1.1                          A bill for an act 
  1.2             relating to human services; making changes to 
  1.3             licensing programs and continuing care programs; 
  1.4             requiring certain activity for identification of a 
  1.5             deceased person; establishing a guest license category 
  1.6             for dentists, dental hygienists, and dental 
  1.7             assistants; changing provisions for prospective 
  1.8             reimbursement rates; clarifying county duties related 
  1.9             to poor relief; amending Minnesota Statutes 2000, 
  1.10            sections 144.05, by adding a subdivision; 150A.06, by 
  1.11            adding a subdivision; 245.462, subdivision 4; 
  1.12            245.4871, subdivision 4; 245.50, subdivisions 1, 2, 5; 
  1.13            245B.02, subdivision 10; 245B.05, subdivision 7; 
  1.14            245B.07, subdivision 1; 261.063; 626.557, subdivision 
  1.15            14; Minnesota Statutes 2001 Supplement, sections 
  1.16            149A.90, subdivision 1; 245A.04, subdivisions 3b, 3d; 
  1.17            256B.0627, subdivision 10; 256B.0911, subdivisions 4b, 
  1.18            4d; 256B.0913, subdivision 5; 256B.0915, subdivision 
  1.19            3; 256B.0924, subdivision 6; 256B.0951, subdivisions 
  1.20            7, 8; 256B.437, subdivision 6; 256B.69, subdivision 5b.
  1.21  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.22                             ARTICLE 1 
  1.23                          CONTINUING CARE 
  1.24     Section 1.  Minnesota Statutes 2000, section 245.462, 
  1.25  subdivision 4, is amended to read: 
  1.26     Subd. 4.  [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 
  1.27  management service provider" means a case manager or case 
  1.28  manager associate employed by the county or other entity 
  1.29  authorized by the county board to provide case management 
  1.30  services specified in section 245.4711.  
  1.31     (b) A case manager must: 
  1.32     (1) be skilled in the process of identifying and assessing 
  1.33  a wide range of client needs; 
  2.1      (2) be knowledgeable about local community resources and 
  2.2   how to use those resources for the benefit of the client; 
  2.3      (3) have a bachelor's degree in one of the behavioral 
  2.4   sciences or related fields including, but not limited to, social 
  2.5   work, psychology, or nursing from an accredited college or 
  2.6   university or meet the requirements of paragraph (c); and 
  2.7      (4) meet the supervision and continuing education 
  2.8   requirements described in paragraphs (d), (e), and (f), as 
  2.9   applicable.  
  2.10     (c) Case managers without a bachelor's degree must meet one 
  2.11  of the requirements in clauses (1) to (3):  
  2.12     (1) have three or four years of experience as a case 
  2.13  manager associate as defined in this section; 
  2.14     (2) be a registered nurse without a bachelor's degree and 
  2.15  have a combination of specialized training in psychiatry and 
  2.16  work experience consisting of community interaction and 
  2.17  involvement or community discharge planning in a mental health 
  2.18  setting totaling three years; or 
  2.19     (3) be a person who qualified as a case manager under the 
  2.20  1998 department of human service waiver provision and meet the 
  2.21  continuing education and mentoring requirements in this section. 
  2.22     (d) A case manager with at least 2,000 hours of supervised 
  2.23  experience in the delivery of services to adults with mental 
  2.24  illness must receive regular ongoing supervision and clinical 
  2.25  supervision totaling 38 hours per year of which at least one 
  2.26  hour per month must be clinical supervision regarding individual 
  2.27  service delivery with a case management supervisor.  The 
  2.28  remaining 26 hours of supervision may be provided by a case 
  2.29  manager with two years of experience.  Group supervision may not 
  2.30  constitute more than one-half of the required supervision 
  2.31  hours.  Clinical supervision must be documented in the client 
  2.32  record. 
  2.33     (e) A case manager without 2,000 hours of supervised 
  2.34  experience in the delivery of services to adults with mental 
  2.35  illness must: 
  2.36     (1) receive clinical supervision regarding individual 
  3.1   service delivery from a mental health professional at least one 
  3.2   hour per week until the requirement of 2,000 hours of experience 
  3.3   is met; and 
  3.4      (2) complete 40 hours of training approved by the 
  3.5   commissioner in case management skills and the characteristics 
  3.6   and needs of adults with serious and persistent mental illness.  
  3.7      (f) A case manager who is not licensed, registered, or 
  3.8   certified by a health-related licensing board must receive 30 
  3.9   hours of continuing education and training in mental illness and 
  3.10  mental health services annually every two years. 
  3.11     (g) A case manager associate (CMA) must: 
  3.12     (1) work under the direction of a case manager or case 
  3.13  management supervisor; 
  3.14     (2) be at least 21 years of age; 
  3.15     (3) have at least a high school diploma or its equivalent; 
  3.16  and 
  3.17     (4) meet one of the following criteria: 
  3.18     (i) have an associate of arts degree in one of the 
  3.19  behavioral sciences or human services; 
  3.20     (ii) be a registered nurse without a bachelor's degree; 
  3.21     (iii) within the previous ten years, have three years of 
  3.22  life experience with serious and persistent mental illness as 
  3.23  defined in section 245.462, subdivision 20; or as a child had 
  3.24  severe emotional disturbance as defined in section 245.4871, 
  3.25  subdivision 6; or have three years life experience as a primary 
  3.26  caregiver to an adult with serious and persistent mental illness 
  3.27  within the previous ten years; 
  3.28     (iv) have 6,000 hours work experience as a nondegreed state 
  3.29  hospital technician; or 
  3.30     (v) be a mental health practitioner as defined in section 
  3.31  245.462, subdivision 17, clause (2). 
  3.32     Individuals meeting one of the criteria in items (i) to 
  3.33  (iv), may qualify as a case manager after four years of 
  3.34  supervised work experience as a case manager associate.  
  3.35  Individuals meeting the criteria in item (v), may qualify as a 
  3.36  case manager after three years of supervised experience as a 
  4.1   case manager associate. 
  4.2      (h) A case management associate must meet the following 
  4.3   supervision, mentoring, and continuing education requirements:  
  4.4      (1) have 40 hours of preservice training described under 
  4.5   paragraph (e), clause (2); 
  4.6      (2) receive at least 40 hours of continuing education in 
  4.7   mental illness and mental health services annually; and 
  4.8      (3) receive at least five hours of mentoring per week from 
  4.9   a case management mentor.  
  4.10  A "case management mentor" means a qualified, practicing case 
  4.11  manager or case management supervisor who teaches or advises and 
  4.12  provides intensive training and clinical supervision to one or 
  4.13  more case manager associates.  Mentoring may occur while 
  4.14  providing direct services to consumers in the office or in the 
  4.15  field and may be provided to individuals or groups of case 
  4.16  manager associates.  At least two mentoring hours per week must 
  4.17  be individual and face-to-face. 
  4.18     (i) A case management supervisor must meet the criteria for 
  4.19  mental health professionals, as specified in section 245.462, 
  4.20  subdivision 18. 
  4.21     (j) An immigrant who does not have the qualifications 
  4.22  specified in this subdivision may provide case management 
  4.23  services to adult immigrants with serious and persistent mental 
  4.24  illness who are members of the same ethnic group as the case 
  4.25  manager if the person:  
  4.26     (1) is currently enrolled in and is actively pursuing 
  4.27  credits toward the completion of a bachelor's degree in one of 
  4.28  the behavioral sciences or a related field including, but not 
  4.29  limited to, social work, psychology, or nursing from an 
  4.30  accredited college or university; 
  4.31     (2) completes 40 hours of training as specified in this 
  4.32  subdivision; and 
  4.33     (3) receives clinical supervision at least once a week 
  4.34  until the requirements of this subdivision are met. 
  4.35     Sec. 2.  Minnesota Statutes 2000, section 245.4871, 
  4.36  subdivision 4, is amended to read: 
  5.1      Subd. 4.  [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 
  5.2   management service provider" means a case manager or case 
  5.3   manager associate employed by the county or other entity 
  5.4   authorized by the county board to provide case management 
  5.5   services specified in subdivision 3 for the child with severe 
  5.6   emotional disturbance and the child's family.  
  5.7      (b) A case manager must: 
  5.8      (1) have experience and training in working with children; 
  5.9      (2) have at least a bachelor's degree in one of the 
  5.10  behavioral sciences or a related field including, but not 
  5.11  limited to, social work, psychology, or nursing from an 
  5.12  accredited college or university or meet the requirements of 
  5.13  paragraph (d); 
  5.14     (3) have experience and training in identifying and 
  5.15  assessing a wide range of children's needs; 
  5.16     (4) be knowledgeable about local community resources and 
  5.17  how to use those resources for the benefit of children and their 
  5.18  families; and 
  5.19     (5) meet the supervision and continuing education 
  5.20  requirements of paragraphs (e), (f), and (g), as applicable. 
  5.21     (c) A case manager may be a member of any professional 
  5.22  discipline that is part of the local system of care for children 
  5.23  established by the county board. 
  5.24     (d) A case manager without a bachelor's degree must meet 
  5.25  one of the requirements in clauses (1) to (3):  
  5.26     (1) have three or four years of experience as a case 
  5.27  manager associate; 
  5.28     (2) be a registered nurse without a bachelor's degree who 
  5.29  has a combination of specialized training in psychiatry and work 
  5.30  experience consisting of community interaction and involvement 
  5.31  or community discharge planning in a mental health setting 
  5.32  totaling three years; or 
  5.33     (3) be a person who qualified as a case manager under the 
  5.34  1998 department of human services waiver provision and meets the 
  5.35  continuing education, supervision, and mentoring requirements in 
  5.36  this section. 
  6.1      (e) A case manager with at least 2,000 hours of supervised 
  6.2   experience in the delivery of mental health services to children 
  6.3   must receive regular ongoing supervision and clinical 
  6.4   supervision totaling 38 hours per year, of which at least one 
  6.5   hour per month must be clinical supervision regarding individual 
  6.6   service delivery with a case management supervisor.  The other 
  6.7   26 hours of supervision may be provided by a case manager with 
  6.8   two years of experience.  Group supervision may not constitute 
  6.9   more than one-half of the required supervision hours. 
  6.10     (f) A case manager without 2,000 hours of supervised 
  6.11  experience in the delivery of mental health services to children 
  6.12  with emotional disturbance must: 
  6.13     (1) begin 40 hours of training approved by the commissioner 
  6.14  of human services in case management skills and in the 
  6.15  characteristics and needs of children with severe emotional 
  6.16  disturbance before beginning to provide case management 
  6.17  services; and 
  6.18     (2) receive clinical supervision regarding individual 
  6.19  service delivery from a mental health professional at least one 
  6.20  hour each week until the requirement of 2,000 hours of 
  6.21  experience is met. 
  6.22     (g) A case manager who is not licensed, registered, or 
  6.23  certified by a health-related licensing board must receive 30 
  6.24  hours of continuing education and training in severe emotional 
  6.25  disturbance and mental health services annually every two years. 
  6.26     (h) Clinical supervision must be documented in the child's 
  6.27  record.  When the case manager is not a mental health 
  6.28  professional, the county board must provide or contract for 
  6.29  needed clinical supervision. 
  6.30     (i) The county board must ensure that the case manager has 
  6.31  the freedom to access and coordinate the services within the 
  6.32  local system of care that are needed by the child. 
  6.33     (j) A case manager associate (CMA) must: 
  6.34     (1) work under the direction of a case manager or case 
  6.35  management supervisor; 
  6.36     (2) be at least 21 years of age; 
  7.1      (3) have at least a high school diploma or its equivalent; 
  7.2   and 
  7.3      (4) meet one of the following criteria: 
  7.4      (i) have an associate of arts degree in one of the 
  7.5   behavioral sciences or human services; 
  7.6      (ii) be a registered nurse without a bachelor's degree; 
  7.7      (iii) have three years of life experience as a primary 
  7.8   caregiver to a child with serious emotional disturbance as 
  7.9   defined in section 245.4871, subdivision 6, within the previous 
  7.10  ten years; 
  7.11     (iv) have 6,000 hours work experience as a nondegreed state 
  7.12  hospital technician; or 
  7.13     (v) be a mental health practitioner as defined in 
  7.14  subdivision 26, clause (2). 
  7.15     Individuals meeting one of the criteria in items (i) to 
  7.16  (iv) may qualify as a case manager after four years of 
  7.17  supervised work experience as a case manager associate.  
  7.18  Individuals meeting the criteria in item (v) may qualify as a 
  7.19  case manager after three years of supervised experience as a 
  7.20  case manager associate. 
  7.21     (k) Case manager associates must meet the following 
  7.22  supervision, mentoring, and continuing education requirements; 
  7.23     (1) have 40 hours of preservice training described under 
  7.24  paragraph (f), clause (1); 
  7.25     (2) receive at least 40 hours of continuing education in 
  7.26  severe emotional disturbance and mental health service annually; 
  7.27  and 
  7.28     (3) receive at least five hours of mentoring per week from 
  7.29  a case management mentor.  A "case management mentor" means a 
  7.30  qualified, practicing case manager or case management supervisor 
  7.31  who teaches or advises and provides intensive training and 
  7.32  clinical supervision to one or more case manager associates.  
  7.33  Mentoring may occur while providing direct services to consumers 
  7.34  in the office or in the field and may be provided to individuals 
  7.35  or groups of case manager associates.  At least two mentoring 
  7.36  hours per week must be individual and face-to-face. 
  8.1      (l) A case management supervisor must meet the criteria for 
  8.2   a mental health professional as specified in section 245.4871, 
  8.3   subdivision 27. 
  8.4      (m) An immigrant who does not have the qualifications 
  8.5   specified in this subdivision may provide case management 
  8.6   services to child immigrants with severe emotional disturbance 
  8.7   of the same ethnic group as the immigrant if the person:  
  8.8      (1) is currently enrolled in and is actively pursuing 
  8.9   credits toward the completion of a bachelor's degree in one of 
  8.10  the behavioral sciences or related fields at an accredited 
  8.11  college or university; 
  8.12     (2) completes 40 hours of training as specified in this 
  8.13  subdivision; and 
  8.14     (3) receives clinical supervision at least once a week 
  8.15  until the requirements of obtaining a bachelor's degree and 
  8.16  2,000 hours of supervised experience are met. 
  8.17     Sec. 3.  Minnesota Statutes 2000, section 245.50, 
  8.18  subdivision 1, is amended to read: 
  8.19     Subdivision 1.  [DEFINITIONS.] For purposes of this 
  8.20  section, the following terms have the meanings given them. 
  8.21     (a) "Bordering state" means Iowa, North Dakota, South 
  8.22  Dakota, or Wisconsin. 
  8.23     (b) "Receiving agency or facility" means a public or 
  8.24  private hospital, mental health center, or other person or 
  8.25  organization authorized by a state to provide which provides 
  8.26  mental health services under this section to individuals from a 
  8.27  state other than the state in which the agency is located. 
  8.28     (c) "Receiving state" means the state in which a receiving 
  8.29  agency is located. 
  8.30     (d) "Sending agency" means a state or county agency which 
  8.31  sends an individual to a bordering state for treatment under 
  8.32  this section. 
  8.33     (e) "Sending state" means the state in which the sending 
  8.34  agency is located. 
  8.35     Sec. 4.  Minnesota Statutes 2000, section 245.50, 
  8.36  subdivision 2, is amended to read: 
  9.1      Subd. 2.  [PURPOSE AND AUTHORITY.] (a) The purpose of this 
  9.2   section is to enable appropriate treatment to be provided to 
  9.3   individuals, across state lines from the individual's state of 
  9.4   residence, in qualified facilities that are closer to the homes 
  9.5   of individuals than are facilities available in the individual's 
  9.6   home state. 
  9.7      (b) Unless prohibited by another law and subject to the 
  9.8   exceptions listed in subdivision 3, a county board or the 
  9.9   commissioner of human services may contract with an agency or 
  9.10  facility in a bordering state for mental health services for 
  9.11  residents of Minnesota, and a Minnesota mental health agency or 
  9.12  facility may contract to provide services to residents of 
  9.13  bordering states.  Except as provided in subdivision 5, a person 
  9.14  who receives services in another state under this section is 
  9.15  subject to the laws of the state in which services are 
  9.16  provided.  A person who will receive services in another state 
  9.17  under this section must be informed of the consequences of 
  9.18  receiving services in another state, including the implications 
  9.19  of the differences in state laws, to the extent the individual 
  9.20  will be subject to the laws of the receiving state. 
  9.21     Sec. 5.  Minnesota Statutes 2000, section 245.50, 
  9.22  subdivision 5, is amended to read: 
  9.23     Subd. 5.  [SPECIAL CONTRACTS; WISCONSIN BORDERING 
  9.24  STATES.] The commissioner of the Minnesota department of human 
  9.25  services must enter into negotiations with appropriate personnel 
  9.26  at the Wisconsin department of health and social services and 
  9.27  must develop an agreement that conforms to the requirements of 
  9.28  subdivision 4, to enable the placement in Minnesota of patients 
  9.29  who are on emergency holds or who have been involuntarily 
  9.30  committed as mentally ill or chemically dependent in Wisconsin 
  9.31  and to enable the temporary placement in Wisconsin of patients 
  9.32  who are on emergency holds in Minnesota under section 253B.05, 
  9.33  provided that the Minnesota courts retain jurisdiction over 
  9.34  Minnesota patients, and the state of Wisconsin affords to 
  9.35  Minnesota patients the rights under Minnesota law.  Persons 
  9.36  committed by the Wisconsin courts and placed in Minnesota 
 10.1   facilities shall continue to be in the legal custody of 
 10.2   Wisconsin and Wisconsin's laws governing length of commitment, 
 10.3   reexaminations, and extension of commitment shall continue to 
 10.4   apply to these residents.  In all other respects, Wisconsin 
 10.5   residents placed in Minnesota facilities are subject to 
 10.6   Minnesota laws.  The agreement must specify that responsibility 
 10.7   for payment for the cost of care of Wisconsin residents shall 
 10.8   remain with the state of Wisconsin and the cost of care of 
 10.9   Minnesota residents shall remain with the state of Minnesota.  
 10.10  The commissioner shall be assisted by attorneys from the 
 10.11  Minnesota attorney general's office in negotiating and 
 10.12  finalizing this agreement.  The agreement shall be completed so 
 10.13  as to permit placement of Wisconsin residents in Minnesota 
 10.14  facilities and Minnesota residents in Wisconsin facilities 
 10.15  beginning July 1, 1994. (a) An individual who is detained, 
 10.16  committed, or placed on an involuntary basis under chapter 253B 
 10.17  may be confined or treated in a bordering state pursuant to a 
 10.18  contract under this section.  An individual who is detained, 
 10.19  committed, or placed on an involuntary basis under the civil law 
 10.20  of a bordering state may be confined or treated in Minnesota 
 10.21  pursuant to a contract under this section.  A peace or health 
 10.22  officer who is acting under the authority of the sending state 
 10.23  may transport an individual to a receiving agency that provides 
 10.24  services pursuant to a contract under this section, and may 
 10.25  transport the individual back to the sending state under the 
 10.26  laws of the sending state.  Court orders valid under the law of 
 10.27  the sending state are granted recognition and reciprocity in the 
 10.28  receiving state for individuals covered by a contract under this 
 10.29  section to the extent that the court orders relate to 
 10.30  confinement for treatment or care of mental illness.  Such 
 10.31  treatment or care may address other conditions that may be 
 10.32  cooccurring with the mental illness.  These court orders are not 
 10.33  subject to legal challenge in the courts of the receiving 
 10.34  state.  Individuals who are detained, committed, or placed under 
 10.35  the law of a sending state and who are transferred to a 
 10.36  receiving state under this section continue to be in the legal 
 11.1   custody of the authority responsible for them under the law of 
 11.2   the sending state.  Except in emergencies, those individuals may 
 11.3   not be transferred, removed, or furloughed from a receiving 
 11.4   agency without the specific approval of the authority 
 11.5   responsible for them under the law of the sending state. 
 11.6      (b) While in the receiving state pursuant to a contract 
 11.7   under this section, an individual shall be subject to the 
 11.8   sending state's laws and rules relating to length of 
 11.9   confinement, reexaminations, and extensions of confinement.  No 
 11.10  individual may be sent to another state pursuant to a contract 
 11.11  under this section until the receiving state has enacted a law 
 11.12  recognizing the validity and applicability of this section. 
 11.13     (c) If an individual receiving services pursuant to a 
 11.14  contract under this section leaves the receiving agency without 
 11.15  permission and the individual is subject to involuntary 
 11.16  confinement under the law of the sending state, the receiving 
 11.17  agency shall use all reasonable means to return the individual 
 11.18  to the receiving agency.  The receiving agency shall immediately 
 11.19  report the absence to the sending agency.  The receiving state 
 11.20  has the primary responsibility for, and the authority to direct, 
 11.21  the return of these individuals within its borders and is liable 
 11.22  for the cost of the action to the extent that it would be liable 
 11.23  for costs of its own resident. 
 11.24     (d) Responsibility for payment for the cost of care remains 
 11.25  with the sending agency. 
 11.26     (e) This subdivision also applies to county contracts under 
 11.27  subdivision 2 which include emergency care and treatment 
 11.28  provided to a county resident in a bordering state. 
 11.29     Sec. 6.  Minnesota Statutes 2001 Supplement, section 
 11.30  256B.0627, subdivision 10, is amended to read: 
 11.31     Subd. 10.  [FISCAL INTERMEDIARY OPTION AVAILABLE FOR 
 11.32  PERSONAL CARE ASSISTANT SERVICES.] (a) The commissioner may 
 11.33  allow a recipient of personal care assistant services to use a 
 11.34  fiscal intermediary to assist the recipient in paying and 
 11.35  accounting for medically necessary covered personal care 
 11.36  assistant services authorized in subdivision 4 and within the 
 12.1   payment parameters of subdivision 5.  Unless otherwise provided 
 12.2   in this subdivision, all other statutory and regulatory 
 12.3   provisions relating to personal care assistant services apply to 
 12.4   a recipient using the fiscal intermediary option. 
 12.5      (b) The recipient or responsible party shall: 
 12.6      (1) recruit, hire, and terminate a qualified professional, 
 12.7   if a qualified professional is requested by the recipient or 
 12.8   responsible party; 
 12.9      (2) verify and document the credentials of the qualified 
 12.10  professional, if a qualified professional is requested by the 
 12.11  recipient or responsible party; 
 12.12     (3) develop a service plan based on physician orders and 
 12.13  public health nurse assessment with the assistance of a 
 12.14  qualified professional, if a qualified professional is requested 
 12.15  by the recipient or responsible party, that addresses the health 
 12.16  and safety of the recipient; 
 12.17     (4) recruit, hire, and terminate the personal care 
 12.18  assistant; 
 12.19     (5) orient and train the personal care assistant with 
 12.20  assistance as needed from the qualified professional; 
 12.21     (6) supervise and evaluate the personal care assistant with 
 12.22  assistance as needed from the recipient's physician or the 
 12.23  qualified professional; 
 12.24     (7) monitor and verify in writing and report to the fiscal 
 12.25  intermediary the number of hours worked by the personal care 
 12.26  assistant and the qualified professional; and 
 12.27     (8) enter into a written agreement, as specified in 
 12.28  paragraph (f). 
 12.29     (c) The duties of the fiscal intermediary shall be to: 
 12.30     (1) bill the medical assistance program for personal care 
 12.31  assistant and qualified professional services; 
 12.32     (2) request and secure background checks on personal care 
 12.33  assistants and qualified professionals according to section 
 12.34  245A.04; 
 12.35     (3) pay the personal care assistant and qualified 
 12.36  professional based on actual hours of services provided; 
 13.1      (4) withhold and pay all applicable federal and state 
 13.2   taxes; 
 13.3      (5) verify and keep records of hours worked by the personal 
 13.4   care assistant and qualified professional; 
 13.5      (6) make the arrangements and pay unemployment insurance, 
 13.6   taxes, workers' compensation, liability insurance, and other 
 13.7   benefits, if any; 
 13.8      (7) enroll in the medical assistance program as a fiscal 
 13.9   intermediary; and 
 13.10     (8) enter into a written agreement as specified in 
 13.11  paragraph (f) before services are provided. 
 13.12     (d) The fiscal intermediary: 
 13.13     (1) may not be related to the recipient, qualified 
 13.14  professional, or the personal care assistant; 
 13.15     (2) must ensure arm's length transactions with the 
 13.16  recipient and personal care assistant; and 
 13.17     (3) shall be considered a joint employer of the personal 
 13.18  care assistant and qualified professional to the extent 
 13.19  specified in this section. 
 13.20     The fiscal intermediary or owners of the entity that 
 13.21  provides fiscal intermediary services under this subdivision 
 13.22  must pass a criminal background check as required in section 
 13.23  256B.0627, subdivision 1, paragraph (e). 
 13.24     (e) If the recipient or responsible party requests a 
 13.25  qualified professional, the qualified professional providing 
 13.26  assistance to the recipient shall meet the qualifications 
 13.27  specified in section 256B.0625, subdivision 19c.  The qualified 
 13.28  professional shall assist the recipient in developing and 
 13.29  revising a plan to meet the recipient's needs, as assessed by 
 13.30  the public health nurse.  In performing this function, the 
 13.31  qualified professional must visit the recipient in the 
 13.32  recipient's home at least once annually.  The qualified 
 13.33  professional must report any suspected abuse, neglect, or 
 13.34  financial exploitation of the recipient to the appropriate 
 13.35  authorities.  
 13.36     (f) The fiscal intermediary, recipient or responsible 
 14.1   party, personal care assistant, and qualified professional shall 
 14.2   enter into a written agreement before services are started.  The 
 14.3   agreement shall include: 
 14.4      (1) the duties of the recipient, qualified professional, 
 14.5   personal care assistant, and fiscal agent based on paragraphs 
 14.6   (a) to (e); 
 14.7      (2) the salary and benefits for the personal care assistant 
 14.8   and the qualified professional; 
 14.9      (3) the administrative fee of the fiscal intermediary and 
 14.10  services paid for with that fee, including background check 
 14.11  fees; 
 14.12     (4) procedures to respond to billing or payment complaints; 
 14.13  and 
 14.14     (5) procedures for hiring and terminating the personal care 
 14.15  assistant and the qualified professional. 
 14.16     (g) The rates paid for personal care assistant 
 14.17  services, shared care services, qualified professional services, 
 14.18  and fiscal intermediary services under this subdivision shall be 
 14.19  the same rates paid for personal care assistant services and 
 14.20  qualified professional services under subdivision 2 
 14.21  respectively.  Except for the administrative fee of the fiscal 
 14.22  intermediary specified in paragraph (f), the remainder of the 
 14.23  rates paid to the fiscal intermediary must be used to pay for 
 14.24  the salary and benefits for the personal care assistant or the 
 14.25  qualified professional. 
 14.26     (h) As part of the assessment defined in subdivision 1, the 
 14.27  following conditions must be met to use or continue use of a 
 14.28  fiscal intermediary: 
 14.29     (1) the recipient must be able to direct the recipient's 
 14.30  own care, or the responsible party for the recipient must be 
 14.31  readily available to direct the care of the personal care 
 14.32  assistant; 
 14.33     (2) the recipient or responsible party must be 
 14.34  knowledgeable of the health care needs of the recipient and be 
 14.35  able to effectively communicate those needs; 
 14.36     (3) a face-to-face assessment must be conducted by the 
 15.1   local county public health nurse at least annually, or when 
 15.2   there is a significant change in the recipient's condition or 
 15.3   change in the need for personal care assistant services; 
 15.4      (4) recipients who choose to use the shared care option as 
 15.5   specified in subdivision 8 must utilize the same fiscal 
 15.6   intermediary; and 
 15.7      the recipient cannot select the shared services option as 
 15.8   specified in subdivision 8; and 
 15.9      (5)  parties must be in compliance with the written 
 15.10  agreement specified in paragraph (f). 
 15.11     (i) The commissioner shall deny, revoke, or suspend the 
 15.12  authorization to use the fiscal intermediary option if: 
 15.13     (1) it has been determined by the qualified professional or 
 15.14  local county public health nurse that the use of this option 
 15.15  jeopardizes the recipient's health and safety; 
 15.16     (2) the parties have failed to comply with the written 
 15.17  agreement specified in paragraph (f); or 
 15.18     (3) the use of the option has led to abusive or fraudulent 
 15.19  billing for personal care assistant services.  
 15.20     The recipient or responsible party may appeal the 
 15.21  commissioner's action according to section 256.045.  The denial, 
 15.22  revocation, or suspension to use the fiscal intermediary option 
 15.23  shall not affect the recipient's authorized level of personal 
 15.24  care assistant services as determined in subdivision 5. 
 15.25     Sec. 7.  Minnesota Statutes 2001 Supplement, section 
 15.26  256B.0911, subdivision 4b, is amended to read: 
 15.27     Subd. 4b.  [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 
 15.28  Exemptions from the federal screening requirements outlined in 
 15.29  subdivision 4a, paragraphs (b) and (c), are limited to: 
 15.30     (1) a person who, having entered an acute care facility 
 15.31  from a certified nursing facility, is returning to a certified 
 15.32  nursing facility; and 
 15.33     (2) a person transferring from one certified nursing 
 15.34  facility in Minnesota to another certified nursing facility in 
 15.35  Minnesota; and 
 15.36     (3) a person, 21 years of age or older, who satisfies the 
 16.1   following criteria, as specified in Code of Federal Regulations, 
 16.2   title 42, section 483.106(b)(2): 
 16.3      (i) the person is admitted to a nursing facility directly 
 16.4   from a hospital after receiving acute inpatient care at the 
 16.5   hospital; 
 16.6      (ii) the person requires nursing facility services for the 
 16.7   same condition for which care was provided in the hospital; and 
 16.8      (iii) the attending physician has certified before the 
 16.9   nursing facility admission that the person is likely to receive 
 16.10  less than 30 days of nursing facility services. 
 16.11     (b) Persons who are exempt from preadmission screening for 
 16.12  purposes of level of care determination include: 
 16.13     (1) persons described in paragraph (a); 
 16.14     (2) an individual who has a contractual right to have 
 16.15  nursing facility care paid for indefinitely by the veterans' 
 16.16  administration; 
 16.17     (3) an individual enrolled in a demonstration project under 
 16.18  section 256B.69, subdivision 8, at the time of application to a 
 16.19  nursing facility; 
 16.20     (4) an individual currently being served under the 
 16.21  alternative care program or under a home and community-based 
 16.22  services waiver authorized under section 1915(c) of the federal 
 16.23  Social Security Act; and 
 16.24     (5) individuals admitted to a certified nursing facility 
 16.25  for a short-term stay, which is expected to be 14 days or less 
 16.26  in duration based upon a physician's certification, and who have 
 16.27  been assessed and approved for nursing facility admission within 
 16.28  the previous six months.  This exemption applies only if the 
 16.29  consultation team member determines at the time of the initial 
 16.30  assessment of the six-month period that it is appropriate to use 
 16.31  the nursing facility for short-term stays and that there is an 
 16.32  adequate plan of care for return to the home or community-based 
 16.33  setting.  If a stay exceeds 14 days, the individual must be 
 16.34  referred no later than the first county working day following 
 16.35  the 14th resident day for a screening, which must be completed 
 16.36  within five working days of the referral.  The payment 
 17.1   limitations in subdivision 7 apply to an individual found at 
 17.2   screening to not meet the level of care criteria for admission 
 17.3   to a certified nursing facility. 
 17.4      (c) Persons admitted to a Medicaid-certified nursing 
 17.5   facility from the community on an emergency basis as described 
 17.6   in paragraph (d) or from an acute care facility on a nonworking 
 17.7   day must be screened the first working day after admission. 
 17.8      (d) Emergency admission to a nursing facility prior to 
 17.9   screening is permitted when all of the following conditions are 
 17.10  met: 
 17.11     (1) a person is admitted from the community to a certified 
 17.12  nursing or certified boarding care facility during county 
 17.13  nonworking hours; 
 17.14     (2) a physician has determined that delaying admission 
 17.15  until preadmission screening is completed would adversely affect 
 17.16  the person's health and safety; 
 17.17     (3) there is a recent precipitating event that precludes 
 17.18  the client from living safely in the community, such as 
 17.19  sustaining an injury, sudden onset of acute illness, or a 
 17.20  caregiver's inability to continue to provide care; 
 17.21     (4) the attending physician has authorized the emergency 
 17.22  placement and has documented the reason that the emergency 
 17.23  placement is recommended; and 
 17.24     (5) the county is contacted on the first working day 
 17.25  following the emergency admission. 
 17.26  Transfer of a patient from an acute care hospital to a nursing 
 17.27  facility is not considered an emergency except for a person who 
 17.28  has received hospital services in the following situations: 
 17.29  hospital admission for observation, care in an emergency room 
 17.30  without hospital admission, or following hospital 24-hour bed 
 17.31  care. 
 17.32     (e) A nursing facility must provide a written notice to 
 17.33  persons who satisfy the criteria in paragraph (a), clause (3), 
 17.34  regarding the person's right to request and receive long-term 
 17.35  care consultation services as defined in subdivision 1a.  The 
 17.36  notice must be provided prior to the person's discharge from the 
 18.1   facility and in a format specified by the commissioner. 
 18.2      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 18.3   following final enactment.  
 18.4      Sec. 8.  Minnesota Statutes 2001 Supplement, section 
 18.5   256B.0911, subdivision 4d, is amended to read: 
 18.6      Subd. 4d.  [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 
 18.7   YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 
 18.8   ensure that individuals with disabilities or chronic illness are 
 18.9   served in the most integrated setting appropriate to their needs 
 18.10  and have the necessary information to make informed choices 
 18.11  about home and community-based service options. 
 18.12     (b) Individuals under 65 years of age who are admitted to a 
 18.13  nursing facility from a hospital must be screened prior to 
 18.14  admission as outlined in subdivisions 4a through 4c. 
 18.15     (c) Individuals under 65 years of age who are admitted to 
 18.16  nursing facilities with only a telephone screening must receive 
 18.17  a face-to-face assessment from the long-term care consultation 
 18.18  team member of the county in which the facility is located or 
 18.19  from the recipient's county case manager within 20 working days 
 18.20  of admission. 
 18.21     (d) Individuals under 65 years of age who are admitted to a 
 18.22  nursing facility without preadmission screening according to the 
 18.23  exemption described in subdivision 4b, paragraph (a), clause 
 18.24  (3), and who remain in the facility longer than 30 days must 
 18.25  receive a face-to-face assessment within 40 days of admission.  
 18.26     (e) At the face-to-face assessment, the long-term care 
 18.27  consultation team member or county case manager must perform the 
 18.28  activities required under subdivision 3b. 
 18.29     (e) (f) For individuals under 21 years of age, a screening 
 18.30  interview which recommends nursing facility admission must be 
 18.31  face-to-face and approved by the commissioner before the 
 18.32  individual is admitted to the nursing facility. 
 18.33     (f) (g) In the event that an individual under 65 years of 
 18.34  age is admitted to a nursing facility on an emergency basis, the 
 18.35  county must be notified of the admission on the next working 
 18.36  day, and a face-to-face assessment as described in paragraph (c) 
 19.1   must be conducted within 20 working days of admission. 
 19.2      (g) (h) At the face-to-face assessment, the long-term care 
 19.3   consultation team member or the case manager must present 
 19.4   information about home and community-based options so the 
 19.5   individual can make informed choices.  If the individual chooses 
 19.6   home and community-based services, the long-term care 
 19.7   consultation team member or case manager must complete a written 
 19.8   relocation plan within 20 working days of the visit.  The plan 
 19.9   shall describe the services needed to move out of the facility 
 19.10  and a time line for the move which is designed to ensure a 
 19.11  smooth transition to the individual's home and community. 
 19.12     (h) (i) An individual under 65 years of age residing in a 
 19.13  nursing facility shall receive a face-to-face assessment at 
 19.14  least every 12 months to review the person's service choices and 
 19.15  available alternatives unless the individual indicates, in 
 19.16  writing, that annual visits are not desired.  In this case, the 
 19.17  individual must receive a face-to-face assessment at least once 
 19.18  every 36 months for the same purposes. 
 19.19     (i) (j) Notwithstanding the provisions of subdivision 6, 
 19.20  the commissioner may pay county agencies directly for 
 19.21  face-to-face assessments for individuals under 65 years of age 
 19.22  who are being considered for placement or residing in a nursing 
 19.23  facility. 
 19.24     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 19.25  following final enactment. 
 19.26     Sec. 9.  Minnesota Statutes 2001 Supplement, section 
 19.27  256B.0913, subdivision 5, is amended to read: 
 19.28     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
 19.29  Alternative care funding may be used for payment of costs of: 
 19.30     (1) adult foster care; 
 19.31     (2) adult day care; 
 19.32     (3) home health aide; 
 19.33     (4) homemaker services; 
 19.34     (5) personal care; 
 19.35     (6) case management; 
 19.36     (7) respite care; 
 20.1      (8) assisted living; 
 20.2      (9) residential care services; 
 20.3      (10) care-related supplies and equipment; 
 20.4      (11) meals delivered to the home; 
 20.5      (12) transportation; 
 20.6      (13) skilled nursing; 
 20.7      (14) chore services; 
 20.8      (15) companion services; 
 20.9      (16) nutrition services; 
 20.10     (17) training for direct informal caregivers; 
 20.11     (18) telemedicine devices to monitor recipients in their 
 20.12  own homes as an alternative to hospital care, nursing home care, 
 20.13  or home visits; 
 20.14     (19) other services which includes discretionary funds and 
 20.15  direct cash payments to clients, following approval by the 
 20.16  commissioner, subject to the provisions of paragraph (j).  Total 
 20.17  annual payments for "other services" for all clients within a 
 20.18  county may not exceed either ten 25 percent of that county's 
 20.19  annual alternative care program base allocation or $5,000, 
 20.20  whichever is greater.  In no case shall this amount exceed the 
 20.21  county's total annual alternative care program base allocation; 
 20.22  and 
 20.23     (20) environmental modifications. 
 20.24     (b) The county agency must ensure that the funds are not 
 20.25  used to supplant services available through other public 
 20.26  assistance or services programs. 
 20.27     (c) Unless specified in statute, the service definitions 
 20.28  and standards for alternative care services shall be the same as 
 20.29  the service definitions and standards specified in the federally 
 20.30  approved elderly waiver plan.  Except for the county agencies' 
 20.31  approval of direct cash payments to clients as described in 
 20.32  paragraph (j) or for a provider of supplies and equipment when 
 20.33  the monthly cost of the supplies and equipment is less than 
 20.34  $250, persons or agencies must be employed by or under a 
 20.35  contract with the county agency or the public health nursing 
 20.36  agency of the local board of health in order to receive funding 
 21.1   under the alternative care program.  Supplies and equipment may 
 21.2   be purchased from a vendor not certified to participate in the 
 21.3   Medicaid program if the cost for the item is less than that of a 
 21.4   Medicaid vendor.  
 21.5      (d) The adult foster care rate shall be considered a 
 21.6   difficulty of care payment and shall not include room and 
 21.7   board.  The adult foster care rate shall be negotiated between 
 21.8   the county agency and the foster care provider.  The alternative 
 21.9   care payment for the foster care service in combination with the 
 21.10  payment for other alternative care services, including case 
 21.11  management, must not exceed the limit specified in subdivision 
 21.12  4, paragraph (a), clause (6). 
 21.13     (e) Personal care services must meet the service standards 
 21.14  defined in the federally approved elderly waiver plan, except 
 21.15  that a county agency may contract with a client's relative who 
 21.16  meets the relative hardship waiver requirement as defined in 
 21.17  section 256B.0627, subdivision 4, paragraph (b), clause (10), to 
 21.18  provide personal care services if the county agency ensures 
 21.19  supervision of this service by a registered nurse or mental 
 21.20  health practitioner.  
 21.21     (f) For purposes of this section, residential care services 
 21.22  are services which are provided to individuals living in 
 21.23  residential care homes.  Residential care homes are currently 
 21.24  licensed as board and lodging establishments and are registered 
 21.25  with the department of health as providing special services 
 21.26  under section 157.17 and are not subject to registration under 
 21.27  chapter 144D.  Residential care services are defined as 
 21.28  "supportive services" and "health-related services."  
 21.29  "Supportive services" means the provision of up to 24-hour 
 21.30  supervision and oversight.  Supportive services includes:  (1) 
 21.31  transportation, when provided by the residential care home only; 
 21.32  (2) socialization, when socialization is part of the plan of 
 21.33  care, has specific goals and outcomes established, and is not 
 21.34  diversional or recreational in nature; (3) assisting clients in 
 21.35  setting up meetings and appointments; (4) assisting clients in 
 21.36  setting up medical and social services; (5) providing assistance 
 22.1   with personal laundry, such as carrying the client's laundry to 
 22.2   the laundry room.  Assistance with personal laundry does not 
 22.3   include any laundry, such as bed linen, that is included in the 
 22.4   room and board rate.  "Health-related services" are limited to 
 22.5   minimal assistance with dressing, grooming, and bathing and 
 22.6   providing reminders to residents to take medications that are 
 22.7   self-administered or providing storage for medications, if 
 22.8   requested.  Individuals receiving residential care services 
 22.9   cannot receive homemaking services funded under this section.  
 22.10     (g) For the purposes of this section, "assisted living" 
 22.11  refers to supportive services provided by a single vendor to 
 22.12  clients who reside in the same apartment building of three or 
 22.13  more units which are not subject to registration under chapter 
 22.14  144D and are licensed by the department of health as a class A 
 22.15  home care provider or a class E home care provider.  Assisted 
 22.16  living services are defined as up to 24-hour supervision, and 
 22.17  oversight, supportive services as defined in clause (1), 
 22.18  individualized home care aide tasks as defined in clause (2), 
 22.19  and individualized home management tasks as defined in clause 
 22.20  (3) provided to residents of a residential center living in 
 22.21  their units or apartments with a full kitchen and bathroom.  A 
 22.22  full kitchen includes a stove, oven, refrigerator, food 
 22.23  preparation counter space, and a kitchen utensil storage 
 22.24  compartment.  Assisted living services must be provided by the 
 22.25  management of the residential center or by providers under 
 22.26  contract with the management or with the county. 
 22.27     (1) Supportive services include:  
 22.28     (i) socialization, when socialization is part of the plan 
 22.29  of care, has specific goals and outcomes established, and is not 
 22.30  diversional or recreational in nature; 
 22.31     (ii) assisting clients in setting up meetings and 
 22.32  appointments; and 
 22.33     (iii) providing transportation, when provided by the 
 22.34  residential center only.  
 22.35     (2) Home care aide tasks means:  
 22.36     (i) preparing modified diets, such as diabetic or low 
 23.1   sodium diets; 
 23.2      (ii) reminding residents to take regularly scheduled 
 23.3   medications or to perform exercises; 
 23.4      (iii) household chores in the presence of technically 
 23.5   sophisticated medical equipment or episodes of acute illness or 
 23.6   infectious disease; 
 23.7      (iv) household chores when the resident's care requires the 
 23.8   prevention of exposure to infectious disease or containment of 
 23.9   infectious disease; and 
 23.10     (v) assisting with dressing, oral hygiene, hair care, 
 23.11  grooming, and bathing, if the resident is ambulatory, and if the 
 23.12  resident has no serious acute illness or infectious disease.  
 23.13  Oral hygiene means care of teeth, gums, and oral prosthetic 
 23.14  devices.  
 23.15     (3) Home management tasks means:  
 23.16     (i) housekeeping; 
 23.17     (ii) laundry; 
 23.18     (iii) preparation of regular snacks and meals; and 
 23.19     (iv) shopping.  
 23.20     Individuals receiving assisted living services shall not 
 23.21  receive both assisted living services and homemaking services.  
 23.22  Individualized means services are chosen and designed 
 23.23  specifically for each resident's needs, rather than provided or 
 23.24  offered to all residents regardless of their illnesses, 
 23.25  disabilities, or physical conditions.  Assisted living services 
 23.26  as defined in this section shall not be authorized in boarding 
 23.27  and lodging establishments licensed according to sections 
 23.28  157.011 and 157.15 to 157.22. 
 23.29     (h) For establishments registered under chapter 144D, 
 23.30  assisted living services under this section means either the 
 23.31  services described in paragraph (g) and delivered by a class E 
 23.32  home care provider licensed by the department of health or the 
 23.33  services described under section 144A.4605 and delivered by an 
 23.34  assisted living home care provider or a class A home care 
 23.35  provider licensed by the commissioner of health. 
 23.36     (i) Payment for assisted living services and residential 
 24.1   care services shall be a monthly rate negotiated and authorized 
 24.2   by the county agency based on an individualized service plan for 
 24.3   each resident and may not cover direct rent or food costs.  
 24.4      (1) The individualized monthly negotiated payment for 
 24.5   assisted living services as described in paragraph (g) or (h), 
 24.6   and residential care services as described in paragraph (f), 
 24.7   shall not exceed the nonfederal share in effect on July 1 of the 
 24.8   state fiscal year for which the rate limit is being calculated 
 24.9   of the greater of either the statewide or any of the geographic 
 24.10  groups' weighted average monthly nursing facility payment rate 
 24.11  of the case mix resident class to which the alternative care 
 24.12  eligible client would be assigned under Minnesota Rules, parts 
 24.13  9549.0050 to 9549.0059, less the maintenance needs allowance as 
 24.14  described in section 256B.0915, subdivision 1d, paragraph (a), 
 24.15  until the first day of the state fiscal year in which a resident 
 24.16  assessment system, under section 256B.437, of nursing home rate 
 24.17  determination is implemented.  Effective on the first day of the 
 24.18  state fiscal year in which a resident assessment system, under 
 24.19  section 256B.437, of nursing home rate determination is 
 24.20  implemented and the first day of each subsequent state fiscal 
 24.21  year, the individualized monthly negotiated payment for the 
 24.22  services described in this clause shall not exceed the limit 
 24.23  described in this clause which was in effect on the last day of 
 24.24  the previous state fiscal year and which has been adjusted by 
 24.25  the greater of any legislatively adopted home and 
 24.26  community-based services cost-of-living percentage increase or 
 24.27  any legislatively adopted statewide percent rate increase for 
 24.28  nursing facilities. 
 24.29     (2) The individualized monthly negotiated payment for 
 24.30  assisted living services described under section 144A.4605 and 
 24.31  delivered by a provider licensed by the department of health as 
 24.32  a class A home care provider or an assisted living home care 
 24.33  provider and provided in a building that is registered as a 
 24.34  housing with services establishment under chapter 144D and that 
 24.35  provides 24-hour supervision in combination with the payment for 
 24.36  other alternative care services, including case management, must 
 25.1   not exceed the limit specified in subdivision 4, paragraph (a), 
 25.2   clause (6). 
 25.3      (j) A county agency may make payment from their alternative 
 25.4   care program allocation for "other services" which include use 
 25.5   of "discretionary funds" for services that are not otherwise 
 25.6   defined in this section and direct cash payments to the client 
 25.7   for the purpose of purchasing the services.  The following 
 25.8   provisions apply to payments under this paragraph: 
 25.9      (1) a cash payment to a client under this provision cannot 
 25.10  exceed 80 percent of the monthly payment limit for that client 
 25.11  as specified in subdivision 4, paragraph (a), clause (6); 
 25.12     (2) a county may not approve any cash payment for a client 
 25.13  who meets either of the following: 
 25.14     (i) has been assessed as having a dependency in 
 25.15  orientation, unless the client has an authorized 
 25.16  representative.  An "authorized representative" means an 
 25.17  individual who is at least 18 years of age and is designated by 
 25.18  the person or the person's legal representative to act on the 
 25.19  person's behalf.  This individual may be a family member, 
 25.20  guardian, representative payee, or other individual designated 
 25.21  by the person or the person's legal representative, if any, to 
 25.22  assist in purchasing and arranging for supports; or 
 25.23     (ii) is concurrently receiving adult foster care, 
 25.24  residential care, or assisted living services; 
 25.25     (3) cash payments to a person or a person's family will be 
 25.26  provided through a monthly payment and be in the form of cash, 
 25.27  voucher, or direct county payment to a vendor.  Fees or premiums 
 25.28  assessed to the person for eligibility for health and human 
 25.29  services are not reimbursable through this service option.  
 25.30  Services and goods purchased through cash payments must be 
 25.31  identified in the person's individualized care plan and must 
 25.32  meet all of the following criteria: 
 25.33     (i) they must be over and above the normal cost of caring 
 25.34  for the person if the person did not have functional 
 25.35  limitations; 
 25.36     (ii) they must be directly attributable to the person's 
 26.1   functional limitations; 
 26.2      (iii) they must have the potential to be effective at 
 26.3   meeting the goals of the program; 
 26.4      (iv) they must be consistent with the needs identified in 
 26.5   the individualized service plan.  The service plan shall specify 
 26.6   the needs of the person and family, the form and amount of 
 26.7   payment, the items and services to be reimbursed, and the 
 26.8   arrangements for management of the individual grant; and 
 26.9      (v) the person, the person's family, or the legal 
 26.10  representative shall be provided sufficient information to 
 26.11  ensure an informed choice of alternatives.  The local agency 
 26.12  shall document this information in the person's care plan, 
 26.13  including the type and level of expenditures to be reimbursed; 
 26.14     (4) the county, lead agency under contract, or tribal 
 26.15  government under contract to administer the alternative care 
 26.16  program shall not be liable for damages, injuries, or 
 26.17  liabilities sustained through the purchase of direct supports or 
 26.18  goods by the person, the person's family, or the authorized 
 26.19  representative with funds received through the cash payments 
 26.20  under this section.  Liabilities include, but are not limited 
 26.21  to, workers' compensation, the Federal Insurance Contributions 
 26.22  Act (FICA), or the Federal Unemployment Tax Act (FUTA); 
 26.23     (5) persons receiving grants under this section shall have 
 26.24  the following responsibilities: 
 26.25     (i) spend the grant money in a manner consistent with their 
 26.26  individualized service plan with the local agency; 
 26.27     (ii) notify the local agency of any necessary changes in 
 26.28  the grant expenditures; 
 26.29     (iii) arrange and pay for supports; and 
 26.30     (iv) inform the local agency of areas where they have 
 26.31  experienced difficulty securing or maintaining supports; and 
 26.32     (6) the county shall report client outcomes, services, and 
 26.33  costs under this paragraph in a manner prescribed by the 
 26.34  commissioner. 
 26.35     (k) Upon implementation of direct cash payments to clients 
 26.36  under this section, any person determined eligible for the 
 27.1   alternative care program who chooses a cash payment approved by 
 27.2   the county agency shall receive the cash payment under this 
 27.3   section and not under section 256.476 unless the person was 
 27.4   receiving a consumer support grant under section 256.476 before 
 27.5   implementation of direct cash payments under this section. 
 27.6      Sec. 10.  Minnesota Statutes 2001 Supplement, section 
 27.7   256B.0915, subdivision 3, is amended to read: 
 27.8      Subd. 3.  [LIMITS OF CASES, RATES, PAYMENTS, AND 
 27.9   FORECASTING.] (a) The number of medical assistance waiver 
 27.10  recipients that a county may serve must be allocated according 
 27.11  to the number of medical assistance waiver cases open on July 1 
 27.12  of each fiscal year.  Additional recipients may be served with 
 27.13  the approval of the commissioner. 
 27.14     (b) The monthly limit for the cost of waivered services to 
 27.15  an individual elderly waiver client shall be the weighted 
 27.16  average monthly nursing facility rate of the case mix resident 
 27.17  class to which the elderly waiver client would be assigned under 
 27.18  Minnesota Rules, parts 9549.0050 to 9549.0059, less the 
 27.19  recipient's maintenance needs allowance as described in 
 27.20  subdivision 1d, paragraph (a), until the first day of the state 
 27.21  fiscal year in which the resident assessment system as described 
 27.22  in section 256B.437 for nursing home rate determination is 
 27.23  implemented.  Effective on the first day of the state fiscal 
 27.24  year in which the resident assessment system as described in 
 27.25  section 256B.437 for nursing home rate determination is 
 27.26  implemented and the first day of each subsequent state fiscal 
 27.27  year, the monthly limit for the cost of waivered services to an 
 27.28  individual elderly waiver client shall be the rate of the case 
 27.29  mix resident class to which the waiver client would be assigned 
 27.30  under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect 
 27.31  on the last day of the previous state fiscal year, adjusted by 
 27.32  the greater of any legislatively adopted home and 
 27.33  community-based services cost-of-living percentage increase or 
 27.34  any legislatively adopted statewide percent rate increase for 
 27.35  nursing facilities. 
 27.36     (c) If extended medical supplies and equipment or 
 28.1   environmental modifications are or will be purchased for an 
 28.2   elderly waiver client, the costs may be prorated for up to 12 
 28.3   consecutive months beginning with the month of purchase.  If the 
 28.4   monthly cost of a recipient's waivered services exceeds the 
 28.5   monthly limit established in paragraph (b), the annual cost of 
 28.6   all waivered services shall be determined.  In this event, the 
 28.7   annual cost of all waivered services shall not exceed 12 times 
 28.8   the monthly limit of waivered services as described in paragraph 
 28.9   (b).  
 28.10     (d) For a person who is a nursing facility resident at the 
 28.11  time of requesting a determination of eligibility for elderly 
 28.12  waivered services, a monthly conversion limit for the cost of 
 28.13  elderly waivered services may be requested.  The monthly 
 28.14  conversion limit for the cost of elderly waiver services shall 
 28.15  be the resident class assigned under Minnesota Rules, parts 
 28.16  9549.0050 to 9549.0059, for that resident in the nursing 
 28.17  facility where the resident currently resides until July 1 of 
 28.18  the state fiscal year in which the resident assessment system as 
 28.19  described in section 256B.437 for nursing home rate 
 28.20  determination is implemented.  Effective on July 1 of the state 
 28.21  fiscal year in which the resident assessment system as described 
 28.22  in section 256B.437 for nursing home rate determination is 
 28.23  implemented, the monthly conversion limit for the cost of 
 28.24  elderly waiver services shall be the per diem nursing facility 
 28.25  rate as determined by the resident assessment system as 
 28.26  described in section 256B.437 for that resident in the nursing 
 28.27  facility where the resident currently resides multiplied by 365 
 28.28  and divided by 12, less the recipient's maintenance needs 
 28.29  allowance as described in subdivision 1d.  The initially 
 28.30  approved conversion rate may be adjusted by the greater of any 
 28.31  subsequent legislatively adopted home and community-based 
 28.32  services cost-of-living percentage increase or any subsequent 
 28.33  legislatively adopted statewide percentage rate increase for 
 28.34  nursing facilities.  The limit under this clause only applies to 
 28.35  persons discharged from a nursing facility after a minimum 
 28.36  30-day stay and found eligible for waivered services on or after 
 29.1   July 1, 1997.  The following costs must be included in 
 29.2   determining the total monthly costs for the waiver client: 
 29.3      (1) cost of all waivered services, including extended 
 29.4   medical supplies and equipment and environmental modifications; 
 29.5   and 
 29.6      (2) cost of skilled nursing, home health aide, and personal 
 29.7   care services reimbursable by medical assistance.  
 29.8      (e) Medical assistance funding for skilled nursing 
 29.9   services, private duty nursing, home health aide, and personal 
 29.10  care services for waiver recipients must be approved by the case 
 29.11  manager and included in the individual care plan. 
 29.12     (f) A county is not required to contract with a provider of 
 29.13  supplies and equipment if the monthly cost of the supplies and 
 29.14  equipment is less than $250.  
 29.15     (g) The adult foster care rate shall be considered a 
 29.16  difficulty of care payment and shall not include room and 
 29.17  board.  The adult foster care service rate shall be negotiated 
 29.18  between the county agency and the foster care provider.  The 
 29.19  elderly waiver payment for the foster care service in 
 29.20  combination with the payment for all other elderly waiver 
 29.21  services, including case management, must not exceed the limit 
 29.22  specified in paragraph (b). 
 29.23     (h) Payment for assisted living service shall be a monthly 
 29.24  rate negotiated and authorized by the county agency based on an 
 29.25  individualized service plan for each resident and may not cover 
 29.26  direct rent or food costs. 
 29.27     (1) The individualized monthly negotiated payment for 
 29.28  assisted living services as described in section 256B.0913, 
 29.29  subdivision 5, paragraph (g) or (h), and residential care 
 29.30  services as described in section 256B.0913, subdivision 5, 
 29.31  paragraph (f), shall not exceed the nonfederal share, in effect 
 29.32  on July 1 of the state fiscal year for which the rate limit is 
 29.33  being calculated, of the greater of either the statewide or any 
 29.34  of the geographic groups' weighted average monthly nursing 
 29.35  facility rate of the case mix resident class to which the 
 29.36  elderly waiver eligible client would be assigned under Minnesota 
 30.1   Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 
 30.2   allowance as described in subdivision 1d, paragraph (a), until 
 30.3   the July 1 of the state fiscal year in which the resident 
 30.4   assessment system as described in section 256B.437 for nursing 
 30.5   home rate determination is implemented.  Effective on July 1 of 
 30.6   the state fiscal year in which the resident assessment system as 
 30.7   described in section 256B.437 for nursing home rate 
 30.8   determination is implemented and July 1 of each subsequent state 
 30.9   fiscal year, the individualized monthly negotiated payment for 
 30.10  the services described in this clause shall not exceed the limit 
 30.11  described in this clause which was in effect on June 30 of the 
 30.12  previous state fiscal year and which has been adjusted by the 
 30.13  greater of any legislatively adopted home and community-based 
 30.14  services cost-of-living percentage increase or any legislatively 
 30.15  adopted statewide percent rate increase for nursing facilities. 
 30.16     (2) The individualized monthly negotiated payment for 
 30.17  assisted living services described in section 144A.4605 and 
 30.18  delivered by a provider licensed by the department of health as 
 30.19  a class A home care provider or an assisted living home care 
 30.20  provider and provided in a building that is registered as a 
 30.21  housing with services establishment under chapter 144D and that 
 30.22  provides 24-hour supervision in combination with the payment for 
 30.23  other elderly waiver services, including case management, must 
 30.24  not exceed the limit specified in paragraph (b). 
 30.25     (i) The county shall negotiate individual service rates 
 30.26  with vendors and may authorize payment for actual costs up to 
 30.27  the county's current approved rate.  Persons or agencies must be 
 30.28  employed by or under a contract with the county agency or the 
 30.29  public health nursing agency of the local board of health in 
 30.30  order to receive funding under the elderly waiver program, 
 30.31  except as a provider of supplies and equipment when the monthly 
 30.32  cost of the supplies and equipment is less than $250.  
 30.33     (j) Reimbursement for the medical assistance recipients 
 30.34  under the approved waiver shall be made from the medical 
 30.35  assistance account through the invoice processing procedures of 
 30.36  the department's Medicaid Management Information System (MMIS), 
 31.1   only with the approval of the client's case manager.  The budget 
 31.2   for the state share of the Medicaid expenditures shall be 
 31.3   forecasted with the medical assistance budget, and shall be 
 31.4   consistent with the approved waiver.  
 31.5      (k) To improve access to community services and eliminate 
 31.6   payment disparities between the alternative care program and the 
 31.7   elderly waiver, the commissioner shall establish statewide 
 31.8   maximum service rate limits and eliminate county-specific 
 31.9   service rate limits. 
 31.10     (1) Effective July 1, 2001, for service rate limits, except 
 31.11  those described or defined in paragraphs (g) and (h), the rate 
 31.12  limit for each service shall be the greater of the alternative 
 31.13  care statewide maximum rate or the elderly waiver statewide 
 31.14  maximum rate. 
 31.15     (2) Counties may negotiate individual service rates with 
 31.16  vendors for actual costs up to the statewide maximum service 
 31.17  rate limit. 
 31.18     (l) Beginning July 1, 1991, the state shall reimburse 
 31.19  counties according to the payment schedule in section 256.025 
 31.20  for the county share of costs incurred under this subdivision on 
 31.21  or after January 1, 1991, for individuals who are receiving 
 31.22  medical assistance. 
 31.23     Sec. 11.  Minnesota Statutes 2001 Supplement, section 
 31.24  256B.0924, subdivision 6, is amended to read: 
 31.25     Subd. 6.  [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 
 31.26  Medical assistance and MinnesotaCare payment for targeted case 
 31.27  management shall be made on a monthly basis.  In order to 
 31.28  receive payment for an eligible adult, the provider must 
 31.29  document at least one contact per month and not more than two 
 31.30  consecutive months without a face-to-face contact with the adult 
 31.31  or the adult's legal representative, family, primary caregiver, 
 31.32  or other relevant persons identified as necessary to the 
 31.33  development or implementation of the goals of the personal 
 31.34  service plan. 
 31.35     (b) Payment for targeted case management provided by county 
 31.36  staff under this subdivision shall be based on the monthly rate 
 32.1   methodology under section 256B.094, subdivision 6, paragraph 
 32.2   (b), calculated as one combined average rate together with adult 
 32.3   mental health case management under section 256B.0625, 
 32.4   subdivision 20, except for calendar year 2002.  In calendar year 
 32.5   2002, the rate for case management under this section shall be 
 32.6   the same as the rate for adult mental health case management in 
 32.7   effect as of December 31, 2001.  Billing and payment must 
 32.8   identify the recipient's primary population group to allow 
 32.9   tracking of revenues. 
 32.10     (c) Payment for targeted case management provided by 
 32.11  county-contracted vendors shall be based on a monthly rate 
 32.12  negotiated by the host county.  The negotiated rate must not 
 32.13  exceed the rate charged by the vendor for the same service to 
 32.14  other payers.  If the service is provided by a team of 
 32.15  contracted vendors, the county may negotiate a team rate with a 
 32.16  vendor who is a member of the team.  The team shall determine 
 32.17  how to distribute the rate among its members.  No reimbursement 
 32.18  received by contracted vendors shall be returned to the county, 
 32.19  except to reimburse the county for advance funding provided by 
 32.20  the county to the vendor. 
 32.21     (d) If the service is provided by a team that includes 
 32.22  contracted vendors and county staff, the costs for county staff 
 32.23  participation on the team shall be included in the rate for 
 32.24  county-provided services.  In this case, the contracted vendor 
 32.25  and the county may each receive separate payment for services 
 32.26  provided by each entity in the same month.  In order to prevent 
 32.27  duplication of services, the county must document, in the 
 32.28  recipient's file, the need for team targeted case management and 
 32.29  a description of the different roles of the team members. 
 32.30     (e) Notwithstanding section 256B.19, subdivision 1, the 
 32.31  nonfederal share of costs for targeted case management shall be 
 32.32  provided by the recipient's county of responsibility, as defined 
 32.33  in sections 256G.01 to 256G.12, from sources other than federal 
 32.34  funds or funds used to match other federal funds. 
 32.35     (f) The commissioner may suspend, reduce, or terminate 
 32.36  reimbursement to a provider that does not meet the reporting or 
 33.1   other requirements of this section.  The county of 
 33.2   responsibility, as defined in sections 256G.01 to 256G.12, is 
 33.3   responsible for any federal disallowances.  The county may share 
 33.4   this responsibility with its contracted vendors. 
 33.5      (g) The commissioner shall set aside five percent of the 
 33.6   federal funds received under this section for use in reimbursing 
 33.7   the state for costs of developing and implementing this section. 
 33.8      (h) Notwithstanding section 256.025, subdivision 2, 
 33.9   payments to counties for targeted case management expenditures 
 33.10  under this section shall only be made from federal earnings from 
 33.11  services provided under this section.  Payments to contracted 
 33.12  vendors shall include both the federal earnings and the county 
 33.13  share. 
 33.14     (i) Notwithstanding section 256B.041, county payments for 
 33.15  the cost of case management services provided by county staff 
 33.16  shall not be made to the state treasurer.  For the purposes of 
 33.17  targeted case management services provided by county staff under 
 33.18  this section, the centralized disbursement of payments to 
 33.19  counties under section 256B.041 consists only of federal 
 33.20  earnings from services provided under this section. 
 33.21     (j) If the recipient is a resident of a nursing facility, 
 33.22  intermediate care facility, or hospital, and the recipient's 
 33.23  institutional care is paid by medical assistance, payment for 
 33.24  targeted case management services under this subdivision is 
 33.25  limited to the last 180 days of the recipient's residency in 
 33.26  that facility and may not exceed more than six months in a 
 33.27  calendar year. 
 33.28     (k) Payment for targeted case management services under 
 33.29  this subdivision shall not duplicate payments made under other 
 33.30  program authorities for the same purpose. 
 33.31     (l) Any growth in targeted case management services and 
 33.32  cost increases under this section shall be the responsibility of 
 33.33  the counties. 
 33.34     Sec. 12.  Minnesota Statutes 2001 Supplement, section 
 33.35  256B.0951, subdivision 7, is amended to read: 
 33.36     Subd. 7.  [WAIVER OF RULES.] If a federal waiver is 
 34.1   approved under subdivision 8, the commissioner of health may 
 34.2   exempt residents of intermediate care facilities for persons 
 34.3   with mental retardation (ICFs/MR) who participate in the 
 34.4   three-year alternative quality assurance pilot project 
 34.5   established in section 256B.095 from the requirements of 
 34.6   Minnesota Rules, chapter 4665, upon approval by the federal 
 34.7   government of a waiver of federal certification requirements for 
 34.8   ICFs/MR.  
 34.9      Sec. 13.  Minnesota Statutes 2001 Supplement, section 
 34.10  256B.0951, subdivision 8, is amended to read: 
 34.11     Subd. 8.  [FEDERAL WAIVER.] The commissioner of human 
 34.12  services shall seek federal authority to waive provisions of 
 34.13  intermediate care facilities for persons with mental retardation 
 34.14  (ICFs/MR) regulations to enable the demonstration and evaluation 
 34.15  of the alternative quality assurance system for ICFs/MR under 
 34.16  the project.  The commissioner of human services shall apply for 
 34.17  any necessary waivers as soon as practicable. a federal waiver 
 34.18  to allow intermediate care facilities for persons with mental 
 34.19  retardation (ICFs/MR) in Region 10 of Minnesota to participate 
 34.20  in the alternative licensing system.  If it is necessary for 
 34.21  purposes of participation in this alternative licensing system 
 34.22  for a facility to be decertified as an ICF/MR facility according 
 34.23  to the terms of the federal waiver, when the facility seeks 
 34.24  recertification under the provisions of ICF/MR regulations at 
 34.25  the end of the demonstration project, it will not be considered 
 34.26  a new ICF/MR as defined under section 252.291 provided the 
 34.27  licensed capacity of the facility did not increase during its 
 34.28  participation in the alternative licensing system.  The 
 34.29  provisions of sections 252.82, 252.292, and 256B.5011 to 
 34.30  256B.5015 will remain applicable for counties in Region 10 of 
 34.31  Minnesota and the ICFs/MR located within those counties 
 34.32  notwithstanding a county's participation in the alternative 
 34.33  licensing system. 
 34.34     Sec. 14.  Minnesota Statutes 2001 Supplement, section 
 34.35  256B.437, subdivision 6, is amended to read: 
 34.36     Subd. 6.  [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 
 35.1   commissioner of human services shall calculate the amount of the 
 35.2   planned closure rate adjustment available under subdivision 3, 
 35.3   paragraph (b), for up to 5,140 beds according to clauses (1) to 
 35.4   (4): 
 35.5      (1) the amount available is the net reduction of nursing 
 35.6   facility beds multiplied by $2,080; 
 35.7      (2) the total number of beds in the nursing facility or 
 35.8   facilities receiving the planned closure rate adjustment must be 
 35.9   identified; 
 35.10     (3) capacity days are determined by multiplying the number 
 35.11  determined under clause (2) by 365; and 
 35.12     (4) the planned closure rate adjustment is the amount 
 35.13  available in clause (1), divided by capacity days determined 
 35.14  under clause (3). 
 35.15     (b) A planned closure rate adjustment under this section is 
 35.16  effective on the first day of the month following completion of 
 35.17  closure of the facility designated for closure in the 
 35.18  application and becomes part of the nursing facility's total 
 35.19  operating payment rate. 
 35.20     (c) Applicants may use the planned closure rate adjustment 
 35.21  to allow for a property payment for a new nursing facility or an 
 35.22  addition to an existing nursing facility or as an operating 
 35.23  payment rate adjustment.  Applications approved under this 
 35.24  subdivision are exempt from other requirements for moratorium 
 35.25  exceptions under section 144A.073, subdivisions 2 and 3. 
 35.26     (d) Upon the request of a closing facility, the 
 35.27  commissioner must allow the facility a closure rate adjustment 
 35.28  as provided under section 144A.161, subdivision 10. 
 35.29     (e) A facility that has received a planned closure rate 
 35.30  adjustment may reassign it to another facility that is under the 
 35.31  same ownership at any time within three years of its effective 
 35.32  date.  The amount of the adjustment shall be computed according 
 35.33  to paragraph (a). 
 35.34     Sec. 15.  [CASE MANAGEMENT STUDY.] 
 35.35     The commissioner of human services shall study case 
 35.36  management services for persons with disabilities, in 
 36.1   consultation with consumers, consumer advocates, and local 
 36.2   social service agencies.  The commissioner shall report to the 
 36.3   chairs and ranking minority members of the house and senate 
 36.4   committees having jurisdiction over health and human services 
 36.5   policy and funding, by January 15, 2003, on strategies that: 
 36.6      (1) streamline administration; 
 36.7      (2) improve case management service availability across the 
 36.8   state; 
 36.9      (3) enhance consumer access to needed services and 
 36.10  supports; 
 36.11     (4) improve accountability and the use of performance 
 36.12  measures; 
 36.13     (5) provide for consumer choice of vendor; and 
 36.14     (6) improve the financing of case management services. 
 36.15     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 36.16  following final enactment. 
 36.17                             ARTICLE 2 
 36.18                             LICENSING 
 36.19     Section 1.  Minnesota Statutes 2001 Supplement, section 
 36.20  245A.04, subdivision 3b, is amended to read: 
 36.21     Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
 36.22  individual who is the subject of the disqualification may 
 36.23  request a reconsideration of the disqualification.  
 36.24     The individual must submit the request for reconsideration 
 36.25  to the commissioner in writing.  A request for reconsideration 
 36.26  for an individual who has been sent a notice of disqualification 
 36.27  under subdivision 3a, paragraph (b), clause (1) or (2), must be 
 36.28  submitted within 30 calendar days of the disqualified 
 36.29  individual's receipt of the notice of disqualification.  Upon 
 36.30  showing that the information in clause (1) or (2) cannot be 
 36.31  obtained within 30 days, the disqualified individual may request 
 36.32  additional time, not to exceed 30 days, to obtain that 
 36.33  information.  A request for reconsideration for an individual 
 36.34  who has been sent a notice of disqualification under subdivision 
 36.35  3a, paragraph (b), clause (3), must be submitted within 15 
 36.36  calendar days of the disqualified individual's receipt of the 
 37.1   notice of disqualification.  An individual who was determined to 
 37.2   have maltreated a child under section 626.556 or a vulnerable 
 37.3   adult under section 626.557, and who was disqualified under this 
 37.4   section on the basis of serious or recurring maltreatment, may 
 37.5   request reconsideration of both the maltreatment and the 
 37.6   disqualification determinations.  The request for 
 37.7   reconsideration of the maltreatment determination and the 
 37.8   disqualification must be submitted within 30 calendar days of 
 37.9   the individual's receipt of the notice of disqualification.  
 37.10  Removal of a disqualified individual from direct contact shall 
 37.11  be ordered if the individual does not request reconsideration 
 37.12  within the prescribed time, and for an individual who submits a 
 37.13  timely request for reconsideration, if the disqualification is 
 37.14  not set aside.  The individual must present information showing 
 37.15  that: 
 37.16     (1) the information the commissioner relied upon is 
 37.17  incorrect or inaccurate.  If the basis of a reconsideration 
 37.18  request is that a maltreatment determination or disposition 
 37.19  under section 626.556 or 626.557 is incorrect, and the 
 37.20  commissioner has issued a final order in an appeal of that 
 37.21  determination or disposition under section 256.045 or 245A.08, 
 37.22  subdivision 5, the commissioner's order is conclusive on the 
 37.23  issue of maltreatment.  If the individual did not request 
 37.24  reconsideration of the maltreatment determination, the 
 37.25  maltreatment determination is deemed conclusive; or 
 37.26     (2) the subject of the study does not pose a risk of harm 
 37.27  to any person served by the applicant, license holder, or 
 37.28  registrant under section 144A.71, subdivision 1. 
 37.29     (b) The commissioner shall rescind the disqualification if 
 37.30  the commissioner finds that the information relied on to 
 37.31  disqualify the subject is incorrect.  The commissioner may set 
 37.32  aside the disqualification under this section if the 
 37.33  commissioner finds that the individual does not pose a risk of 
 37.34  harm to any person served by the applicant, license holder, or 
 37.35  registrant under section 144A.71, subdivision 1.  In determining 
 37.36  that an individual does not pose a risk of harm, the 
 38.1   commissioner shall consider the nature, severity, and 
 38.2   consequences of the event or events that lead to 
 38.3   disqualification, whether there is more than one disqualifying 
 38.4   event, the age and vulnerability of the victim at the time of 
 38.5   the event, the harm suffered by the victim, the similarity 
 38.6   between the victim and persons served by the program, the time 
 38.7   elapsed without a repeat of the same or similar event, 
 38.8   documentation of successful completion by the individual studied 
 38.9   of training or rehabilitation pertinent to the event, and any 
 38.10  other information relevant to reconsideration.  In reviewing a 
 38.11  disqualification under this section, the commissioner shall give 
 38.12  preeminent weight to the safety of each person to be served by 
 38.13  the license holder, applicant, or registrant under section 
 38.14  144A.71, subdivision 1, over the interests of the license 
 38.15  holder, applicant, or registrant under section 144A.71, 
 38.16  subdivision 1. 
 38.17     (c) Unless the information the commissioner relied on in 
 38.18  disqualifying an individual is incorrect, the commissioner may 
 38.19  not set aside the disqualification of an individual in 
 38.20  connection with a license to provide family day care for 
 38.21  children, foster care for children in the provider's own home, 
 38.22  or foster care or day care services for adults in the provider's 
 38.23  own home if: 
 38.24     (1) less than ten years have passed since the discharge of 
 38.25  the sentence imposed for the offense; and the individual has 
 38.26  been convicted of a violation of any offense listed in sections 
 38.27  609.20 (manslaughter in the first degree), 609.205 (manslaughter 
 38.28  in the second degree), criminal vehicular homicide under 609.21 
 38.29  (criminal vehicular homicide and injury), 609.215 (aiding 
 38.30  suicide or aiding attempted suicide), felony violations under 
 38.31  609.221 to 609.2231 (assault in the first, second, third, or 
 38.32  fourth degree), 609.713 (terroristic threats), 609.235 (use of 
 38.33  drugs to injure or to facilitate crime), 609.24 (simple 
 38.34  robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 
 38.35  609.255 (false imprisonment), 609.561 or 609.562 (arson in the 
 38.36  first or second degree), 609.71 (riot), burglary in the first or 
 39.1   second degree under 609.582 (burglary), 609.66 (dangerous 
 39.2   weapon), 609.665 (spring guns), 609.67 (machine guns and 
 39.3   short-barreled shotguns), 609.749 (harassment; stalking), 
 39.4   152.021 or 152.022 (controlled substance crime in the first or 
 39.5   second degree), 152.023, subdivision 1, clause (3) or (4), or 
 39.6   subdivision 2, clause (4) (controlled substance crime in the 
 39.7   third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
 39.8   (controlled substance crime in the fourth degree), 152.024 or 
 39.9   152.025 (controlled substance crime in the fourth or fifth 
 39.10  degree), 609.224, subdivision 2, paragraph (c) (fifth-degree 
 39.11  assault by a caregiver against a vulnerable adult), 609.228 
 39.12  (great bodily harm caused by distribution of drugs), 609.23 
 39.13  (mistreatment of persons confined), 609.231 (mistreatment of 
 39.14  residents or patients), 609.2325 (criminal abuse of a vulnerable 
 39.15  adult), 609.233 (criminal neglect of a vulnerable adult), 
 39.16  609.2335 (financial exploitation of a vulnerable adult), 609.234 
 39.17  (failure to report), 609.265 (abduction), 609.2664 to 609.2665 
 39.18  (manslaughter of an unborn child in the first or second degree), 
 39.19  609.267 to 609.2672 (assault of an unborn child in the first, 
 39.20  second, or third degree), 609.268 (injury or death of an unborn 
 39.21  child in the commission of a crime), 617.293 (disseminating or 
 39.22  displaying harmful material to minors), a felony level 
 39.23  conviction involving alcohol or drug use, a gross misdemeanor 
 39.24  offense under 609.324, subdivision 1 (other prohibited acts), a 
 39.25  gross misdemeanor offense under 609.378 (neglect or endangerment 
 39.26  of a child), a gross misdemeanor offense under 609.377 
 39.27  (malicious punishment of a child), 609.72, subdivision 3 
 39.28  (disorderly conduct against a vulnerable adult); or an attempt 
 39.29  or conspiracy to commit any of these offenses, as each of these 
 39.30  offenses is defined in Minnesota Statutes; or an offense in any 
 39.31  other state, the elements of which are substantially similar to 
 39.32  the elements of any of the foregoing offenses; 
 39.33     (2) regardless of how much time has passed since the 
 39.34  involuntary termination of parental rights under section 
 39.35  260C.301 or the discharge of the sentence imposed for the 
 39.36  offense, the individual was convicted of a violation of any 
 40.1   offense listed in sections 609.185 to 609.195 (murder in the 
 40.2   first, second, or third degree), 609.20 (manslaughter in the 
 40.3   first degree), 609.205 (manslaughter in the second degree), 
 40.4   criminal vehicular homicide under 609.21 (criminal vehicular 
 40.5   homicide and injury), 609.235 (use of drugs to injure or to 
 40.6   facilitate crime), 609.24 (simple robbery), 609.245 (aggravated 
 40.7   robbery), 609.25 (kidnapping), 609.255 (false imprisonment), 
 40.8   609.561 or 609.562 (arson in the first or second degree), 
 40.9   609.749 (harassment; stalking), 609.228 (great bodily harm 
 40.10  caused by distribution of drugs), 609.2664 to 609.2665 
 40.11  (manslaughter of an unborn child in the first or second degree), 
 40.12  609.267 or 609.2671 (assault of an unborn child in the first or 
 40.13  second degree), 609.268 (injury or death of an unborn child in 
 40.14  the commission of a crime), 609.221 to 609.223 (assault in the 
 40.15  first, second, or third degree), 609.582 (burglary in the first 
 40.16  degree), 609.66, subdivision 1e (drive-by shooting), 609.165 
 40.17  (felon ineligible to possess firearm), 609.498, subdivision 1 
 40.18  (tampering with a witness), 609.687 (adulteration), 609.855, 
 40.19  subdivision 5 (shooting in or at a public transit vehicle or 
 40.20  facility), 609.229 (crime committed for benefit of a gang), 
 40.21  609.2661 to 609.2663 (murder of an unborn child in the first, 
 40.22  second, or third degree), a felony offense under 609.377 
 40.23  (malicious punishment of a child), a felony offense under 
 40.24  609.324, subdivision 1 (other prohibited acts), a felony offense 
 40.25  under 609.378 (neglect or endangerment of a child), 609.322 
 40.26  (solicitation, inducement, and promotion of prostitution), 
 40.27  609.342 to 609.345 (criminal sexual conduct in the first, 
 40.28  second, third, or fourth degree), 609.352 (solicitation of 
 40.29  children to engage in sexual conduct), 617.246 (use of minors in 
 40.30  a sexual performance), 617.247 (possession of pictorial 
 40.31  representations of a minor), 609.365 (incest), a felony offense 
 40.32  under sections 609.2242 and 609.2243 (domestic assault), a 
 40.33  felony offense under 624.713 (certain persons not to possess 
 40.34  pistols), 152.021, 152.022, or 152.023 (controlled substance 
 40.35  crime in the first, second, or third degree), a felony offense 
 40.36  of spousal abuse, a felony offense of child abuse or neglect, a 
 41.1   felony offense of a crime against children, or an attempt or 
 41.2   conspiracy to commit any of these offenses as defined in 
 41.3   Minnesota Statutes, or an offense in any other state, the 
 41.4   elements of which are substantially similar to any of the 
 41.5   foregoing offenses; 
 41.6      (3) within the seven years preceding the study, the 
 41.7   individual committed an act that constitutes maltreatment of a 
 41.8   child under section 626.556, subdivision 10e, and that resulted 
 41.9   in substantial bodily harm as defined in section 609.02, 
 41.10  subdivision 7a, or substantial mental or emotional harm as 
 41.11  supported by competent psychological or psychiatric evidence; or 
 41.12     (4) within the seven years preceding the study, the 
 41.13  individual was determined under section 626.557 to be the 
 41.14  perpetrator of a substantiated incident of maltreatment of a 
 41.15  vulnerable adult that resulted in substantial bodily harm as 
 41.16  defined in section 609.02, subdivision 7a, or substantial mental 
 41.17  or emotional harm as supported by competent psychological or 
 41.18  psychiatric evidence. 
 41.19     In the case of any ground for disqualification under 
 41.20  clauses (1) to (4), if the act was committed by an individual 
 41.21  other than the applicant, license holder, or registrant under 
 41.22  section 144A.71, subdivision 1, residing in the applicant's or 
 41.23  license holder's home, or the home of a registrant under section 
 41.24  144A.71, subdivision 1, the applicant, license holder, or 
 41.25  registrant under section 144A.71, subdivision 1, may seek 
 41.26  reconsideration when the individual who committed the act no 
 41.27  longer resides in the home.  
 41.28     The disqualification periods provided under clauses (1), 
 41.29  (3), and (4) are the minimum applicable disqualification 
 41.30  periods.  The commissioner may determine that an individual 
 41.31  should continue to be disqualified from licensure or 
 41.32  registration under section 144A.71, subdivision 1, because the 
 41.33  license holder, applicant, or registrant under section 144A.71, 
 41.34  subdivision 1, poses a risk of harm to a person served by that 
 41.35  individual after the minimum disqualification period has passed. 
 41.36     (d) The commissioner shall respond in writing or by 
 42.1   electronic transmission to all reconsideration requests for 
 42.2   which the basis for the request is that the information relied 
 42.3   upon by the commissioner to disqualify is incorrect or 
 42.4   inaccurate within 30 working days of receipt of a request and 
 42.5   all relevant information.  If the basis for the request is that 
 42.6   the individual does not pose a risk of harm, the commissioner 
 42.7   shall respond to the request within 15 working days after 
 42.8   receiving the request for reconsideration and all relevant 
 42.9   information.  If the request is based on both the correctness or 
 42.10  accuracy of the information relied on to disqualify the 
 42.11  individual and the risk of harm, the commissioner shall respond 
 42.12  to the request within 45 working days after receiving the 
 42.13  request for reconsideration and all relevant information.  If 
 42.14  the disqualification is set aside, the commissioner shall notify 
 42.15  the applicant or license holder in writing or by electronic 
 42.16  transmission of the decision. 
 42.17     (e) Except as provided in subdivision 3c, if a 
 42.18  disqualification is not set aside or is not rescinded, an 
 42.19  individual who was disqualified on the basis of a preponderance 
 42.20  of evidence that the individual committed an act or acts that 
 42.21  meet the definition of any of the crimes lists in subdivision 
 42.22  3d, paragraph (a), clauses (1) to (4); or for failure to make 
 42.23  required reports under section 626.556, subdivision 3, or 
 42.24  626.557, subdivision 3, pursuant to subdivision 3d, paragraph 
 42.25  (a), clause (4), may request a fair hearing under section 
 42.26  256.045.  Except as provided under subdivision 3c, the 
 42.27  commissioner's final order for an individual under this 
 42.28  paragraph is conclusive on the issue of maltreatment and 
 42.29  disqualification, including for purposes of subsequent studies 
 42.30  conducted under subdivision 3, and is the only administrative 
 42.31  appeal of the final agency determination, specifically, 
 42.32  including a challenge to the accuracy and completeness of data 
 42.33  under section 13.04.  
 42.34     (f) Except as provided under subdivision 3c, if an 
 42.35  individual was disqualified on the basis of a determination of 
 42.36  maltreatment under section 626.556 or 626.557, which was serious 
 43.1   or recurring, and the individual has requested reconsideration 
 43.2   of the maltreatment determination under section 626.556, 
 43.3   subdivision 10i, or 626.557, subdivision 9d, and also requested 
 43.4   reconsideration of the disqualification under this subdivision, 
 43.5   reconsideration of the maltreatment determination and 
 43.6   reconsideration of the disqualification shall be consolidated 
 43.7   into a single reconsideration.  For maltreatment and 
 43.8   disqualification determinations made by county agencies, the 
 43.9   consolidated reconsideration shall be conducted by the county 
 43.10  agency.  Except as provided under subdivision 3c, if an 
 43.11  individual who was disqualified on the basis of serious or 
 43.12  recurring maltreatment requests a fair hearing on the 
 43.13  maltreatment determination under section 626.556, subdivision 
 43.14  10i, or 626.557, subdivision 9d, the scope of the fair hearing 
 43.15  under section 256.045 shall include the maltreatment 
 43.16  determination and the disqualification.  Except as provided 
 43.17  under subdivision 3c, the commissioner's final order for an 
 43.18  individual under this paragraph is conclusive on the issue of 
 43.19  maltreatment and disqualification, including for purposes of 
 43.20  subsequent studies conducted under subdivision 3, and is the 
 43.21  only administrative appeal of the final agency determination, 
 43.22  specifically, including a challenge to the accuracy and 
 43.23  completeness of data under section 13.04. 
 43.24     Sec. 2.  Minnesota Statutes 2001 Supplement, section 
 43.25  245A.04, subdivision 3d, is amended to read: 
 43.26     Subd. 3d.  [DISQUALIFICATION.] (a) Upon receipt of 
 43.27  information showing, or when a background study completed under 
 43.28  subdivision 3 shows any of the following:  a conviction of one 
 43.29  or more crimes listed in clauses (1) to (4); the individual has 
 43.30  admitted to or a preponderance of the evidence indicates the 
 43.31  individual has committed an act or acts that meet the definition 
 43.32  of any of the crimes listed in clauses (1) to (4); or an 
 43.33  investigation results in an administrative determination listed 
 43.34  under clause (4), the individual shall be disqualified from any 
 43.35  position allowing direct contact with persons receiving services 
 43.36  from the license holder, entity identified in subdivision 3, 
 44.1   paragraph (a), or registrant under section 144A.71, subdivision 
 44.2   1, and for individuals studied under section 245A.04, 
 44.3   subdivision 3, paragraph (c), clauses (2), (6), and (7), the 
 44.4   individual shall also be disqualified from access to a person 
 44.5   receiving services from the license holder: 
 44.6      (1) regardless of how much time has passed since the 
 44.7   involuntary termination of parental rights under section 
 44.8   260C.301 or the discharge of the sentence imposed for the 
 44.9   offense, and unless otherwise specified, regardless of the level 
 44.10  of the conviction, the individual was convicted of any of the 
 44.11  following offenses:  sections 609.185 (murder in the first 
 44.12  degree); 609.19 (murder in the second degree); 609.195 (murder 
 44.13  in the third degree); 609.2661 (murder of an unborn child in the 
 44.14  first degree); 609.2662 (murder of an unborn child in the second 
 44.15  degree); 609.2663 (murder of an unborn child in the third 
 44.16  degree); 609.20 (manslaughter in the first degree); 609.205 
 44.17  (manslaughter in the second degree); 609.21 (criminal vehicular 
 44.18  homicide and injury); 609.221 to 609.223 (assault in the first, 
 44.19  second, or third degree); 609.228 (great bodily harm caused by 
 44.20  distribution of drugs); 609.235 (use of drugs to injure or 
 44.21  facilitate crime); 609.24 (simple robbery); 609.245 (aggravated 
 44.22  robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 
 44.23  609.267 (assault of an unborn child in the first degree); 
 44.24  609.2671 (assault of an unborn child in the second degree); 
 44.25  609.268 (injury or death of an unborn child in the commission of 
 44.26  a crime); 609.561 (arson in the first degree); 609.562 (arson in 
 44.27  the second degree); 609.582 (burglary); 609.749 (harassment; 
 44.28  stalking; penalties); 609.165 (felon ineligible to possess 
 44.29  firearm); 609.66, subdivision 1e (drive-by shooting); 609.687 
 44.30  (adulteration); 609.855, subdivision 5 (shooting at or in a 
 44.31  public transit vehicle or facility); felony offense under 
 44.32  624.713 (certain persons not to possess pistols); 609.229 (crime 
 44.33  committed for benefit of a gang); 609.498, subdivision 1 
 44.34  (tampering with a witness); 609.2664 (manslaughter of an unborn 
 44.35  child in the first degree); 609.2665 (manslaughter of an unborn 
 44.36  child in the second degree); 152.021, 152.022, or 152.023 
 45.1   (controlled substance crime in the first, second, or third 
 45.2   degree); 609.322 (solicitation, inducement, and promotion of 
 45.3   prostitution); 609.342 (criminal sexual conduct in the first 
 45.4   degree); 609.343 (criminal sexual conduct in the second degree); 
 45.5   609.344 (criminal sexual conduct in the third degree); 609.345 
 45.6   (criminal sexual conduct in the fourth degree); 609.352 
 45.7   (solicitation of children to engage in sexual conduct); 609.365 
 45.8   (incest); felony offense under 609.377 (malicious punishment of 
 45.9   a child); a felony offense under 609.378 (neglect or 
 45.10  endangerment of a child); a felony offense under 609.324, 
 45.11  subdivision 1 (other prohibited acts); 617.246 (use of minors in 
 45.12  sexual performance prohibited); 617.247 (possession of pictorial 
 45.13  representations of minors); a felony offense under sections 
 45.14  609.2242 and 609.2243 (domestic assault), a felony offense of 
 45.15  spousal abuse, a felony offense of child abuse or neglect, a 
 45.16  felony offense of a crime against children; or attempt or 
 45.17  conspiracy to commit any of these offenses as defined in 
 45.18  Minnesota Statutes, or an offense in any other state or country, 
 45.19  where the elements are substantially similar to any of the 
 45.20  offenses listed in this clause; 
 45.21     (2) if less than 15 years have passed since the discharge 
 45.22  of the sentence imposed for the offense; and the individual has 
 45.23  received a felony conviction for a violation of any of these 
 45.24  offenses:  sections 609.20 (manslaughter in the first degree); 
 45.25  609.205 (manslaughter in the second degree); 609.21 (criminal 
 45.26  vehicular homicide and injury); 609.215 (suicide); 609.221 to 
 45.27  609.2231 (assault in the first, second, third, or fourth 
 45.28  degree); repeat offenses under 609.224 (assault in the fifth 
 45.29  degree); repeat offenses under 609.3451 (criminal sexual conduct 
 45.30  in the fifth degree); 609.713 (terroristic threats); 609.235 
 45.31  (use of drugs to injure or facilitate crime); 609.24 (simple 
 45.32  robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 
 45.33  609.255 (false imprisonment); 609.561 (arson in the first 
 45.34  degree); 609.562 (arson in the second degree); 609.563 (arson in 
 45.35  the third degree); repeat offenses under 617.23 (indecent 
 45.36  exposure; penalties); repeat offenses under 617.241 (obscene 
 46.1   materials and performances; distribution and exhibition 
 46.2   prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 
 46.3   609.67 (machine guns and short-barreled shotguns); 609.749 
 46.4   (harassment; stalking; penalties); 609.228 (great bodily harm 
 46.5   caused by distribution of drugs); 609.2325 (criminal abuse of a 
 46.6   vulnerable adult); 609.2664 (manslaughter of an unborn child in 
 46.7   the first degree); 609.2665 (manslaughter of an unborn child in 
 46.8   the second degree); 609.267 (assault of an unborn child in the 
 46.9   first degree); 609.2671 (assault of an unborn child in the 
 46.10  second degree); 609.268 (injury or death of an unborn child in 
 46.11  the commission of a crime); 609.52 (theft); 609.2335 (financial 
 46.12  exploitation of a vulnerable adult); 609.521 (possession of 
 46.13  shoplifting gear); 609.582 (burglary); 609.625 (aggravated 
 46.14  forgery); 609.63 (forgery); 609.631 (check forgery; offering a 
 46.15  forged check); 609.635 (obtaining signature by false pretense); 
 46.16  609.27 (coercion); 609.275 (attempt to coerce); 609.687 
 46.17  (adulteration); 260C.301 (grounds for termination of parental 
 46.18  rights); chapter 152 (drugs; controlled substance); 152.024 or 
 46.19  152.025 (controlled substance crime in the fourth or fifth 
 46.20  degree); and a felony level conviction involving alcohol or drug 
 46.21  use.  An attempt or conspiracy to commit any of these offenses, 
 46.22  as each of these offenses is defined in Minnesota Statutes; or 
 46.23  an offense in any other state or country, the elements of which 
 46.24  are substantially similar to the elements of the offenses in 
 46.25  this clause.  If the individual studied is convicted of one of 
 46.26  the felonies listed in this clause, but the sentence is a gross 
 46.27  misdemeanor or misdemeanor disposition, the lookback period for 
 46.28  the conviction is the period applicable to the disposition, that 
 46.29  is the period for gross misdemeanors or misdemeanors; 
 46.30     (3) if less than ten years have passed since the discharge 
 46.31  of the sentence imposed for the offense; and the individual has 
 46.32  received a gross misdemeanor conviction for a violation of any 
 46.33  of the following offenses:  sections 609.224 (assault in the 
 46.34  fifth degree); 609.2242 and 609.2243 (domestic assault); 
 46.35  violation of an order for protection under 518B.01, subdivision 
 46.36  14; 609.3451 (criminal sexual conduct in the fifth degree); 
 47.1   repeat offenses under 609.746 (interference with privacy); 
 47.2   repeat offenses under 617.23 (indecent exposure); 617.241 
 47.3   (obscene materials and performances); 617.243 (indecent 
 47.4   literature, distribution); 617.293 (harmful materials; 
 47.5   dissemination and display to minors prohibited); 609.71 (riot); 
 47.6   609.66 (dangerous weapons); 609.749 (harassment; stalking; 
 47.7   penalties); 609.224, subdivision 2, paragraph (c) (assault in 
 47.8   the fifth degree by a caregiver against a vulnerable adult); 
 47.9   609.23 (mistreatment of persons confined); 609.231 (mistreatment 
 47.10  of residents or patients); 609.2325 (criminal abuse of a 
 47.11  vulnerable adult); 609.233 (criminal neglect of a vulnerable 
 47.12  adult); 609.2335 (financial exploitation of a vulnerable adult); 
 47.13  609.234 (failure to report maltreatment of a vulnerable adult); 
 47.14  609.72, subdivision 3 (disorderly conduct against a vulnerable 
 47.15  adult); 609.265 (abduction); 609.378 (neglect or endangerment of 
 47.16  a child); 609.377 (malicious punishment of a child); 609.324, 
 47.17  subdivision 1a (other prohibited acts; minor engaged in 
 47.18  prostitution); 609.33 (disorderly house); 609.52 (theft); 
 47.19  609.582 (burglary); 609.631 (check forgery; offering a forged 
 47.20  check); 609.275 (attempt to coerce); or an attempt or conspiracy 
 47.21  to commit any of these offenses, as each of these offenses is 
 47.22  defined in Minnesota Statutes; or an offense in any other state 
 47.23  or country, the elements of which are substantially similar to 
 47.24  the elements of any of the offenses listed in this clause.  If 
 47.25  the defendant is convicted of one of the gross misdemeanors 
 47.26  listed in this clause, but the sentence is a misdemeanor 
 47.27  disposition, the lookback period for the conviction is the 
 47.28  period applicable to misdemeanors; or 
 47.29     (4) if less than seven years have passed since the 
 47.30  discharge of the sentence imposed for the offense; and the 
 47.31  individual has received a misdemeanor conviction for a violation 
 47.32  of any of the following offenses:  sections 609.224 (assault in 
 47.33  the fifth degree); 609.2242 (domestic assault); violation of an 
 47.34  order for protection under 518B.01 (Domestic Abuse Act); 
 47.35  violation of an order for protection under 609.3232 (protective 
 47.36  order authorized; procedures; penalties); 609.746 (interference 
 48.1   with privacy); 609.79 (obscene or harassing phone calls); 
 48.2   609.795 (letter, telegram, or package; opening; harassment); 
 48.3   617.23 (indecent exposure; penalties); 609.2672 (assault of an 
 48.4   unborn child in the third degree); 617.293 (harmful materials; 
 48.5   dissemination and display to minors prohibited); 609.66 
 48.6   (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 
 48.7   exploitation of a vulnerable adult); 609.234 (failure to report 
 48.8   maltreatment of a vulnerable adult); 609.52 (theft); 609.27 
 48.9   (coercion); or an attempt or conspiracy to commit any of these 
 48.10  offenses, as each of these offenses is defined in Minnesota 
 48.11  Statutes; or an offense in any other state or country, the 
 48.12  elements of which are substantially similar to the elements of 
 48.13  any of the offenses listed in this clause; a determination or 
 48.14  disposition of failure to make required reports under section 
 48.15  626.556, subdivision 3, or 626.557, subdivision 3, for incidents 
 48.16  in which:  (i) the final disposition under section 626.556 or 
 48.17  626.557 was substantiated maltreatment, and (ii) the 
 48.18  maltreatment was recurring or serious; or a determination or 
 48.19  disposition of substantiated serious or recurring maltreatment 
 48.20  of a minor under section 626.556 or of a vulnerable adult under 
 48.21  section 626.557 for which there is a preponderance of evidence 
 48.22  that the maltreatment occurred, and that the subject was 
 48.23  responsible for the maltreatment. 
 48.24     For the purposes of this section, "serious maltreatment" 
 48.25  means sexual abuse; maltreatment resulting in death; or 
 48.26  maltreatment resulting in serious injury which reasonably 
 48.27  requires the care of a physician whether or not the care of a 
 48.28  physician was sought; or abuse resulting in serious injury.  For 
 48.29  purposes of this section, "abuse resulting in serious injury" 
 48.30  means:  bruises, bites, skin laceration or tissue damage; 
 48.31  fractures; dislocations; evidence of internal injuries; head 
 48.32  injuries with loss of consciousness; extensive second-degree or 
 48.33  third-degree burns and other burns for which complications are 
 48.34  present; extensive second-degree or third-degree frostbite, and 
 48.35  others for which complications are present; irreversible 
 48.36  mobility or avulsion of teeth; injuries to the eyeball; 
 49.1   ingestion of foreign substances and objects that are harmful; 
 49.2   near drowning; and heat exhaustion or sunstroke.  For purposes 
 49.3   of this section, "care of a physician" is treatment received or 
 49.4   ordered by a physician, but does not include diagnostic testing, 
 49.5   assessment, or observation.  For the purposes of this section, 
 49.6   "recurring maltreatment" means more than one incident of 
 49.7   maltreatment for which there is a preponderance of evidence that 
 49.8   the maltreatment occurred, and that the subject was responsible 
 49.9   for the maltreatment.  For purposes of this section, "access" 
 49.10  means physical access to an individual receiving services or the 
 49.11  individual's personal property without continuous, direct 
 49.12  supervision as defined in section 245A.04, subdivision 3.  
 49.13     (b) Except for background studies related to child foster 
 49.14  care, adult foster care, or family child care licensure, when 
 49.15  the subject of a background study is regulated by a 
 49.16  health-related licensing board as defined in chapter 214, and 
 49.17  the regulated person has been determined to have been 
 49.18  responsible for substantiated maltreatment under section 626.556 
 49.19  or 626.557, instead of the commissioner making a decision 
 49.20  regarding disqualification, the board shall make a determination 
 49.21  whether to impose disciplinary or corrective action under 
 49.22  chapter 214. 
 49.23     (1) The commissioner shall notify the health-related 
 49.24  licensing board: 
 49.25     (i) upon completion of a background study that produces a 
 49.26  record showing that the individual was determined to have been 
 49.27  responsible for substantiated maltreatment; 
 49.28     (ii) upon the commissioner's completion of an investigation 
 49.29  that determined the individual was responsible for substantiated 
 49.30  maltreatment; or 
 49.31     (iii) upon receipt from another agency of a finding of 
 49.32  substantiated maltreatment for which the individual was 
 49.33  responsible. 
 49.34     (2) The commissioner's notice shall indicate whether the 
 49.35  individual would have been disqualified by the commissioner for 
 49.36  the substantiated maltreatment if the individual were not 
 50.1   regulated by the board.  The commissioner shall concurrently 
 50.2   send this notice to the individual. 
 50.3      (3) Notwithstanding the exclusion from this subdivision for 
 50.4   individuals who provide child foster care, adult foster care, or 
 50.5   family child care, when the commissioner or a local agency has 
 50.6   reason to believe that the direct contact services provided by 
 50.7   the individual may fall within the jurisdiction of a 
 50.8   health-related licensing board, a referral shall be made to the 
 50.9   board as provided in this section. 
 50.10     (4) If, upon review of the information provided by the 
 50.11  commissioner, a health-related licensing board informs the 
 50.12  commissioner that the board does not have jurisdiction to take 
 50.13  disciplinary or corrective action, the commissioner shall make 
 50.14  the appropriate disqualification decision regarding the 
 50.15  individual as otherwise provided in this chapter. 
 50.16     (5) The commissioner has the authority to monitor the 
 50.17  facility's compliance with any requirements that the 
 50.18  health-related licensing board places on regulated persons 
 50.19  practicing in a facility either during the period pending a 
 50.20  final decision on a disciplinary or corrective action or as a 
 50.21  result of a disciplinary or corrective action.  The commissioner 
 50.22  has the authority to order the immediate removal of a regulated 
 50.23  person from direct contact or access when a board issues an 
 50.24  order of temporary suspension based on a determination that the 
 50.25  regulated person poses an immediate risk of harm to persons 
 50.26  receiving services in a licensed facility. 
 50.27     (6) A facility that allows a regulated person to provide 
 50.28  direct contact services while not complying with the 
 50.29  requirements imposed by the health-related licensing board is 
 50.30  subject to action by the commissioner as specified under 
 50.31  sections 245A.06 and 245A.07. 
 50.32     (7) The commissioner shall notify a health-related 
 50.33  licensing board immediately upon receipt of knowledge of 
 50.34  noncompliance with requirements placed on a facility or upon a 
 50.35  person regulated by the board. 
 50.36     Sec. 3.  Minnesota Statutes 2000, section 245B.02, 
 51.1   subdivision 10, is amended to read: 
 51.2      Subd. 10.  [INCIDENT.] "Incident" means any of the 
 51.3   following: 
 51.4      (1) serious injury as determined by section 245.91, 
 51.5   subdivision 6; accident; reports of a child or vulnerable adult 
 51.6   maltreatment; circumstances that involve a law enforcement 
 51.7   agency; or 
 51.8      (2) a consumer's death; 
 51.9      (3) any medical emergencies, unexpected serious illnesses, 
 51.10  or accidents that require physician treatment or 
 51.11  hospitalization; 
 51.12     (4) a consumer's unauthorized absence; 
 51.13     (5) any fires or other circumstances involving a law 
 51.14  enforcement agency; 
 51.15     (6) physical aggression by a consumer against another 
 51.16  consumer that causes physical pain, injury, or persistent 
 51.17  emotional distress, including, but not limited to, hitting, 
 51.18  slapping, kicking, scratching, pinching, biting, pushing, and 
 51.19  spitting; 
 51.20     (7) any sexual activity between consumers involving force 
 51.21  or coercion as defined under section 609.341, subdivisions 3 and 
 51.22  14; or 
 51.23     (8) a report of child or vulnerable adult maltreatment 
 51.24  under section 626.556 or 626.557. 
 51.25     Sec. 4.  Minnesota Statutes 2000, section 245B.05, 
 51.26  subdivision 7, is amended to read: 
 51.27     Subd. 7.  [REPORTING INCIDENTS AND EMERGENCIES.] (a) The 
 51.28  license holder must maintain information about and report the 
 51.29  following incidents under section 245B.02, subdivision 10, 
 51.30  clauses (1) to (7), to the consumer's legal representative, 
 51.31  other licensed caregiver, if any, and case manager within 24 
 51.32  hours of the occurrence, or within 24 hours of receipt of the 
 51.33  information: 
 51.34     (1) the death of a consumer; 
 51.35     (2) any medical emergencies, unexpected serious illnesses, 
 51.36  or accidents that require physician treatment or 
 52.1   hospitalization; 
 52.2      (3) a consumer's unauthorized absence; or 
 52.3      (4) any fires and incidents involving a law enforcement 
 52.4   agency unless the incident has been reported by another license 
 52.5   holder.  An incident under section 245B.02, subdivision 10, 
 52.6   clause (8), must be reported as required under paragraph (c) 
 52.7   unless the incident has been reported by another license holder. 
 52.8      (b) When the incident involves more than one consumer, the 
 52.9   license holder must not disclose personally identifiable 
 52.10  information about any other consumer when making the report to 
 52.11  each consumer's legal representative, other licensed caregiver, 
 52.12  if any, and case manager unless the license holder has the 
 52.13  consent of a consumer or a consumer's legal representative. 
 52.14     (c) Within 24 hours of reporting maltreatment as required 
 52.15  under section 626.556 or 626.557, the license holder must inform 
 52.16  the consumer's legal representative and case manager of the 
 52.17  report unless there is reason to believe that the legal 
 52.18  representative or case manager is involved in the suspected 
 52.19  maltreatment.  The information the license holder must disclose 
 52.20  is the nature of the activity or occurrence reported, the agency 
 52.21  that receives the report, and the telephone number of the 
 52.22  department of human services licensing division. 
 52.23     (d) Death or serious injury of the consumer must also be 
 52.24  reported to the department of human services licensing division 
 52.25  and the ombudsman, as required under sections 245.91 and 245.94, 
 52.26  subdivision 2a. 
 52.27     Sec. 5.  Minnesota Statutes 2000, section 245B.07, 
 52.28  subdivision 1, is amended to read: 
 52.29     Subdivision 1.  [CONSUMER DATA FILE.] The license holder 
 52.30  must maintain the following information for each consumer: 
 52.31     (1) identifying information that includes date of birth, 
 52.32  medications, legal representative, history, medical, and other 
 52.33  individual-specific information, and names and telephone numbers 
 52.34  of contacts; 
 52.35     (2) consumer health information, including individual 
 52.36  medication administration and monitoring information; 
 53.1      (3) the consumer's individual service plan.  When a 
 53.2   consumer's case manager does not provide a current individual 
 53.3   service plan, the license holder shall make a written request to 
 53.4   the case manager to provide a copy of the individual service 
 53.5   plan and inform the consumer or the consumer's legal 
 53.6   representative of the right to an individual service plan and 
 53.7   the right to appeal under section 256.045; 
 53.8      (4) copies of assessments, analyses, summaries, and 
 53.9   recommendations; 
 53.10     (5) progress review reports; 
 53.11     (6) incident and emergency reports incidents involving the 
 53.12  consumer; 
 53.13     (7) reports required under section 245B.05, subdivision 7; 
 53.14     (8) discharge summary, when applicable; 
 53.15     (8) (9) record of other license holders serving the 
 53.16  consumer that includes a contact person and telephone numbers, 
 53.17  services being provided, services that require coordination 
 53.18  between two license holders, and name of staff responsible for 
 53.19  coordination; and 
 53.20     (9) incidents involving (10) information about verbal and 
 53.21  physical aggression between consumers directed at the consumer 
 53.22  by another consumer; and 
 53.23     (11) information about self-abuse affecting the consumer. 
 53.24     Sec. 6.  Minnesota Statutes 2000, section 626.557, 
 53.25  subdivision 14, is amended to read: 
 53.26     Subd. 14.  [ABUSE PREVENTION PLANS.] (a) Each facility, 
 53.27  except home health agencies and personal care attendant services 
 53.28  providers, shall establish and enforce an ongoing written abuse 
 53.29  prevention plan.  The plan shall contain an assessment of the 
 53.30  physical plant, its environment, and its population identifying 
 53.31  factors which may encourage or permit abuse, and a statement of 
 53.32  specific measures to be taken to minimize the risk of abuse.  
 53.33  The plan shall comply with any rules governing the plan 
 53.34  promulgated by the licensing agency.  
 53.35     (b) Each facility, including a home health care agency and 
 53.36  personal care attendant services providers, shall develop an 
 54.1   individual abuse prevention plan for each vulnerable adult 
 54.2   residing there or receiving services from them.  The plan shall 
 54.3   contain an individualized assessment of the person's 
 54.4   susceptibility to abuse by other individuals, including other 
 54.5   vulnerable adults, and a statement of the specific measures to 
 54.6   be taken to minimize the risk of abuse to that person.  For the 
 54.7   purposes of this clause, the term "abuse" includes self-abuse. 
 54.8                              ARTICLE 3 
 54.9                            MISCELLANEOUS 
 54.10     Section 1.  Minnesota Statutes 2000, section 144.05, is 
 54.11  amended by adding a subdivision to read: 
 54.12     Subd. 4.  [IDENTIFICATION OF DECEASED INDIVIDUALS.] Upon 
 54.13  receiving notice under section 149A.90, subdivision 1, of the 
 54.14  death of an individual who cannot be identified, the 
 54.15  commissioner must post on the department's Web site information 
 54.16  regarding the individual for purposes of obtaining information 
 54.17  that may aid in identifying the individual and for purposes of 
 54.18  notifying relatives who may be seeking the individual.  The 
 54.19  information must remain on the Web site continuously until the 
 54.20  person's identity is determined. 
 54.21     Sec. 2.  Minnesota Statutes 2001 Supplement, section 
 54.22  149A.90, subdivision 1, is amended to read: 
 54.23     Subdivision 1.  [DEATH RECORD.] (a) Except as provided in 
 54.24  this section, a death record must be completed and filed for 
 54.25  every known death by the mortician, funeral director, or other 
 54.26  person lawfully in charge of the disposition of the body. 
 54.27     (b) If the body is that of an individual whose identity is 
 54.28  unknown, the person in charge of the disposition of the body 
 54.29  must notify the commissioner for purposes of compliance with 
 54.30  section 144.05, subdivision 4. 
 54.31     Sec. 3.  Minnesota Statutes 2000, section 150A.06, is 
 54.32  amended by adding a subdivision to read: 
 54.33     Subd. 2c.  [GUEST LICENSE OR REGISTRATION.] (a) The board 
 54.34  shall grant a guest license to practice as a dentist or dental 
 54.35  hygienist or a guest registration to practice as a dental 
 54.36  assistant if the following conditions are met: 
 55.1      (1) the dentist, dental hygienist, or dental assistant is 
 55.2   currently licensed or registered in good standing in North 
 55.3   Dakota, South Dakota, Iowa, or Wisconsin; 
 55.4      (2) the dentist, dental hygienist, or dental assistant is 
 55.5   currently engaged in the practice of that person's respective 
 55.6   profession in North Dakota, South Dakota, Iowa, or Wisconsin; 
 55.7      (3) the dentist, dental hygienist, or dental assistant is 
 55.8   seeking to practice in a public health setting in Minnesota that 
 55.9   (i) is approved by the board; (ii) was established by a 
 55.10  nonprofit organization that is tax exempt under chapter 
 55.11  501(c)(3) of the Internal Revenue Code of 1986; and (iii) 
 55.12  provides dental care to patients who have difficulty accessing 
 55.13  dental care; 
 55.14     (4) the dentist, dental hygienist, or dental assistant 
 55.15  agrees to treat indigent patients who meet the eligibility 
 55.16  criteria established by the clinic; and 
 55.17     (5) the dentist, dental hygienist, or dental assistant has 
 55.18  applied to the board for a guest license or registration, 
 55.19  providing evidence of being currently licensed or registered in 
 55.20  good standing in North Dakota, South Dakota, Iowa, or Wisconsin, 
 55.21  and has paid a nonrefundable license fee to the board of $50. 
 55.22     (b) A dentist, dental hygienist, or dental assistant 
 55.23  practicing under a guest license or registration may only 
 55.24  practice at a single, specific location in Minnesota.  A guest 
 55.25  license or registration must be renewed annually with the board 
 55.26  and an annual renewal fee of $50 must be paid to the board.  If 
 55.27  the clinic in Minnesota at which a dentist, dental hygienist, or 
 55.28  dental assistant seeks to practice permanently ceases operation, 
 55.29  the guest license or registration issued under this subdivision 
 55.30  is automatically revoked. 
 55.31     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 55.32  following final enactment. 
 55.33     Sec. 4.  Minnesota Statutes 2001 Supplement, section 
 55.34  256B.69, subdivision 5b, is amended to read: 
 55.35     Subd. 5b.  [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 
 55.36  prepaid medical assistance and general assistance medical care 
 56.1   program contract rates set by the commissioner under subdivision 
 56.2   5 and effective on or after January 1, 1998, capitation rates 
 56.3   for nonmetropolitan counties shall on a weighted average be no 
 56.4   less than 88 percent of the capitation rates for metropolitan 
 56.5   counties, excluding Hennepin county.  The commissioner shall 
 56.6   make a pro rata adjustment in capitation rates paid to counties 
 56.7   other than nonmetropolitan counties in order to make this 
 56.8   provision budget neutral.  The commissioner, in consultation 
 56.9   with a health care actuary, shall evaluate the regional rate 
 56.10  relationships based on actual health plan costs for Minnesota 
 56.11  health care programs.  The commissioner may establish, based on 
 56.12  the actuary's recommendation, new rate regions that recognize 
 56.13  metropolitan areas outside of the seven-county metropolitan area.
 56.14     (b) For prepaid medical assistance program contract rates 
 56.15  set by the commissioner under subdivision 5 and effective on or 
 56.16  after January 1, 2001, capitation rates for nonmetropolitan 
 56.17  counties shall, on a weighted average, be no less than 89 
 56.18  percent of the capitation rates for metropolitan counties, 
 56.19  excluding Hennepin county. 
 56.20     (c) This subdivision shall not affect the nongeographically 
 56.21  based risk adjusted rates established under section 62Q.03, 
 56.22  subdivision 5a. 
 56.23     Sec. 5.  Minnesota Statutes 2000, section 261.063, is 
 56.24  amended to read: 
 56.25     261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 
 56.26  PENALTY.] 
 56.27     (a) The board of county commissioners of each county shall 
 56.28  annually levy taxes and fix a rate sufficient to produce the 
 56.29  full amount required for poor relief, general assistance, 
 56.30  Minnesota family investment program, county share of county and 
 56.31  state supplemental aid to supplemental security income 
 56.32  applicants or recipients, and any other social security measures 
 56.33  wherein there is now or may hereafter be county participation, 
 56.34  sufficient to produce the full amount necessary for each such 
 56.35  item, including administrative expenses, for the ensuing year, 
 56.36  within the time fixed by law in addition to all other tax levies 
 57.1   and tax rates, however fixed or determined, and any commissioner 
 57.2   who shall fail to comply herewith shall be guilty of a gross 
 57.3   misdemeanor and shall be immediately removed from office by the 
 57.4   governor.  For the purposes of this paragraph, "poor relief" 
 57.5   means county services provided under sections 261.035, 261.04, 
 57.6   and 261.21 to 261.231. 
 57.7      (b) Nothing within the provisions of this section shall be 
 57.8   construed as requiring a county agency to provide income support 
 57.9   or cash assistance to needy persons when they are no longer 
 57.10  eligible for assistance under general assistance, the Minnesota 
 57.11  family investment program, or Minnesota supplemental aid.