottery Cash Flow     1,158,000     1,158,000
578.43  (e) Community Support Grants
578.44      12,698,000     12,920,000 
578.45  (f) Medical Assistance Long-Term 
578.46  Care Waivers and Home Care
578.47     452,689,000    533,489,000 
578.48  [PROVIDER RATE INCREASES.] (1) The 
578.49  commissioner shall increase 
578.50  reimbursement rates by 3.0 percent the 
578.51  first year of the biennium and by 3.0 
578.52  percent the second year for the 
578.53  providers listed in paragraph (2).  The 
578.54  increases shall be effective for 
578.55  services rendered on or after July 1 of 
578.56  each year. 
578.57  (2) The rate increases described in 
579.1   this section shall be provided to home 
579.2   and community-based waivered services 
579.3   for persons with mental retardation or 
579.4   related conditions under Minnesota 
579.5   Statutes, section 256B.501; home and 
579.6   community-based waivered services for 
579.7   the elderly under Minnesota Statutes, 
579.8   section 256B.0915; waivered services 
579.9   under community alternatives for 
579.10  disabled individuals under Minnesota 
579.11  Statutes, section 256B.49; community 
579.12  alternative care waivered services 
579.13  under Minnesota Statutes, section 
579.14  256B.49; traumatic brain injury 
579.15  waivered services under Minnesota 
579.16  Statutes, section 256B.49; nursing 
579.17  services and home health services under 
579.18  Minnesota Statutes, section 256B.0625, 
579.19  subdivision 6a; personal care services 
579.20  and nursing supervision of personal 
579.21  care services under Minnesota Statutes, 
579.22  section 256B.0625, subdivision 19a; 
579.23  private-duty nursing services under 
579.24  Minnesota Statutes, section 256B.0625, 
579.25  subdivision 7; day training and 
579.26  habilitation services for adults with 
579.27  mental retardation or related 
579.28  conditions under Minnesota Statutes, 
579.29  sections 252.40 to 252.46; alternative 
579.30  care services under Minnesota Statutes, 
579.31  section 256B.0913; adult residential 
579.32  program grants under Minnesota Rules, 
579.33  parts 9535.2000 to 9535.3000; adult and 
579.34  family community support grants under 
579.35  Minnesota Rules, parts 9535.1700 to 
579.36  9535.1760; semi-independent living 
579.37  services under Minnesota Statutes, 
579.38  section 252.275, including SILS funding 
579.39  under county social services grants 
579.40  formerly funded under Minnesota 
579.41  Statutes, chapter 256I; community 
579.42  support services for deaf and 
579.43  hard-of-hearing adults with mental 
579.44  illness who use or wish to use sign 
579.45  language as their primary means of 
579.46  communication; and living skills 
579.47  training programs for persons with 
579.48  intractable epilepsy who need 
579.49  assistance in the transition to 
579.50  independent living; and group 
579.51  residential housing supplementary 
579.52  service rate under Minnesota Statutes, 
579.53  section 256I.05, subdivision 1a. 
579.54  (g) Medical Assistance Long-Term 
579.55  Care Facilities
579.56     590,638,000    599,866,000 
579.57  [MORATORIUM EXCEPTIONS.] During each 
579.58  year of the biennium beginning July 1, 
579.59  2001, the commissioner of health may 
579.60  approve moratorium exception projects 
579.61  under Minnesota Statutes, section 
579.62  144A.073, for which the full annualized 
579.63  state share of medical assistance costs 
579.64  does not exceed $2,000,000. 
579.65  [NURSING FACILITY OPERATED BY THE RED 
579.66  LAKE BAND OF CHIPPEWA INDIANS.] (1) The 
579.67  medical assistance payment rates for 
580.1   the 47-bed nursing facility operated by 
580.2   the Red Lake Band of Chippewa Indians 
580.3   must be calculated according to 
580.4   allowable reimbursement costs under the 
580.5   medical assistance program, as 
580.6   specified in Minnesota Statutes, 
580.7   section 246.50, and are subject to the 
580.8   facility-specific Medicare upper limits.
580.9   (2) In addition, the commissioner shall 
580.10  make available rate adjustments for the 
580.11  biennium beginning July 1, 2001, on the 
580.12  same basis as the adjustments provided 
580.13  to nursing facilities under Minnesota 
580.14  Statutes, section 256B.431.  The 
580.15  commissioner must use the facility's 
580.16  final 2000 and 2001 Medicare cost 
580.17  reports to calculate the adjustments.  
580.18  This rate increase shall become part of 
580.19  the facility's base rate for future 
580.20  rate years. 
580.21  [ICF/MR DISALLOWANCES.] Of this 
580.22  appropriation, $65,000 in each fiscal 
580.23  year is to reimburse a four-bed ICF/MR 
580.24  in Ramsey county for disallowance 
580.25  resulting from field audit findings. 
580.26  The commissioner shall exempt these 
580.27  facilities from the provisions of 
580.28  Minnesota Statutes, section 256B.501, 
580.29  subdivision 5b, paragraph (d), clause 
580.30  (6), for the rate years beginning 
580.31  October 1, 1996, and October 1, 1997. 
580.32  [COMMUNITY SERVICES DEVELOPMENT GRANTS 
580.33  PROGRAM.] Of this appropriation, 
580.34  $18,000,000 for the biennium ending 
580.35  June 30, 2003, is to the commissioner 
580.36  for grants under Minnesota Statutes, 
580.37  section 256.9754.  Unexpended 
580.38  appropriations in fiscal year 2002 do 
580.39  not cancel but are available to the 
580.40  commissioner for these purposes in 
580.41  fiscal year 2003.  This is a one-time 
580.42  appropriation and shall not become part 
580.43  of the base-level funding for the 
580.44  2004-2005 biennium. 
580.45  [LONG-TERM CARE CONSULTATION SERVICES.] 
580.46  Long-term care consultation services 
580.47  payments to all counties shall continue 
580.48  at the payment amount in effect for 
580.49  preadmission screening in fiscal year 
580.50  2001. 
580.51  (h) Alternative Care Grants  
580.52  General              75,764,000    89,646,000
580.53  [ALTERNATIVE CARE TRANSFER.] Any money 
580.54  allocated to the alternative care 
580.55  program that is not spent for the 
580.56  purposes indicated does not cancel but 
580.57  shall be transferred to the medical 
580.58  assistance account. 
580.59  [ALTERNATIVE CARE APPROPRIATION.] The 
580.60  commissioner may expend the money 
580.61  appropriated for the alternative care 
580.62  program for that purpose in either year 
580.63  of the biennium. 
581.1   (i) Group Residential Housing
581.2   General              78,712,000    86,807,000
581.3   (j) Chemical Dependency
581.4   Entitlement Grants
581.5   General              39,459,000    41,045,000
581.6   (k) Chemical Dependency 
581.7   Nonentitlement Grants
581.8   General               5,941,000     5,918,000
581.9   [CONSOLIDATED CHEMICAL DEPENDENCY 
581.10  TREATMENT FUND ONE-TIME TRANSFER.] 
581.11  $9,367,000 of funds available in the 
581.12  consolidated chemical dependency 
581.13  treatment fund general reserve account 
581.14  is transferred in fiscal year 2002 to 
581.15  the general fund. 
581.16  Subd. 10.  Continuing Care Management
581.17  General              24,546,000    23,928,000
581.18  State Government
581.19  Special Revenue         115,000       115,000
581.20  Lottery Cash Flow       142,000       142,000
581.21  [COUNTY INVOLVEMENT COSTS.] Of this 
581.22  appropriation, up to $481,000 in fiscal 
581.23  year 2002 and up to $642,000 in fiscal 
581.24  year 2003 are for the commissioner to 
581.25  allocate to counties for resident 
581.26  relocation costs resulting from planned 
581.27  closures under Minnesota Statutes, 
581.28  section 256B.437, and resident 
581.29  relocations under Minnesota Statutes, 
581.30  section 144A.161.  Unexpended funds for 
581.31  fiscal year 2002 do not cancel but are 
581.32  available to the commissioner for this 
581.33  purpose in fiscal year 2003. 
581.34  [REGION 10 QUALITY ASSURANCE 
581.35  COMMISSION.] (1) Of the appropriation 
581.36  from the general fund for the biennium 
581.37  ending June 30, 2003, $548,000 is to 
581.38  the commissioner of human services to 
581.39  be allocated to the region 10 quality 
581.40  assurance commission for operating 
581.41  costs of the alternative quality 
581.42  assurance licensing project and for 
581.43  grants to counties participating in 
581.44  that project. 
581.45  (2) $50,000 is appropriated from the 
581.46  general fund to the commissioner of 
581.47  human services for the biennium ending 
581.48  June 30, 2003, for the region 10 
581.49  quality assurance commission to conduct 
581.50  the evaluation required under Minnesota 
581.51  Statutes, section 256B.0951, 
581.52  subdivision 9. 
581.53  (3) $150,000 is appropriated from the 
581.54  general fund to the commissioner of 
581.55  human services for the biennium ending 
581.56  June 30, 2003, for the commissioner to 
581.57  conduct the project evaluation required 
582.1   for the federal 1115 waiver of ICF/MR 
582.2   regulations. 
582.3   Subd. 11.  Economic Support Grants
582.4   General              91,086,000    90,136,000
582.5   Federal TANF        233,209,000   202,741,000
582.6   The amounts that may be spent from this 
582.7   appropriation for each purpose are as 
582.8   follows: 
582.9   (a) Assistance to Families Grants
582.10  General              25,237,000    21,821,000
582.11  Federal TANF        164,745,000   133,553,000
582.12  (b) Work Grants              
582.13  General               9,844,000     9,844,000
582.14  Federal TANF         67,203,000    66,403,000
582.15  [NONTRADITIONAL CAREER ASSISTANCE.] Of 
582.16  the federal TANF appropriation, 
582.17  $500,000 for fiscal year 2002 and 
582.18  $500,000 for fiscal year 2003 is for 
582.19  grants for nontraditional career 
582.20  assistance training programs under 
582.21  Minnesota Statutes, section 256K.30. 
582.22  This is a one-time appropriation and 
582.23  shall not be added to the base-level 
582.24  funding in the 2004-2005 biennium. 
582.25  [SUPPORTIVE HOUSING AND MANAGED CARE 
582.26  PILOT PROJECT.] Of the general fund 
582.27  appropriation, $2,000,000 in fiscal 
582.28  year 2002 and $5,000,000 in fiscal year 
582.29  2003 is for the supportive housing and 
582.30  managed care pilot project under 
582.31  Minnesota Statutes, section 256K.25. 
582.32  This appropriation may be transferred 
582.33  between fiscal years within the 
582.34  biennium. 
582.35  [INTENSIVE INTERVENTION TRANSITIONAL 
582.36  EMPLOYMENT TRAINING PROJECT.] Of the 
582.37  federal TANF appropriation, $800,000 
582.38  for the biennium ending June 30, 2003, 
582.39  is for the Southeast Asian 
582.40  collaborative in Hennepin county for an 
582.41  intensive intervention transitional 
582.42  employment training project, which 
582.43  serves TANF-eligible recipients, and 
582.44  which moves refugee and immigrant 
582.45  welfare recipients into unsubsidized 
582.46  employment leading to 
582.47  self-sufficiency.  The commissioner 
582.48  must select one of the five partners in 
582.49  the collaborative as the fiscal agent 
582.50  for the project.  The primary effort of 
582.51  the project must be on intensive 
582.52  employment skills training, including 
582.53  workplace English and overcoming 
582.54  cultural barriers, and on specialized 
582.55  training in fields of work which 
582.56  involve a credit-based curriculum.  For 
582.57  recipients without a high school 
582.58  diploma or a GED, extra effort shall be 
583.1   made to help the recipient meet the 
583.2   "ability to benefit test" so the 
583.3   recipient can receive financial aid for 
583.4   further training.  During the 
583.5   specialized training, efforts should be 
583.6   made to involve the recipients with an 
583.7   internship program and retention 
583.8   specialist.  A minor amount of the 
583.9   grant may be used for other efforts to 
583.10  make the recipient families more 
583.11  self-sufficient as provided within TANF 
583.12  rules.  This is a one-time 
583.13  appropriation and shall not be added to 
583.14  the base-level funding for the 
583.15  2004-2005 biennium. 
583.16  [LOCAL INTERVENTION GRANTS FOR 
583.17  SELF-SUFFICIENCY CARRYFORWARD.] 
583.18  Unexpended funds appropriated for local 
583.19  intervention grants under Minnesota 
583.20  Statutes, section 256J.625, for fiscal 
583.21  year 2002 do not cancel but are 
583.22  available to the commissioner for these 
583.23  purposes in fiscal year 2003. 
583.24  [WELFARE-TO-WORK GRANTS.] Of the 
583.25  federal TANF appropriation, $5,000,000 
583.26  each year in fiscal year 2002 and 
583.27  fiscal year 2003 is for welfare-to-work 
583.28  programs administered by the 
583.29  commissioner of economic security that 
583.30  have utilized all of the federal 
583.31  welfare-to-work funding received.  The 
583.32  commissioner of economic security shall 
583.33  establish guidelines for distributing 
583.34  the funds to local workforce service 
583.35  areas based on current expenditures and 
583.36  documented need and, by January 15, 
583.37  2003, shall report to the chairs of the 
583.38  house health and human services finance 
583.39  committee and the senate health, human 
583.40  services and corrections budget 
583.41  division on the use of state and 
583.42  federal funds appropriated for 
583.43  welfare-to-work programs and the 
583.44  effectiveness of such programs. 
583.45  (c) Economic Support Grants -      
583.46  Other Assistance
583.47  General               4,682,000     6,931,000
583.48  Federal TANF          1,001,000     2,525,000
583.49  [TANF TRANSFER TO CHILD CARE AND 
583.50  DEVELOPMENT BLOCK GRANT.] $1,526,000 
583.51  for fiscal year 2003 is appropriated to 
583.52  the commissioner of children, families, 
583.53  and learning for the purposes of 
583.54  Minnesota Statutes, section 119B.05.  
583.55  The commissioner of human services 
583.56  shall authorize a sufficient transfer 
583.57  of funds from the state's federal TANF 
583.58  block grant to the state's child care 
583.59  and development fund block grant to 
583.60  meet this appropriation. 
583.61  [WORKING FAMILY TAX CREDITS.] (1) On a 
583.62  regular basis, the commissioner of 
583.63  revenue, with the assistance of the 
583.64  commissioner of human services, shall 
584.1   calculate the value of the refundable 
584.2   portion of the Minnesota working family 
584.3   credits provided under Minnesota 
584.4   Statutes, section 290.0671, that 
584.5   qualifies for federal reimbursement 
584.6   from the temporary assistance for needy 
584.7   families block grant.  The commissioner 
584.8   of revenue shall provide the 
584.9   commissioner of human services with 
584.10  such expenditure records and 
584.11  information as are necessary to support 
584.12  draws of federal funds.  
584.13  (2) Federal TANF funds, as specified in 
584.14  this paragraph, are appropriated to the 
584.15  commissioner of human services based on 
584.16  calculations under paragraph (a) of 
584.17  working family tax credit expenditures 
584.18  that qualify for reimbursement from the 
584.19  TANF block grant for income tax refunds 
584.20  payable in federal fiscal years 
584.21  beginning October 1, 2001.  The draws 
584.22  of federal TANF funds shall be made on 
584.23  a regular basis based on calculations 
584.24  of credit expenditures by the 
584.25  commissioner of revenue.  Up to the 
584.26  following amounts of federal TANF draws 
584.27  are appropriated to the commissioner of 
584.28  human services to deposit in the 
584.29  general fund:  in fiscal year 2002, 
584.30  $25,000,000; and in fiscal year 2003, 
584.31  $16,000,000. 
584.32  (d) Child Support Enforcement
584.33  General               4,239,000     4,239,000
584.34  Federal TANF            260,000       260,000
584.35  [CHILD SUPPORT PAYMENT CENTER.] 
584.36  Payments to the commissioner from other 
584.37  governmental units, private 
584.38  enterprises, and individuals for 
584.39  services performed by the child support 
584.40  payment center must be deposited in the 
584.41  state systems account authorized under 
584.42  Minnesota Statutes, section 256.014.  
584.43  These payments are appropriated to the 
584.44  commissioner for the operation of the 
584.45  child support payment center or system, 
584.46  according to Minnesota Statutes, 
584.47  section 256.014. 
584.48  (e) General Assistance
584.49  General              17,156,000    15,700,000
584.50  [GENERAL ASSISTANCE STANDARD.] The 
584.51  commissioner shall set the monthly 
584.52  standard of assistance for general 
584.53  assistance units consisting of an adult 
584.54  recipient who is childless and 
584.55  unmarried or living apart from his or 
584.56  her parents or a legal guardian at 
584.57  $203.  The commissioner may reduce this 
584.58  amount in accordance with Laws 1997, 
584.59  chapter 85, article 3, section 54. 
584.60  (f) Minnesota Supplemental Aid
584.61  General              29,678,000    31,351,000
585.1   (g) Refugee Services         
585.2   General                 250,000       250,000
585.3   Subd. 12.  Economic Support  
585.4   Management
585.5   General              37,775,000    37,405,000
585.6   Health Care
585.7   Access                1,318,000     1,318,000
585.8   Federal TANF          2,493,000       943,000
585.9   The amounts that may be spent from this 
585.10  appropriation for each purpose are as 
585.11  follows: 
585.12  (a) Economic Support Policy  
585.13  Administration
585.14  General               6,528,000     6,191,000
585.15  Federal TANF          2,493,000       943,000
585.16  [FOOD STAMP ADMINISTRATIVE 
585.17  REIMBURSEMENT.] The commissioner shall 
585.18  reduce quarterly food stamp 
585.19  administrative reimbursement to 
585.20  counties in fiscal years 2002 and 2003 
585.21  by the amount that the United States 
585.22  Department of Health and Human Services 
585.23  determines to be the county random 
585.24  moment study share of the food stamp 
585.25  adjustment under Public Law Number 
585.26  105-185.  The reductions shall be 
585.27  allocated to each county in proportion 
585.28  to each county's contribution, if any, 
585.29  to the amount of the adjustment.  Any 
585.30  adjustment to medical assistance 
585.31  administrative reimbursement that is 
585.32  based on the United States Department 
585.33  of Health and Human Services' 
585.34  determinations under Public Law Number 
585.35  105-185 shall be distributed to 
585.36  counties in the same manner.  
585.37  [EMPLOYMENT SERVICES TRACKING SYSTEM.] 
585.38  Of the federal TANF appropriation, 
585.39  $1,750,000 in fiscal year 2002 and 
585.40  $200,000 in fiscal year 2003 are for 
585.41  development of an employment tracking 
585.42  system in collaboration with the 
585.43  department of economic security.  
585.44  Unexpended funds in fiscal year 2002 do 
585.45  not cancel but are available to the 
585.46  commissioner for these purposes in 
585.47  fiscal year 2003.  This is a one-time 
585.48  appropriation and shall not be added to 
585.49  the base-level funding for the 
585.50  2004-2005 biennium. 
585.51  (b) Economic Support Operations 
585.52  General              31,247,000    31,214,000
585.53  Health Care 
585.54  Access                1,318,000     1,318,000
585.55  Federal TANF        ...,-0-,...   ...,-0-,...
586.1   [SPENDING AUTHORITY FOR FOOD STAMP 
586.2   ENHANCED FUNDING.] In the event that 
586.3   Minnesota qualifies for United States 
586.4   Department of Agriculture Food and 
586.5   Nutrition Services Food Stamp Program 
586.6   enhanced funding beginning in federal 
586.7   fiscal year 1998, the money is 
586.8   appropriated to the commissioner for 
586.9   the purposes of the program.  The 
586.10  commissioner shall retain 25 percent of 
586.11  the enhanced funding for the Minnesota 
586.12  food assistance program, with the 
586.13  remaining 75 percent divided among the 
586.14  counties according to a formula that 
586.15  takes into account each county's impact 
586.16  on the statewide food stamp error rate. 
586.17  [FINANCIAL INSTITUTION DATA MATCH AND 
586.18  PAYMENT OF FEES.] The commissioner is 
586.19  authorized to allocate up to $310,000 
586.20  each year in fiscal year 2002 and 
586.21  fiscal year 2003 from the PRISM special 
586.22  revenue account to make payments to 
586.23  financial institutions in exchange for 
586.24  performing data matches between account 
586.25  information held by financial 
586.26  institutions and the public authority's 
586.27  database of child support obligors as 
586.28  authorized by Minnesota Statutes, 
586.29  section 13B.06, subdivision 7. 
586.30  Sec. 3.  COMMISSIONER OF HEALTH 
586.31  Subdivision 1.  Total 
586.32  Appropriation                        130,391,000    130,516,000
586.33                Summary by Fund
586.34  General              84,419,000    82,960,000 
586.35  State Government 
586.36  Special Revenue      24,144,000    25,728,000 
586.37  Health Care 
586.38  Access                6,828,000     6,828,000 
586.39  Federal TANF         15,000,000    15,000,000 
586.40  Subd. 2.  Family and 
586.41  Community Health                      64,335,000     64,647,000 
586.42                Summary by Fund
586.43  General              44,743,000    44,056,000
586.44  State Government 
586.45  Special Revenue         936,000     1,935,000 
586.46  Health Care 
586.47  Access                3,656,000     3,656,000 
586.48  Federal TANF         15,000,000    15,000,000 
586.49  [ELIMINATING HEALTH DISPARITIES.] Of 
586.50  the general fund appropriation, 
586.51  $6,000,000 each year is for reducing 
586.52  health disparities.  Of the amounts 
586.53  available: 
586.54  (1) $1,500,000 each year is for 
586.55  competitive grants under Minnesota 
587.1   Statutes, section 145.928, subdivision 
587.2   7, to eligible applicants to reduce 
587.3   health disparities in infant mortality 
587.4   rates and adult and child immunization 
587.5   rates. 
587.6   (2) $2,000,000 each year is for 
587.7   competitive grants under Minnesota 
587.8   Statutes, section 145.928, subdivision 
587.9   8, to eligible applicants to reduce 
587.10  health disparities in breast and 
587.11  cervical cancer screening rates, 
587.12  HIV/AIDS and sexually transmitted 
587.13  infection rates, cardiovascular disease 
587.14  rates, diabetes rates, and rates of 
587.15  accidental injuries and violence. 
587.16  (3) $500,000 each year is for grants 
587.17  under Minnesota Statutes, section 
587.18  145.928, subdivision 9, to community 
587.19  health boards as defined in Minnesota 
587.20  Statutes, section 145A.02, to improve 
587.21  access to health screening and 
587.22  follow-up services for refugee 
587.23  populations. 
587.24  (4) $2,000,000 each year is for grants 
587.25  to community health boards as defined 
587.26  in Minnesota Statutes, section 145A.02, 
587.27  according to the formula in Minnesota 
587.28  Statutes, section 145.882, subdivision 
587.29  4a, to provide services targeted at 
587.30  reducing maternal and child health 
587.31  disparities. 
587.32  [TEEN PREGNANCY PREVENTION.] 
587.33  $10,000,000 from the TANF fund for the 
587.34  2002-2003 biennium is appropriated to 
587.35  the commissioner of health for a teen 
587.36  pregnancy prevention program.  Of the 
587.37  amounts available: 
587.38  (1) $1,750,000 in fiscal year 2002 and 
587.39  $2,500,000 in fiscal year 2003 are for 
587.40  teen pregnancy prevention disparity 
587.41  grants under Minnesota Statutes, 
587.42  section 145.9257, subdivision 6. 
587.43  (2) $1,500,000 in fiscal year 2002 and 
587.44  $1,500,000 in fiscal year 2003 are for 
587.45  high-risk community teen pregnancy 
587.46  prevention grants under Minnesota 
587.47  Statutes, section 145.9257, subdivision 
587.48  7. 
587.49  (3) $1,000,000 in fiscal year 2002 and 
587.50  $1,000,000 in fiscal year 2003 are for 
587.51  transfer to the commissioner of 
587.52  children, families, and learning to 
587.53  increase the number of adolescent 
587.54  parenting grants. 
587.55  (4) $750,000 in fiscal year 2002 is for 
587.56  one-time grants to public school 
587.57  districts to implement an abstinence 
587.58  until marriage curriculum and to train 
587.59  staff to implement the curriculum.  The 
587.60  curriculum shall educate adolescents 
587.61  that abstinence from sexual activity 
587.62  outside of marriage is the expected 
587.63  standard and that sexual activity 
588.1   outside the context of marriage is 
588.2   likely to have harmful emotional, 
588.3   physical, and social effects; and shall 
588.4   provide an explanation of the value of 
588.5   the institution of marriage and a 
588.6   discussion of the historical purpose 
588.7   and significance of marriage.  The 
588.8   commissioner of health, in consultation 
588.9   with the commissioner of children, 
588.10  families, and learning, shall make 
588.11  school districts aware of the 
588.12  availability of funds for this 
588.13  purpose.  This appropriation shall not 
588.14  become part of the base-level funding 
588.15  for this activity. 
588.16  [POISON INFORMATION SYSTEM.] Of the 
588.17  general fund appropriation, $1,360,000 
588.18  each fiscal year is for poison control 
588.19  system grants under Minnesota Statutes, 
588.20  section 145.93.  This is a one-time 
588.21  appropriation that shall not become 
588.22  part of base-level funding in 2004-2005.
588.23  [SUICIDE PREVENTION.] Of the general 
588.24  fund appropriation, $1,100,000 each 
588.25  fiscal year is for suicide prevention 
588.26  activities under Minnesota Statutes, 
588.27  section 145.56.  Of the amounts 
588.28  available: 
588.29  (1) $275,000 each fiscal year is for 
588.30  refining, coordinating, and 
588.31  implementing the suicide prevention 
588.32  plan according to Minnesota Statutes, 
588.33  section 145.56, subdivisions 1, 3, 4, 
588.34  and 5. 
588.35  (2) $825,000 each fiscal year is to 
588.36  fund community-based programs under 
588.37  Minnesota Statutes, section 145.56, 
588.38  subdivision 2. 
588.39  [TANF HOME VISITING PROGRAM.] Of the 
588.40  federal TANF appropriation, $10,000,000 
588.41  in fiscal year 2002 and $10,000,000 in 
588.42  fiscal year 2003 are for family home 
588.43  visiting programs under Minnesota 
588.44  Statutes, section 145A.17.  These 
588.45  amounts include $7,000,000 in fiscal 
588.46  year 2002 and $7,000,000 in fiscal year 
588.47  2003 of appropriations to the 
588.48  commissioner of human services for 
588.49  transfer to the commissioner of health 
588.50  authorized in Laws 2000, chapter 488, 
588.51  article 13, section 15, subdivision 6, 
588.52  clause (3), as amended by Laws 2000, 
588.53  chapter 499, sections 22 and 39. 
588.54  [TANF HOME VISITING CARRYFORWARD.] Any 
588.55  unexpended balance of the TANF funds 
588.56  appropriated for family home visiting 
588.57  in the first year of the biennium does 
588.58  not cancel but is available for the 
588.59  second year. 
588.60  [TEEN PREGNANCY PREVENTION 
588.61  CARRYFORWARD.] Any unexpended balance 
588.62  of the TANF funds appropriated for teen 
588.63  pregnancy prevention in the first 
588.64  fiscal year of the biennium does not 
589.1   cancel but is available for the second 
589.2   year. 
589.3   [WIC TRANSFERS.] The general fund 
589.4   appropriation for the women, infants, 
589.5   and children (WIC) food supplement 
589.6   program is available for either year of 
589.7   the biennium.  Transfers of these funds 
589.8   between fiscal years must be either to 
589.9   maximize federal funds or to minimize 
589.10  fluctuations in the number of program 
589.11  participants. 
589.12  [MINNESOTA CHILDREN WITH SPECIAL HEALTH 
589.13  NEEDS CARRYFORWARD.] General fund 
589.14  appropriations for treatment services 
589.15  in the services for Minnesota children 
589.16  with special health needs program are 
589.17  available for either year of the 
589.18  biennium. 
589.19  [ONE-TIME REDUCTION FOR FAMILY PLANNING 
589.20  SPECIAL PROJECT GRANTS.] For fiscal 
589.21  year 2003, base-level funding for the 
589.22  Family Planning Special Project Grants 
589.23  under Minnesota Statutes, section 
589.24  145.925, shall be reduced by $690,000. 
589.25  Subd. 3.  Access and Quality 
589.26  Improvement                           31,284,000     30,268,000 
589.27                Summary by Fund
589.28  General              21,160,000    20,194,000 
589.29  State Government 
589.30  Special Revenue       6,952,000     6,902,000 
589.31  Health Care 
589.32  Access                3,172,000     3,172,000 
589.33  [HEALTH CARE SAFETY NET.] (1) Of the 
589.34  general fund appropriation, $5,000,000 
589.35  each year is for a grant program to aid 
589.36  safety net community clinics. 
589.37  (2) $5,000,000 each year is for a grant 
589.38  program to provide rural hospital 
589.39  capital improvement grants described in 
589.40  Minnesota Statutes, section 144.148.  
589.41  [LICENSE FEES.] Notwithstanding the 
589.42  provisions of Minnesota Statutes, 
589.43  sections 144.122, 144.53, and 144A.07, 
589.44  a health care facility licensed under 
589.45  the provisions of Minnesota Statutes, 
589.46  chapter 144 or 144A, may submit the 
589.47  required fee for licensure renewal in 
589.48  quarterly installments.  Any health 
589.49  care facility requesting to pay the 
589.50  renewal fees in quarterly payments 
589.51  shall make the request at the time of 
589.52  license renewal.  Facilities licensed 
589.53  under the provisions of Minnesota 
589.54  Statutes, chapter 144, shall submit 
589.55  quarterly payments by January 1, April 
589.56  1, July 1, and October 1 of each year.  
589.57  Nursing homes licensed under Minnesota 
589.58  Statutes, chapter 144A, shall submit 
589.59  the first quarterly payment with the 
589.60  application for renewal, and the 
590.1   remaining payments shall be submitted 
590.2   at three-month intervals from the 
590.3   license expiration date.  The 
590.4   commissioner of health can require full 
590.5   payment of any outstanding balance if a 
590.6   quarterly payment is late.  Full 
590.7   payment of the annual renewal fee will 
590.8   be required in the event that the 
590.9   facility is sold or ceases operation 
590.10  during the licensure year.  Failure to 
590.11  pay the licensure fee is grounds for 
590.12  the nonrenewal of the license. 
590.13  Subd. 4.  Health Protection           29,808,000     30,639,000 
590.14                Summary by Fund 
590.15  General              13,699,000    13,895,000 
590.16  State Government 
590.17  Special Revenue      16,109,000    16,744,000 
590.18  [EMERGING HEALTH THREATS.] (a) Of the 
590.19  general fund appropriation, $2,200,000 
590.20  in the first year and $2,400,000 in the 
590.21  second year are to increase the state 
590.22  capacity to identify and respond to 
590.23  emerging health threats.  
590.24  (b) Of these amounts, $1,900,000 in the 
590.25  first year and $2,100,000 in the second 
590.26  year are to expand state laboratory 
590.27  capacity to identify infectious disease 
590.28  organisms, evaluate environmental 
590.29  contaminants, develop new analytical 
590.30  techniques, provide emergency response, 
590.31  and support local government by 
590.32  training health care system workers to 
590.33  deal with biological and chemical 
590.34  health threats.  
590.35  (c) $300,000 each year is to train, 
590.36  consult, and otherwise assist local 
590.37  officials responding to clandestine 
590.38  drug laboratories and minimizing health 
590.39  risks to responders and the public.  
590.40  Subd. 5.  Management and 
590.41  Support Services                       4,964,000      4,962,000 
590.42                Summary by Fund
590.43  General               4,817,000     4,815,000 
590.44  State Government 
590.45  Special Revenue         147,000       147,000 
590.46  Sec. 4.  VETERANS NURSING   
590.47  HOMES BOARD                           30,943,000     30,019,000 
590.48  [VETERANS HOME RATE INCREASE.] Of the 
590.49  general fund appropriation, $607,000 in 
590.50  fiscal year 2002 and $1,235,000 in 
590.51  fiscal year 2003 is for a base 
590.52  adjustment for salary and benefits for 
590.53  employees of the veterans nursing homes 
590.54  board. 
590.55  [VETERANS HOMES SPECIAL REVENUE 
590.56  ACCOUNT.] The general fund 
590.57  appropriations made to the board may be 
591.1   transferred to a veterans homes special 
591.2   revenue account in the special revenue 
591.3   fund in the same manner as other 
591.4   receipts are deposited according to 
591.5   Minnesota Statutes, section 198.34, and 
591.6   are appropriated to the board for the 
591.7   operation of board facilities and 
591.8   programs. 
591.9   [SETTING COST OF CARE.] The cost of 
591.10  care for the domiciliary residents at 
591.11  the Minneapolis veterans home for 
591.12  fiscal year 2002 and fiscal year 2003 
591.13  shall be calculated based on 100 
591.14  percent occupancy at each facility. 
591.15  [DEFICIENCY FUNDING.] Of the general 
591.16  fund appropriation in fiscal year 2002, 
591.17  $2,000,000 is available with the 
591.18  approval of the commissioner of 
591.19  finance.  Approval of the commissioner 
591.20  of finance is contingent upon review of 
591.21  the board's submittal of a report 
591.22  outlining the following: 
591.23  (1) a long-term revenue outlook for the 
591.24  homes; 
591.25  (2) a review and recommendation of 
591.26  alternative funding sources for the 
591.27  homes' operations; and 
591.28  (3) administrative and service options 
591.29  to bring cost growth in line with 
591.30  revenues. 
591.31  Sec. 5.  HEALTH-RELATED BOARDS 
591.32  Subdivision 1.  Total       
591.33  Appropriation                         10,800,000     10,892,000 
591.34  [STATE GOVERNMENT SPECIAL REVENUE 
591.35  FUND.] The appropriations in this 
591.36  section are from the state government 
591.37  special revenue fund. 
591.38  [NO SPENDING IN EXCESS OF REVENUES.] 
591.39  The commissioner of finance shall not 
591.40  permit the allotment, encumbrance, or 
591.41  expenditure of money appropriated in 
591.42  this section in excess of the 
591.43  anticipated biennial revenues or 
591.44  accumulated surplus revenues from fees 
591.45  collected by the boards.  Neither this 
591.46  provision nor Minnesota Statutes, 
591.47  section 214.06, applies to transfers 
591.48  from the general contingent account. 
591.49  Subd. 2.  Board of Chiropractic 
591.50  Examiners                                361,000        361,000
591.51  Subd. 3.  Board of Dentistry             806,000        806,000
591.52  Subd. 4.  Board of Dietetic
591.53  and Nutrition Practice                    95,000         95,000
591.54  Subd. 5.  Board of Marriage and 
591.55  Family Therapy                           111,000        111,000
591.56  Subd. 6.  Board of Medical  
591.57  Practice                               3,270,000      3,270,000
592.1   Subd. 7.  Board of Nursing             2,704,000      2,772,000
592.2   [HEALTH PROFESSIONAL SERVICES 
592.3   ACTIVITY.] Of these appropriations, 
592.4   $534,000 in fiscal year 2002 and 
592.5   $566,000 in fiscal year 2003 are for 
592.6   the Health Professional Services 
592.7   Activity. 
592.8   Subd. 8.  Board of Nursing 
592.9   Home Administrators                      194,000        186,000
592.10  Subd. 9.  Board of Optometry              90,000         90,000
592.11  Subd. 10.  Board of Pharmacy           1,301,000      1,316,000
592.12  [ADMINISTRATIVE SERVICES UNIT.] Of this 
592.13  appropriation, $433,000 the first year 
592.14  and $441,000 the second year are for 
592.15  the health boards administrative 
592.16  services unit.  The administrative 
592.17  services unit may receive and expend 
592.18  reimbursements for services performed 
592.19  for other agencies. 
592.20  Subd. 11.  Board of Physical Therapy     185,000        185,000
592.21  Subd. 12.  Board of Podiatry              52,000         42,000
592.22  Subd. 13.  Board of Psychology           653,000        647,000
592.23  Subd. 14.  Board of Social Work          825,000        832,000
592.24  Subd. 15.  Board of Veterinary 
592.25  Medicine                                 153,000        179,000
592.26  Sec. 6.  EMERGENCY MEDICAL
592.27  SERVICES BOARD                         3,033,000      3,037,000 
592.28                Summary by Fund
592.29  General               3,033,000     3,037,000
592.30  [COMPREHENSIVE ADVANCED LIFE SUPPORT 
592.31  (CALS).] $500,000 in fiscal year 2002 
592.32  and $500,000 in fiscal year 2003 are 
592.33  for the comprehensive advanced life 
592.34  support educational program under 
592.35  Minnesota Statutes, section 144E.37. 
592.36  Sec. 7.  COUNCIL ON DISABILITY           692,000        714,000
592.37  Sec. 8.  OMBUDSMAN FOR MENTAL 
592.38  HEALTH AND MENTAL RETARDATION          1,378,000      1,378,000
592.39  Sec. 9.  OMBUDSMAN
592.40  FOR FAMILIES                             171,000        171,000
592.41  Sec. 10.  TRANSFERS 
592.42  Subdivision 1.  Grants
592.43  The commissioner of human services, 
592.44  with the approval of the commissioner 
592.45  of finance, and after notification of 
592.46  the chair of the senate health and 
592.47  family security budget division and the 
592.48  chair of the house health and human 
592.49  services finance committee, may 
592.50  transfer unencumbered appropriation 
593.1   balances for the biennium ending June 
593.2   30, 2003, within fiscal years among the 
593.3   MFIP, general assistance, general 
593.4   assistance medical care, medical 
593.5   assistance, Minnesota supplemental aid, 
593.6   and group residential housing programs, 
593.7   and the entitlement portion of the 
593.8   chemical dependency consolidated 
593.9   treatment fund, and between fiscal 
593.10  years of the biennium. 
593.11  Subd. 2.  Administration
593.12  Positions, salary money, and nonsalary 
593.13  administrative money may be transferred 
593.14  within the departments of human 
593.15  services and health and within the 
593.16  programs operated by the veterans 
593.17  nursing homes board as the 
593.18  commissioners and the board consider 
593.19  necessary, with the advance approval of 
593.20  the commissioner of finance.  The 
593.21  commissioner or the board shall inform 
593.22  the chairs of the house health and 
593.23  human services finance committee and 
593.24  the senate health and family security 
593.25  budget division quarterly about 
593.26  transfers made under this provision. 
593.27  Sec. 11.  INDIRECT COSTS NOT TO
593.28  FUND PROGRAMS.
593.29  The commissioners of health and of 
593.30  human services shall not use indirect 
593.31  cost allocations to pay for the 
593.32  operational costs of any program for 
593.33  which they are responsible. 
593.34  Sec. 12.  CARRYOVER LIMITATION 
593.35  None of the appropriations in this 
593.36  article which are allowed to be carried 
593.37  forward from fiscal year 2002 to fiscal 
593.38  year 2003 shall become part of the base 
593.39  level funding for the 2004-2005 
593.40  biennial budget, unless specifically 
593.41  directed by the legislature. 
593.42  Sec. 13.  SUNSET OF UNCODIFIED LANGUAGE
593.43  All uncodified language contained in 
593.44  this article expires on June 30, 2003, 
593.45  unless a different expiration date is 
593.46  explicit. 
593.47   Sec. 14.  FINANCIAL ADJUSTMENTS AND DIRECT CARE 
593.48  STAFF OR SERVICES 
593.49  The commissioners of health and of 
593.50  human services, in making agency 
593.51  financial adjustments related to 
593.52  funding levels for salary supplements 
593.53  and rent increases, shall not layoff 
593.54  employees providing direct health care 
593.55  or mental health services to patients, 
593.56  or reduce the level of funding for the 
593.57  provision of direct health care and 
593.58  mental health services. 
593.59     Sec. 15.  Minnesota Statutes 2000, section 13B.06, 
594.1   subdivision 4, is amended to read: 
594.2      Subd. 4.  [METHOD TO PROVIDE DATA.] To comply with the 
594.3   requirements of this section, a financial institution may either:
594.4      (1) provide to the public authority a list containing only 
594.5   the names and other necessary personal identifying information 
594.6   of all account holders for the public authority to compare 
594.7   against its list of child support obligors for the purpose of 
594.8   identifying which obligors maintain an account at the financial 
594.9   institution; the names of the obligors who maintain an account 
594.10  at the institution shall then be transmitted to the financial 
594.11  institution which shall provide the public authority with 
594.12  account information on those obligors; or 
594.13     (2) must obtain a list of child support obligors from the 
594.14  public authority and compare that data to the data maintained at 
594.15  the financial institution to identify which of the identified 
594.16  obligors maintains an account at the financial institution. 
594.17     A financial institution shall elect either method in 
594.18  writing upon written request of the public authority, and the 
594.19  election remains in effect unless the public authority agrees in 
594.20  writing to a change. 
594.21     The commissioner shall keep track of the number of 
594.22  financial institutions that elect to report under clauses (1) 
594.23  and (2) respectively and shall report this information to the 
594.24  legislature by December 1, 1999. 
594.25     Sec. 16.  [246.141] [PROJECT LABOR.] 
594.26     Wages for project labor may be paid by the commissioner out 
594.27  of repairs and betterments money if the individual is to be 
594.28  engaged in a construction project or a repair project of 
594.29  short-term and nonrecurring nature.  Compensation for project 
594.30  labor shall be based on the prevailing wage rates, as defined in 
594.31  section 177.42, subdivision 6.  Project laborers are excluded 
594.32  from the provisions of sections 43A.22 to 43A.30, and shall not 
594.33  be eligible for state-paid insurance and benefits. 
594.34     Sec. 17.  [EXCHANGE OF RECORDS BETWEEN DEPARTMENT OF HEALTH 
594.35  AND DEPARTMENT OF HUMAN SERVICES.] 
594.36     The commissioners of health and human services shall 
595.1   exchange birth record data and data contained in recognitions of 
595.2   parentage for the purpose of identifying a child who is subject 
595.3   to threatened injury by a person responsible for a child's care 
595.4   to the extent possible using existing resources and information 
595.5   systems.