1.1                          A bill for an act 
  1.2             relating to state government; making changes to public 
  1.3             assistance programs, health care programs, continuing 
  1.4             care for persons with disabilities, and children's 
  1.5             services; establishing the Community Services Act; 
  1.6             changing estate recovery provisions for medical 
  1.7             assistance; modifying local public health grants; 
  1.8             appropriating money; amending Minnesota Statutes 2002, 
  1.9             sections 16A.724; 62J.692, subdivision 4, by adding a 
  1.10            subdivision; 62Q.19, subdivision 1; 69.021, 
  1.11            subdivision 11; 144.1222, by adding a subdivision; 
  1.12            144.125; 144.128; 144.1483; 144.1488, subdivision 4; 
  1.13            144.1491, subdivision 1; 144.1502, subdivision 4; 
  1.14            144.551, subdivision 1; 144A.4605, subdivision 4; 
  1.15            144E.11, subdivision 6; 145.88; 145.881, subdivision 
  1.16            2; 145.882, subdivisions 1, 2, 3, 7, by adding a 
  1.17            subdivision; 145.883, subdivisions 1, 9; 145A.02, 
  1.18            subdivisions 5, 6, 7; 145A.06, subdivision 1; 145A.09, 
  1.19            subdivisions 2, 4, 7; 145A.10, subdivisions 2, 10, by 
  1.20            adding a subdivision; 145A.11, subdivisions 2, 4; 
  1.21            145A.12, subdivisions 1, 2, by adding a subdivision; 
  1.22            145A.13, by adding a subdivision; 145A.14, subdivision 
  1.23            2; 147A.08; 148.5194, subdivisions 1, 2, 3, by adding 
  1.24            a subdivision; 148.6445, subdivision 7; 153A.17; 
  1.25            245.4874; 245A.10; 245B.06, subdivision 8; 246.54; 
  1.26            252.27, subdivision 2a; 252.46, subdivision 1; 256.01, 
  1.27            subdivision 2; 256.476, subdivisions 1, 3, 4, 5, 11; 
  1.28            256.482, subdivision 8; 256.935, subdivision 1; 
  1.29            256.955, subdivision 2a; 256.9657, subdivision 1; 
  1.30            256.969, subdivisions 2b, 3a; 256.9754, subdivisions 
  1.31            2, 3, 4, 5; 256.984, subdivision 1; 256B.055, by 
  1.32            adding a subdivision; 256B.056, subdivisions 1a, 1c; 
  1.33            256B.057, subdivisions 1, 2, 3b, 9; 256B.0595, 
  1.34            subdivisions 1, 2; 256B.06, subdivision 4; 256B.061; 
  1.35            256B.0625, subdivisions 13, 20, 23, by adding 
  1.36            subdivisions; 256B.0635, subdivisions 1, 2; 256B.0913, 
  1.37            subdivisions 2, 4, 5, 6, 7, 8, 10, 12; 256B.0915, 
  1.38            subdivision 3; 256B.0945, subdivisions 2, 4; 256B.15, 
  1.39            subdivisions 1, 1a, 2, 3, 4, by adding subdivisions; 
  1.40            256B.19, subdivisions 1, 1d; 256B.195, subdivision 4; 
  1.41            256B.32, subdivision 1; 256B.431, subdivisions 2r, 23, 
  1.42            32, 36, by adding subdivisions; 256B.434, subdivision 
  1.43            4; 256B.48, subdivision 1; 256B.501, subdivision 1, by 
  1.44            adding a subdivision; 256B.5012, by adding a 
  1.45            subdivision; 256B.5015; 256B.69, subdivisions 2, 4, 
  1.46            5c, by adding a subdivision; 256B.75; 256B.76; 
  2.1             256D.03, subdivisions 3, 4; 256D.06, subdivision 2; 
  2.2             256D.44, subdivision 5; 256D.46, subdivisions 1, 3; 
  2.3             256D.48, subdivision 1; 256E.081, subdivision 3; 
  2.4             256F.10, subdivision 6; 256G.05, subdivision 2; 
  2.5             256I.02; 256I.04, subdivision 3; 256I.05, subdivisions 
  2.6             1, 1a, 2, 7c; 256J.01, subdivision 5; 256J.02, 
  2.7             subdivision 2; 256J.021; 256J.08, subdivisions 35, 65, 
  2.8             82, 85, by adding subdivisions; 256J.09, subdivisions 
  2.9             2, 3, 3a, 3b, 8, 10; 256J.14; 256J.20, subdivision 3; 
  2.10            256J.21, subdivision 2; 256J.24, subdivisions 3, 5, 6, 
  2.11            7, 10; 256J.30, subdivision 9; 256J.32, subdivisions 
  2.12            2, 4, 5a, by adding a subdivision; 256J.37, 
  2.13            subdivision 9, by adding subdivisions; 256J.38, 
  2.14            subdivisions 3, 4; 256J.42, subdivisions 4, 5, 6; 
  2.15            256J.425, subdivisions 1, 1a, 2, 3, 4, 6, 7; 256J.45, 
  2.16            subdivision 2; 256J.46, subdivisions 1, 2, 2a; 
  2.17            256J.49, subdivisions 4, 5, 9, 13, by adding 
  2.18            subdivisions; 256J.50, subdivisions 1, 8, 9, 10; 
  2.19            256J.51, subdivisions 1, 2, 3, 4; 256J.53, 
  2.20            subdivisions 1, 2, 5; 256J.54, subdivisions 1, 2, 3, 
  2.21            5; 256J.55, subdivisions 1, 2; 256J.56; 256J.57; 
  2.22            256J.62, subdivision 9; 256J.645, subdivision 3; 
  2.23            256J.66, subdivision 2; 256J.67, subdivisions 1, 3; 
  2.24            256J.69, subdivision 2; 256J.75, subdivision 3; 
  2.25            256J.751, subdivisions 1, 2, 5; 256L.02, by adding a 
  2.26            subdivision; 256L.03, subdivisions 3, 5; 256L.04, 
  2.27            subdivision 1; 256L.05, subdivisions 1, 3, 3a, 3c, 4; 
  2.28            256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; 
  2.29            256L.09, subdivision 4; 256L.12, subdivision 9, by 
  2.30            adding a subdivision; 256L.15, subdivisions 1, 2, 3; 
  2.31            259.67, subdivision 4; 260B.157, subdivision 1; 
  2.32            260B.176, subdivision 2; 260B.178, subdivision 1; 
  2.33            260B.193, subdivision 2; 260B.235, subdivision 6; 
  2.34            261.063; 295.55, subdivision 2; 295.58; 326.42; 
  2.35            393.07, subdivision 10; 514.981, subdivision 6; 
  2.36            518.551, subdivision 7; 518.6111, subdivisions 2, 3, 
  2.37            4, 16; 524.3-805; 626.559, subdivision 5; Laws 1997, 
  2.38            chapter 203, article 9, section 21, as amended; 
  2.39            proposing coding for new law in Minnesota Statutes, 
  2.40            chapters 144; 145; 145A; 148C; 256B; 256D; 256I; 256J; 
  2.41            514; proposing coding for new law as Minnesota 
  2.42            Statutes, chapter 256M; repealing Minnesota Statutes 
  2.43            2002, sections 62J.694, subdivisions 1, 2, 2a, 3; 
  2.44            144.126; 144.1484; 144.1494; 144.1495; 144.1496; 
  2.45            144.1497; 144.395, subdivisions 1, 2; 144.396; 
  2.46            144.401; 144.9507, subdivision 3; 144A.36; 144A.38; 
  2.47            145.56, subdivision 2; 145.882, subdivisions 4, 5, 6, 
  2.48            8; 145.883, subdivisions 4, 7; 145.884; 145.885; 
  2.49            145.886; 145.888; 145.889; 145.890; 145.9266, 
  2.50            subdivisions 2, 4, 5, 6, 7; 145.928, subdivision 9; 
  2.51            145A.02, subdivisions 9, 10, 11, 12, 13, 14; 145A.10, 
  2.52            subdivisions 5, 6, 8; 145A.11, subdivision 3; 145A.12, 
  2.53            subdivisions 3, 4, 5; 145A.14, subdivisions 3, 4; 
  2.54            145A.17, subdivision 2; 148.5194, subdivision 3a; 
  2.55            148.6445, subdivision 9; 245.4712, subdivision 2; 
  2.56            245.478; 245.4886; 245.4888; 245.496; 254A.17; 
  2.57            256.955, subdivision 8; 256.973; 256.9752; 256.9753; 
  2.58            256.976; 256.977; 256.9772; 256B.055, subdivision 10a; 
  2.59            256B.057, subdivision 1b; 256B.0625, subdivisions 5a, 
  2.60            35, 36; 256B.0917; 256B.0928; 256B.0945, subdivisions 
  2.61            6, 7, 8, 9, 10; 256B.095; 256B.0951; 256B.0952; 
  2.62            256B.0953; 256B.0954; 256B.0955; 256B.195, subdivision 
  2.63            5; 256B.437, subdivision 2; 256B.5013, subdivision 4; 
  2.64            256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 
  2.65            256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 
  2.66            256E.11; 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 
  2.67            256F.02; 256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 
  2.68            256F.08; 256F.10, subdivision 7; 256F.11; 256F.12; 
  2.69            256F.14; 256J.02, subdivision 3; 256J.08, subdivisions 
  2.70            28, 70; 256J.24, subdivision 8; 256J.30, subdivision 
  2.71            10; 256J.462; 256J.47; 256J.48; 256J.49, subdivisions 
  3.1             1a, 2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7; 
  3.2             256J.52, subdivisions 1, 2, 3, 4, 5, 5a, 6, 7, 8, 9; 
  3.3             256J.55, subdivision 5; 256J.62, subdivisions 1, 2a, 
  3.4             3a, 4, 6, 7, 8; 256J.625; 256J.655; 256J.74, 
  3.5             subdivision 3; 256J.751, subdivisions 3, 4; 256J.76; 
  3.6             256K.30; 256L.02, subdivision 3; 256L.04, subdivision 
  3.7             9; 257.075; 257.81; 260.152; 626.562; Laws 1988, 
  3.8             chapter 689, article 2, section 251; Laws 2000, 
  3.9             chapter 488, article 10, section 29; Laws 2001, First 
  3.10            Special Session chapter 9, article 13, section 24; 
  3.11            Laws 2002, chapter 374, article 9, section 8; 
  3.12            Minnesota Rules, parts 4705.0100; 4705.0200; 
  3.13            4705.0300; 4705.0400; 4705.0500; 4705.0600; 4705.0700; 
  3.14            4705.0800; 4705.0900; 4705.1000; 4705.1100; 4705.1200; 
  3.15            4705.1300; 4705.1400; 4705.1500; 4705.1600; 4736.0010; 
  3.16            4736.0020; 4736.0030; 4736.0040; 4736.0050; 4736.0060; 
  3.17            4736.0070; 4736.0080; 4736.0090; 4736.0120; 4736.0130; 
  3.18            4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 
  3.19            4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 
  3.20            4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 
  3.21            4763.0250; 4763.0260; 4763.0270; 4763.0285; 4763.0295; 
  3.22            4763.0300; 9505.0324; 9505.0326; 9505.0327; 9545.2000; 
  3.23            9545.2010; 9545.2020; 9545.2030; 9545.2040; 9550.0010; 
  3.24            9550.0020; 9550.0030; 9550.0040; 9550.0050; 9550.0060; 
  3.25            9550.0070; 9550.0080; 9550.0090; 9550.0091; 9550.0092; 
  3.26            9550.0093. 
  3.27  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  3.28                             ARTICLE 1 
  3.29          WELFARE REFORM; PUBLIC ASSISTANCE MODIFICATIONS 
  3.30     Section 1.  Minnesota Statutes 2002, section 256.935, 
  3.31  subdivision 1, is amended to read: 
  3.32     Subdivision 1.  [FUNERAL EXPENSES.] On the death of any 
  3.33  person receiving public assistance through MFIP, the county 
  3.34  agency shall pay an amount for funeral expenses not exceeding 
  3.35  the amount paid for comparable services under section 261.035 
  3.36  plus actual cemetery charges.  No funeral expenses shall be paid 
  3.37  if the estate of the deceased is sufficient to pay such expenses 
  3.38  or if the spouse, who was legally responsible for the support of 
  3.39  the deceased while living, is able to pay such expenses; 
  3.40  provided, that the additional payment or donation of the cost of 
  3.41  cemetery lot, interment, religious service, or for the 
  3.42  transportation of the body into or out of the community in which 
  3.43  the deceased resided, shall not limit payment by the county 
  3.44  agency as herein authorized.  Freedom of choice in the selection 
  3.45  of a funeral director shall be granted to persons lawfully 
  3.46  authorized to make arrangements for the burial of any such 
  3.47  deceased recipient.  In determining the sufficiency of such 
  3.48  estate, due regard shall be had for the nature and marketability 
  4.1   of the assets of the estate.  The county agency may grant 
  4.2   funeral expenses where the sale would cause undue loss to the 
  4.3   estate.  Any amount paid for funeral expenses shall be a prior 
  4.4   claim against the estate, as provided in section 524.3-805, and 
  4.5   any amount recovered shall be reimbursed to the agency which 
  4.6   paid the expenses.  The commissioner shall specify requirements 
  4.7   for reports, including fiscal reports, according to section 
  4.8   256.01, subdivision 2, paragraph (17).  The state share shall 
  4.9   pay the entire amount of county agency expenditures.  Benefits 
  4.10  shall be issued to recipients by the state or county subject to 
  4.11  provisions of section 256.017. 
  4.12     Sec. 2.  Minnesota Statutes 2002, section 256.984, 
  4.13  subdivision 1, is amended to read: 
  4.14     Subdivision 1.  [DECLARATION.] Every application for public 
  4.15  assistance under this chapter and/or or chapters 256B, 256D, 
  4.16  256K, MFIP program 256J, and food stamps or food support under 
  4.17  chapter 393 shall be in writing or reduced to writing as 
  4.18  prescribed by the state agency and shall contain the following 
  4.19  declaration which shall be signed by the applicant: 
  4.20     "I declare under the penalties of perjury that this 
  4.21     application has been examined by me and to the best of my 
  4.22     knowledge is a true and correct statement of every material 
  4.23     point.  I understand that a person convicted of perjury may 
  4.24     be sentenced to imprisonment of not more than five years or 
  4.25     to payment of a fine of not more than $10,000, or both." 
  4.26     Sec. 3.  Minnesota Statutes 2002, section 256D.06, 
  4.27  subdivision 2, is amended to read: 
  4.28     Subd. 2.  [EMERGENCY NEED.] Notwithstanding the provisions 
  4.29  of subdivision 1, a grant of emergency general assistance shall, 
  4.30  to the extent funds are available, be made to an eligible single 
  4.31  adult, married couple, or family for an emergency need, as 
  4.32  defined in rules promulgated by the commissioner, where the 
  4.33  recipient requests temporary assistance not exceeding 30 days if 
  4.34  an emergency situation appears to exist and (a) until March 31, 
  4.35  1998, the individual is ineligible for the program of emergency 
  4.36  assistance under aid to families with dependent children and is 
  5.1   not a recipient of aid to families with dependent children at 
  5.2   the time of application; or (b) the individual or family is (i) 
  5.3   ineligible for MFIP or is not a participant of MFIP; and (ii) is 
  5.4   ineligible for emergency assistance under section 256J.48.  If 
  5.5   an applicant or recipient relates facts to the county agency 
  5.6   which may be sufficient to constitute an emergency situation, 
  5.7   the county agency shall, to the extent funds are available, 
  5.8   advise the person of the procedure for applying for assistance 
  5.9   according to this subdivision.  An emergency general assistance 
  5.10  grant is available to a recipient not more than once in any 
  5.11  12-month period.  Funding for an emergency general assistance 
  5.12  program is limited to an amount equal to the actual state 
  5.13  expenditure for emergency general assistance in fiscal year 
  5.14  2002.  Each fiscal year, the commissioner shall allocate to 
  5.15  counties the money appropriated for emergency general assistance 
  5.16  grants based on each county agency's average share of state's 
  5.17  emergency general expenditures for the immediate past three 
  5.18  fiscal years, and may reallocate any unspent amounts to other 
  5.19  counties.  Any emergency general assistance expenditures by a 
  5.20  county above the amount of the commissioner's allocation to the 
  5.21  county must be made from county funds. 
  5.22     Sec. 4.  Minnesota Statutes 2002, section 256D.44, 
  5.23  subdivision 5, is amended to read: 
  5.24     Subd. 5.  [SPECIAL NEEDS.] In addition to the state 
  5.25  standards of assistance established in subdivisions 1 to 4, 
  5.26  payments are allowed for the following special needs of 
  5.27  recipients of Minnesota supplemental aid who are not residents 
  5.28  of a nursing home, a regional treatment center, or a group 
  5.29  residential housing facility. 
  5.30     (a) The county agency shall pay a monthly allowance for 
  5.31  medically prescribed diets payable under the Minnesota family 
  5.32  investment program if the cost of those additional dietary needs 
  5.33  cannot be met through some other maintenance benefit.  The need 
  5.34  for special diets or dietary items must be prescribed by a 
  5.35  licensed physician.  Costs for special diets shall be determined 
  5.36  as percentages of the allotment for a one-person household under 
  6.1   the thrifty food plan as defined by the United States Department 
  6.2   of Agriculture.  The types of diets and the percentages of the 
  6.3   thrifty food plan that are covered are as follows: 
  6.4      (1) high protein diet, at least 80 grams daily, 25 percent 
  6.5   of thrifty food plan; 
  6.6      (2) controlled protein diet, 40 to 60 grams and requires 
  6.7   special products, 100 percent of thrifty food plan; 
  6.8      (3) controlled protein diet, less than 40 grams and 
  6.9   requires special products, 125 percent of thrifty food plan; 
  6.10     (4) low cholesterol diet, 25 percent of thrifty food plan; 
  6.11     (5) high residue diet, 20 percent of thrifty food plan; 
  6.12     (6) pregnancy and lactation diet, 35 percent of thrifty 
  6.13  food plan; 
  6.14     (7) gluten-free diet, 25 percent of thrifty food plan; 
  6.15     (8) lactose-free diet, 25 percent of thrifty food plan; 
  6.16     (9) antidumping diet, 15 percent of thrifty food plan; 
  6.17     (10) hypoglycemic diet, 15 percent of thrifty food plan; or 
  6.18     (11) ketogenic diet, 25 percent of thrifty food plan. 
  6.19     (b) Payment for nonrecurring special needs must be allowed 
  6.20  for necessary home repairs or necessary repairs or replacement 
  6.21  of household furniture and appliances using the payment standard 
  6.22  of the AFDC program in effect on July 16, 1996, for these 
  6.23  expenses, as long as other funding sources are not available.  
  6.24     (c) A fee for guardian or conservator service is allowed at 
  6.25  a reasonable rate negotiated by the county or approved by the 
  6.26  court.  This rate shall not exceed five percent of the 
  6.27  assistance unit's gross monthly income up to a maximum of $100 
  6.28  per month.  If the guardian or conservator is a member of the 
  6.29  county agency staff, no fee is allowed. 
  6.30     (d) The county agency shall continue to pay a monthly 
  6.31  allowance of $68 for restaurant meals for a person who was 
  6.32  receiving a restaurant meal allowance on June 1, 1990, and who 
  6.33  eats two or more meals in a restaurant daily.  The allowance 
  6.34  must continue until the person has not received Minnesota 
  6.35  supplemental aid for one full calendar month or until the 
  6.36  person's living arrangement changes and the person no longer 
  7.1   meets the criteria for the restaurant meal allowance, whichever 
  7.2   occurs first. 
  7.3      (e) A fee of ten percent of the recipient's gross income or 
  7.4   $25, whichever is less, is allowed for representative payee 
  7.5   services provided by an agency that meets the requirements under 
  7.6   SSI regulations to charge a fee for representative payee 
  7.7   services.  This special need is available to all recipients of 
  7.8   Minnesota supplemental aid regardless of their living 
  7.9   arrangement.  
  7.10     (f) Notwithstanding the language in this subdivision, an 
  7.11  amount equal to the maximum allotment authorized by the federal 
  7.12  Food Stamp Program for a single individual which is in effect on 
  7.13  the first day of January of the previous year will be added to 
  7.14  the standards of assistance established in subdivisions 1 to 4 
  7.15  for individuals under the age of 65 who are relocating from an 
  7.16  institution and who are shelter needy.  An eligible individual 
  7.17  who receives this benefit prior to age 65 may continue to 
  7.18  receive the benefit after the age of 65. 
  7.19     "Shelter needy" means that the assistance unit incurs 
  7.20  monthly shelter costs that exceed 40 percent of the assistance 
  7.21  unit's gross income before the application of this special needs 
  7.22  standard.  "Gross income" for the purposes of this section is 
  7.23  the applicant's or recipient's income as defined in section 
  7.24  256D.35, subdivision 10, or the standard specified in 
  7.25  subdivision 3, whichever is greater.  A recipient of a federal 
  7.26  or state housing subsidy, that limits shelter costs to a 
  7.27  percentage of gross income, shall not be considered shelter 
  7.28  needy for purposes of this paragraph. 
  7.29     Sec. 5.  Minnesota Statutes 2002, section 256D.46, 
  7.30  subdivision 1, is amended to read: 
  7.31     Subdivision 1.  [ELIGIBILITY.] A county agency must grant 
  7.32  emergency Minnesota supplemental aid must be granted, to the 
  7.33  extent funds are available, if the recipient is without adequate 
  7.34  resources to resolve an emergency that, if unresolved, will 
  7.35  threaten the health or safety of the recipient.  For the 
  7.36  purposes of this section, the term "recipient" includes persons 
  8.1   for whom a group residential housing benefit is being paid under 
  8.2   sections 256I.01 to 256I.06. 
  8.3      Sec. 6.  Minnesota Statutes 2002, section 256D.46, 
  8.4   subdivision 3, is amended to read: 
  8.5      Subd. 3.  [PAYMENT AMOUNT.] The amount of assistance 
  8.6   granted under emergency Minnesota supplemental aid is limited to 
  8.7   the amount necessary to resolve the emergency.  An emergency 
  8.8   Minnesota supplemental aid grant is available to a recipient no 
  8.9   more than once in any 12-month period.  Funding for emergency 
  8.10  Minnesota supplemental aid is limited to an amount equal to the 
  8.11  actual state expenditure for emergency Minnesota supplemental 
  8.12  aid in state fiscal year 2002.  Each fiscal year, the 
  8.13  commissioner shall allocate to counties the money appropriated 
  8.14  for emergency Minnesota supplemental aid grants based on each 
  8.15  county agency's average share of state's emergency Minnesota 
  8.16  supplemental aid expenditures for the immediate past three 
  8.17  fiscal years, and may reallocate any unspent amounts to other 
  8.18  counties.  Any emergency Minnesota supplemental aid expenditures 
  8.19  by a county above the amount of the commissioner's allocation to 
  8.20  the county must be made from county funds. 
  8.21     Sec. 7.  Minnesota Statutes 2002, section 256D.48, 
  8.22  subdivision 1, is amended to read: 
  8.23     Subdivision 1.  [NEED FOR PROTECTIVE PAYEE.] The county 
  8.24  agency shall determine whether a recipient needs a protective 
  8.25  payee when a physical or mental condition renders the recipient 
  8.26  unable to manage funds and when payments to the recipient would 
  8.27  be contrary to the recipient's welfare.  Protective payments 
  8.28  must be issued when there is evidence of:  (1) repeated 
  8.29  inability to plan the use of income to meet necessary 
  8.30  expenditures; (2) repeated observation that the recipient is not 
  8.31  properly fed or clothed; (3) repeated failure to meet 
  8.32  obligations for rent, utilities, food, and other essentials; (4) 
  8.33  evictions or a repeated incurrence of debts; or (5) lost or 
  8.34  stolen checks; or (6) use of emergency Minnesota supplemental 
  8.35  aid more than twice in a calendar year.  The determination of 
  8.36  representative payment by the Social Security Administration for 
  9.1   the recipient is sufficient reason for protective payment of 
  9.2   Minnesota supplemental aid payments.  
  9.3      Sec. 8.  Minnesota Statutes 2002, section 256J.01, 
  9.4   subdivision 5, is amended to read: 
  9.5      Subd. 5.  [COMPLIANCE SYSTEM.] The commissioner shall 
  9.6   administer a compliance system for the state's temporary 
  9.7   assistance for needy families (TANF) program, the food stamp 
  9.8   program, emergency assistance, general assistance, medical 
  9.9   assistance, general assistance medical care, emergency general 
  9.10  assistance, Minnesota supplemental aid, preadmission screening, 
  9.11  child support program, and alternative care grants under the 
  9.12  powers and authorities named in section 256.01, subdivision 2.  
  9.13  The purpose of the compliance system is to permit the 
  9.14  commissioner to supervise the administration of public 
  9.15  assistance programs and to enforce timely and accurate 
  9.16  distribution of benefits, completeness of service and efficient 
  9.17  and effective program management and operations, to increase 
  9.18  uniformity and consistency in the administration and delivery of 
  9.19  public assistance programs throughout the state, and to reduce 
  9.20  the possibility of sanction and fiscal disallowances for 
  9.21  noncompliance with federal regulations and state statutes. 
  9.22     Sec. 9.  Minnesota Statutes 2002, section 256J.02, 
  9.23  subdivision 2, is amended to read: 
  9.24     Subd. 2.  [USE OF MONEY.] State money appropriated for 
  9.25  purposes of this section and TANF block grant money must be used 
  9.26  for: 
  9.27     (1) financial assistance to or on behalf of any minor child 
  9.28  who is a resident of this state under section 256J.12; 
  9.29     (2) employment and training services under this chapter or 
  9.30  chapter 256K; 
  9.31     (3) emergency financial assistance and services under 
  9.32  section 256J.48; 
  9.33     (4) diversionary assistance under section 256J.47; 
  9.34     (5) the health care and human services training and 
  9.35  retention program under chapter 116L, for costs associated with 
  9.36  families with children with incomes below 200 percent of the 
 10.1   federal poverty guidelines; 
 10.2      (6) (3) the pathways program under section 116L.04, 
 10.3   subdivision 1a; 
 10.4      (7) welfare-to-work extended employment services for MFIP 
 10.5   participants with severe impairment to employment as defined in 
 10.6   section 268A.15, subdivision 1a; 
 10.7      (8) the family homeless prevention and assistance program 
 10.8   under section 462A.204; 
 10.9      (9) the rent assistance for family stabilization 
 10.10  demonstration project under section 462A.205; 
 10.11     (10) (4) welfare to work transportation authorized under 
 10.12  Public Law Number 105-178; 
 10.13     (11) (5) reimbursements for the federal share of child 
 10.14  support collections passed through to the custodial parent; 
 10.15     (12) (6) reimbursements for the working family credit under 
 10.16  section 290.0671; 
 10.17     (13) intensive ESL grants under Laws 2000, chapter 489, 
 10.18  article 1; 
 10.19     (14) transitional housing programs under section 119A.43; 
 10.20     (15) programs and pilot projects under chapter 256K; and 
 10.21     (16) (7) program administration under this chapter; 
 10.22     (8) the diversionary work program under section 256J.95; 
 10.23     (9) the MFIP consolidated fund under section 256J.626; and 
 10.24     (10) the Minnesota department of health consolidated fund 
 10.25  under Laws 2001, First Special Session chapter 9, article 17, 
 10.26  section 3, subdivision 2. 
 10.27     Sec. 10.  Minnesota Statutes 2002, section 256J.021, is 
 10.28  amended to read: 
 10.29     256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.] 
 10.30     Beginning October 1, 2001, and each year thereafter, the 
 10.31  commissioner of human services must treat financial assistance 
 10.32  MFIP expenditures made to or on behalf of any minor child under 
 10.33  section 256J.02, subdivision 2, clause (1), who is a resident of 
 10.34  this state under section 256J.12, and who is part of a 
 10.35  two-parent eligible household as expenditures under a separately 
 10.36  funded state program and report those expenditures to the 
 11.1   federal Department of Health and Human Services as separate 
 11.2   state program expenditures under Code of Federal Regulations, 
 11.3   title 45, section 263.5. 
 11.4      Sec. 11.  Minnesota Statutes 2002, section 256J.08, is 
 11.5   amended by adding a subdivision to read: 
 11.6      Subd. 11a.  [CHILD ONLY CASE.] "Child only case" means a 
 11.7   case that would be part of the child only TANF program under 
 11.8   section 256J.88. 
 11.9      Sec. 12.  Minnesota Statutes 2002, section 256J.08, is 
 11.10  amended by adding a subdivision to read: 
 11.11     Subd. 24b.  [DIVERSIONARY WORK PROGRAM OR DWP.] 
 11.12  "Diversionary work program" or "DWP" has the meaning given in 
 11.13  section 256J.95. 
 11.14     Sec. 13.  Minnesota Statutes 2002, section 256J.08, is 
 11.15  amended by adding a subdivision to read: 
 11.16     Subd. 28b.  [EMPLOYABLE.] "Employable" means a person is 
 11.17  capable of performing existing positions in the local labor 
 11.18  market, regardless of the current availability of openings for 
 11.19  those positions. 
 11.20     Sec. 14.  Minnesota Statutes 2002, section 256J.08, is 
 11.21  amended by adding a subdivision to read: 
 11.22     Subd. 34a.  [FAMILY VIOLENCE.] (a) "Family violence" means 
 11.23  the following, if committed against a family or household member 
 11.24  by a family or household member: 
 11.25     (1) physical harm, bodily injury, or assault; 
 11.26     (2) the infliction of fear of imminent physical harm, 
 11.27  bodily injury, or assault; or 
 11.28     (3) terroristic threats, within the meaning of section 
 11.29  609.713, subdivision 1; criminal sexual conduct, within the 
 11.30  meaning of section 609.342, 609.343, 609.344, 609.345, or 
 11.31  609.3451; or interference with an emergency call within the 
 11.32  meaning of section 609.78, subdivision 2. 
 11.33     (b) For the purposes of family violence, "family or 
 11.34  household member" means:  
 11.35     (1) spouses and former spouses; 
 11.36     (2) parents and children; 
 12.1      (3) persons related by blood; 
 12.2      (4) persons who are residing together or who have resided 
 12.3   together in the past; 
 12.4      (5) persons who have a child in common regardless of 
 12.5   whether they have been married or have lived together at any 
 12.6   time; 
 12.7      (6) a man and woman if the woman is pregnant and the man is 
 12.8   alleged to be the father, regardless of whether they have been 
 12.9   married or have lived together at anytime; and 
 12.10     (7) persons involved in a current or past significant 
 12.11  romantic or sexual relationship. 
 12.12     Sec. 15.  Minnesota Statutes, section 256J.08, is amended 
 12.13  by adding a subdivision to read: 
 12.14     Subd. 34b.  [FAMILY VIOLENCE WAIVER.] "Family violence 
 12.15  waiver" means a waiver of the 60-month time limit for victims of 
 12.16  family violence who meet the criteria in section 256J.545 and 
 12.17  are complying with an employment plan in section 256J.521, 
 12.18  subdivision 3. 
 12.19     Sec. 16.  Minnesota Statutes 2002, section 256J.08, 
 12.20  subdivision 35, is amended to read: 
 12.21     Subd. 35.  [FAMILY WAGE LEVEL.] "Family wage level" means 
 12.22  110 percent of the transitional standard as specified in section 
 12.23  256J.24, subdivision 7. 
 12.24     Sec. 17.  Minnesota Statutes 2002, section 256J.08, is 
 12.25  amended by adding a subdivision to read: 
 12.26     Subd. 51b.  [LEARNING DISABLED.] "Learning disabled," for 
 12.27  purposes of an extension to the 60-month time limit under 
 12.28  section 256J.425, subdivision 3, clause (3), means the person 
 12.29  has a disorder in one or more of the psychological processes 
 12.30  involved in perceiving, understanding, or using concepts through 
 12.31  verbal language or nonverbal means.  Learning disabled does not 
 12.32  include learning problems that are primarily the result of 
 12.33  visual, hearing, or motor handicaps, mental retardation, 
 12.34  emotional disturbance, or due to environmental, cultural, or 
 12.35  economic disadvantage. 
 12.36     Sec. 18.  Minnesota Statutes 2002, section 256J.08, 
 13.1   subdivision 65, is amended to read: 
 13.2      Subd. 65.  [PARTICIPANT.] "Participant" means a person who 
 13.3   is currently receiving cash assistance or the food portion 
 13.4   available through MFIP as funded by TANF and the food stamp 
 13.5   program.  A person who fails to withdraw or access 
 13.6   electronically any portion of the person's cash and food 
 13.7   assistance payment by the end of the payment month, who makes a 
 13.8   written request for closure before the first of a payment month 
 13.9   and repays cash and food assistance electronically issued for 
 13.10  that payment month within that payment month, or who returns any 
 13.11  uncashed assistance check and food coupons and withdraws from 
 13.12  the program is not a participant.  A person who withdraws a cash 
 13.13  or food assistance payment by electronic transfer or receives 
 13.14  and cashes an MFIP assistance check or food coupons and is 
 13.15  subsequently determined to be ineligible for assistance for that 
 13.16  period of time is a participant, regardless whether that 
 13.17  assistance is repaid.  The term "participant" includes the 
 13.18  caregiver relative and the minor child whose needs are included 
 13.19  in the assistance payment.  A person in an assistance unit who 
 13.20  does not receive a cash and food assistance payment because the 
 13.21  person case has been suspended from MFIP is a participant.  A 
 13.22  person who receives cash payments under the diversionary work 
 13.23  program under section 256J.95 is a participant. 
 13.24     Sec. 19.  Minnesota Statutes 2002, section 256J.08, is 
 13.25  amended by adding a subdivision to read: 
 13.26     Subd. 65a.  [PARTICIPATION REQUIREMENTS OF 
 13.27  TANF.] "Participation requirements of TANF" means activities and 
 13.28  hourly requirements allowed under title IV-A of the federal 
 13.29  Social Security Act. 
 13.30     Sec. 20.  Minnesota Statutes 2002, section 256J.08, is 
 13.31  amended by adding a subdivision to read: 
 13.32     Subd. 73a.  [QUALIFIED PROFESSIONAL.] (a) For physical 
 13.33  illness, injury, or incapacity, a "qualified professional" means 
 13.34  a licensed physician, a physician's assistant, a nurse 
 13.35  practitioner, or in the case of spinal subluxation, a licensed 
 13.36  chiropractor. 
 14.1      (b) For mental retardation and intelligence testing, a 
 14.2   "qualified professional" means an individual qualified by 
 14.3   training and experience to administer the tests necessary to 
 14.4   make determinations, such as tests of intellectual functioning, 
 14.5   assessments of adaptive behavior, adaptive skills, and 
 14.6   developmental functioning.  These professionals include licensed 
 14.7   psychologists, certified school psychologists, or certified 
 14.8   psychometrists working under the supervision of a licensed 
 14.9   psychologist. 
 14.10     (c) For learning disabilities, a "qualified professional" 
 14.11  means a licensed psychologist or school psychologist with 
 14.12  experience determining learning disabilities.  
 14.13     (d) For mental health, a "qualified professional" means a 
 14.14  licensed physician or a qualified mental health professional.  A 
 14.15  "qualified mental health professional" means: 
 14.16     (1) for children, in psychiatric nursing, a registered 
 14.17  nurse who is licensed under sections 148.171 to 148.285, and who 
 14.18  is certified as a clinical specialist in child and adolescent 
 14.19  psychiatric or mental health nursing by a national nurse 
 14.20  certification organization or who has a master's degree in 
 14.21  nursing or one of the behavioral sciences or related fields from 
 14.22  an accredited college or university or its equivalent, with at 
 14.23  least 4,000 hours of post-master's supervised experience in the 
 14.24  delivery of clinical services in the treatment of mental 
 14.25  illness; 
 14.26     (2) for adults, in psychiatric nursing, a registered nurse 
 14.27  who is licensed under sections 148.171 to 148.285, and who is 
 14.28  certified as a clinical specialist in adult psychiatric and 
 14.29  mental health nursing by a national nurse certification 
 14.30  organization or who has a master's degree in nursing or one of 
 14.31  the behavioral sciences or related fields from an accredited 
 14.32  college or university or its equivalent, with at least 4,000 
 14.33  hours of post-master's supervised experience in the delivery of 
 14.34  clinical services in the treatment of mental illness; 
 14.35     (3) in clinical social work, a person licensed as an 
 14.36  independent clinical social worker under section 148B.21, 
 15.1   subdivision 6, or a person with a master's degree in social work 
 15.2   from an accredited college or university, with at least 4,000 
 15.3   hours of post-master's supervised experience in the delivery of 
 15.4   clinical services in the treatment of mental illness; 
 15.5      (4) in psychology, an individual licensed by the board of 
 15.6   psychology under sections 148.88 to 148.98, who has stated to 
 15.7   the board of psychology competencies in the diagnosis and 
 15.8   treatment of mental illness; 
 15.9      (5) in psychiatry, a physician licensed under chapter 147 
 15.10  and certified by the American Board of Psychiatry and Neurology 
 15.11  or eligible for board certification in psychiatry; and 
 15.12     (6) in marriage and family therapy, the mental health 
 15.13  professional must be a marriage and family therapist licensed 
 15.14  under sections 148B.29 to 148B.39, with at least two years of 
 15.15  post-master's supervised experience in the delivery of clinical 
 15.16  services in the treatment of mental illness. 
 15.17     Sec. 21.  Minnesota Statutes 2002, section 256J.08, 
 15.18  subdivision 82, is amended to read: 
 15.19     Subd. 82.  [SANCTION.] "Sanction" means the reduction of a 
 15.20  family's assistance payment by a specified percentage of the 
 15.21  MFIP standard of need because:  a nonexempt participant fails to 
 15.22  comply with the requirements of sections 256J.52 256J.515 to 
 15.23  256J.55 256J.57; a parental caregiver fails without good cause 
 15.24  to cooperate with the child support enforcement requirements; or 
 15.25  a participant fails to comply with the insurance, tort 
 15.26  liability, or other requirements of this chapter. 
 15.27     Sec. 22.  Minnesota Statutes 2002, section 256J.08, is 
 15.28  amended by adding a subdivision to read: 
 15.29     Subd. 84a.  [SSI RECIPIENT.] "SSI recipient" means a person 
 15.30  who receives at least $1 in SSI benefits, or who is not 
 15.31  receiving an SSI benefit due to recoupment or a one month 
 15.32  suspension by the Social Security Administration due to excess 
 15.33  income. 
 15.34     Sec. 23.  Minnesota Statutes 2002, section 256J.08, 
 15.35  subdivision 85, is amended to read: 
 15.36     Subd. 85.  [TRANSITIONAL STANDARD.] "Transitional standard" 
 16.1   means the basic standard for a family with no other income or a 
 16.2   nonworking family without earned income and is a combination of 
 16.3   the cash assistance needs portion and food assistance needs for 
 16.4   a family of that size portion as specified in section 256J.24, 
 16.5   subdivision 5. 
 16.6      Sec. 24.  Minnesota Statutes 2002, section 256J.08, is 
 16.7   amended by adding a subdivision to read: 
 16.8      Subd. 90.  [SEVERE FORMS OF TRAFFICKING IN 
 16.9   PERSONS.] "Severe forms of trafficking in persons" means:  (1) 
 16.10  sex trafficking in which a commercial sex act is induced by 
 16.11  force, fraud, or coercion, or in which the person induced to 
 16.12  perform the act has not attained 18 years of age; or (2) the 
 16.13  recruitment, harboring, transportation, provision, or obtaining 
 16.14  of a person for labor or services through the use of force, 
 16.15  fraud, or coercion for the purposes of subjection to involuntary 
 16.16  servitude, peonage, debt bondage, or slavery. 
 16.17     Sec. 25.  Minnesota Statutes 2002, section 256J.09, 
 16.18  subdivision 2, is amended to read: 
 16.19     Subd. 2.  [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 
 16.20  INFORMATION.] When a person inquires about assistance, a county 
 16.21  agency must: 
 16.22     (1) explain the eligibility requirements of, and how to 
 16.23  apply for, diversionary assistance as provided in section 
 16.24  256J.47; emergency assistance as provided in section 256J.48; 
 16.25  MFIP as provided in section 256J.10; or any other assistance for 
 16.26  which the person may be eligible; and 
 16.27     (2) offer the person brochures developed or approved by the 
 16.28  commissioner that describe how to apply for assistance. 
 16.29     Sec. 26.  Minnesota Statutes 2002, section 256J.09, 
 16.30  subdivision 3, is amended to read: 
 16.31     Subd. 3.  [SUBMITTING THE APPLICATION FORM.] (a) A county 
 16.32  agency must offer, in person or by mail, the application forms 
 16.33  prescribed by the commissioner as soon as a person makes a 
 16.34  written or oral inquiry.  At that time, the county agency must: 
 16.35     (1) inform the person that assistance begins with the date 
 16.36  the signed application is received by the county agency or the 
 17.1   date all eligibility criteria are met, whichever is later; 
 17.2      (2) inform the person that any delay in submitting the 
 17.3   application will reduce the amount of assistance paid for the 
 17.4   month of application; 
 17.5      (3) inform a person that the person may submit the 
 17.6   application before an interview; 
 17.7      (4) explain the information that will be verified during 
 17.8   the application process by the county agency as provided in 
 17.9   section 256J.32; 
 17.10     (5) inform a person about the county agency's average 
 17.11  application processing time and explain how the application will 
 17.12  be processed under subdivision 5; 
 17.13     (6) explain how to contact the county agency if a person's 
 17.14  application information changes and how to withdraw the 
 17.15  application; 
 17.16     (7) inform a person that the next step in the application 
 17.17  process is an interview and what a person must do if the 
 17.18  application is approved including, but not limited to, attending 
 17.19  orientation under section 256J.45 and complying with employment 
 17.20  and training services requirements in sections 256J.52 256J.515 
 17.21  to 256J.55 256J.57; 
 17.22     (8) explain the child care and transportation services that 
 17.23  are available under paragraph (c) to enable caregivers to attend 
 17.24  the interview, screening, and orientation; and 
 17.25     (9) identify any language barriers and arrange for 
 17.26  translation assistance during appointments, including, but not 
 17.27  limited to, screening under subdivision 3a, orientation under 
 17.28  section 256J.45, and the initial assessment under section 
 17.29  256J.52 256J.521.  
 17.30     (b) Upon receipt of a signed application, the county agency 
 17.31  must stamp the date of receipt on the face of the application.  
 17.32  The county agency must process the application within the time 
 17.33  period required under subdivision 5.  An applicant may withdraw 
 17.34  the application at any time by giving written or oral notice to 
 17.35  the county agency.  The county agency must issue a written 
 17.36  notice confirming the withdrawal.  The notice must inform the 
 18.1   applicant of the county agency's understanding that the 
 18.2   applicant has withdrawn the application and no longer wants to 
 18.3   pursue it.  When, within ten days of the date of the agency's 
 18.4   notice, an applicant informs a county agency, in writing, that 
 18.5   the applicant does not wish to withdraw the application, the 
 18.6   county agency must reinstate the application and finish 
 18.7   processing the application. 
 18.8      (c) Upon a participant's request, the county agency must 
 18.9   arrange for transportation and child care or reimburse the 
 18.10  participant for transportation and child care expenses necessary 
 18.11  to enable participants to attend the screening under subdivision 
 18.12  3a and orientation under section 256J.45.  
 18.13     Sec. 27.  Minnesota Statutes 2002, section 256J.09, 
 18.14  subdivision 3a, is amended to read: 
 18.15     Subd. 3a.  [SCREENING.] The county agency, or at county 
 18.16  option, the county's employment and training service provider as 
 18.17  defined in section 256J.49, must screen each applicant to 
 18.18  determine immediate needs and to determine if the applicant may 
 18.19  be eligible for: 
 18.20     (1) another program that is not partially funded through 
 18.21  the federal temporary assistance to needy families block grant 
 18.22  under Title I of Public Law Number 104-193, including the 
 18.23  expedited issuance of food stamps under section 256J.28, 
 18.24  subdivision 1.  If the applicant may be eligible for another 
 18.25  program, a county caseworker must provide the appropriate 
 18.26  referral to the program; 
 18.27     (2) the diversionary assistance program under section 
 18.28  256J.47; or 
 18.29     (3) the emergency assistance program under section 
 18.30  256J.48.  If the applicant appears eligible for another program, 
 18.31  including any program funded by the MFIP consolidated fund, the 
 18.32  county must make a referral to the appropriate program. 
 18.33     Sec. 28.  Minnesota Statutes 2002, section 256J.09, 
 18.34  subdivision 3b, is amended to read: 
 18.35     Subd. 3b.  [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 
 18.36  If the applicant is not diverted from applying for MFIP, and if 
 19.1   the applicant meets the MFIP eligibility requirements, then a 
 19.2   county agency must: 
 19.3      (1) identify an applicant who is under the age of 
 19.4   20 without a high school diploma or its equivalent and explain 
 19.5   to the applicant the assessment procedures and employment plan 
 19.6   requirements for minor parents under section 256J.54; 
 19.7      (2) explain to the applicant the eligibility criteria in 
 19.8   section 256J.545 for an exemption under the family violence 
 19.9   provisions in section 256J.52, subdivision 6 waiver, and explain 
 19.10  what an applicant should do to develop an alternative employment 
 19.11  plan; 
 19.12     (3) determine if an applicant qualifies for an exemption 
 19.13  under section 256J.56 from employment and training services 
 19.14  requirements, explain how a person should report to the county 
 19.15  agency any status changes, and explain that an applicant who is 
 19.16  exempt may volunteer to participate in employment and training 
 19.17  services; 
 19.18     (4) for applicants who are not exempt from the requirement 
 19.19  to attend orientation, arrange for an orientation under section 
 19.20  256J.45 and an initial assessment under section 256J.52 
 19.21  256J.521; 
 19.22     (5) inform an applicant who is not exempt from the 
 19.23  requirement to attend orientation that failure to attend the 
 19.24  orientation is considered an occurrence of noncompliance with 
 19.25  program requirements and will result in an imposition of a 
 19.26  sanction under section 256J.46; and 
 19.27     (6) explain how to contact the county agency if an 
 19.28  applicant has questions about compliance with program 
 19.29  requirements. 
 19.30     Sec. 29.  Minnesota Statutes 2002, section 256J.09, 
 19.31  subdivision 8, is amended to read: 
 19.32     Subd. 8.  [ADDITIONAL APPLICATIONS.] Until a county agency 
 19.33  issues notice of approval or denial, additional applications 
 19.34  submitted by an applicant are void.  However, an application for 
 19.35  monthly assistance or other benefits funded under section 
 19.36  256J.626 and an application for emergency assistance or 
 20.1   emergency general assistance may exist concurrently.  More than 
 20.2   one application for monthly assistance, emergency assistance, or 
 20.3   emergency general assistance may exist concurrently when the 
 20.4   county agency decisions on one or more earlier applications have 
 20.5   been appealed to the commissioner, and the applicant asserts 
 20.6   that a change in circumstances has occurred that would allow 
 20.7   eligibility.  A county agency must require additional 
 20.8   application forms or supplemental forms as prescribed by the 
 20.9   commissioner when a payee's name changes, or when a caregiver 
 20.10  requests the addition of another person to the assistance unit.  
 20.11     Sec. 30.  Minnesota Statutes 2002, section 256J.09, 
 20.12  subdivision 10, is amended to read: 
 20.13     Subd. 10.  [APPLICANTS WHO DO NOT MEET ELIGIBILITY 
 20.14  REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 
 20.15  applicant is not eligible for MFIP or the diversionary work 
 20.16  program under section 256J.95 because the applicant does not 
 20.17  meet eligibility requirements, the county agency must determine 
 20.18  whether the applicant is eligible for food stamps, medical 
 20.19  assistance, diversionary assistance, or has a need for emergency 
 20.20  assistance when the applicant meets the eligibility requirements 
 20.21  for those programs or health care programs.  The county must 
 20.22  also inform applicants about resources available through the 
 20.23  county or other agencies to meet short-term emergency needs. 
 20.24     Sec. 31.  Minnesota Statutes 2002, section 256J.14, is 
 20.25  amended to read: 
 20.26     256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 
 20.27     (a) The definitions in this paragraph only apply to this 
 20.28  subdivision. 
 20.29     (1) "Household of a parent, legal guardian, or other adult 
 20.30  relative" means the place of residence of: 
 20.31     (i) a natural or adoptive parent; 
 20.32     (ii) a legal guardian according to appointment or 
 20.33  acceptance under section 260C.325, 525.615, or 525.6165, and 
 20.34  related laws; 
 20.35     (iii) a caregiver as defined in section 256J.08, 
 20.36  subdivision 11; or 
 21.1      (iv) an appropriate adult relative designated by a county 
 21.2   agency. 
 21.3      (2) "Adult-supervised supportive living arrangement" means 
 21.4   a private family setting which assumes responsibility for the 
 21.5   care and control of the minor parent and minor child, or other 
 21.6   living arrangement, not including a public institution, licensed 
 21.7   by the commissioner of human services which ensures that the 
 21.8   minor parent receives adult supervision and supportive services, 
 21.9   such as counseling, guidance, independent living skills 
 21.10  training, or supervision. 
 21.11     (b) A minor parent and the minor child who is in the care 
 21.12  of the minor parent must reside in the household of a parent, 
 21.13  legal guardian, other adult relative, or in an adult-supervised 
 21.14  supportive living arrangement in order to receive MFIP unless: 
 21.15     (1) the minor parent has no living parent, other adult 
 21.16  relative, or legal guardian whose whereabouts is known; 
 21.17     (2) no living parent, other adult relative, or legal 
 21.18  guardian of the minor parent allows the minor parent to live in 
 21.19  the parent's, other adult relative's, or legal guardian's home; 
 21.20     (3) the minor parent lived apart from the minor parent's 
 21.21  own parent or legal guardian for a period of at least one year 
 21.22  before either the birth of the minor child or the minor parent's 
 21.23  application for MFIP; 
 21.24     (4) the physical or emotional health or safety of the minor 
 21.25  parent or minor child would be jeopardized if the minor parent 
 21.26  and the minor child resided in the same residence with the minor 
 21.27  parent's parent, other adult relative, or legal guardian; or 
 21.28     (5) an adult supervised supportive living arrangement is 
 21.29  not available for the minor parent and child in the county in 
 21.30  which the minor parent and child currently reside.  If an adult 
 21.31  supervised supportive living arrangement becomes available 
 21.32  within the county, the minor parent and child must reside in 
 21.33  that arrangement. 
 21.34     (c) The county agency shall inform minor applicants both 
 21.35  orally and in writing about the eligibility requirements, their 
 21.36  rights and obligations under the MFIP program, and any other 
 22.1   applicable orientation information.  The county must advise the 
 22.2   minor of the possible exemptions under section 256J.54, 
 22.3   subdivision 5, and specifically ask whether one or more of these 
 22.4   exemptions is applicable.  If the minor alleges one or more of 
 22.5   these exemptions, then the county must assist the minor in 
 22.6   obtaining the necessary verifications to determine whether or 
 22.7   not these exemptions apply. 
 22.8      (d) If the county worker has reason to suspect that the 
 22.9   physical or emotional health or safety of the minor parent or 
 22.10  minor child would be jeopardized if they resided with the minor 
 22.11  parent's parent, other adult relative, or legal guardian, then 
 22.12  the county worker must make a referral to child protective 
 22.13  services to determine if paragraph (b), clause (4), applies.  A 
 22.14  new determination by the county worker is not necessary if one 
 22.15  has been made within the last six months, unless there has been 
 22.16  a significant change in circumstances which justifies a new 
 22.17  referral and determination. 
 22.18     (e) If a minor parent is not living with a parent, legal 
 22.19  guardian, or other adult relative due to paragraph (b), clause 
 22.20  (1), (2), or (4), the minor parent must reside, when possible, 
 22.21  in a living arrangement that meets the standards of paragraph 
 22.22  (a), clause (2). 
 22.23     (f) Regardless of living arrangement, MFIP must be paid, 
 22.24  when possible, in the form of a protective payment on behalf of 
 22.25  the minor parent and minor child according to section 256J.39, 
 22.26  subdivisions 2 to 4. 
 22.27     Sec. 32.  Minnesota Statutes 2002, section 256J.20, 
 22.28  subdivision 3, is amended to read: 
 22.29     Subd. 3.  [OTHER PROPERTY LIMITATIONS.] To be eligible for 
 22.30  MFIP, the equity value of all nonexcluded real and personal 
 22.31  property of the assistance unit must not exceed $2,000 for 
 22.32  applicants and $5,000 for ongoing participants.  The value of 
 22.33  assets in clauses (1) to (19) must be excluded when determining 
 22.34  the equity value of real and personal property: 
 22.35     (1) a licensed vehicle up to a loan value of less than or 
 22.36  equal to $7,500.  The county agency shall apply any excess loan 
 23.1   value as if it were equity value to the asset limit described in 
 23.2   this section.  If the assistance unit owns more than one 
 23.3   licensed vehicle, the county agency shall determine the vehicle 
 23.4   with the highest loan value and count only the loan value over 
 23.5   $7,500, excluding:  (i) the value of one vehicle per physically 
 23.6   disabled person when the vehicle is needed to transport the 
 23.7   disabled unit member; this exclusion does not apply to mentally 
 23.8   disabled people; (ii) the value of special equipment for a 
 23.9   handicapped member of the assistance unit; and (iii) any vehicle 
 23.10  used for long-distance travel, other than daily commuting, for 
 23.11  the employment of a unit member. 
 23.12     The county agency shall count the loan value of all other 
 23.13  vehicles and apply this amount as if it were equity value to the 
 23.14  asset limit described in this section.  To establish the loan 
 23.15  value of vehicles, a county agency must use the N.A.D.A. 
 23.16  Official Used Car Guide, Midwest Edition, for newer model cars.  
 23.17  When a vehicle is not listed in the guidebook, or when the 
 23.18  applicant or participant disputes the loan value listed in the 
 23.19  guidebook as unreasonable given the condition of the particular 
 23.20  vehicle, the county agency may require the applicant or 
 23.21  participant document the loan value by securing a written 
 23.22  statement from a motor vehicle dealer licensed under section 
 23.23  168.27, stating the amount that the dealer would pay to purchase 
 23.24  the vehicle.  The county agency shall reimburse the applicant or 
 23.25  participant for the cost of a written statement that documents a 
 23.26  lower loan value; 
 23.27     (2) the value of life insurance policies for members of the 
 23.28  assistance unit; 
 23.29     (3) one burial plot per member of an assistance unit; 
 23.30     (4) the value of personal property needed to produce earned 
 23.31  income, including tools, implements, farm animals, inventory, 
 23.32  business loans, business checking and savings accounts used at 
 23.33  least annually and used exclusively for the operation of a 
 23.34  self-employment business, and any motor vehicles if at least 50 
 23.35  percent of the vehicle's use is to produce income and if the 
 23.36  vehicles are essential for the self-employment business; 
 24.1      (5) the value of personal property not otherwise specified 
 24.2   which is commonly used by household members in day-to-day living 
 24.3   such as clothing, necessary household furniture, equipment, and 
 24.4   other basic maintenance items essential for daily living; 
 24.5      (6) the value of real and personal property owned by a 
 24.6   recipient of Supplemental Security Income or Minnesota 
 24.7   supplemental aid; 
 24.8      (7) the value of corrective payments, but only for the 
 24.9   month in which the payment is received and for the following 
 24.10  month; 
 24.11     (8) a mobile home or other vehicle used by an applicant or 
 24.12  participant as the applicant's or participant's home; 
 24.13     (9) money in a separate escrow account that is needed to 
 24.14  pay real estate taxes or insurance and that is used for this 
 24.15  purpose; 
 24.16     (10) money held in escrow to cover employee FICA, employee 
 24.17  tax withholding, sales tax withholding, employee worker 
 24.18  compensation, business insurance, property rental, property 
 24.19  taxes, and other costs that are paid at least annually, but less 
 24.20  often than monthly; 
 24.21     (11) monthly assistance, emergency assistance, and 
 24.22  diversionary payments for the current month's needs or 
 24.23  short-term emergency needs under section 256J.626, subdivision 
 24.24  2; 
 24.25     (12) the value of school loans, grants, or scholarships for 
 24.26  the period they are intended to cover; 
 24.27     (13) payments listed in section 256J.21, subdivision 2, 
 24.28  clause (9), which are held in escrow for a period not to exceed 
 24.29  three months to replace or repair personal or real property; 
 24.30     (14) income received in a budget month through the end of 
 24.31  the payment month; 
 24.32     (15) savings from earned income of a minor child or a minor 
 24.33  parent that are set aside in a separate account designated 
 24.34  specifically for future education or employment costs; 
 24.35     (16) the federal earned income credit, Minnesota working 
 24.36  family credit, state and federal income tax refunds, state 
 25.1   homeowners and renters credits under chapter 290A, property tax 
 25.2   rebates and other federal or state tax rebates in the month 
 25.3   received and the following month; 
 25.4      (17) payments excluded under federal law as long as those 
 25.5   payments are held in a separate account from any nonexcluded 
 25.6   funds; 
 25.7      (18) the assets of children ineligible to receive MFIP 
 25.8   benefits because foster care or adoption assistance payments are 
 25.9   made on their behalf; and 
 25.10     (19) the assets of persons whose income is excluded under 
 25.11  section 256J.21, subdivision 2, clause (43). 
 25.12     Sec. 33.  Minnesota Statutes 2002, section 256J.21, 
 25.13  subdivision 2, is amended to read: 
 25.14     Subd. 2.  [INCOME EXCLUSIONS.] The following must be 
 25.15  excluded in determining a family's available income: 
 25.16     (1) payments for basic care, difficulty of care, and 
 25.17  clothing allowances received for providing family foster care to 
 25.18  children or adults under Minnesota Rules, parts 9545.0010 to 
 25.19  9545.0260 and 9555.5050 to 9555.6265, and payments received and 
 25.20  used for care and maintenance of a third-party beneficiary who 
 25.21  is not a household member; 
 25.22     (2) reimbursements for employment training received through 
 25.23  the Job Training Partnership Workforce Investment Act 1998, 
 25.24  United States Code, title 29 20, chapter 19 73, sections 1501 
 25.25  to 1792b section 9201; 
 25.26     (3) reimbursement for out-of-pocket expenses incurred while 
 25.27  performing volunteer services, jury duty, employment, or 
 25.28  informal carpooling arrangements directly related to employment; 
 25.29     (4) all educational assistance, except the county agency 
 25.30  must count graduate student teaching assistantships, 
 25.31  fellowships, and other similar paid work as earned income and, 
 25.32  after allowing deductions for any unmet and necessary 
 25.33  educational expenses, shall count scholarships or grants awarded 
 25.34  to graduate students that do not require teaching or research as 
 25.35  unearned income; 
 25.36     (5) loans, regardless of purpose, from public or private 
 26.1   lending institutions, governmental lending institutions, or 
 26.2   governmental agencies; 
 26.3      (6) loans from private individuals, regardless of purpose, 
 26.4   provided an applicant or participant documents that the lender 
 26.5   expects repayment; 
 26.6      (7)(i) state income tax refunds; and 
 26.7      (ii) federal income tax refunds; 
 26.8      (8)(i) federal earned income credits; 
 26.9      (ii) Minnesota working family credits; 
 26.10     (iii) state homeowners and renters credits under chapter 
 26.11  290A; and 
 26.12     (iv) federal or state tax rebates; 
 26.13     (9) funds received for reimbursement, replacement, or 
 26.14  rebate of personal or real property when these payments are made 
 26.15  by public agencies, awarded by a court, solicited through public 
 26.16  appeal, or made as a grant by a federal agency, state or local 
 26.17  government, or disaster assistance organizations, subsequent to 
 26.18  a presidential declaration of disaster; 
 26.19     (10) the portion of an insurance settlement that is used to 
 26.20  pay medical, funeral, and burial expenses, or to repair or 
 26.21  replace insured property; 
 26.22     (11) reimbursements for medical expenses that cannot be 
 26.23  paid by medical assistance; 
 26.24     (12) payments by a vocational rehabilitation program 
 26.25  administered by the state under chapter 268A, except those 
 26.26  payments that are for current living expenses; 
 26.27     (13) in-kind income, including any payments directly made 
 26.28  by a third party to a provider of goods and services; 
 26.29     (14) assistance payments to correct underpayments, but only 
 26.30  for the month in which the payment is received; 
 26.31     (15) emergency assistance payments for short-term emergency 
 26.32  needs under section 256J.626, subdivision 2; 
 26.33     (16) funeral and cemetery payments as provided by section 
 26.34  256.935; 
 26.35     (17) nonrecurring cash gifts of $30 or less, not exceeding 
 26.36  $30 per participant in a calendar month; 
 27.1      (18) any form of energy assistance payment made through 
 27.2   Public Law Number 97-35, Low-Income Home Energy Assistance Act 
 27.3   of 1981, payments made directly to energy providers by other 
 27.4   public and private agencies, and any form of credit or rebate 
 27.5   payment issued by energy providers; 
 27.6      (19) Supplemental Security Income (SSI), including 
 27.7   retroactive SSI payments and other income of an SSI recipient, 
 27.8   except as described in section 256J.37, subdivision 3b; 
 27.9      (20) Minnesota supplemental aid, including retroactive 
 27.10  payments; 
 27.11     (21) proceeds from the sale of real or personal property; 
 27.12     (22) adoption assistance payments under section 259.67; 
 27.13     (23) state-funded family subsidy program payments made 
 27.14  under section 252.32 to help families care for children with 
 27.15  mental retardation or related conditions, consumer support grant 
 27.16  funds under section 256.476, and resources and services for a 
 27.17  disabled household member under one of the home and 
 27.18  community-based waiver services programs under chapter 256B; 
 27.19     (24) interest payments and dividends from property that is 
 27.20  not excluded from and that does not exceed the asset limit; 
 27.21     (25) rent rebates; 
 27.22     (26) income earned by a minor caregiver, minor child 
 27.23  through age 6, or a minor child who is at least a half-time 
 27.24  student in an approved elementary or secondary education 
 27.25  program; 
 27.26     (27) income earned by a caregiver under age 20 who is at 
 27.27  least a half-time student in an approved elementary or secondary 
 27.28  education program; 
 27.29     (28) MFIP child care payments under section 119B.05; 
 27.30     (29) all other payments made through MFIP to support a 
 27.31  caregiver's pursuit of greater self-support economic stability; 
 27.32     (30) income a participant receives related to shared living 
 27.33  expenses; 
 27.34     (31) reverse mortgages; 
 27.35     (32) benefits provided by the Child Nutrition Act of 1966, 
 27.36  United States Code, title 42, chapter 13A, sections 1771 to 
 28.1   1790; 
 28.2      (33) benefits provided by the women, infants, and children 
 28.3   (WIC) nutrition program, United States Code, title 42, chapter 
 28.4   13A, section 1786; 
 28.5      (34) benefits from the National School Lunch Act, United 
 28.6   States Code, title 42, chapter 13, sections 1751 to 1769e; 
 28.7      (35) relocation assistance for displaced persons under the 
 28.8   Uniform Relocation Assistance and Real Property Acquisition 
 28.9   Policies Act of 1970, United States Code, title 42, chapter 61, 
 28.10  subchapter II, section 4636, or the National Housing Act, United 
 28.11  States Code, title 12, chapter 13, sections 1701 to 1750jj; 
 28.12     (36) benefits from the Trade Act of 1974, United States 
 28.13  Code, title 19, chapter 12, part 2, sections 2271 to 2322; 
 28.14     (37) war reparations payments to Japanese Americans and 
 28.15  Aleuts under United States Code, title 50, sections 1989 to 
 28.16  1989d; 
 28.17     (38) payments to veterans or their dependents as a result 
 28.18  of legal settlements regarding Agent Orange or other chemical 
 28.19  exposure under Public Law Number 101-239, section 10405, 
 28.20  paragraph (a)(2)(E); 
 28.21     (39) income that is otherwise specifically excluded from 
 28.22  MFIP consideration in federal law, state law, or federal 
 28.23  regulation; 
 28.24     (40) security and utility deposit refunds; 
 28.25     (41) American Indian tribal land settlements excluded under 
 28.26  Public Law Numbers Laws 98-123, 98-124, and 99-377 to the 
 28.27  Mississippi Band Chippewa Indians of White Earth, Leech Lake, 
 28.28  and Mille Lacs reservations and payments to members of the White 
 28.29  Earth Band, under United States Code, title 25, chapter 9, 
 28.30  section 331, and chapter 16, section 1407; 
 28.31     (42) all income of the minor parent's parents and 
 28.32  stepparents when determining the grant for the minor parent in 
 28.33  households that include a minor parent living with parents or 
 28.34  stepparents on MFIP with other children; 
 28.35     (43) income of the minor parent's parents and stepparents 
 28.36  equal to 200 percent of the federal poverty guideline for a 
 29.1   family size not including the minor parent and the minor 
 29.2   parent's child in households that include a minor parent living 
 29.3   with parents or stepparents not on MFIP when determining the 
 29.4   grant for the minor parent.  The remainder of income is deemed 
 29.5   as specified in section 256J.37, subdivision 1b; 
 29.6      (44) payments made to children eligible for relative 
 29.7   custody assistance under section 257.85; 
 29.8      (45) vendor payments for goods and services made on behalf 
 29.9   of a client unless the client has the option of receiving the 
 29.10  payment in cash; and 
 29.11     (46) the principal portion of a contract for deed payment. 
 29.12     Sec. 34.  Minnesota Statutes 2002, section 256J.24, 
 29.13  subdivision 3, is amended to read: 
 29.14     Subd. 3.  [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 
 29.15  ASSISTANCE UNIT.] (a) The following individuals who are part of 
 29.16  the assistance unit determined under subdivision 2 are 
 29.17  ineligible to receive MFIP: 
 29.18     (1) individuals receiving who are recipients of 
 29.19  Supplemental Security Income or Minnesota supplemental aid; 
 29.20     (2) individuals disqualified from the food stamp program or 
 29.21  MFIP, until the disqualification ends; 
 29.22     (3) children on whose behalf federal, state or local foster 
 29.23  care payments are made, except as provided in sections 256J.13, 
 29.24  subdivision 2, and 256J.74, subdivision 2; and 
 29.25     (4) children receiving ongoing monthly adoption assistance 
 29.26  payments under section 259.67.  
 29.27     (b) The exclusion of a person under this subdivision does 
 29.28  not alter the mandatory assistance unit composition. 
 29.29     Sec. 35.  Minnesota Statutes 2002, section 256J.24, 
 29.30  subdivision 5, is amended to read: 
 29.31     Subd. 5.  [MFIP TRANSITIONAL STANDARD.] The following table 
 29.32  represents the MFIP transitional standard table when all members 
 29.33  of is based on the number of persons in the assistance unit are 
 29.34  eligible for both food and cash assistance unless the 
 29.35  restrictions in subdivision 6 on the birth of a child apply.  
 29.36  The following table represents the transitional standards 
 30.1   effective October 1, 2002. 
 30.2       Number of       Transitional         Cash       Food
 30.3    Eligible People     Standard           Portion    Portion
 30.4         1                $351   $370:      $250       $120
 30.5         2                $609   $658:      $437       $221
 30.6         3                $763   $844:      $532       $312
 30.7         4                $903   $998:      $621       $377
 30.8         5              $1,025 $1,135:      $697       $438
 30.9         6              $1,165 $1,296:      $773       $523
 30.10        7              $1,273 $1,414:      $850       $564
 30.11        8              $1,403 $1,558:      $916       $642
 30.12        9              $1,530 $1,700:      $980       $720
 30.13       10              $1,653 $1,836:    $1,035       $801
 30.14  over 10            add $121   $136:       $53        $83
 30.15  per additional member.
 30.16     The commissioner shall annually publish in the State 
 30.17  Register the transitional standard for an assistance unit sizes 
 30.18  1 to 10 including a breakdown of the cash and food portions. 
 30.19     Sec. 36.  Minnesota Statutes 2002, section 256J.24, 
 30.20  subdivision 6, is amended to read: 
 30.21     Subd. 6.  [APPLICATION OF ASSISTANCE STANDARDS FAMILY CAP.] 
 30.22  The standards apply to the number of eligible persons in the 
 30.23  assistance unit.  (a) MFIP assistance units shall not receive an 
 30.24  increase in the cash portion of the transitional standard as a 
 30.25  result of the birth of a child, unless one of the conditions 
 30.26  under paragraph (b) is met.  The child shall be considered a 
 30.27  member of the assistance unit according to subdivisions 1 to 3, 
 30.28  but shall be excluded in determining family size for purposes of 
 30.29  determining the amount of the cash portion of the transitional 
 30.30  standard under subdivision 5.  The child shall be included in 
 30.31  determining family size for purposes of determining the food 
 30.32  portion of the transitional standard.  The transitional standard 
 30.33  under this subdivision shall be the total of the cash and food 
 30.34  portions as specified in this paragraph.  The family wage level 
 30.35  under this subdivision shall be based on the family size used to 
 30.36  determine the food portion of the transitional standard. 
 31.1      (b) A child shall be included in determining family size 
 31.2   for purposes of determining the amount of the cash portion of 
 31.3   the MFIP transitional standard when at least one of the 
 31.4   following conditions is met: 
 31.5      (1) for families receiving MFIP assistance on July 1, 2003, 
 31.6   the child is born to the adult parent before May 1, 2004; 
 31.7      (2) for families who apply for the diversionary work 
 31.8   program under section 256J.95 or MFIP assistance on or after 
 31.9   July 1, 2003, the child is born to the adult parent within ten 
 31.10  months of the date the family is eligible for assistance; 
 31.11     (3) the child was conceived as a result of a sexual assault 
 31.12  or incest, provided that: 
 31.13     (i) the incident has been reported to a law enforcement 
 31.14  agency which determines that there is probable cause to believe 
 31.15  the crime occurred; and 
 31.16     (ii) a physician verifies that there is reason to believe 
 31.17  the pregnancy or birth resulted from the reported incident; 
 31.18     (4) the child's mother is a minor caregiver as defined in 
 31.19  section 256J.08, subdivision 59, and the child, or multiple 
 31.20  children, are the mother's first birth; or 
 31.21     (5) any child previously excluded in determining family 
 31.22  size under paragraph (a) shall be included if the adult parent 
 31.23  or parents have not received benefits from the diversionary work 
 31.24  program under section 256J.95 or MFIP assistance in the previous 
 31.25  ten months.  An adult parent or parents who reapply and have 
 31.26  received benefits from the diversionary work program or MFIP 
 31.27  assistance in the past ten months shall be under the ten-month 
 31.28  grace period of their previous application under clause (2). 
 31.29     (c) Income and resources of a child excluded under this 
 31.30  subdivision must be considered using the same policies as for 
 31.31  other children when determining the grant amount of the 
 31.32  assistance unit. 
 31.33     (d) The caregiver must assign support and cooperate with 
 31.34  the child support enforcement agency to establish paternity and 
 31.35  collect child support on behalf of the excluded child.  Failure 
 31.36  to cooperate results in the sanction specified in section 
 32.1   256J.46, subdivisions 2 and 2a.  Current support paid on behalf 
 32.2   of the excluded child shall be distributed according to section 
 32.3   256.741, subdivision 15, and counted to determine the grant 
 32.4   amount of the assistance unit. 
 32.5      (e) County agencies must inform applicants of the 
 32.6   provisions under this subdivision at the time of each 
 32.7   application and at recertification.  
 32.8      (f) Children excluded under this provision shall be deemed 
 32.9   MFIP recipients for purposes of child care under chapter 119B. 
 32.10     Sec. 37.  Minnesota Statutes 2002, section 256J.24, 
 32.11  subdivision 7, is amended to read: 
 32.12     Subd. 7.  [FAMILY WAGE LEVEL STANDARD.] The family wage 
 32.13  level standard is 110 percent of the transitional standard under 
 32.14  subdivision 5 or 6, when applicable, and is the standard used 
 32.15  when there is earned income in the assistance unit.  As 
 32.16  specified in section 256J.21, earned income is subtracted from 
 32.17  the family wage level to determine the amount of the assistance 
 32.18  payment.  Not including The family wage level standard, 
 32.19  assistance payments payment may not exceed the MFIP standard of 
 32.20  need transitional standard under subdivision 5 or 6, or the 
 32.21  shared household standard under subdivision 9, whichever is 
 32.22  applicable, for the assistance unit. 
 32.23     Sec. 38.  Minnesota Statutes 2002, section 256J.24, 
 32.24  subdivision 10, is amended to read: 
 32.25     Subd. 10.  [MFIP EXIT LEVEL.] The commissioner shall adjust 
 32.26  the MFIP earned income disregard to ensure that most 
 32.27  participants do not lose eligibility for MFIP until their income 
 32.28  reaches at least 120 115 percent of the federal poverty 
 32.29  guidelines in effect in October of each fiscal year.  The 
 32.30  adjustment to the disregard shall be based on a household size 
 32.31  of three, and the resulting earned income disregard percentage 
 32.32  must be applied to all household sizes.  The adjustment under 
 32.33  this subdivision must be implemented at the same time as the 
 32.34  October food stamp cost-of-living adjustment is reflected in the 
 32.35  food portion of MFIP transitional standard as required under 
 32.36  subdivision 5a. 
 33.1      Sec. 39.  Minnesota Statutes 2002, section 256J.30, 
 33.2   subdivision 9, is amended to read: 
 33.3      Subd. 9.  [CHANGES THAT MUST BE REPORTED.] A caregiver must 
 33.4   report the changes or anticipated changes specified in clauses 
 33.5   (1) to (17) (16) within ten days of the date they occur, at the 
 33.6   time of the periodic recertification of eligibility under 
 33.7   section 256J.32, subdivision 6, or within eight calendar days of 
 33.8   a reporting period as in subdivision 5 or 6, whichever occurs 
 33.9   first.  A caregiver must report other changes at the time of the 
 33.10  periodic recertification of eligibility under section 256J.32, 
 33.11  subdivision 6, or at the end of a reporting period under 
 33.12  subdivision 5 or 6, as applicable.  A caregiver must make these 
 33.13  reports in writing to the county agency.  When a county agency 
 33.14  could have reduced or terminated assistance for one or more 
 33.15  payment months if a delay in reporting a change specified under 
 33.16  clauses (1) to (16) (15) had not occurred, the county agency 
 33.17  must determine whether a timely notice under section 256J.31, 
 33.18  subdivision 4, could have been issued on the day that the change 
 33.19  occurred.  When a timely notice could have been issued, each 
 33.20  month's overpayment subsequent to that notice must be considered 
 33.21  a client error overpayment under section 256J.38.  Calculation 
 33.22  of overpayments for late reporting under clause (17) (16) is 
 33.23  specified in section 256J.09, subdivision 9.  Changes in 
 33.24  circumstances which must be reported within ten days must also 
 33.25  be reported on the MFIP household report form for the reporting 
 33.26  period in which those changes occurred.  Within ten days, a 
 33.27  caregiver must report: 
 33.28     (1) a change in initial employment; 
 33.29     (2) a change in initial receipt of unearned income; 
 33.30     (3) a recurring change in unearned income; 
 33.31     (4) a nonrecurring change of unearned income that exceeds 
 33.32  $30; 
 33.33     (5) the receipt of a lump sum; 
 33.34     (6) an increase in assets that may cause the assistance 
 33.35  unit to exceed asset limits; 
 33.36     (7) a change in the physical or mental status of an 
 34.1   incapacitated member of the assistance unit if the physical or 
 34.2   mental status is the basis of exemption from an MFIP employment 
 34.3   services program under section 256J.56 or for reducing the 
 34.4   hourly requirements under section 256J.55, subdivision 1, or the 
 34.5   type of activities included in an employment plan under section 
 34.6   256J.521, subdivision 2; 
 34.7      (8) a change in employment status; 
 34.8      (9) information affecting an exception under section 
 34.9   256J.24, subdivision 9; 
 34.10     (10) a change in health insurance coverage; 
 34.11     (11) the marriage or divorce of an assistance unit member; 
 34.12     (12) (11) the death of a parent, minor child, or 
 34.13  financially responsible person; 
 34.14     (13) (12) a change in address or living quarters of the 
 34.15  assistance unit; 
 34.16     (14) (13) the sale, purchase, or other transfer of 
 34.17  property; 
 34.18     (15) (14) a change in school attendance of a custodial 
 34.19  parent caregiver under age 20 or an employed child; 
 34.20     (16) (15) filing a lawsuit, a workers' compensation claim, 
 34.21  or a monetary claim against a third party; and 
 34.22     (17) (16) a change in household composition, including 
 34.23  births, returns to and departures from the home of assistance 
 34.24  unit members and financially responsible persons, or a change in 
 34.25  the custody of a minor child. 
 34.26     Sec. 40.  Minnesota Statutes 2002, section 256J.32, 
 34.27  subdivision 2, is amended to read: 
 34.28     Subd. 2.  [DOCUMENTATION.] The applicant or participant 
 34.29  must document the information required under subdivisions 4 to 6 
 34.30  or authorize the county agency to verify the information.  The 
 34.31  applicant or participant has the burden of providing documentary 
 34.32  evidence to verify eligibility.  The county agency shall assist 
 34.33  the applicant or participant in obtaining required documents 
 34.34  when the applicant or participant is unable to do so.  When an 
 34.35  applicant or participant and the county agency are unable to 
 34.36  obtain documents needed to verify information, the county agency 
 35.1   may accept an affidavit from an applicant or participant as 
 35.2   sufficient documentation.  The county agency may accept an 
 35.3   affidavit only for factors specified under subdivision 8.  
 35.4      Sec. 41.  Minnesota Statutes 2002, section 256J.32, 
 35.5   subdivision 4, is amended to read: 
 35.6      Subd. 4.  [FACTORS TO BE VERIFIED.] The county agency shall 
 35.7   verify the following at application: 
 35.8      (1) identity of adults; 
 35.9      (2) presence of the minor child in the home, if 
 35.10  questionable; 
 35.11     (3) relationship of a minor child to caregivers in the 
 35.12  assistance unit; 
 35.13     (4) age, if necessary to determine MFIP eligibility; 
 35.14     (5) immigration status; 
 35.15     (6) social security number according to the requirements of 
 35.16  section 256J.30, subdivision 12; 
 35.17     (7) income; 
 35.18     (8) self-employment expenses used as a deduction; 
 35.19     (9) source and purpose of deposits and withdrawals from 
 35.20  business accounts; 
 35.21     (10) spousal support and child support payments made to 
 35.22  persons outside the household; 
 35.23     (11) real property; 
 35.24     (12) vehicles; 
 35.25     (13) checking and savings accounts; 
 35.26     (14) savings certificates, savings bonds, stocks, and 
 35.27  individual retirement accounts; 
 35.28     (15) pregnancy, if related to eligibility; 
 35.29     (16) inconsistent information, if related to eligibility; 
 35.30     (17) medical insurance; 
 35.31     (18) burial accounts; 
 35.32     (19) (18) school attendance, if related to eligibility; 
 35.33     (20) (19) residence; 
 35.34     (21) (20) a claim of family violence if used as a basis for 
 35.35  a to qualify for the family violence waiver from the 60-month 
 35.36  time limit in section 256J.42 and regular employment and 
 36.1   training services requirements in section 256J.56; 
 36.2      (22) (21) disability if used as the basis for an exemption 
 36.3   from employment and training services requirements under section 
 36.4   256J.56 or as the basis for reducing the hourly participation 
 36.5   requirements under section 256J.55, subdivision 1, or the type 
 36.6   of activity included in an employment plan under section 
 36.7   256J.521, subdivision 2; and 
 36.8      (23) (22) information needed to establish an exception 
 36.9   under section 256J.24, subdivision 9. 
 36.10     Sec. 42.  Minnesota Statutes 2002, section 256J.32, 
 36.11  subdivision 5a, is amended to read: 
 36.12     Subd. 5a.  [INCONSISTENT INFORMATION.] When the county 
 36.13  agency verifies inconsistent information under subdivision 4, 
 36.14  clause (16), or 6, clause (4) (5), the reason for verifying the 
 36.15  information must be documented in the financial case record. 
 36.16     Sec. 43.  Minnesota Statutes 2002, section 256J.32, is 
 36.17  amended by adding a subdivision to read: 
 36.18     Subd. 8.  [AFFIDAVIT.] The county agency may accept an 
 36.19  affidavit from the applicant or recipient as sufficient 
 36.20  documentation at the time of application or recertification only 
 36.21  for the following factors: 
 36.22     (1) a claim of family violence if used as a basis to 
 36.23  qualify for the family violence waiver; 
 36.24     (2) information needed to establish an exception under 
 36.25  section 256J.24, subdivision 9; 
 36.26     (3) relationship of a minor child to caregivers in the 
 36.27  assistance unit; and 
 36.28     (4) citizenship status from a noncitizen who reports to be, 
 36.29  or is identified as, a victim of severe forms of trafficking in 
 36.30  persons, if the noncitizen reports that the noncitizen's 
 36.31  immigration documents are being held by an individual or group 
 36.32  of individuals against the noncitizen's will.  The noncitizen 
 36.33  must follow up with the Office of Refugee Resettlement (ORR) to 
 36.34  pursue certification.  If verification that certification is 
 36.35  being pursued is not received within 30 days, the MFIP case must 
 36.36  be closed and the agency shall pursue overpayments.  The ORR 
 37.1   documents certifying the noncitizen's status as a victim of 
 37.2   severe forms of trafficking in persons, or the reason for the 
 37.3   delay in processing, must be received within 90 days, or the 
 37.4   MFIP case must be closed and the agency shall pursue 
 37.5   overpayments. 
 37.6      Sec. 44.  Minnesota Statutes 2002, section 256J.37, is 
 37.7   amended by adding a subdivision to read: 
 37.8      Subd. 3a.  [RENTAL SUBSIDIES; UNEARNED INCOME.] (a) 
 37.9   Effective July 1, 2003, the county agency shall count $100 of 
 37.10  the value of public and assisted rental subsidies provided 
 37.11  through the Department of Housing and Urban Development (HUD) as 
 37.12  unearned income to the cash portion of the MFIP grant.  The full 
 37.13  amount of the subsidy must be counted as unearned income when 
 37.14  the subsidy is less than $100. 
 37.15     (b) The provisions of this subdivision shall not apply to 
 37.16  an MFIP assistance unit which includes a participant who is: 
 37.17     (1) age 60 or older; 
 37.18     (2) a caregiver who is suffering from an illness, injury, 
 37.19  or incapacity that has been certified by a qualified 
 37.20  professional when the illness, injury, or incapacity is expected 
 37.21  to continue for more than 30 days and prevents the person from 
 37.22  obtaining or retaining employment; or 
 37.23     (3) a caregiver whose presence in the home is required due 
 37.24  to the illness or incapacity of another member in the assistance 
 37.25  unit, a relative in the household, or a foster child in the 
 37.26  household when the illness or incapacity and the need for the 
 37.27  participant's presence in the home has been certified by a 
 37.28  qualified professional and is expected to continue for more than 
 37.29  30 days. 
 37.30     (c) The provisions of this subdivision shall not apply to 
 37.31  an MFIP assistance unit where the parental caregiver is an SSI 
 37.32  recipient. 
 37.33     Sec. 45.  Minnesota Statutes 2002, section 256J.37, is 
 37.34  amended by adding a subdivision to read: 
 37.35     Subd. 3b.  [TREATMENT OF SUPPLEMENTAL SECURITY 
 37.36  INCOME.] Effective July 1, 2003, the county shall reduce the 
 38.1   cash portion of the MFIP grant by $175 per SSI recipient who 
 38.2   resides in the household, and who would otherwise be included in 
 38.3   the MFIP assistance unit under section 256J.24, subdivision 2, 
 38.4   but is excluded solely due to the supplemental security income 
 38.5   recipient status under section 256J.24, subdivision 3, paragraph 
 38.6   (a), clause (1).  If the SSI recipient receives less than $175 
 38.7   of supplemental security income, only the amount received shall 
 38.8   be used in calculating the MFIP cash assistance payment.  This 
 38.9   provision does not apply to relative caregivers who could elect 
 38.10  to be included in the MFIP assistance unit under section 
 38.11  256J.24, subdivision 4, unless the caregiver's children or 
 38.12  stepchildren are included in the MFIP assistance unit. 
 38.13     Sec. 46.  Minnesota Statutes 2002, section 256J.37, 
 38.14  subdivision 9, is amended to read: 
 38.15     Subd. 9.  [UNEARNED INCOME.] (a) The county agency must 
 38.16  apply unearned income to the MFIP standard of need.  When 
 38.17  determining the amount of unearned income, the county agency 
 38.18  must deduct the costs necessary to secure payments of unearned 
 38.19  income.  These costs include legal fees, medical fees, and 
 38.20  mandatory deductions such as federal and state income taxes. 
 38.21     (b) Effective July 1, 2003, the county agency shall count 
 38.22  $100 of the value of public and assisted rental subsidies 
 38.23  provided through the Department of Housing and Urban Development 
 38.24  (HUD) as unearned income.  The full amount of the subsidy must 
 38.25  be counted as unearned income when the subsidy is less than $100.
 38.26     (c) The provisions of paragraph (b) shall not apply to MFIP 
 38.27  participants who are exempt from the employment and training 
 38.28  services component because they are: 
 38.29     (i) individuals who are age 60 or older; 
 38.30     (ii) individuals who are suffering from a professionally 
 38.31  certified permanent or temporary illness, injury, or incapacity 
 38.32  which is expected to continue for more than 30 days and which 
 38.33  prevents the person from obtaining or retaining employment; or 
 38.34     (iii) caregivers whose presence in the home is required 
 38.35  because of the professionally certified illness or incapacity of 
 38.36  another member in the assistance unit, a relative in the 
 39.1   household, or a foster child in the household. 
 39.2      (d) The provisions of paragraph (b) shall not apply to an 
 39.3   MFIP assistance unit where the parental caregiver receives 
 39.4   supplemental security income. 
 39.5      Sec. 47.  Minnesota Statutes 2002, section 256J.38, 
 39.6   subdivision 3, is amended to read: 
 39.7      Subd. 3.  [RECOVERING OVERPAYMENTS FROM FORMER 
 39.8   PARTICIPANTS.] A county agency must initiate efforts to recover 
 39.9   overpayments paid to a former participant or caregiver.  Adults 
 39.10  Caregivers, both parental and nonparental, and minor caregivers 
 39.11  of an assistance unit at the time an overpayment occurs, whether 
 39.12  receiving assistance or not, are jointly and individually liable 
 39.13  for repayment of the overpayment.  The county agency must 
 39.14  request repayment from the former participants and caregivers.  
 39.15  When an agreement for repayment is not completed within six 
 39.16  months of the date of discovery or when there is a default on an 
 39.17  agreement for repayment after six months, the county agency must 
 39.18  initiate recovery consistent with chapter 270A, or section 
 39.19  541.05.  When a person has been convicted of fraud under section 
 39.20  256.98, recovery must be sought regardless of the amount of 
 39.21  overpayment.  When an overpayment is less than $35, and is not 
 39.22  the result of a fraud conviction under section 256.98, the 
 39.23  county agency must not seek recovery under this subdivision.  
 39.24  The county agency must retain information about all overpayments 
 39.25  regardless of the amount.  When an adult, adult caregiver, or 
 39.26  minor caregiver reapplies for assistance, the overpayment must 
 39.27  be recouped under subdivision 4. 
 39.28     Sec. 48.  Minnesota Statutes 2002, section 256J.38, 
 39.29  subdivision 4, is amended to read: 
 39.30     Subd. 4.  [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 
 39.31  participant may voluntarily repay, in part or in full, an 
 39.32  overpayment even if assistance is reduced under this 
 39.33  subdivision, until the total amount of the overpayment is 
 39.34  repaid.  When an overpayment occurs due to fraud, the county 
 39.35  agency must recover from the overpaid assistance unit, including 
 39.36  child only cases, ten percent of the applicable standard or the 
 40.1   amount of the monthly assistance payment, whichever is less.  
 40.2   When a nonfraud overpayment occurs, the county agency must 
 40.3   recover from the overpaid assistance unit, including child only 
 40.4   cases, three percent of the MFIP standard of need or the amount 
 40.5   of the monthly assistance payment, whichever is less.  
 40.6      Sec. 49.  Minnesota Statutes 2002, section 256J.42, 
 40.7   subdivision 4, is amended to read: 
 40.8      Subd. 4.  [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance 
 40.9   received by an assistance unit in a month when a caregiver 
 40.10  complied with a safety an employment plan or after October 1, 
 40.11  2001, complied or is complying with an alternative employment 
 40.12  plan under section 256J.49 256J.521, subdivision 1a 3, does 
 40.13  not count toward the 60-month limitation on assistance. 
 40.14     Sec. 50.  Minnesota Statutes 2002, section 256J.42, 
 40.15  subdivision 5, is amended to read: 
 40.16     Subd. 5.  [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 
 40.17  assistance received by an assistance unit does not count toward 
 40.18  the 60-month limit on assistance during a month in which the 
 40.19  caregiver is in the category in age 60 or older, including 
 40.20  months during which the caregiver was exempt under section 
 40.21  256J.56, paragraph (a), clause (1). 
 40.22     (b) From July 1, 1997, until the date MFIP is operative in 
 40.23  the caregiver's county of financial responsibility, any cash 
 40.24  assistance received by a caregiver who is complying with 
 40.25  Minnesota Statutes 1996, section 256.73, subdivision 5a, and 
 40.26  Minnesota Statutes 1998, section 256.736, if applicable, does 
 40.27  not count toward the 60-month limit on assistance.  Thereafter, 
 40.28  any cash assistance received by a minor caregiver who is 
 40.29  complying with the requirements of sections 256J.14 and 256J.54, 
 40.30  if applicable, does not count towards the 60-month limit on 
 40.31  assistance. 
 40.32     (c) Any diversionary assistance or emergency assistance 
 40.33  received prior to July 1, 2003, does not count toward the 
 40.34  60-month limit. 
 40.35     (d) Any cash assistance received by an 18- or 19-year-old 
 40.36  caregiver who is complying with the requirements of an 
 41.1   employment plan that includes an education option under section 
 41.2   256J.54 does not count toward the 60-month limit. 
 41.3      (e) Payments provided to meet short-term emergency needs 
 41.4   under section 256J.626 and diversionary work program benefits 
 41.5   provided under section 256J.95 do not count toward the 60-month 
 41.6   time limit. 
 41.7      Sec. 51.  Minnesota Statutes 2002, section 256J.42, 
 41.8   subdivision 6, is amended to read: 
 41.9      Subd. 6.  [CASE REVIEW.] (a) Within 180 days, but not less 
 41.10  than 60 days, before the end of the participant's 60th month on 
 41.11  assistance, the county agency or job counselor must review the 
 41.12  participant's case to determine if the employment plan is still 
 41.13  appropriate or if the participant is exempt under section 
 41.14  256J.56 from the employment and training services component, and 
 41.15  attempt to meet with the participant face-to-face. 
 41.16     (b) During the face-to-face meeting, a county agency or the 
 41.17  job counselor must: 
 41.18     (1) inform the participant how many months of counted 
 41.19  assistance the participant has accrued and when the participant 
 41.20  is expected to reach the 60th month; 
 41.21     (2) explain the hardship extension criteria under section 
 41.22  256J.425 and what the participant should do if the participant 
 41.23  thinks a hardship extension applies; 
 41.24     (3) identify other resources that may be available to the 
 41.25  participant to meet the needs of the family; and 
 41.26     (4) inform the participant of the right to appeal the case 
 41.27  closure under section 256J.40. 
 41.28     (c) If a face-to-face meeting is not possible, the county 
 41.29  agency must send the participant a notice of adverse action as 
 41.30  provided in section 256J.31, subdivisions 4 and 5. 
 41.31     (d) Before a participant's case is closed under this 
 41.32  section, the county must ensure that: 
 41.33     (1) the case has been reviewed by the job counselor's 
 41.34  supervisor or the review team designated in by the county's 
 41.35  approved local service unit plan county to determine if the 
 41.36  criteria for a hardship extension, if requested, were applied 
 42.1   appropriately; and 
 42.2      (2) the county agency or the job counselor attempted to 
 42.3   meet with the participant face-to-face. 
 42.4      Sec. 52.  Minnesota Statutes 2002, section 256J.425, 
 42.5   subdivision 1, is amended to read: 
 42.6      Subdivision 1.  [ELIGIBILITY.] (a) To be eligible for a 
 42.7   hardship extension, a participant in an assistance unit subject 
 42.8   to the time limit under section 256J.42, subdivision 1, in which 
 42.9   any participant has received 60 counted months of assistance, 
 42.10  must be in compliance in the participant's 60th counted month 
 42.11  the participant is applying for the extension.  For purposes of 
 42.12  determining eligibility for a hardship extension, a participant 
 42.13  is in compliance in any month that the participant has not been 
 42.14  sanctioned. 
 42.15     (b) If one participant in a two-parent assistance unit is 
 42.16  determined to be ineligible for a hardship extension, the county 
 42.17  shall give the assistance unit the option of disqualifying the 
 42.18  ineligible participant from MFIP.  In that case, the assistance 
 42.19  unit shall be treated as a one-parent assistance unit and the 
 42.20  assistance unit's MFIP grant shall be calculated using the 
 42.21  shared household standard under section 256J.08, subdivision 82a.
 42.22     Sec. 53.  Minnesota Statutes 2002, section 256J.425, 
 42.23  subdivision 1a, is amended to read: 
 42.24     Subd. 1a.  [REVIEW.] If a county grants a hardship 
 42.25  extension under this section, a county agency shall review the 
 42.26  case every six or 12 months, whichever is appropriate based on 
 42.27  the participant's circumstances and the extension 
 42.28  category.  More frequent reviews shall be required if 
 42.29  eligibility for an extension is based on a condition that is 
 42.30  subject to change in less than six months. 
 42.31     Sec. 54.  Minnesota Statutes 2002, section 256J.425, 
 42.32  subdivision 2, is amended to read: 
 42.33     Subd. 2.  [ILL OR INCAPACITATED.] (a) An assistance unit 
 42.34  subject to the time limit in section 256J.42, subdivision 1, in 
 42.35  which any participant has received 60 counted months of 
 42.36  assistance, is eligible to receive months of assistance under a 
 43.1   hardship extension if the participant who reached the time limit 
 43.2   belongs to any of the following groups: 
 43.3      (1) participants who are suffering from a professionally 
 43.4   certified an illness, injury, or incapacity which has been 
 43.5   certified by a qualified professional when the illness, injury, 
 43.6   or incapacity is expected to continue for more than 30 days 
 43.7   and which prevents the person from obtaining or retaining 
 43.8   employment and who are following.  These participants must 
 43.9   follow the treatment recommendations of the health care provider 
 43.10  qualified professional certifying the illness, injury, or 
 43.11  incapacity; 
 43.12     (2) participants whose presence in the home is required as 
 43.13  a caregiver because of a professionally certified the illness or 
 43.14  incapacity of another member in the assistance unit, a relative 
 43.15  in the household, or a foster child in the household and when 
 43.16  the illness or incapacity and the need for the participant's 
 43.17  presence in the home has been certified by a qualified 
 43.18  professional and is expected to continue for more than 30 days; 
 43.19  or 
 43.20     (3) caregivers with a child or an adult in the household 
 43.21  who meets the disability or medical criteria for home care 
 43.22  services under section 256B.0627, subdivision 1, paragraph 
 43.23  (c) (f), or a home and community-based waiver services program 
 43.24  under chapter 256B, or meets the criteria for severe emotional 
 43.25  disturbance under section 245.4871, subdivision 6, or for 
 43.26  serious and persistent mental illness under section 245.462, 
 43.27  subdivision 20, paragraph (c).  Caregivers in this category are 
 43.28  presumed to be prevented from obtaining or retaining employment. 
 43.29     (b) An assistance unit receiving assistance under a 
 43.30  hardship extension under this subdivision may continue to 
 43.31  receive assistance as long as the participant meets the criteria 
 43.32  in paragraph (a), clause (1), (2), or (3). 
 43.33     Sec. 55.  Minnesota Statutes 2002, section 256J.425, 
 43.34  subdivision 3, is amended to read: 
 43.35     Subd. 3.  [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 
 43.36  subject to the time limit in section 256J.42, subdivision 1, in 
 44.1   which any participant has received 60 counted months of 
 44.2   assistance, is eligible to receive months of assistance under a 
 44.3   hardship extension if the participant who reached the time limit 
 44.4   belongs to any of the following groups: 
 44.5      (1) a person who is diagnosed by a licensed physician, 
 44.6   psychological practitioner, or other qualified professional, as 
 44.7   mentally retarded or mentally ill, and that condition prevents 
 44.8   the person from obtaining or retaining unsubsidized employment; 
 44.9      (2) a person who: 
 44.10     (i) has been assessed by a vocational specialist or the 
 44.11  county agency to be unemployable for purposes of this 
 44.12  subdivision; or 
 44.13     (ii) has an IQ below 80 who has been assessed by a 
 44.14  vocational specialist or a county agency to be employable, but 
 44.15  not at a level that makes the participant eligible for an 
 44.16  extension under subdivision 4 or,.  The determination of IQ 
 44.17  level must be made by a qualified professional.  In the case of 
 44.18  a non-English-speaking person for whom it is not possible to 
 44.19  provide a determination due to language barriers or absence of 
 44.20  culturally appropriate assessment tools, is determined by a 
 44.21  qualified professional to have an IQ below 80.  A person is 
 44.22  considered employable if positions of employment in the local 
 44.23  labor market exist, regardless of the current availability of 
 44.24  openings for those positions, that the person is capable of 
 44.25  performing:  (A) the determination must be made by a qualified 
 44.26  professional with experience conducting culturally appropriate 
 44.27  assessments, whenever possible; (B) the county may accept 
 44.28  reports that identify an IQ range as opposed to a specific 
 44.29  score; (C) these reports must include a statement of confidence 
 44.30  in the results; 
 44.31     (3) a person who is determined by the county agency a 
 44.32  qualified professional to be learning disabled or, and the 
 44.33  disability severely limits the person's ability to obtain, 
 44.34  perform, or maintain suitable employment.  For purposes of the 
 44.35  initial approval of a learning disability extension, the 
 44.36  determination must have been made or confirmed within the 
 45.1   previous 12 months.  In the case of a non-English-speaking 
 45.2   person for whom it is not possible to provide a medical 
 45.3   diagnosis due to language barriers or absence of culturally 
 45.4   appropriate assessment tools, is determined by a qualified 
 45.5   professional to have a learning disability.  If a rehabilitation 
 45.6   plan for the person is developed or approved by the county 
 45.7   agency, the plan must be incorporated into the employment plan.  
 45.8   However, a rehabilitation plan does not replace the requirement 
 45.9   to develop and comply with an employment plan under section 
 45.10  256J.52.  For purposes of this section, "learning disabled" 
 45.11  means the applicant or recipient has a disorder in one or more 
 45.12  of the psychological processes involved in perceiving, 
 45.13  understanding, or using concepts through verbal language or 
 45.14  nonverbal means.  The disability must severely limit the 
 45.15  applicant or recipient in obtaining, performing, or maintaining 
 45.16  suitable employment.  Learning disabled does not include 
 45.17  learning problems that are primarily the result of visual, 
 45.18  hearing, or motor handicaps; mental retardation; emotional 
 45.19  disturbance; or due to environmental, cultural, or economic 
 45.20  disadvantage:  (i) the determination must be made by a qualified 
 45.21  professional with experience conducting culturally appropriate 
 45.22  assessments, whenever possible; and (ii) these reports must 
 45.23  include a statement of confidence in the results.  If a 
 45.24  rehabilitation plan for a participant extended as learning 
 45.25  disabled is developed or approved by the county agency, the plan 
 45.26  must be incorporated into the employment plan.  However, a 
 45.27  rehabilitation plan does not replace the requirement to develop 
 45.28  and comply with an employment plan under section 256J.521; or 
 45.29     (4) a person who is a victim of has been granted a family 
 45.30  violence as defined in section 256J.49, subdivision 2 waiver, 
 45.31  and who is participating in complying with an alternative 
 45.32  employment plan under section 256J.49 256J.521, subdivision 1a 
 45.33  3.  
 45.34     Sec. 56.  Minnesota Statutes 2002, section 256J.425, 
 45.35  subdivision 4, is amended to read: 
 45.36     Subd. 4.  [EMPLOYED PARTICIPANTS.] (a) An assistance unit 
 46.1   subject to the time limit under section 256J.42, subdivision 1, 
 46.2   in which any participant has received 60 months of assistance, 
 46.3   is eligible to receive assistance under a hardship extension if 
 46.4   the participant who reached the time limit belongs to: 
 46.5      (1) a one-parent assistance unit in which the participant 
 46.6   is participating in work activities for at least 30 hours per 
 46.7   week, of which an average of at least 25 hours per week every 
 46.8   month are spent participating in employment; 
 46.9      (2) a two-parent assistance unit in which the participants 
 46.10  are participating in work activities for at least 55 hours per 
 46.11  week, of which an average of at least 45 hours per week every 
 46.12  month are spent participating in employment; or 
 46.13     (3) an assistance unit in which a participant is 
 46.14  participating in employment for fewer hours than those specified 
 46.15  in clause (1), and the participant submits verification from a 
 46.16  health care provider qualified professional, in a form 
 46.17  acceptable to the commissioner, stating that the number of hours 
 46.18  the participant may work is limited due to illness or 
 46.19  disability, as long as the participant is participating in 
 46.20  employment for at least the number of hours specified by 
 46.21  the health care provider qualified professional.  The 
 46.22  participant must be following the treatment recommendations of 
 46.23  the health care provider qualified professional providing the 
 46.24  verification.  The commissioner shall develop a form to be 
 46.25  completed and signed by the health care provider qualified 
 46.26  professional, documenting the diagnosis and any additional 
 46.27  information necessary to document the functional limitations of 
 46.28  the participant that limit work hours.  If the participant is 
 46.29  part of a two-parent assistance unit, the other parent must be 
 46.30  treated as a one-parent assistance unit for purposes of meeting 
 46.31  the work requirements under this subdivision. 
 46.32     (b) For purposes of this section, employment means: 
 46.33     (1) unsubsidized employment under section 256J.49, 
 46.34  subdivision 13, clause (1); 
 46.35     (2) subsidized employment under section 256J.49, 
 46.36  subdivision 13, clause (2); 
 47.1      (3) on-the-job training under section 256J.49, subdivision 
 47.2   13, clause (4) (2); 
 47.3      (4) an apprenticeship under section 256J.49, subdivision 
 47.4   13, clause (19) (1); 
 47.5      (5) supported work.  For purposes of this section, 
 47.6   "supported work" means services supporting a participant on the 
 47.7   job which include, but are not limited to, supervision, job 
 47.8   coaching, and subsidized wages under section 256J.49, 
 47.9   subdivision 13, clause (2); 
 47.10     (6) a combination of clauses (1) to (5); or 
 47.11     (7) child care under section 256J.49, subdivision 13, 
 47.12  clause (25) (7), if it is in combination with paid employment. 
 47.13     (c) If a participant is complying with a child protection 
 47.14  plan under chapter 260C, the number of hours required under the 
 47.15  child protection plan count toward the number of hours required 
 47.16  under this subdivision.  
 47.17     (d) The county shall provide the opportunity for subsidized 
 47.18  employment to participants needing that type of employment 
 47.19  within available appropriations. 
 47.20     (e) To be eligible for a hardship extension for employed 
 47.21  participants under this subdivision, a participant in a 
 47.22  one-parent assistance unit or both parents in a two-parent 
 47.23  assistance unit must be in compliance for at least ten out of 
 47.24  the 12 months immediately preceding the participant's 61st month 
 47.25  on assistance.  If only one parent in a two-parent assistance 
 47.26  unit fails to be in compliance ten out of the 12 months 
 47.27  immediately preceding the participant's 61st month, the county 
 47.28  shall give the assistance unit the option of disqualifying the 
 47.29  noncompliant parent.  If the noncompliant participant is 
 47.30  disqualified, the assistance unit must be treated as a 
 47.31  one-parent assistance unit for the purposes of meeting the work 
 47.32  requirements under this subdivision and the assistance unit's 
 47.33  MFIP grant shall be calculated using the shared household 
 47.34  standard under section 256J.08, subdivision 82a. 
 47.35     (f) The employment plan developed under section 256J.52 
 47.36  256J.521, subdivision 5 2, for participants under this 
 48.1   subdivision must contain the number of hours specified in 
 48.2   paragraph (a) related to employment and work activities.  The 
 48.3   job counselor and the participant must sign the employment plan 
 48.4   to indicate agreement between the job counselor and the 
 48.5   participant on the contents of the plan. 
 48.6      (g) Participants who fail to meet the requirements in 
 48.7   paragraph (a), without good cause under section 256J.57, shall 
 48.8   be sanctioned or permanently disqualified under subdivision 6.  
 48.9   Good cause may only be granted for that portion of the month for 
 48.10  which the good cause reason applies.  Participants must meet all 
 48.11  remaining requirements in the approved employment plan or be 
 48.12  subject to sanction or permanent disqualification.  
 48.13     (h) If the noncompliance with an employment plan is due to 
 48.14  the involuntary loss of employment, the participant is exempt 
 48.15  from the hourly employment requirement under this subdivision 
 48.16  for one month.  Participants must meet all remaining 
 48.17  requirements in the approved employment plan or be subject to 
 48.18  sanction or permanent disqualification.  This exemption is 
 48.19  available to one-parent assistance units a participant two times 
 48.20  in a 12-month period, and two-parent assistance units, two times 
 48.21  per parent in a 12-month period. 
 48.22     (i) This subdivision expires on June 30, 2004. 
 48.23     Sec. 57.  Minnesota Statutes 2002, section 256J.425, 
 48.24  subdivision 6, is amended to read: 
 48.25     Subd. 6.  [SANCTIONS FOR EXTENDED CASES.] (a) If one or 
 48.26  both participants in an assistance unit receiving assistance 
 48.27  under subdivision 3 or 4 are not in compliance with the 
 48.28  employment and training service requirements in sections 256J.52 
 48.29  256J.521 to 256J.55 256J.57, the sanctions under this 
 48.30  subdivision apply.  For a first occurrence of noncompliance, an 
 48.31  assistance unit must be sanctioned under section 256J.46, 
 48.32  subdivision 1, paragraph (d) (c), clause (1).  For a second or 
 48.33  third occurrence of noncompliance, the assistance unit must be 
 48.34  sanctioned under section 256J.46, subdivision 1, 
 48.35  paragraph (d) (c), clause (2).  For a fourth occurrence of 
 48.36  noncompliance, the assistance unit is disqualified from MFIP.  
 49.1   If a participant is determined to be out of compliance, the 
 49.2   participant may claim a good cause exception under section 
 49.3   256J.57, however, the participant may not claim an exemption 
 49.4   under section 256J.56.  
 49.5      (b) If both participants in a two-parent assistance unit 
 49.6   are out of compliance at the same time, it is considered one 
 49.7   occurrence of noncompliance.  
 49.8      Sec. 58.  Minnesota Statutes 2002, section 256J.425, 
 49.9   subdivision 7, is amended to read: 
 49.10     Subd. 7.  [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 
 49.11  assistance unit that is disqualified under subdivision 6, 
 49.12  paragraph (a), may be approved for MFIP if the participant 
 49.13  complies with MFIP program requirements and demonstrates 
 49.14  compliance for up to one month.  No assistance shall be paid 
 49.15  during this period. 
 49.16     (b) An assistance unit that is disqualified under 
 49.17  subdivision 6, paragraph (a), and that reapplies under paragraph 
 49.18  (a) is subject to sanction under section 256J.46, subdivision 1, 
 49.19  paragraph (d) (c), clause (1), for a first occurrence of 
 49.20  noncompliance.  A subsequent occurrence of noncompliance results 
 49.21  in a permanent disqualification. 
 49.22     (c) If one participant in a two-parent assistance unit 
 49.23  receiving assistance under a hardship extension under 
 49.24  subdivision 3 or 4 is determined to be out of compliance with 
 49.25  the employment and training services requirements under sections 
 49.26  256J.52 256J.521 to 256J.55 256J.57, the county shall give the 
 49.27  assistance unit the option of disqualifying the noncompliant 
 49.28  participant from MFIP.  In that case, the assistance unit shall 
 49.29  be treated as a one-parent assistance unit for the purposes of 
 49.30  meeting the work requirements under subdivision 4 and the 
 49.31  assistance unit's MFIP grant shall be calculated using the 
 49.32  shared household standard under section 256J.08, subdivision 
 49.33  82a.  An applicant who is disqualified from receiving assistance 
 49.34  under this paragraph may reapply under paragraph (a).  If a 
 49.35  participant is disqualified from MFIP under this subdivision a 
 49.36  second time, the participant is permanently disqualified from 
 50.1   MFIP. 
 50.2      (d) Prior to a disqualification under this subdivision, a 
 50.3   county agency must review the participant's case to determine if 
 50.4   the employment plan is still appropriate and attempt to meet 
 50.5   with the participant face-to-face.  If a face-to-face meeting is 
 50.6   not conducted, the county agency must send the participant a 
 50.7   notice of adverse action as provided in section 256J.31.  During 
 50.8   the face-to-face meeting, the county agency must: 
 50.9      (1) determine whether the continued noncompliance can be 
 50.10  explained and mitigated by providing a needed preemployment 
 50.11  activity, as defined in section 256J.49, subdivision 13, clause 
 50.12  (16), or services under a local intervention grant for 
 50.13  self-sufficiency under section 256J.625 (9); 
 50.14     (2) determine whether the participant qualifies for a good 
 50.15  cause exception under section 256J.57; 
 50.16     (3) inform the participant of the family violence waiver 
 50.17  provisions and make appropriate referrals if the waiver is 
 50.18  requested; 
 50.19     (4) inform the participant of the participant's sanction 
 50.20  status and explain the consequences of continuing noncompliance; 
 50.21     (4) (5) identify other resources that may be available to 
 50.22  the participant to meet the needs of the family; and 
 50.23     (5) (6) inform the participant of the right to appeal under 
 50.24  section 256J.40. 
 50.25     Sec. 59.  Minnesota Statutes 2002, section 256J.45, 
 50.26  subdivision 2, is amended to read: 
 50.27     Subd. 2.  [GENERAL INFORMATION.] The MFIP orientation must 
 50.28  consist of a presentation that informs caregivers of: 
 50.29     (1) the necessity to obtain immediate employment; 
 50.30     (2) the work incentives under MFIP, including the 
 50.31  availability of the federal earned income tax credit and the 
 50.32  Minnesota working family tax credit; 
 50.33     (3) the requirement to comply with the employment plan and 
 50.34  other requirements of the employment and training services 
 50.35  component of MFIP, including a description of the range of work 
 50.36  and training activities that are allowable under MFIP to meet 
 51.1   the individual needs of participants; 
 51.2      (4) the consequences for failing to comply with the 
 51.3   employment plan and other program requirements, and that the 
 51.4   county agency may not impose a sanction when failure to comply 
 51.5   is due to the unavailability of child care or other 
 51.6   circumstances where the participant has good cause under 
 51.7   subdivision 3; 
 51.8      (5) the rights, responsibilities, and obligations of 
 51.9   participants; 
 51.10     (6) the types and locations of child care services 
 51.11  available through the county agency; 
 51.12     (7) the availability and the benefits of the early 
 51.13  childhood health and developmental screening under sections 
 51.14  121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 
 51.15     (8) the caregiver's eligibility for transition year child 
 51.16  care assistance under section 119B.05; 
 51.17     (9) the caregiver's eligibility for extended medical 
 51.18  assistance when the caregiver loses eligibility for MFIP due to 
 51.19  increased earnings or increased child or spousal support the 
 51.20  availability of all health care programs, including transitional 
 51.21  medical assistance; 
 51.22     (10) the caregiver's option to choose an employment and 
 51.23  training provider and information about each provider, including 
 51.24  but not limited to, services offered, program components, job 
 51.25  placement rates, job placement wages, and job retention rates; 
 51.26     (11) the caregiver's option to request approval of an 
 51.27  education and training plan according to section 256J.52 
 51.28  256J.53; 
 51.29     (12) the work study programs available under the higher 
 51.30  education system; and 
 51.31     (13) effective October 1, 2001, information about the 
 51.32  60-month time limit exemption and waivers of regular employment 
 51.33  and training requirements for family violence victims exemptions 
 51.34  under the family violence waiver and referral information about 
 51.35  shelters and programs for victims of family violence. 
 51.36     Sec. 60.  Minnesota Statutes 2002, section 256J.46, 
 52.1   subdivision 1, is amended to read: 
 52.2      Subdivision 1.  [PARTICIPANTS NOT COMPLYING WITH PROGRAM 
 52.3   REQUIREMENTS.] (a) A participant who fails without good 
 52.4   cause under section 256J.57 to comply with the requirements of 
 52.5   this chapter, and who is not subject to a sanction under 
 52.6   subdivision 2, shall be subject to a sanction as provided in 
 52.7   this subdivision.  Prior to the imposition of a sanction, a 
 52.8   county agency shall provide a notice of intent to sanction under 
 52.9   section 256J.57, subdivision 2, and, when applicable, a notice 
 52.10  of adverse action as provided in section 256J.31. 
 52.11     (b) A participant who fails to comply with an alternative 
 52.12  employment plan must have the plan reviewed by a person trained 
 52.13  in domestic violence and a job counselor or the county agency to 
 52.14  determine if components of the alternative employment plan are 
 52.15  still appropriate.  If the activities are no longer appropriate, 
 52.16  the plan must be revised with a person trained in domestic 
 52.17  violence and approved by a job counselor or the county agency.  
 52.18  A participant who fails to comply with a plan that is determined 
 52.19  not to need revision will lose their exemption and be required 
 52.20  to comply with regular employment services activities.  
 52.21     (c) A sanction under this subdivision becomes effective the 
 52.22  month following the month in which a required notice is given.  
 52.23  A sanction must not be imposed when a participant comes into 
 52.24  compliance with the requirements for orientation under section 
 52.25  256J.45 or third-party liability for medical services under 
 52.26  section 256J.30, subdivision 10, prior to the effective date of 
 52.27  the sanction.  A sanction must not be imposed when a participant 
 52.28  comes into compliance with the requirements for employment and 
 52.29  training services under sections 256J.49 256J.515 to 
 52.30  256J.55 256J.57 ten days prior to the effective date of the 
 52.31  sanction.  For purposes of this subdivision, each month that a 
 52.32  participant fails to comply with a requirement of this chapter 
 52.33  shall be considered a separate occurrence of noncompliance.  A 
 52.34  participant who has had one or more sanctions imposed must 
 52.35  remain in compliance with the provisions of this chapter for six 
 52.36  months in order for a subsequent occurrence of noncompliance to 
 53.1   be considered a first occurrence.  If both participants in a 
 53.2   two-parent assistance unit are out of compliance at the same 
 53.3   time, it is considered one occurrence of noncompliance.  
 53.4      (d) (c) Sanctions for noncompliance shall be imposed as 
 53.5   follows: 
 53.6      (1) For the first occurrence of noncompliance by a 
 53.7   participant in an assistance unit, the assistance unit's grant 
 53.8   shall be reduced by ten percent of the MFIP standard of need for 
 53.9   an assistance unit of the same size with the residual grant paid 
 53.10  to the participant.  The reduction in the grant amount must be 
 53.11  in effect for a minimum of one month and shall be removed in the 
 53.12  month following the month that the participant returns to 
 53.13  compliance.  
 53.14     (2) For a second or subsequent, third, fourth, fifth, or 
 53.15  sixth occurrence of noncompliance by a participant in an 
 53.16  assistance unit, or when each of the participants in a 
 53.17  two-parent assistance unit have a first occurrence of 
 53.18  noncompliance at the same time, the assistance unit's shelter 
 53.19  costs shall be vendor paid up to the amount of the cash portion 
 53.20  of the MFIP grant for which the assistance unit is eligible.  At 
 53.21  county option, the assistance unit's utilities may also be 
 53.22  vendor paid up to the amount of the cash portion of the MFIP 
 53.23  grant remaining after vendor payment of the assistance unit's 
 53.24  shelter costs.  The residual amount of the grant after vendor 
 53.25  payment, if any, must be reduced by an amount equal to 30 
 53.26  percent of the MFIP standard of need for an assistance unit of 
 53.27  the same size before the residual grant is paid to the 
 53.28  assistance unit.  The reduction in the grant amount must be in 
 53.29  effect for a minimum of one month and shall be removed in the 
 53.30  month following the month that the participant in a one-parent 
 53.31  assistance unit returns to compliance.  In a two-parent 
 53.32  assistance unit, the grant reduction must be in effect for a 
 53.33  minimum of one month and shall be removed in the month following 
 53.34  the month both participants return to compliance.  The vendor 
 53.35  payment of shelter costs and, if applicable, utilities shall be 
 53.36  removed six months after the month in which the participant or 
 54.1   participants return to compliance.  If an assistance unit is 
 54.2   sanctioned under this clause, the participant's case file must 
 54.3   be reviewed as required under paragraph (e) to determine if the 
 54.4   employment plan is still appropriate. 
 54.5      (e) When a sanction under paragraph (d), clause (2), is in 
 54.6   effect (d) For a seventh occurrence of noncompliance by a 
 54.7   participant in an assistance unit, or when the participants in a 
 54.8   two-parent assistance unit have a total of seven occurrences of 
 54.9   noncompliance, the county agency shall close the MFIP assistance 
 54.10  unit's financial assistance case, both the cash and food 
 54.11  portions.  The case must remain closed for a minimum of one full 
 54.12  month.  Closure under this paragraph does not make a participant 
 54.13  automatically ineligible for food support, if otherwise eligible.
 54.14  Before the case is closed, the county agency must review the 
 54.15  participant's case to determine if the employment plan is still 
 54.16  appropriate and attempt to meet with the participant 
 54.17  face-to-face.  The participant may bring an advocate to the 
 54.18  face-to-face meeting.  If a face-to-face meeting is not 
 54.19  conducted, the county agency must send the participant a written 
 54.20  notice that includes the information required under clause (1). 
 54.21     (1) During the face-to-face meeting, the county agency must:
 54.22     (i) determine whether the continued noncompliance can be 
 54.23  explained and mitigated by providing a needed preemployment 
 54.24  activity, as defined in section 256J.49, subdivision 13, clause 
 54.25  (16), or services under a local intervention grant for 
 54.26  self-sufficiency under section 256J.625 (9); 
 54.27     (ii) determine whether the participant qualifies for a good 
 54.28  cause exception under section 256J.57, or if the sanction is for 
 54.29  noncooperation with child support requirements, determine if the 
 54.30  participant qualifies for a good cause exemption under section 
 54.31  256.741, subdivision 10; 
 54.32     (iii) determine whether the participant qualifies for an 
 54.33  exemption under section 256J.56 or the work activities in the 
 54.34  employment plan are appropriate based on the criteria in section 
 54.35  256J.521, subdivision 2 or 3; 
 54.36     (iv) determine whether the participant qualifies for an 
 55.1   exemption from regular employment services requirements for 
 55.2   victims of family violence under section 256J.52, subdivision 
 55.3   6 determine whether the participant qualifies for the family 
 55.4   violence waiver; 
 55.5      (v) inform the participant of the participant's sanction 
 55.6   status and explain the consequences of continuing noncompliance; 
 55.7      (vi) identify other resources that may be available to the 
 55.8   participant to meet the needs of the family; and 
 55.9      (vii) inform the participant of the right to appeal under 
 55.10  section 256J.40. 
 55.11     (2) If the lack of an identified activity or service can 
 55.12  explain the noncompliance, the county must work with the 
 55.13  participant to provide the identified activity, and the county 
 55.14  must restore the participant's grant amount to the full amount 
 55.15  for which the assistance unit is eligible.  The grant must be 
 55.16  restored retroactively to the first day of the month in which 
 55.17  the participant was found to lack preemployment activities or to 
 55.18  qualify for an exemption under section 256J.56, a good cause 
 55.19  exception under section 256J.57, or an exemption for victims of 
 55.20  family violence under section 256J.52, subdivision 6. 
 55.21     (3) If the participant is found to qualify for a good cause 
 55.22  exception or an exemption, the county must restore the 
 55.23  participant's grant to the full amount for which the assistance 
 55.24  unit is eligible.  The grant must be restored to the full amount 
 55.25  for which the assistance unit is eligible retroactively to the 
 55.26  first day of the month in which the participant was found to 
 55.27  lack preemployment activities or to qualify for an exemption 
 55.28  under section 256J.56, a family violence waiver, or for a good 
 55.29  cause exemption under section 256.741, subdivision 10, or 
 55.30  256J.57. 
 55.31     (e) For the purpose of applying sanctions under this 
 55.32  section, only occurrences of noncompliance that occur after the 
 55.33  effective date of this section shall be considered.  If the 
 55.34  participant is in 30 percent sanction in the month this section 
 55.35  takes effect, that month counts as the first occurrence for 
 55.36  purposes of applying the sanctions under this section, but the 
 56.1   sanction shall remain at 30 percent for that month. 
 56.2      (f) An assistance unit whose case is closed under paragraph 
 56.3   (d) or (g), or under an approved county option sanction plan 
 56.4   under section 256J.462 in effect June 30, 2003, or a county 
 56.5   pilot project under Laws 2000, chapter 488, article 10, section 
 56.6   29, in effect June 30, 2003, may reapply for MFIP and shall be 
 56.7   eligible if the participant complies with MFIP program 
 56.8   requirements and demonstrates compliance for up to one month.  
 56.9   No assistance shall be paid during this period. 
 56.10     (g) An assistance unit whose case has been closed for 
 56.11  noncompliance, that reapplies under paragraph (f) is subject to 
 56.12  sanction under paragraph (c), clause (2), for a first occurrence 
 56.13  of noncompliance.  Any subsequent occurrence of noncompliance 
 56.14  shall result in case closure under paragraph (d). 
 56.15     Sec. 61.  Minnesota Statutes 2002, section 256J.46, 
 56.16  subdivision 2, is amended to read: 
 56.17     Subd. 2.  [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 
 56.18  REQUIREMENTS.] The grant of an MFIP caregiver who refuses to 
 56.19  cooperate, as determined by the child support enforcement 
 56.20  agency, with support requirements under section 256.741, shall 
 56.21  be subject to sanction as specified in this subdivision and 
 56.22  subdivision 1.  For a first occurrence of noncooperation, the 
 56.23  assistance unit's grant must be reduced by 25 30 percent of the 
 56.24  applicable MFIP standard of need.  Subsequent occurrences of 
 56.25  noncooperation shall be subject to sanction under subdivision 1, 
 56.26  paragraphs (c), clause (2), and (d).  The residual amount of the 
 56.27  grant, if any, must be paid to the caregiver.  A sanction under 
 56.28  this subdivision becomes effective the first month following the 
 56.29  month in which a required notice is given.  A sanction must not 
 56.30  be imposed when a caregiver comes into compliance with the 
 56.31  requirements under section 256.741 prior to the effective date 
 56.32  of the sanction.  The sanction shall be removed in the month 
 56.33  following the month that the caregiver cooperates with the 
 56.34  support requirements.  Each month that an MFIP caregiver fails 
 56.35  to comply with the requirements of section 256.741 must be 
 56.36  considered a separate occurrence of noncompliance for the 
 57.1   purpose of applying sanctions under subdivision 1, paragraphs 
 57.2   (c), clause (2), and (d).  An MFIP caregiver who has had one or 
 57.3   more sanctions imposed must remain in compliance with the 
 57.4   requirements of section 256.741 for six months in order for a 
 57.5   subsequent sanction to be considered a first occurrence. 
 57.6      Sec. 62.  Minnesota Statutes 2002, section 256J.46, 
 57.7   subdivision 2a, is amended to read: 
 57.8      Subd. 2a.  [DUAL SANCTIONS.] (a) Notwithstanding the 
 57.9   provisions of subdivisions 1 and 2, for a participant subject to 
 57.10  a sanction for refusal to comply with child support requirements 
 57.11  under subdivision 2 and subject to a concurrent sanction for 
 57.12  refusal to cooperate with other program requirements under 
 57.13  subdivision 1, sanctions shall be imposed in the manner 
 57.14  prescribed in this subdivision. 
 57.15     A participant who has had one or more sanctions imposed 
 57.16  under this subdivision must remain in compliance with the 
 57.17  provisions of this chapter for six months in order for a 
 57.18  subsequent occurrence of noncompliance to be considered a first 
 57.19  occurrence.  Any vendor payment of shelter costs or utilities 
 57.20  under this subdivision must remain in effect for six months 
 57.21  after the month in which the participant is no longer subject to 
 57.22  sanction under subdivision 1. 
 57.23     (b) If the participant was subject to sanction for: 
 57.24     (i) noncompliance under subdivision 1 before being subject 
 57.25  to sanction for noncooperation under subdivision 2; or 
 57.26     (ii) noncooperation under subdivision 2 before being 
 57.27  subject to sanction for noncompliance under subdivision 1, the 
 57.28  participant is considered to have a second occurrence of 
 57.29  noncompliance and shall be sanctioned as provided in subdivision 
 57.30  1, paragraph (d) (c), clause (2).  Each subsequent occurrence of 
 57.31  noncompliance shall be considered one additional occurrence and 
 57.32  shall be subject to the applicable level of sanction under 
 57.33  subdivision 1, paragraph (d), or section 256J.462.  The 
 57.34  requirement that the county conduct a review as specified in 
 57.35  subdivision 1, paragraph (e) (d), remains in effect. 
 57.36     (c) A participant who first becomes subject to sanction 
 58.1   under both subdivisions 1 and 2 in the same month is subject to 
 58.2   sanction as follows: 
 58.3      (i) in the first month of noncompliance and noncooperation, 
 58.4   the participant's grant must be reduced by 25 percent of the 
 58.5   applicable MFIP standard of need, with any residual amount paid 
 58.6   to the participant; 
 58.7      (ii) in the second and subsequent months of noncompliance 
 58.8   and noncooperation, the participant shall be subject to the 
 58.9   applicable level of sanction under subdivision 1, paragraph (d), 
 58.10  or section 256J.462. 
 58.11     The requirement that the county conduct a review as 
 58.12  specified in subdivision 1, paragraph (e) (d), remains in effect.
 58.13     (d) A participant remains subject to sanction under 
 58.14  subdivision 2 if the participant: 
 58.15     (i) returns to compliance and is no longer subject to 
 58.16  sanction under subdivision 1 or section 256J.462 for 
 58.17  noncompliance with section 256J.45 or sections 256J.515 to 
 58.18  256J.57; or 
 58.19     (ii) has the sanction under subdivision 1, paragraph (d), 
 58.20  or section 256J.462 for noncompliance with section 256J.45 or 
 58.21  sections 256J.515 to 256J.57 removed upon completion of the 
 58.22  review under subdivision 1, paragraph (e). 
 58.23     A participant remains subject to the applicable level of 
 58.24  sanction under subdivision 1, paragraph (d), or section 256J.462 
 58.25  if the participant cooperates and is no longer subject to 
 58.26  sanction under subdivision 2. 
 58.27     Sec. 63.  Minnesota Statutes 2002, section 256J.49, 
 58.28  subdivision 4, is amended to read: 
 58.29     Subd. 4.  [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 
 58.30  "Employment and training service provider" means: 
 58.31     (1) a public, private, or nonprofit employment and training 
 58.32  agency certified by the commissioner of economic security under 
 58.33  sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 
 58.34  is approved under section 256J.51 and is included in the county 
 58.35  plan service agreement submitted under section 256J.50 256J.626, 
 58.36  subdivision 7 4; 
 59.1      (2) a public, private, or nonprofit agency that is not 
 59.2   certified by the commissioner under clause (1), but with which a 
 59.3   county has contracted to provide employment and training 
 59.4   services and which is included in the county's plan service 
 59.5   agreement submitted under section 256J.50 256J.626, 
 59.6   subdivision 7 4; or 
 59.7      (3) a county agency, if the county has opted to provide 
 59.8   employment and training services and the county has indicated 
 59.9   that fact in the plan service agreement submitted under section 
 59.10  256J.50 256J.626, subdivision 7 4. 
 59.11     Notwithstanding section 268.871, an employment and training 
 59.12  services provider meeting this definition may deliver employment 
 59.13  and training services under this chapter. 
 59.14     Sec. 64.  Minnesota Statutes 2002, section 256J.49, 
 59.15  subdivision 5, is amended to read: 
 59.16     Subd. 5.  [EMPLOYMENT PLAN.] "Employment plan" means a plan 
 59.17  developed by the job counselor and the participant which 
 59.18  identifies the participant's most direct path to unsubsidized 
 59.19  employment, lists the specific steps that the caregiver will 
 59.20  take on that path, and includes a timetable for the completion 
 59.21  of each step.  The plan should also identify any subsequent 
 59.22  steps that support long-term economic stability.  For 
 59.23  participants who request and qualify for a family violence 
 59.24  waiver, an employment plan must be developed by the job 
 59.25  counselor, the participant, and a person trained in domestic 
 59.26  violence and follow the employment plan provisions in section 
 59.27  256J.521, subdivision 3. 
 59.28     Sec. 65.  Minnesota Statutes 2002, section 256J.49, is 
 59.29  amended by adding a subdivision to read: 
 59.30     Subd. 6a.  [FUNCTIONAL WORK LITERACY.] "Functional work 
 59.31  literacy" means an intensive English as a second language 
 59.32  program that is work focused and offers at least 20 hours of 
 59.33  class time per week. 
 59.34     Sec. 66.  Minnesota Statutes 2002, section 256J.49, 
 59.35  subdivision 9, is amended to read: 
 59.36     Subd. 9.  [PARTICIPANT.] "Participant" means a recipient of 
 60.1   MFIP assistance who participates or is required to participate 
 60.2   in employment and training services under sections 256J.515 to 
 60.3   256J.57 and 256J.95. 
 60.4      Sec. 67.  Minnesota Statutes 2002, section 256J.49, 
 60.5   subdivision 13, is amended to read: 
 60.6      Subd. 13.  [WORK ACTIVITY.] "Work activity" means any 
 60.7   activity in a participant's approved employment plan that is 
 60.8   tied to the participant's leads to employment goal.  For 
 60.9   purposes of the MFIP program, any activity that is included in a 
 60.10  participant's approved employment plan meets this includes 
 60.11  activities that meet the definition of work activity as counted 
 60.12  under the federal participation standards requirements of TANF.  
 60.13  Work activity includes, but is not limited to: 
 60.14     (1) unsubsidized employment, including work study and paid 
 60.15  apprenticeships or internships; 
 60.16     (2) subsidized private sector or public sector employment, 
 60.17  including grant diversion as specified in section 256J.69, 
 60.18  on-the-job training as specified in section 256J.66, the 
 60.19  self-employment investment demonstration program (SEID) as 
 60.20  specified in section 256J.65, paid work experience, and 
 60.21  supported work when a wage subsidy is provided; 
 60.22     (3) unpaid work experience, including CWEP community 
 60.23  service, volunteer work, the community work experience program 
 60.24  as specified in section 256J.67, unpaid apprenticeships or 
 60.25  internships, and including work associated with the refurbishing 
 60.26  of publicly assisted housing if sufficient private sector 
 60.27  employment is not available supported work when a wage subsidy 
 60.28  is not provided; 
 60.29     (4) on-the-job training as specified in section 256J.66 job 
 60.30  search including job readiness assistance, job clubs, job 
 60.31  placement, job-related counseling, and job retention services; 
 60.32     (5) job search, either supervised or unsupervised; 
 60.33     (6) job readiness assistance; 
 60.34     (7) job clubs, including job search workshops; 
 60.35     (8) job placement; 
 60.36     (9) job development; 
 61.1      (10) job-related counseling; 
 61.2      (11) job coaching; 
 61.3      (12) job retention services; 
 61.4      (13) job-specific training or education; 
 61.5      (14) job skills training directly related to employment; 
 61.6      (15) the self-employment investment demonstration (SEID), 
 61.7   as specified in section 256J.65; 
 61.8      (16) preemployment activities, based on availability and 
 61.9   resources, such as volunteer work, literacy programs and related 
 61.10  activities, citizenship classes, English as a second language 
 61.11  (ESL) classes as limited by the provisions of section 256J.52, 
 61.12  subdivisions 3, paragraph (d), and 5, paragraph (c), or 
 61.13  participation in dislocated worker services, chemical dependency 
 61.14  treatment, mental health services, peer group networks, 
 61.15  displaced homemaker programs, strength-based resiliency 
 61.16  training, parenting education, or other programs designed to 
 61.17  help families reach their employment goals and enhance their 
 61.18  ability to care for their children; 
 61.19     (17) community service programs; 
 61.20     (18) vocational educational training or educational 
 61.21  programs that can reasonably be expected to lead to employment, 
 61.22  as limited by the provisions of section 256J.53; 
 61.23     (19) apprenticeships; 
 61.24     (20) satisfactory attendance in general educational 
 61.25  development diploma classes or an adult diploma program; 
 61.26     (21) satisfactory attendance at secondary school, if the 
 61.27  participant has not received a high school diploma; 
 61.28     (22) adult basic education classes; 
 61.29     (23) internships; 
 61.30     (24) bilingual employment and training services; 
 61.31     (25) providing child care services to a participant who is 
 61.32  working in a community service program; and 
 61.33     (26) activities included in an alternative employment plan 
 61.34  that is developed under section 256J.52, subdivision 6. 
 61.35     (5) job readiness education, including English as a second 
 61.36  language (ESL) or functional work literacy classes as limited by 
 62.1   the provisions of section 256J.531, subdivision 2, general 
 62.2   educational development (GED) course work, high school 
 62.3   completion, and adult basic education as limited by the 
 62.4   provisions of section 256J.531, subdivision 1; 
 62.5      (6) job skills training directly related to employment, 
 62.6   including education and training that can reasonably be expected 
 62.7   to lead to employment, as limited by the provisions of section 
 62.8   256J.53; 
 62.9      (7) providing child care services to a participant who is 
 62.10  working in a community service program; 
 62.11     (8) activities included in the employment plan that is 
 62.12  developed under section 256J.521, subdivision 3; and 
 62.13     (9) preemployment activities including chemical and mental 
 62.14  health assessments, treatment, and services; learning 
 62.15  disabilities services; child protective services; family 
 62.16  stabilization services; or other programs designed to enhance 
 62.17  employability. 
 62.18     Sec. 68.  Minnesota Statutes 2002, section 256J.49, is 
 62.19  amended by adding a subdivision to read: 
 62.20     Subd. 14.  [SUPPORTED WORK.] "Supported work" means a 
 62.21  subsidized or unsubsidized work experience placement with a 
 62.22  public or private sector employer, which may include services 
 62.23  such as individual supervision and job coaching to support the 
 62.24  participant on the job. 
 62.25     Sec. 69.  Minnesota Statutes 2002, section 256J.50, 
 62.26  subdivision 1, is amended to read: 
 62.27     Subdivision 1.  [EMPLOYMENT AND TRAINING SERVICES COMPONENT 
 62.28  OF MFIP.] (a) By January 1, 1998, Each county must develop and 
 62.29  implement provide an employment and training services component 
 62.30  of MFIP which is designed to put participants on the most direct 
 62.31  path to unsubsidized employment.  Participation in these 
 62.32  services is mandatory for all MFIP caregivers, unless the 
 62.33  caregiver is exempt under section 256J.56. 
 62.34     (b) A county must provide employment and training services 
 62.35  under sections 256J.515 to 256J.74 within 30 days after 
 62.36  the caregiver's participation becomes mandatory under 
 63.1   subdivision 5 or within 30 days of receipt of a request for 
 63.2   services from a caregiver who under section 256J.42 is no longer 
 63.3   eligible to receive MFIP but whose income is below 120 percent 
 63.4   of the federal poverty guidelines for a family of the same 
 63.5   size.  The request must be made within 12 months of the date the 
 63.6   caregivers' MFIP case was closed caregiver is determined 
 63.7   eligible for MFIP, or within five days when the caregiver 
 63.8   participated in the diversionary work program under section 
 63.9   256J.95 within the past 12 months. 
 63.10     Sec. 70.  Minnesota Statutes 2002, section 256J.50, 
 63.11  subdivision 8, is amended to read: 
 63.12     Subd. 8.  [COUNTY DUTY TO ENSURE EMPLOYMENT AND TRAINING 
 63.13  CHOICES FOR PARTICIPANTS.] Each county, or group of counties 
 63.14  working cooperatively, shall make available to participants the 
 63.15  choice of at least two employment and training service providers 
 63.16  as defined under section 256J.49, subdivision 4, except in 
 63.17  counties utilizing workforce centers that use multiple 
 63.18  employment and training services, offer multiple services 
 63.19  options under a collaborative effort and can document that 
 63.20  participants have choice among employment and training services 
 63.21  designed to meet specialized needs.  The requirements of this 
 63.22  subdivision do not apply to the diversionary work program under 
 63.23  section 256J.95. 
 63.24     Sec. 71.  Minnesota Statutes 2002, section 256J.50, 
 63.25  subdivision 9, is amended to read: 
 63.26     Subd. 9.  [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding 
 63.27  subdivision 8, a county that explains in the plan service 
 63.28  agreement required under section 256J.626, subdivision 7 4, that 
 63.29  the provision of alternative employment and training service 
 63.30  providers would result in financial hardship for the county is 
 63.31  not required to make available more than one employment and 
 63.32  training provider. 
 63.33     Sec. 72.  Minnesota Statutes 2002, section 256J.50, 
 63.34  subdivision 10, is amended to read: 
 63.35     Subd. 10.  [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY 
 63.36  VIOLENCE.] (a) County agencies and their contractors must 
 64.1   provide universal notification to all applicants and recipients 
 64.2   of MFIP that: 
 64.3      (1) referrals to counseling and supportive services are 
 64.4   available for victims of family violence; 
 64.5      (2) nonpermanent resident battered individuals married to 
 64.6   United States citizens or permanent residents may be eligible to 
 64.7   petition for permanent residency under the federal Violence 
 64.8   Against Women Act, and that referrals to appropriate legal 
 64.9   services are available; 
 64.10     (3) victims of family violence are exempt from the 60-month 
 64.11  limit on assistance while the individual is if they are 
 64.12  complying with an approved safety plan or, after October 1, 
 64.13  2001, an alternative employment plan, as defined in under 
 64.14  section 256J.49 256J.521, subdivision 1a 3; and 
 64.15     (4) victims of family violence may choose to have regular 
 64.16  work requirements waived while the individual is complying with 
 64.17  an alternative employment plan as defined in under section 
 64.18  256J.49 256J.521, subdivision 1a 3.  
 64.19     (b) If an alternative employment plan under section 
 64.20  256J.521, subdivision 3, is denied, the county or a job 
 64.21  counselor must provide reasons why the plan is not approved and 
 64.22  document how the denial of the plan does not interfere with the 
 64.23  safety of the participant or children. 
 64.24     Notification must be in writing and orally at the time of 
 64.25  application and recertification, when the individual is referred 
 64.26  to the title IV-D child support agency, and at the beginning of 
 64.27  any job training or work placement assistance program. 
 64.28     Sec. 73.  Minnesota Statutes 2002, section 256J.51, 
 64.29  subdivision 1, is amended to read: 
 64.30     Subdivision 1.  [PROVIDER APPLICATION.] An employment and 
 64.31  training service provider that is not included in a county's 
 64.32  plan service agreement under section 256J.50 256J.626, 
 64.33  subdivision 7 4, because the county has demonstrated financial 
 64.34  hardship under section 256J.50, subdivision 9 of that section 5, 
 64.35  may appeal its exclusion to the commissioner of economic 
 64.36  security under this section. 
 65.1      Sec. 74.  Minnesota Statutes 2002, section 256J.51, 
 65.2   subdivision 2, is amended to read: 
 65.3      Subd. 2.  [APPEAL; ALTERNATE APPROVAL.] (a) An employment 
 65.4   and training service provider that is not included by a county 
 65.5   agency in the plan service agreement under section 
 65.6   256J.50 256J.626, subdivision 7 4, and that meets the criteria 
 65.7   in paragraph (b), may appeal its exclusion to the commissioner 
 65.8   of economic security, and may request alternative approval by 
 65.9   the commissioner of economic security to provide services in the 
 65.10  county.  
 65.11     (b) An employment and training services provider that is 
 65.12  requesting alternative approval must demonstrate to the 
 65.13  commissioner that the provider meets the standards specified in 
 65.14  section 268.871, subdivision 1, paragraph (b), except that the 
 65.15  provider's past experience may be in services and programs 
 65.16  similar to those specified in section 268.871, subdivision 1, 
 65.17  paragraph (b). 
 65.18     Sec. 75.  Minnesota Statutes 2002, section 256J.51, 
 65.19  subdivision 3, is amended to read: 
 65.20     Subd. 3.  [COMMISSIONER'S REVIEW.] (a) The commissioner 
 65.21  must act on a request for alternative approval under this 
 65.22  section within 30 days of the receipt of the request.  If after 
 65.23  reviewing the provider's request, and the county's plan service 
 65.24  agreement submitted under section 256J.50 256J.626, 
 65.25  subdivision 7 4, the commissioner determines that the provider 
 65.26  meets the criteria under subdivision 2, paragraph (b), and that 
 65.27  approval of the provider would not cause financial hardship to 
 65.28  the county, the county must submit a revised plan service 
 65.29  agreement under subdivision 4 that includes the approved 
 65.30  provider.  
 65.31     (b) If the commissioner determines that the approval of the 
 65.32  provider would cause financial hardship to the county, the 
 65.33  commissioner must notify the provider and the county of this 
 65.34  determination.  The alternate approval process under this 
 65.35  section shall be closed to other requests for alternate approval 
 65.36  to provide employment and training services in the county for up 
 66.1   to 12 months from the date that the commissioner makes a 
 66.2   determination under this paragraph. 
 66.3      Sec. 76.  Minnesota Statutes 2002, section 256J.51, 
 66.4   subdivision 4, is amended to read: 
 66.5      Subd. 4.  [REVISED PLAN SERVICE AGREEMENT REQUIRED.] The 
 66.6   commissioner of economic security must notify the county agency 
 66.7   when the commissioner grants an alternative approval to an 
 66.8   employment and training service provider under subdivision 2.  
 66.9   Upon receipt of the notice, the county agency must submit a 
 66.10  revised plan service agreement under section 256J.50 256J.626, 
 66.11  subdivision 7 4, that includes the approved provider.  The 
 66.12  county has 90 days from the receipt of the commissioner's notice 
 66.13  to submit the revised plan service agreement. 
 66.14     Sec. 77.  [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.] 
 66.15     Subdivision 1.  [ASSESSMENTS.] (a) For purposes of MFIP 
 66.16  employment services, assessment is a continuing process of 
 66.17  gathering information related to employability for the purpose 
 66.18  of identifying both participant's strengths and strategies for 
 66.19  coping with issues that interfere with employment.  The job 
 66.20  counselor must use information from the assessment process to 
 66.21  develop and update the employment plan under subdivision 2. 
 66.22     (b) The scope of assessment must cover at least the 
 66.23  following areas: 
 66.24     (1) basic information about the participant's ability to 
 66.25  obtain and retain employment, including:  a review of the 
 66.26  participant's education level; interests, skills, and abilities; 
 66.27  prior employment or work experience; transferable work skills; 
 66.28  child care and transportation needs; 
 66.29     (2) identification of personal and family circumstances 
 66.30  that impact the participant's ability to obtain and retain 
 66.31  employment, including:  any special needs of the children, the 
 66.32  level of English proficiency, and any involvement with social 
 66.33  services or the legal system; 
 66.34     (3) the results of a mental and chemical health screening 
 66.35  tool designed by the commissioner and results of the brief 
 66.36  screening tool for special learning needs.  Screening for mental 
 67.1   and chemical health and special learning needs must be completed 
 67.2   by participants who are unable to find suitable employment after 
 67.3   six weeks of job search under subdivision 2, paragraph (b), and 
 67.4   participants who are determined to have barriers to employment 
 67.5   under subdivision 2, paragraph (d).  Failure to complete the 
 67.6   screens will result in sanction under section 256J.46; and 
 67.7      (4) a comprehensive review of participation and progress 
 67.8   for participants who have received MFIP assistance and have not 
 67.9   worked in unsubsidized employment during the past 12 months.  
 67.10  The purpose of the review is to determine the need for 
 67.11  additional services and supports, including placement in 
 67.12  subsidized employment or unpaid work experience under section 
 67.13  256J.49, subdivision 13. 
 67.14     (c) Information gathered during a caregiver's participation 
 67.15  in the diversionary work program under section 256J.95 must be 
 67.16  incorporated into the assessment process. 
 67.17     (d) The job counselor may require the participant to 
 67.18  complete a professional chemical use assessment to be performed 
 67.19  according to the rules adopted under section 254A.03, 
 67.20  subdivision 3, including provisions in the administrative rules 
 67.21  which recognize the cultural background of the participant, or a 
 67.22  professional psychological assessment as a component of the 
 67.23  assessment process, when the job counselor has a reasonable 
 67.24  belief, based on objective evidence, that a participant's 
 67.25  ability to obtain and retain suitable employment is impaired by 
 67.26  a medical condition.  The job counselor may assist the 
 67.27  participant with arranging services, including child care 
 67.28  assistance and transportation, necessary to meet needs 
 67.29  identified by the assessment.  Data gathered as part of a 
 67.30  professional assessment must be classified and disclosed 
 67.31  according to the provisions in section 13.46. 
 67.32     Subd. 2.  [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the 
 67.33  assessment under subdivision 1, the job counselor and the 
 67.34  participant must develop an employment plan that includes 
 67.35  participation in activities and hours that meet the requirements 
 67.36  of section 256J.55, subdivision 1.  The purpose of the 
 68.1   employment plan is to identify for each participant the most 
 68.2   direct path to unsubsidized employment and any subsequent steps 
 68.3   that support long-term economic stability.  The employment plan 
 68.4   should be developed using the highest level of activity 
 68.5   appropriate for the participant.  Activities must be chosen from 
 68.6   clauses (1) to (6), which are listed in order of preference.  
 68.7   The employment plan must also list the specific steps the 
 68.8   participant will take to obtain employment, including steps 
 68.9   necessary for the participant to progress from one level of 
 68.10  activity to another, and a timetable for completion of each 
 68.11  step.  Levels of activity include: 
 68.12     (1) unsubsidized employment; 
 68.13     (2) job search; 
 68.14     (3) subsidized employment or unpaid work experience; 
 68.15     (4) unsubsidized employment and job readiness education or 
 68.16  job skills training; 
 68.17     (5) unsubsidized employment or unpaid work experience, and 
 68.18  activities related to a family violence waiver or preemployment 
 68.19  needs; and 
 68.20     (6) activities related to a family violence waiver or 
 68.21  preemployment needs. 
 68.22     (b) Participants who are determined able to work in 
 68.23  unsubsidized employment must job search at least 30 hours per 
 68.24  week for up to six weeks, and accept any offer of suitable 
 68.25  employment.  The remaining hours necessary to meet the 
 68.26  requirements of section 256J.55, subdivision 1, may be met 
 68.27  through participation in other work activities under section 
 68.28  256J.49, subdivision 13.  The participant's employment plan must 
 68.29  specify, at a minimum:  (1) whether the job search is supervised 
 68.30  or unsupervised; (2) support services that will be provided; and 
 68.31  (3) how frequently the participant must report to the job 
 68.32  counselor.  Participants who are unable to find suitable 
 68.33  employment after six weeks must meet with the job counselor to 
 68.34  determine whether other activities in paragraph (a) should be 
 68.35  incorporated into the employment plan.  Job search activities 
 68.36  which are continued after six weeks must be structured and 
 69.1   supervised. 
 69.2      (c) Beginning July 1, 2004, activities and hourly 
 69.3   requirements in the employment plan may be adjusted as necessary 
 69.4   to accommodate the personal and family circumstances of 
 69.5   participants identified under section 256J.561, subdivision 1, 
 69.6   paragraph (d).  Participants who no longer meet the provisions 
 69.7   of section 256J.561, subdivision 1, paragraph (d), must meet 
 69.8   with the job counselor within ten days of the determination to 
 69.9   revise the employment plan. 
 69.10     (d) Participants who are determined to have barriers that 
 69.11  will not be overcome during six weeks of job search under 
 69.12  paragraph (b) must work with the job counselor to develop an 
 69.13  employment plan that addresses those barriers by incorporating 
 69.14  appropriate activities from paragraph (a), clauses (1) to (6).  
 69.15  The employment plan must include enough hours to meet the 
 69.16  participation requirements in section 256J.55, subdivision 1, 
 69.17  unless a compelling reason to require fewer hours is noted in 
 69.18  the participant's file. 
 69.19     (e) The job counselor and the participant must sign the 
 69.20  employment plan to indicate agreement on the contents.  Failure 
 69.21  to develop or comply with activities in the plan, or voluntarily 
 69.22  quitting suitable employment without good cause, will result in 
 69.23  the imposition of a sanction under section 256J.46. 
 69.24     (f) Employment plans must be reviewed at least every three 
 69.25  months to determine whether activities and hourly requirements 
 69.26  should be revised. 
 69.27     Subd. 3.  [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A 
 69.28  participant who requests and qualifies for a family violence 
 69.29  waiver shall develop or revise the employment plan as specified 
 69.30  in this subdivision with a job counselor or county, and a person 
 69.31  trained in domestic violence.  The revised or new employment 
 69.32  plan must be approved by the county or the job counselor.  The 
 69.33  plan may address safety, legal, or emotional issues, and other 
 69.34  demands on the family as a result of the family violence.  
 69.35  Information in section 256J.515, clauses (1) to (8), must be 
 69.36  included as part of the development of the plan. 
 70.1      (b) The primary goal of an employment plan developed under 
 70.2   this subdivision is to ensure the safety of the caregiver and 
 70.3   children.  To the extent it is consistent with ensuring safety, 
 70.4   the plan shall also include activities that are designed to lead 
 70.5   to economic stability.  An activity is inconsistent with 
 70.6   ensuring safety if, in the opinion of a person trained in 
 70.7   domestic violence, the activity would endanger the safety of the 
 70.8   participant or children.  A plan under this subdivision may not 
 70.9   automatically include a provision that requires a participant to 
 70.10  obtain an order for protection or to attend counseling. 
 70.11     (c) If at any time there is a disagreement over whether the 
 70.12  activities in the plan are appropriate or the participant is not 
 70.13  complying with activities in the plan under this subdivision, 
 70.14  the participant must receive the assistance of a person trained 
 70.15  in domestic violence to help resolve the disagreement or 
 70.16  noncompliance with the county or job counselor.  If the person 
 70.17  trained in domestic violence recommends that the activities are 
 70.18  still appropriate, the county or a job counselor must approve 
 70.19  the activities in the plan or provide written reasons why 
 70.20  activities in the plan are not approved and document how denial 
 70.21  of the activities do not endanger the safety of the participant 
 70.22  or children. 
 70.23     Subd. 4.  [SELF-EMPLOYMENT.] (a) Self-employment activities 
 70.24  may be included in an employment plan contingent on the 
 70.25  development of a business plan which establishes a timetable and 
 70.26  earning goals that will result in the participant exiting MFIP 
 70.27  assistance.  Business plans must be developed with assistance 
 70.28  from an individual or organization with expertise in small 
 70.29  business as approved by the job counselor. 
 70.30     (b) Participants with an approved plan that includes 
 70.31  self-employment must meet the participation requirements in 
 70.32  section 256J.55, subdivision 1.  Only hours where the 
 70.33  participant earns at least minimum wage shall be counted toward 
 70.34  the requirement.  Additional activities and hours necessary to 
 70.35  meet the participation requirements in section 256J.55, 
 70.36  subdivision 1, must be included in the employment plan. 
 71.1      (c) Employment plans which include self-employment 
 71.2   activities must be reviewed every three months.  Participants 
 71.3   who fail, without good cause, to make satisfactory progress as 
 71.4   established in the business plan must revise the employment plan 
 71.5   to replace the self-employment with other approved work 
 71.6   activities. 
 71.7      (d) The requirements of this subdivision may be waived for 
 71.8   participants who are enrolled in the self-employment investment 
 71.9   demonstration program (SEID) under section 256J.65, and who make 
 71.10  satisfactory progress as determined by the job counselor and the 
 71.11  SEID provider. 
 71.12     Subd. 5.  [TRANSITION FROM THE DIVERSIONARY WORK 
 71.13  PROGRAM.] Participants who become eligible for MFIP assistance 
 71.14  after completing the diversionary work program under section 
 71.15  256J.95 must comply with all requirements of subdivisions 1 and 
 71.16  2.  Participants who become eligible for MFIP assistance after 
 71.17  being determined unable to benefit from the diversionary work 
 71.18  program must comply with the requirements of subdivisions 1 and 
 71.19  2, with the exception of subdivision 2, paragraph (b). 
 71.20     Subd. 6.  [LOSS OF EMPLOYMENT.] Participants who are laid 
 71.21  off, quit with good cause, or are terminated from employment 
 71.22  through no fault of their own must meet with the job counselor 
 71.23  within ten working days to ascertain the reason for the job loss 
 71.24  and to revise the employment plan as necessary to address the 
 71.25  problem. 
 71.26     Sec. 78.  Minnesota Statutes 2002, section 256J.53, 
 71.27  subdivision 1, is amended to read: 
 71.28     Subdivision 1.  [LENGTH OF PROGRAM.] (a) In order for a 
 71.29  post-secondary education or training program to be an approved 
 71.30  work activity as defined in section 256J.49, subdivision 13, 
 71.31  clause (18) (6), it must be a program lasting 24 12 months or 
 71.32  less, and the participant must meet the requirements of 
 71.33  subdivisions 2 and, 3, and 5.  
 71.34     (b) The 12 months of allowable postsecondary education or 
 71.35  training may be used to complete the final 12 months of a longer 
 71.36  program, provided the program does not exceed the undergraduate 
 72.1   level. 
 72.2      (c) All course work must be completed within 18 months of 
 72.3   enrollment in the program. 
 72.4      Sec. 79.  Minnesota Statutes 2002, section 256J.53, 
 72.5   subdivision 2, is amended to read: 
 72.6      Subd. 2.  [DOCUMENTATION SUPPORTING PROGRAM APPROVAL OF 
 72.7   POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a 
 72.8   post-secondary education or training program to be an approved 
 72.9   activity in a participant's an employment plan, the participant 
 72.10  or the employment and training service provider must provide 
 72.11  documentation that: be working in unsubsidized employment at 
 72.12  least 25 hours per week. 
 72.13     (b) Participants seeking approval of a postsecondary 
 72.14  education or training plan must provide documentation that: 
 72.15     (1) the participant's employment plan identifies specific 
 72.16  goals that goal can only be met with the additional education or 
 72.17  training; 
 72.18     (2) there are suitable employment opportunities that 
 72.19  require the specific education or training in the area in which 
 72.20  the participant resides or is willing to reside; 
 72.21     (3) the education or training will result in significantly 
 72.22  higher wages for the participant than the participant could earn 
 72.23  without the education or training; 
 72.24     (4) the participant can meet the requirements for admission 
 72.25  into the program; and 
 72.26     (5) there is a reasonable expectation that the participant 
 72.27  will complete the training program based on such factors as the 
 72.28  participant's MFIP assessment, previous education, training, and 
 72.29  work history; current motivation; and changes in previous 
 72.30  circumstances. 
 72.31     (c) The hourly unsubsidized employment requirement may be 
 72.32  reduced for intensive education or training programs lasting 12 
 72.33  weeks or less when full-time attendance is required. 
 72.34     (d) Participants with an approved employment plan in place 
 72.35  on July 1, 2003, which includes more than 12 months of 
 72.36  postsecondary education or training shall be allowed to complete 
 73.1   that plan provided that participation requirements in section 
 73.2   256J.55, subdivision 1, and conditions specified in paragraph 
 73.3   (b), and subdivisions 3 and 5 are met. 
 73.4      Sec. 80.  Minnesota Statutes 2002, section 256J.53, 
 73.5   subdivision 5, is amended to read: 
 73.6      Subd. 5.  [JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY 
 73.7   REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.] If a 
 73.8   participant's employment plan includes a post-secondary 
 73.9   educational or training program, the plan must include an 
 73.10  anticipated completion date for those activities.  At the time 
 73.11  the education or training is completed, the participant must 
 73.12  participate in job search.  If, after three months of job 
 73.13  search, the participant does not find a job that is consistent 
 73.14  with the participant's employment goal, the participant must 
 73.15  accept any offer of suitable employment.  Upon completion of an 
 73.16  approved education or training program, a participant who does 
 73.17  not meet the participation requirements in section 256J.55, 
 73.18  subdivision 1, through unsubsidized employment must participate 
 73.19  in job search.  If, after six weeks of job search, the 
 73.20  participant does not find a full-time job consistent with the 
 73.21  employment goal, the participant must accept any offer of 
 73.22  full-time suitable employment, or meet with the job counselor to 
 73.23  revise the employment plan to include additional work activities 
 73.24  necessary to meet hourly requirements. 
 73.25     Sec. 81.  [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND 
 73.26  LANGUAGE.] 
 73.27     Subdivision 1.  [APPROVAL OF ADULT BASIC EDUCATION.] With 
 73.28  the exception of classes related to obtaining a general 
 73.29  equivalency development credential, a participant must have 
 73.30  reading or mathematics proficiency below a ninth grade level in 
 73.31  order for adult basic education classes to be an approved work 
 73.32  activity.  The employment plan must also specify that the 
 73.33  participant fulfill no more than one-half of the participation 
 73.34  requirements in section 256J.55, subdivision 1, through 
 73.35  attending adult basic education or general education development 
 73.36  classes. 
 74.1      Subd. 2.  [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In 
 74.2   order for English as a second language (ESL) classes to be an 
 74.3   approved work activity in an employment plan, a participant must 
 74.4   be below a spoken language proficiency level of SPL6 or its 
 74.5   equivalent, as measured by a nationally recognized test.  In 
 74.6   approving ESL as a work activity, the job counselor must give 
 74.7   preference to enrollment in a functional work literacy program, 
 74.8   if one is available, over a regular ESL program.  A participant 
 74.9   may not be approved for more than a combined total of 24 months 
 74.10  of ESL classes while participating in the diversionary work 
 74.11  program and the employment and training services component of 
 74.12  MFIP.  The employment plan must also specify that the 
 74.13  participant fulfill no more than one-half of the participation 
 74.14  requirements in section 256J.55, subdivision 1, through 
 74.15  attending ESL classes. 
 74.16     Sec. 82.  Minnesota Statutes 2002, section 256J.54, 
 74.17  subdivision 1, is amended to read: 
 74.18     Subdivision 1.  [ASSESSMENT OF EDUCATIONAL PROGRESS AND 
 74.19  NEEDS.] (a) The county agency must document the educational 
 74.20  level of each MFIP caregiver who is under the age of 20 and 
 74.21  determine if the caregiver has obtained a high school diploma or 
 74.22  its equivalent.  If the caregiver has not obtained a high school 
 74.23  diploma or its equivalent, and is not exempt from the 
 74.24  requirement to attend school under subdivision 5, the county 
 74.25  agency must complete an individual assessment for the 
 74.26  caregiver unless the caregiver is exempt from the requirement to 
 74.27  attend school under subdivision 5 or has chosen to have an 
 74.28  employment plan under section 256J.521, subdivision 2, as 
 74.29  allowed in paragraph (b).  The assessment must be performed as 
 74.30  soon as possible but within 30 days of determining MFIP 
 74.31  eligibility for the caregiver.  The assessment must provide an 
 74.32  initial examination of the caregiver's educational progress and 
 74.33  needs, literacy level, child care and supportive service needs, 
 74.34  family circumstances, skills, and work experience.  In the case 
 74.35  of a caregiver under the age of 18, the assessment must also 
 74.36  consider the results of either the caregiver's or the 
 75.1   caregiver's minor child's child and teen checkup under Minnesota 
 75.2   Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available, 
 75.3   and the effect of a child's development and educational needs on 
 75.4   the caregiver's ability to participate in the program.  The 
 75.5   county agency must advise the caregiver that the caregiver's 
 75.6   first goal must be to complete an appropriate educational 
 75.7   education option if one is identified for the caregiver through 
 75.8   the assessment and, in consultation with educational agencies, 
 75.9   must review the various school completion options with the 
 75.10  caregiver and assist in selecting the most appropriate option.  
 75.11     (b) The county agency must give a caregiver, who is age 18 
 75.12  or 19 and has not obtained a high school diploma or its 
 75.13  equivalent, the option to choose an employment plan with an 
 75.14  education option under subdivision 3 or an employment plan under 
 75.15  section 256J.521, subdivision 2. 
 75.16     Sec. 83.  Minnesota Statutes 2002, section 256J.54, 
 75.17  subdivision 2, is amended to read: 
 75.18     Subd. 2.  [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 
 75.19  PLAN.] For caregivers who are under age 18 without a high school 
 75.20  diploma or its equivalent, the assessment under subdivision 1 
 75.21  and the employment plan under subdivision 3 must be completed by 
 75.22  the social services agency under section 257.33.  For caregivers 
 75.23  who are age 18 or 19 without a high school diploma or its 
 75.24  equivalent who choose to have an employment plan with an 
 75.25  education option under subdivision 3, the assessment under 
 75.26  subdivision 1 and the employment plan under subdivision 3 must 
 75.27  be completed by the job counselor or, at county option, by the 
 75.28  social services agency under section 257.33.  Upon reaching age 
 75.29  18 or 19 a caregiver who received social services under section 
 75.30  257.33 and is without a high school diploma or its equivalent 
 75.31  has the option to choose whether to continue receiving services 
 75.32  under the caregiver's plan from the social services agency or to 
 75.33  utilize an MFIP employment and training service provider.  The 
 75.34  social services agency or the job counselor shall consult with 
 75.35  representatives of educational agencies that are required to 
 75.36  assist in developing educational plans under section 124D.331. 
 76.1      Sec. 84.  Minnesota Statutes 2002, section 256J.54, 
 76.2   subdivision 3, is amended to read: 
 76.3      Subd. 3.  [EDUCATIONAL EDUCATION OPTION DEVELOPED.] If the 
 76.4   job counselor or county social services agency identifies an 
 76.5   appropriate educational education option for a minor caregiver 
 76.6   under the age of 20 without a high school diploma or its 
 76.7   equivalent, or a caregiver age 18 or 19 without a high school 
 76.8   diploma or its equivalent who chooses an employment plan with an 
 76.9   education option, the job counselor or agency must develop an 
 76.10  employment plan which reflects the identified option.  The plan 
 76.11  must specify that participation in an educational activity is 
 76.12  required, what school or educational program is most 
 76.13  appropriate, the services that will be provided, the activities 
 76.14  the caregiver will take part in, including child care and 
 76.15  supportive services, the consequences to the caregiver for 
 76.16  failing to participate or comply with the specified 
 76.17  requirements, and the right to appeal any adverse action.  The 
 76.18  employment plan must, to the extent possible, reflect the 
 76.19  preferences of the caregiver. 
 76.20     Sec. 85.  Minnesota Statutes 2002, section 256J.54, 
 76.21  subdivision 5, is amended to read: 
 76.22     Subd. 5.  [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 
 76.23  the provisions of section 256J.56, minor parents, or 18- or 
 76.24  19-year-old parents without a high school diploma or its 
 76.25  equivalent who chooses an employment plan with an education 
 76.26  option must attend school unless: 
 76.27     (1) transportation services needed to enable the caregiver 
 76.28  to attend school are not available; 
 76.29     (2) appropriate child care services needed to enable the 
 76.30  caregiver to attend school are not available; 
 76.31     (3) the caregiver is ill or incapacitated seriously enough 
 76.32  to prevent attendance at school; or 
 76.33     (4) the caregiver is needed in the home because of the 
 76.34  illness or incapacity of another member of the household.  This 
 76.35  includes a caregiver of a child who is younger than six weeks of 
 76.36  age. 
 77.1      (b) The caregiver must be enrolled in a secondary school 
 77.2   and meeting the school's attendance requirements.  The county, 
 77.3   social service agency, or job counselor must verify at least 
 77.4   once per quarter that the caregiver is meeting the school's 
 77.5   attendance requirements.  An enrolled caregiver is considered to 
 77.6   be meeting the attendance requirements when the school is not in 
 77.7   regular session, including during holiday and summer breaks.  
 77.8      Sec. 86.  [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.] 
 77.9      (a) In order to qualify for a family violence waiver, an 
 77.10  individual must provide documentation of past or current family 
 77.11  violence which may prevent the individual from participating in 
 77.12  certain employment activities.  A claim of family violence must 
 77.13  be documented by the applicant or participant providing a sworn 
 77.14  statement which is supported by collateral documentation. 
 77.15     (b) Collateral documentation may consist of: 
 77.16     (1) police, government agency, or court records; 
 77.17     (2) a statement from a battered women's shelter staff with 
 77.18  knowledge of the circumstances or credible evidence that 
 77.19  supports the sworn statement; 
 77.20     (3) a statement from a sexual assault or domestic violence 
 77.21  advocate with knowledge of the circumstances or credible 
 77.22  evidence that supports the sworn statement; 
 77.23     (4) a statement from professionals from whom the applicant 
 77.24  or recipient has sought assistance for the abuse; or 
 77.25     (5) a sworn statement from any other individual with 
 77.26  knowledge of circumstances or credible evidence that supports 
 77.27  the sworn statement. 
 77.28     Sec. 87.  Minnesota Statutes 2002, section 256J.55, 
 77.29  subdivision 1, is amended to read: 
 77.30     Subdivision 1.  [COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT 
 77.31  PLAN; SUITABLE EMPLOYMENT PARTICIPATION REQUIREMENTS.] (a) Each 
 77.32  MFIP participant must comply with the terms of the participant's 
 77.33  job search support plan or employment plan.  When the 
 77.34  participant has completed the steps listed in the employment 
 77.35  plan, the participant must comply with section 256J.53, 
 77.36  subdivision 5, if applicable, and then the participant must not 
 78.1   refuse any offer of suitable employment.  The participant may 
 78.2   choose to accept an offer of suitable employment before the 
 78.3   participant has completed the steps of the employment plan. 
 78.4      (b) For a participant under the age of 20 who is without a 
 78.5   high school diploma or general educational development diploma, 
 78.6   the requirement to comply with the terms of the employment plan 
 78.7   means the participant must meet the requirements of section 
 78.8   256J.54. 
 78.9      (c) Failure to develop or comply with a job search support 
 78.10  plan or an employment plan, or quitting suitable employment 
 78.11  without good cause, shall result in the imposition of a sanction 
 78.12  as specified in sections 256J.46 and 256J.57. 
 78.13     (a) All caregivers must participate in employment services 
 78.14  under sections 256J.515 to 256J.57 concurrent with receipt of 
 78.15  MFIP assistance. 
 78.16     (b) Until July 1, 2004, participants who meet the 
 78.17  requirements of section 256J.56 are exempt from participation 
 78.18  requirements. 
 78.19     (c) Participants under paragraph (a) must develop and 
 78.20  comply with an employment plan under section 256J.521, or 
 78.21  section 256J.54 in the case of a participant under the age of 20 
 78.22  who has not obtained a high school diploma or its equivalent. 
 78.23     (d) With the exception of participants under the age of 20 
 78.24  who must meet the education requirements of section 256J.54, all 
 78.25  participants must meet the hourly participation requirements of 
 78.26  TANF or the hourly requirements listed in clauses (1) to (3), 
 78.27  whichever is higher. 
 78.28     (1) In single-parent families with no children under six 
 78.29  years of age, the job counselor and the caregiver must develop 
 78.30  an employment plan that includes 30 to 35 hours per week of work 
 78.31  activities. 
 78.32     (2) In single-parent families with a child under six years 
 78.33  of age, the job counselor and the caregiver must develop an 
 78.34  employment plan that includes 20 to 35 hours per week of work 
 78.35  activities. 
 78.36     (3) In two-parent families, the job counselor and the 
 79.1   caregivers must develop employment plans which result in a 
 79.2   combined total of at least 55 hours per week of work activities. 
 79.3      (e) Failure to participate in employment services, 
 79.4   including the requirement to develop and comply with an 
 79.5   employment plan, including hourly requirements, without good 
 79.6   cause under section 256J.57, shall result in the imposition of a 
 79.7   sanction under section 256J.46. 
 79.8      Sec. 88.  Minnesota Statutes 2002, section 256J.55, 
 79.9   subdivision 2, is amended to read: 
 79.10     Subd. 2.  [DUTY TO REPORT.] The participant must inform the 
 79.11  job counselor within three ten working days regarding any 
 79.12  changes related to the participant's employment status. 
 79.13     Sec. 89.  Minnesota Statutes 2002, section 256J.56, is 
 79.14  amended to read: 
 79.15     256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 
 79.16  EXEMPTIONS.] 
 79.17     (a) An MFIP participant is exempt from the requirements of 
 79.18  sections 256J.52 256J.515 to 256J.55 256J.57 if the participant 
 79.19  belongs to any of the following groups: 
 79.20     (1) participants who are age 60 or older; 
 79.21     (2) participants who are suffering from a professionally 
 79.22  certified permanent or temporary illness, injury, or incapacity 
 79.23  which has been certified by a qualified professional when the 
 79.24  illness, injury, or incapacity is expected to continue for more 
 79.25  than 30 days and which prevents the person from obtaining or 
 79.26  retaining employment.  Persons in this category with a temporary 
 79.27  illness, injury, or incapacity must be reevaluated at least 
 79.28  quarterly; 
 79.29     (3) participants whose presence in the home is required as 
 79.30  a caregiver because of a professionally certified the illness or 
 79.31  incapacity of another member in the assistance unit, a relative 
 79.32  in the household, or a foster child in the household and when 
 79.33  the illness or incapacity and the need for the participant's 
 79.34  presence in the home has been certified by a qualified 
 79.35  professional and is expected to continue for more than 30 days; 
 79.36     (4) women who are pregnant, if the pregnancy has resulted 
 80.1   in a professionally certified an incapacity that prevents the 
 80.2   woman from obtaining or retaining employment, and the incapacity 
 80.3   has been certified by a qualified professional; 
 80.4      (5) caregivers of a child under the age of one year who 
 80.5   personally provide full-time care for the child.  This exemption 
 80.6   may be used for only 12 months in a lifetime.  In two-parent 
 80.7   households, only one parent or other relative may qualify for 
 80.8   this exemption; 
 80.9      (6) participants experiencing a personal or family crisis 
 80.10  that makes them incapable of participating in the program, as 
 80.11  determined by the county agency.  If the participant does not 
 80.12  agree with the county agency's determination, the participant 
 80.13  may seek professional certification from a qualified 
 80.14  professional, as defined in section 256J.08, that the 
 80.15  participant is incapable of participating in the program. 
 80.16     Persons in this exemption category must be reevaluated 
 80.17  every 60 days.  A personal or family crisis related to family 
 80.18  violence, as determined by the county or a job counselor with 
 80.19  the assistance of a person trained in domestic violence, should 
 80.20  not result in an exemption, but should be addressed through the 
 80.21  development or revision of an alternative employment plan under 
 80.22  section 256J.52 256J.521, subdivision 6 3; or 
 80.23     (7) caregivers with a child or an adult in the household 
 80.24  who meets the disability or medical criteria for home care 
 80.25  services under section 256B.0627, subdivision 1, 
 80.26  paragraph (c) (f), or a home and community-based waiver services 
 80.27  program under chapter 256B, or meets the criteria for severe 
 80.28  emotional disturbance under section 245.4871, subdivision 6, or 
 80.29  for serious and persistent mental illness under section 245.462, 
 80.30  subdivision 20, paragraph (c).  Caregivers in this exemption 
 80.31  category are presumed to be prevented from obtaining or 
 80.32  retaining employment. 
 80.33     A caregiver who is exempt under clause (5) must enroll in 
 80.34  and attend an early childhood and family education class, a 
 80.35  parenting class, or some similar activity, if available, during 
 80.36  the period of time the caregiver is exempt under this section.  
 81.1   Notwithstanding section 256J.46, failure to attend the required 
 81.2   activity shall not result in the imposition of a sanction. 
 81.3      (b) The county agency must provide employment and training 
 81.4   services to MFIP participants who are exempt under this section, 
 81.5   but who volunteer to participate.  Exempt volunteers may request 
 81.6   approval for any work activity under section 256J.49, 
 81.7   subdivision 13.  The hourly participation requirements for 
 81.8   nonexempt participants under section 256J.50 256J.55, 
 81.9   subdivision 5 1, do not apply to exempt participants who 
 81.10  volunteer to participate. 
 81.11     (c) This section expires on June 30, 2004. 
 81.12     Sec. 90.  [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.] 
 81.13     Subdivision 1.  [IMPLEMENTATION OF UNIVERSAL PARTICIPATION 
 81.14  REQUIREMENTS.] (a) All caregivers whose applications were 
 81.15  received July 1, 2004, or after, are immediately subject to the 
 81.16  requirements in subdivision 2. 
 81.17     (b) For all MFIP participants who were exempt from 
 81.18  participating in employment services under section 256J.56 as of 
 81.19  June 30, 2004, between July 1, 2004, and June 30, 2005, the 
 81.20  county, as part of the participant's recertification under 
 81.21  section 256J.32, subdivision 6, shall determine whether a new 
 81.22  employment plan is required to meet the requirements in 
 81.23  subdivision 2.  Counties shall notify each participant who is in 
 81.24  need of an employment plan that the participant must meet with a 
 81.25  job counselor within ten days to develop an employment plan.  
 81.26  Until a participant's employment plan is developed, the 
 81.27  participant shall be considered in compliance with the 
 81.28  participation requirements in this section if the participant 
 81.29  continues to meet the criteria for an exemption under section 
 81.30  256J.56 as in effect on June 30, 2004, and is cooperating in the 
 81.31  development of the new plan. 
 81.32     Subd. 2.  [PARTICIPATION REQUIREMENTS.] (a) All MFIP 
 81.33  caregivers, except caregivers who meet the criteria in 
 81.34  subdivision 3, must participate in employment services.  Except 
 81.35  as specified in paragraphs (b) to (d), the employment plan must 
 81.36  meet the requirements of section 256J.521, subdivision 2, 
 82.1   contain allowable work activities, as defined in section 
 82.2   256J.49, subdivision 13, and, include at a minimum, the number 
 82.3   of participation hours required under section 256J.55, 
 82.4   subdivision 1. 
 82.5      (b) Minor caregivers and caregivers who are less than age 
 82.6   20 who have not completed high school or obtained a GED are 
 82.7   required to comply with section 256J.54. 
 82.8      (c) A participant who has a family violence waiver shall 
 82.9   develop and comply with an employment plan under section 
 82.10  256J.521, subdivision 3. 
 82.11     (d) As specified in section 256J.521, subdivision 2, 
 82.12  paragraph (c), a participant who meets any one of the following 
 82.13  criteria may work with the job counselor to develop an 
 82.14  employment plan that contains less than the number of 
 82.15  participation hours under section 256J.55, subdivision 1.  
 82.16  Employment plans for participants covered under this paragraph 
 82.17  must be tailored to recognize the special circumstances of 
 82.18  caregivers and families including limitations due to illness or 
 82.19  disability and caregiving needs: 
 82.20     (1) a participant who is age 60 or older; 
 82.21     (2) a participant who has been diagnosed by a qualified 
 82.22  professional as suffering from an illness or incapacity that is 
 82.23  expected to last for 30 days or more, including a pregnant 
 82.24  participant who is determined to be unable to obtain or retain 
 82.25  employment due to the pregnancy; or 
 82.26     (3) a participant who is determined by a qualified 
 82.27  professional as being needed in the home to care for an ill or 
 82.28  incapacitated family member, including caregivers with a child 
 82.29  or an adult in the household who meets the disability or medical 
 82.30  criteria for home care services under section 256B.0627, 
 82.31  subdivision 1, paragraph (f), or a home and community-based 
 82.32  waiver services program under chapter 256B, or meets the 
 82.33  criteria for severe emotional disturbance under section 
 82.34  245.4871, subdivision 6, or for serious and persistent mental 
 82.35  illness under section 245.462, subdivision 20, paragraph (c). 
 82.36     (e) For participants covered under paragraphs (c) and (d), 
 83.1   the county shall review the participant's employment services 
 83.2   status every three months to determine whether conditions have 
 83.3   changed.  When it is determined that the participant's status is 
 83.4   no longer covered under paragraph (c) or (d), the county shall 
 83.5   notify the participant that a new or revised employment plan is 
 83.6   needed.  The participant and job counselor shall meet within ten 
 83.7   days of the determination to revise the employment plan. 
 83.8      Subd. 3.  [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant 
 83.9   who has a natural born child who is less than 12 weeks of age 
 83.10  who meets the criteria in clauses (1) and (2) is not required to 
 83.11  participate in employment services until the child reaches 12 
 83.12  weeks of age.  To be eligible for this provision, the following 
 83.13  conditions must be met: 
 83.14     (1) the child must have been born within ten months of the 
 83.15  caregiver's application for the diversionary work program or 
 83.16  MFIP; and 
 83.17     (2) the assistance unit must not have already used this 
 83.18  provision or the previously allowed child under age one 
 83.19  exemption.  However, an assistance unit that has an approved 
 83.20  child under age one exemption at the time this provision becomes 
 83.21  effective may continue to use that exemption until the child 
 83.22  reaches one year of age. 
 83.23     (b) The provision in paragraph (a) ends the first full 
 83.24  month after the child reaches 12 weeks of age.  This provision 
 83.25  is available only once in a caregiver's lifetime.  In a 
 83.26  two-parent household, only one parent shall be allowed to use 
 83.27  this provision.  The participant and job counselor must meet 
 83.28  within ten days after the child reaches 12 weeks of age to 
 83.29  revise the participant's employment plan. 
 83.30     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
 83.31     Sec. 91.  Minnesota Statutes 2002, section 256J.57, is 
 83.32  amended to read: 
 83.33     256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE; 
 83.34  CONCILIATION CONFERENCE.] 
 83.35     Subdivision 1.  [GOOD CAUSE FOR FAILURE TO COMPLY.] The 
 83.36  county agency shall not impose the sanction under section 
 84.1   256J.46 if it determines that the participant has good cause for 
 84.2   failing to comply with the requirements of sections 256J.52 
 84.3   256J.515 to 256J.55 256J.57.  Good cause exists when: 
 84.4      (1) appropriate child care is not available; 
 84.5      (2) the job does not meet the definition of suitable 
 84.6   employment; 
 84.7      (3) the participant is ill or injured; 
 84.8      (4) a member of the assistance unit, a relative in the 
 84.9   household, or a foster child in the household is ill and needs 
 84.10  care by the participant that prevents the participant from 
 84.11  complying with the job search support plan or employment plan; 
 84.12     (5) the parental caregiver is unable to secure necessary 
 84.13  transportation; 
 84.14     (6) the parental caregiver is in an emergency situation 
 84.15  that prevents compliance with the job search support plan or 
 84.16  employment plan; 
 84.17     (7) the schedule of compliance with the job search support 
 84.18  plan or employment plan conflicts with judicial proceedings; 
 84.19     (8) a mandatory MFIP meeting is scheduled during a time 
 84.20  that conflicts with a judicial proceeding or a meeting related 
 84.21  to a juvenile court matter, or a participant's work schedule; 
 84.22     (9) the parental caregiver is already participating in 
 84.23  acceptable work activities; 
 84.24     (10) the employment plan requires an educational program 
 84.25  for a caregiver under age 20, but the educational program is not 
 84.26  available; 
 84.27     (11) activities identified in the job search support plan 
 84.28  or employment plan are not available; 
 84.29     (12) the parental caregiver is willing to accept suitable 
 84.30  employment, but suitable employment is not available; or 
 84.31     (13) the parental caregiver documents other verifiable 
 84.32  impediments to compliance with the job search support plan or 
 84.33  employment plan beyond the parental caregiver's control. 
 84.34     The job counselor shall work with the participant to 
 84.35  reschedule mandatory meetings for individuals who fall under 
 84.36  clauses (1), (3), (4), (5), (6), (7), and (8). 
 85.1      Subd. 2.  [NOTICE OF INTENT TO SANCTION.] (a) When a 
 85.2   participant fails without good cause to comply with the 
 85.3   requirements of sections 256J.52 256J.515 to 256J.55 256J.57, 
 85.4   the job counselor or the county agency must provide a notice of 
 85.5   intent to sanction to the participant specifying the program 
 85.6   requirements that were not complied with, informing the 
 85.7   participant that the county agency will impose the sanctions 
 85.8   specified in section 256J.46, and informing the participant of 
 85.9   the opportunity to request a conciliation conference as 
 85.10  specified in paragraph (b).  The notice must also state that the 
 85.11  participant's continuing noncompliance with the specified 
 85.12  requirements will result in additional sanctions under section 
 85.13  256J.46, without the need for additional notices or conciliation 
 85.14  conferences under this subdivision.  The notice, written in 
 85.15  English, must include the department of human services language 
 85.16  block, and must be sent to every applicable participant.  If the 
 85.17  participant does not request a conciliation conference within 
 85.18  ten calendar days of the mailing of the notice of intent to 
 85.19  sanction, the job counselor must notify the county agency that 
 85.20  the assistance payment should be reduced.  The county must then 
 85.21  send a notice of adverse action to the participant informing the 
 85.22  participant of the sanction that will be imposed, the reasons 
 85.23  for the sanction, the effective date of the sanction, and the 
 85.24  participant's right to have a fair hearing under section 256J.40.
 85.25     (b) The participant may request a conciliation conference 
 85.26  by sending a written request, by making a telephone request, or 
 85.27  by making an in-person request.  The request must be received 
 85.28  within ten calendar days of the date the county agency mailed 
 85.29  the ten-day notice of intent to sanction.  If a timely request 
 85.30  for a conciliation is received, the county agency's service 
 85.31  provider must conduct the conference within five days of the 
 85.32  request.  The job counselor's supervisor, or a designee of the 
 85.33  supervisor, must review the outcome of the conciliation 
 85.34  conference.  If the conciliation conference resolves the 
 85.35  noncompliance, the job counselor must promptly inform the county 
 85.36  agency and request withdrawal of the sanction notice. 
 86.1      (c) Upon receiving a sanction notice, the participant may 
 86.2   request a fair hearing under section 256J.40, without exercising 
 86.3   the option of a conciliation conference.  In such cases, the 
 86.4   county agency shall not require the participant to engage in a 
 86.5   conciliation conference prior to the fair hearing. 
 86.6      (d) If the participant requests a fair hearing or a 
 86.7   conciliation conference, sanctions will not be imposed until 
 86.8   there is a determination of noncompliance.  Sanctions must be 
 86.9   imposed as provided in section 256J.46. 
 86.10     Sec. 92.  Minnesota Statutes 2002, section 256J.62, 
 86.11  subdivision 9, is amended to read: 
 86.12     Subd. 9.  [CONTINUATION OF CERTAIN SERVICES.] Only if 
 86.13  services were approved as part of an employment plan prior to 
 86.14  June 30, 2003, at the request of the participant, the county may 
 86.15  continue to provide case management, counseling, or other 
 86.16  support services to a participant: 
 86.17     (a) (1) who has achieved the employment goal; or 
 86.18     (b) (2) who under section 256J.42 is no longer eligible to 
 86.19  receive MFIP but whose income is below 115 percent of the 
 86.20  federal poverty guidelines for a family of the same size. 
 86.21     These services may be provided for up to 12 months 
 86.22  following termination of the participant's eligibility for MFIP. 
 86.23     Sec. 93.  [256J.626] [MFIP CONSOLIDATED FUND.] 
 86.24     Subdivision 1.  [CONSOLIDATED FUND.] The consolidated fund 
 86.25  is established to support counties and tribes in meeting their 
 86.26  duties under this chapter.  Counties and tribes must use funds 
 86.27  from the consolidated fund to develop programs and services that 
 86.28  are designed to improve participant outcomes as measured in 
 86.29  section 256J.751, subdivision 2.  Counties may use the funds for 
 86.30  any allowable expenditures under subdivision 2.  Tribes may use 
 86.31  the funds for any allowable expenditures under subdivision 2, 
 86.32  except those in clauses (1) and (6). 
 86.33     Subd. 2.  [ALLOWABLE EXPENDITURES.] (a) The commissioner 
 86.34  must restrict expenditures under the consolidated fund to 
 86.35  benefits and services allowed under title IV-A of the federal 
 86.36  Social Security Act.  Allowable expenditures under the 
 87.1   consolidated fund may include, but are not limited to: 
 87.2      (1) short-term, nonrecurring shelter and utility needs that 
 87.3   are excluded from the definition of assistance under Code of 
 87.4   Federal Regulations, title 45, section 260.31, for families who 
 87.5   meet the residency requirement in section 256J.12, subdivisions 
 87.6   1 and 1a.  Payments under this subdivision are not considered 
 87.7   TANF cash assistance and are not counted towards the 60-month 
 87.8   time limit; 
 87.9      (2) transportation needed to obtain or retain employment or 
 87.10  to participate in other approved work activities; 
 87.11     (3) direct and administrative costs of staff to deliver 
 87.12  employment services for MFIP or the diversionary work program, 
 87.13  to administer financial assistance, and to provide specialized 
 87.14  services intended to assist hard-to-employ participants to 
 87.15  transition to work; 
 87.16     (4) costs of education and training including functional 
 87.17  work literacy and English as a second language; 
 87.18     (5) cost of work supports including tools, clothing, boots, 
 87.19  and other work-related expenses; 
 87.20     (6) county administrative expenses as defined in Code of 
 87.21  Federal Regulations, title 45, section 260(b); 
 87.22     (7) services to parenting and pregnant teens; 
 87.23     (8) supported work; 
 87.24     (9) wage subsidies; 
 87.25     (10) child care needed for MFIP or diversionary work 
 87.26  program participants to participate in social services; 
 87.27     (11) child care to ensure that families leaving MFIP or 
 87.28  diversionary work program will continue to receive child care 
 87.29  assistance from the time the family no longer qualifies for 
 87.30  transition year child care until an opening occurs under the 
 87.31  basic sliding fee child care program; and 
 87.32     (12) services to help noncustodial parents of minor 
 87.33  children receiving MFIP or DWP assistance who live in Minnesota, 
 87.34  but do not live in the same household as the child, obtain or 
 87.35  retain employment. 
 87.36     (b) Administrative costs that are not matched with county 
 88.1   funds as provided in subdivision 8 may not exceed 7.5 percent of 
 88.2   a county's or 15 percent of a tribe's reimbursement under this 
 88.3   section.  The commissioner shall define administrative costs for 
 88.4   purposes of this subdivision. 
 88.5      Subd. 3.  [ELIGIBILITY FOR SERVICES.] Families with a minor 
 88.6   child, as defined in section 256J.08, or a noncustodial parent 
 88.7   of a minor child receiving assistance, with incomes below 200 
 88.8   percent of the federal poverty guideline for a family of the 
 88.9   applicable size, are eligible for services funded under the 
 88.10  consolidated fund.  Counties and tribes must give priority to 
 88.11  families currently receiving MFIP or diversionary work program, 
 88.12  and families at risk of receiving MFIP or diversionary work 
 88.13  program. 
 88.14     Subd. 4.  [COUNTY AND TRIBAL BIENNIAL SERVICE 
 88.15  AGREEMENTS.] (a) Effective January 1, 2004, and each two-year 
 88.16  period thereafter, each county and tribe must have in place an 
 88.17  approved biennial service agreement related to the services and 
 88.18  programs in this chapter.  Counties may collaborate to develop 
 88.19  multicounty, multitribal, or regional service agreements. 
 88.20     (b) The service agreements will be completed in a form 
 88.21  prescribed by the commissioner.  The agreement must include: 
 88.22     (1) a statement of the needs of the service population and 
 88.23  strengths and resources in the community; 
 88.24     (2) numerical goals for participant outcomes measures to be 
 88.25  accomplished during the biennial period.  The commissioner may 
 88.26  identify outcomes from section 256J.751, subdivision 2, as core 
 88.27  outcomes for all counties and tribes; 
 88.28     (3) strategies the county or tribe will pursue to achieve 
 88.29  the outcome targets.  Strategies must include specification of 
 88.30  how funds under this section will be used and may include 
 88.31  community partnerships that will be established or strengthened; 
 88.32  and 
 88.33     (4) other items prescribed by the commissioner in 
 88.34  consultation with counties and tribes. 
 88.35     (c) The commissioner shall provide each county and tribe 
 88.36  with information needed to complete an agreement, including:  
 89.1   (1) information on MFIP cases in the county or tribe; (2) 
 89.2   comparisons with the rest of the state; (3) baseline performance 
 89.3   on outcome measures; and (4) promising program practices. 
 89.4      (d) The service agreement must be submitted to the 
 89.5   commissioner by October 15, 2003, and October 15 of each second 
 89.6   year thereafter.  The county or tribe must allow a period of not 
 89.7   less than 30 days prior to the submission of the agreement to 
 89.8   solicit comments from the public on the contents of the 
 89.9   agreement. 
 89.10     (e) The commissioner must, within 60 days of receiving each 
 89.11  county or tribal service agreement, inform the county or tribe 
 89.12  if the service agreement is approved.  If the service agreement 
 89.13  is not approved, the commissioner must inform the county or 
 89.14  tribe of any revisions needed prior to approval. 
 89.15     (f) The service agreement in this subdivision supersedes 
 89.16  the plan requirements of section 268.88. 
 89.17     Subd. 5.  [INNOVATION PROJECTS.] Beginning January 1, 2005, 
 89.18  no more than $3,000,000 of the funds annually appropriated to 
 89.19  the commissioner for use in the consolidated fund shall be 
 89.20  available to the commissioner for projects testing innovative 
 89.21  approaches to improving outcomes for MFIP participants, and 
 89.22  persons at risk of receiving MFIP as detailed in subdivision 3.  
 89.23  Projects shall be targeted to geographic areas with poor 
 89.24  outcomes as specified in section 256J.751, subdivision 5, or to 
 89.25  subgroups within the MFIP case load who are experiencing poor 
 89.26  outcomes. 
 89.27     Subd. 6.  [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For 
 89.28  purposes of this section, the following terms have the meanings 
 89.29  given them: 
 89.30     (1) "2002 historic spending base" means the commissioner's 
 89.31  determination of the sum of the reimbursement related to fiscal 
 89.32  year 2002 of county or tribal agency expenditures for the base 
 89.33  programs listed in clause (4), items (i) to (iv), and earnings 
 89.34  related to calendar year 2002 in the base program listed in 
 89.35  clause (4), item (v), and the amount of spending in fiscal year 
 89.36  2002 in the base program listed in clause (4), item (vi), issued 
 90.1   to or on behalf of persons residing in the county or tribal 
 90.2   service delivery area. 
 90.3      (2) "Initial allocation" means the amount potentially 
 90.4   available to each county or tribe based on the formula in 
 90.5   paragraphs (b) to (d). 
 90.6      (3) "Final allocation" means the amount available to each 
 90.7   county or tribe based on the formula in paragraphs (b) to (d), 
 90.8   after adjustment by subdivision 7. 
 90.9      (4) "Base programs" means the: 
 90.10     (i) MFIP employment and training services under section 
 90.11  256J.62, subdivision 1, in effect June 30, 2002; 
 90.12     (ii) bilingual employment and training services to refugees 
 90.13  under section 256J.62, subdivision 6, in effect June 30, 2002; 
 90.14     (iii) work literacy language programs under section 
 90.15  256J.62, subdivision 7, in effect June 30, 2002; 
 90.16     (iv) supported work program authorized in Laws 2001, First 
 90.17  Special Session chapter 9, article 17, section 2, in effect June 
 90.18  30, 2002; 
 90.19     (v) administrative aid program under section 256J.76 in 
 90.20  effect December 31, 2002; and 
 90.21     (vi) emergency assistance program under section 256J.48 in 
 90.22  effect June 30, 2002. 
 90.23     (b)(1) Beginning July 1, 2003, the commissioner shall 
 90.24  determine the initial allocation of funds available under this 
 90.25  section according to clause (2). 
 90.26     (2)(i) Ninety percent of the funds available for the period 
 90.27  beginning July 1, 2003, and ending December 31, 2004, shall be 
 90.28  allocated to each county or tribe in proportion to the county's 
 90.29  or tribe's share of the statewide 2002 historic spending base; 
 90.30     (ii) the remaining funds for the period beginning July 1, 
 90.31  2003, and ending December 31, 2004, shall be allocated to each 
 90.32  county or tribe in proportion to the average number of MFIP 
 90.33  cases: 
 90.34     (A) the average number of cases must be based upon counts 
 90.35  of MFIP or tribal TANF cases as of March 31, June 30, September 
 90.36  30, and December 31 using the most recent available data, less 
 91.1   the number of child only cases.  Two-parent cases, with the 
 91.2   exception of those with a caregiver age 60 or over, will be 
 91.3   multiplied by a factor of two; 
 91.4      (B) the MFIP or tribal TANF case count for each eligible 
 91.5   tribal provider shall be based upon the number of MFIP or tribal 
 91.6   TANF cases with participating adults who are enrolled in, or are 
 91.7   eligible for enrollment in, the tribe; and to be counted, the 
 91.8   case must be an active MFIP case, and the case members must 
 91.9   reside within the tribal program's service delivery area; and 
 91.10     (C) to prevent duplicate counts, MFIP or tribal TANF cases 
 91.11  counted for determining allocations to tribal providers shall be 
 91.12  removed from the case counts of the respective counties where 
 91.13  they reside. 
 91.14     (c)(1) Beginning January 1, 2005, the commissioner shall 
 91.15  determine the initial allocation of funds to be made available 
 91.16  under this section according to clause (2). 
 91.17     (2)(i) Seventy percent of the funds available for the 
 91.18  calendar year shall be allocated to each county or tribe in 
 91.19  proportion to the county's or tribe's share of the statewide 
 91.20  2002 historic spending base; 
 91.21     (ii) the remaining funds shall be allocated to each county 
 91.22  or tribe in proportion to the sum of the average number of MFIP 
 91.23  cases and the average monthly count of diversionary work program 
 91.24  cases.  The commissioner shall determine the count of MFIP and 
 91.25  diversionary work program cases according to subitems (A) to (C):
 91.26     (A) the average number of cases must be based upon counts 
 91.27  of MFIP, tribal TANF, or diversionary work program cases as of 
 91.28  March 31, June 30, September 30, and December 31 using the most 
 91.29  recent available data, less the number of child only cases.  
 91.30  Two-parent cases, with the exception of those with a caregiver 
 91.31  age 60 or over, will be multiplied by a factor of two; 
 91.32     (B) the case count for each eligible tribal provider shall 
 91.33  be based upon the number of MFIP, tribal TANF, or diversionary 
 91.34  work program cases with participating adults who are enrolled 
 91.35  in, or are eligible for enrollment in, the tribe; and to be 
 91.36  counted, the case must be an active MFIP or diversionary work 
 92.1   program case, and the case members must reside within the tribal 
 92.2   program's service delivery area; and 
 92.3      (C) to prevent duplicate counts, MFIP, tribal TANF, or 
 92.4   diversionary work program cases counted for determining 
 92.5   allocations to tribal providers shall be removed from the case 
 92.6   counts of the respective counties where they reside. 
 92.7      (d)(1) Beginning January 1, 2006, and effective January 1 
 92.8   of each subsequent year, the commissioner shall determine the 
 92.9   initial allocation of funds available under this section 
 92.10  according to clause (2). 
 92.11     (2)(i) Fifty percent of the funds available for the 
 92.12  calendar year shall be allocated to each county or tribe in 
 92.13  proportion to the county's or tribe's share of the statewide 
 92.14  2002 historic spending base; 
 92.15     (ii) the remaining funds shall be allocated to each county 
 92.16  or tribe in proportion to the sum of the average number of MFIP 
 92.17  cases and the average monthly count of diversionary work program 
 92.18  cases.  The commissioner shall determine the count of MFIP and 
 92.19  diversionary work program cases according to subitems (A) to (C):
 92.20     (A) the average number of cases must be based upon counts 
 92.21  of MFIP, tribal TANF, or diversionary work program cases as of 
 92.22  March 31, June 30, September 30, and December 31 using the most 
 92.23  recent available data, less the number of child only cases.  
 92.24  Two-parent cases, with the exception of those with a caregiver 
 92.25  age 60 or over, will be multiplied by a factor of two; 
 92.26     (B) the case count for each eligible tribal provider shall 
 92.27  be based upon the number of MFIP, tribal TANF, or diversionary 
 92.28  work program cases with participating adults who are enrolled 
 92.29  in, or are eligible for, enrollment in the tribe; and to be 
 92.30  counted, the case must be an active MFIP or diversionary work 
 92.31  program case, and the case members must reside within the tribal 
 92.32  program's service delivery area; and 
 92.33     (C) to prevent duplicate counts, MFIP, tribal TANF, or 
 92.34  diversionary work program cases counted for determining 
 92.35  allocations to tribal providers shall be removed from the case 
 92.36  counts of the respective counties where they reside. 
 93.1      (e) Before November 30, 2003, a county or tribe may ask for 
 93.2   a review of the commissioner's determination of the historic 
 93.3   base spending when the county or tribe believes the 2002 
 93.4   information was inaccurate or incomplete.  By January 1, 2004, 
 93.5   the commissioner must adjust that county's or tribe's base when 
 93.6   the commissioner has determined that inaccurate or incomplete 
 93.7   information was used to develop that base.  The commissioner 
 93.8   shall adjust each county's or tribe's initial allocation under 
 93.9   paragraph (c) and final allocation under subdivision 7 to 
 93.10  reflect the base change. 
 93.11     (f) Effective January 1, 2005, and effective January 1 of 
 93.12  each succeeding year, counties and tribes will have their final 
 93.13  allocations adjusted based on the performance provisions of 
 93.14  subdivision 7. 
 93.15     Subd. 7.  [PERFORMANCE BASE FUNDS.] (a) Beginning with 
 93.16  allocations for calendar year 2005, each county and tribe will 
 93.17  be allocated 95 percent of their initial allocation.  Counties 
 93.18  and tribes will be allocated additional funds based on 
 93.19  performance as follows: 
 93.20     (1) a county or tribe that achieves a 50 percent rate or 
 93.21  higher on the MFIP participation rate under section 256J.751, 
 93.22  subdivision 2, clause (8), as averaged across the four quarterly 
 93.23  measurements in the preceding year, will receive an additional 
 93.24  allocation equal to 2.5 percent of its initial allocation; and 
 93.25     (2) a county or tribe that performs above the top of its 
 93.26  range of expected performance on the three-year self-support 
 93.27  index under section 256J.751, subdivision 2, clause (7), in both 
 93.28  measurements in the preceding year will receive an additional 
 93.29  allocation equal to five percent of its initial allocation; or 
 93.30     (3) a county or tribe that performs within its range of 
 93.31  expected performance on the three-year self-support index under 
 93.32  section 256J.751, subdivision 2, clause (7), in both 
 93.33  measurements in the preceding year, or above the top of its 
 93.34  range of expected performance in one measurement and within its 
 93.35  expected range of performance in the other measurement, will 
 93.36  receive an additional allocation equal to 2.5 percent of its 
 94.1   initial allocation. 
 94.2      (b) Funds remaining unallocated after the performance-based 
 94.3   allocations in paragraph (a) are available to the commissioner 
 94.4   for innovation projects under subdivision 5. 
 94.5      (c)(1) If available funds are insufficient to meet county 
 94.6   and tribal allocations under paragraph (a), the commissioner may 
 94.7   make available for allocation funds that are unobligated and 
 94.8   available from the innovation projects through the end of the 
 94.9   current biennium. 
 94.10     (2) If after the application of clause (1) funds remain 
 94.11  insufficient to meet county and tribal allocations under 
 94.12  paragraph (a), the commissioner must proportionally reduce the 
 94.13  allocation of each county and tribe with respect to their 
 94.14  maximum allocation available under paragraph (a). 
 94.15     Subd. 8.  [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a) 
 94.16  The commissioner shall specify requirements for reporting 
 94.17  according to section 256.01, subdivision 2, clause (17).  Each 
 94.18  county or tribe shall be reimbursed for eligible expenditures up 
 94.19  to the limit of its allocation and subject to availability of 
 94.20  funds. 
 94.21     (b) Reimbursements for county administrative-related 
 94.22  expenditures determined through the income maintenance random 
 94.23  moment time study shall be reimbursed at a rate of 50 percent of 
 94.24  eligible expenditures.  
 94.25     (c) The commissioner of human services shall review county 
 94.26  and tribal agency expenditures of the MFIP consolidated fund as 
 94.27  appropriate and may reallocate unencumbered or unexpended money 
 94.28  appropriated under this section to those county and tribal 
 94.29  agencies that can demonstrate a need for additional money. 
 94.30     Subd. 9.  [REPORT.] By January 1, 2004, the commissioner 
 94.31  shall, in consultation with counties and tribes: 
 94.32     (1) determine how performance-based allocations under 
 94.33  subdivision 7, paragraph (a), clauses (2) and (3), will be 
 94.34  allocated to groupings of counties and tribes when groupings are 
 94.35  used to measure expected performance ranges for the self-support 
 94.36  index under section 256J.751, subdivision 2, clause (7); and 
 95.1      (2) determine how performance-based allocations under 
 95.2   subdivision 7, paragraph (a), clauses (2) and (3), will be 
 95.3   allocated to tribes. 
 95.4      Sec. 94.  Minnesota Statutes 2002, section 256J.645, 
 95.5   subdivision 3, is amended to read: 
 95.6      Subd. 3.  [FUNDING.] If the commissioner and an Indian 
 95.7   tribe are parties to an agreement under this subdivision, the 
 95.8   agreement shall annually provide to the Indian tribe the funding 
 95.9   allocated in section 256J.62, subdivisions 1 and 2a 256J.626. 
 95.10     Sec. 95.  Minnesota Statutes 2002, section 256J.66, 
 95.11  subdivision 2, is amended to read: 
 95.12     Subd. 2.  [TRAINING AND PLACEMENT.] (a) County agencies 
 95.13  shall limit the length of training based on the complexity of 
 95.14  the job and the caregiver's previous experience and training.  
 95.15  Placement in an on-the-job training position with an employer is 
 95.16  for the purpose of training and employment with the same 
 95.17  employer who has agreed to retain the person upon satisfactory 
 95.18  completion of training. 
 95.19     (b) Placement of any participant in an on-the-job training 
 95.20  position must be compatible with the participant's assessment 
 95.21  and employment plan under section 256J.52 256J.521. 
 95.22     Sec. 96.  Minnesota Statutes 2002, section 256J.67, 
 95.23  subdivision 1, is amended to read: 
 95.24     Subdivision 1.  [ESTABLISHING THE COMMUNITY WORK EXPERIENCE 
 95.25  PROGRAM.] To the extent of available resources, each county 
 95.26  agency may establish and operate a work experience component for 
 95.27  MFIP caregivers who are participating in employment and training 
 95.28  services.  This option for county agencies supersedes the 
 95.29  requirement in section 402(a)(1)(B)(iv) of the Social Security 
 95.30  Act that caregivers who have received assistance for two months 
 95.31  and who are not exempt from work requirements must participate 
 95.32  in a work experience program.  The purpose of the work 
 95.33  experience component is to enhance the caregiver's employability 
 95.34  and self-sufficiency and to provide meaningful, productive work 
 95.35  activities.  The county shall use this program for an individual 
 95.36  after exhausting all other unsubsidized employment 
 96.1   opportunities.  The county agency shall not require a caregiver 
 96.2   to participate in the community work experience program unless 
 96.3   the caregiver has been given an opportunity to participate in 
 96.4   other work activities.  
 96.5      Sec. 97.  Minnesota Statutes 2002, section 256J.67, 
 96.6   subdivision 3, is amended to read: 
 96.7      Subd. 3.  [EMPLOYMENT OPTIONS.] (a) Work sites developed 
 96.8   under this section are limited to projects that serve a useful 
 96.9   public service such as:  health, social service, environmental 
 96.10  protection, education, urban and rural development and 
 96.11  redevelopment, welfare, recreation, public facilities, public 
 96.12  safety, community service, services to aged or disabled 
 96.13  citizens, and child care.  To the extent possible, the prior 
 96.14  training, skills, and experience of a caregiver must be 
 96.15  considered in making appropriate work experience assignments. 
 96.16     (b) Structured, supervised volunteer work with an agency or 
 96.17  organization, which is monitored by the county service provider, 
 96.18  may, with the approval of the county agency, be used as a work 
 96.19  experience placement. 
 96.20     (c) As a condition of placing a caregiver in a program 
 96.21  under this section, the county agency shall first provide the 
 96.22  caregiver the opportunity: 
 96.23     (1) for placement in suitable subsidized or unsubsidized 
 96.24  employment through participation in a job search; or 
 96.25     (2) for placement in suitable employment through 
 96.26  participation in on-the-job training, if such employment is 
 96.27  available. 
 96.28     Sec. 98.  Minnesota Statutes 2002, section 256J.69, 
 96.29  subdivision 2, is amended to read: 
 96.30     Subd. 2.  [TRAINING AND PLACEMENT.] (a) County agencies 
 96.31  shall limit the length of training to nine months.  Placement in 
 96.32  a grant diversion training position with an employer is for the 
 96.33  purpose of training and employment with the same employer who 
 96.34  has agreed to retain the person upon satisfactory completion of 
 96.35  training. 
 96.36     (b) Placement of any participant in a grant diversion 
 97.1   subsidized training position must be compatible with the 
 97.2   assessment and employment plan or employability development plan 
 97.3   established for the recipient under section 256J.52 or 256K.03, 
 97.4   subdivision 8 256J.521. 
 97.5      Sec. 99.  Minnesota Statutes 2002, section 256J.75, 
 97.6   subdivision 3, is amended to read: 
 97.7      Subd. 3.  [RESPONSIBILITY FOR INCORRECT ASSISTANCE 
 97.8   PAYMENTS.] A county of residence, when different from the county 
 97.9   of financial responsibility, will be charged by the commissioner 
 97.10  for the value of incorrect assistance payments and medical 
 97.11  assistance paid to or on behalf of a person who was not eligible 
 97.12  to receive that amount.  Incorrect payments include payments to 
 97.13  an ineligible person or family resulting from decisions, 
 97.14  failures to act, miscalculations, or overdue recertification.  
 97.15  However, financial responsibility does not accrue for a county 
 97.16  when the recertification is overdue at the time the referral is 
 97.17  received by the county of residence or when the county of 
 97.18  financial responsibility does not act on the recommendation of 
 97.19  the county of residence.  When federal or state law requires 
 97.20  that medical assistance continue after assistance ends, this 
 97.21  subdivision also governs financial responsibility for the 
 97.22  extended medical assistance. 
 97.23     Sec. 100.  Minnesota Statutes 2002, section 256J.751, 
 97.24  subdivision 1, is amended to read: 
 97.25     Subdivision 1.  [QUARTERLY MONTHLY COUNTY CASELOAD REPORT.] 
 97.26  The commissioner shall report quarterly monthly to each county 
 97.27  on the county's performance on the following measures following 
 97.28  caseload information: 
 97.29     (1) number of cases receiving only the food portion of 
 97.30  assistance; 
 97.31     (2) number of child-only cases; 
 97.32     (3) number of minor caregivers; 
 97.33     (4) number of cases that are exempt from the 60-month time 
 97.34  limit by the exemption category under section 256J.42; 
 97.35     (5) number of participants who are exempt from employment 
 97.36  and training services requirements by the exemption category 
 98.1   under section 256J.56; 
 98.2      (6) number of assistance units receiving assistance under a 
 98.3   hardship extension under section 256J.425; 
 98.4      (7) number of participants and number of months spent in 
 98.5   each level of sanction under section 256J.46, subdivision 1; 
 98.6      (8) number of MFIP cases that have left assistance; 
 98.7      (9) federal participation requirements as specified in 
 98.8   title 1 of Public Law Number 104-193; 
 98.9      (10) median placement wage rate; and 
 98.10     (11) of each county's total MFIP caseload less the number 
 98.11  of cases in clauses (1) to (6): 
 98.12     (i) number of one-parent cases; 
 98.13     (ii) number of two-parent cases; 
 98.14     (iii) percent of one-parent cases that are working more 
 98.15  than 20 hours per week; 
 98.16     (iv) percent of two-parent cases that are working more than 
 98.17  20 hours per week; and 
 98.18     (v) percent of cases that have received more than 36 months 
 98.19  of assistance. 
 98.20     (1) total number of cases receiving MFIP, and subtotals of 
 98.21  cases with one eligible parent, two eligible parents, and an 
 98.22  eligible caregiver who is not a parent; 
 98.23     (2) total number of child only assistance cases; 
 98.24     (3) total number of eligible adults and children receiving 
 98.25  an MFIP grant, and subtotals for cases with one eligible parent, 
 98.26  two eligible parents, an eligible caregiver who is not a parent, 
 98.27  and child only cases; 
 98.28     (4) number of cases with an exemption from the 60-month 
 98.29  time limit based on a family violence waiver; 
 98.30     (5) number of MFIP cases with work hours, and subtotals for 
 98.31  cases with one eligible parent, two eligible parents, and an 
 98.32  eligible caregiver who is not a parent; 
 98.33     (6) number of employed MFIP cases, and subtotals for cases 
 98.34  with one eligible parent, two eligible parents, and an eligible 
 98.35  caregiver who is not a parent; 
 98.36     (7) average monthly gross earnings, and averages for 
 99.1   subgroups of cases with one eligible parent, two eligible 
 99.2   parents, and an eligible caregiver who is not a parent; 
 99.3      (8) number of employed cases receiving only the food 
 99.4   portion of assistance; 
 99.5      (9) number of parents or caregivers exempt from work 
 99.6   activity requirements, with subtotals for each exemption type; 
 99.7   and 
 99.8      (10) number of cases with a sanction, with subtotals by 
 99.9   level of sanction for cases with one eligible parent, two 
 99.10  eligible parents, and an eligible caregiver who is not a parent. 
 99.11     Sec. 101.  Minnesota Statutes 2002, section 256J.751, 
 99.12  subdivision 2, is amended to read: 
 99.13     Subd. 2.  [QUARTERLY COMPARISON REPORT.] The commissioner 
 99.14  shall report quarterly to all counties on each county's 
 99.15  performance on the following measures: 
 99.16     (1) percent of MFIP caseload working in paid employment; 
 99.17     (2) percent of MFIP caseload receiving only the food 
 99.18  portion of assistance; 
 99.19     (3) number of MFIP cases that have left assistance; 
 99.20     (4) federal participation requirements as specified in 
 99.21  Title 1 of Public Law Number 104-193; 
 99.22     (5) median placement wage rate; and 
 99.23     (6) caseload by months of TANF assistance; 
 99.24     (7) percent of MFIP cases off cash assistance or working 30 
 99.25  or more hours per week at one-year, two-year, and three-year 
 99.26  follow-up points from a base line quarter.  This measure is 
 99.27  called the self-support index.  Twice annually, the commissioner 
 99.28  shall report an expected range of performance for each county, 
 99.29  county grouping, and tribe on the self-support index.  The 
 99.30  expected range shall be derived by a statistical methodology 
 99.31  developed by the commissioner in consultation with the counties 
 99.32  and tribes.  The statistical methodology shall control 
 99.33  differences across counties in economic conditions and 
 99.34  demographics of the MFIP case load; and 
 99.35     (8) the MFIP work participation rate, defined as the 
 99.36  participation requirements specified in title 1 of Public Law 
100.1   104-193 applied to all MFIP cases. 
100.2      Sec. 102.  Minnesota Statutes 2002, section 256J.751, 
100.3   subdivision 5, is amended to read: 
100.4      Subd. 5.  [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 
100.5   (a) If sanctions occur for failure to meet the performance 
100.6   standards specified in title 1 of Public Law Number 104-193 of 
100.7   the Personal Responsibility and Work Opportunity Act of 1996, 
100.8   the state shall pay 88 percent of the sanction.  The remaining 
100.9   12 percent of the sanction will be paid by the counties.  The 
100.10  county portion of the sanction will be distributed across all 
100.11  counties in proportion to each county's percentage of the MFIP 
100.12  average monthly caseload during the period for which the 
100.13  sanction was applied. 
100.14     (b) If a county fails to meet the performance standards 
100.15  specified in title 1 of Public Law Number 104-193 of the 
100.16  Personal Responsibility and Work Opportunity Act of 1996 for any 
100.17  year, the commissioner shall work with counties to organize a 
100.18  joint state-county technical assistance team to work with the 
100.19  county.  The commissioner shall coordinate any technical 
100.20  assistance with other departments and agencies including the 
100.21  departments of economic security and children, families, and 
100.22  learning as necessary to achieve the purpose of this paragraph. 
100.23     (c) For state performance measures, a low-performing county 
100.24  is one that: 
100.25     (1) performs below the bottom of their expected range for 
100.26  the measure in subdivision 2, clause (7), in both measurements 
100.27  during the year; or 
100.28     (2) performs below 40 percent for the measure in 
100.29  subdivision 2, clause (8), as averaged across the four quarterly 
100.30  measurements for the year, or the ten counties with the lowest 
100.31  rates if more than ten are below 40 percent. 
100.32     (d) Low-performing counties under paragraph (c) must engage 
100.33  in corrective action planning as defined by the commissioner.  
100.34  The commissioner may coordinate technical assistance as 
100.35  specified in paragraph (b) for low-performing counties under 
100.36  paragraph (c). 
101.1      Sec. 103.  [256J.95] [DIVERSIONARY WORK PROGRAM.] 
101.2      Subdivision 1.  [ESTABLISHING A DIVERSIONARY WORK PROGRAM 
101.3   (DWP).] (a) The Personal Responsibility and Work Opportunity 
101.4   Reconciliation Act of 1996, Public Law 104-193, establishes 
101.5   block grants to states for temporary assistance for needy 
101.6   families (TANF).  TANF provisions allow states to use TANF 
101.7   dollars for nonrecurrent, short-term diversionary benefits.  The 
101.8   diversionary work program established on July 1, 2003, is 
101.9   Minnesota's TANF program to provide short-term diversionary 
101.10  benefits to eligible recipients of the diversionary work program.
101.11     (b) The goal of the diversionary work program is to provide 
101.12  short-term, necessary services and supports to families which 
101.13  will lead to unsubsidized employment, increase economic 
101.14  stability, and reduce the risk of those families needing longer 
101.15  term assistance, under the Minnesota family investment program 
101.16  (MFIP). 
101.17     (c) When a family unit meets the eligibility criteria in 
101.18  this section, the family must receive a diversionary work 
101.19  program grant and is not eligible for MFIP. 
101.20     (d) A family unit is eligible for the diversionary work 
101.21  program for a maximum of four months only once in a 12-month 
101.22  period.  The 12-month period begins at the date of application 
101.23  or the date eligibility is met, whichever is later.  During the 
101.24  four-month period, family maintenance needs as defined in 
101.25  subdivision 2, shall be vendor paid, up to the cash portion of 
101.26  the MFIP standard of need for the same size household.  To the 
101.27  extent there is a balance available between the amount paid for 
101.28  family maintenance needs and the cash portion of the 
101.29  transitional standard, a personal needs allowance of up to $70 
101.30  per DWP recipient in the family unit shall be issued.  The 
101.31  personal needs allowance payment plus the family maintenance 
101.32  needs shall not exceed the cash portion of the MFIP standard of 
101.33  need.  Counties may provide supportive and other allowable 
101.34  services funded by the MFIP consolidated fund under section 
101.35  256J.626 to eligible participants during the four-month 
101.36  diversionary period. 
102.1      Subd. 2.  [DEFINITIONS.] The terms used in this section 
102.2   have the following meanings. 
102.3      (a) "Diversionary Work Program (DWP)" means the program 
102.4   established under this section. 
102.5      (b) "Employment plan" means a plan developed by the job 
102.6   counselor and the participant which identifies the participant's 
102.7   most direct path to unsubsidized employment, lists the specific 
102.8   steps that the caregiver will take on that path, and includes a 
102.9   timetable for the completion of each step.  For participants who 
102.10  request and qualify for a family violence waiver in section 
102.11  256J.521, subdivision 3, an employment plan must be developed by 
102.12  the job counselor, the participant and a person trained in 
102.13  domestic violence and follow the employment plan provisions in 
102.14  section 256J.521, subdivision 3.  Employment plans under this 
102.15  section shall be written for a period of time not to exceed four 
102.16  months. 
102.17     (c) "Employment services" means programs, activities, and 
102.18  services in this section that are designed to assist 
102.19  participants in obtaining and retaining employment. 
102.20     (d) "Family maintenance needs" means current housing costs 
102.21  including rent, manufactured home lot rental costs, or monthly 
102.22  principal, interest, insurance premiums, and property taxes due 
102.23  for mortgages or contracts for deed, association fees required 
102.24  for homeownership, utility costs for current month expenses of 
102.25  gas and electric, garbage, water and sewer, and a flat rate of 
102.26  $35 for a telephone. 
102.27     (e) "Family unit" means a group of people applying for or 
102.28  receiving DWP benefits together.  For the purposes of 
102.29  determining eligibility for this program, the unit includes the 
102.30  relationships in section 256J.08, subdivision 34. 
102.31     (f) "Minnesota family investment program (MFIP)" means the 
102.32  assistance program as defined in section 256J.08, subdivision 57.
102.33     (g) "Personal needs allowance" means an allowance of up to 
102.34  $70 per month per DWP unit member to pay for expenses such as 
102.35  household products and personal products. 
102.36     (h) "Work activities" means allowable work activities as 
103.1   defined in section 256J.49, subdivision 13. 
103.2      Subd. 3.  [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 
103.3   Except for the categories of family units listed below, all 
103.4   family units who apply for cash benefits and who meet MFIP 
103.5   eligibility as required in section 256J.10, are eligible and 
103.6   must participate in the diversionary work program.  Family units 
103.7   that are not eligible for the diversionary work program include: 
103.8      (1) child only cases; 
103.9      (2) a single-parent family unit that includes a child under 
103.10  12 weeks of age.  A parent is eligible for this exception once 
103.11  in a parent's lifetime and is not eligible if the parent has 
103.12  already used the previously allowed child under age one 
103.13  exemption from MFIP employment services; 
103.14     (3) a minor parent without a high school diploma or its 
103.15  equivalent; 
103.16     (4) a caregiver 18 or 19 years of age without a high school 
103.17  diploma or its equivalent who chooses to have an employment plan 
103.18  with an education option; 
103.19     (5) a caregiver age 60 or over; 
103.20     (6) family units with a parent who received DWP benefits 
103.21  within a 12-month period as defined in subdivision 1, paragraph 
103.22  (d); and 
103.23     (7) family units with a parent who received MFIP within the 
103.24  past 12 months. 
103.25     (b) A two-parent family must participate in DWP unless both 
103.26  parents meet the criteria for an exception under paragraph (a), 
103.27  clauses (1) through (5), or the family unit includes a parent 
103.28  who meets the criteria in paragraph (a), clause (6) or (7). 
103.29     Subd. 4.  [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 
103.30  be eligible for DWP, an applicant must comply with the 
103.31  requirements of paragraphs (b) to (d). 
103.32     (b) Applicants and participants must cooperate with the 
103.33  requirements of the child support enforcement program, but will 
103.34  not be charged a fee under section 518.551, subdivision 7. 
103.35     (c) The applicant must provide each member of the family 
103.36  unit's social security number to the county agency.  This 
104.1   requirement is satisfied when each member of the family unit 
104.2   cooperates with the procedures for verification of numbers, 
104.3   issuance of duplicate cards, and issuance of new numbers which 
104.4   have been established jointly between the Social Security 
104.5   Administration and the commissioner. 
104.6      (d) Before DWP benefits can be issued to a family unit, the 
104.7   caregiver must, in conjunction with a job counselor, develop and 
104.8   sign an employment plan.  In two-parent family units, both 
104.9   parents must develop and sign employment plans before benefits 
104.10  can be issued.  Food support and health care benefits are not 
104.11  contingent on the requirement for a signed employment plan. 
104.12     Subd. 5.  [SUBMITTING APPLICATION FORM.] The eligibility 
104.13  date for the diversionary work program begins with the date the 
104.14  signed combined application form (CAF) is received by the county 
104.15  agency or the date diversionary work program eligibility 
104.16  criteria are met, whichever is later.  The county agency must 
104.17  inform the applicant that any delay in submitting the 
104.18  application will reduce the benefits paid for the month of 
104.19  application.  The county agency must inform a person that an 
104.20  application may be submitted before the person has an interview 
104.21  appointment.  Upon receipt of a signed application, the county 
104.22  agency must stamp the date of receipt on the face of the 
104.23  application.  The applicant may withdraw the application at any 
104.24  time prior to approval by giving written or oral notice to the 
104.25  county agency.  The county agency must follow the notice 
104.26  requirements in section 256J.09, subdivision 3, when issuing a 
104.27  notice confirming the withdrawal. 
104.28     Subd. 6.  [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 
104.29  of the application, the county agency must determine if the 
104.30  applicant may be eligible for other benefits as required in 
104.31  sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 
104.32  and 5.  The county must also follow the provisions in section 
104.33  256J.09, subdivision 3b, clause (2). 
104.34     Subd. 7.  [PROGRAM AND PROCESSING STANDARDS.] (a) The 
104.35  interview to determine financial eligibility for the 
104.36  diversionary work program must be conducted within five working 
105.1   days of the receipt of the cash application form.  During the 
105.2   intake interview the financial worker must discuss: 
105.3      (1) the goals, requirements, and services of the 
105.4   diversionary work program; 
105.5      (2) the availability of child care assistance.  If child 
105.6   care is needed, the worker must obtain a completed application 
105.7   for child care from the applicant before the interview is 
105.8   terminated.  The same day the application for child care is 
105.9   received, the application must be forwarded to the appropriate 
105.10  child care worker.  For purposes of eligibility for child care 
105.11  assistance under chapter 119B, DWP participants shall be 
105.12  eligible for the same benefits as MFIP recipients; and 
105.13     (3) if the applicant has not requested food support and 
105.14  health care assistance on the application, the county agency 
105.15  shall, during the interview process, talk with the applicant 
105.16  about the availability of these benefits. 
105.17     (b) The county shall follow section 256J.74, subdivision 2, 
105.18  paragraph (b), clauses (1) and (2), when an applicant or a 
105.19  recipient of DWP has a person who is a member of more than one 
105.20  assistance unit in a given payment month. 
105.21     (c) If within 30 days the county agency cannot determine 
105.22  eligibility for the diversionary work program, the county must 
105.23  deny the application and inform the applicant of the decision 
105.24  according to the notice provisions in section 256J.31.  A family 
105.25  unit is eligible for a fair hearing under section 256J.40.  
105.26     Subd. 8.  [VERIFICATION REQUIREMENTS.] (a) A county agency 
105.27  must only require verification of information necessary to 
105.28  determine DWP eligibility and the amount of the payment.  The 
105.29  applicant or participant must document the information required 
105.30  or authorize the county agency to verify the information.  The 
105.31  applicant or participant has the burden of providing documentary 
105.32  evidence to verify eligibility.  The county agency shall assist 
105.33  the applicant or participant in obtaining required documents 
105.34  when the applicant or participant is unable to do so. 
105.35     (b) A county agency must not request information about an 
105.36  applicant or participant that is not a matter of public record 
106.1   from a source other than county agencies, the department of 
106.2   human services, or the United States Department of Health and 
106.3   Human Services without the person's prior written consent.  An 
106.4   applicant's signature on an application form constitutes consent 
106.5   for contact with the sources specified on the application.  A 
106.6   county agency may use a single consent form to contact a group 
106.7   of similar sources, but the sources to be contacted must be 
106.8   identified by the county agency prior to requesting an 
106.9   applicant's consent. 
106.10     (c) Factors to be verified shall follow section 256J.32, 
106.11  subdivision 4.  Except for personal needs, family maintenance 
106.12  needs must be verified before the expense can be allowed in the 
106.13  calculation of the DWP grant. 
106.14     Subd. 9.  [PROPERTY AND INCOME LIMITATIONS.] The asset 
106.15  limits and exclusions in section 256J.20, apply to applicants 
106.16  and recipients of DWP.  All payments, unless excluded in section 
106.17  256J.21, must be counted as income to determine eligibility for 
106.18  the diversionary work program.  The county shall treat income as 
106.19  outlined in section 256J.37, except for subdivision 3a.  The 
106.20  initial income test and the disregards in section 256J.21, 
106.21  subdivision 3, shall be followed for determining eligibility for 
106.22  the diversionary work program. 
106.23     Subd. 10.  [DIVERSIONARY WORK PROGRAM GRANT.] (a) The 
106.24  amount of cash benefits that a family unit is eligible for under 
106.25  the diversionary work program is based on the number of persons 
106.26  in the family unit, the family maintenance needs, personal needs 
106.27  allowance, and countable income.  The county agency shall 
106.28  evaluate the income of the family unit that is requesting 
106.29  payments under the diversionary work program.  Countable income 
106.30  means gross earned and unearned income not excluded or 
106.31  disregarded under MFIP.  The same disregards for earned income 
106.32  that are allowed under MFIP are allowed for the diversionary 
106.33  work program. 
106.34     (b) The DWP grant is based on the family maintenance needs 
106.35  for which the DWP family unit is responsible plus a personal 
106.36  needs allowance.  Housing and utilities shall be vendor paid.  
107.1   Unless otherwise stated in this section, actual housing and 
107.2   utility expenses shall be used when determining the amount of 
107.3   the DWP grant. 
107.4      (c) The maximum monthly benefit amount available under the 
107.5   diversionary work program is the difference between the family 
107.6   unit's family maintenance needs under paragraph (b) and the 
107.7   family unit's countable income not to exceed the cash portion of 
107.8   the MFIP standard of need as defined in section 256J.08, 
107.9   subdivision 55a, for the family unit's size.  The family wage 
107.10  level as defined in section 256J.08, subdivision 35, shall be 
107.11  used when determining the amount of countable income for working 
107.12  members. 
107.13     (d) Once the county has determined a grant amount, the DWP 
107.14  grant amount will not be decreased if the determination is based 
107.15  on the best information available at the time of approval and 
107.16  shall not be decreased because of any additional income to the 
107.17  family unit.  The grant can be increased if a participant later 
107.18  verifies an increase in family maintenance needs or family unit 
107.19  size.  The minimum cash benefit amount, if income and asset 
107.20  tests are met, is $10.  Benefits of $10 shall not be vendor paid.
107.21     (e) When all criteria are met, including the development of 
107.22  an employment plan as described in subdivision 14 and 
107.23  eligibility exists for the month of application, the amount of 
107.24  benefits for the diversionary work program retroactive to the 
107.25  date of application is as specified in section 256J.35, 
107.26  paragraph (a). 
107.27     (f) Any month during the four-month DWP period that a 
107.28  person receives a DWP benefit directly or through a vendor 
107.29  payment made on the person's behalf, that person is ineligible 
107.30  for MFIP or any other TANF cash program except for benefits 
107.31  defined in section 256J.626, subdivision 2, clause (1). 
107.32     If during the four-month period a family unit that receives 
107.33  DWP benefits moves to a county that has not established a 
107.34  diversionary work program, the family unit may be eligible for 
107.35  MFIP the month following the last month of the issuance of the 
107.36  DWP benefit. 
108.1      Subd. 11.  [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 
108.2   caregivers, except caregivers who meet the criteria in paragraph 
108.3   (d), are required to participate in DWP employment services.  
108.4   Except as specified in paragraphs (b) and (c), employment plans 
108.5   under DWP must, at a minimum, meet the requirements in section 
108.6   256J.55, subdivision 1. 
108.7      (b) A caregiver who is a member of a two-parent family that 
108.8   is required to participate in DWP who would otherwise be 
108.9   ineligible for DWP under subdivision 3 may be allowed to develop 
108.10  an employment plan under section 256J.521, subdivision 2, 
108.11  paragraph (c), that may contain alternate activities and reduced 
108.12  hours.  
108.13     (c) A participant who has a family violence waiver shall be 
108.14  allowed to develop an employment plan under section 256J.521, 
108.15  subdivision 3. 
108.16     (d) One parent in a two-parent family unit that has a 
108.17  natural born child under 12 weeks of age is not required to have 
108.18  an employment plan until the child reaches 12 weeks of age 
108.19  unless the family unit has already used the exclusion under 
108.20  section 256J.561, subdivision 2, or the previously allowed child 
108.21  under age one exemption under section 256J.56, paragraph (a), 
108.22  clause (5). 
108.23     (e) The provision in paragraph (d) ends the first full 
108.24  month after the child reaches 12 weeks of age.  This provision 
108.25  is allowable only once in a caregiver's lifetime.  In a 
108.26  two-parent household, only one parent shall be allowed to use 
108.27  this category. 
108.28     (f) The participant and job counselor must meet within ten 
108.29  working days after the child reaches 12 weeks of age to revise 
108.30  the participant's employment plan.  The employment plan for a 
108.31  family unit that has a child under 12 weeks of age that has 
108.32  already used the exclusion in section 256J.561 or the previously 
108.33  allowed child under age one exemption under section 256J.56, 
108.34  paragraph (a), clause (5), must be tailored to recognize the 
108.35  caregiving needs of the parent. 
108.36     Subd. 12.  [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 
109.1   time during the DWP application process or during the four-month 
109.2   DWP eligibility period, it is determined that a participant is 
109.3   unlikely to benefit from the diversionary work program, the 
109.4   county shall convert or refer the participant to MFIP as 
109.5   specified in paragraph (d).  Participants who are determined to 
109.6   be unlikely to benefit from the diversionary work program must 
109.7   develop and sign an employment plan.  Participants are 
109.8   determined to be unlikely to benefit from the DWP program for 
109.9   any one of the reasons listed in paragraph (b), provided the 
109.10  necessary documentation is available to support the 
109.11  determination. 
109.12     (b)(1) a participant who has been determined by a qualified 
109.13  professional as being unable to obtain or retain employment due 
109.14  to an illness, injury, or incapacity that is expected to last at 
109.15  least 60 days; 
109.16     (2) a participant who is determined by a qualified 
109.17  professional as being needed in the home to care for a family 
109.18  member due to an illness, injury, or incapacity that is expected 
109.19  to last at least 60 days; 
109.20     (3) a participant who is determined by a qualified 
109.21  professional as being needed in the home to care for a child 
109.22  meeting the special medical criteria in section 256J.425, 
109.23  subdivision 2, clause (3); 
109.24     (4) a pregnant participant who is determined by a qualified 
109.25  professional as being unable to obtain or retain employment due 
109.26  to the pregnancy; and 
109.27     (5) a participant who has applied for SSI or RSDI. 
109.28     (c) In a two-parent family unit, both parents must be 
109.29  determined to be unlikely to benefit from the diversionary work 
109.30  program before the family unit can be converted or referred to 
109.31  MFIP. 
109.32     (d) A participant who is determined to be unlikely to 
109.33  benefit from the diversionary work program shall be converted to 
109.34  MFIP and, if the determination was made within 30 days of the 
109.35  initial application for benefits, a new combined application 
109.36  form will not be required.  A participant who is determined to 
110.1   be unlikely to benefit from the diversionary work program shall 
110.2   be referred to MFIP and, if the determination is made more than 
110.3   30 days after the initial application, the participant must 
110.4   submit a new combined application form.  The county agency shall 
110.5   process the combined application form by the first of the 
110.6   following month to ensure that no gap in benefits is due to 
110.7   delayed action by the county agency. 
110.8      Subd. 13.  [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 
110.9   Within one working day of determination that the applicant is 
110.10  eligible for the diversionary work program, but before benefits 
110.11  are issued to or on behalf of the family unit, the county shall 
110.12  refer all caregivers to employment services.  The referral to 
110.13  the DWP employment services must be in writing and must contain 
110.14  the following information: 
110.15     (1) notification that, as part of the application process, 
110.16  applicants are required to develop an employment plan or the DWP 
110.17  application will be denied; 
110.18     (2) the employment services provider name and phone number; 
110.19     (3) the date, time, and location of the scheduled 
110.20  employment services interview; 
110.21     (4) the immediate availability of supportive services, 
110.22  including, but not limited to, child care, transportation, and 
110.23  other work-related aid; and 
110.24     (5) the rights, responsibilities, and obligations of 
110.25  participants in the program, including, but not limited to, the 
110.26  grounds for good cause, the consequences of refusing or failing 
110.27  to participate fully with program requirements, and the appeal 
110.28  process. 
110.29     Subd. 14.  [EMPLOYMENT PLAN; DWP BENEFITS.] Within five 
110.30  working days of being notified that a participant is financially 
110.31  eligible for the diversionary work program, the employment 
110.32  services provider and participant shall meet to develop an 
110.33  employment plan.  Once the employment plan has been developed 
110.34  and signed by the participant and the job counselor, the 
110.35  employment services provider shall notify the county within one 
110.36  working day that the employment plan has been signed.  The 
111.1   county shall issue DWP benefits within one working day after 
111.2   receiving notice that the employment plan has been signed. 
111.3      Subd. 15.  [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 
111.4   Except as specified in paragraphs (b) to (d), employment 
111.5   activities listed in section 256J.49, subdivision 13, are 
111.6   allowable under the diversionary work program. 
111.7      (b) Work activities under section 256J.49, subdivision 13, 
111.8   clause (5), shall be allowable only when in combination with 
111.9   approved work activities under section 256J.49, subdivision 13, 
111.10  clauses (1) to (4), and shall be limited to no more than 
111.11  one-half of the hours required in the employment plan. 
111.12     (c) In order for an English as a second language (ESL) 
111.13  class to be an approved work activity, a participant must: 
111.14     (1) be below a spoken language proficiency level of SPL6 or 
111.15  its equivalent, as measured by a nationally recognized test; and 
111.16     (2) not have been enrolled in ESL for more than 24 months 
111.17  while previously participating in MFIP or DWP.  A participant 
111.18  who has been enrolled in ESL for 20 or more months may be 
111.19  approved for ESL until the participant has received 24 total 
111.20  months. 
111.21     (d) Work activities under section 256J.49, subdivision 13, 
111.22  clause (6), shall be allowable only when the training or 
111.23  education program will be completed within the four-month DWP 
111.24  period.  Training or education programs that will not be 
111.25  completed within the four-month DWP period shall not be approved.
111.26     Subd. 16.  [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 
111.27  unit that includes a participant who fails to comply with DWP 
111.28  employment service or child support enforcement requirements, 
111.29  without good cause as defined in sections 256.741 and 256J.57, 
111.30  shall be disqualified from the diversionary work program.  The 
111.31  county shall provide written notice as specified in section 
111.32  256J.31 to the participant prior to disqualifying the family 
111.33  unit due to noncompliance with employment service or child 
111.34  support.  The disqualification does not apply to food support or 
111.35  health care benefits. 
111.36     Subd. 17.  [GOOD CAUSE FOR NOT COMPLYING WITH 
112.1   REQUIREMENTS.] A participant who fails to comply with the 
112.2   requirements of the diversionary work program may claim good 
112.3   cause for reasons listed in sections 256.741 and 256J.57, 
112.4   subdivision 1, clauses (1) to (13).  The county shall not impose 
112.5   a disqualification if good cause exists. 
112.6      Subd. 18.  [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 
112.7   participant who has been disqualified from the diversionary work 
112.8   program due to noncompliance with employment services may regain 
112.9   eligibility for the diversionary work program by complying with 
112.10  program requirements.  A participant who has been disqualified 
112.11  from the diversionary work program due to noncooperation with 
112.12  child support enforcement requirements may regain eligibility by 
112.13  complying with child support requirements under section 
112.14  256J.741.  Once a participant has been reinstated, the county 
112.15  shall issue prorated benefits for the remaining portion of the 
112.16  month.  A family unit that has been disqualified from the 
112.17  diversionary work program due to noncompliance shall not be 
112.18  eligible for MFIP or any other TANF cash program during the 
112.19  period of time the participant remains noncompliant.  In a 
112.20  two-parent family, both parents must be in compliance before the 
112.21  family unit can regain eligibility for benefits. 
112.22     Subd. 19.  [RECOVERY OF OVERPAYMENTS.] When an overpayment 
112.23  or an ATM error is determined, the overpayment shall be recouped 
112.24  or recovered as specified in section 256J.38. 
112.25     Subd. 20.  [IMPLEMENTATION OF DWP.] Counties may establish 
112.26  a diversionary work program according to this section any time 
112.27  on or after July 1, 2003.  Prior to establishing a diversionary 
112.28  work program, the county must notify the commissioner.  All 
112.29  counties must implement the provisions of this section no later 
112.30  than July 1, 2004. 
112.31     Sec. 104.  Minnesota Statutes 2002, section 261.063, is 
112.32  amended to read: 
112.33     261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 
112.34  PENALTY.] 
112.35     (a) The board of county commissioners of each county shall 
112.36  annually levy taxes and fix a rate sufficient to produce the 
113.1   full amount required for poor relief, general assistance, 
113.2   Minnesota family investment program, diversionary work program, 
113.3   county share of county and state supplemental aid to 
113.4   supplemental security income applicants or recipients, and any 
113.5   other social security measures wherein there is now or may 
113.6   hereafter be county participation, sufficient to produce the 
113.7   full amount necessary for each such item, including 
113.8   administrative expenses, for the ensuing year, within the time 
113.9   fixed by law in addition to all other tax levies and tax rates, 
113.10  however fixed or determined, and any commissioner who shall fail 
113.11  to comply herewith shall be guilty of a gross misdemeanor and 
113.12  shall be immediately removed from office by the governor.  For 
113.13  the purposes of this paragraph, "poor relief" means county 
113.14  services provided under sections 261.035, 261.04, and 261.21 to 
113.15  261.231. 
113.16     (b) Nothing within the provisions of this section shall be 
113.17  construed as requiring a county agency to provide income support 
113.18  or cash assistance to needy persons when they are no longer 
113.19  eligible for assistance under general assistance, the Minnesota 
113.20  family investment program chapter 256J, or Minnesota 
113.21  supplemental aid. 
113.22     Sec. 105.  Minnesota Statutes 2002, section 393.07, 
113.23  subdivision 10, is amended to read: 
113.24     Subd. 10.  [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 
113.25  CHILD NUTRITION ACT.] (a) The local social services agency shall 
113.26  establish and administer the food stamp or support program 
113.27  according to rules of the commissioner of human services, the 
113.28  supervision of the commissioner as specified in section 256.01, 
113.29  and all federal laws and regulations.  The commissioner of human 
113.30  services shall monitor food stamp or support program delivery on 
113.31  an ongoing basis to ensure that each county complies with 
113.32  federal laws and regulations.  Program requirements to be 
113.33  monitored include, but are not limited to, number of 
113.34  applications, number of approvals, number of cases pending, 
113.35  length of time required to process each application and deliver 
113.36  benefits, number of applicants eligible for expedited issuance, 
114.1   length of time required to process and deliver expedited 
114.2   issuance, number of terminations and reasons for terminations, 
114.3   client profiles by age, household composition and income level 
114.4   and sources, and the use of phone certification and home 
114.5   visits.  The commissioner shall determine the county-by-county 
114.6   and statewide participation rate.  
114.7      (b) On July 1 of each year, the commissioner of human 
114.8   services shall determine a statewide and county-by-county food 
114.9   stamp program participation rate.  The commissioner may 
114.10  designate a different agency to administer the food stamp 
114.11  program in a county if the agency administering the program 
114.12  fails to increase the food stamp program participation rate 
114.13  among families or eligible individuals, or comply with all 
114.14  federal laws and regulations governing the food stamp program.  
114.15  The commissioner shall review agency performance annually to 
114.16  determine compliance with this paragraph. 
114.17     (c) A person who commits any of the following acts has 
114.18  violated section 256.98 or 609.821, or both, and is subject to 
114.19  both the criminal and civil penalties provided under those 
114.20  sections: 
114.21     (1) obtains or attempts to obtain, or aids or abets any 
114.22  person to obtain by means of a willful statement or 
114.23  misrepresentation, or intentional concealment of a material 
114.24  fact, food stamps or vouchers issued according to sections 
114.25  145.891 to 145.897 to which the person is not entitled or in an 
114.26  amount greater than that to which that person is entitled or 
114.27  which specify nutritional supplements to which that person is 
114.28  not entitled; or 
114.29     (2) presents or causes to be presented, coupons or vouchers 
114.30  issued according to sections 145.891 to 145.897 for payment or 
114.31  redemption knowing them to have been received, transferred or 
114.32  used in a manner contrary to existing state or federal law; or 
114.33     (3) willfully uses, possesses, or transfers food stamp 
114.34  coupons, authorization to purchase cards or vouchers issued 
114.35  according to sections 145.891 to 145.897 in any manner contrary 
114.36  to existing state or federal law, rules, or regulations; or 
115.1      (4) buys or sells food stamp coupons, authorization to 
115.2   purchase cards, other assistance transaction devices, vouchers 
115.3   issued according to sections 145.891 to 145.897, or any food 
115.4   obtained through the redemption of vouchers issued according to 
115.5   sections 145.891 to 145.897 for cash or consideration other than 
115.6   eligible food. 
115.7      (d) A peace officer or welfare fraud investigator may 
115.8   confiscate food stamps, authorization to purchase cards, or 
115.9   other assistance transaction devices found in the possession of 
115.10  any person who is neither a recipient of the food stamp program 
115.11  nor otherwise authorized to possess and use such materials.  
115.12  Confiscated property shall be disposed of as the commissioner 
115.13  may direct and consistent with state and federal food stamp 
115.14  law.  The confiscated property must be retained for a period of 
115.15  not less than 30 days to allow any affected person to appeal the 
115.16  confiscation under section 256.045. 
115.17     (e) Food stamp overpayment claims which are due in whole or 
115.18  in part to client error shall be established by the county 
115.19  agency for a period of six years from the date of any resultant 
115.20  overpayment.  
115.21     (f) With regard to the federal tax revenue offset program 
115.22  only, recovery incentives authorized by the federal food and 
115.23  consumer service shall be retained at the rate of 50 percent by 
115.24  the state agency and 50 percent by the certifying county agency. 
115.25     (g) A peace officer, welfare fraud investigator, federal 
115.26  law enforcement official, or the commissioner of health may 
115.27  confiscate vouchers found in the possession of any person who is 
115.28  neither issued vouchers under sections 145.891 to 145.897, nor 
115.29  otherwise authorized to possess and use such vouchers.  
115.30  Confiscated property shall be disposed of as the commissioner of 
115.31  health may direct and consistent with state and federal law.  
115.32  The confiscated property must be retained for a period of not 
115.33  less than 30 days. 
115.34     (h) The commissioner of human services shall seek a waiver 
115.35  from the United States Department of Agriculture to allow the 
115.36  state to specify foods that may and may not be purchased in 
116.1   Minnesota with benefits funded by the federal Food Stamp Program.
116.2      Sec. 106.  Laws 1997, chapter 203, article 9, section 21, 
116.3   as amended by Laws 1998, chapter 407, article 6, section 111, 
116.4   Laws 2000, chapter 488, article 10, section 28, and Laws 2001, 
116.5   First Special Session chapter 9, article 10, section 62, is 
116.6   amended to read: 
116.7      Sec. 21.  [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 
116.8      (a) Effective on the date specified, the following persons 
116.9   will be ineligible for general assistance and general assistance 
116.10  medical care under Minnesota Statutes, chapter 256D, group 
116.11  residential housing under Minnesota Statutes, chapter 256I, and 
116.12  MFIP assistance under Minnesota Statutes, chapter 256J, funded 
116.13  with state money: 
116.14     (1) Beginning July 1, 2002, persons who are terminated from 
116.15  or denied Supplemental Security Income due to the 1996 changes 
116.16  in the federal law making persons whose alcohol or drug 
116.17  addiction is a material factor contributing to the person's 
116.18  disability ineligible for Supplemental Security Income, and are 
116.19  eligible for general assistance under Minnesota Statutes, 
116.20  section 256D.05, subdivision 1, paragraph (a), clause (15), 
116.21  general assistance medical care under Minnesota Statutes, 
116.22  chapter 256D, or group residential housing under Minnesota 
116.23  Statutes, chapter 256I; and 
116.24     (2) Beginning July 1, 2002, legal noncitizens who are 
116.25  ineligible for Supplemental Security Income due to the 1996 
116.26  changes in federal law making certain noncitizens ineligible for 
116.27  these programs due to their noncitizen status; and. 
116.28     (3) Beginning July 1, 2003, legal noncitizens who are 
116.29  eligible for MFIP assistance, either the cash assistance portion 
116.30  or the food assistance portion, funded entirely with state money.
116.31     (b) State money that remains unspent due to changes in 
116.32  federal law enacted after May 12, 1997, that reduce state 
116.33  spending for legal noncitizens or for persons whose alcohol or 
116.34  drug addiction is a material factor contributing to the person's 
116.35  disability, or enacted after February 1, 1998, that reduce state 
116.36  spending for food benefits for legal noncitizens shall not 
117.1   cancel and shall be deposited in the TANF reserve account. 
117.2      Sec. 107.  [REVISOR'S INSTRUCTION.] 
117.3      (a) In the next publication of Minnesota Statutes, the 
117.4   revisor of statutes shall codify section 104 of this act. 
117.5      (b) Wherever "food stamp" or "food stamps" appears in 
117.6   Minnesota Statutes and Rules, the revisor of statutes shall 
117.7   insert "food support" or "or food support" except for instances 
117.8   where federal code or federal law is referenced. 
117.9      (c) For sections in Minnesota Statutes and Minnesota Rules 
117.10  affected by the repealed sections in this article, the revisor 
117.11  shall delete internal cross-references where appropriate and 
117.12  make changes necessary to correct the punctuation, grammar, or 
117.13  structure of the remaining text and preserve its meaning. 
117.14     Sec. 108.  [REPEALER.] 
117.15     (a) Minnesota Statutes 2002, sections 256J.02, subdivision 
117.16  3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8; 
117.17  256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49, 
117.18  subdivisions 1a, 6, and 7; 256J.49, subdivision 2; 256J.50, 
117.19  subdivisions 2, 3, 3a, 5, and 7; 256J.52, subdivisions 1, 2, 3, 
117.20  4, 5, 5a, 6, 7, 8, and 9; 256J.55, subdivision 5; 256J.62, 
117.21  subdivisions 1, 2a, 3a, 4, 6, 7, and 8; 256J.625; 256J.655; 
117.22  256J.74, subdivision 3; 256J.751, subdivisions 3 and 4; 256J.76; 
117.23  and 256K.30, are repealed. 
117.24     (b) Laws 2000, chapter 488, article 10, section 29, is 
117.25  repealed. 
117.26                             ARTICLE 2 
117.27                            HEALTH CARE 
117.28     Section 1.  Minnesota Statutes 2002, section 16A.724, is 
117.29  amended to read: 
117.30     16A.724 [HEALTH CARE ACCESS FUND.] 
117.31     A health care access fund is created in the state 
117.32  treasury.  The fund is a direct appropriated special revenue 
117.33  fund.  The commissioner shall deposit to the credit of the fund 
117.34  money made available to the fund.  Notwithstanding section 
117.35  11A.20, after June 30, 1997, all investment income and all 
117.36  investment losses attributable to the investment of the health 
118.1   care access fund not currently needed shall be credited to the 
118.2   health care access fund.  The health care access fund shall 
118.3   sunset on June 30, 2005, and all remaining funds shall be 
118.4   deposited in the general fund.  Beginning July 1, 2005, all 
118.5   activities which would otherwise receive funding from the health 
118.6   care access fund shall be funded out of the general fund. 
118.7      Sec. 2.  Minnesota Statutes 2002, section 256.01, 
118.8   subdivision 2, is amended to read: 
118.9      Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
118.10  section 241.021, subdivision 2, the commissioner of human 
118.11  services shall: 
118.12     (1) Administer and supervise all forms of public assistance 
118.13  provided for by state law and other welfare activities or 
118.14  services as are vested in the commissioner.  Administration and 
118.15  supervision of human services activities or services includes, 
118.16  but is not limited to, assuring timely and accurate distribution 
118.17  of benefits, completeness of service, and quality program 
118.18  management.  In addition to administering and supervising human 
118.19  services activities vested by law in the department, the 
118.20  commissioner shall have the authority to: 
118.21     (a) require county agency participation in training and 
118.22  technical assistance programs to promote compliance with 
118.23  statutes, rules, federal laws, regulations, and policies 
118.24  governing human services; 
118.25     (b) monitor, on an ongoing basis, the performance of county 
118.26  agencies in the operation and administration of human services, 
118.27  enforce compliance with statutes, rules, federal laws, 
118.28  regulations, and policies governing welfare services and promote 
118.29  excellence of administration and program operation; 
118.30     (c) develop a quality control program or other monitoring 
118.31  program to review county performance and accuracy of benefit 
118.32  determinations; 
118.33     (d) require county agencies to make an adjustment to the 
118.34  public assistance benefits issued to any individual consistent 
118.35  with federal law and regulation and state law and rule and to 
118.36  issue or recover benefits as appropriate; 
119.1      (e) delay or deny payment of all or part of the state and 
119.2   federal share of benefits and administrative reimbursement 
119.3   according to the procedures set forth in section 256.017; 
119.4      (f) make contracts with and grants to public and private 
119.5   agencies and organizations, both profit and nonprofit, and 
119.6   individuals, using appropriated funds; and 
119.7      (g) enter into contractual agreements with federally 
119.8   recognized Indian tribes with a reservation in Minnesota to the 
119.9   extent necessary for the tribe to operate a federally approved 
119.10  family assistance program or any other program under the 
119.11  supervision of the commissioner.  The commissioner shall consult 
119.12  with the affected county or counties in the contractual 
119.13  agreement negotiations, if the county or counties wish to be 
119.14  included, in order to avoid the duplication of county and tribal 
119.15  assistance program services.  The commissioner may establish 
119.16  necessary accounts for the purposes of receiving and disbursing 
119.17  funds as necessary for the operation of the programs. 
119.18     (2) Inform county agencies, on a timely basis, of changes 
119.19  in statute, rule, federal law, regulation, and policy necessary 
119.20  to county agency administration of the programs. 
119.21     (3) Administer and supervise all child welfare activities; 
119.22  promote the enforcement of laws protecting handicapped, 
119.23  dependent, neglected and delinquent children, and children born 
119.24  to mothers who were not married to the children's fathers at the 
119.25  times of the conception nor at the births of the children; 
119.26  license and supervise child-caring and child-placing agencies 
119.27  and institutions; supervise the care of children in boarding and 
119.28  foster homes or in private institutions; and generally perform 
119.29  all functions relating to the field of child welfare now vested 
119.30  in the state board of control. 
119.31     (4) Administer and supervise all noninstitutional service 
119.32  to handicapped persons, including those who are visually 
119.33  impaired, hearing impaired, or physically impaired or otherwise 
119.34  handicapped.  The commissioner may provide and contract for the 
119.35  care and treatment of qualified indigent children in facilities 
119.36  other than those located and available at state hospitals when 
120.1   it is not feasible to provide the service in state hospitals. 
120.2      (5) Assist and actively cooperate with other departments, 
120.3   agencies and institutions, local, state, and federal, by 
120.4   performing services in conformity with the purposes of Laws 
120.5   1939, chapter 431. 
120.6      (6) Act as the agent of and cooperate with the federal 
120.7   government in matters of mutual concern relative to and in 
120.8   conformity with the provisions of Laws 1939, chapter 431, 
120.9   including the administration of any federal funds granted to the 
120.10  state to aid in the performance of any functions of the 
120.11  commissioner as specified in Laws 1939, chapter 431, and 
120.12  including the promulgation of rules making uniformly available 
120.13  medical care benefits to all recipients of public assistance, at 
120.14  such times as the federal government increases its participation 
120.15  in assistance expenditures for medical care to recipients of 
120.16  public assistance, the cost thereof to be borne in the same 
120.17  proportion as are grants of aid to said recipients. 
120.18     (7) Establish and maintain any administrative units 
120.19  reasonably necessary for the performance of administrative 
120.20  functions common to all divisions of the department. 
120.21     (8) Act as designated guardian of both the estate and the 
120.22  person of all the wards of the state of Minnesota, whether by 
120.23  operation of law or by an order of court, without any further 
120.24  act or proceeding whatever, except as to persons committed as 
120.25  mentally retarded.  For children under the guardianship of the 
120.26  commissioner whose interests would be best served by adoptive 
120.27  placement, the commissioner may contract with a licensed 
120.28  child-placing agency or a Minnesota tribal social services 
120.29  agency to provide adoption services.  A contract with a licensed 
120.30  child-placing agency must be designed to supplement existing 
120.31  county efforts and may not replace existing county programs, 
120.32  unless the replacement is agreed to by the county board and the 
120.33  appropriate exclusive bargaining representative or the 
120.34  commissioner has evidence that child placements of the county 
120.35  continue to be substantially below that of other counties.  
120.36  Funds encumbered and obligated under an agreement for a specific 
121.1   child shall remain available until the terms of the agreement 
121.2   are fulfilled or the agreement is terminated. 
121.3      (9) Act as coordinating referral and informational center 
121.4   on requests for service for newly arrived immigrants coming to 
121.5   Minnesota. 
121.6      (10) The specific enumeration of powers and duties as 
121.7   hereinabove set forth shall in no way be construed to be a 
121.8   limitation upon the general transfer of powers herein contained. 
121.9      (11) Establish county, regional, or statewide schedules of 
121.10  maximum fees and charges which may be paid by county agencies 
121.11  for medical, dental, surgical, hospital, nursing and nursing 
121.12  home care and medicine and medical supplies under all programs 
121.13  of medical care provided by the state and for congregate living 
121.14  care under the income maintenance programs. 
121.15     (12) Have the authority to conduct and administer 
121.16  experimental projects to test methods and procedures of 
121.17  administering assistance and services to recipients or potential 
121.18  recipients of public welfare.  To carry out such experimental 
121.19  projects, it is further provided that the commissioner of human 
121.20  services is authorized to waive the enforcement of existing 
121.21  specific statutory program requirements, rules, and standards in 
121.22  one or more counties.  The order establishing the waiver shall 
121.23  provide alternative methods and procedures of administration, 
121.24  shall not be in conflict with the basic purposes, coverage, or 
121.25  benefits provided by law, and in no event shall the duration of 
121.26  a project exceed four years.  It is further provided that no 
121.27  order establishing an experimental project as authorized by the 
121.28  provisions of this section shall become effective until the 
121.29  following conditions have been met: 
121.30     (a) The secretary of health and human services of the 
121.31  United States has agreed, for the same project, to waive state 
121.32  plan requirements relative to statewide uniformity. 
121.33     (b) A comprehensive plan, including estimated project 
121.34  costs, shall be approved by the legislative advisory commission 
121.35  and filed with the commissioner of administration.  
121.36     (13) According to federal requirements, establish 
122.1   procedures to be followed by local welfare boards in creating 
122.2   citizen advisory committees, including procedures for selection 
122.3   of committee members. 
122.4      (14) Allocate federal fiscal disallowances or sanctions 
122.5   which are based on quality control error rates for the aid to 
122.6   families with dependent children program formerly codified in 
122.7   sections 256.72 to 256.87, medical assistance, or food stamp 
122.8   program in the following manner:  
122.9      (a) One-half of the total amount of the disallowance shall 
122.10  be borne by the county boards responsible for administering the 
122.11  programs.  For the medical assistance and the AFDC program 
122.12  formerly codified in sections 256.72 to 256.87, disallowances 
122.13  shall be shared by each county board in the same proportion as 
122.14  that county's expenditures for the sanctioned program are to the 
122.15  total of all counties' expenditures for the AFDC program 
122.16  formerly codified in sections 256.72 to 256.87, and medical 
122.17  assistance programs.  For the food stamp program, sanctions 
122.18  shall be shared by each county board, with 50 percent of the 
122.19  sanction being distributed to each county in the same proportion 
122.20  as that county's administrative costs for food stamps are to the 
122.21  total of all food stamp administrative costs for all counties, 
122.22  and 50 percent of the sanctions being distributed to each county 
122.23  in the same proportion as that county's value of food stamp 
122.24  benefits issued are to the total of all benefits issued for all 
122.25  counties.  Each county shall pay its share of the disallowance 
122.26  to the state of Minnesota.  When a county fails to pay the 
122.27  amount due hereunder, the commissioner may deduct the amount 
122.28  from reimbursement otherwise due the county, or the attorney 
122.29  general, upon the request of the commissioner, may institute 
122.30  civil action to recover the amount due. 
122.31     (b) Notwithstanding the provisions of paragraph (a), if the 
122.32  disallowance results from knowing noncompliance by one or more 
122.33  counties with a specific program instruction, and that knowing 
122.34  noncompliance is a matter of official county board record, the 
122.35  commissioner may require payment or recover from the county or 
122.36  counties, in the manner prescribed in paragraph (a), an amount 
123.1   equal to the portion of the total disallowance which resulted 
123.2   from the noncompliance, and may distribute the balance of the 
123.3   disallowance according to paragraph (a).  
123.4      (15) Develop and implement special projects that maximize 
123.5   reimbursements and result in the recovery of money to the 
123.6   state.  For the purpose of recovering state money, the 
123.7   commissioner may enter into contracts with third parties.  Any 
123.8   recoveries that result from projects or contracts entered into 
123.9   under this paragraph shall be deposited in the state treasury 
123.10  and credited to a special account until the balance in the 
123.11  account reaches $1,000,000.  When the balance in the account 
123.12  exceeds $1,000,000, the excess shall be transferred and credited 
123.13  to the general fund.  All money in the account is appropriated 
123.14  to the commissioner for the purposes of this paragraph. 
123.15     (16) Have the authority to make direct payments to 
123.16  facilities providing shelter to women and their children 
123.17  according to section 256D.05, subdivision 3.  Upon the written 
123.18  request of a shelter facility that has been denied payments 
123.19  under section 256D.05, subdivision 3, the commissioner shall 
123.20  review all relevant evidence and make a determination within 30 
123.21  days of the request for review regarding issuance of direct 
123.22  payments to the shelter facility.  Failure to act within 30 days 
123.23  shall be considered a determination not to issue direct payments.
123.24     (17) Have the authority to establish and enforce the 
123.25  following county reporting requirements:  
123.26     (a) The commissioner shall establish fiscal and statistical 
123.27  reporting requirements necessary to account for the expenditure 
123.28  of funds allocated to counties for human services programs.  
123.29  When establishing financial and statistical reporting 
123.30  requirements, the commissioner shall evaluate all reports, in 
123.31  consultation with the counties, to determine if the reports can 
123.32  be simplified or the number of reports can be reduced. 
123.33     (b) The county board shall submit monthly or quarterly 
123.34  reports to the department as required by the commissioner.  
123.35  Monthly reports are due no later than 15 working days after the 
123.36  end of the month.  Quarterly reports are due no later than 30 
124.1   calendar days after the end of the quarter, unless the 
124.2   commissioner determines that the deadline must be shortened to 
124.3   20 calendar days to avoid jeopardizing compliance with federal 
124.4   deadlines or risking a loss of federal funding.  Only reports 
124.5   that are complete, legible, and in the required format shall be 
124.6   accepted by the commissioner.  
124.7      (c) If the required reports are not received by the 
124.8   deadlines established in clause (b), the commissioner may delay 
124.9   payments and withhold funds from the county board until the next 
124.10  reporting period.  When the report is needed to account for the 
124.11  use of federal funds and the late report results in a reduction 
124.12  in federal funding, the commissioner shall withhold from the 
124.13  county boards with late reports an amount equal to the reduction 
124.14  in federal funding until full federal funding is received.  
124.15     (d) A county board that submits reports that are late, 
124.16  illegible, incomplete, or not in the required format for two out 
124.17  of three consecutive reporting periods is considered 
124.18  noncompliant.  When a county board is found to be noncompliant, 
124.19  the commissioner shall notify the county board of the reason the 
124.20  county board is considered noncompliant and request that the 
124.21  county board develop a corrective action plan stating how the 
124.22  county board plans to correct the problem.  The corrective 
124.23  action plan must be submitted to the commissioner within 45 days 
124.24  after the date the county board received notice of noncompliance.
124.25     (e) The final deadline for fiscal reports or amendments to 
124.26  fiscal reports is one year after the date the report was 
124.27  originally due.  If the commissioner does not receive a report 
124.28  by the final deadline, the county board forfeits the funding 
124.29  associated with the report for that reporting period and the 
124.30  county board must repay any funds associated with the report 
124.31  received for that reporting period. 
124.32     (f) The commissioner may not delay payments, withhold 
124.33  funds, or require repayment under paragraph (c) or (e) if the 
124.34  county demonstrates that the commissioner failed to provide 
124.35  appropriate forms, guidelines, and technical assistance to 
124.36  enable the county to comply with the requirements.  If the 
125.1   county board disagrees with an action taken by the commissioner 
125.2   under paragraph (c) or (e), the county board may appeal the 
125.3   action according to sections 14.57 to 14.69. 
125.4      (g) Counties subject to withholding of funds under 
125.5   paragraph (c) or forfeiture or repayment of funds under 
125.6   paragraph (e) shall not reduce or withhold benefits or services 
125.7   to clients to cover costs incurred due to actions taken by the 
125.8   commissioner under paragraph (c) or (e). 
125.9      (18) Allocate federal fiscal disallowances or sanctions for 
125.10  audit exceptions when federal fiscal disallowances or sanctions 
125.11  are based on a statewide random sample for the foster care 
125.12  program under title IV-E of the Social Security Act, United 
125.13  States Code, title 42, in direct proportion to each county's 
125.14  title IV-E foster care maintenance claim for that period. 
125.15     (19) Be responsible for ensuring the detection, prevention, 
125.16  investigation, and resolution of fraudulent activities or 
125.17  behavior by applicants, recipients, and other participants in 
125.18  the human services programs administered by the department. 
125.19     (20) Require county agencies to identify overpayments, 
125.20  establish claims, and utilize all available and cost-beneficial 
125.21  methodologies to collect and recover these overpayments in the 
125.22  human services programs administered by the department. 
125.23     (21) Have the authority to administer a drug rebate program 
125.24  for drugs purchased pursuant to the prescription drug program 
125.25  established under section 256.955 after the beneficiary's 
125.26  satisfaction of any deductible established in the program.  The 
125.27  commissioner shall require a rebate agreement from all 
125.28  manufacturers of covered drugs as defined in section 256B.0625, 
125.29  subdivision 13.  Rebate agreements for prescription drugs 
125.30  delivered on or after July 1, 2002, must include rebates for 
125.31  individuals covered under the prescription drug program who are 
125.32  under 65 years of age.  For each drug, the amount of the rebate 
125.33  shall be equal to the basic rebate as defined for purposes of 
125.34  the federal rebate program in United States Code, title 42, 
125.35  section 1396r-8(c)(1).  This basic rebate shall be applied to 
125.36  single-source and multiple-source drugs.  The manufacturers must 
126.1   provide full payment within 30 days of receipt of the state 
126.2   invoice for the rebate within the terms and conditions used for 
126.3   the federal rebate program established pursuant to section 1927 
126.4   of title XIX of the Social Security Act.  The manufacturers must 
126.5   provide the commissioner with any information necessary to 
126.6   verify the rebate determined per drug.  The rebate program shall 
126.7   utilize the terms and conditions used for the federal rebate 
126.8   program established pursuant to section 1927 of title XIX of the 
126.9   Social Security Act. 
126.10     (22) Have the authority to administer the federal drug 
126.11  rebate program for drugs purchased under the medical assistance 
126.12  program as allowed by section 1927 of title XIX of the Social 
126.13  Security Act and according to the terms and conditions of 
126.14  section 1927.  Rebates shall be collected for all drugs that 
126.15  have been dispensed or administered in an outpatient setting and 
126.16  that are from manufacturers who have signed a rebate agreement 
126.17  with the United States Department of Health and Human Services. 
126.18     (23) Have the authority to administer a supplemental drug 
126.19  rebate program for drugs purchased under the medical assistance 
126.20  program.  The commissioner may enter into supplemental rebate 
126.21  contracts with pharmaceutical manufacturers and may require 
126.22  prior authorization for drugs that are from manufacturers that 
126.23  have not signed a supplemental rebate contract.  Prior 
126.24  authorization of drugs shall be subject to the provisions of 
126.25  section 256B.0625, subdivision 13. 
126.26     (24) Operate the department's communication systems account 
126.27  established in Laws 1993, First Special Session chapter 1, 
126.28  article 1, section 2, subdivision 2, to manage shared 
126.29  communication costs necessary for the operation of the programs 
126.30  the commissioner supervises.  A communications account may also 
126.31  be established for each regional treatment center which operates 
126.32  communications systems.  Each account must be used to manage 
126.33  shared communication costs necessary for the operations of the 
126.34  programs the commissioner supervises.  The commissioner may 
126.35  distribute the costs of operating and maintaining communication 
126.36  systems to participants in a manner that reflects actual usage. 
127.1   Costs may include acquisition, licensing, insurance, 
127.2   maintenance, repair, staff time and other costs as determined by 
127.3   the commissioner.  Nonprofit organizations and state, county, 
127.4   and local government agencies involved in the operation of 
127.5   programs the commissioner supervises may participate in the use 
127.6   of the department's communications technology and share in the 
127.7   cost of operation.  The commissioner may accept on behalf of the 
127.8   state any gift, bequest, devise or personal property of any 
127.9   kind, or money tendered to the state for any lawful purpose 
127.10  pertaining to the communication activities of the department.  
127.11  Any money received for this purpose must be deposited in the 
127.12  department's communication systems accounts.  Money collected by 
127.13  the commissioner for the use of communication systems must be 
127.14  deposited in the state communication systems account and is 
127.15  appropriated to the commissioner for purposes of this section. 
127.16     (25) Receive any federal matching money that is made 
127.17  available through the medical assistance program for the 
127.18  consumer satisfaction survey.  Any federal money received for 
127.19  the survey is appropriated to the commissioner for this 
127.20  purpose.  The commissioner may expend the federal money received 
127.21  for the consumer satisfaction survey in either year of the 
127.22  biennium. 
127.23     (26) Incorporate cost reimbursement claims from First Call 
127.24  Minnesota and Greater Twin Cities United Way into the federal 
127.25  cost reimbursement claiming processes of the department 
127.26  according to federal law, rule, and regulations.  Any 
127.27  reimbursement received is appropriated to the commissioner and 
127.28  shall be disbursed to First Call Minnesota and Greater Twin 
127.29  Cities United Way according to normal department payment 
127.30  schedules. 
127.31     (27) Develop recommended standards for foster care homes 
127.32  that address the components of specialized therapeutic services 
127.33  to be provided by foster care homes with those services.  
127.34     Sec. 3.  Minnesota Statutes 2002, section 256.955, 
127.35  subdivision 2a, is amended to read: 
127.36     Subd. 2a.  [ELIGIBILITY.] An individual satisfying the 
128.1   following requirements and the requirements described in 
128.2   subdivision 2, paragraph (d), is eligible for the prescription 
128.3   drug program: 
128.4      (1) is at least 65 years of age or older; and 
128.5      (2) is eligible as a qualified Medicare beneficiary 
128.6   according to section 256B.057, subdivision 3, or 3a, or 3b, 
128.7   clause (1), or is eligible under section 256B.057, subdivision 
128.8   3, or 3a, or 3b, clause (1), and is also eligible for medical 
128.9   assistance or general assistance medical care with a spenddown 
128.10  as defined in section 256B.056, subdivision 5. 
128.11     Sec. 4.  Minnesota Statutes 2002, section 256.969, 
128.12  subdivision 2b, is amended to read: 
128.13     Subd. 2b.  [OPERATING PAYMENT RATES.] In determining 
128.14  operating payment rates for admissions occurring on or after the 
128.15  rate year beginning January 1, 1991, and every two years after, 
128.16  or more frequently as determined by the commissioner, the 
128.17  commissioner shall obtain operating data from an updated base 
128.18  year and establish operating payment rates per admission for 
128.19  each hospital based on the cost-finding methods and allowable 
128.20  costs of the Medicare program in effect during the base year.  
128.21  Rates under the general assistance medical care, medical 
128.22  assistance, and MinnesotaCare programs shall not be rebased to 
128.23  more current data on January 1, 1997, and January 1, 2005.  The 
128.24  base year operating payment rate per admission is standardized 
128.25  by the case mix index and adjusted by the hospital cost index, 
128.26  relative values, and disproportionate population adjustment.  
128.27  The cost and charge data used to establish operating rates shall 
128.28  only reflect inpatient services covered by medical assistance 
128.29  and shall not include property cost information and costs 
128.30  recognized in outlier payments. 
128.31     Sec. 5.  Minnesota Statutes 2002, section 256.969, 
128.32  subdivision 3a, is amended to read: 
128.33     Subd. 3a.  [PAYMENTS.] (a) Acute care hospital billings 
128.34  under the medical assistance program must not be submitted until 
128.35  the recipient is discharged.  However, the commissioner shall 
128.36  establish monthly interim payments for inpatient hospitals that 
129.1   have individual patient lengths of stay over 30 days regardless 
129.2   of diagnostic category.  Except as provided in section 256.9693, 
129.3   medical assistance reimbursement for treatment of mental illness 
129.4   shall be reimbursed based on diagnostic classifications.  
129.5   Individual hospital payments established under this section and 
129.6   sections 256.9685, 256.9686, and 256.9695, in addition to third 
129.7   party and recipient liability, for discharges occurring during 
129.8   the rate year shall not exceed, in aggregate, the charges for 
129.9   the medical assistance covered inpatient services paid for the 
129.10  same period of time to the hospital.  This payment limitation 
129.11  shall be calculated separately for medical assistance and 
129.12  general assistance medical care services.  The limitation on 
129.13  general assistance medical care shall be effective for 
129.14  admissions occurring on or after July 1, 1991.  Services that 
129.15  have rates established under subdivision 11 or 12, must be 
129.16  limited separately from other services.  After consulting with 
129.17  the affected hospitals, the commissioner may consider related 
129.18  hospitals one entity and may merge the payment rates while 
129.19  maintaining separate provider numbers.  The operating and 
129.20  property base rates per admission or per day shall be derived 
129.21  from the best Medicare and claims data available when rates are 
129.22  established.  The commissioner shall determine the best Medicare 
129.23  and claims data, taking into consideration variables of recency 
129.24  of the data, audit disposition, settlement status, and the 
129.25  ability to set rates in a timely manner.  The commissioner shall 
129.26  notify hospitals of payment rates by December 1 of the year 
129.27  preceding the rate year.  The rate setting data must reflect the 
129.28  admissions data used to establish relative values.  Base year 
129.29  changes from 1981 to the base year established for the rate year 
129.30  beginning January 1, 1991, and for subsequent rate years, shall 
129.31  not be limited to the limits ending June 30, 1987, on the 
129.32  maximum rate of increase under subdivision 1.  The commissioner 
129.33  may adjust base year cost, relative value, and case mix index 
129.34  data to exclude the costs of services that have been 
129.35  discontinued by the October 1 of the year preceding the rate 
129.36  year or that are paid separately from inpatient services.  
130.1   Inpatient stays that encompass portions of two or more rate 
130.2   years shall have payments established based on payment rates in 
130.3   effect at the time of admission unless the date of admission 
130.4   preceded the rate year in effect by six months or more.  In this 
130.5   case, operating payment rates for services rendered during the 
130.6   rate year in effect and established based on the date of 
130.7   admission shall be adjusted to the rate year in effect by the 
130.8   hospital cost index. 
130.9      (b) For fee-for-service admissions occurring on or after 
130.10  July 1, 2002, the total payment, before third-party liability 
130.11  and spenddown, made to hospitals for inpatient services is 
130.12  reduced by .5 percent from the current statutory rates.  
130.13     (c) In addition to the reduction in paragraph (b), the 
130.14  total payment for fee-for-service admissions occurring on or 
130.15  after July 1, 2003, made to hospitals for inpatient services 
130.16  before third-party liability and spenddown, is reduced five 
130.17  percent from the current statutory rates.  Mental health 
130.18  services within diagnosis related groups 424 to 432, and 
130.19  facilities defined under subdivision 16 are excluded from this 
130.20  paragraph. 
130.21     Sec. 6.  Minnesota Statutes 2002, section 256B.055, is 
130.22  amended by adding a subdivision to read: 
130.23     Subd. 13.  [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.] 
130.24  Beginning October 1, 2003, persons who would be eligible for 
130.25  medical assistance under chapter 256B but for residing in a 
130.26  facility that is determined by the commissioner or the federal 
130.27  Centers for Medicare and Medicaid Services to be an institution 
130.28  for mental diseases are eligible for medical assistance without 
130.29  federal financial participation. 
130.30     Sec. 7.  Minnesota Statutes 2002, section 256B.056, 
130.31  subdivision 1a, is amended to read: 
130.32     Subd. 1a.  [INCOME AND ASSETS GENERALLY.] Unless 
130.33  specifically required by state law or rule or federal law or 
130.34  regulation, the methodologies used in counting income and assets 
130.35  to determine eligibility for medical assistance for persons 
130.36  whose eligibility category is based on blindness, disability, or 
131.1   age of 65 or more years, the methodologies for the supplemental 
131.2   security income program shall be used.  Increases in benefits 
131.3   under title II of the Social Security Act shall not be counted 
131.4   as income for purposes of this subdivision until July 1 of each 
131.5   year.  Effective upon federal approval, for children eligible 
131.6   under section 256B.055, subdivision 12, or for home and 
131.7   community-based waiver services whose eligibility for medical 
131.8   assistance is determined without regard to parental income, 
131.9   child support payments, including any payments made by an 
131.10  obligor in satisfaction of or in addition to a temporary or 
131.11  permanent order for child support, and social security payments 
131.12  are not counted as income.  For families and children, which 
131.13  includes all other eligibility categories, the methodologies 
131.14  under the state's AFDC plan in effect as of July 16, 1996, as 
131.15  required by the Personal Responsibility and Work Opportunity 
131.16  Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193, 
131.17  shall be used, except that effective July 1, 2002, the $90 and 
131.18  $30 and one-third earned income disregards shall not apply and 
131.19  the disregard specified in subdivision 1c shall apply October 1, 
131.20  2003, the earned income disregards and deductions are limited to 
131.21  those in subdivision 1c.  For these purposes, a "methodology" 
131.22  does not include an asset or income standard, or accounting 
131.23  method, or method of determining effective dates. 
131.24     Sec. 8.  Minnesota Statutes 2002, section 256B.056, 
131.25  subdivision 1c, is amended to read: 
131.26     Subd. 1c.  [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] 
131.27  (a)(1) For children ages one to five whose eligibility is 
131.28  determined under section 256B.057, subdivision 2, 21 percent of 
131.29  countable earned income shall be disregarded for up to four 
131.30  months.  This clause expires July 1, 2003. 
131.31     (2) For children ages one through 18 whose eligibility is 
131.32  determined under section 256B.057, subdivision 2, the following 
131.33  deductions shall be applied to income counted toward the child's 
131.34  eligibility as allowed under the state's AFDC plan in effect as 
131.35  of July 16, 1996:  $90 work expense, dependent care, and child 
131.36  support paid under court order.  This clause is effective 
132.1   October 1, 2003. 
132.2      (b) For families with children whose eligibility is 
132.3   determined using the standard specified in section 256B.056, 
132.4   subdivision 4, paragraph (c), 17 percent of countable earned 
132.5   income shall be disregarded for up to four months and the 
132.6   following deductions shall be applied to each individual's 
132.7   income counted toward eligibility as allowed under the state's 
132.8   AFDC plan in effect as of July 16, 1996:  dependent care and 
132.9   child support paid under court order. 
132.10     (c) If the four month disregard in paragraph (b) has been 
132.11  applied to the wage earner's income for four months, the 
132.12  disregard shall not be applied again until the wage earner's 
132.13  income has not been considered in determining medical assistance 
132.14  eligibility for 12 consecutive months.  
132.15     <b>[EFFECTIVE DATE.]</b> The amendments to paragraphs (b) and (c) 
132.16  are effective July 1, 2003. 
132.17     Sec. 9.  Minnesota Statutes 2002, section 256B.057, 
132.18  subdivision 1, is amended to read: 
132.19     Subdivision 1.  [PREGNANT WOMEN AND INFANTS.] (a) An infant 
132.20  less than one year of age or a pregnant woman who has written 
132.21  verification of a positive pregnancy test from a physician or 
132.22  licensed registered nurse, is eligible for medical assistance if 
132.23  countable family income is equal to or less than 275 percent of 
132.24  the federal poverty guideline for the same family size.  A 
132.25  pregnant woman who has written verification of a positive 
132.26  pregnancy test from a physician or licensed registered nurse is 
132.27  eligible for medical assistance if countable family income is 
132.28  equal to or less than 200 percent of the federal poverty 
132.29  guideline for the same family size.  For purposes of this 
132.30  subdivision, "countable family income" means the amount of 
132.31  income considered available using the methodology of the AFDC 
132.32  program under the state's AFDC plan as of July 16, 1996, as 
132.33  required by the Personal Responsibility and Work Opportunity 
132.34  Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193, 
132.35  except for the earned income disregard and employment deductions.
132.36     (b) An amount equal to the amount of earned income 
133.1   exceeding 275 percent of the federal poverty guideline, up to a 
133.2   maximum of the amount by which the combined total of 185 percent 
133.3   of the federal poverty guideline plus the earned income 
133.4   disregards and deductions of the AFDC program under the state's 
133.5   AFDC plan as of July 16, 1996, as required by the Personal 
133.6   Responsibility and Work Opportunity Reconciliation Act of 1996 
133.7   (PRWORA), Public Law Number 104-193, exceeds 275 percent of the 
133.8   federal poverty guideline will be deducted for pregnant women 
133.9   and infants less than one year of age.  This paragraph expires 
133.10  July 1, 2003. 
133.11     (c) Dependent care and child support paid under court order 
133.12  shall be deducted from the countable income of pregnant women. 
133.13     (b) (d) An infant born on or after January 1, 1991, to a 
133.14  woman who was eligible for and receiving medical assistance on 
133.15  the date of the child's birth shall continue to be eligible for 
133.16  medical assistance without redetermination until the child's 
133.17  first birthday, as long as the child remains in the woman's 
133.18  household. 
133.19     <b>[EFFECTIVE DATE.]</b> This section is effective February 1, 
133.20  2004, except where a different date is specified in the text. 
133.21     Sec. 10.  Minnesota Statutes 2002, section 256B.057, 
133.22  subdivision 2, is amended to read: 
133.23     Subd. 2.  [CHILDREN.] Except as specified in subdivision 
133.24  1b, effective July 1, 2002 October 1, 2003, a child one through 
133.25  18 years of age in a family whose countable income is no greater 
133.26  than 170 150 percent of the federal poverty guidelines for the 
133.27  same family size, is eligible for medical assistance.  
133.28     Sec. 11.  Minnesota Statutes 2002, section 256B.057, 
133.29  subdivision 3b, is amended to read: 
133.30     Subd. 3b.  [QUALIFYING INDIVIDUALS.] Beginning July 1, 
133.31  1998, to the extent of the federal allocation to Minnesota 
133.32  contingent upon federal funding, a person who would otherwise be 
133.33  eligible as a qualified Medicare beneficiary under subdivision 
133.34  3, except that the person's income is in excess of the limit, is 
133.35  eligible as a qualifying individual according to the following 
133.36  criteria: 
134.1      (1) if the person's income is greater than 120 percent, but 
134.2   less than 135 percent of the official federal poverty guidelines 
134.3   for the applicable family size, the person is eligible for 
134.4   medical assistance reimbursement of Medicare Part B premiums; or 
134.5      (2) if the person's income is equal to or greater than 135 
134.6   percent but less than 175 percent of the official federal 
134.7   poverty guidelines for the applicable family size, the person is 
134.8   eligible for medical assistance reimbursement of that portion of 
134.9   the Medicare Part B premium attributable to an increase in Part 
134.10  B expenditures which resulted from the shift of home care 
134.11  services from Medicare Part A to Medicare Part B under Public 
134.12  Law Number 105-33, section 4732, the Balanced Budget Act of 1997.
134.13     The commissioner shall limit enrollment of qualifying 
134.14  individuals under this subdivision according to the requirements 
134.15  of Public Law Number 105-33, section 4732. 
134.16     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
134.17     Sec. 12.  Minnesota Statutes 2002, section 256B.057, 
134.18  subdivision 9, is amended to read: 
134.19     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
134.20  assistance may be paid for a person who is employed and who: 
134.21     (1) meets the definition of disabled under the supplemental 
134.22  security income program; 
134.23     (2) is at least 16 but less than 65 years of age; 
134.24     (3) meets the asset limits in paragraph (b); and 
134.25     (4) effective November 1, 2003, pays a premium, if 
134.26  required, and other obligations under paragraph (c) (d).  
134.27  Any spousal income or assets shall be disregarded for purposes 
134.28  of eligibility and premium determinations. 
134.29     After the month of enrollment, a person enrolled in medical 
134.30  assistance under this subdivision who: 
134.31     (1) is temporarily unable to work and without receipt of 
134.32  earned income due to a medical condition, as verified by a 
134.33  physician, may retain eligibility for up to four calendar 
134.34  months; or 
134.35     (2) effective January 1, 2004, loses employment for reasons 
134.36  not attributable to the enrollee, may retain eligibility for up 
135.1   to four consecutive months after the month of job loss.  To 
135.2   receive a four-month extension, enrollees must verify the 
135.3   medical condition or provide notification of job loss.  All 
135.4   other eligibility requirements must be met and the enrollee must 
135.5   pay all calculated premium costs for continued eligibility. 
135.6      (b) For purposes of determining eligibility under this 
135.7   subdivision, a person's assets must not exceed $20,000, 
135.8   excluding: 
135.9      (1) all assets excluded under section 256B.056; 
135.10     (2) retirement accounts, including individual accounts, 
135.11  401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 
135.12     (3) medical expense accounts set up through the person's 
135.13  employer. 
135.14     (c)(1) Effective January 1, 2004, for purposes of 
135.15  eligibility, there will be a $65 earned income disregard.  To be 
135.16  eligible, a person applying for medical assistance under this 
135.17  subdivision must have earned income above the disregard level. 
135.18     (2) Effective January 1, 2004, to be considered earned 
135.19  income, Medicare, social security, and applicable state and 
135.20  federal income taxes must be withheld.  To be eligible, a person 
135.21  must document earned income tax withholding. 
135.22     (d)(1) A person whose earned and unearned income is equal 
135.23  to or greater than 100 percent of federal poverty guidelines for 
135.24  the applicable family size must pay a premium to be eligible for 
135.25  medical assistance under this subdivision.  The premium shall be 
135.26  based on the person's gross earned and unearned income and the 
135.27  applicable family size using a sliding fee scale established by 
135.28  the commissioner, which begins at one percent of income at 100 
135.29  percent of the federal poverty guidelines and increases to 7.5 
135.30  percent of income for those with incomes at or above 300 percent 
135.31  of the federal poverty guidelines.  Annual adjustments in the 
135.32  premium schedule based upon changes in the federal poverty 
135.33  guidelines shall be effective for premiums due in July of each 
135.34  year.  
135.35     (2) Effective January 1, 2004, all enrollees must pay a 
135.36  premium to be eligible for medical assistance under this 
136.1   subdivision.  An enrollee shall pay the greater of a $35 premium 
136.2   or the premium calculated in clause (1). 
136.3      (3) Effective November 1, 2003, all enrollees who receive 
136.4   unearned income must pay five percent of unearned income in 
136.5   addition to the premium amount. 
136.6      (4) Effective November 1, 2003, for enrollees with income 
136.7   equal to or more than the limit under subdivision 3a who are 
136.8   also enrolled in Medicare the commissioner must reduce 
136.9   reimbursement to the enrollee for Medicare Part B premiums under 
136.10  section 256B.0625, subdivision 15, paragraph (a), based on a 
136.11  sliding fee scale established by the commissioner.  The scale is 
136.12  based on the person's gross earned and unearned income.  The 
136.13  obligation of the enrollee shall begin at a dollar amount 
136.14  determined by the commissioner for incomes equal to the limit 
136.15  under subdivision 3a and increase to the full amount of the 
136.16  Medicare Part B premium cost for incomes equal to or greater 
136.17  than 300 percent of the federal poverty guidelines. 
136.18     (d) (e) A person's eligibility and premium shall be 
136.19  determined by the local county agency.  Premiums must be paid to 
136.20  the commissioner.  All premiums are dedicated to the 
136.21  commissioner. 
136.22     (e) (f) Any required premium shall be determined at 
136.23  application and redetermined annually at recertification at the 
136.24  enrollee's six-month income review or when a change in income or 
136.25  family household size occurs is reported.  Enrollees must report 
136.26  any change in income or household size within ten days of when 
136.27  the change occurs.  A decreased premium resulting from a 
136.28  reported change in income or household size shall be effective 
136.29  the first day of the next available billing month after the 
136.30  change is reported.  Except for changes occurring from annual 
136.31  cost-of-living increases or verification of income under section 
136.32  256B.061, paragraph (b), a change resulting in an increased 
136.33  premium shall not affect the premium amount until the next 
136.34  six-month review. 
136.35     (f) (g) Premium payment is due upon notification from the 
136.36  commissioner of the premium amount required.  Premiums may be 
137.1   paid in installments at the discretion of the commissioner. 
137.2      (g) (h) Nonpayment of the premium shall result in denial or 
137.3   termination of medical assistance unless the person demonstrates 
137.4   good cause for nonpayment.  Good cause exists if the 
137.5   requirements specified in Minnesota Rules, part 9506.0040, 
137.6   subpart 7, items B to D, are met.  Except when an installment 
137.7   agreement is accepted by the commissioner, all persons 
137.8   disenrolled for nonpayment of a premium must pay any past due 
137.9   premiums as well as current premiums due prior to being 
137.10  reenrolled.  Nonpayment shall include payment with a returned, 
137.11  refused, or dishonored instrument.  The commissioner may require 
137.12  a guaranteed form of payment as the only means to replace a 
137.13  returned, refused, or dishonored instrument. 
137.14     <b>[EFFECTIVE DATE.]</b> This section is effective November 1, 
137.15  2003, except the amendments to Minnesota Statutes 2002, section 
137.16  256B.057, subdivision 9, paragraphs (e) and (g), are effective 
137.17  July 1, 2003. 
137.18     Sec. 13.  Minnesota Statutes 2002, section 256B.0595, 
137.19  subdivision 1, is amended to read: 
137.20     Subdivision 1.  [PROHIBITED TRANSFERS.] (a) For transfers 
137.21  of assets made on or before August 10, 1993, if a person or the 
137.22  person's spouse has given away, sold, or disposed of, for less 
137.23  than fair market value, any asset or interest therein, except 
137.24  assets other than the homestead that are excluded under the 
137.25  supplemental security program, within 30 months before or any 
137.26  time after the date of institutionalization if the person has 
137.27  been determined eligible for medical assistance, or within 30 
137.28  months before or any time after the date of the first approved 
137.29  application for medical assistance if the person has not yet 
137.30  been determined eligible for medical assistance, the person is 
137.31  ineligible for long-term care services for the period of time 
137.32  determined under subdivision 2.  
137.33     (b) Effective for transfers made after August 10, 1993, a 
137.34  person, a person's spouse, or any person, court, or 
137.35  administrative body with legal authority to act in place of, on 
137.36  behalf of, at the direction of, or upon the request of the 
138.1   person or person's spouse, may not give away, sell, or dispose 
138.2   of, for less than fair market value, any asset or interest 
138.3   therein, except assets other than the homestead that are 
138.4   excluded under the supplemental security income program, for the 
138.5   purpose of establishing or maintaining medical assistance 
138.6   eligibility.  This applies to all transfers, including those 
138.7   made by a community spouse after the month in which the 
138.8   institutionalized spouse is determined eligible for medical 
138.9   assistance.  For purposes of determining eligibility for 
138.10  long-term care services, any transfer of such assets within 36 
138.11  months before or any time after an institutionalized person 
138.12  applies for medical assistance, or 36 months before or any time 
138.13  after a medical assistance recipient becomes institutionalized, 
138.14  for less than fair market value may be considered.  Any such 
138.15  transfer is presumed to have been made for the purpose of 
138.16  establishing or maintaining medical assistance eligibility and 
138.17  the person is ineligible for long-term care services for the 
138.18  period of time determined under subdivision 2, unless the person 
138.19  furnishes convincing evidence to establish that the transaction 
138.20  was exclusively for another purpose, or unless the transfer is 
138.21  permitted under subdivision 3 or 4.  Notwithstanding the 
138.22  provisions of this paragraph, in the case of payments from a 
138.23  trust or portions of a trust that are considered transfers of 
138.24  assets under federal law, any transfers made within 60 months 
138.25  before or any time after an institutionalized person applies for 
138.26  medical assistance and within 60 months before or any time after 
138.27  a medical assistance recipient becomes institutionalized, may be 
138.28  considered. 
138.29     Effective July 1, 2003, or upon receipt of federal 
138.30  approval, whichever is later, the 36-month period for transfers 
138.31  of assets shall be extended by another 36 months, and the 
138.32  60-month period for transfers to trusts shall be extended by 
138.33  another 12 months for purposes of transfers under this paragraph 
138.34  and paragraphs (c) through (f). 
138.35     (c) This section applies to transfers, for less than fair 
138.36  market value, of income or assets, including assets that are 
139.1   considered income in the month received, such as inheritances, 
139.2   court settlements, and retroactive benefit payments or income to 
139.3   which the person or the person's spouse is entitled but does not 
139.4   receive due to action by the person, the person's spouse, or any 
139.5   person, court, or administrative body with legal authority to 
139.6   act in place of, on behalf of, at the direction of, or upon the 
139.7   request of the person or the person's spouse.  
139.8      (d) This section applies to payments for care or personal 
139.9   services provided by a relative, unless the compensation was 
139.10  stipulated in a notarized, written agreement which was in 
139.11  existence when the service was performed, the care or services 
139.12  directly benefited the person, and the payments made represented 
139.13  reasonable compensation for the care or services provided.  A 
139.14  notarized written agreement is not required if payment for the 
139.15  services was made within 60 days after the service was provided. 
139.16     (e) This section applies to the portion of any asset or 
139.17  interest that a person, a person's spouse, or any person, court, 
139.18  or administrative body with legal authority to act in place of, 
139.19  on behalf of, at the direction of, or upon the request of the 
139.20  person or the person's spouse, transfers to any annuity that 
139.21  exceeds the value of the benefit likely to be returned to the 
139.22  person or spouse while alive, based on estimated life expectancy 
139.23  using the life expectancy tables employed by the supplemental 
139.24  security income program to determine the value of an agreement 
139.25  for services for life.  The commissioner may adopt rules 
139.26  reducing life expectancies based on the need for long-term 
139.27  care.  This section applies to an annuity described in this 
139.28  paragraph purchased on or after March 1, 2002, that: 
139.29     (1) is not purchased from an insurance company or financial 
139.30  institution that is subject to licensing or regulation by the 
139.31  Minnesota department of commerce or a similar regulatory agency 
139.32  of another state; 
139.33     (2) does not pay out principal and interest in equal 
139.34  monthly installments; or 
139.35     (3) does not begin payment at the earliest possible date 
139.36  after annuitization.  
140.1      (f) For purposes of this section, long-term care services 
140.2   include services in a nursing facility, services that are 
140.3   eligible for payment according to section 256B.0625, subdivision 
140.4   2, because they are provided in a swing bed, intermediate care 
140.5   facility for persons with mental retardation, and home and 
140.6   community-based services provided pursuant to sections 
140.7   256B.0915, 256B.092, and 256B.49.  For purposes of this 
140.8   subdivision and subdivisions 2, 3, and 4, "institutionalized 
140.9   person" includes a person who is an inpatient in a nursing 
140.10  facility or in a swing bed, or intermediate care facility for 
140.11  persons with mental retardation or who is receiving home and 
140.12  community-based services under sections 256B.0915, 256B.092, and 
140.13  256B.49. 
140.14     (g) The commissioner shall seek federal approval to extend 
140.15  the period for evaluating transfers of assets or interests for 
140.16  less than fair market value in subdivision 1, paragraphs (b) 
140.17  through (f), to a total of 72 months. 
140.18     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003.  
140.19  If the amendments to this section are not effective because of 
140.20  prohibitions in federal law, the commissioner shall seek a 
140.21  waiver of those prohibitions or other federal authority, and 
140.22  each provision shall become effective upon receipt of federal 
140.23  approval, notification to the revisor of statutes, and 
140.24  publication of a notice in the State Register. 
140.25     Sec. 14.  Minnesota Statutes 2002, section 256B.0595, 
140.26  subdivision 2, is amended to read: 
140.27     Subd. 2.  [PERIOD OF INELIGIBILITY.] (a) For any 
140.28  uncompensated transfer occurring on or before August 10, 1993, 
140.29  the number of months of ineligibility for long-term care 
140.30  services shall be the lesser of 30 months, or the uncompensated 
140.31  transfer amount divided by the average medical assistance rate 
140.32  for nursing facility services in the state in effect on the date 
140.33  of application.  The amount used to calculate the average 
140.34  medical assistance payment rate shall be adjusted each July 1 to 
140.35  reflect payment rates for the previous calendar year.  The 
140.36  period of ineligibility begins with the month in which the 
141.1   assets were transferred.  If the transfer was not reported to 
141.2   the local agency at the time of application, and the applicant 
141.3   received long-term care services during what would have been the 
141.4   period of ineligibility if the transfer had been reported, a 
141.5   cause of action exists against the transferee for the cost of 
141.6   long-term care services provided during the period of 
141.7   ineligibility, or for the uncompensated amount of the transfer, 
141.8   whichever is less.  The action may be brought by the state or 
141.9   the local agency responsible for providing medical assistance 
141.10  under chapter 256G.  The uncompensated transfer amount is the 
141.11  fair market value of the asset at the time it was given away, 
141.12  sold, or disposed of, less the amount of compensation received.  
141.13     (b) For uncompensated transfers made after August 10, 1993, 
141.14  the number of months of ineligibility for long-term care 
141.15  services shall be the total uncompensated value of the resources 
141.16  transferred divided by the average medical assistance rate for 
141.17  nursing facility services in the state in effect on the date of 
141.18  application.  The amount used to calculate the average medical 
141.19  assistance payment rate shall be adjusted each July 1 to reflect 
141.20  payment rates for the previous calendar year.  The period of 
141.21  ineligibility begins with the first day of the month after the 
141.22  month in which the assets were transferred except that if one or 
141.23  more uncompensated transfers are made during a period of 
141.24  ineligibility, the total assets transferred during the 
141.25  ineligibility period shall be combined and a penalty period 
141.26  calculated to begin in on the first day of the month after the 
141.27  month in which the first uncompensated transfer was 
141.28  made.  Effective upon federal approval, the period of 
141.29  ineligibility for uncompensated transfers begins on the first 
141.30  day of the month in which an applicant would otherwise be 
141.31  eligible for long-term care services, or in the case of a 
141.32  transfer affecting a person receiving long-term care services, 
141.33  on the first day of the month after the month the local agency 
141.34  learns of the uncompensated transfer.  If the transfer was not 
141.35  reported to the local agency at the time of application, and the 
141.36  applicant received medical assistance services during what would 
142.1   have been the period of ineligibility if the transfer had been 
142.2   reported, a cause of action exists against the transferee for 
142.3   the cost of medical assistance services provided during the 
142.4   period of ineligibility, or for the uncompensated amount of the 
142.5   transfer, whichever is less.  The action may be brought by the 
142.6   state or the local agency responsible for providing medical 
142.7   assistance under chapter 256G.  The uncompensated transfer 
142.8   amount is the fair market value of the asset at the time it was 
142.9   given away, sold, or disposed of, less the amount of 
142.10  compensation received.  Effective for transfers made on or after 
142.11  March 1, 1996, involving persons who apply for medical 
142.12  assistance on or after April 13, 1996, no cause of action exists 
142.13  for a transfer unless: 
142.14     (1) the transferee knew or should have known that the 
142.15  transfer was being made by a person who was a resident of a 
142.16  long-term care facility or was receiving that level of care in 
142.17  the community at the time of the transfer; 
142.18     (2) the transferee knew or should have known that the 
142.19  transfer was being made to assist the person to qualify for or 
142.20  retain medical assistance eligibility; or 
142.21     (3) the transferee actively solicited the transfer with 
142.22  intent to assist the person to qualify for or retain eligibility 
142.23  for medical assistance.  
142.24     (c) If a calculation of a penalty period results in a 
142.25  partial month, payments for long-term care services shall be 
142.26  reduced in an amount equal to the fraction, except that in 
142.27  calculating the value of uncompensated transfers, if the total 
142.28  value of all uncompensated transfers made in a month not 
142.29  included in an existing penalty period does not exceed $200, 
142.30  then such transfers shall be disregarded for each month prior to 
142.31  the month of application for or during receipt of medical 
142.32  assistance. 
142.33     (d) The commissioner shall seek federal approval for 
142.34  purposes of establishing that the period of ineligibility 
142.35  determined under paragraphs (b) and (c) shall begin on the first 
142.36  day of the month in which the applicant would otherwise be 
143.1   eligible for long-term care services, or in the case of a 
143.2   transfer affecting a recipient of long-term care services, the 
143.3   first day of the month after the month in which the local agency 
143.4   learns of the uncompensated transfer. 
143.5      <b>[EFFECTIVE DATE.]</b> Paragraph (b) of this section is 
143.6   effective July 1, 2003.  If the amendments to this section are 
143.7   not effective because of prohibitions in federal law, the 
143.8   commissioner shall seek a waiver of those prohibitions or other 
143.9   federal authority, and each provision shall become effective 
143.10  upon receipt of federal approval, notification to the revisor of 
143.11  statutes, and publication of a notice in the State Register to 
143.12  that effect. 
143.13     Sec. 15.  Minnesota Statutes 2002, section 256B.06, 
143.14  subdivision 4, is amended to read: 
143.15     Subd. 4.  [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 
143.16  medical assistance is limited to citizens of the United States, 
143.17  qualified noncitizens as defined in this subdivision, and other 
143.18  persons residing lawfully in the United States. 
143.19     (b) "Qualified noncitizen" means a person who meets one of 
143.20  the following immigration criteria: 
143.21     (1) admitted for lawful permanent residence according to 
143.22  United States Code, title 8; 
143.23     (2) admitted to the United States as a refugee according to 
143.24  United States Code, title 8, section 1157; 
143.25     (3) granted asylum according to United States Code, title 
143.26  8, section 1158; 
143.27     (4) granted withholding of deportation according to United 
143.28  States Code, title 8, section 1253(h); 
143.29     (5) paroled for a period of at least one year according to 
143.30  United States Code, title 8, section 1182(d)(5); 
143.31     (6) granted conditional entrant status according to United 
143.32  States Code, title 8, section 1153(a)(7); 
143.33     (7) determined to be a battered noncitizen by the United 
143.34  States Attorney General according to the Illegal Immigration 
143.35  Reform and Immigrant Responsibility Act of 1996, title V of the 
143.36  Omnibus Consolidated Appropriations Bill, Public Law Number 
144.1   104-200; 
144.2      (8) is a child of a noncitizen determined to be a battered 
144.3   noncitizen by the United States Attorney General according to 
144.4   the Illegal Immigration Reform and Immigrant Responsibility Act 
144.5   of 1996, title V, of the Omnibus Consolidated Appropriations 
144.6   Bill, Public Law Number 104-200; or 
144.7      (9) determined to be a Cuban or Haitian entrant as defined 
144.8   in section 501(e) of Public Law Number 96-422, the Refugee 
144.9   Education Assistance Act of 1980. 
144.10     (c) All qualified noncitizens who were residing in the 
144.11  United States before August 22, 1996, who otherwise meet the 
144.12  eligibility requirements of chapter 256B, are eligible for 
144.13  medical assistance with federal financial participation. 
144.14     (d) All qualified noncitizens who entered the United States 
144.15  on or after August 22, 1996, and who otherwise meet the 
144.16  eligibility requirements of chapter 256B, are eligible for 
144.17  medical assistance with federal financial participation through 
144.18  November 30, 1996. 
144.19     Beginning December 1, 1996, qualified noncitizens who 
144.20  entered the United States on or after August 22, 1996, and who 
144.21  otherwise meet the eligibility requirements of chapter 256B are 
144.22  eligible for medical assistance with federal participation for 
144.23  five years if they meet one of the following criteria: 
144.24     (i) refugees admitted to the United States according to 
144.25  United States Code, title 8, section 1157; 
144.26     (ii) persons granted asylum according to United States 
144.27  Code, title 8, section 1158; 
144.28     (iii) persons granted withholding of deportation according 
144.29  to United States Code, title 8, section 1253(h); 
144.30     (iv) veterans of the United States Armed Forces with an 
144.31  honorable discharge for a reason other than noncitizen status, 
144.32  their spouses and unmarried minor dependent children; or 
144.33     (v) persons on active duty in the United States Armed 
144.34  Forces, other than for training, their spouses and unmarried 
144.35  minor dependent children. 
144.36     Beginning December 1, 1996, qualified noncitizens who do 
145.1   not meet one of the criteria in items (i) to (v) are eligible 
145.2   for medical assistance without federal financial participation 
145.3   as described in paragraph (j) (i). 
145.4      (e) Noncitizens who are not qualified noncitizens as 
145.5   defined in paragraph (b), who are lawfully residing in the 
145.6   United States and who otherwise meet the eligibility 
145.7   requirements of chapter 256B, are eligible for medical 
145.8   assistance under clauses (1) to (3).  These individuals must 
145.9   cooperate with the Immigration and Naturalization Service to 
145.10  pursue any applicable immigration status, including citizenship, 
145.11  that would qualify them for medical assistance with federal 
145.12  financial participation. 
145.13     (1) Persons who were medical assistance recipients on 
145.14  August 22, 1996, are eligible for medical assistance with 
145.15  federal financial participation through December 31, 1996. 
145.16     (2) Beginning January 1, 1997, persons described in clause 
145.17  (1) are eligible for medical assistance without federal 
145.18  financial participation as described in paragraph (j) (i). 
145.19     (3) Beginning December 1, 1996, persons residing in the 
145.20  United States prior to August 22, 1996, who were not receiving 
145.21  medical assistance and persons who arrived on or after August 
145.22  22, 1996, are eligible for medical assistance without federal 
145.23  financial participation as described in paragraph (j) (i). 
145.24     (f) Nonimmigrants who otherwise meet the eligibility 
145.25  requirements of chapter 256B are eligible for the benefits as 
145.26  provided in paragraphs (g) to (i) and (h).  For purposes of this 
145.27  subdivision, a "nonimmigrant" is a person in one of the classes 
145.28  listed in United States Code, title 8, section 1101(a)(15). 
145.29     (g) Payment shall also be made for care and services that 
145.30  are furnished to noncitizens, regardless of immigration status, 
145.31  who otherwise meet the eligibility requirements of chapter 256B, 
145.32  if such care and services are necessary for the treatment of an 
145.33  emergency medical condition, except for organ transplants and 
145.34  related care and services and routine prenatal care.  
145.35     (h) For purposes of this subdivision, the term "emergency 
145.36  medical condition" means a medical condition that meets the 
146.1   requirements of United States Code, title 42, section 1396b(v). 
146.2      (i) Pregnant noncitizens who are undocumented or 
146.3   nonimmigrants, who otherwise meet the eligibility requirements 
146.4   of chapter 256B, are eligible for medical assistance payment 
146.5   without federal financial participation for care and services 
146.6   through the period of pregnancy, and 60 days postpartum, except 
146.7   for labor and delivery.  
146.8      (j) Qualified noncitizens as described in paragraph (d), 
146.9   and all other noncitizens lawfully residing in the United States 
146.10  as described in paragraph (e), who are ineligible for medical 
146.11  assistance with federal financial participation and who 
146.12  otherwise meet the eligibility requirements of chapter 256B and 
146.13  of this paragraph, are eligible for medical assistance without 
146.14  federal financial participation.  Qualified noncitizens as 
146.15  described in paragraph (d) are only eligible for medical 
146.16  assistance without federal financial participation for five 
146.17  years from their date of entry into the United States.  
146.18     (k) The commissioner shall submit to the legislature by 
146.19  December 31, 1998, a report on the number of recipients and cost 
146.20  of coverage of care and services made according to paragraphs 
146.21  (i) and (j). 
146.22     (j) Beginning October 1, 2003, persons who are receiving 
146.23  care and rehabilitation services from a nonprofit center 
146.24  established to serve victims of torture and are otherwise 
146.25  ineligible for medical assistance under chapter 256B or general 
146.26  assistance medical care under section 256D.03 are eligible for 
146.27  medical assistance without federal financial participation.  
146.28  These individuals are eligible only for the period during which 
146.29  they are receiving services from the center.  Individuals 
146.30  eligible under this clause shall not be required to participate 
146.31  in prepaid medical assistance. 
146.32     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
146.33  except where a different date is specified in the text. 
146.34     Sec. 16.  Minnesota Statutes 2002, section 256B.061, is 
146.35  amended to read: 
146.36     256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 
147.1      (a) If any individual has been determined to be eligible 
147.2   for medical assistance, it will be made available for care and 
147.3   services included under the plan and furnished in or after the 
147.4   third month before the month in which the individual made 
147.5   application for such assistance, if such individual was, or upon 
147.6   application would have been, eligible for medical assistance at 
147.7   the time the care and services were furnished.  The commissioner 
147.8   may limit, restrict, or suspend the eligibility of an individual 
147.9   for up to one year upon that individual's conviction of a 
147.10  criminal offense related to application for or receipt of 
147.11  medical assistance benefits. 
147.12     (b) On the basis of information provided on the completed 
147.13  application, an applicant who meets the following criteria shall 
147.14  be determined eligible beginning in the month of application: 
147.15     (1) whose gross income is less than 90 percent of the 
147.16  applicable income standard; 
147.17     (2) whose total liquid assets are less than 90 percent of 
147.18  the asset limit; 
147.19     (3) does not reside in a long-term care facility; and 
147.20     (4) meets all other eligibility requirements. 
147.21  The applicant must provide all required verifications within 30 
147.22  days' notice of the eligibility determination or eligibility 
147.23  shall be terminated. 
147.24     <b>[EFFECTIVE DATE.]</b> This section is repealed April 1, 2005, 
147.25  if the HealthMatch system is operational.  If the HealthMatch 
147.26  system is not operational, this section is effective July 1, 
147.27  2005. 
147.28     Sec. 17.  Minnesota Statutes 2002, section 256B.0625, 
147.29  subdivision 13, is amended to read: 
147.30     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
147.31  except for fertility drugs when specifically used to enhance 
147.32  fertility, if prescribed by a licensed practitioner and 
147.33  dispensed by a licensed pharmacist, by a physician enrolled in 
147.34  the medical assistance program as a dispensing physician, or by 
147.35  a physician or a nurse practitioner employed by or under 
147.36  contract with a community health board as defined in section 
148.1   145A.02, subdivision 5, for the purposes of communicable disease 
148.2   control.  The commissioner, after receiving recommendations from 
148.3   professional medical associations and professional pharmacist 
148.4   associations, shall designate a formulary committee to advise 
148.5   the commissioner on the names of drugs for which payment is 
148.6   made, recommend a system for reimbursing providers on a set fee 
148.7   or charge basis rather than the present system, and develop 
148.8   methods encouraging use of generic drugs when they are less 
148.9   expensive and equally effective as trademark drugs.  The 
148.10  formulary committee shall consist of nine members, four of whom 
148.11  shall be physicians who are not employed by the department of 
148.12  human services, and a majority of whose practice is for persons 
148.13  paying privately or through health insurance, three of whom 
148.14  shall be pharmacists who are not employed by the department of 
148.15  human services, and a majority of whose practice is for persons 
148.16  paying privately or through health insurance, a consumer 
148.17  representative, and a nursing home representative. Committee 
148.18  members shall serve three-year terms and shall serve without 
148.19  compensation.  Members may be reappointed once.  
148.20     (b) The commissioner shall establish a drug formulary.  Its 
148.21  establishment and publication shall not be subject to the 
148.22  requirements of the Administrative Procedure Act, but the 
148.23  formulary committee shall review and comment on the formulary 
148.24  contents.  
148.25     The formulary shall not include:  
148.26     (i) drugs or products for which there is no federal 
148.27  funding; 
148.28     (ii) over-the-counter drugs, except for antacids, 
148.29  acetaminophen, family planning products, aspirin, insulin, 
148.30  products for the treatment of lice, vitamins for adults with 
148.31  documented vitamin deficiencies, vitamins for children under the 
148.32  age of seven and pregnant or nursing women, and any other 
148.33  over-the-counter drug identified by the commissioner, in 
148.34  consultation with the drug formulary committee, as necessary, 
148.35  appropriate, and cost-effective for the treatment of certain 
148.36  specified chronic diseases, conditions or disorders, and this 
149.1   determination shall not be subject to the requirements of 
149.2   chapter 14; 
149.3      (iii) anorectics, except that medically necessary 
149.4   anorectics shall be covered for a recipient previously diagnosed 
149.5   as having pickwickian syndrome and currently diagnosed as having 
149.6   diabetes and being morbidly obese drugs used for weight loss; 
149.7      (iv) drugs for which medical value has not been 
149.8   established; and 
149.9      (v) drugs from manufacturers who have not signed a rebate 
149.10  agreement with the Department of Health and Human Services 
149.11  pursuant to section 1927 of title XIX of the Social Security Act.
149.12     The commissioner shall publish conditions for prohibiting 
149.13  payment for specific drugs after considering the formulary 
149.14  committee's recommendations.  An honorarium of $100 per meeting 
149.15  and reimbursement for mileage shall be paid to each committee 
149.16  member in attendance.  
149.17     (c) The dispensed quantity of a prescribed drug must not 
149.18  exceed a 30-day supply.  The basis for determining the amount of 
149.19  payment shall be the lower of the actual acquisition costs of 
149.20  the drugs plus a fixed dispensing fee; the maximum allowable 
149.21  cost set by the federal government or by the commissioner plus 
149.22  the fixed dispensing fee; or the usual and customary price 
149.23  charged to the public.  The amount of payment basis must be 
149.24  reduced to reflect all discount amounts applied to the charge by 
149.25  any provider/insurer agreement or contract for submitted charges 
149.26  to medical assistance programs.  The net submitted charge may 
149.27  not be greater than the patient liability for the service.  The 
149.28  pharmacy dispensing fee shall be $3.65, except that the 
149.29  dispensing fee for intravenous solutions which must be 
149.30  compounded by the pharmacist shall be $8 per bag, $14 per bag 
149.31  for cancer chemotherapy products, and $30 per bag for total 
149.32  parenteral nutritional products dispensed in one liter 
149.33  quantities, or $44 per bag for total parenteral nutritional 
149.34  products dispensed in quantities greater than one liter.  Actual 
149.35  acquisition cost includes quantity and other special discounts 
149.36  except time and cash discounts.  The actual acquisition cost of 
150.1   a drug shall be estimated by the commissioner, at average 
150.2   wholesale price minus nine 14 percent, except that where a drug 
150.3   has had its wholesale price reduced as a result of the actions 
150.4   of the National Association of Medicaid Fraud Control Units, the 
150.5   estimated actual acquisition cost shall be the reduced average 
150.6   wholesale price, without the nine 14 percent deduction.  The 
150.7   maximum allowable cost of a multisource drug may be set by the 
150.8   commissioner and it shall be comparable to, but no higher than, 
150.9   the maximum amount paid by other third-party payors in this 
150.10  state who have maximum allowable cost programs.  The 
150.11  commissioner shall set maximum allowable costs for multisource 
150.12  drugs that are not on the federal upper limit list as described 
150.13  in United States Code, title 42, chapter 7, section 1396r-8(e), 
150.14  the Social Security Act, and Code of Federal Regulations, title 
150.15  42, part 447, section 447.332.  Establishment of the amount of 
150.16  payment for drugs shall not be subject to the requirements of 
150.17  the Administrative Procedure Act.  An additional dispensing fee 
150.18  of $.30 may be added to the dispensing fee paid to pharmacists 
150.19  for legend drug prescriptions dispensed to residents of 
150.20  long-term care facilities when a unit dose blister card system, 
150.21  approved by the department, is used.  Under this type of 
150.22  dispensing system, the pharmacist must dispense a 30-day supply 
150.23  of drug.  The National Drug Code (NDC) from the drug container 
150.24  used to fill the blister card must be identified on the claim to 
150.25  the department.  The unit dose blister card containing the drug 
150.26  must meet the packaging standards set forth in Minnesota Rules, 
150.27  part 6800.2700, that govern the return of unused drugs to the 
150.28  pharmacy for reuse.  The pharmacy provider will be required to 
150.29  credit the department for the actual acquisition cost of all 
150.30  unused drugs that are eligible for reuse.  Over-the-counter 
150.31  medications must be dispensed in the manufacturer's unopened 
150.32  package.  The commissioner may permit the drug clozapine to be 
150.33  dispensed in a quantity that is less than a 30-day supply.  
150.34  Whenever a generically equivalent product is available, payment 
150.35  shall be on the basis of the actual acquisition cost of the 
150.36  generic drug, unless the prescriber specifically indicates 
151.1   "dispense as written - brand necessary" on the prescription as 
151.2   required by section 151.21, subdivision 2. or on the maximum 
151.3   allowable cost established by the commissioner.  The 
151.4   commissioner may require prior authorization for brand-name 
151.5   drugs whenever a generically equivalent product is available 
151.6   even if the prescriber specifically indicates "dispense as 
151.7   written - brand necessary" on the prescription as required by 
151.8   section 151.21, subdivision 2.  The formulary committee shall 
151.9   establish general criteria to be used for the prior 
151.10  authorization of brand-name drugs for which generically 
151.11  equivalent drugs are available, but formulary committee review 
151.12  of each brand-name drug for which a generically equivalent drug 
151.13  is available shall not be required. 
151.14     (d) For purposes of this subdivision, "multisource drugs" 
151.15  means covered outpatient drugs, excluding innovator multisource 
151.16  drugs for which there are two or more drug products, which: 
151.17     (1) are related as therapeutically equivalent under the 
151.18  Food and Drug Administration's most recent publication of 
151.19  "Approved Drug Products with Therapeutic Equivalence 
151.20  Evaluations"; 
151.21     (2) are pharmaceutically equivalent and bioequivalent as 
151.22  determined by the Food and Drug Administration; and 
151.23     (3) are sold or marketed in Minnesota. 
151.24  "Innovator multisource drug" means a multisource drug that was 
151.25  originally marketed under an original new drug application 
151.26  approved by the Food and Drug Administration. 
151.27     (e) The formulary committee shall review and recommend 
151.28  drugs which require prior authorization.  The formulary 
151.29  committee may recommend drugs for prior authorization directly 
151.30  to the commissioner, as long as opportunity for public input is 
151.31  provided.  Prior authorization may be requested by the 
151.32  commissioner based on medical and clinical criteria and on cost 
151.33  before certain drugs are eligible for payment.  Before a drug 
151.34  may be considered for prior authorization at the request of the 
151.35  commissioner: 
151.36     (1) the drug formulary committee must develop criteria to 
152.1   be used for identifying drugs; the development of these criteria 
152.2   is not subject to the requirements of chapter 14, but the 
152.3   formulary committee shall provide opportunity for public input 
152.4   in developing criteria; 
152.5      (2) the drug formulary committee must hold a public forum 
152.6   and receive public comment for an additional 15 days; 
152.7      (3) the drug formulary committee must consider data from 
152.8   the state Medicaid program if such data is available; and 
152.9      (4) the commissioner must provide information to the 
152.10  formulary committee on the impact that placing the drug on prior 
152.11  authorization will have on the quality of patient care and on 
152.12  program costs, and information regarding whether the drug is 
152.13  subject to clinical abuse or misuse.  
152.14     Prior authorization may be required by the commissioner 
152.15  before certain formulary drugs are eligible for payment.  If 
152.16  prior authorization of a drug is required by the commissioner, 
152.17  the commissioner must provide a 30-day notice period before 
152.18  implementing the prior authorization.  If a prior authorization 
152.19  request is denied by the department, the recipient may appeal 
152.20  the denial in accordance with section 256.045.  If an appeal is 
152.21  filed, the drug must be provided without prior authorization 
152.22  until a decision is made on the appeal.  
152.23     (f) (e) The basis for determining the amount of payment for 
152.24  drugs administered in an outpatient setting shall be the lower 
152.25  of the usual and customary cost submitted by the provider; the 
152.26  average wholesale price minus five percent; or the maximum 
152.27  allowable cost set by the federal government under United States 
152.28  Code, title 42, chapter 7, section 1396r-8(e), and Code of 
152.29  Federal Regulations, title 42, section 447.332, or by the 
152.30  commissioner under paragraph (c). 
152.31     (g) (f) Prior authorization shall not be required or 
152.32  utilized for any antipsychotic drug prescribed for the treatment 
152.33  of mental illness where there is no generically equivalent drug 
152.34  available unless the commissioner determines that prior 
152.35  authorization is necessary for patient safety.  This paragraph 
152.36  applies to any supplemental drug rebate program established or 
153.1   administered by the commissioner. 
153.2      (h) (g) Prior authorization shall not be required or 
153.3   utilized for any antihemophilic factor drug prescribed for the 
153.4   treatment of hemophilia and blood disorders where there is no 
153.5   generically equivalent drug available unless the commissioner 
153.6   determines that prior authorization is necessary for patient 
153.7   safety.  This paragraph applies to any supplemental drug rebate 
153.8   program established or administered by the commissioner.  This 
153.9   paragraph expires July 1, 2003. 
153.10     Sec. 18.  [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.] 
153.11     Subdivision 1.  [CO-PAYMENTS.] (a) Except as provided in 
153.12  subdivision 2, the medical assistance benefit plan shall include 
153.13  the following co-payments for all recipients, effective for 
153.14  services provided on or after October 1, 2003: 
153.15     (1) $3 per nonpreventive visit.  For purposes of this 
153.16  subdivision, a visit means an episode of service which is 
153.17  required because of a recipient's symptoms, diagnosis, or 
153.18  established illness, and which is delivered in an ambulatory 
153.19  setting by a physician or physician ancillary, dentist, 
153.20  chiropractor, podiatrist, nurse midwife, mental health 
153.21  professional, advanced practice nurse, physical therapist, 
153.22  occupational therapist, speech therapist, audiologist, optician, 
153.23  or optometrist; 
153.24     (2) $3 for eyeglasses; 
153.25     (3) $6 for nonemergency visits to a hospital-based 
153.26  emergency room; and 
153.27     (4) $3 per brand-name drug prescription and $1 per generic 
153.28  drug prescription. 
153.29     (b) Recipients of medical assistance are responsible for 
153.30  all co-payments in this subdivision. 
153.31     Subd. 2.  [EXCEPTIONS.] Co-payments shall be subject to the 
153.32  following exceptions: 
153.33     (1) children under the age of 21; 
153.34     (2) pregnant women for services that relate to the 
153.35  pregnancy or any other medical condition that may complicate the 
153.36  pregnancy; 
154.1      (3) recipients expected to reside for at least 30 days in a 
154.2   hospital, nursing home, or intermediate care facility for the 
154.3   mentally retarded; 
154.4      (4) recipients receiving hospice care; 
154.5      (5) 100 percent federally funded services provided by an 
154.6   Indian health service; 
154.7      (6) emergency services; 
154.8      (7) family planning services; 
154.9      (8) services that are paid by Medicare, resulting in the 
154.10  medical assistance program paying for the coinsurance and 
154.11  deductible; and 
154.12     (9) co-payments that exceed one per day per provider for 
154.13  nonpreventive visits, eyeglasses, and nonemergency visits to a 
154.14  hospital-based emergency room. 
154.15     Subd. 3.  [COLLECTION.] The medical assistance 
154.16  reimbursement to the provider shall be reduced by the amount of 
154.17  the co-payment.  The provider collects the co-payment from the 
154.18  recipient.  Providers may not deny services to individuals who 
154.19  are unable to pay the co-payment.  Providers must accept an 
154.20  assertion from the recipient that they are unable to pay. 
154.21     Sec. 19.  Minnesota Statutes 2002, section 256B.0635, 
154.22  subdivision 1, is amended to read: 
154.23     Subdivision 1.  [INCREASED EMPLOYMENT.] (a) Until June 30, 
154.24  2002, medical assistance may be paid for persons who received 
154.25  MFIP or medical assistance for families and children in at least 
154.26  three of six months preceding the month in which the person 
154.27  became ineligible for MFIP or medical assistance, if the 
154.28  ineligibility was due to an increase in hours of employment or 
154.29  employment income or due to the loss of an earned income 
154.30  disregard.  In addition, to receive continued assistance under 
154.31  this section, persons who received medical assistance for 
154.32  families and children but did not receive MFIP must have had 
154.33  income less than or equal to the assistance standard for their 
154.34  family size under the state's AFDC plan in effect as of July 16, 
154.35  1996, increased by three percent effective July 1, 2000, at the 
154.36  time medical assistance eligibility began.  A person who is 
155.1   eligible for extended medical assistance is entitled to six 
155.2   months of assistance without reapplication, unless the 
155.3   assistance unit ceases to include a dependent child.  For a 
155.4   person under 21 years of age, medical assistance may not be 
155.5   discontinued within the six-month period of extended eligibility 
155.6   until it has been determined that the person is not otherwise 
155.7   eligible for medical assistance.  Medical assistance may be 
155.8   continued for an additional six months if the person meets all 
155.9   requirements for the additional six months, according to title 
155.10  XIX of the Social Security Act, as amended by section 303 of the 
155.11  Family Support Act of 1988, Public Law Number 100-485. 
155.12     (b) Beginning July 1, 2002, contingent upon federal 
155.13  funding, medical assistance for families and children may be 
155.14  paid for persons who were eligible under section 256B.055, 
155.15  subdivision 3a, in at least three of six months preceding the 
155.16  month in which the person became ineligible under that section 
155.17  if the ineligibility was due to an increase in hours of 
155.18  employment or employment income or due to the loss of an earned 
155.19  income disregard.  A person who is eligible for extended medical 
155.20  assistance is entitled to six months of assistance without 
155.21  reapplication, unless the assistance unit ceases to include a 
155.22  dependent child, except medical assistance may not be 
155.23  discontinued for that dependent child under 21 years of age 
155.24  within the six-month period of extended eligibility until it has 
155.25  been determined that the person is not otherwise eligible for 
155.26  medical assistance.  Medical assistance may be continued for an 
155.27  additional six months if the person meets all requirements for 
155.28  the additional six months, according to title XIX of the Social 
155.29  Security Act, as amended by section 303 of the Family Support 
155.30  Act of 1988, Public Law Number 100-485. 
155.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
155.32     Sec. 20.  Minnesota Statutes 2002, section 256B.0635, 
155.33  subdivision 2, is amended to read: 
155.34     Subd. 2.  [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 
155.35  June 30, 2002, medical assistance may be paid for persons who 
155.36  received MFIP or medical assistance for families and children in 
156.1   at least three of the six months preceding the month in which 
156.2   the person became ineligible for MFIP or medical assistance, if 
156.3   the ineligibility was the result of the collection of child or 
156.4   spousal support under part D of title IV of the Social Security 
156.5   Act.  In addition, to receive continued assistance under this 
156.6   section, persons who received medical assistance for families 
156.7   and children but did not receive MFIP must have had income less 
156.8   than or equal to the assistance standard for their family size 
156.9   under the state's AFDC plan in effect as of July 16, 1996, 
156.10  increased by three percent effective July 1, 2000, at the time 
156.11  medical assistance eligibility began.  A person who is eligible 
156.12  for extended medical assistance under this subdivision is 
156.13  entitled to four months of assistance without reapplication, 
156.14  unless the assistance unit ceases to include a dependent child, 
156.15  except medical assistance may not be discontinued for that 
156.16  dependent child under 21 years of age within the four-month 
156.17  period of extended eligibility until it has been determined that 
156.18  the person is not otherwise eligible for medical assistance. 
156.19     (b) Beginning July 1, 2002, contingent upon federal 
156.20  funding, medical assistance for families and children may be 
156.21  paid for persons who were eligible under section 256B.055, 
156.22  subdivision 3a, in at least three of the six months preceding 
156.23  the month in which the person became ineligible under that 
156.24  section if the ineligibility was the result of the collection of 
156.25  child or spousal support under part D of title IV of the Social 
156.26  Security Act.  A person who is eligible for extended medical 
156.27  assistance under this subdivision is entitled to four months of 
156.28  assistance without reapplication, unless the assistance unit 
156.29  ceases to include a dependent child, except medical assistance 
156.30  may not be discontinued for that dependent child under 21 years 
156.31  of age within the four-month period of extended eligibility 
156.32  until it has been determined that the person is not otherwise 
156.33  eligible for medical assistance. 
156.34     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
156.35     Sec. 21.  Minnesota Statutes 2002, section 256B.15, 
156.36  subdivision 1, is amended to read: 
157.1      Subdivision 1.  [POLICY, APPLICABILITY, PURPOSE, AND 
157.2   CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 
157.3   that individuals or couples, either or both of whom participate 
157.4   in the medical assistance program, use their own assets to pay 
157.5   their share of the total cost of their care during or after 
157.6   their enrollment in the program according to applicable federal 
157.7   law and the laws of this state.  The following provisions apply: 
157.8      (1) subdivisions 1c to 1k shall not apply to claims arising 
157.9   under this section which are presented under section 525.313; 
157.10     (2) the provisions of subdivisions 1c to 1k expanding the 
157.11  interests included in an estate for purposes of recovery under 
157.12  this section give effect to the provisions of United States 
157.13  Code, title 42, section 1396p, governing recoveries, but do not 
157.14  give rise to any express or implied liens in favor of any other 
157.15  parties not named in these provisions; 
157.16     (3) the continuation of a recipient's life estate or joint 
157.17  tenancy interest in real property after the recipient's death 
157.18  for the purpose of recovering medical assistance under this 
157.19  section modifies common law principles holding that these 
157.20  interests terminate on the death of the holder; 
157.21     (4) all laws, rules, and regulations governing or involved 
157.22  with a recovery of medical assistance shall be liberally 
157.23  construed to accomplish their intended purposes; and 
157.24     (5) a deceased recipient's life estate and joint tenancy 
157.25  interests continued under this section shall be owned by the 
157.26  remaindermen or surviving joint tenants as their interests may 
157.27  appear on the date of the recipient's death.  They shall not be 
157.28  merged into the remainder interest or the interests of the 
157.29  surviving joint tenants by reason of ownership.  They shall be 
157.30  subject to the provisions of this section.  Any conveyance, 
157.31  transfer, sale, assignment, or encumbrance by a remainderman, a 
157.32  surviving joint tenant, or their heirs, successors, and assigns 
157.33  shall be deemed to include all of their interest in the deceased 
157.34  recipient's life estate or joint tenancy interest continued 
157.35  under this section. 
157.36     (b) For purposes of this section, "medical assistance" 
158.1   includes the medical assistance program under this chapter and 
158.2   the general assistance medical care program under chapter 256D, 
158.3   but does not include the alternative care program for nonmedical 
158.4   assistance recipients under section 256B.0913, subdivision 4. 
158.5      <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
158.6   and applies to estates of decedents who die on or after that 
158.7   date. 
158.8      Sec. 22.  Minnesota Statutes 2002, section 256B.15, 
158.9   subdivision 1a, is amended to read: 
158.10     Subd. 1a.  [ESTATES SUBJECT TO CLAIMS.] If a person 
158.11  receives any medical assistance hereunder, on the person's 
158.12  death, if single, or on the death of the survivor of a married 
158.13  couple, either or both of whom received medical assistance, or 
158.14  as otherwise provided for in this section, the total amount paid 
158.15  for medical assistance rendered for the person and spouse shall 
158.16  be filed as a claim against the estate of the person or the 
158.17  estate of the surviving spouse in the court having jurisdiction 
158.18  to probate the estate or to issue a decree of descent according 
158.19  to sections 525.31 to 525.313.  
158.20     A claim shall be filed if medical assistance was rendered 
158.21  for either or both persons under one of the following 
158.22  circumstances: 
158.23     (a) the person was over 55 years of age, and received 
158.24  services under this chapter, excluding alternative care; 
158.25     (b) the person resided in a medical institution for six 
158.26  months or longer, received services under this chapter excluding 
158.27  alternative care, and, at the time of institutionalization or 
158.28  application for medical assistance, whichever is later, the 
158.29  person could not have reasonably been expected to be discharged 
158.30  and returned home, as certified in writing by the person's 
158.31  treating physician.  For purposes of this section only, a 
158.32  "medical institution" means a skilled nursing facility, 
158.33  intermediate care facility, intermediate care facility for 
158.34  persons with mental retardation, nursing facility, or inpatient 
158.35  hospital; or 
158.36     (c) the person received general assistance medical care 
159.1   services under chapter 256D.  
159.2      The claim shall be considered an expense of the last 
159.3   illness of the decedent for the purpose of section 524.3-805.  
159.4   Any statute of limitations that purports to limit any county 
159.5   agency or the state agency, or both, to recover for medical 
159.6   assistance granted hereunder shall not apply to any claim made 
159.7   hereunder for reimbursement for any medical assistance granted 
159.8   hereunder.  Notice of the claim shall be given to all heirs and 
159.9   devisees of the decedent whose identity can be ascertained with 
159.10  reasonable diligence.  The notice must include procedures and 
159.11  instructions for making an application for a hardship waiver 
159.12  under subdivision 5; time frames for submitting an application 
159.13  and determination; and information regarding appeal rights and 
159.14  procedures.  Counties are entitled to one-half of the nonfederal 
159.15  share of medical assistance collections from estates that are 
159.16  directly attributable to county effort.  
159.17     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
159.18  and applies to the estates of decedents who die on and after 
159.19  that date. 
159.20     Sec. 23.  Minnesota Statutes 2002, section 256B.15, is 
159.21  amended by adding a subdivision to read: 
159.22     Subd. 1c.  [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 
159.23  with a claim or potential claim under this section may file a 
159.24  notice of potential claim under this subdivision anytime before 
159.25  or after a medical assistance recipient dies.  The claimant 
159.26  shall be the state agency.  A notice filed prior to the 
159.27  recipient's death shall not take effect and shall not be 
159.28  effective as notice until the recipient dies.  A notice filed 
159.29  after a recipient dies shall be effective from the time of 
159.30  filing.  
159.31     (b) The notice of claim shall be filed or recorded in the 
159.32  real estate records in the office of the county recorder or 
159.33  registrar of titles for each county in which any part of the 
159.34  property is located.  The recorder shall accept the notice for 
159.35  recording or filing.  The registrar of titles shall accept the 
159.36  notice for filing if the recipient has a recorded interest in 
160.1   the property.  The notice must be filed within one year after 
160.2   the date of the recipient's death.  The registrar of titles 
160.3   shall not carry forward to a new certificate of title any notice 
160.4   filed more than one year from the date of the recipient's death. 
160.5      (c) The notice must be dated, state the name of the 
160.6   claimant, the medical assistance recipient's name and social 
160.7   security number if filed before their death and their date of 
160.8   death if filed after they die, the name and date of death of any 
160.9   predeceased spouse of the medical assistance recipient for whom 
160.10  a claim may exist, a statement that the claimant may have a 
160.11  claim arising under this section, generally identify the 
160.12  recipient's interest in the property, contain a legal 
160.13  description for the property and whether it is abstract or 
160.14  registered property, a statement of when the notice becomes 
160.15  effective and the effect of the notice, be signed by an 
160.16  authorized representative of the state agency, and may include 
160.17  such other contents as the state or county agency may deem 
160.18  appropriate. 
160.19     Sec. 24.  Minnesota Statutes 2002, section 256B.15, is 
160.20  amended by adding a subdivision to read: 
160.21     Subd. 1d.  [EFFECT OF NOTICE.] From the time it takes 
160.22  effect, the notice shall be notice to remaindermen, joint 
160.23  tenants, or to anyone else owning or acquiring an interest in or 
160.24  encumbrance against the property described in the notice that 
160.25  the medical assistance recipient's life estate, joint tenancy, 
160.26  or other interests in the real estate described in the notice: 
160.27     (1) shall, in the case of life estate and joint tenancy 
160.28  interests, continue to exist for purposes of this section, and 
160.29  be subject to liens and claims as provided in this section; 
160.30     (2) shall be subject to a lien in favor of the claimant 
160.31  effective upon the death of the recipient and dealt with as 
160.32  provided in this section; 
160.33     (3) may be included in the recipient's estate, as defined 
160.34  in this section; and 
160.35     (4) may be subject to administration and all other 
160.36  provisions of chapter 524 and may be sold, assigned, 
161.1   transferred, or encumbered free and clear of their interest or 
161.2   encumbrance to satisfy claims under this section. 
161.3      Sec. 25.  Minnesota Statutes 2002, section 256B.15, is 
161.4   amended by adding a subdivision to read: 
161.5      Subd. 1e.  [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 
161.6   claimant may fully or partially release the notice and the lien 
161.7   arising out of the notice of record in the real estate records 
161.8   where the notice is filed or recorded at any time.  The claimant 
161.9   may give a full or partial release to extinguish any life 
161.10  estates or joint tenancy interests which are or may be continued 
161.11  under this section or whose existence or nonexistence may create 
161.12  a cloud on the title to real property at any time whether or not 
161.13  a notice has been filed.  The recorder or registrar of titles 
161.14  shall accept the release for recording or filing.  If the 
161.15  release is a partial release, it must include a legal 
161.16  description of the property being released. 
161.17     (b) At any time, the claimant may, at the claimant's 
161.18  discretion, wholly or partially release, subordinate, modify, or 
161.19  amend the recorded notice and the lien arising out of the notice.
161.20     Sec. 26.  Minnesota Statutes 2002, section 256B.15, is 
161.21  amended by adding a subdivision to read: 
161.22     Subd. 1f.  [AGENCY LIEN.] (a) The notice shall constitute a 
161.23  lien in favor of the department of human services against the 
161.24  recipient's interests in the real estate it describes for a 
161.25  period of 20 years from the date of filing or the date of the 
161.26  recipient's death, whichever is later.  Notwithstanding any law 
161.27  or rule to the contrary, a recipient's life estate and joint 
161.28  tenancy interests shall not end upon the recipient's death but 
161.29  shall continue according to subdivisions 1h, 1i, and 1j.  The 
161.30  amount of the lien shall be equal to the total amount of the 
161.31  claims that could be presented in the recipient's estate under 
161.32  this section. 
161.33     (b) If no estate has been opened for the deceased 
161.34  recipient, any holder of an interest in the property may apply 
161.35  to the lien holder for a statement of the amount of the lien or 
161.36  for a full or partial release of the lien.  The application 
162.1   shall include the applicant's name, current mailing address, 
162.2   current home and work telephone numbers, and a description of 
162.3   their interest in the property, a legal description of the 
162.4   recipient's interest in the property, and the deceased 
162.5   recipient's name, date of birth, and social security number.  
162.6   The lien holder shall send the applicant by certified mail, 
162.7   return receipt requested, a written statement showing the amount 
162.8   of the lien, whether the lien holder is willing to release the 
162.9   lien and under what conditions, and inform them of the right to 
162.10  a hearing under section 256.045.  The lien holder shall have the 
162.11  discretion to compromise and settle the lien upon any terms and 
162.12  conditions the lien holder deems appropriate. 
162.13     (c) Any holder of an interest in property subject to the 
162.14  lien has a right to request a hearing under section 256.045 to 
162.15  determine the validity, extent, or amount of the lien.  The 
162.16  request must be in writing, and must include the names, current 
162.17  addresses, and home and business telephone numbers for all other 
162.18  parties holding an interest in the property.  A request for a 
162.19  hearing by any holder of an interest in the property shall be 
162.20  deemed to be a request for a hearing by all parties owning 
162.21  interests in the property.  Notice of the hearing shall be given 
162.22  to the lien holder, the party filing the appeal, and all of the 
162.23  other holders of interests in the property at the addresses 
162.24  listed in the appeal by certified mail, return receipt 
162.25  requested, or by ordinary mail.  Any owner of an interest in the 
162.26  property to whom notice of the hearing is mailed shall be deemed 
162.27  to have waived any and all claims or defenses in respect to the 
162.28  lien unless they appear and assert any claims or defenses at the 
162.29  hearing. 
162.30     (d) If the claim the lien secures could be filed under 
162.31  subdivision 1h, the lien holder may collect, compromise, settle, 
162.32  or release the lien upon any terms and conditions it deems 
162.33  appropriate.  If the claim the lien secures could be filed under 
162.34  subdivision 1i or 1j, the lien may be adjusted or enforced to 
162.35  the same extent had it been filed under subdivisions 1i and 1j, 
162.36  and the provisions of subdivisions 1i, clause (f), and lj, 
163.1   clause (d), shall apply to voluntary payment, settlement, or 
163.2   satisfaction of the lien. 
163.3      (e) If no probate proceedings have been commenced for the 
163.4   recipient as of the date the lien holder executes a release of 
163.5   the lien on a recipient's life estate or joint tenancy interest, 
163.6   created for purposes of this section, the release shall 
163.7   terminate the life estate or joint tenancy interest created 
163.8   under this section as of the date it is recorded or filed to the 
163.9   extent of the release.  If the claimant executes a release for 
163.10  purposes of extinguishing a life estate or a joint tenancy 
163.11  interest created under this section to remove a cloud on title 
163.12  to real property, the release shall have the effect of 
163.13  extinguishing any life estate or joint tenancy interests in the 
163.14  property it describes which may have been continued by reason of 
163.15  this section retroactive to the date of death of the deceased 
163.16  life tenant or joint tenant except as provided for in section 
163.17  514.981, subdivision 6. 
163.18     (f) If the deceased recipient's estate is probated, a claim 
163.19  shall be filed under this section.  The amount of the lien shall 
163.20  be limited to the amount of the claim as finally allowed.  If 
163.21  the claim the lien secures is filed under subdivision 1h, the 
163.22  lien may be released in full after any allowance of the claim 
163.23  becomes final or according to any agreement to settle and 
163.24  satisfy the claim.  The release shall release the lien but shall 
163.25  not extinguish or terminate the interest being released.  If the 
163.26  claim the lien secures is filed under subdivision 1i or 1j, the 
163.27  lien shall be released after the lien under subdivision 1i or 1j 
163.28  is filed or recorded, or settled according to any agreement to 
163.29  settle and satisfy the claim.  The release shall not extinguish 
163.30  or terminate the interest being released.  If the claim is 
163.31  finally disallowed in full, the claimant shall release the 
163.32  claimant's lien at the claimant's expense. 
163.33     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
163.34  2003, and applies to the estates of decedents who die on or 
163.35  after that date. 
163.36     Sec. 27.  Minnesota Statutes 2002, section 256B.15, is 
164.1   amended by adding a subdivision to read: 
164.2      Subd. 1g.  [ESTATE PROPERTY.] Notwithstanding any law or 
164.3   rule to the contrary, if a claim is presented under this 
164.4   section, interests or the proceeds of interests in real property 
164.5   a decedent owned as a life tenant or a joint tenant with a right 
164.6   of survivorship shall be part of the decedent's estate, subject 
164.7   to administration, and shall be dealt with as provided in this 
164.8   section. 
164.9      <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
164.10  2003, and applies to the estates of decedents who die on or 
164.11  after that date. 
164.12     Sec. 28.  Minnesota Statutes 2002, section 256B.15, is 
164.13  amended by adding a subdivision to read: 
164.14     Subd. 1h.  [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 
164.15  ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 
164.16  (k) apply if a person received medical assistance for which a 
164.17  claim may be filed under this section and died single, or the 
164.18  surviving spouse of the couple and was not survived by any of 
164.19  the persons described in subdivisions 3 and 4. 
164.20     (b) For purposes of this section, the person's estate 
164.21  consists of:  (1) their probate estate; (2) all of the person's 
164.22  interests or proceeds of those interests in real property the 
164.23  person owned as a life tenant or as a joint tenant with a right 
164.24  of survivorship at the time of the person's death; (3) all of 
164.25  the person's interests or proceeds of those interests in 
164.26  securities the person owned in beneficiary form as provided 
164.27  under sections 524.6-301 to 524.6-311 at the time of the 
164.28  person's death, to the extent they become part of the probate 
164.29  estate under section 524.6-307; and (4) all of the person's 
164.30  interests in joint accounts, multiple party accounts, and pay on 
164.31  death accounts, or the proceeds of those accounts, as provided 
164.32  under sections 524.6-201 to 524.6-214 at the time of the 
164.33  person's death to the extent they become part of the probate 
164.34  estate under section 524.6-207.  Notwithstanding any law or rule 
164.35  to the contrary, a state or county agency with a claim under 
164.36  this section shall be a creditor under section 524.6-307. 
165.1      (c) Notwithstanding any law or rule to the contrary, the 
165.2   person's life estate or joint tenancy interest in real property 
165.3   not subject to a medical assistance lien under sections 514.980 
165.4   to 514.985 on the date of the person's death shall not end upon 
165.5   the person's death and shall continue as provided in this 
165.6   subdivision.  The life estate in the person's estate shall be 
165.7   that portion of the interest in the real property subject to the 
165.8   life estate which is equal to the percentage factor for the life 
165.9   estate of the person and the medical assistance recipient's age 
165.10  on the date of the person's death as listed in the Life Estate 
165.11  Mortality Table of the health care program's manual.  The joint 
165.12  tenancy interest in real property in the estate shall be equal 
165.13  to the fractional interest the person would have owned in the 
165.14  jointly held interest in the property had they and the other 
165.15  owners held title to the property as tenants in common on the 
165.16  date the person died. 
165.17     (d) The court upon its own motion, or upon motion by the 
165.18  personal representative or any interested party, may enter an 
165.19  order directing the remaindermen or surviving joint tenants and 
165.20  their spouses, if any, to sign all documents, take all actions, 
165.21  and otherwise fully cooperate with the personal representative 
165.22  and the court to liquidate the decedent's life estate or joint 
165.23  tenancy interests in the estate and deliver the cash or the 
165.24  proceeds of those interests to the personal representative and 
165.25  provide for any legal and equitable sanctions as the court deems 
165.26  appropriate to enforce and carry out the order, including an 
165.27  award of reasonable attorney fees. 
165.28     (e) The personal representative may make, execute, and 
165.29  deliver any conveyances or other documents necessary to convey 
165.30  the decedent's life estate or joint tenancy interest in the 
165.31  estate that are necessary to liquidate and reduce to cash the 
165.32  decedent's interest or for any other purposes. 
165.33     (f) Subject to administration, all costs, including 
165.34  reasonable attorney fees, directly and immediately related to 
165.35  liquidating the decedent's life estate or joint tenancy interest 
165.36  in the decedent's estate, shall be paid from the gross proceeds 
166.1   of the liquidation allocable to the decedent's interest and the 
166.2   net proceeds shall be turned over to the personal representative 
166.3   and applied to payment of the claim presented under this section.
166.4      (g) The personal representative shall bring a motion in the 
166.5   district court in which the estate is being probated to compel 
166.6   the remaindermen or surviving joint tenants to account for and 
166.7   deliver to the personal representative all or any part of the 
166.8   proceeds of any sale, mortgage, transfer, conveyance, or any 
166.9   disposition of real property allocable to the decedent's life 
166.10  estate or joint tenancy interest in the decedent's estate, and 
166.11  do everything necessary to liquidate and reduce to cash the 
166.12  decedent's interest and turn the proceeds of the sale or other 
166.13  disposition over to the personal representative.  The court may 
166.14  grant any legal or equitable relief including, but not limited 
166.15  to, ordering a partition of real estate under chapter 558 
166.16  necessary to make the value of the decedent's life estate or 
166.17  joint tenancy interest available to the estate for payment of a 
166.18  claim under this section. 
166.19     (h) Subject to administration, the personal representative 
166.20  shall use all of the cash or proceeds of interests to pay an 
166.21  allowable claim under this section.  The remaindermen or 
166.22  surviving joint tenants and their spouses, if any, may enter 
166.23  into a written agreement with the personal representative or the 
166.24  claimant to settle and satisfy obligations imposed at any time 
166.25  before or after a claim is filed. 
166.26     (i) The personal representative may provide any or all of 
166.27  the other owners, remaindermen, or surviving joint tenants with 
166.28  an affidavit terminating the decedent's estate's interest in 
166.29  real property the decedent owned as a life tenant or as a joint 
166.30  tenant with others, if the personal representative determines 
166.31  that neither the decedent nor any of the decedent's predeceased 
166.32  spouses received any medical assistance for which a claim could 
166.33  be filed under this section, or if the personal representative 
166.34  has filed an affidavit with the court that the estate has other 
166.35  assets sufficient to pay a claim, as presented, or if there is a 
166.36  written agreement under paragraph (h), or if the claim, as 
167.1   allowed, has been paid in full or to the full extent of the 
167.2   assets the estate has available to pay it.  The affidavit may be 
167.3   recorded in the office of the county recorder or filed in the 
167.4   office of the registrar of titles for the county in which the 
167.5   real property is located.  Except as provided in section 
167.6   514.981, subdivision 6, when recorded or filed, the affidavit 
167.7   shall terminate the decedent's interest in real estate the 
167.8   decedent owned as a life tenant or a joint tenant with others.  
167.9   The affidavit shall:  (1) be signed by the personal 
167.10  representative; (2) identify the decedent and the interest being 
167.11  terminated; (3) give recording information sufficient to 
167.12  identify the instrument that created the interest in real 
167.13  property being terminated; (4) legally describe the affected 
167.14  real property; (5) state that the personal representative has 
167.15  determined that neither the decedent nor any of the decedent's 
167.16  predeceased spouses received any medical assistance for which a 
167.17  claim could be filed under this section; (6) state that the 
167.18  decedent's estate has other assets sufficient to pay the claim, 
167.19  as presented, or that there is a written agreement between the 
167.20  personal representative and the claimant and the other owners or 
167.21  remaindermen or other joint tenants to satisfy the obligations 
167.22  imposed under this subdivision; and (7) state that the affidavit 
167.23  is being given to terminate the estate's interest under this 
167.24  subdivision, and any other contents as may be appropriate.  
167.25  The recorder or registrar of titles shall accept the affidavit 
167.26  for recording or filing.  The affidavit shall be effective as 
167.27  provided in this section and shall constitute notice even if it 
167.28  does not include recording information sufficient to identify 
167.29  the instrument creating the interest it terminates.  The 
167.30  affidavit shall be conclusive evidence of the stated facts. 
167.31     (j) The holder of a lien arising under subdivision 1c shall 
167.32  release the lien at the holder's expense against an interest 
167.33  terminated under paragraph (h) to the extent of the termination. 
167.34     (k) If a lien arising under subdivision 1c is not released 
167.35  under paragraph (j), prior to closing the estate, the personal 
167.36  representative shall deed the interest subject to the lien to 
168.1   the remaindermen or surviving joint tenants as their interests 
168.2   may appear.  Upon recording or filing, the deed shall work a 
168.3   merger of the recipient's life estate or joint tenancy interest, 
168.4   subject to the lien, into the remainder interest or interest the 
168.5   decedent and others owned jointly.  The lien shall attach to and 
168.6   run with the property to the extent of the decedent's interest 
168.7   at the time of the decedent's death. 
168.8      <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
168.9   2003, and applies to the estates of decedents who die on or 
168.10  after that date. 
168.11     Sec. 29.  Minnesota Statutes 2002, section 256B.15, is 
168.12  amended by adding a subdivision to read: 
168.13     Subd. 1i.  [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 
168.14  AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 
168.15  the person's estate consists of the person's probate estate and 
168.16  all of the person's interests in real property the person owned 
168.17  as a life tenant or a joint tenant at the time of the person's 
168.18  death. 
168.19     (b) Notwithstanding any law or rule to the contrary, this 
168.20  subdivision applies if a person received medical assistance for 
168.21  which a claim could be filed under this section but for the fact 
168.22  the person was survived by a spouse or by a person listed in 
168.23  subdivision 3, or if subdivision 4 applies to a claim arising 
168.24  under this section. 
168.25     (c) The person's life estate or joint tenancy interests in 
168.26  real property not subject to a medical assistance lien under 
168.27  sections 514.980 to 514.985 on the date of the person's death 
168.28  shall not end upon death and shall continue as provided in this 
168.29  subdivision.  The life estate in the estate shall be the portion 
168.30  of the interest in the property subject to the life estate that 
168.31  is equal to the percentage factor for the life estate of the 
168.32  medical assistance recipient's age on the date of the person's 
168.33  death as listed in the Life Estate Mortality Table in the health 
168.34  care program's manual.  The joint tenancy interest in the estate 
168.35  shall be equal to the fractional interest the medical assistance 
168.36  recipient would have owned in the jointly held interest in the 
169.1   property had they and the other owners held title to the 
169.2   property as tenants in common on the date the medical assistance 
169.3   recipient died. 
169.4      (d) The county agency shall file a claim in the estate 
169.5   under this section on behalf of the claimant who shall be the 
169.6   commissioner of human services, notwithstanding that the 
169.7   decedent is survived by a spouse or a person listed in 
169.8   subdivision 3.  The claim, as allowed, shall not be paid by the 
169.9   estate and shall be disposed of as provided in this paragraph.  
169.10  The personal representative or the court shall make, execute, 
169.11  and deliver a lien in favor of the claimant on the decedent's 
169.12  interest in real property in the estate in the amount of the 
169.13  allowed claim on forms provided by the commissioner to the 
169.14  county agency filing the lien.  The lien shall bear interest as 
169.15  provided under section 524.3-806, shall attach to the property 
169.16  it describes upon filing or recording, and shall remain a lien 
169.17  on the real property it describes for a period of 20 years from 
169.18  the date it is filed or recorded.  The lien shall be a 
169.19  disposition of the claim sufficient to permit the estate to 
169.20  close. 
169.21     (e) The state or county agency shall file or record the 
169.22  lien in the office of the county recorder or registrar of titles 
169.23  for each county in which any of the real property is located.  
169.24  The recorder or registrar of titles shall accept the lien for 
169.25  filing or recording.  All recording or filing fees shall be paid 
169.26  by the department of human services.  The recorder or registrar 
169.27  of titles shall mail the recorded lien to the department of 
169.28  human services.  The lien need not be attested, certified, or 
169.29  acknowledged as a condition of recording or filing.  Upon 
169.30  recording or filing of a lien against a life estate or a joint 
169.31  tenancy interest, the interest subject to the lien shall merge 
169.32  into the remainder interest or the interest the recipient and 
169.33  others owned jointly.  The lien shall attach to and run with the 
169.34  property to the extent of the decedent's interest in the 
169.35  property at the time of the decedent's death as determined under 
169.36  this section.  
170.1      (f) The department shall make no adjustment or recovery 
170.2   under the lien until after the decedent's spouse, if any, has 
170.3   died, and only at a time when the decedent has no surviving 
170.4   child described in subdivision 3.  The estate, any owner of an 
170.5   interest in the property which is or may be subject to the lien, 
170.6   or any other interested party, may voluntarily pay off, settle, 
170.7   or otherwise satisfy the claim secured or to be secured by the 
170.8   lien at any time before or after the lien is filed or recorded.  
170.9   Such payoffs, settlements, and satisfactions shall be deemed to 
170.10  be voluntary repayments of past medical assistance payments for 
170.11  the benefit of the deceased recipient, and neither the process 
170.12  of settling the claim, the payment of the claim, or the 
170.13  acceptance of a payment shall constitute an adjustment or 
170.14  recovery that is prohibited under this subdivision. 
170.15     (g) The lien under this subdivision may be enforced or 
170.16  foreclosed in the manner provided by law for the enforcement of 
170.17  judgment liens against real estate or by a foreclosure by action 
170.18  under chapter 581.  When the lien is paid, satisfied, or 
170.19  otherwise discharged, the state or county agency shall prepare 
170.20  and file a release of lien at its own expense.  No action to 
170.21  foreclose the lien shall be commenced unless the lien holder has 
170.22  first given 30 days' prior written notice to pay the lien to the 
170.23  owners and parties in possession of the property subject to the 
170.24  lien.  The notice shall:  (1) include the name, address, and 
170.25  telephone number of the lien holder; (2) describe the lien; (3) 
170.26  give the amount of the lien; (4) inform the owner or party in 
170.27  possession that payment of the lien in full must be made to the 
170.28  lien holder within 30 days after service of the notice or the 
170.29  lien holder may begin proceedings to foreclose the lien; and (5) 
170.30  be served by personal service, certified mail, return receipt 
170.31  requested, ordinary first class mail, or by publishing it once 
170.32  in a newspaper of general circulation in the county in which any 
170.33  part of the property is located.  Service of the notice shall be 
170.34  complete upon mailing or publication. 
170.35     <b>[EFFECTIVE DATE.]</b> This section takes effect August 1, 2003, 
170.36  and applies to estates of decedents who die on and after that 
171.1   date. 
171.2      Sec. 30.  Minnesota Statutes 2002, section 256B.15, is 
171.3   amended by adding a subdivision to read: 
171.4      Subd. 1j.  [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 
171.5   OTHER SURVIVORS.] For purposes of this subdivision, the 
171.6   provisions in subdivision 1i, paragraphs (a) to (c) apply. 
171.7      (a) If payment of a claim filed under this section is 
171.8   limited as provided in subdivision 4, and if the estate does not 
171.9   have other assets sufficient to pay the claim in full, as 
171.10  allowed, the personal representative or the court shall make, 
171.11  execute, and deliver a lien on the property in the estate that 
171.12  is exempt from the claim under subdivision 4 in favor of the 
171.13  commissioner of human services on forms provided by the 
171.14  commissioner to the county agency filing the claim.  If the 
171.15  estate pays a claim filed under this section in full from other 
171.16  assets of the estate, no lien shall be filed against the 
171.17  property described in subdivision 4. 
171.18     (b) The lien shall be in an amount equal to the unpaid 
171.19  balance of the allowed claim under this section remaining after 
171.20  the estate has applied all other available assets of the estate 
171.21  to pay the claim.  The property exempt under subdivision 4 shall 
171.22  not be sold, assigned, transferred, conveyed, encumbered, or 
171.23  distributed until after the personal representative has 
171.24  determined the estate has other assets sufficient to pay the 
171.25  allowed claim in full, or until after the lien has been filed or 
171.26  recorded.  The lien shall bear interest as provided under 
171.27  section 524.3-806, shall attach to the property it describes 
171.28  upon filing or recording, and shall remain a lien on the real 
171.29  property it describes for a period of 20 years from the date it 
171.30  is filed or recorded.  The lien shall be a disposition of the 
171.31  claim sufficient to permit the estate to close. 
171.32     (c) The state or county agency shall file or record the 
171.33  lien in the office of the county recorder or registrar of titles 
171.34  in each county in which any of the real property is located.  
171.35  The department shall pay the filing fees.  The lien need not be 
171.36  attested, certified, or acknowledged as a condition of recording 
172.1   or filing.  The recorder or registrar of titles shall accept the 
172.2   lien for filing or recording. 
172.3      (d) The commissioner shall make no adjustment or recovery 
172.4   under the lien until none of the persons listed in subdivision 4 
172.5   are residing on the property or until the property is sold or 
172.6   transferred.  The estate or any owner of an interest in the 
172.7   property that is or may be subject to the lien, or any other 
172.8   interested party, may voluntarily pay off, settle, or otherwise 
172.9   satisfy the claim secured or to be secured by the lien at any 
172.10  time before or after the lien is filed or recorded.  The 
172.11  payoffs, settlements, and satisfactions shall be deemed to be 
172.12  voluntary repayments of past medical assistance payments for the 
172.13  benefit of the deceased recipient and neither the process of 
172.14  settling the claim, the payment of the claim, or acceptance of a 
172.15  payment shall constitute an adjustment or recovery that is 
172.16  prohibited under this subdivision. 
172.17     (e) A lien under this subdivision may be enforced or 
172.18  foreclosed in the manner provided for by law for the enforcement 
172.19  of judgment liens against real estate or by a foreclosure by 
172.20  action under chapter 581.  When the lien has been paid, 
172.21  satisfied, or otherwise discharged, the claimant shall prepare 
172.22  and file a release of lien at the claimant's expense.  No action 
172.23  to foreclose the lien shall be commenced unless the lien holder 
172.24  has first given 30 days prior written notice to pay the lien to 
172.25  the record owners of the property and the parties in possession 
172.26  of the property subject to the lien.  The notice shall:  (1) 
172.27  include the name, address, and telephone number of the lien 
172.28  holder; (2) describe the lien; (3) give the amount of the lien; 
172.29  (4) inform the owner or party in possession that payment of the 
172.30  lien in full must be made to the lien holder within 30 days 
172.31  after service of the notice or the lien holder may begin 
172.32  proceedings to foreclose the lien; and (5) be served by personal 
172.33  service, certified mail, return receipt requested, ordinary 
172.34  first class mail, or by publishing it once in a newspaper of 
172.35  general circulation in the county in which any part of the 
172.36  property is located.  Service shall be complete upon mailing or 
173.1   publication. 
173.2      (f) Upon filing or recording of a lien against a life 
173.3   estate or joint tenancy interest under this subdivision, the 
173.4   interest subject to the lien shall merge into the remainder 
173.5   interest or the interest the decedent and others owned jointly, 
173.6   effective on the date of recording and filing.  The lien shall 
173.7   attach to and run with the property to the extent of the 
173.8   decedent's interest in the property at the time of the 
173.9   decedent's death as determined under this section. 
173.10     (g)(1) An affidavit may be provided by a personal 
173.11  representative stating the personal representative has 
173.12  determined in good faith that a decedent survived by a spouse or 
173.13  a person listed in subdivision 3, or by a person listed in 
173.14  subdivision 4, or the decedent's predeceased spouse did not 
173.15  receive any medical assistance giving rise to a claim under this 
173.16  section, or that the real property described in subdivision 4 is 
173.17  not needed to pay in full a claim arising under this section. 
173.18     (2) The affidavit shall:  (i) describe the property and the 
173.19  interest being extinguished; (ii) name the decedent and give the 
173.20  date of death; (iii) state the facts listed in clause (1); (iv) 
173.21  state that the affidavit is being filed to terminate the life 
173.22  estate or joint tenancy interest created under this subdivision; 
173.23  (v) be signed by the personal representative; and (vi) contain 
173.24  any other information that the affiant deems appropriate. 
173.25     (3) Except as provided in section 514.981, subdivision 6, 
173.26  when the affidavit is filed or recorded, the life estate or 
173.27  joint tenancy interest in real property that the affidavit 
173.28  describes shall be terminated effective as of the date of filing 
173.29  or recording.  The termination shall be final and may not be set 
173.30  aside for any reason. 
173.31     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
173.32  2003, and applies to the estates of decedents who die on or 
173.33  after that date. 
173.34     Sec. 31.  Minnesota Statutes 2002, section 256B.15, is 
173.35  amended by adding a subdivision to read: 
173.36     Subd. 1k.  [FILING.] Any notice, lien, release, or other 
174.1   document filed under subdivisions 1c to 1l, and any lien, 
174.2   release of lien, or other documents relating to a lien filed 
174.3   under subdivisions 1h and 1i must be filed or recorded in the 
174.4   office of the county recorder or registrar of titles, as 
174.5   appropriate, in the county where the affected real property is 
174.6   located.  Notwithstanding section 386.77, the state or county 
174.7   agency shall pay any applicable filing fee.  An attestation, 
174.8   certification, or acknowledgment is not required as a condition 
174.9   of filing.  If the property described in the filing is 
174.10  registered property, the registrar of titles shall record the 
174.11  filing on the certificate of title for each parcel of property 
174.12  described in the filing.  If the property described in the 
174.13  filing is abstract property, the recorder shall file and index 
174.14  the property in the county's grantor-grantee indexes and any 
174.15  tract indexes the county maintains for each parcel of property 
174.16  described in the filing.  The recorder or registrar of titles 
174.17  shall return the filed document to the party filing it at no 
174.18  cost.  If the party making the filing provides a duplicate copy 
174.19  of the filing, the recorder or registrar of titles shall show 
174.20  the recording or filing data on the copy and return it to the 
174.21  party at no extra cost. 
174.22     <b>[EFFECTIVE DATE.]</b> This section takes effect on August 1, 
174.23  2003, and applies to the estates of decedents who die on or 
174.24  after that date. 
174.25     Sec. 32.  Minnesota Statutes 2002, section 256B.15, 
174.26  subdivision 3, is amended to read: 
174.27     Subd. 3.  [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 
174.28  CHILDREN.] If a decedent who is survived by a spouse, or was 
174.29  single, or who was the surviving spouse of a married couple, and 
174.30  is survived by a child who is under age 21 or blind or 
174.31  permanently and totally disabled according to the supplemental 
174.32  security income program criteria, no a claim shall be filed 
174.33  against the estate according to this section. 
174.34     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
174.35  and applies to decedents who die on or after that date. 
174.36     Sec. 33.  Minnesota Statutes 2002, section 256B.15, 
175.1   subdivision 4, is amended to read: 
175.2      Subd. 4.  [OTHER SURVIVORS.] If the decedent who was single 
175.3   or the surviving spouse of a married couple is survived by one 
175.4   of the following persons, a claim exists against the estate in 
175.5   an amount not to exceed the value of the nonhomestead property 
175.6   included in the estate and the personal representative shall 
175.7   make, execute, and deliver to the county agency a lien against 
175.8   the homestead property in the estate for any unpaid balance of 
175.9   the claim to the claimant as provided under this section: 
175.10     (a) a sibling who resided in the decedent medical 
175.11  assistance recipient's home at least one year before the 
175.12  decedent's institutionalization and continuously since the date 
175.13  of institutionalization; or 
175.14     (b) a son or daughter or a grandchild who resided in the 
175.15  decedent medical assistance recipient's home for at least two 
175.16  years immediately before the parent's or grandparent's 
175.17  institutionalization and continuously since the date of 
175.18  institutionalization, and who establishes by a preponderance of 
175.19  the evidence having provided care to the parent or grandparent 
175.20  who received medical assistance, that the care was provided 
175.21  before institutionalization, and that the care permitted the 
175.22  parent or grandparent to reside at home rather than in an 
175.23  institution. 
175.24     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
175.25  and applies to decedents who die on or after that date. 
175.26     Sec. 34.  Minnesota Statutes 2002, section 256B.195, 
175.27  subdivision 4, is amended to read: 
175.28     Subd. 4.  [ADJUSTMENTS PERMITTED.] (a) The commissioner may 
175.29  adjust the intergovernmental transfers under subdivision 2 and 
175.30  the payments under subdivision 3, and payments and transfers 
175.31  under subdivision 5, based on the commissioner's determination 
175.32  of Medicare upper payment limits, hospital-specific charge 
175.33  limits, and hospital-specific limitations on disproportionate 
175.34  share payments.  Any adjustments must be made on a proportional 
175.35  basis.  If participation by a particular hospital under this 
175.36  section is limited, the commissioner shall adjust the payments 
176.1   that relate to that hospital under subdivisions 2, and 3, and 5 
176.2   on a proportional basis in order to allow the hospital to 
176.3   participate under this section to the fullest extent possible 
176.4   and shall increase other payments under subdivisions 2, and 3, 
176.5   and 5 to the extent allowable to maintain the overall level of 
176.6   payments under this section.  The commissioner may make 
176.7   adjustments under this subdivision only after consultation with 
176.8   the counties and hospitals identified in subdivisions 2 and 3, 
176.9   and, if subdivision 5 receives federal approval, with the 
176.10  hospital and educational institution identified in subdivision 5.
176.11     (b) The ratio of medical assistance payments specified in 
176.12  subdivision 3 to the intergovernmental transfers specified in 
176.13  subdivision 2 shall not be reduced except as provided under 
176.14  paragraph (a).  
176.15     (c) The increase in intergovernmental transfers and 
176.16  payments that result from section 256.969, subdivision 3a, 
176.17  paragraph (c), shall be paid to the general fund. 
176.18     Sec. 35.  Minnesota Statutes 2002, section 256B.32, 
176.19  subdivision 1, is amended to read: 
176.20     Subdivision 1.  [FACILITY FEE PAYMENT.] (a) The 
176.21  commissioner shall establish a facility fee payment mechanism 
176.22  that will pay a facility fee to all enrolled outpatient 
176.23  hospitals for each emergency room or outpatient clinic visit 
176.24  provided on or after July 1, 1989.  This payment mechanism may 
176.25  not result in an overall increase in outpatient payment rates.  
176.26  This section does not apply to federally mandated maximum 
176.27  payment limits, department approved program packages, or 
176.28  services billed using a nonoutpatient hospital provider number. 
176.29     (b) For fee-for-service services provided on or after July 
176.30  1, 2002, the total payment, before third-party liability and 
176.31  spenddown, made to hospitals for outpatient hospital facility 
176.32  services is reduced by .5 percent from the current statutory 
176.33  rates. 
176.34     (c) In addition to the reduction in paragraph (b), the 
176.35  total payment for fee-for-service services provided on or after 
176.36  July 1, 2003, made to hospitals for outpatient hospital facility 
177.1   services before third-party liability and spenddown, is reduced 
177.2   five percent from the current statutory rates.  Facilities 
177.3   defined under section 256.969, subdivision 16, are excluded from 
177.4   this paragraph. 
177.5      Sec. 36.  Minnesota Statutes 2002, section 256B.69, 
177.6   subdivision 2, is amended to read: 
177.7      Subd. 2.  [DEFINITIONS.] For the purposes of this section, 
177.8   the following terms have the meanings given.  
177.9      (a) "Commissioner" means the commissioner of human services.
177.10  For the remainder of this section, the commissioner's 
177.11  responsibilities for methods and policies for implementing the 
177.12  project will be proposed by the project advisory committees and 
177.13  approved by the commissioner.  
177.14     (b) "Demonstration provider" means a health maintenance 
177.15  organization, community integrated service network, or 
177.16  accountable provider network authorized and operating under 
177.17  chapter 62D, 62N, or 62T that participates in the demonstration 
177.18  project according to criteria, standards, methods, and other 
177.19  requirements established for the project and approved by the 
177.20  commissioner.  For purposes of this section, a county board, or 
177.21  group of county boards operating under a joint powers agreement, 
177.22  is considered a demonstration provider if the county or group of 
177.23  county boards meets the requirements of section 256B.692.  
177.24  Notwithstanding the above, Itasca county may continue to 
177.25  participate as a demonstration provider until July 1, 2004. 
177.26     (c) "Eligible individuals" means those persons eligible for 
177.27  medical assistance benefits as defined in sections 256B.055, 
177.28  256B.056, and 256B.06. 
177.29     (d) "Limitation of choice" means suspending freedom of 
177.30  choice while allowing eligible individuals to choose among the 
177.31  demonstration providers.  
177.32     (e) This paragraph supersedes paragraph (c) as long as the 
177.33  Minnesota health care reform waiver remains in effect.  When the 
177.34  waiver expires, this paragraph expires and the commissioner of 
177.35  human services shall publish a notice in the State Register and 
177.36  notify the revisor of statutes.  "Eligible individuals" means 
178.1   those persons eligible for medical assistance benefits as 
178.2   defined in sections 256B.055, 256B.056, and 256B.06.  
178.3   Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 
178.4   individual who becomes ineligible for the program because of 
178.5   failure to submit income reports or recertification forms in a 
178.6   timely manner, shall remain enrolled in the prepaid health plan 
178.7   and shall remain eligible to receive medical assistance coverage 
178.8   through the last day of the month following the month in which 
178.9   the enrollee became ineligible for the medical assistance 
178.10  program. 
178.11     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
178.12     Sec. 37.  Minnesota Statutes 2002, section 256B.69, 
178.13  subdivision 4, is amended to read: 
178.14     Subd. 4.  [LIMITATION OF CHOICE.] (a) The commissioner 
178.15  shall develop criteria to determine when limitation of choice 
178.16  may be implemented in the experimental counties.  The criteria 
178.17  shall ensure that all eligible individuals in the county have 
178.18  continuing access to the full range of medical assistance 
178.19  services as specified in subdivision 6.  
178.20     (b) The commissioner shall exempt the following persons 
178.21  from participation in the project, in addition to those who do 
178.22  not meet the criteria for limitation of choice:  
178.23     (1) persons eligible for medical assistance according to 
178.24  section 256B.055, subdivision 1; 
178.25     (2) persons eligible for medical assistance due to 
178.26  blindness or disability as determined by the social security 
178.27  administration or the state medical review team, unless:  
178.28     (i) they are 65 years of age or older; or 
178.29     (ii) they reside in Itasca county or they reside in a 
178.30  county in which the commissioner conducts a pilot project under 
178.31  a waiver granted pursuant to section 1115 of the Social Security 
178.32  Act; 
178.33     (3) recipients who currently have private coverage through 
178.34  a health maintenance organization; 
178.35     (4) recipients who are eligible for medical assistance by 
178.36  spending down excess income for medical expenses other than the 
179.1   nursing facility per diem expense; 
179.2      (5) recipients who receive benefits under the Refugee 
179.3   Assistance Program, established under United States Code, title 
179.4   8, section 1522(e); 
179.5      (6) children who are both determined to be severely 
179.6   emotionally disturbed and receiving case management services 
179.7   according to section 256B.0625, subdivision 20; 
179.8      (7) adults who are both determined to be seriously and 
179.9   persistently mentally ill and received case management services 
179.10  according to section 256B.0625, subdivision 20; and 
179.11     (8) persons eligible for medical assistance according to 
179.12  section 256B.057, subdivision 10; and 
179.13     (9) persons with access to cost-effective 
179.14  employer-sponsored private health insurance or persons enrolled 
179.15  in an individual health plan determined to be cost-effective 
179.16  according to section 256B.0625, subdivision 15.  
179.17  Children under age 21 who are in foster placement may enroll in 
179.18  the project on an elective basis.  Individuals excluded under 
179.19  clauses (6) and (7) may choose to enroll on an elective basis.  
179.20     (c) The commissioner may allow persons with a one-month 
179.21  spenddown who are otherwise eligible to enroll to voluntarily 
179.22  enroll or remain enrolled, if they elect to prepay their monthly 
179.23  spenddown to the state.  
179.24     (d) The commissioner may require those individuals to 
179.25  enroll in the prepaid medical assistance program who otherwise 
179.26  would have been excluded under paragraph (b), clauses (1), (3), 
179.27  and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 
179.28  items H, K, and L.  
179.29     (e) Before limitation of choice is implemented, eligible 
179.30  individuals shall be notified and after notification, shall be 
179.31  allowed to choose only among demonstration providers.  The 
179.32  commissioner may assign an individual with private coverage 
179.33  through a health maintenance organization, to the same health 
179.34  maintenance organization for medical assistance coverage, if the 
179.35  health maintenance organization is under contract for medical 
179.36  assistance in the individual's county of residence.  After 
180.1   initially choosing a provider, the recipient is allowed to 
180.2   change that choice only at specified times as allowed by the 
180.3   commissioner.  If a demonstration provider ends participation in 
180.4   the project for any reason, a recipient enrolled with that 
180.5   provider must select a new provider but may change providers 
180.6   without cause once more within the first 60 days after 
180.7   enrollment with the second provider. 
180.8      Sec. 38.  Minnesota Statutes 2002, section 256B.69, 
180.9   subdivision 5c, is amended to read: 
180.10     Subd. 5c.  [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 
180.11  commissioner of human services shall transfer each year to the 
180.12  medical education and research fund established under section 
180.13  62J.692, the following: 
180.14     (1) an amount equal to the reduction in the prepaid medical 
180.15  assistance and prepaid general assistance medical care payments 
180.16  as specified in this clause.  Until January 1, 2002, the county 
180.17  medical assistance and general assistance medical care 
180.18  capitation base rate prior to plan specific adjustments and 
180.19  after the regional rate adjustments under section 256B.69, 
180.20  subdivision 5b, is reduced 6.3 percent for Hennepin county, two 
180.21  percent for the remaining metropolitan counties, and no 
180.22  reduction for nonmetropolitan Minnesota counties; and after 
180.23  January 1, 2002, the county medical assistance and general 
180.24  assistance medical care capitation base rate prior to plan 
180.25  specific adjustments is reduced 6.3 percent for Hennepin county, 
180.26  two percent for the remaining metropolitan counties, and 1.6 
180.27  percent for nonmetropolitan Minnesota counties.  Nursing 
180.28  facility and elderly waiver payments and demonstration project 
180.29  payments operating under subdivision 23 are excluded from this 
180.30  reduction.  The amount calculated under this clause shall not be 
180.31  adjusted for periods already paid due to subsequent changes to 
180.32  the capitation payments; 
180.33     (2) beginning July 1, 2001, $2,537,000 2003, $2,157,000 
180.34  from the capitation rates paid under this section plus any 
180.35  federal matching funds on this amount; 
180.36     (3) beginning July 1, 2002, an additional $12,700,000 from 
181.1   the capitation rates paid under this section; and 
181.2      (4) beginning July 1, 2003, an additional $4,700,000 from 
181.3   the capitation rates paid under this section. 
181.4      (b) This subdivision shall be effective upon approval of a 
181.5   federal waiver which allows federal financial participation in 
181.6   the medical education and research fund. 
181.7      (c) Effective July 1, 2003, the amount from general 
181.8   assistance medical care under paragraph (a), clause (1), shall 
181.9   be transferred to the general fund. 
181.10     Sec. 39.  Minnesota Statutes 2002, section 256B.69, is 
181.11  amended by adding a subdivision to read: 
181.12     Subd. 5h.  [PAYMENT REDUCTION.] In addition to the 
181.13  reduction in subdivision 5g, the total payment made to managed 
181.14  care plans under the medical assistance program is reduced one 
181.15  percent for services provided on or after October 1, 2003, and 
181.16  an additional one percent for services provided on or after 
181.17  January 1, 2004.  This provision excludes payments for nursing 
181.18  home services, home and community-based waivers, and payments to 
181.19  demonstration projects for persons with disabilities. 
181.20     Sec. 40.  Minnesota Statutes 2002, section 256B.75, is 
181.21  amended to read: 
181.22     256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
181.23     (a) For outpatient hospital facility fee payments for 
181.24  services rendered on or after October 1, 1992, the commissioner 
181.25  of human services shall pay the lower of (1) submitted charge, 
181.26  or (2) 32 percent above the rate in effect on June 30, 1992, 
181.27  except for those services for which there is a federal maximum 
181.28  allowable payment.  Effective for services rendered on or after 
181.29  January 1, 2000, payment rates for nonsurgical outpatient 
181.30  hospital facility fees and emergency room facility fees shall be 
181.31  increased by eight percent over the rates in effect on December 
181.32  31, 1999, except for those services for which there is a federal 
181.33  maximum allowable payment.  Services for which there is a 
181.34  federal maximum allowable payment shall be paid at the lower of 
181.35  (1) submitted charge, or (2) the federal maximum allowable 
181.36  payment.  Total aggregate payment for outpatient hospital 
182.1   facility fee services shall not exceed the Medicare upper 
182.2   limit.  If it is determined that a provision of this section 
182.3   conflicts with existing or future requirements of the United 
182.4   States government with respect to federal financial 
182.5   participation in medical assistance, the federal requirements 
182.6   prevail.  The commissioner may, in the aggregate, prospectively 
182.7   reduce payment rates to avoid reduced federal financial 
182.8   participation resulting from rates that are in excess of the 
182.9   Medicare upper limitations. 
182.10     (b) Notwithstanding paragraph (a), payment for outpatient, 
182.11  emergency, and ambulatory surgery hospital facility fee services 
182.12  for critical access hospitals designated under section 144.1483, 
182.13  clause (11), shall be paid on a cost-based payment system that 
182.14  is based on the cost-finding methods and allowable costs of the 
182.15  Medicare program. 
182.16     (c) Effective for services provided on or after July 1, 
182.17  2003, rates that are based on the Medicare outpatient 
182.18  prospective payment system shall be replaced by a budget neutral 
182.19  prospective payment system that is derived using medical 
182.20  assistance data.  The commissioner shall provide a proposal to 
182.21  the 2003 legislature to define and implement this provision. 
182.22     (d) For fee-for-service services provided on or after July 
182.23  1, 2002, the total payment, before third-party liability and 
182.24  spenddown, made to hospitals for outpatient hospital facility 
182.25  services is reduced by .5 percent from the current statutory 
182.26  rate. 
182.27     (e) In addition to the reduction in paragraph (d), the 
182.28  total payment for fee-for-service services provided on or after 
182.29  July 1, 2003, made to hospitals for outpatient hospital facility 
182.30  services before third-party liability and spenddown, is reduced 
182.31  five percent from the current statutory rates.  Facilities 
182.32  defined under section 256.969, subdivision 16, are excluded from 
182.33  this paragraph. 
182.34     Sec. 41.  Minnesota Statutes 2002, section 256B.76, is 
182.35  amended to read: 
182.36     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
183.1      (a) Effective for services rendered on or after October 1, 
183.2   1992, the commissioner shall make payments for physician 
183.3   services as follows: 
183.4      (1) payment for level one Centers for Medicare and Medicaid 
183.5   Services' common procedural coding system codes titled "office 
183.6   and other outpatient services," "preventive medicine new and 
183.7   established patient," "delivery, antepartum, and postpartum 
183.8   care," "critical care," cesarean delivery and pharmacologic 
183.9   management provided to psychiatric patients, and level three 
183.10  codes for enhanced services for prenatal high risk, shall be 
183.11  paid at the lower of (i) submitted charges, or (ii) 25 percent 
183.12  above the rate in effect on June 30, 1992.  If the rate on any 
183.13  procedure code within these categories is different than the 
183.14  rate that would have been paid under the methodology in section 
183.15  256B.74, subdivision 2, then the larger rate shall be paid; 
183.16     (2) payments for all other services shall be paid at the 
183.17  lower of (i) submitted charges, or (ii) 15.4 percent above the 
183.18  rate in effect on June 30, 1992; 
183.19     (3) all physician rates shall be converted from the 50th 
183.20  percentile of 1982 to the 50th percentile of 1989, less the 
183.21  percent in aggregate necessary to equal the above increases 
183.22  except that payment rates for home health agency services shall 
183.23  be the rates in effect on September 30, 1992; 
183.24     (4) effective for services rendered on or after January 1, 
183.25  2000, payment rates for physician and professional services 
183.26  shall be increased by three percent over the rates in effect on 
183.27  December 31, 1999, except for home health agency and family 
183.28  planning agency services; and 
183.29     (5) the increases in clause (4) shall be implemented 
183.30  January 1, 2000, for managed care. 
183.31     (b) Effective for services rendered on or after October 1, 
183.32  1992, the commissioner shall make payments for dental services 
183.33  as follows: 
183.34     (1) dental services shall be paid at the lower of (i) 
183.35  submitted charges, or (ii) 25 percent above the rate in effect 
183.36  on June 30, 1992; 
184.1      (2) dental rates shall be converted from the 50th 
184.2   percentile of 1982 to the 50th percentile of 1989, less the 
184.3   percent in aggregate necessary to equal the above increases; 
184.4      (3) effective for services rendered on or after January 1, 
184.5   2000, payment rates for dental services shall be increased by 
184.6   three percent over the rates in effect on December 31, 1999; 
184.7      (4) the commissioner shall award grants to community 
184.8   clinics or other nonprofit community organizations, political 
184.9   subdivisions, professional associations, or other organizations 
184.10  that demonstrate the ability to provide dental services 
184.11  effectively to public program recipients.  Grants may be used to 
184.12  fund the costs related to coordinating access for recipients, 
184.13  developing and implementing patient care criteria, upgrading or 
184.14  establishing new facilities, acquiring furnishings or equipment, 
184.15  recruiting new providers, or other development costs that will 
184.16  improve access to dental care in a region.  In awarding grants, 
184.17  the commissioner shall give priority to applicants that plan to 
184.18  serve areas of the state in which the number of dental providers 
184.19  is not currently sufficient to meet the needs of recipients of 
184.20  public programs or uninsured individuals.  The commissioner 
184.21  shall consider the following in awarding the grants: 
184.22     (i) potential to successfully increase access to an 
184.23  underserved population; 
184.24     (ii) the ability to raise matching funds; 
184.25     (iii) the long-term viability of the project to improve 
184.26  access beyond the period of initial funding; 
184.27     (iv) the efficiency in the use of the funding; and 
184.28     (v) the experience of the proposers in providing services 
184.29  to the target population. 
184.30     The commissioner shall monitor the grants and may terminate 
184.31  a grant if the grantee does not increase dental access for 
184.32  public program recipients.  The commissioner shall consider 
184.33  grants for the following: 
184.34     (i) implementation of new programs or continued expansion 
184.35  of current access programs that have demonstrated success in 
184.36  providing dental services in underserved areas; 
185.1      (ii) a pilot program for utilizing hygienists outside of a 
185.2   traditional dental office to provide dental hygiene services; 
185.3   and 
185.4      (iii) a program that organizes a network of volunteer 
185.5   dentists, establishes a system to refer eligible individuals to 
185.6   volunteer dentists, and through that network provides donated 
185.7   dental care services to public program recipients or uninsured 
185.8   individuals; 
185.9      (5) beginning October 1, 1999, the payment for tooth 
185.10  sealants and fluoride treatments shall be the lower of (i) 
185.11  submitted charge, or (ii) 80 percent of median 1997 charges; 
185.12     (6) the increases listed in clauses (3) and (5) shall be 
185.13  implemented January 1, 2000, for managed care; and 
185.14     (7) effective for services provided on or after January 1, 
185.15  2002, payment for diagnostic examinations and dental x-rays 
185.16  provided to children under age 21 shall be the lower of (i) the 
185.17  submitted charge, or (ii) 85 percent of median 1999 charges.  
185.18     (c) Effective for dental services rendered on or after 
185.19  January 1, 2002, the commissioner may, within the limits of 
185.20  available appropriation, increase reimbursements to dentists and 
185.21  dental clinics deemed by the commissioner to be critical access 
185.22  dental providers.  Reimbursement to a critical access dental 
185.23  provider may be increased by not more than 50 percent above the 
185.24  reimbursement rate that would otherwise be paid to the 
185.25  provider.  Payments to health plan companies shall be adjusted 
185.26  to reflect increased reimbursements to critical access dental 
185.27  providers as approved by the commissioner.  In determining which 
185.28  dentists and dental clinics shall be deemed critical access 
185.29  dental providers, the commissioner shall review: 
185.30     (1) the utilization rate in the service area in which the 
185.31  dentist or dental clinic operates for dental services to 
185.32  patients covered by medical assistance, general assistance 
185.33  medical care, or MinnesotaCare as their primary source of 
185.34  coverage; 
185.35     (2) the level of services provided by the dentist or dental 
185.36  clinic to patients covered by medical assistance, general 
186.1   assistance medical care, or MinnesotaCare as their primary 
186.2   source of coverage; and 
186.3      (3) whether the level of services provided by the dentist 
186.4   or dental clinic is critical to maintaining adequate levels of 
186.5   patient access within the service area. 
186.6   In the absence of a critical access dental provider in a service 
186.7   area, the commissioner may designate a dentist or dental clinic 
186.8   as a critical access dental provider if the dentist or dental 
186.9   clinic is willing to provide care to patients covered by medical 
186.10  assistance, general assistance medical care, or MinnesotaCare at 
186.11  a level which significantly increases access to dental care in 
186.12  the service area. 
186.13     (d) Effective July 1, 2001, the medical assistance rates 
186.14  for outpatient mental health services provided by an entity that 
186.15  operates: 
186.16     (1) a Medicare-certified comprehensive outpatient 
186.17  rehabilitation facility; and 
186.18     (2) a facility that was certified prior to January 1, 1993, 
186.19  with at least 33 percent of the clients receiving rehabilitation 
186.20  services in the most recent calendar year who are medical 
186.21  assistance recipients, will be increased by 38 percent, when 
186.22  those services are provided within the comprehensive outpatient 
186.23  rehabilitation facility and provided to residents of nursing 
186.24  facilities owned by the entity. 
186.25     (e) An entity that operates both a Medicare certified 
186.26  comprehensive outpatient rehabilitation facility and a facility 
186.27  which was certified prior to January 1, 1993, that is licensed 
186.28  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
186.29  whom at least 33 percent of the clients receiving rehabilitation 
186.30  services in the most recent calendar year are medical assistance 
186.31  recipients, shall be reimbursed by the commissioner for 
186.32  rehabilitation services at rates that are 38 percent greater 
186.33  than the maximum reimbursement rate allowed under paragraph (a), 
186.34  clause (2), when those services are (1) provided within the 
186.35  comprehensive outpatient rehabilitation facility and (2) 
186.36  provided to residents of nursing facilities owned by the entity. 
187.1      (f) Effective for services rendered on or after January 1, 
187.2   2007, the commissioner shall make payments for physician and 
187.3   professional services based on the Medicare relative value units 
187.4   (RVUs).  This change shall be budget neutral and the cost of 
187.5   implementing RVUs will be incorporated in the established 
187.6   conversion factor. 
187.7      Sec. 42.  Minnesota Statutes 2002, section 256D.03, 
187.8   subdivision 3, is amended to read: 
187.9      Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
187.10  (a) General assistance medical care may be paid for any person 
187.11  who is not eligible for medical assistance under chapter 256B, 
187.12  including eligibility for medical assistance based on a 
187.13  spenddown of excess income according to section 256B.056, 
187.14  subdivision 5, or MinnesotaCare as defined in paragraph (b), 
187.15  except as provided in paragraph (c);, and: 
187.16     (1) who is receiving assistance under section 256D.05, 
187.17  except for families with children who are eligible under 
187.18  Minnesota family investment program (MFIP), who is having a 
187.19  payment made on the person's behalf under sections 256I.01 to 
187.20  256I.06, or who resides in group residential housing as defined 
187.21  in chapter 256I and can meet a spenddown using the cost of 
187.22  remedial services received through group residential housing; or 
187.23     (2)(i) who is a resident of Minnesota; and whose equity in 
187.24  assets is not in excess of $1,000 per assistance unit the limits 
187.25  in section 256B.056, subdivision 3c.  Exempt assets, the 
187.26  reduction of excess assets, and the waiver of excess assets must 
187.27  conform to the medical assistance program in chapter 256B, with 
187.28  the following exception:  the maximum amount of undistributed 
187.29  funds in a trust that could be distributed to or on behalf of 
187.30  the beneficiary by the trustee, assuming the full exercise of 
187.31  the trustee's discretion under the terms of the trust, must be 
187.32  applied toward the asset maximum; and 
187.33     (ii) (2) who has gross countable income not in excess of 
187.34  the assistance standards established in section 256B.056, 
187.35  subdivision 5c, paragraph (b), or whose excess income is spent 
187.36  down to that standard using a six-month budget period.  The 
188.1   method for calculating earned income disregards and deductions 
188.2   for a person who resides with a dependent child under age 21 
188.3   shall follow the AFDC income disregard and deductions in effect 
188.4   under the July 16, 1996, AFDC state plan.  The earned income and 
188.5   work expense deductions for a person who does not reside with a 
188.6   dependent child under age 21 shall be the same as the method 
188.7   used to determine eligibility for a person under section 
188.8   256D.06, subdivision 1, except the disregard of the first $50 of 
188.9   earned income is not allowed; 
188.10     (3) who would be eligible for medical assistance except 
188.11  that the person resides in a facility that is determined by the 
188.12  commissioner or the federal Centers for Medicare and Medicaid 
188.13  Services to be an institution for mental diseases; or 
188.14     (4) who is ineligible for medical assistance under chapter 
188.15  256B or general assistance medical care under any other 
188.16  provision of this section, and is receiving care and 
188.17  rehabilitation services from a nonprofit center established to 
188.18  serve victims of torture.  These individuals are eligible for 
188.19  general assistance medical care only for the period during which 
188.20  they are receiving services from the center.  During this period 
188.21  of eligibility, individuals eligible under this clause shall not 
188.22  be required to participate in prepaid general assistance medical 
188.23  care 75 percent of the federal poverty guidelines for the family 
188.24  size in effect on October 1, 2003.  
188.25     (b) Beginning January 1, 2000, applicants or recipients who 
188.26  meet all eligibility requirements of MinnesotaCare as defined in 
188.27  sections 256L.01 to 256L.16, and are: 
188.28     (i) adults with dependent children under 21 whose gross 
188.29  family income is equal to or less than 275 percent of the 
188.30  federal poverty guidelines; or 
188.31     (ii) adults without children with earned income and whose 
188.32  family gross income is between equal to or less than 75 percent 
188.33  of the federal poverty guidelines and the amount set by section 
188.34  256L.04, subdivision 7 in effect on October 1, 2003, shall be 
188.35  terminated from general assistance medical care upon enrollment 
188.36  in MinnesotaCare.  Earned income is deemed available to family 
189.1   members as defined in section 256D.02, subdivision 8. 
189.2      (c) For services rendered on or after July 1, 1997, 
189.3   eligibility is limited to one month prior to application if the 
189.4   person is determined eligible in the prior month applications 
189.5   received on or after October 1, 2003, eligibility may begin no 
189.6   earlier than the date of application.  A redetermination of 
189.7   eligibility must occur every 12 months.  Beginning January 1, 
189.8   2000, Minnesota health care program applications completed by 
189.9   recipients and applicants who are persons described in paragraph 
189.10  (b), may be returned to the county agency to be forwarded to the 
189.11  department of human services or sent directly to the department 
189.12  of human services for enrollment in MinnesotaCare.  If all other 
189.13  eligibility requirements of this subdivision are met, 
189.14  eligibility for general assistance medical care shall be 
189.15  available in any month during which a MinnesotaCare eligibility 
189.16  determination and enrollment are pending.  Upon notification of 
189.17  eligibility for MinnesotaCare, notice of termination for 
189.18  eligibility for general assistance medical care shall be sent to 
189.19  an applicant or recipient.  If all other eligibility 
189.20  requirements of this subdivision are met, eligibility for 
189.21  general assistance medical care shall be available until 
189.22  enrollment in MinnesotaCare subject to the provisions of 
189.23  paragraph (e). 
189.24     (d) The date of an initial Minnesota health care program 
189.25  application necessary to begin a determination of eligibility 
189.26  shall be the date the applicant has provided a name, address, 
189.27  and social security number, signed and dated, to the county 
189.28  agency or the department of human services.  If the applicant is 
189.29  unable to provide an initial application when health care is 
189.30  delivered due to a medical condition or disability, a health 
189.31  care provider may act on the person's behalf to complete the 
189.32  initial application.  The applicant must complete the remainder 
189.33  of the application and provide necessary verification before 
189.34  eligibility can be determined.  The county agency must assist 
189.35  the applicant in obtaining verification if necessary.  On the 
189.36  basis of information provided on the completed application, an 
190.1   applicant who meets the following criteria shall be determined 
190.2   eligible beginning in the month of application: 
190.3      (1) has gross income less than 90 percent of the applicable 
190.4   income standard; 
190.5      (2) has liquid assets that total within $300 of the asset 
190.6   standard; 
190.7      (3) does not reside in a long-term care facility; and 
190.8      (4) meets all other eligibility requirements. 
190.9   The applicant must provide all required verifications within 30 
190.10  days' notice of the eligibility determination or eligibility 
190.11  shall be terminated. 
190.12     (e) County agencies are authorized to use all automated 
190.13  databases containing information regarding recipients' or 
190.14  applicants' income in order to determine eligibility for general 
190.15  assistance medical care or MinnesotaCare.  Such use shall be 
190.16  considered sufficient in order to determine eligibility and 
190.17  premium payments by the county agency. 
190.18     (f) General assistance medical care is not available for a 
190.19  person in a correctional facility unless the person is detained 
190.20  by law for less than one year in a county correctional or 
190.21  detention facility as a person accused or convicted of a crime, 
190.22  or admitted as an inpatient to a hospital on a criminal hold 
190.23  order, and the person is a recipient of general assistance 
190.24  medical care at the time the person is detained by law or 
190.25  admitted on a criminal hold order and as long as the person 
190.26  continues to meet other eligibility requirements of this 
190.27  subdivision.  
190.28     (g) General assistance medical care is not available for 
190.29  applicants or recipients who do not cooperate with the county 
190.30  agency to meet the requirements of medical assistance.  General 
190.31  assistance medical care is limited to payment of emergency 
190.32  services only for applicants or recipients as described in 
190.33  paragraph (b), whose MinnesotaCare coverage is denied or 
190.34  terminated for nonpayment of premiums as required by sections 
190.35  256L.06 and 256L.07.  
190.36     (h) In determining the amount of assets of an individual, 
191.1   there shall be included any asset or interest in an asset, 
191.2   including an asset excluded under paragraph (a), that was given 
191.3   away, sold, or disposed of for less than fair market value 
191.4   within the 60 months preceding application for general 
191.5   assistance medical care or during the period of eligibility.  
191.6   Any transfer described in this paragraph shall be presumed to 
191.7   have been for the purpose of establishing eligibility for 
191.8   general assistance medical care, unless the individual furnishes 
191.9   convincing evidence to establish that the transaction was 
191.10  exclusively for another purpose.  For purposes of this 
191.11  paragraph, the value of the asset or interest shall be the fair 
191.12  market value at the time it was given away, sold, or disposed 
191.13  of, less the amount of compensation received.  For any 
191.14  uncompensated transfer, the number of months of ineligibility, 
191.15  including partial months, shall be calculated by dividing the 
191.16  uncompensated transfer amount by the average monthly per person 
191.17  payment made by the medical assistance program to skilled 
191.18  nursing facilities for the previous calendar year.  The 
191.19  individual shall remain ineligible until this fixed period has 
191.20  expired.  The period of ineligibility may exceed 30 months, and 
191.21  a reapplication for benefits after 30 months from the date of 
191.22  the transfer shall not result in eligibility unless and until 
191.23  the period of ineligibility has expired.  The period of 
191.24  ineligibility begins in the month the transfer was reported to 
191.25  the county agency, or if the transfer was not reported, the 
191.26  month in which the county agency discovered the transfer, 
191.27  whichever comes first.  For applicants, the period of 
191.28  ineligibility begins on the date of the first approved 
191.29  application. 
191.30     (i) When determining eligibility for any state benefits 
191.31  under this subdivision, the income and resources of all 
191.32  noncitizens shall be deemed to include their sponsor's income 
191.33  and resources as defined in the Personal Responsibility and Work 
191.34  Opportunity Reconciliation Act of 1996, title IV, Public Law 
191.35  Number 104-193, sections 421 and 422, and subsequently set out 
191.36  in federal rules. 
192.1      (j)(1) An Undocumented noncitizen or a nonimmigrant 
192.2   is noncitizens and nonimmigrants are ineligible for general 
192.3   assistance medical care other than emergency services, except 
192.4   for an individual eligible under paragraph (a), clause (4).  For 
192.5   purposes of this subdivision, a nonimmigrant is an individual in 
192.6   one or more of the classes listed in United States Code, title 
192.7   8, section 1101(a)(15), and an undocumented noncitizen is an 
192.8   individual who resides in the United States without the approval 
192.9   or acquiescence of the Immigration and Naturalization Service. 
192.10     (2) This paragraph does not apply to a child under age 18, 
192.11  to a Cuban or Haitian entrant as defined in Public Law Number 
192.12  96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 
192.13  aged, blind, or disabled as defined in Code of Federal 
192.14  Regulations, title 42, sections 435.520, 435.530, 435.531, 
192.15  435.540, and 435.541, or effective October 1, 1998, to an 
192.16  individual eligible for general assistance medical care under 
192.17  paragraph (a), clause (4), who cooperates with the Immigration 
192.18  and Naturalization Service to pursue any applicable immigration 
192.19  status, including citizenship, that would qualify the individual 
192.20  for medical assistance with federal financial participation. 
192.21     (k) For purposes of paragraphs (g) and (j), "emergency 
192.22  services" has the meaning given in Code of Federal Regulations, 
192.23  title 42, section 440.255(b)(1), except that it also means 
192.24  services rendered because of suspected or actual pesticide 
192.25  poisoning.  
192.26     (l) Notwithstanding any other provision of law, a 
192.27  noncitizen who is ineligible for medical assistance due to the 
192.28  deeming of a sponsor's income and resources, is ineligible for 
192.29  general assistance medical care. 
192.30     (m) Effective July 1, 2003, general assistance medical care 
192.31  emergency services end.  Effective October 1, 2004, the general 
192.32  assistance medical care program ends.  Persons enrolled in 
192.33  general assistance medical care as of September 30, 2004, will 
192.34  be converted to MinnesotaCare if they meet all the requirements 
192.35  of chapter 256L.  
192.36     <b>[EFFECTIVE DATE.]</b> (a) The amendments to paragraphs (a), 
193.1   clauses (1) to (4), and (b) and (c), are effective October 1, 
193.2   2003. 
193.3      (b) The amendment to paragraph (d) is effective April 1, 
193.4   2005, if the HealthMatch system is operational.  If the 
193.5   HealthMatch system is not operational on April 1, 2005, then the 
193.6   amendment to paragraph (d) is effective July 1, 2005. 
193.7      (c) The amendments to paragraphs (j), (g), and (k), are 
193.8   effective July 1, 2003. 
193.9      Sec. 43.  Minnesota Statutes 2002, section 256D.03, 
193.10  subdivision 4, is amended to read: 
193.11     Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
193.12  For a person who is eligible under subdivision 3, paragraph (a), 
193.13  clause (3), general assistance medical care covers, except as 
193.14  provided in paragraph (c): 
193.15     (1) inpatient hospital services; 
193.16     (2) outpatient hospital services; 
193.17     (3) services provided by Medicare certified rehabilitation 
193.18  agencies; 
193.19     (4) prescription drugs and other products recommended 
193.20  through the process established in section 256B.0625, 
193.21  subdivision 13; 
193.22     (5) equipment necessary to administer insulin and 
193.23  diagnostic supplies and equipment for diabetics to monitor blood 
193.24  sugar level; 
193.25     (6) eyeglasses and eye examinations provided by a physician 
193.26  or optometrist; 
193.27     (7) hearing aids; 
193.28     (8) prosthetic devices; 
193.29     (9) laboratory and X-ray services; 
193.30     (10) physician's services; 
193.31     (11) medical transportation; 
193.32     (12) chiropractic services as covered under the medical 
193.33  assistance program; 
193.34     (13) podiatric services; 
193.35     (14) dental services; 
193.36     (15) outpatient services provided by a mental health center 
194.1   or clinic that is under contract with the county board and is 
194.2   established under section 245.62; 
194.3      (16) day treatment services for mental illness provided 
194.4   under contract with the county board; 
194.5      (17) prescribed medications for persons who have been 
194.6   diagnosed as mentally ill as necessary to prevent more 
194.7   restrictive institutionalization; 
194.8      (18) psychological services, medical supplies and 
194.9   equipment, and Medicare premiums, coinsurance and deductible 
194.10  payments; 
194.11     (19) medical equipment not specifically listed in this 
194.12  paragraph when the use of the equipment will prevent the need 
194.13  for costlier services that are reimbursable under this 
194.14  subdivision; 
194.15     (20) services performed by a certified pediatric nurse 
194.16  practitioner, a certified family nurse practitioner, a certified 
194.17  adult nurse practitioner, a certified obstetric/gynecological 
194.18  nurse practitioner, a certified neonatal nurse practitioner, or 
194.19  a certified geriatric nurse practitioner in independent 
194.20  practice, if (1) the service is otherwise covered under this 
194.21  chapter as a physician service, (2) the service provided on an 
194.22  inpatient basis is not included as part of the cost for 
194.23  inpatient services included in the operating payment rate, and 
194.24  (3) the service is within the scope of practice of the nurse 
194.25  practitioner's license as a registered nurse, as defined in 
194.26  section 148.171; 
194.27     (21) services of a certified public health nurse or a 
194.28  registered nurse practicing in a public health nursing clinic 
194.29  that is a department of, or that operates under the direct 
194.30  authority of, a unit of government, if the service is within the 
194.31  scope of practice of the public health nurse's license as a 
194.32  registered nurse, as defined in section 148.171; and 
194.33     (22) telemedicine consultations, to the extent they are 
194.34  covered under section 256B.0625, subdivision 3b.  
194.35     (b) Except as provided in paragraph (c), for a recipient 
194.36  who is eligible under subdivision 3, paragraph (a), clause (1) 
195.1   or (2), general assistance medical care covers the services 
195.2   listed in paragraph (a) with the exception of special 
195.3   transportation services. 
195.4      (c) Gender reassignment surgery and related services are 
195.5   not covered services under this subdivision unless the 
195.6   individual began receiving gender reassignment services prior to 
195.7   July 1, 1995.  
195.8      (d) In order to contain costs, the commissioner of human 
195.9   services shall select vendors of medical care who can provide 
195.10  the most economical care consistent with high medical standards 
195.11  and shall where possible contract with organizations on a 
195.12  prepaid capitation basis to provide these services.  The 
195.13  commissioner shall consider proposals by counties and vendors 
195.14  for prepaid health plans, competitive bidding programs, block 
195.15  grants, or other vendor payment mechanisms designed to provide 
195.16  services in an economical manner or to control utilization, with 
195.17  safeguards to ensure that necessary services are provided.  
195.18  Before implementing prepaid programs in counties with a county 
195.19  operated or affiliated public teaching hospital or a hospital or 
195.20  clinic operated by the University of Minnesota, the commissioner 
195.21  shall consider the risks the prepaid program creates for the 
195.22  hospital and allow the county or hospital the opportunity to 
195.23  participate in the program in a manner that reflects the risk of 
195.24  adverse selection and the nature of the patients served by the 
195.25  hospital, provided the terms of participation in the program are 
195.26  competitive with the terms of other participants considering the 
195.27  nature of the population served.  Payment for services provided 
195.28  pursuant to this subdivision shall be as provided to medical 
195.29  assistance vendors of these services under sections 256B.02, 
195.30  subdivision 8, and 256B.0625.  For payments made during fiscal 
195.31  year 1990 and later years, the commissioner shall consult with 
195.32  an independent actuary in establishing prepayment rates, but 
195.33  shall retain final control over the rate methodology.  
195.34  Notwithstanding the provisions of subdivision 3, an individual 
195.35  who becomes ineligible for general assistance medical care 
195.36  because of failure to submit income reports or recertification 
196.1   forms in a timely manner, shall remain enrolled in the prepaid 
196.2   health plan and shall remain eligible for general assistance 
196.3   medical care coverage through the last day of the month in which 
196.4   the enrollee became ineligible for general assistance medical 
196.5   care. 
196.6      (e) There shall be no copayment required of any recipient 
196.7   of benefits for any services provided under this subdivision.  A 
196.8   hospital receiving a reduced payment as a result of this section 
196.9   may apply the unpaid balance toward satisfaction of the 
196.10  hospital's bad debts. 
196.11     (f) Any county may, from its own resources, provide medical 
196.12  payments for which state payments are not made. 
196.13     (g) Chemical dependency services that are reimbursed under 
196.14  chapter 254B must not be reimbursed under general assistance 
196.15  medical care. 
196.16     (h) The maximum payment for new vendors enrolled in the 
196.17  general assistance medical care program after the base year 
196.18  shall be determined from the average usual and customary charge 
196.19  of the same vendor type enrolled in the base year. 
196.20     (i) The conditions of payment for services under this 
196.21  subdivision are the same as the conditions specified in rules 
196.22  adopted under chapter 256B governing the medical assistance 
196.23  program, unless otherwise provided by statute or rule. 
196.24     Sec. 44.  [256D.031] [GAMC CO-PAYMENTS AND COINSURANCE.] 
196.25     Subdivision 1.  [CO-PAYMENTS AND COINSURANCE.] (a) Except 
196.26  as provided in subdivision 2, the general assistance medical 
196.27  care benefit plan under section 256D.03, subdivision 3, shall 
196.28  include the following co-payments for all recipients effective 
196.29  for services provided on or after October 1, 2003: 
196.30     (1) $3 per nonpreventive visit.  For purposes of this 
196.31  subdivision, a visit means an episode of service which is 
196.32  required because of a recipient's symptoms, diagnosis, or 
196.33  established illness, and which is delivered in an ambulatory 
196.34  setting by a physician or physician ancillary, dentist, 
196.35  chiropractor, podiatrist, nurse midwife, mental health 
196.36  professional, advanced practice nurse, physical therapist, 
197.1   occupational therapist, speech therapist, audiologist, optician, 
197.2   or optometrist; 
197.3      (2) $3 for eyeglasses; 
197.4      (3) $6 for nonemergency visits to a hospital-based 
197.5   emergency room; and 
197.6      (4) $3 per brand-name drug prescription and $1 per generic 
197.7   drug prescription. 
197.8      (b) Recipients of general assistance medical care are 
197.9   responsible for all co-payments in this subdivision. 
197.10     Subd. 2.  [EXCEPTIONS.] Co-payments shall be subject to the 
197.11  following exceptions: 
197.12     (1) children under the age of 21; 
197.13     (2) pregnant women for services that relate to the 
197.14  pregnancy or any other medical condition that may complicate the 
197.15  pregnancy; 
197.16     (3) recipients expected to reside for at least 30 days in a 
197.17  hospital, nursing home, or intermediate care facility for the 
197.18  mentally retarded; 
197.19     (4) recipients receiving hospice care; 
197.20     (5) 100 percent federally funded services provided by an 
197.21  Indian health service; 
197.22     (6) emergency services; 
197.23     (7) family planning services; 
197.24     (8) services that are paid by Medicare, resulting in the 
197.25  medical assistance program paying for the coinsurance and 
197.26  deductible; and 
197.27     (9) co-payments that exceed one per day per provider for 
197.28  nonpreventive office visits, eyeglasses, and nonemergency visits 
197.29  to a hospital-based emergency room. 
197.30     Subd. 3.  [COLLECTION.] The general assistance medical care 
197.31  reimbursement to the provider shall be reduced by the amount of 
197.32  the co-payment.  The provider collects the co-payment from the 
197.33  recipient.  Providers may not deny services to individuals who 
197.34  are unable to pay the co-payment.  Providers must accept an 
197.35  assertion from the recipient that they are unable to pay. 
197.36     Sec. 45.  Minnesota Statutes 2002, section 256G.05, 
198.1   subdivision 2, is amended to read: 
198.2      Subd. 2.  [NON-MINNESOTA RESIDENTS.] State residence is not 
198.3   required for receiving emergency assistance in the Minnesota 
198.4   supplemental aid program.  The receipt of emergency assistance 
198.5   must not be used as a factor in determining county or state 
198.6   residence.  Non-Minnesota residents are not eligible for 
198.7   emergency general assistance medical care, except emergency 
198.8   hospital services, and professional services incident to the 
198.9   hospital services, for the treatment of acute trauma resulting 
198.10  from an accident occurring in Minnesota.  To be eligible under 
198.11  this subdivision a non-Minnesota resident must verify that they 
198.12  are not eligible for coverage under any other health care 
198.13  program, including coverage from a program in their state of 
198.14  residence. 
198.15     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
198.16     Sec. 46.  Minnesota Statutes 2002, section 256L.02, is 
198.17  amended by adding a subdivision to read: 
198.18     Subd. 3a.  [FUNDING SOURCE.] Beginning July 1, 2005, all 
198.19  MinnesotaCare obligations shall be funded out of the general 
198.20  fund. 
198.21     Sec. 47.  Minnesota Statutes 2002, section 256L.03, 
198.22  subdivision 3, is amended to read: 
198.23     Subd. 3.  [INPATIENT HOSPITAL SERVICES.] (a) Covered health 
198.24  services shall include inpatient hospital services, including 
198.25  inpatient hospital mental health services and inpatient hospital 
198.26  and residential chemical dependency treatment, subject to those 
198.27  limitations necessary to coordinate the provision of these 
198.28  services with eligibility under the medical assistance 
198.29  spenddown.  Prior to July 1, 1997, the inpatient hospital 
198.30  benefit for adult enrollees is subject to an annual benefit 
198.31  limit of $10,000.  The inpatient hospital benefit for adult 
198.32  enrollees who qualify under section 256L.04, subdivision 7, or 
198.33  who qualify under section 256L.04, subdivisions 1 and 2, with 
198.34  family gross income that exceeds 175 percent of the federal 
198.35  poverty guidelines and who are not pregnant, is subject to an 
198.36  annual limit of $10,000.  For services provided on or after 
199.1   October 1, 2004, the annual limit of $10,000 does not apply to 
199.2   adults who qualify under section 256L.04, subdivision 7, whose 
199.3   gross income is at or below 75 percent of the federal poverty 
199.4   guidelines.  
199.5      (b) Admissions for inpatient hospital services paid for 
199.6   under section 256L.11, subdivision 3, must be certified as 
199.7   medically necessary in accordance with Minnesota Rules, parts 
199.8   9505.0500 to 9505.0540, except as provided in clauses (1) and 
199.9   (2): 
199.10     (1) all admissions must be certified, except those 
199.11  authorized under rules established under section 254A.03, 
199.12  subdivision 3, or approved under Medicare; and 
199.13     (2) payment under section 256L.11, subdivision 3, shall be 
199.14  reduced by five percent for admissions for which certification 
199.15  is requested more than 30 days after the day of admission.  The 
199.16  hospital may not seek payment from the enrollee for the amount 
199.17  of the payment reduction under this clause. 
199.18     Sec. 48.  Minnesota Statutes 2002, section 256L.03, 
199.19  subdivision 5, is amended to read: 
199.20     Subd. 5.  [COPAYMENTS AND COINSURANCE.] (a) Except as 
199.21  provided in paragraphs (b) and (c), the MinnesotaCare benefit 
199.22  plan shall include the following copayments and coinsurance 
199.23  requirements for all enrollees effective for services provided 
199.24  on or after October 1, 2003:  
199.25     (1) ten percent of the paid charges for inpatient hospital 
199.26  services for adult enrollees, subject to an annual inpatient 
199.27  out-of-pocket maximum of $1,000 per individual and $3,000 per 
199.28  family; 
199.29     (2) $3 per prescription for adult enrollees nonpreventive 
199.30  visit.  For purposes of this subdivision, a visit means an 
199.31  episode of service which is required because of a recipient's 
199.32  symptoms, diagnosis, or established illness, and which is 
199.33  delivered in an ambulatory setting by a physician or physician 
199.34  ancillary, dentist, chiropractor, podiatrist, nurse, midwife, 
199.35  mental health professional, advanced practice nurse, physical 
199.36  therapist, occupational therapist, speech therapist, 
200.1   audiologist, optician, or optometrist; 
200.2      (3) $25 for eyeglasses for adult enrollees; and 
200.3      (4) $6 for nonemergency visits to a hospital-based 
200.4   emergency room; 
200.5      (5) $3 per prescription; and 
200.6      (6) 50 percent of the fee-for-service rate for adult dental 
200.7   care services other than preventive care services for persons 
200.8   eligible under section 256L.04 256L.05, subdivisions 1 to 7, 
200.9   with income equal to or less than 175 percent of the federal 
200.10  poverty guidelines. 
200.11     (b) Paragraph (a), clause (1), does not apply to parents 
200.12  and relative caretakers of children under the age of 21 in 
200.13  households with family income equal to or less than 175 percent 
200.14  of the federal poverty guidelines.  Paragraph (a), clause (1), 
200.15  does not apply to parents and relative caretakers of children 
200.16  under the age of 21 in households with family income greater 
200.17  than 175 percent of the federal poverty guidelines for inpatient 
200.18  hospital admissions occurring on or after January 1, 
200.19  2001.  Effective for services provided on or after October 1, 
200.20  2004, paragraph (a), clause (1), does not apply to single adults 
200.21  and households without children whose gross income is at or 
200.22  below 75 percent of the federal poverty guidelines. 
200.23     (c) Paragraph (a), clauses (1) to (4) (6), do not apply to 
200.24  pregnant women and children under the age of 21.: 
200.25     (1) children under the age of 21; 
200.26     (2) pregnant women for services that relate to the 
200.27  pregnancy or any other medical condition that may complicate the 
200.28  pregnancy; 
200.29     (3) enrollees expected to reside for at least 30 days in a 
200.30  hospital, nursing home, or intermediate care facility for the 
200.31  mentally retarded; 
200.32     (4) enrollees receiving hospice care; 
200.33     (5) 100 percent federally funded services provided by an 
200.34  Indian Health Service; 
200.35     (6) emergency services; 
200.36     (7) family planning services; 
201.1      (8) services that are paid by Medicare, resulting in the 
201.2   medical assistance program paying for the coinsurance and 
201.3   deductible; and 
201.4      (9) co-payments that exceed one per day per provider for 
201.5   nonpreventive office visits, eyeglasses, and nonemergency visits 
201.6   to a hospital emergency room. 
201.7      (d) Adult enrollees with family gross income that exceeds 
201.8   175 percent of the federal poverty guidelines and who are not 
201.9   pregnant shall be financially responsible for the coinsurance 
201.10  amount, if applicable, and amounts which exceed the $10,000 
201.11  inpatient hospital benefit limit. 
201.12     (e) When a MinnesotaCare enrollee becomes a member of a 
201.13  prepaid health plan, or changes from one prepaid health plan to 
201.14  another during a calendar year, any charges submitted towards 
201.15  the $10,000 annual inpatient benefit limit, and any 
201.16  out-of-pocket expenses incurred by the enrollee for inpatient 
201.17  services, that were submitted or incurred prior to enrollment, 
201.18  or prior to the change in health plans, shall be disregarded. 
201.19     (f) Enrollees are responsible for all co-payments and 
201.20  coinsurance in this subdivision. 
201.21     (g) The MinnesotaCare reimbursement to the provider shall 
201.22  be reduced by the amount of the co-payment.  The provider 
201.23  collects the co-payment from the recipient.  Providers may not 
201.24  deny services to individuals who are unable to pay the 
201.25  co-payment.  Providers must accept an assertion from the 
201.26  recipient that they are unable to pay. 
201.27     Sec. 49.  Minnesota Statutes 2002, section 256L.04, 
201.28  subdivision 1, is amended to read: 
201.29     Subdivision 1.  [FAMILIES WITH CHILDREN.] (a) Families with 
201.30  children with family income equal to or less than 275 percent of 
201.31  the federal poverty guidelines for the applicable family size 
201.32  shall be eligible for MinnesotaCare according to this section.  
201.33  All other provisions of sections 256L.01 to 256L.18, including 
201.34  the insurance-related barriers to enrollment under section 
201.35  256L.07, shall apply unless otherwise specified. 
201.36     (b) Parents who enroll in the MinnesotaCare program must 
202.1   also enroll their children and dependent siblings, if the 
202.2   children and their dependent siblings are eligible.  Children 
202.3   and dependent siblings may be enrolled separately without 
202.4   enrollment by parents.  However, if one parent in the household 
202.5   enrolls, both parents must enroll, unless other insurance is 
202.6   available.  If one child from a family is enrolled, all children 
202.7   must be enrolled, unless other insurance is available.  If one 
202.8   spouse in a household enrolls, the other spouse in the household 
202.9   must also enroll, unless other insurance is available.  Families 
202.10  cannot choose to enroll only certain uninsured members.  
202.11     (c) Beginning February 1, 2004, the dependent sibling 
202.12  definition no longer applies to the MinnesotaCare program.  
202.13  These persons are no longer counted in the parental household 
202.14  and may apply as a separate household. 
202.15     <b>[EFFECTIVE DATE.]</b> This section is effective February 1, 
202.16  2004. 
202.17     Sec. 50.  Minnesota Statutes 2002, section 256L.05, 
202.18  subdivision 1, is amended to read: 
202.19     Subdivision 1.  [APPLICATION AND INFORMATION AVAILABILITY.] 
202.20  Applications and other information must be made available to 
202.21  provider offices, local human services agencies, school 
202.22  districts, public and private elementary schools in which 25 
202.23  percent or more of the students receive free or reduced price 
202.24  lunches, community health offices, and Women, Infants and 
202.25  Children (WIC) program sites.  These sites may accept 
202.26  applications and forward the forms to the commissioner.  
202.27  Otherwise, applicants may apply directly to the commissioner.  
202.28  Beginning January 1, 2000, MinnesotaCare enrollment sites will 
202.29  be expanded to include local county human services agencies 
202.30  which choose to participate.  Beginning October 1, 2004, all 
202.31  local county human service agencies must accept and process 
202.32  applications and renewals for single adults and households 
202.33  without children with income at or below 75 percent of the 
202.34  federal poverty guidelines who choose to have the county 
202.35  administer their case. 
202.36     Sec. 51.  Minnesota Statutes 2002, section 256L.05, 
203.1   subdivision 3, is amended to read: 
203.2      Subd. 3.  [EFFECTIVE DATE OF COVERAGE.] (a) The effective 
203.3   date of coverage is the first day of the month following the 
203.4   month in which eligibility is approved and the first premium 
203.5   payment has been received.  As provided in section 256B.057, 
203.6   coverage for newborns is automatic from the date of birth and 
203.7   must be coordinated with other health coverage.  The effective 
203.8   date of coverage for eligible newly adoptive children added to a 
203.9   family receiving covered health services is the date of entry 
203.10  into the family.  The effective date of coverage for other new 
203.11  recipients added to the family receiving covered health services 
203.12  is the first day of the month following the month in which 
203.13  eligibility is approved or at renewal, whichever the family 
203.14  receiving covered health services prefers.  All eligibility 
203.15  criteria must be met by the family at the time the new family 
203.16  member is added.  The income of the new family member is 
203.17  included with the family's gross income and the adjusted premium 
203.18  begins in the month the new family member is added.  
203.19     (b) The initial premium must be received by the last 
203.20  working day of the month for coverage to begin the first day of 
203.21  the following month.  
203.22     (c) Benefits are not available until the day following 
203.23  discharge if an enrollee is hospitalized on the first day of 
203.24  coverage.  
203.25     (d) Notwithstanding any other law to the contrary, benefits 
203.26  under sections 256L.01 to 256L.18 are secondary to a plan of 
203.27  insurance or benefit program under which an eligible person may 
203.28  have coverage and the commissioner shall use cost avoidance 
203.29  techniques to ensure coordination of any other health coverage 
203.30  for eligible persons.  The commissioner shall identify eligible 
203.31  persons who may have coverage or benefits under other plans of 
203.32  insurance or who become eligible for medical assistance. 
203.33     (e) Notwithstanding paragraphs (a) and (b), effective 
203.34  October 1, 2004, coverage begins for single adults and 
203.35  households without children with gross family income at or below 
203.36  75 percent of the federal poverty guidelines the first day of 
204.1   the month following approval.  
204.2      (f) Effective October 1, 2004, the date of an initial 
204.3   application necessary to begin a determination of eligibility 
204.4   for single adults and households without children with gross 
204.5   family income at or below 75 percent of the federal poverty 
204.6   guidelines shall be the date the applicant has provided a name, 
204.7   address, and social security number, signed and dated, to the 
204.8   county agency or the department of human services.  If the 
204.9   applicant is unable to provide an initial application when 
204.10  health care is delivered due to a medical condition or 
204.11  disability, a health care provider may act on the person's 
204.12  behalf to complete the initial application.  The applicant must 
204.13  complete the remainder of the application and provide necessary 
204.14  verification before eligibility can be determined.  The county 
204.15  agency must assist the applicant in obtaining verification if 
204.16  necessary. 
204.17     Sec. 52.  Minnesota Statutes 2002, section 256L.05, 
204.18  subdivision 3a, is amended to read: 
204.19     Subd. 3a.  [RENEWAL OF ELIGIBILITY.] (a) Beginning January 
204.20  1, 1999, an enrollee's eligibility must be renewed every 12 
204.21  months.  The 12-month period begins in the month after the month 
204.22  the application is approved.  
204.23     (b) Beginning October 1, 2004, an enrollee's eligibility 
204.24  must be renewed every six months.  The first six-month period of 
204.25  eligibility begins in the month after the month the application 
204.26  is approved.  Each new period of eligibility must take into 
204.27  account any changes in circumstances that impact eligibility and 
204.28  premium amount.  An enrollee must provide all the information 
204.29  needed to redetermine eligibility by the first day of the month 
204.30  that ends the eligibility period.  The premium for the new 
204.31  period of eligibility must be received as provided in section 
204.32  256L.06 in order for eligibility to continue. 
204.33     Sec. 53.  Minnesota Statutes 2002, section 256L.05, 
204.34  subdivision 3c, is amended to read: 
204.35     Subd. 3c.  [RETROACTIVE COVERAGE.] Notwithstanding 
204.36  subdivision 3, the effective date of coverage shall be the first 
205.1   day of the month following termination from medical assistance 
205.2   or general assistance medical care for families and individuals 
205.3   who are eligible for MinnesotaCare and who submitted a written 
205.4   request for retroactive MinnesotaCare coverage with a completed 
205.5   application within 30 days of the mailing of notification of 
205.6   termination from medical assistance or general assistance 
205.7   medical care.  The applicant must provide all required 
205.8   verifications within 30 days of the written request for 
205.9   verification.  For retroactive coverage, premiums must be paid 
205.10  in full for any retroactive month, current month, and next month 
205.11  within 30 days of the premium billing. 
205.12     <b>[EFFECTIVE DATE.]</b> This section is effective November 1, 
205.13  2004. 
205.14     Sec. 54.  Minnesota Statutes 2002, section 256L.05, 
205.15  subdivision 4, is amended to read: 
205.16     Subd. 4.  [APPLICATION PROCESSING.] The commissioner of 
205.17  human services shall determine an applicant's eligibility for 
205.18  MinnesotaCare no more than 30 days from the date that the 
205.19  application is received by the department of human services.  
205.20  Beginning January 1, 2000, this requirement also applies to 
205.21  local county human services agencies that determine eligibility 
205.22  for MinnesotaCare.  Once annually at application or 
205.23  reenrollment, to prevent processing delays, applicants or 
205.24  enrollees who, from the information provided on the application, 
205.25  appear to meet eligibility requirements shall be enrolled upon 
205.26  timely payment of premiums.  The enrollee must provide all 
205.27  required verifications within 30 days of notification of the 
205.28  eligibility determination or coverage from the program shall be 
205.29  terminated.  Enrollees who are determined to be ineligible when 
205.30  verifications are provided shall be disenrolled from the program.
205.31     <b>[EFFECTIVE DATE.]</b> This section is effective April 1, 2005, 
205.32  if the HealthMatch system is operational.  If the HealthMatch 
205.33  system is not operational on April 1, 2005, then this section is 
205.34  effective July 1, 2005. 
205.35     Sec. 55.  Minnesota Statutes 2002, section 256L.06, 
205.36  subdivision 3, is amended to read: 
206.1      Subd. 3.  [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 
206.2   are dedicated to the commissioner for MinnesotaCare. 
206.3      (b) The commissioner shall develop and implement procedures 
206.4   to:  (1) require enrollees to report changes in income; (2) 
206.5   adjust sliding scale premium payments, based upon changes in 
206.6   enrollee income; and (3) disenroll enrollees from MinnesotaCare 
206.7   for failure to pay required premiums.  Failure to pay includes 
206.8   payment with a dishonored check, a returned automatic bank 
206.9   withdrawal, or a refused credit card or debit card payment.  The 
206.10  commissioner may demand a guaranteed form of payment, including 
206.11  a cashier's check or a money order, as the only means to replace 
206.12  a dishonored, returned, or refused payment. 
206.13     (c) Premiums are calculated on a calendar month basis and 
206.14  may be paid on a monthly, quarterly, or annual semiannual basis, 
206.15  with the first payment due upon notice from the commissioner of 
206.16  the premium amount required.  The commissioner shall inform 
206.17  applicants and enrollees of these premium payment options. 
206.18  Premium payment is required before enrollment is complete and to 
206.19  maintain eligibility in MinnesotaCare.  Premium payments 
206.20  received before noon are credited the same day.  Premium 
206.21  payments received after noon are credited on the next working 
206.22  day.  
206.23     (d) Nonpayment of the premium will result in disenrollment 
206.24  from the plan effective for the calendar month for which the 
206.25  premium was due.  Persons disenrolled for nonpayment or who 
206.26  voluntarily terminate coverage from the program may not reenroll 
206.27  until four calendar months have elapsed.  Persons disenrolled 
206.28  for nonpayment who pay all past due premiums as well as current 
206.29  premiums due, including premiums due for the period of 
206.30  disenrollment, within 20 days of disenrollment, shall be 
206.31  reenrolled retroactively to the first day of disenrollment.  
206.32  Persons disenrolled for nonpayment or who voluntarily terminate 
206.33  coverage from the program may not reenroll for four calendar 
206.34  months unless the person demonstrates good cause for 
206.35  nonpayment.  Good cause does not exist if a person chooses to 
206.36  pay other family expenses instead of the premium.  The 
207.1   commissioner shall define good cause in rule. 
207.2      <b>[EFFECTIVE DATE.]</b> This section is effective October 1, 2004.
207.3      Sec. 56.  Minnesota Statutes 2002, section 256L.07, 
207.4   subdivision 1, is amended to read: 
207.5      Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Children 
207.6   enrolled in the original children's health plan as of September 
207.7   30, 1992, children who enrolled in the MinnesotaCare program 
207.8   after September 30, 1992, pursuant to Laws 1992, chapter 549, 
207.9   article 4, section 17, and children who have family gross 
207.10  incomes that are equal to or less than 175 150 percent of the 
207.11  federal poverty guidelines are eligible without meeting the 
207.12  requirements of subdivision 2 and the four-month requirement in 
207.13  subdivision 3, as long as they maintain continuous coverage in 
207.14  the MinnesotaCare program or medical assistance.  Children who 
207.15  apply for MinnesotaCare on or after the implementation date of 
207.16  the employer-subsidized health coverage program as described in 
207.17  Laws 1998, chapter 407, article 5, section 45, who have family 
207.18  gross incomes that are equal to or less than 175 150 percent of 
207.19  the federal poverty guidelines, must meet the requirements of 
207.20  subdivision 2 to be eligible for MinnesotaCare. 
207.21     (b) Families enrolled in MinnesotaCare under section 
207.22  256L.04, subdivision 1, whose income increases above 275 percent 
207.23  of the federal poverty guidelines, are no longer eligible for 
207.24  the program and shall be disenrolled by the commissioner.  
207.25  Individuals enrolled in MinnesotaCare under section 256L.04, 
207.26  subdivision 7, whose income increases above 175 percent of the 
207.27  federal poverty guidelines are no longer eligible for the 
207.28  program and shall be disenrolled by the commissioner.  For 
207.29  persons disenrolled under this subdivision, MinnesotaCare 
207.30  coverage terminates the last day of the calendar month following 
207.31  the month in which the commissioner determines that the income 
207.32  of a family or individual exceeds program income limits.  
207.33     (c)(1) Notwithstanding paragraph (b), individuals and 
207.34  families enrolled in MinnesotaCare under section 256L.04, 
207.35  subdivision 1, may remain enrolled in MinnesotaCare if ten 
207.36  percent of their annual income is less than the annual premium 
208.1   for a policy with a $500 deductible available through the 
208.2   Minnesota comprehensive health association.  Individuals and 
208.3   Families who are no longer eligible for MinnesotaCare under this 
208.4   subdivision shall be given an 18-month notice period from the 
208.5   date that ineligibility is determined before 
208.6   disenrollment.  This clause expires February 1, 2004. 
208.7      (2) Effective February 1, 2004, notwithstanding paragraph 
208.8   (b), children may remain enrolled in MinnesotaCare if ten 
208.9   percent of their annual family income is less than the annual 
208.10  premium for a policy with a $500 deductible available through 
208.11  the Minnesota comprehensive health association.  Children who 
208.12  are no longer eligible for MinnesotaCare under this clause shall 
208.13  be given a 12-month notice period from the date that 
208.14  ineligibility is determined before disenrollment.  The premium 
208.15  for children remaining eligible under this clause shall be the 
208.16  maximum premium determined under section 256L.15, subdivision 2, 
208.17  paragraph (b), until July 1, 2005, when the premium shall be 
208.18  determined by section 256L.15, subdivision 2, paragraph (c). 
208.19     <b>[EFFECTIVE DATE.]</b> The amendments to paragraph (a) are 
208.20  effective July 1, 2003.  The amendments to paragraph (c), clause 
208.21  (1), are effective October 1, 2003. 
208.22     Sec. 57.  Minnesota Statutes 2002, section 256L.07, 
208.23  subdivision 2, is amended to read: 
208.24     Subd. 2.  [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 
208.25  COVERAGE.] (a) To be eligible, a family or individual must not 
208.26  have access to subsidized health coverage through an employer 
208.27  and must not have had access to employer-subsidized coverage 
208.28  through a current employer for 18 months prior to application or 
208.29  reapplication.  A family or individual whose employer-subsidized 
208.30  coverage is lost due to an employer terminating health care 
208.31  coverage as an employee benefit during the previous 18 months is 
208.32  not eligible.  
208.33     (b) This subdivision does not apply to a family or 
208.34  individual who was enrolled in MinnesotaCare within six months 
208.35  or less of reapplication and who no longer has 
208.36  employer-subsidized coverage due to the employer terminating 
209.1   health care coverage as an employee benefit.  
209.2      (c) For purposes of this requirement, subsidized health 
209.3   coverage means health coverage for which the employer pays at 
209.4   least 50 percent of the cost of coverage for the employee or 
209.5   dependent, or a higher percentage as specified by the 
209.6   commissioner.  Children are eligible for employer-subsidized 
209.7   coverage through either parent, including the noncustodial 
209.8   parent.  The commissioner must treat employer contributions to 
209.9   Internal Revenue Code Section 125 plans and any other employer 
209.10  benefits intended to pay health care costs as qualified employer 
209.11  subsidies toward the cost of health coverage for employees for 
209.12  purposes of this subdivision. 
209.13     (d) Notwithstanding paragraph (c), beginning February 1, 
209.14  2004, health coverage for single adults and households without 
209.15  children and adults in families with children shall be 
209.16  considered to be subsidized health coverage if the employer 
209.17  contributes any amount towards the cost of coverage. 
209.18     Sec. 58.  Minnesota Statutes 2002, section 256L.07, 
209.19  subdivision 3, is amended to read: 
209.20     Subd. 3.  [OTHER HEALTH COVERAGE.] (a) Families and 
209.21  individuals enrolled in the MinnesotaCare program must have no 
209.22  health coverage while enrolled or for at least four months prior 
209.23  to application and renewal.  Children enrolled in the original 
209.24  children's health plan and children in families with income 
209.25  equal to or less than 175 150 percent of the federal poverty 
209.26  guidelines, who have other health insurance, are eligible if the 
209.27  coverage: 
209.28     (1) lacks two or more of the following: 
209.29     (i) basic hospital insurance; 
209.30     (ii) medical-surgical insurance; 
209.31     (iii) prescription drug coverage; 
209.32     (iv) dental coverage; or 
209.33     (v) vision coverage; 
209.34     (2) requires a deductible of $100 or more per person per 
209.35  year; or 
209.36     (3) lacks coverage because the child has exceeded the 
210.1   maximum coverage for a particular diagnosis or the policy 
210.2   excludes a particular diagnosis. 
210.3      The commissioner may change this eligibility criterion for 
210.4   sliding scale premiums in order to remain within the limits of 
210.5   available appropriations.  The requirement of no health coverage 
210.6   does not apply to newborns. 
210.7      (b) Medical assistance, general assistance medical care, 
210.8   and the Civilian Health and Medical Program of the Uniformed 
210.9   Service, CHAMPUS, or other coverage provided under United States 
210.10  Code, title 10, subtitle A, part II, chapter 55, are not 
210.11  considered insurance or health coverage for purposes of the 
210.12  four-month requirement described in this subdivision. 
210.13     (c) For purposes of this subdivision, Medicare Part A or B 
210.14  coverage under title XVIII of the Social Security Act, United 
210.15  States Code, title 42, sections 1395c to 1395w-4, is considered 
210.16  health coverage.  An applicant or enrollee may not refuse 
210.17  Medicare coverage to establish eligibility for MinnesotaCare. 
210.18     (d) Applicants who were recipients of medical assistance or 
210.19  general assistance medical care within one month of application 
210.20  must meet the provisions of this subdivision and subdivision 2. 
210.21     (e) Effective October 1, 2003, applicants who were 
210.22  recipients of medical assistance and had cost-effective health 
210.23  insurance which was paid for by medical assistance are exempt 
210.24  from the four-month requirement under this section. 
210.25     (f) Notwithstanding paragraph (a), effective October 1, 
210.26  2004, individuals enrolled in the MinnesotaCare program under 
210.27  section 256L.04, subdivision 7, who have gross family income at 
210.28  or below 75 percent are not subject to the requirement of having 
210.29  no other health coverage for four months prior to application 
210.30  and renewal. 
210.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
210.32  except where a different effective date is specified in the text.
210.33     Sec. 59.  Minnesota Statutes 2002, section 256L.09, 
210.34  subdivision 4, is amended to read: 
210.35     Subd. 4.  [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 
210.36  purposes of this section, a permanent Minnesota resident is a 
211.1   person who has demonstrated, through persuasive and objective 
211.2   evidence, that the person is domiciled in the state and intends 
211.3   to live in the state permanently. 
211.4      (b) To be eligible as a permanent resident, an applicant 
211.5   must demonstrate the requisite intent to live in the state 
211.6   permanently by: 
211.7      (1) showing that the applicant maintains a residence at a 
211.8   verified address other than a place of public accommodation, 
211.9   through the use of evidence of residence described in section 
211.10  256D.02, subdivision 12a, clause (1); 
211.11     (2) demonstrating that the applicant has been continuously 
211.12  domiciled in the state for no less than 180 days immediately 
211.13  before the application; and 
211.14     (3) signing an affidavit declaring that (A) the applicant 
211.15  currently resides in the state and intends to reside in the 
211.16  state permanently; and (B) the applicant did not come to the 
211.17  state for the primary purpose of obtaining medical coverage or 
211.18  treatment; 
211.19     (4) effective October 1, 2004, single adults and adults in 
211.20  households without children who have gross family income at or 
211.21  below 75 percent of the federal poverty guidelines are exempt 
211.22  from the requirements of clause (1); 
211.23     (5) effective October 1, 2004, single adults and adults in 
211.24  households without children who have gross family income at or 
211.25  below 75 percent of the federal poverty guidelines are exempt 
211.26  from clause (2), but shall demonstrate that they have been 
211.27  continuously domiciled in the state for no less than 30 days 
211.28  before the date of application.  In cases of medical 
211.29  emergencies, the 30-day residency requirement is waived; and 
211.30     (6) effective October 1, 2004, migrant workers as defined 
211.31  in section 256J.08 who are single adults and adults in 
211.32  households without children who have gross family income at or 
211.33  below 75 percent of the federal poverty guidelines are exempt 
211.34  from the residency requirements of this section, provided the 
211.35  migrant worker provides verification that the migrant family 
211.36  worked in this state within the last 12 months and earned at 
212.1   least $1,000 in gross wages during the time the migrant worker 
212.2   worked in this state. 
212.3      (c) A person who is temporarily absent from the state does 
212.4   not lose eligibility for MinnesotaCare.  "Temporarily absent 
212.5   from the state" means the person is out of the state for a 
212.6   temporary purpose and intends to return when the purpose of the 
212.7   absence has been accomplished.  A person is not temporarily 
212.8   absent from the state if another state has determined that the 
212.9   person is a resident for any purpose.  If temporarily absent 
212.10  from the state, the person must follow the requirements of the 
212.11  health plan in which the person is enrolled to receive services. 
212.12     Sec. 60.  Minnesota Statutes 2002, section 256L.12, 
212.13  subdivision 9, is amended to read: 
212.14     Subd. 9.  [RATE SETTING; PERFORMANCE WITHHOLDS.] (a) Rates 
212.15  will be prospective, per capita, where possible.  The 
212.16  commissioner may allow health plans to arrange for inpatient 
212.17  hospital services on a risk or nonrisk basis.  The commissioner 
212.18  shall consult with an independent actuary to determine 
212.19  appropriate rates. 
212.20     (b) For services rendered on or after January 1, 2003, to 
212.21  December 31, 2003, the commissioner shall withhold .5 percent of 
212.22  managed care plan payments under this section pending completion 
212.23  of performance targets.  The withheld funds must be returned no 
212.24  sooner than July 1 and no later than July 31 of the following 
212.25  year if performance targets in the contract are achieved.  A 
212.26  managed care plan may include as admitted assets under section 
212.27  62D.044 any amount withheld under this paragraph that is 
212.28  reasonably expected to be returned.  
212.29     (c) For services rendered on or after January 1, 2004, the 
212.30  commissioner shall withhold five percent of managed care plan 
212.31  payments under this section pending completion of performance 
212.32  targets.  The withheld funds must be returned no sooner than 
212.33  July 1 and no later than July 31 of the following calendar year 
212.34  if performance targets in the contract are achieved.  A managed 
212.35  care plan may include as admitted assets under section 62D.044 
212.36  any amount withheld under this paragraph that is reasonably 
213.1   expected to be returned. 
213.2      Sec. 61.  Minnesota Statutes 2002, section 256L.12, is 
213.3   amending by adding a subdivision to read: 
213.4      Subd. 9a.  [RATE SETTING; RATABLE REDUCTION.] For services 
213.5   rendered on or after October 1, 2003, the total payment made to 
213.6   managed care plans under the MinnesotaCare program is reduced 
213.7   one percent. 
213.8      Sec. 62.  Minnesota Statutes 2002, section 256L.15, 
213.9   subdivision 1, is amended to read: 
213.10     Subdivision 1.  [PREMIUM DETERMINATION.] (a) Families with 
213.11  children and individuals shall pay a premium determined 
213.12  according to a sliding fee based on a percentage of the family's 
213.13  gross family income subdivision 2.  
213.14     (b) Pregnant women and children under age two are exempt 
213.15  from the provisions of section 256L.06, subdivision 3, paragraph 
213.16  (b), clause (3), requiring disenrollment for failure to pay 
213.17  premiums.  For pregnant women, this exemption continues until 
213.18  the first day of the month following the 60th day postpartum.  
213.19  Women who remain enrolled during pregnancy or the postpartum 
213.20  period, despite nonpayment of premiums, shall be disenrolled on 
213.21  the first of the month following the 60th day postpartum for the 
213.22  penalty period that otherwise applies under section 256L.06, 
213.23  unless they begin paying premiums. 
213.24     (c) Effective October 1, 2004, single adults and households 
213.25  without children with gross family income at or below 75 percent 
213.26  of the federal poverty guidelines who are eligible under section 
213.27  256L.04, subdivision 7, do not have a premium obligation. 
213.28     Sec. 63.  Minnesota Statutes 2002, section 256L.15, 
213.29  subdivision 2, is amended to read: 
213.30     Subd. 2.  [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 
213.31  GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 
213.32  establish a sliding fee scale to determine the percentage of 
213.33  gross individual or family income that households at different 
213.34  income levels must pay to obtain coverage through the 
213.35  MinnesotaCare program.  The sliding fee scale must be based on 
213.36  the enrollee's gross individual or family income.  The sliding 
214.1   fee scale must contain separate tables based on enrollment of 
214.2   one, two, or three or more persons.  The sliding fee scale 
214.3   begins with a premium of 1.5 percent of gross individual or 
214.4   family income for individuals or families with incomes below the 
214.5   limits for the medical assistance program for families and 
214.6   children in effect on January 1, 1999, and proceeds through the 
214.7   following evenly spaced steps:  1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 
214.8   7.4, and 8.8 percent.  These percentages are matched to evenly 
214.9   spaced income steps ranging from the medical assistance income 
214.10  limit for families and children in effect on January 1, 1999, to 
214.11  275 percent of the federal poverty guidelines for the applicable 
214.12  family size, up to a family size of five.  The sliding fee scale 
214.13  for a family of five must be used for families of more than 
214.14  five.  The sliding fee scale and percentages are not subject to 
214.15  the provisions of chapter 14.  If a family or individual reports 
214.16  increased income after enrollment, premiums shall not be 
214.17  adjusted until eligibility renewal. 
214.18     (b)(1) Enrolled individuals and families whose gross annual 
214.19  income increases above 275 percent of the federal poverty 
214.20  guideline shall pay the maximum premium.  This clause expires 
214.21  effective February 1, 2004. 
214.22     (2) Effective October 1, 2003, enrolled single adults and 
214.23  households without children who have gross family income above 
214.24  75 percent of the federal poverty guidelines shall pay the 
214.25  maximum premium. 
214.26     (3) Effective February 1, 2004, adults in families with 
214.27  children whose gross income is above 200 percent of the federal 
214.28  poverty guidelines shall pay the maximum premium. 
214.29     (4) The maximum premium is defined as a base charge for 
214.30  one, two, or three or more enrollees so that if all 
214.31  MinnesotaCare cases paid the maximum premium, the total revenue 
214.32  would equal the total cost of MinnesotaCare medical coverage and 
214.33  administration.  In this calculation, administrative costs shall 
214.34  be assumed to equal ten percent of the total.  The costs of 
214.35  medical coverage for pregnant women and children under age two 
214.36  and the enrollees in these groups shall be excluded from the 
215.1   total.  The maximum premium for two enrollees shall be twice the 
215.2   maximum premium for one, and the maximum premium for three or 
215.3   more enrollees shall be three times the maximum premium for one. 
215.4      (c) Effective July 1, 2005, single adults and households 
215.5   without children who have gross family income above 75 percent 
215.6   of the federal poverty guidelines and adults in families with 
215.7   children whose gross income is above 200 percent of the federal 
215.8   poverty guidelines shall pay the full cost premium.  The full 
215.9   cost premium is defined as a base charge for one, two, or three 
215.10  or more enrollees so that if the base charge were paid by all 
215.11  MinnesotaCare cases subject to the full cost premium, the total 
215.12  revenue would approximately equal the total cost of 
215.13  MinnesotaCare medical coverage and administration for cases 
215.14  subject to the full cost premium.  In this calculation, 
215.15  administrative costs shall be assumed to equal ten percent of 
215.16  the total.  The full cost premium for two enrollees shall be 
215.17  twice the full cost premium for one, and the full cost premium 
215.18  for three or more enrollees shall be three times the full cost 
215.19  premium for one. 
215.20     <b>[EFFECTIVE DATE.]</b> The amendments to paragraph (a) are 
215.21  effective October 1, 2004.  The amendment to paragraph (b) is 
215.22  effective October 1, 2003. 
215.23     Sec. 64.  Minnesota Statutes 2002, section 256L.15, 
215.24  subdivision 3, is amended to read: 
215.25     Subd. 3.  [EXCEPTIONS TO SLIDING SCALE.] An annual premium 
215.26  of $48 is required for all children in families with income at 
215.27  or less than 175 150 percent of federal poverty guidelines. 
215.28     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
215.29     Sec. 65.  Minnesota Statutes 2002, section 295.58, is 
215.30  amended to read: 
215.31     295.58 [DEPOSIT OF REVENUES AND PAYMENT OF REFUNDS.] 
215.32     The commissioner shall deposit all revenues, including 
215.33  penalties and interest, derived from the taxes imposed by 
215.34  sections 295.50 to 295.57 and from the insurance premiums tax 
215.35  imposed by section 297I.05, subdivision 5, on health maintenance 
215.36  organizations, community integrated service networks, and 
216.1   nonprofit health service plan corporations in the health care 
216.2   access fund.  There is annually appropriated from the health 
216.3   care access fund to the commissioner of revenue the amount 
216.4   necessary to make refunds under this chapter.  Beginning July 1, 
216.5   2005, the commissioner shall deposit all revenues, including 
216.6   penalties and interest, derived from the taxes imposed by 
216.7   sections 295.50 to 295.57 and from the insurance premiums tax 
216.8   imposed by section 297I.05, subdivision 5, on health maintenance 
216.9   organizations, community integrated service networks, and 
216.10  nonprofit health service plan corporations in the general fund.  
216.11  There is annually appropriated from the general fund to the 
216.12  commissioner of revenue the amount necessary to make refunds 
216.13  under this chapter. 
216.14     Sec. 66.  Minnesota Statutes 2002, section 514.981, 
216.15  subdivision 6, is amended to read: 
216.16     Subd. 6.  [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 
216.17  AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 
216.18  the real property it describes for a period of ten years from 
216.19  the date it attaches according to section 514.981, subdivision 
216.20  2, paragraph (a), except as otherwise provided for in sections 
216.21  514.980 to 514.985.  The agency may renew a medical assistance 
216.22  lien for an additional ten years from the date it would 
216.23  otherwise expire by recording or filing a certificate of renewal 
216.24  before the lien expires.  The certificate shall be recorded or 
216.25  filed in the office of the county recorder or registrar of 
216.26  titles for the county in which the lien is recorded or filed.  
216.27  The certificate must refer to the recording or filing data for 
216.28  the medical assistance lien it renews.  The certificate need not 
216.29  be attested, certified, or acknowledged as a condition for 
216.30  recording or filing.  The registrar of titles or the recorder 
216.31  shall file, record, index, and return the certificate of renewal 
216.32  in the same manner as provided for medical assistance liens in 
216.33  section 514.982, subdivision 2. 
216.34     (b) A medical assistance lien is not enforceable against 
216.35  the real property of an estate to the extent there is a 
216.36  determination by a court of competent jurisdiction, or by an 
217.1   officer of the court designated for that purpose, that there are 
217.2   insufficient assets in the estate to satisfy the agency's 
217.3   medical assistance lien in whole or in part because of the 
217.4   homestead exemption under section 256B.15, subdivision 4, the 
217.5   rights of the surviving spouse or minor children under section 
217.6   524.2-403, paragraphs (a) and (b), or claims with a priority 
217.7   under section 524.3-805, paragraph (a), clauses (1) to (4).  For 
217.8   purposes of this section, the rights of the decedent's adult 
217.9   children to exempt property under section 524.2-403, paragraph 
217.10  (b), shall not be considered costs of administration under 
217.11  section 524.3-805, paragraph (a), clause (1). 
217.12     (c) Notwithstanding any law or rule to the contrary, the 
217.13  provisions in clauses (1) to (7) apply if a life estate subject 
217.14  to a medical assistance lien ends according to its terms, or if 
217.15  a medical assistance recipient who owns a life estate or any 
217.16  interest in real property as a joint tenant that is subject to a 
217.17  medical assistance lien dies. 
217.18     (1) The medical assistance recipient's life estate or joint 
217.19  tenancy interest in the real property shall not end upon the 
217.20  recipient's death but shall merge into the remainder interest or 
217.21  other interest in real property the medical assistance recipient 
217.22  owned in joint tenancy with others.  The medical assistance lien 
217.23  shall attach to and run with the remainder or other interest in 
217.24  the real property to the extent of the medical assistance 
217.25  recipient's interest in the property at the time of the 
217.26  recipient's death as determined under this section. 
217.27     (2) If the medical assistance recipient's interest was a 
217.28  life estate in real property, the lien shall be a lien against 
217.29  the portion of the remainder equal to the percentage factor for 
217.30  the life estate of a person the medical assistance recipient's 
217.31  age on the date the life estate ended according to its terms or 
217.32  the date of the medical assistance recipient's death as listed 
217.33  in the Life Estate Mortality Table in the health care program's 
217.34  manual. 
217.35     (3) If the medical assistance recipient owned the interest 
217.36  in real property in joint tenancy with others, the lien shall be 
218.1   a lien against the portion of that interest equal to the 
218.2   fractional interest the medical assistance recipient would have 
218.3   owned in the jointly owned interest had the medical assistance 
218.4   recipient and the other owners held title to that interest as 
218.5   tenants in common on the date the medical assistance recipient 
218.6   died. 
218.7      (4) The medical assistance lien shall remain a lien against 
218.8   the remainder or other jointly owned interest for the length of 
218.9   time and be renewable as provided in paragraph (a). 
218.10     (5) Section 514.981, subdivision 5, paragraphs (a), clause 
218.11  (4), (b), clauses (1) and (2); and subdivision 6, paragraph (b), 
218.12  do not apply to medical assistance liens which attach to 
218.13  interests in real property as provided under this subdivision. 
218.14     (6) The continuation of a medical assistance recipient's 
218.15  life estate or joint tenancy interest in real property after the 
218.16  medical assistance recipient's death for the purpose of 
218.17  recovering medical assistance provided for in sections 514.980 
218.18  to 514.985 modifies common law principles holding that these 
218.19  interests terminate on the death of the holder. 
218.20     (7) Notwithstanding any law or rule to the contrary, no 
218.21  release, satisfaction, discharge, or affidavit under section 
218.22  256B.15 shall extinguish or terminate the life estate or joint 
218.23  tenancy interest of a medical assistance recipient subject to a 
218.24  lien under sections 514.980 to 514.985 on the date the recipient 
218.25  dies. 
218.26     <b>[EFFECTIVE DATE.]</b> This section is effective August 1, 2003, 
218.27  and applies to all medical assistance liens recorded or filed on 
218.28  or after that date. 
218.29     Sec. 67.  [REVISOR'S INSTRUCTION.] 
218.30     For sections in Minnesota Statutes and Minnesota Rules 
218.31  affected by the repealed sections in this article, the revisor 
218.32  shall delete internal cross-references where appropriate and 
218.33  make changes necessary to correct the punctuation, grammar, or 
218.34  structure of the remaining text and preserve its meaning. 
218.35     Sec. 68.  [REPEALER.] 
218.36     (a) Minnesota Statutes 2002, sections 256.955, subdivision 
219.1   8; 256B.0625, subdivision 5a; 256B.057, subdivision 1b; and 
219.2   256B.195, subdivision 5, are repealed July 1, 2003.  
219.3      (b) Minnesota Statutes 2002, section 256L.04, subdivision 
219.4   9, is repealed October 1, 2004. 
219.5      (c) Minnesota Statutes 2002, section 256B.055, subdivision 
219.6   10a, is repealed July 1, 2003, or upon federal approval, 
219.7   whichever is later. 
219.8      (d) Minnesota Statutes 2002, section 256L.02, subdivision 
219.9   3, is repealed June 30, 2005. 
219.10                             ARTICLE 3 
219.11                           LONG-TERM CARE 
219.12     Section 1.  Minnesota Statutes 2002, section 144A.4605, 
219.13  subdivision 4, is amended to read: 
219.14     Subd. 4.  [LICENSE REQUIRED.] (a) A housing with services 
219.15  establishment registered under chapter 144D that is required to 
219.16  obtain a home care license must obtain an assisted living home 
219.17  care license according to this section or a class A or class E 
219.18  license according to rule.  A housing with services 
219.19  establishment that obtains a class E license under this 
219.20  subdivision remains subject to the payment limitations in 
219.21  sections 256B.0913, subdivision 5 5f, paragraph (h) (b), and 
219.22  256B.0915, subdivision 3, paragraph (g) 3d. 
219.23     (b) A board and lodging establishment registered for 
219.24  special services as of December 31, 1996, and also registered as 
219.25  a housing with services establishment under chapter 144D, must 
219.26  deliver home care services according to sections 144A.43 to 
219.27  144A.47, and may apply for a waiver from requirements under 
219.28  Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 
219.29  licensed agency under the standards of section 157.17.  Such 
219.30  waivers as may be granted by the department will expire upon 
219.31  promulgation of home care rules implementing section 144A.4605. 
219.32     (c) An adult foster care provider licensed by the 
219.33  department of human services and registered under chapter 144D 
219.34  may continue to provide health-related services under its foster 
219.35  care license until the promulgation of home care rules 
219.36  implementing this section. 
220.1      (d) An assisted living home care provider licensed under 
220.2   this section must comply with the disclosure provisions of 
220.3   section 325F.72 to the extent they are applicable. 
220.4      Sec. 2.  Minnesota Statutes 2002, section 256.9657, 
220.5   subdivision 1, is amended to read: 
220.6      Subdivision 1.  [NURSING HOME LICENSE SURCHARGE.] (a) 
220.7   Effective July 1, 1993, each non-state-operated nursing home 
220.8   licensed under chapter 144A shall pay to the commissioner an 
220.9   annual surcharge according to the schedule in subdivision 4.  
220.10  The surcharge shall be calculated as $620 per licensed bed.  If 
220.11  the number of licensed beds is reduced, the surcharge shall be 
220.12  based on the number of remaining licensed beds the second month 
220.13  following the receipt of timely notice by the commissioner of 
220.14  human services that beds have been delicensed.  The nursing home 
220.15  must notify the commissioner of health in writing when beds are 
220.16  delicensed.  The commissioner of health must notify the 
220.17  commissioner of human services within ten working days after 
220.18  receiving written notification.  If the notification is received 
220.19  by the commissioner of human services by the 15th of the month, 
220.20  the invoice for the second following month must be reduced to 
220.21  recognize the delicensing of beds.  Beds on layaway status 
220.22  continue to be subject to the surcharge.  The commissioner of 
220.23  human services must acknowledge a medical care surcharge appeal 
220.24  within 30 days of receipt of the written appeal from the 
220.25  provider. 
220.26     (b) Effective July 1, 1994, the surcharge in paragraph (a) 
220.27  shall be increased to $625. 
220.28     (c) Effective August 15, 2002, the surcharge under 
220.29  paragraph (b) shall be increased to $990. 
220.30     (d) Effective July 15, 2003, the surcharge under paragraph 
220.31  (c) shall be increased to $2,700. 
220.32     (e) The commissioner may reduce, and may subsequently 
220.33  restore, the surcharge under paragraph (d) based on the 
220.34  commissioner's determination of a permissible surcharge. 
220.35     (f) Between April 1, 2002, and August 15, 2003 2004, a 
220.36  facility governed by this subdivision may elect to assume full 
221.1   participation in the medical assistance program by agreeing to 
221.2   comply with all of the requirements of the medical assistance 
221.3   program, including the rate equalization law in section 256B.48, 
221.4   subdivision 1, paragraph (a), and all other requirements 
221.5   established in law or rule, and to begin intake of new medical 
221.6   assistance recipients.  Rates will be determined under Minnesota 
221.7   Rules, parts 9549.0010 to 9549.0080.  Notwithstanding section 
221.8   256B.431, subdivision 27, paragraph (i), rate calculations will 
221.9   be subject to limits as prescribed in rule and law.  Other than 
221.10  the adjustments in sections 256B.431, subdivisions 30 and 32; 
221.11  256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 
221.12  9549.0057, and any other applicable legislation enacted prior to 
221.13  the finalization of rates, facilities assuming full 
221.14  participation in medical assistance under this paragraph are not 
221.15  eligible for any rate adjustments until the July 1 following 
221.16  their settle-up period. 
221.17     <b>[EFFECTIVE DATE.]</b> This section is effective June 30, 2003. 
221.18     Sec. 3.  Minnesota Statutes 2002, section 256.9754, 
221.19  subdivision 2, is amended to read: 
221.20     Subd. 2.  [CREATION.] The community services development 
221.21  grants program There is created under the administration of the 
221.22  commissioner of human services the consolidated ElderCare 
221.23  development grant fund for the purpose of rebalancing the 
221.24  long-term care system and increasing home and community-based 
221.25  care alternatives that sustain independent living.  
221.26     Sec. 4.  Minnesota Statutes 2002, section 256.9754, 
221.27  subdivision 3, is amended to read: 
221.28     Subd. 3.  [PROVISION OF GRANTS.] The commissioner shall 
221.29  make grants available to communities, providers of older adult 
221.30  services identified in subdivision 1, or to a consortium of 
221.31  providers of older adult services, to establish older adult 
221.32  services.  Grants may be provided for capital and other costs 
221.33  including, but not limited to, start-up and training costs, 
221.34  equipment, and supplies related to older adult services or other 
221.35  residential or service alternatives to nursing facility care.  
221.36  Grants may also be made to renovate current buildings, provide 
222.1   transportation services, fund programs that would allow older 
222.2   adults or disabled individuals to stay in their own homes by 
222.3   sharing a home, fund programs that coordinate and manage formal 
222.4   and informal services to older adults in their homes to enable 
222.5   them to live as independently as possible in their own homes as 
222.6   an alternative to nursing home care, or expand state-funded 
222.7   programs in the area.  Other services eligible for funding 
222.8   include:  transportation; chore services and homemaking; home 
222.9   health care and personal care assistance; care coordination; 
222.10  housing with services, such as assisted living and foster care; 
222.11  home modification; adult day services; caregiver support and 
222.12  respite; living-at-home block nurse; service integration and 
222.13  development; telemedicine, telehomecare, or other 
222.14  technology-based solutions; grocery shopping; and services 
222.15  identified as needed for community transition. 
222.16     Sec. 5.  Minnesota Statutes 2002, section 256.9754, 
222.17  subdivision 4, is amended to read: 
222.18     Subd. 4.  [ELIGIBILITY.] Grants may be awarded only to 
222.19  communities and providers, including for-profits, nonprofits, 
222.20  and governmental units, or to a consortium of providers that 
222.21  have a local match of 25 percent in the form of cash or in-kind 
222.22  services, except that for capital costs the match is 50 percent 
222.23  of the costs for the project in the form of donations, local tax 
222.24  dollars, in-kind donations, fund-raising, or other local matches.
222.25     Sec. 6.  Minnesota Statutes 2002, section 256.9754, 
222.26  subdivision 5, is amended to read: 
222.27     Subd. 5.  [GRANT PREFERENCE.] The commissioner of human 
222.28  services shall give preference when awarding grants under this 
222.29  section to areas where nursing facility closures have occurred 
222.30  or are occurring.  The commissioner may award grants to the 
222.31  extent grant funds are available and to the extent applications 
222.32  are approved by the commissioner.  Denial of approval of an 
222.33  application in one year does not preclude submission of an 
222.34  application in a subsequent year.  The maximum grant amount is 
222.35  limited to $750,000. 
222.36     Sec. 7.  Minnesota Statutes 2002, section 256B.0913, 
223.1   subdivision 2, is amended to read: 
223.2      Subd. 2.  [ELIGIBILITY FOR SERVICES.] Alternative care 
223.3   services are available to Minnesotans age 65 or older who are 
223.4   not eligible for medical assistance without a spenddown or 
223.5   waiver obligation but who would be eligible for medical 
223.6   assistance within 180 days of admission to a nursing facility 
223.7   and subject to subdivisions 4 to 13. 
223.8      Sec. 8.  Minnesota Statutes 2002, section 256B.0913, 
223.9   subdivision 4, is amended to read: 
223.10     Subd. 4.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 
223.11  NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 
223.12  under the alternative care program is available to persons who 
223.13  meet the following criteria: 
223.14     (1) the person has been determined by a community 
223.15  assessment under section 256B.0911 to be a person who would 
223.16  require the level of care provided in a nursing facility, but 
223.17  for the provision of services under the alternative care 
223.18  program; 
223.19     (2) the person is age 65 or older; 
223.20     (3) the person would be eligible for medical assistance 
223.21  within 180 days of admission to a nursing facility; 
223.22     (4) the person is not ineligible for the medical assistance 
223.23  program due to an asset transfer penalty; 
223.24     (5) the person needs services that are not funded through 
223.25  other state or federal funding; and 
223.26     (6) the monthly cost of the alternative care services 
223.27  funded by the program for this person does not exceed 75 percent 
223.28  of the statewide weighted average monthly nursing facility rate 
223.29  of the case mix resident class to which the individual 
223.30  alternative care client would be assigned under Minnesota Rules, 
223.31  parts 9549.0050 to 9549.0059, less the recipient's maintenance 
223.32  needs allowance as described in section 256B.0915, subdivision 
223.33  1d, paragraph (a), until the first day of the state fiscal year 
223.34  in which the resident assessment system, under section 256B.437, 
223.35  for nursing home rate determination is implemented.  Effective 
223.36  on the first day of the state fiscal year in which a resident 
224.1   assessment system, under section 256B.437, for nursing home rate 
224.2   determination is implemented and the first day of each 
224.3   subsequent state fiscal year, the monthly cost of alternative 
224.4   care services for this person shall not exceed the alternative 
224.5   care monthly cap for the case mix resident class to which the 
224.6   alternative care client would be assigned under Minnesota Rules, 
224.7   parts 9549.0050 to 9549.0059, which was in effect on the last 
224.8   day of the previous state fiscal year, and adjusted by the 
224.9   greater of any legislatively adopted home and community-based 
224.10  services cost-of-living percentage increase or any legislatively 
224.11  adopted statewide percent rate increase for nursing 
224.12  facilities monthly limit described under section 256B.0915, 
224.13  subdivision 3a.  This monthly limit does not prohibit the 
224.14  alternative care client from payment for additional services, 
224.15  but in no case may the cost of additional services purchased 
224.16  under this section exceed the difference between the client's 
224.17  monthly service limit defined under section 256B.0915, 
224.18  subdivision 3, and the alternative care program monthly service 
224.19  limit defined in this paragraph.  If medical supplies and 
224.20  equipment or environmental modifications are or will be 
224.21  purchased for an alternative care services recipient, the costs 
224.22  may be prorated on a monthly basis for up to 12 consecutive 
224.23  months beginning with the month of purchase.  If the monthly 
224.24  cost of a recipient's other alternative care services exceeds 
224.25  the monthly limit established in this paragraph, the annual cost 
224.26  of the alternative care services shall be determined.  In this 
224.27  event, the annual cost of alternative care services shall not 
224.28  exceed 12 times the monthly limit described in this paragraph.; 
224.29  and 
224.30     (7) the person is not ineligible due to nonpayment of the 
224.31  assessed monthly premium charge over 60 days past due.  
224.32  Following disenrollment due to nonpayment of a monthly premium, 
224.33  eligibility shall not be reinstated for a period of 90 days 
224.34  pending eligibility redetermination. 
224.35     (b) Alternative care funding under this subdivision is not 
224.36  available for a person who is a medical assistance recipient or 
225.1   who would be eligible for medical assistance without a spenddown 
225.2   or waiver obligation.  A person whose initial application for 
225.3   medical assistance and the elderly waiver program is being 
225.4   processed may be served under the alternative care program for a 
225.5   period up to 60 days.  If the individual is found to be eligible 
225.6   for medical assistance, medical assistance must be billed for 
225.7   services payable under the federally approved elderly waiver 
225.8   plan and delivered from the date the individual was found 
225.9   eligible for the federally approved elderly waiver plan.  
225.10  Notwithstanding this provision, upon federal approval, 
225.11  alternative care funds may not be used to pay for any service 
225.12  the cost of which is payable by medical assistance or which is 
225.13  used by a recipient to meet a medical assistance income 
225.14  spenddown or waiver obligation; or a medical assistance income 
225.15  spenddown for a person who is eligible to participate under the 
225.16  special income standard provisions through the federally 
225.17  approved elderly waiver program.  
225.18     (c) Alternative care funding is not available for a person 
225.19  who resides in a licensed nursing home, certified boarding care 
225.20  home, hospital, or intermediate care facility, except for case 
225.21  management services which are provided in support of the 
225.22  discharge planning process to for a nursing home resident or 
225.23  certified boarding care home resident to assist with a 
225.24  relocation process to a community-based setting. 
225.25     (d) Alternative care funding is not available for a person 
225.26  whose income is greater than the maintenance needs allowance 
225.27  under section 256B.0915, subdivision 1, paragraph (d), but equal 
225.28  to or less than 120 percent of the federal poverty guideline 
225.29  effective July 1, in the year for which alternative care 
225.30  eligibility is determined, who would be eligible for the elderly 
225.31  waiver with a waiver obligation. 
225.32     Sec. 9.  Minnesota Statutes 2002, section 256B.0913, 
225.33  subdivision 5, is amended to read: 
225.34     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
225.35  Alternative care funding may be used for payment of costs of: 
225.36     (1) adult foster care; 
226.1      (2) adult day care; 
226.2      (3) home health aide; 
226.3      (4) homemaker services; 
226.4      (5) personal care; 
226.5      (6) case management; 
226.6      (7) respite care; 
226.7      (8) assisted living; 
226.8      (9) residential care services; 
226.9      (10) care-related supplies and equipment; 
226.10     (11) meals delivered to the home; 
226.11     (12) transportation; 
226.12     (13) nursing services; 
226.13     (14) chore services; 
226.14     (15) companion services; 
226.15     (16) nutrition services; 
226.16     (17) training for direct informal caregivers; 
226.17     (18) telehome care devices to monitor recipients provide 
226.18  services in their own homes as an alternative to hospital care, 
226.19  nursing home care, or home in conjunction with in-home visits; 
226.20     (19) other services which includes discretionary funds and 
226.21  direct cash payments to clients, services, for which counties 
226.22  may make payment from their alternative care program allocation 
226.23  or services not otherwise defined in this section or section 
226.24  256B.0625, following approval by the commissioner, subject to 
226.25  the provisions of paragraph (j).  Total annual payments for 
226.26  "other services" for all clients within a county may not exceed 
226.27  25 percent of that county's annual alternative care program base 
226.28  allocation; and 
226.29     (20) environmental modifications.; and 
226.30     (21) direct cash payments for which counties may make 
226.31  payment from their alternative care program allocation to 
226.32  clients for the purpose of purchasing services, following 
226.33  approval by the commissioner, and subject to the provisions of 
226.34  subdivision 5h, until approval and implementation of 
226.35  consumer-directed services through the federally approved 
226.36  elderly waiver plan.  Upon implementation, consumer-directed 
227.1   services under the alternative care program are available 
227.2   statewide and limited to the average monthly expenditures 
227.3   representative of all alternative care program participants for 
227.4   the same case mix resident class assigned in the most recent 
227.5   fiscal year for which complete expenditure data is available. 
227.6      Total annual payments for discretionary services and direct 
227.7   cash payments, until the federally approved consumer-directed 
227.8   service option is implemented statewide, for all clients within 
227.9   a county may not exceed 25 percent of that county's annual 
227.10  alternative care program base allocation.  Thereafter, 
227.11  discretionary services are limited to 25 percent of the county's 
227.12  annual alternative care program base allocation. 
227.13     Subd. 5a.  [SERVICES; SERVICE DEFINITIONS; SERVICE 
227.14  STANDARDS.] (a) Unless specified in statute, the services, 
227.15  service definitions, and standards for alternative care services 
227.16  shall be the same as the services, service definitions, and 
227.17  standards specified in the federally approved elderly waiver 
227.18  plan, except for transitional support services. 
227.19     (b) The county agency must ensure that the funds are not 
227.20  used to supplant services available through other public 
227.21  assistance or services programs. 
227.22     (c) Unless specified in statute, the services, service 
227.23  definitions, and standards for alternative care services shall 
227.24  be the same as the services, service definitions, and standards 
227.25  specified in the federally approved elderly waiver plan.  Except 
227.26  for the county agencies' approval of direct cash payments to 
227.27  clients as described in paragraph (j) or For a provider of 
227.28  supplies and equipment when the monthly cost of the supplies and 
227.29  equipment is less than $250, persons or agencies must be 
227.30  employed by or under a contract with the county agency or the 
227.31  public health nursing agency of the local board of health in 
227.32  order to receive funding under the alternative care program.  
227.33  Supplies and equipment may be purchased from a vendor not 
227.34  certified to participate in the Medicaid program if the cost for 
227.35  the item is less than that of a Medicaid vendor.  
227.36     (c) Personal care services must meet the service standards 
228.1   defined in the federally approved elderly waiver plan, except 
228.2   that a county agency may contract with a client's relative who 
228.3   meets the relative hardship waiver requirements or a relative 
228.4   who meets the criteria and is also the responsible party under 
228.5   an individual service plan that ensures the client's health and 
228.6   safety and supervision of the personal care services by a 
228.7   qualified professional as defined in section 256B.0625, 
228.8   subdivision 19c.  Relative hardship is established by the county 
228.9   when the client's care causes a relative caregiver to do any of 
228.10  the following:  resign from a paying job, reduce work hours 
228.11  resulting in lost wages, obtain a leave of absence resulting in 
228.12  lost wages, incur substantial client-related expenses, provide 
228.13  services to address authorized, unstaffed direct care time, or 
228.14  meet special needs of the client unmet in the formal service 
228.15  plan. 
228.16     (d) Subd. 5b.  [ADULT FOSTER CARE RATE.] The adult foster 
228.17  care rate shall be considered a difficulty of care payment and 
228.18  shall not include room and board.  The adult foster care rate 
228.19  shall be negotiated between the county agency and the foster 
228.20  care provider.  The alternative care payment for the foster care 
228.21  service in combination with the payment for other alternative 
228.22  care services, including case management, must not exceed the 
228.23  limit specified in subdivision 4, paragraph (a), clause (6). 
228.24     (e) Personal care services must meet the service standards 
228.25  defined in the federally approved elderly waiver plan, except 
228.26  that a county agency may contract with a client's relative who 
228.27  meets the relative hardship waiver requirement as defined in 
228.28  section 256B.0627, subdivision 4, paragraph (b), clause (10), to 
228.29  provide personal care services if the county agency ensures 
228.30  supervision of this service by a qualified professional as 
228.31  defined in section 256B.0625, subdivision 19c.  
228.32     (f)  Subd. 5c.  [RESIDENTIAL CARE SERVICES; SUPPORTIVE 
228.33  SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 
228.34  section, residential care services are services which are 
228.35  provided to individuals living in residential care homes.  
228.36  Residential care homes are currently licensed as board and 
229.1   lodging establishments under section 157.16, and are registered 
229.2   with the department of health as providing special services 
229.3   under section 157.17 and are not subject to registration except 
229.4   settings that are currently registered under chapter 144D.  
229.5   Residential care services are defined as "supportive services" 
229.6   and "health-related services."  "Supportive services" means the 
229.7   provision of up to 24-hour supervision and oversight.  
229.8   Supportive services includes:  (1) transportation, when provided 
229.9   by the residential care home only; (2) socialization, when 
229.10  socialization is part of the plan of care, has specific goals 
229.11  and outcomes established, and is not diversional or recreational 
229.12  in nature; (3) assisting clients in setting up meetings and 
229.13  appointments; (4) assisting clients in setting up medical and 
229.14  social services; (5) providing assistance with personal laundry, 
229.15  such as carrying the client's laundry to the laundry room.  
229.16  Assistance with personal laundry does not include any laundry, 
229.17  such as bed linen, that is included in the room and board rate 
229.18  services as defined in section 157.17, subdivision 1, paragraph 
229.19  (a).  "Health-related services" are limited to minimal 
229.20  assistance with dressing, grooming, and bathing and providing 
229.21  reminders to residents to take medications that are 
229.22  self-administered or providing storage for medications, if 
229.23  requested means services covered in section 157.17, subdivision 
229.24  1, paragraph (b).  Individuals receiving residential care 
229.25  services cannot receive homemaking services funded under this 
229.26  section.  
229.27     (g) Subd. 5d.  [ASSISTED LIVING SERVICES.] For the purposes 
229.28  of this section, "assisted living" refers to supportive services 
229.29  provided by a single vendor to clients who reside in the same 
229.30  apartment building of three or more units which are not subject 
229.31  to registration under chapter 144D and are licensed by the 
229.32  department of health as a class A home care provider or a class 
229.33  E home care provider.  Assisted living services are defined as 
229.34  up to 24-hour supervision, and oversight, and supportive 
229.35  services as defined in clause (1) section 157.17, subdivision 1, 
229.36  paragraph (a), individualized home care aide tasks as defined in 
230.1   clause (2) Minnesota Rules, part 4668.0110, and individualized 
230.2   home management tasks as defined in clause (3) Minnesota Rules, 
230.3   part 4668.0120 provided to residents of a residential center 
230.4   living in their units or apartments with a full kitchen and 
230.5   bathroom.  A full kitchen includes a stove, oven, refrigerator, 
230.6   food preparation counter space, and a kitchen utensil storage 
230.7   compartment.  Assisted living services must be provided by the 
230.8   management of the residential center or by providers under 
230.9   contract with the management or with the county. 
230.10     (1) Supportive services include:  
230.11     (i) socialization, when socialization is part of the plan 
230.12  of care, has specific goals and outcomes established, and is not 
230.13  diversional or recreational in nature; 
230.14     (ii) assisting clients in setting up meetings and 
230.15  appointments; and 
230.16     (iii) providing transportation, when provided by the 
230.17  residential center only.  
230.18     (2) Home care aide tasks means:  
230.19     (i) preparing modified diets, such as diabetic or low 
230.20  sodium diets; 
230.21     (ii) reminding residents to take regularly scheduled 
230.22  medications or to perform exercises; 
230.23     (iii) household chores in the presence of technically 
230.24  sophisticated medical equipment or episodes of acute illness or 
230.25  infectious disease; 
230.26     (iv) household chores when the resident's care requires the 
230.27  prevention of exposure to infectious disease or containment of 
230.28  infectious disease; and 
230.29     (v) assisting with dressing, oral hygiene, hair care, 
230.30  grooming, and bathing, if the resident is ambulatory, and if the 
230.31  resident has no serious acute illness or infectious disease.  
230.32  Oral hygiene means care of teeth, gums, and oral prosthetic 
230.33  devices.  
230.34     (3) Home management tasks means:  
230.35     (i) housekeeping; 
230.36     (ii) laundry; 
231.1      (iii) preparation of regular snacks and meals; and 
231.2      (iv) shopping.  
231.3      Subd. 5e.  [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 
231.4   Individuals receiving assisted living services shall not receive 
231.5   both assisted living services and homemaking services.  
231.6   Individualized means services are chosen and designed 
231.7   specifically for each resident's needs, rather than provided or 
231.8   offered to all residents regardless of their illnesses, 
231.9   disabilities, or physical conditions.  Assisted living services 
231.10  as defined in this section shall not be authorized in boarding 
231.11  and lodging establishments licensed according to sections 
231.12  157.011 and 157.15 to 157.22. 
231.13     (h) (b) For establishments registered under chapter 144D, 
231.14  assisted living services under this section means either the 
231.15  services described in paragraph (g) subdivision 5d and delivered 
231.16  by a class E home care provider licensed by the department of 
231.17  health or the services described under section 144A.4605 and 
231.18  delivered by an assisted living home care provider or a class A 
231.19  home care provider licensed by the commissioner of health. 
231.20     (i) Subd. 5f.  [PAYMENT RATES FOR ASSISTED LIVING SERVICES 
231.21  AND RESIDENTIAL CARE.] (a) Payment for assisted living services 
231.22  and residential care services shall be a monthly rate negotiated 
231.23  and authorized by the county agency based on an individualized 
231.24  service plan for each resident and may not cover direct rent or 
231.25  food costs.  
231.26     (1) (b) The individualized monthly negotiated payment for 
231.27  assisted living services as described in paragraph 
231.28  (g) subdivision 5d or (h) 5e, paragraph (b), and residential 
231.29  care services as described in paragraph (f) subdivision 5c, 
231.30  shall not exceed the nonfederal share in effect on July 1 of the 
231.31  state fiscal year for which the rate limit is being calculated 
231.32  of the greater of either the statewide or any of the geographic 
231.33  groups' weighted average monthly nursing facility payment rate 
231.34  of the case mix resident class to which the alternative care 
231.35  eligible client would be assigned under Minnesota Rules, parts 
231.36  9549.0050 to 9549.0059, less the maintenance needs allowance as 
232.1   described in section 256B.0915, subdivision 1d, paragraph (a), 
232.2   until the first day of the state fiscal year in which a resident 
232.3   assessment system, under section 256B.437, of nursing home rate 
232.4   determination is implemented.  Effective on the first day of the 
232.5   state fiscal year in which a resident assessment system, under 
232.6   section 256B.437, of nursing home rate determination is 
232.7   implemented and the first day of each subsequent state fiscal 
232.8   year, the individualized monthly negotiated payment for the 
232.9   services described in this clause shall not exceed the limit 
232.10  described in this clause which was in effect on the last day of 
232.11  the previous state fiscal year and which has been adjusted by 
232.12  the greater of any legislatively adopted home and 
232.13  community-based services cost-of-living percentage increase or 
232.14  any legislatively adopted statewide percent rate increase for 
232.15  nursing facilities groups according to subdivision 4, paragraph 
232.16  (a), clause (6). 
232.17     (2) (c) The individualized monthly negotiated payment for 
232.18  assisted living services described under section 144A.4605 and 
232.19  delivered by a provider licensed by the department of health as 
232.20  a class A home care provider or an assisted living home care 
232.21  provider and provided in a building that is registered as a 
232.22  housing with services establishment under chapter 144D and that 
232.23  provides 24-hour supervision in combination with the payment for 
232.24  other alternative care services, including case management, must 
232.25  not exceed the limit specified in subdivision 4, paragraph (a), 
232.26  clause (6). 
232.27     (j) Subd. 5g.  [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 
232.28  A county agency may make payment from their alternative care 
232.29  program allocation for "other services" which include use of 
232.30  "discretionary funds" for services that are not otherwise 
232.31  defined in this section and direct cash payments to the client 
232.32  for the purpose of purchasing the services.  The following 
232.33  provisions apply to payments under this paragraph subdivision: 
232.34     (1) a cash payment to a client under this provision cannot 
232.35  exceed the monthly payment limit for that client as specified in 
232.36  subdivision 4, paragraph (a), clause (6); and 
233.1      (2) a county may not approve any cash payment for a client 
233.2   who meets either of the following: 
233.3      (i) has been assessed as having a dependency in 
233.4   orientation, unless the client has an authorized 
233.5   representative.  An "authorized representative" means an 
233.6   individual who is at least 18 years of age and is designated by 
233.7   the person or the person's legal representative to act on the 
233.8   person's behalf.  This individual may be a family member, 
233.9   guardian, representative payee, or other individual designated 
233.10  by the person or the person's legal representative, if any, to 
233.11  assist in purchasing and arranging for supports; or 
233.12     (ii) is concurrently receiving adult foster care, 
233.13  residential care, or assisted living services;. 
233.14     (3)  Subd. 5h.  [CASH PAYMENTS TO PERSONS.] (a) Cash 
233.15  payments to a person or a person's family will be provided 
233.16  through a monthly payment and be in the form of cash, voucher, 
233.17  or direct county payment to a vendor.  Fees or premiums assessed 
233.18  to the person for eligibility for health and human services are 
233.19  not reimbursable through this service option.  Services and 
233.20  goods purchased through cash payments must be identified in the 
233.21  person's individualized care plan and must meet all of the 
233.22  following criteria: 
233.23     (i) (1) they must be over and above the normal cost of 
233.24  caring for the person if the person did not have functional 
233.25  limitations; 
233.26     (ii) (2) they must be directly attributable to the person's 
233.27  functional limitations; 
233.28     (iii) (3) they must have the potential to be effective at 
233.29  meeting the goals of the program; and 
233.30     (iv) (4) they must be consistent with the needs identified 
233.31  in the individualized service plan.  The service plan shall 
233.32  specify the needs of the person and family, the form and amount 
233.33  of payment, the items and services to be reimbursed, and the 
233.34  arrangements for management of the individual grant; and. 
233.35     (v) (b) The person, the person's family, or the legal 
233.36  representative shall be provided sufficient information to 
234.1   ensure an informed choice of alternatives.  The local agency 
234.2   shall document this information in the person's care plan, 
234.3   including the type and level of expenditures to be reimbursed;. 
234.4      (c) Persons receiving grants under this section shall have 
234.5   the following responsibilities: 
234.6      (1) spend the grant money in a manner consistent with their 
234.7   individualized service plan with the local agency; 
234.8      (2) notify the local agency of any necessary changes in the 
234.9   grant expenditures; 
234.10     (3) arrange and pay for supports; and 
234.11     (4) inform the local agency of areas where they have 
234.12  experienced difficulty securing or maintaining supports. 
234.13     (d) The county shall report client outcomes, services, and 
234.14  costs under this paragraph in a manner prescribed by the 
234.15  commissioner. 
234.16     (4) Subd. 5i.  [IMMUNITY.] The state of Minnesota, county, 
234.17  lead agency under contract, or tribal government under contract 
234.18  to administer the alternative care program shall not be liable 
234.19  for damages, injuries, or liabilities sustained through the 
234.20  purchase of direct supports or goods by the person, the person's 
234.21  family, or the authorized representative with funds received 
234.22  through the cash payments under this section.  Liabilities 
234.23  include, but are not limited to, workers' compensation, the 
234.24  Federal Insurance Contributions Act (FICA), or the Federal 
234.25  Unemployment Tax Act (FUTA);. 
234.26     (5) persons receiving grants under this section shall have 
234.27  the following responsibilities: 
234.28     (i) spend the grant money in a manner consistent with their 
234.29  individualized service plan with the local agency; 
234.30     (ii) notify the local agency of any necessary changes in 
234.31  the grant expenditures; 
234.32     (iii) arrange and pay for supports; and 
234.33     (iv) inform the local agency of areas where they have 
234.34  experienced difficulty securing or maintaining supports; and 
234.35     (6) the county shall report client outcomes, services, and 
234.36  costs under this paragraph in a manner prescribed by the 
235.1   commissioner. 
235.2      Sec. 10.  Minnesota Statutes 2002, section 256B.0913, 
235.3   subdivision 6, is amended to read: 
235.4      Subd. 6.  [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 
235.5   The alternative care program is administered by the county 
235.6   agency.  This agency is the lead agency responsible for the 
235.7   local administration of the alternative care program as 
235.8   described in this section.  However, it may contract with the 
235.9   public health nursing service to be the lead agency.  The 
235.10  commissioner may contract with federally recognized Indian 
235.11  tribes with a reservation in Minnesota to serve as the lead 
235.12  agency responsible for the local administration of the 
235.13  alternative care program as described in the contract. 
235.14     (b) Alternative care pilot projects operate according to 
235.15  this section and the provisions of Laws 1993, First Special 
235.16  Session chapter 1, article 5, section 133, under agreement with 
235.17  the commissioner.  Each pilot project contract period shall 
235.18  begin no later than the first payment cycle of the state fiscal 
235.19  year and continue through the last payment cycle of the state 
235.20  fiscal year. 
235.21     Sec. 11.  Minnesota Statutes 2002, section 256B.0913, 
235.22  subdivision 7, is amended to read: 
235.23     Subd. 7.  [CASE MANAGEMENT.] Providers of case management 
235.24  services for persons receiving services funded by the 
235.25  alternative care program must meet the qualification 
235.26  requirements and standards specified in section 256B.0915, 
235.27  subdivision 1b.  The case manager must not approve alternative 
235.28  care funding for a client in any setting in which the case 
235.29  manager cannot reasonably ensure the client's health and 
235.30  safety.  The case manager is responsible for the 
235.31  cost-effectiveness of the alternative care individual care plan 
235.32  and must not approve any care plan in which the cost of services 
235.33  funded by alternative care and client contributions exceeds the 
235.34  limit specified in section 256B.0915, subdivision 3, paragraph 
235.35  (b).  The county may allow a case manager employed by the county 
235.36  to delegate certain aspects of the case management activity to 
236.1   another individual employed by the county provided there is 
236.2   oversight of the individual by the case manager.  The case 
236.3   manager may not delegate those aspects which require 
236.4   professional judgment including assessments, reassessments, and 
236.5   care plan development. 
236.6      Sec. 12.  Minnesota Statutes 2002, section 256B.0913, 
236.7   subdivision 8, is amended to read: 
236.8      Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 
236.9   case manager shall implement the plan of care for each 
236.10  alternative care client and ensure that a client's service needs 
236.11  and eligibility are reassessed at least every 12 months.  The 
236.12  plan shall include any services prescribed by the individual's 
236.13  attending physician as necessary to allow the individual to 
236.14  remain in a community setting.  In developing the individual's 
236.15  care plan, the case manager should include the use of volunteers 
236.16  from families and neighbors, religious organizations, social 
236.17  clubs, and civic and service organizations to support the formal 
236.18  home care services.  The county shall be held harmless for 
236.19  damages or injuries sustained through the use of volunteers 
236.20  under this subdivision including workers' compensation 
236.21  liability.  The lead agency shall provide documentation in each 
236.22  individual's plan of care and, if requested, to the commissioner 
236.23  that the most cost-effective alternatives available have been 
236.24  offered to the individual and that the individual was free to 
236.25  choose among available qualified providers, both public and 
236.26  private, including qualified case management or service 
236.27  coordination providers other than those employed by the lead 
236.28  agency when the lead agency maintains responsibility for prior 
236.29  authorizing services in accordance with statutory and 
236.30  administrative requirements.  The case manager must give the 
236.31  individual a ten-day written notice of any denial, termination, 
236.32  or reduction of alternative care services. 
236.33     (b) If the county administering alternative care services 
236.34  is different than the county of financial responsibility, the 
236.35  care plan may be implemented without the approval of the county 
236.36  of financial responsibility. 
237.1      Sec. 13.  Minnesota Statutes 2002, section 256B.0913, 
237.2   subdivision 10, is amended to read: 
237.3      Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
237.4   appropriation for fiscal years 1992 and beyond shall cover only 
237.5   alternative care eligible clients.  By July 1 of each year, the 
237.6   commissioner shall allocate to county agencies the state funds 
237.7   available for alternative care for persons eligible under 
237.8   subdivision 2. 
237.9      (b) The adjusted base for each county is the county's 
237.10  current fiscal year base allocation plus any targeted funds 
237.11  approved during the current fiscal year.  Calculations for 
237.12  paragraphs (c) and (d) are to be made as follows:  for each 
237.13  county, the determination of alternative care program 
237.14  expenditures shall be based on payments for services rendered 
237.15  from April 1 through March 31 in the base year, to the extent 
237.16  that claims have been submitted and paid by June 1 of that year. 
237.17     (c) If the alternative care program expenditures as defined 
237.18  in paragraph (b) are 95 percent or more of the county's adjusted 
237.19  base allocation, the allocation for the next fiscal year is 100 
237.20  percent of the adjusted base, plus inflation to the extent that 
237.21  inflation is included in the state budget. 
237.22     (d) If the alternative care program expenditures as defined 
237.23  in paragraph (b) are less than 95 percent of the county's 
237.24  adjusted base allocation, the allocation for the next fiscal 
237.25  year is the adjusted base allocation less the amount of unspent 
237.26  funds below the 95 percent level. 
237.27     (e) If the annual legislative appropriation for the 
237.28  alternative care program is inadequate to fund the combined 
237.29  county allocations for a biennium, the commissioner shall 
237.30  distribute to each county the entire annual appropriation as 
237.31  that county's percentage of the computed base as calculated in 
237.32  paragraphs (c) and (d). 
237.33     (f) On agreement between the commissioner and the lead 
237.34  agency, the commissioner may have discretion to reallocate 
237.35  alternative care base allocations distributed to lead agencies 
237.36  in which the base amount exceeds program expenditures. 
238.1      Sec. 14.  Minnesota Statutes 2002, section 256B.0913, 
238.2   subdivision 12, is amended to read: 
238.3      Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
238.4   all alternative care eligible clients to help pay for the cost 
238.5   of participating in the program.  The amount of the premium for 
238.6   the alternative care client shall be determined as follows: 
238.7      (1) when the alternative care client's income less 
238.8   recurring and predictable medical expenses is greater than the 
238.9   recipient's maintenance needs allowance as defined in section 
238.10  256B.0915, subdivision 1d, paragraph (a), but less than 150 
238.11  percent of the federal poverty guideline effective on July 1 of 
238.12  the state fiscal year in which the premium is being computed, 
238.13  and total assets are less than $10,000, the fee is zero ten 
238.14  percent of the cost of alternative care services; or 
238.15     (2) when the alternative care client's income less 
238.16  recurring and predictable medical expenses is greater than 150 
238.17  percent or greater of the federal poverty guideline effective on 
238.18  July 1 of the state fiscal year in which the premium is being 
238.19  computed, and total assets are less than $10,000, the fee is 25 
238.20  percent of the cost of alternative care services or the 
238.21  difference between 150 percent of the federal poverty guideline 
238.22  effective on July 1 of the state fiscal year in which the 
238.23  premium is being computed and the client's income less recurring 
238.24  and predictable medical expenses, whichever is less; and 
238.25     (3) when the alternative care client's or total assets are 
238.26  greater than or equal to $10,000, the fee is 25 percent of the 
238.27  cost of alternative care services.  
238.28     For married persons, total assets are defined as the total 
238.29  marital assets less the estimated community spouse asset 
238.30  allowance, under section 256B.059, if applicable.  For married 
238.31  persons, total income is defined as the client's income less the 
238.32  monthly spousal allotment, under section 256B.058. 
238.33     All alternative care services except case management shall 
238.34  be included in the estimated costs for the purpose of 
238.35  determining 25 percent of the costs premium amount. 
238.36     Premiums are due and payable each month alternative care 
239.1   services are received unless the actual cost of the services is 
239.2   less than the premium, in which case the fee is the lesser 
239.3   amount. 
239.4      (b) The fee shall be waived by the commissioner when: 
239.5      (1) a person who is residing in a nursing facility is 
239.6   receiving case management only; 
239.7      (2) a person is applying for medical assistance; 
239.8      (3) a married couple is requesting an asset assessment 
239.9   under the spousal impoverishment provisions; 
239.10     (4) (3) a person is found eligible for alternative care, 
239.11  but is not yet receiving alternative care services; or 
239.12     (5) (4) a person's fee under paragraph (a) is less than 
239.13  $25; or 
239.14     (5) a person has chosen to participate in a 
239.15  consumer-directed service plan for which the cost is no greater 
239.16  than the total cost of the person's alternative care service 
239.17  plan less the monthly premium amount that would otherwise be 
239.18  assessed. 
239.19     (c) The county agency must record in the state's receivable 
239.20  system the client's assessed premium amount or the reason the 
239.21  premium has been waived.  The commissioner will bill and collect 
239.22  the premium from the client.  Money collected must be deposited 
239.23  in the general fund and is appropriated to the commissioner for 
239.24  the alternative care program.  The client must supply the county 
239.25  with the client's social security number at the time of 
239.26  application.  The county shall supply the commissioner with the 
239.27  client's social security number and other information the 
239.28  commissioner requires to collect the premium from the client.  
239.29  The commissioner shall collect unpaid premiums using the Revenue 
239.30  Recapture Act in chapter 270A and other methods available to the 
239.31  commissioner.  The commissioner may require counties to inform 
239.32  clients of the collection procedures that may be used by the 
239.33  state if a premium is not paid.  This paragraph does not apply 
239.34  to alternative care pilot projects authorized in Laws 1993, 
239.35  First Special Session chapter 1, article 5, section 133, if a 
239.36  county operating under the pilot project reports the following 
240.1   dollar amounts to the commissioner quarterly: 
240.2      (1) total premiums billed to clients; 
240.3      (2) total collections of premiums billed; and 
240.4      (3) balance of premiums owed by clients. 
240.5   If a county does not adhere to these reporting requirements, the 
240.6   commissioner may terminate the billing, collecting, and 
240.7   remitting portions of the pilot project and require the county 
240.8   involved to operate under the procedures set forth in this 
240.9   paragraph. 
240.10     Sec. 15.  Minnesota Statutes 2002, section 256B.0915, 
240.11  subdivision 3, is amended to read: 
240.12     Subd. 3.  [LIMITS OF CASES, RATES, PAYMENTS, AND 
240.13  FORECASTING.] (a) The number of medical assistance waiver 
240.14  recipients that a county may serve must be allocated according 
240.15  to the number of medical assistance waiver cases open on July 1 
240.16  of each fiscal year.  Additional recipients may be served with 
240.17  the approval of the commissioner. 
240.18     (b) Subd. 3a.  [ELDERLY WAIVER COST LIMITS.] (a) The 
240.19  monthly limit for the cost of waivered services to an individual 
240.20  elderly waiver client shall be the weighted average monthly 
240.21  nursing facility rate of the case mix resident class to which 
240.22  the elderly waiver client would be assigned under Minnesota 
240.23  Rules, parts 9549.0050 to 9549.0059, less the recipient's 
240.24  maintenance needs allowance as described in subdivision 1d, 
240.25  paragraph (a), until the first day of the state fiscal year in 
240.26  which the resident assessment system as described in section 
240.27  256B.437 for nursing home rate determination is implemented.  
240.28  Effective on the first day of the state fiscal year in which the 
240.29  resident assessment system as described in section 256B.437 for 
240.30  nursing home rate determination is implemented and the first day 
240.31  of each subsequent state fiscal year, the monthly limit for the 
240.32  cost of waivered services to an individual elderly waiver client 
240.33  shall be the rate of the case mix resident class to which the 
240.34  waiver client would be assigned under Minnesota Rules, parts 
240.35  9549.0050 to 9549.0059, in effect on the last day of the 
240.36  previous state fiscal year, adjusted by the greater of any 
241.1   legislatively adopted home and community-based services 
241.2   cost-of-living percentage increase or any legislatively adopted 
241.3   statewide percent rate increase for nursing facilities. 
241.4      (c) (b) If extended medical supplies and equipment or 
241.5   environmental modifications are or will be purchased for an 
241.6   elderly waiver client, the costs may be prorated for up to 12 
241.7   consecutive months beginning with the month of purchase.  If the 
241.8   monthly cost of a recipient's waivered services exceeds the 
241.9   monthly limit established in paragraph (b) (a), the annual cost 
241.10  of all waivered services shall be determined.  In this event, 
241.11  the annual cost of all waivered services shall not exceed 12 
241.12  times the monthly limit of waivered services as described in 
241.13  paragraph (b) (a).  
241.14     (d) Subd. 3b.  [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 
241.15  WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 
241.16  nursing facility resident at the time of requesting a 
241.17  determination of eligibility for elderly waivered services, a 
241.18  monthly conversion limit for the cost of elderly waivered 
241.19  services may be requested.  The monthly conversion limit for the 
241.20  cost of elderly waiver services shall be the resident class 
241.21  assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
241.22  for that resident in the nursing facility where the resident 
241.23  currently resides until July 1 of the state fiscal year in which 
241.24  the resident assessment system as described in section 256B.437 
241.25  for nursing home rate determination is implemented.  Effective 
241.26  on July 1 of the state fiscal year in which the resident 
241.27  assessment system as described in section 256B.437 for nursing 
241.28  home rate determination is implemented, the monthly conversion 
241.29  limit for the cost of elderly waiver services shall be the per 
241.30  diem nursing facility rate as determined by the resident 
241.31  assessment system as described in section 256B.437 for that 
241.32  resident in the nursing facility where the resident currently 
241.33  resides multiplied by 365 and divided by 12, less the 
241.34  recipient's maintenance needs allowance as described in 
241.35  subdivision 1d.  The initially approved conversion rate may be 
241.36  adjusted by the greater of any subsequent legislatively adopted 
242.1   home and community-based services cost-of-living percentage 
242.2   increase or any subsequent legislatively adopted statewide 
242.3   percentage rate increase for nursing facilities.  The limit 
242.4   under this clause subdivision only applies to persons discharged 
242.5   from a nursing facility after a minimum 30-day stay and found 
242.6   eligible for waivered services on or after July 1, 1997.  
242.7      (b) The following costs must be included in determining the 
242.8   total monthly costs for the waiver client: 
242.9      (1) cost of all waivered services, including extended 
242.10  medical supplies and equipment and environmental modifications; 
242.11  and 
242.12     (2) cost of skilled nursing, home health aide, and personal 
242.13  care services reimbursable by medical assistance.  
242.14     (e) Subd. 3c.  [SERVICE APPROVAL AND CONTRACTING 
242.15  PROVISIONS.] (a) Medical assistance funding for skilled nursing 
242.16  services, private duty nursing, home health aide, and personal 
242.17  care services for waiver recipients must be approved by the case 
242.18  manager and included in the individual care plan. 
242.19     (f) (b) A county is not required to contract with a 
242.20  provider of supplies and equipment if the monthly cost of the 
242.21  supplies and equipment is less than $250.  
242.22     (g) Subd. 3d.  [ADULT FOSTER CARE RATE.] The adult foster 
242.23  care rate shall be considered a difficulty of care payment and 
242.24  shall not include room and board.  The adult foster care service 
242.25  rate shall be negotiated between the county agency and the 
242.26  foster care provider.  The elderly waiver payment for the foster 
242.27  care service in combination with the payment for all other 
242.28  elderly waiver services, including case management, must not 
242.29  exceed the limit specified in subdivision 3a, paragraph (b) (a). 
242.30     (h) Subd. 3e.  [ASSISTED LIVING SERVICE RATE.] (a) Payment 
242.31  for assisted living service shall be a monthly rate negotiated 
242.32  and authorized by the county agency based on an individualized 
242.33  service plan for each resident and may not cover direct rent or 
242.34  food costs. 
242.35     (1) (b) The individualized monthly negotiated payment for 
242.36  assisted living services as described in section 256B.0913, 
243.1   subdivision 5, paragraph (g) or (h) subdivisions 5d to 5f, and 
243.2   residential care services as described in section 256B.0913, 
243.3   subdivision 5, paragraph (f) 5c, shall not exceed the nonfederal 
243.4   share, in effect on July 1 of the state fiscal year for which 
243.5   the rate limit is being calculated, of the greater of either the 
243.6   statewide or any of the geographic groups' weighted average 
243.7   monthly nursing facility rate of the case mix resident class to 
243.8   which the elderly waiver eligible client would be assigned under 
243.9   Minnesota Rules, parts 9549.0050 to 9549.0059, less the 
243.10  maintenance needs allowance as described in subdivision 1d, 
243.11  paragraph (a), until the July 1 of the state fiscal year in 
243.12  which the resident assessment system as described in section 
243.13  256B.437 for nursing home rate determination is implemented.  
243.14  Effective on July 1 of the state fiscal year in which the 
243.15  resident assessment system as described in section 256B.437 for 
243.16  nursing home rate determination is implemented and July 1 of 
243.17  each subsequent state fiscal year, the individualized monthly 
243.18  negotiated payment for the services described in this clause 
243.19  shall not exceed the limit described in this clause which was in 
243.20  effect on June 30 of the previous state fiscal year and which 
243.21  has been adjusted by the greater of any legislatively adopted 
243.22  home and community-based services cost-of-living percentage 
243.23  increase or any legislatively adopted statewide percent rate 
243.24  increase for nursing facilities. 
243.25     (2) (c) The individualized monthly negotiated payment for 
243.26  assisted living services described in section 144A.4605 and 
243.27  delivered by a provider licensed by the department of health as 
243.28  a class A home care provider or an assisted living home care 
243.29  provider and provided in a building that is registered as a 
243.30  housing with services establishment under chapter 144D and that 
243.31  provides 24-hour supervision in combination with the payment for 
243.32  other elderly waiver services, including case management, must 
243.33  not exceed the limit specified in paragraph (b) subdivision 3a. 
243.34     (i) Subd. 3f.  [INDIVIDUAL SERVICE RATES; EXPENDITURE 
243.35  FORECASTS.] (a) The county shall negotiate individual service 
243.36  rates with vendors and may authorize payment for actual costs up 
244.1   to the county's current approved rate.  Persons or agencies must 
244.2   be employed by or under a contract with the county agency or the 
244.3   public health nursing agency of the local board of health in 
244.4   order to receive funding under the elderly waiver program, 
244.5   except as a provider of supplies and equipment when the monthly 
244.6   cost of the supplies and equipment is less than $250.  
244.7      (j) (b) Reimbursement for the medical assistance recipients 
244.8   under the approved waiver shall be made from the medical 
244.9   assistance account through the invoice processing procedures of 
244.10  the department's Medicaid Management Information System (MMIS), 
244.11  only with the approval of the client's case manager.  The budget 
244.12  for the state share of the Medicaid expenditures shall be 
244.13  forecasted with the medical assistance budget, and shall be 
244.14  consistent with the approved waiver.  
244.15     (k) Subd. 3g.  [SERVICE RATE LIMITS; STATE ASSUMPTION OF 
244.16  COSTS.] (a) To improve access to community services and 
244.17  eliminate payment disparities between the alternative care 
244.18  program and the elderly waiver, the commissioner shall establish 
244.19  statewide maximum service rate limits and eliminate 
244.20  county-specific service rate limits. 
244.21     (1) (b) Effective July 1, 2001, for service rate limits, 
244.22  except those described or defined in paragraphs (g) and 
244.23  (h) subdivisions 3d and 3e, the rate limit for each service 
244.24  shall be the greater of the alternative care statewide maximum 
244.25  rate or the elderly waiver statewide maximum rate. 
244.26     (2) (c) Counties may negotiate individual service rates 
244.27  with vendors for actual costs up to the statewide maximum 
244.28  service rate limit. 
244.29     Sec. 16.  Minnesota Statutes 2002, section 256B.15, 
244.30  subdivision 1, is amended to read: 
244.31     Subdivision 1.  [DEFINITION.] For purposes of this section, 
244.32  "medical assistance" includes the medical assistance program 
244.33  under this chapter and the general assistance medical care 
244.34  program under chapter 256D, but does not include the alternative 
244.35  care program for nonmedical assistance recipients under section 
244.36  256B.0913, subdivision 4 and alternative care for nonmedical 
245.1   assistance recipients under section 256B.0913. 
245.2      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
245.3   for decedents dying on or after that date. 
245.4      Sec. 17.  Minnesota Statutes 2002, section 256B.15, 
245.5   subdivision 1a, is amended to read: 
245.6      Subd. 1a.  [ESTATES SUBJECT TO CLAIMS.] If a person 
245.7   receives any medical assistance hereunder, on the person's 
245.8   death, if single, or on the death of the survivor of a married 
245.9   couple, either or both of whom received medical assistance, the 
245.10  total amount paid for medical assistance rendered for the person 
245.11  and spouse shall be filed as a claim against the estate of the 
245.12  person or the estate of the surviving spouse in the court having 
245.13  jurisdiction to probate the estate or to issue a decree of 
245.14  descent according to sections 525.31 to 525.313.  
245.15     A claim shall be filed if medical assistance was rendered 
245.16  for either or both persons under one of the following 
245.17  circumstances: 
245.18     (a) the person was over 55 years of age, and received 
245.19  services under this chapter, excluding alternative care; 
245.20     (b) the person resided in a medical institution for six 
245.21  months or longer, received services under this chapter excluding 
245.22  alternative care, and, at the time of institutionalization or 
245.23  application for medical assistance, whichever is later, the 
245.24  person could not have reasonably been expected to be discharged 
245.25  and returned home, as certified in writing by the person's 
245.26  treating physician.  For purposes of this section only, a 
245.27  "medical institution" means a skilled nursing facility, 
245.28  intermediate care facility, intermediate care facility for 
245.29  persons with mental retardation, nursing facility, or inpatient 
245.30  hospital; or 
245.31     (c) the person received general assistance medical care 
245.32  services under chapter 256D.  
245.33     The claim shall be considered an expense of the last 
245.34  illness of the decedent for the purpose of section 524.3-805.  
245.35  Any statute of limitations that purports to limit any county 
245.36  agency or the state agency, or both, to recover for medical 
246.1   assistance granted hereunder shall not apply to any claim made 
246.2   hereunder for reimbursement for any medical assistance granted 
246.3   hereunder.  Notice of the claim shall be given to all heirs and 
246.4   devisees of the decedent whose identity can be ascertained with 
246.5   reasonable diligence.  The notice must include procedures and 
246.6   instructions for making an application for a hardship waiver 
246.7   under subdivision 5; time frames for submitting an application 
246.8   and determination; and information regarding appeal rights and 
246.9   procedures.  Counties are entitled to one-half of the nonfederal 
246.10  share of medical assistance collections from estates that are 
246.11  directly attributable to county effort.  Counties are entitled 
246.12  to ten percent of the collections for alternative care directly 
246.13  attributable to county effort. 
246.14     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
246.15  for decedents dying on or after that date. 
246.16     Sec. 18.  Minnesota Statutes 2002, section 256B.15, 
246.17  subdivision 2, is amended to read: 
246.18     Subd. 2.  [LIMITATIONS ON CLAIMS.] The claim shall include 
246.19  only the total amount of medical assistance rendered after age 
246.20  55 or during a period of institutionalization described in 
246.21  subdivision 1a, clause (b), and the total amount of general 
246.22  assistance medical care rendered, and shall not include 
246.23  interest.  Claims that have been allowed but not paid shall bear 
246.24  interest according to section 524.3-806, paragraph (d).  A claim 
246.25  against the estate of a surviving spouse who did not receive 
246.26  medical assistance, for medical assistance rendered for the 
246.27  predeceased spouse, is limited to the value of the assets of the 
246.28  estate that were marital property or jointly owned property at 
246.29  any time during the marriage.  Claims for alternative care shall 
246.30  be net of all premiums paid under section 256B.0913, subdivision 
246.31  12, on or after July 1, 2003, and shall be limited to services 
246.32  provided on or after July 1, 2003. 
246.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
246.34  for decedents dying on or after that date. 
246.35     Sec. 19.  Minnesota Statutes 2002, section 256B.19, 
246.36  subdivision 1d, is amended to read: 
247.1      Subd. 1d.  [PORTION OF NONFEDERAL SHARE TO BE PAID BY 
247.2   CERTAIN COUNTIES.] (a) In addition to the percentage 
247.3   contribution paid by a county under subdivision 1, the 
247.4   governmental units designated in this subdivision shall be 
247.5   responsible for an additional portion of the nonfederal share of 
247.6   medical assistance cost.  For purposes of this subdivision, 
247.7   "designated governmental unit" means the counties of Becker, 
247.8   Beltrami, Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, 
247.9   Pennington, Pipestone, Ramsey, St. Louis, Steele, Todd, 
247.10  Traverse, and Wadena. 
247.11     (b) Beginning in 1994, each of the governmental units 
247.12  designated in this subdivision shall transfer before noon on May 
247.13  31 to the state Medicaid agency an amount equal to the number of 
247.14  licensed beds in any nursing home owned and operated by the 
247.15  county on that date, with the county named as licensee, 
247.16  multiplied by $5,723.  If two or more counties own and operate a 
247.17  nursing home, the payment shall be prorated.  These sums shall 
247.18  be part of the designated governmental unit's portion of the 
247.19  nonfederal share of medical assistance costs. 
247.20     (c) Beginning in 2002, in addition to any transfer under 
247.21  paragraph (b), each of the governmental units designated in this 
247.22  subdivision shall transfer before noon on May 31 to the state 
247.23  Medicaid agency an amount equal to the number of licensed beds 
247.24  in any nursing home owned and operated by the county on that 
247.25  date, with the county named as licensee, multiplied by $10,784.  
247.26  The provisions of paragraph (b) apply to transfers under this 
247.27  paragraph. 
247.28     (d) Beginning in 2004, in addition to any transfer under 
247.29  paragraphs (b) and (c), each of the governmental units 
247.30  designated in this subdivision shall transfer before noon on May 
247.31  31 to the state Medicaid agency an amount equal to the number of 
247.32  licensed beds in any nursing home owned and operated by the 
247.33  county on that date, with the county named as licensee, 
247.34  multiplied by $2,230.  The provisions of paragraph (b) apply to 
247.35  transfers under this paragraph. 
247.36     (e) The commissioner may reduce the intergovernmental 
248.1   transfers under paragraph paragraphs (c) and (d) based on the 
248.2   commissioner's determination of the payment rate in section 
248.3   256B.431, subdivision 23, paragraphs (c) and, (d), and (e).  Any 
248.4   adjustments must be made on a per-bed basis and must result in 
248.5   an amount equivalent to the total amount resulting from the rate 
248.6   adjustment in section 256B.431, subdivision 23, paragraphs (c) 
248.7   and, (d), and (e). 
248.8      <b>[EFFECTIVE DATE.]</b> This section is effective June 30, 2003. 
248.9      Sec. 20.  Minnesota Statutes 2002, section 256B.431, 
248.10  subdivision 2r, is amended to read: 
248.11     Subd. 2r.  [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 
248.12  July 1, 1993, the commissioner shall limit payment for leave 
248.13  days in a nursing facility to 79 percent of that nursing 
248.14  facility's total payment rate for the involved 
248.15  resident.  Effective July 1, 2003, for facilities reimbursed 
248.16  under this section or section 256B.434, the commissioner shall 
248.17  limit payment for leave days in a nursing facility to 60 percent 
248.18  of that nursing facility's total payment rate for the involved 
248.19  resident. 
248.20     Sec. 21.  Minnesota Statutes 2002, section 256B.431, is 
248.21  amended by adding a subdivision to read: 
248.22     Subd. 2t.  [PAYMENT LIMITATION.] Beginning July 1, 2003, 
248.23  for facilities reimbursed under this section or section 
248.24  256B.434, the amount that shall be paid by or on behalf of the 
248.25  Medicaid program for days with co-payments during a 
248.26  Medicare-covered skilled nursing facility stay shall not result 
248.27  in total payment to the facility by the Medicare program and the 
248.28  Medicaid program being greater than the Medicaid RUG-III 
248.29  case-mix payment rate. 
248.30     Sec. 22.  Minnesota Statutes 2002, section 256B.431, 
248.31  subdivision 23, is amended to read: 
248.32     Subd. 23.  [COUNTY NURSING HOME PAYMENT ADJUSTMENTS.] (a) 
248.33  Beginning in 1994, the commissioner shall pay a nursing home 
248.34  payment adjustment on May 31 after noon to a county in which is 
248.35  located a nursing home that, on that date, was county-owned and 
248.36  operated, with the county named as licensee by the commissioner 
249.1   of health, and had over 40 beds and medical assistance occupancy 
249.2   in excess of 50 percent during the reporting year ending 
249.3   September 30, 1991.  The adjustment shall be an amount equal to 
249.4   $16 per calendar day multiplied by the number of beds licensed 
249.5   in the facility as of September 30, 1991 on that date. 
249.6      (b) Payments under paragraph (a) are excluded from medical 
249.7   assistance per diem rate calculations.  These payments are 
249.8   required notwithstanding any rule prohibiting medical assistance 
249.9   payments from exceeding payments from private pay residents.  A 
249.10  facility receiving a payment under paragraph (a) may not 
249.11  increase charges to private pay residents by an amount 
249.12  equivalent to the per diem amount payments under paragraph (a) 
249.13  would equal if converted to a per diem. 
249.14     (c) Beginning in 2002, in addition to any payment under 
249.15  paragraph (a), the commissioner shall pay to a nursing facility 
249.16  described in paragraph (a) an adjustment in an amount equal to 
249.17  $29.55 per calendar day multiplied by the number of beds 
249.18  licensed in the facility on that date.  The provisions of 
249.19  paragraphs (a) and (b) apply to payments under this paragraph. 
249.20     (d) Beginning in 2004, in addition to any payment under 
249.21  paragraphs (a) and (c), the commissioner shall pay to a nursing 
249.22  facility described in paragraph (a) an adjustment in an amount 
249.23  equal to $6.11 per calendar day multiplied by the number of beds 
249.24  licensed in the facility on that date.  The provisions of 
249.25  paragraphs (a) and (b) apply to payments under this paragraph.  
249.26     (e) The commissioner may reduce payments under 
249.27  paragraph paragraphs (c) and (d) based on the commissioner's 
249.28  determination of Medicare upper payment limits.  Any adjustments 
249.29  must be proportional to adjustments made under section 256B.19, 
249.30  subdivision 1d, paragraph (d) (e). 
249.31     <b>[EFFECTIVE DATE.]</b> This section is effective June 30, 2003. 
249.32     Sec. 23.  Minnesota Statutes 2002, section 256B.431, 
249.33  subdivision 32, is amended to read: 
249.34     Subd. 32.  [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 
249.35  years beginning on or after July 1, 2001, the total payment rate 
249.36  for a facility reimbursed under this section, section 256B.434, 
250.1   or any other section for the first 90 paid days after admission 
250.2   shall be: 
250.3      (1) for the first 30 paid days, the rate shall be 120 
250.4   percent of the facility's medical assistance rate for each case 
250.5   mix class; and 
250.6      (2) for the next 60 paid days after the first 30 paid days, 
250.7   the rate shall be 110 percent of the facility's medical 
250.8   assistance rate for each case mix class.; 
250.9      (b) (3) beginning with the 91st paid day after admission, 
250.10  the payment rate shall be the rate otherwise determined under 
250.11  this section, section 256B.434, or any other section.; and 
250.12     (c) (4) payments under this subdivision applies paragraph 
250.13  apply to admissions occurring on or after July 1, 2001, and 
250.14  resident days from that date through June 30, 2003. 
250.15     (b) For rate years beginning on or after July 1, 2003, the 
250.16  total payment rate for a facility reimbursed under this section, 
250.17  section 256B.434, or any other section shall be: 
250.18     (1) for the first 30 calendar days after admission, the 
250.19  rate shall be 120 percent of the facility's medical assistance 
250.20  rate for each RUG class; 
250.21     (2) beginning with the 31st calendar day after admission, 
250.22  the payment rate shall be the rate otherwise determined under 
250.23  this section, section 256B.434, or any other section; and 
250.24     (3) payments under this paragraph apply to admissions 
250.25  occurring on or after July 1, 2003. 
250.26     (c) Effective January 1, 2004, the enhanced rates under 
250.27  this subdivision shall not be allowed if a resident has resided 
250.28  in any nursing facility during the previous 30 calendar days. 
250.29     Sec. 24.  Minnesota Statutes 2002, section 256B.431, 
250.30  subdivision 36, is amended to read: 
250.31     Subd. 36.  [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 
250.32  ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 
250.33  1, 2001, and June 30, 2003, the commissioner shall provide to 
250.34  each nursing facility reimbursed under this section, section 
250.35  256B.434, or any other section, a scholarship per diem of 25 
250.36  cents to the total operating payment rate to be used: 
251.1      (1) for employee scholarships that satisfy the following 
251.2   requirements: 
251.3      (i) scholarships are available to all employees who work an 
251.4   average of at least 20 hours per week at the facility except the 
251.5   administrator, department supervisors, and registered nurses; 
251.6   and 
251.7      (ii) the course of study is expected to lead to career 
251.8   advancement with the facility or in long-term care, including 
251.9   medical care interpreter services and social work; and 
251.10     (2) to provide job-related training in English as a second 
251.11  language. 
251.12     (b) A facility receiving a rate adjustment under this 
251.13  subdivision may submit to the commissioner on a schedule 
251.14  determined by the commissioner and on a form supplied by the 
251.15  commissioner a calculation of the scholarship per diem, 
251.16  including:  the amount received from this rate adjustment; the 
251.17  amount used for training in English as a second language; the 
251.18  number of persons receiving the training; the name of the person 
251.19  or entity providing the training; and for each scholarship 
251.20  recipient, the name of the recipient, the amount awarded, the 
251.21  educational institution attended, the nature of the educational 
251.22  program, the program completion date, and a determination of the 
251.23  per diem amount of these costs based on actual resident days. 
251.24     (c) On July 1, 2003, the commissioner shall remove the 25 
251.25  cent scholarship per diem from the total operating payment rate 
251.26  of each facility. 
251.27     (d) For rate years beginning after June 30, 2003, the 
251.28  commissioner shall provide to each facility the scholarship per 
251.29  diem determined in paragraph (b). 
251.30     Sec. 25.  Minnesota Statutes 2002, section 256B.431, is 
251.31  amended by adding a subdivision to read: 
251.32     Subd. 38.  [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 
251.33  YEAR 2004.] Effective June 1, 2003, the commissioner shall 
251.34  provide to each nursing home reimbursed under this section or 
251.35  section 256B.434, an increase in each case mix payment rate 
251.36  equal to the increase in the per-bed surcharge paid under 
252.1   section 256.9657, subdivision 1, paragraph (d), divided by 365 
252.2   and further divided by .90.  The increase shall not be subject 
252.3   to any annual percentage increase.  The 30-day advance notice 
252.4   requirement in section 256B.47, subdivision 2, shall not apply 
252.5   to rate increases resulting from this section.  The commissioner 
252.6   shall not adjust the rate increase under this subdivision unless 
252.7   an adjustment under section 256.9657, subdivision 1, paragraph 
252.8   (e), is greater than 1.5 percent of the surcharge amount. 
252.9      <b>[EFFECTIVE DATE.]</b> This section is effective May 31, 2003. 
252.10     Sec. 26.  Minnesota Statutes 2002, section 256B.431, is 
252.11  amended by adding a subdivision to read: 
252.12     Subd. 39.  [NURSING FACILITY RATE ADJUSTMENT.] (a) For the 
252.13  rate year beginning July 1, 2003, the commissioner shall 
252.14  implement a reduction to the rates provided to each nursing 
252.15  facility reimbursed under this section or section 256B.434, 
252.16  equal to four percent of the operating and property components 
252.17  of the total payment rates in effect on June 30, 2003. 
252.18     (b) Nursing facilities, individually or as groups, may 
252.19  elect to reduce their licensed capacity as an alternative to the 
252.20  rate adjustment in paragraph (a).  This election must be 
252.21  requested within 60 days of the effective date of this section 
252.22  and agreed to on a form to be provided by the commissioner.  The 
252.23  facility or group of facilities electing to reduce licensed 
252.24  capacity must agree to:  (i) reduce their licensed number of 
252.25  beds by October 1, 2003, to 95 percent of the number of beds 
252.26  actually occupied on January 1, 2003; (ii) reduce their licensed 
252.27  number of beds by January 1, 2004, to 90 percent of the number 
252.28  of beds actually occupied on January 1, 2003; (iii) reduce their 
252.29  licensed number of beds by April 1, 2004, to 85 percent of the 
252.30  number of beds actually occupied on January 1, 2003; and (iv) 
252.31  not remove any beds from layaway until after June 30, 2007.  For 
252.32  beds placed in layaway prior to January 1, 2003, in determining 
252.33  the five-year limit that a bed may remain in layaway under 
252.34  section 144A.071, subdivision 4b, the commissioner shall allow 
252.35  beds to be removed from layaway until January 1, 2008.  For 
252.36  purposes of this section, a vacant bed shall be considered 
253.1   occupied on January 1, 2003, if the facility was holding the bed 
253.2   for a resident on hospital leave or therapeutic leave.  For 
253.3   purposes of this section, a bed shall be considered removed from 
253.4   service on the date the commissioner receives notification from 
253.5   a nursing facility that a bed is to be delicensed within 60 
253.6   days.  Any bed delicensed on or after January 1, 2003, may be 
253.7   counted by the facility toward the capacity reduction elected 
253.8   under this paragraph. 
253.9      (c) If a nursing facility that elects to reduce its 
253.10  capacity according to paragraph (b) fails to do so, the 
253.11  commissioner shall reduce the payment rate of that nursing 
253.12  facility according to paragraph (a), retroactively from July 1, 
253.13  2003.  The commissioner may grant extensions of up to 90 days to 
253.14  the requirements in paragraph (b) to facilities electing to 
253.15  reduce capacity.  In granting an extension, the commissioner 
253.16  shall consider the number of admissions to and discharges from 
253.17  the facility, progress in reducing occupancy, and the 
253.18  availability of beds in the county in which the facility is 
253.19  located, measured by the number of beds per 1,000 individuals 
253.20  age 65 and older. 
253.21     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
253.22  following final enactment. 
253.23     Sec. 27.  Minnesota Statutes 2002, section 256B.434, 
253.24  subdivision 4, is amended to read: 
253.25     Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
253.26  nursing facilities which have their payment rates determined 
253.27  under this section rather than section 256B.431, the 
253.28  commissioner shall establish a rate under this subdivision.  The 
253.29  nursing facility must enter into a written contract with the 
253.30  commissioner. 
253.31     (b) A nursing facility's case mix payment rate for the 
253.32  first rate year of a facility's contract under this section is 
253.33  the payment rate the facility would have received under section 
253.34  256B.431. 
253.35     (c) A nursing facility's case mix payment rates for the 
253.36  second and subsequent years of a facility's contract under this 
254.1   section are the previous rate year's contract payment rates plus 
254.2   an inflation adjustment and, for facilities reimbursed under 
254.3   this section or section 256B.431, an adjustment to include the 
254.4   cost of any increase in health department licensing fees for the 
254.5   facility taking effect on or after July 1, 2001.  The index for 
254.6   the inflation adjustment must be based on the change in the 
254.7   Consumer Price Index-All Items (United States City average) 
254.8   (CPI-U) forecasted by Data Resources, Inc. the commissioner of 
254.9   finance's national economic consultant, as forecasted in the 
254.10  fourth quarter of the calendar year preceding the rate year.  
254.11  The inflation adjustment must be based on the 12-month period 
254.12  from the midpoint of the previous rate year to the midpoint of 
254.13  the rate year for which the rate is being determined.  For the 
254.14  rate years beginning on July 1, 1999, July 1, 2000, July 1, 
254.15  2001, and July 1, 2002, July 1, 2003, and July 1, 2004, this 
254.16  paragraph shall apply only to the property-related payment rate, 
254.17  except that adjustments to include the cost of any increase in 
254.18  health department licensing fees taking effect on or after July 
254.19  1, 2001, shall be provided.  In determining the amount of the 
254.20  property-related payment rate adjustment under this paragraph, 
254.21  the commissioner shall determine the proportion of the 
254.22  facility's rates that are property-related based on the 
254.23  facility's most recent cost report. 
254.24     (d) The commissioner shall develop additional 
254.25  incentive-based payments of up to five percent above the 
254.26  standard contract rate for achieving outcomes specified in each 
254.27  contract.  The specified facility-specific outcomes must be 
254.28  measurable and approved by the commissioner.  The commissioner 
254.29  may establish, for each contract, various levels of achievement 
254.30  within an outcome.  After the outcomes have been specified the 
254.31  commissioner shall assign various levels of payment associated 
254.32  with achieving the outcome.  Any incentive-based payment cancels 
254.33  if there is a termination of the contract.  In establishing the 
254.34  specified outcomes and related criteria the commissioner shall 
254.35  consider the following state policy objectives: 
254.36     (1) improved cost effectiveness and quality of life as 
255.1   measured by improved clinical outcomes; 
255.2      (2) successful diversion or discharge to community 
255.3   alternatives; 
255.4      (3) decreased acute care costs; 
255.5      (4) improved consumer satisfaction; 
255.6      (5) the achievement of quality; or 
255.7      (6) any additional outcomes proposed by a nursing facility 
255.8   that the commissioner finds desirable. 
255.9      Sec. 28.  Minnesota Statutes 2002, section 256B.48, 
255.10  subdivision 1, is amended to read: 
255.11     Subdivision 1.  [PROHIBITED PRACTICES.] A nursing facility 
255.12  is not eligible to receive medical assistance payments unless it 
255.13  refrains from all of the following: 
255.14     (a) Charging private paying residents rates for similar 
255.15  services which exceed those which are approved by the state 
255.16  agency for medical assistance recipients as determined by the 
255.17  prospective desk audit rate, except under the following 
255.18  circumstances:  (1) the nursing facility may (1) (i) charge 
255.19  private paying residents a higher rate for a private room, and 
255.20  (2) (ii) charge for special services which are not included in 
255.21  the daily rate if medical assistance residents are charged 
255.22  separately at the same rate for the same services in addition to 
255.23  the daily rate paid by the commissioner.; (2) effective July 1, 
255.24  2003, nursing facilities may charge private paying residents 
255.25  rates up to two percent higher than the allowable payment rate 
255.26  in effect on June 30, 2003, plus an adjustment equal to any 
255.27  other rate increase provided in law, for the RUGs group 
255.28  currently assigned to the resident; (3) effective July 1, 2004, 
255.29  nursing facilities may charge private paying residents rates up 
255.30  to four percent higher than the allowable payment rate in effect 
255.31  on June 30, 2003, plus an adjustment equal to any other rate 
255.32  increase provided in law, for the RUGs group currently assigned 
255.33  to the resident; (4) effective July 1, 2005, nursing facilities 
255.34  may charge private paying residents rates up to six percent 
255.35  higher than the allowable payment rate in effect on June 30, 
255.36  2003, plus an adjustment equal to any other rate increase 
256.1   provided in law, for the RUGs group currently assigned to the 
256.2   resident; and (5) effective July 1, 2006, nursing facilities may 
256.3   charge private paying residents rates up to eight percent higher 
256.4   than the allowable payment rate in effect on June 30, 2003, plus 
256.5   an adjustment equal to any other rate increase provided in law, 
256.6   for the RUGs group currently assigned to the resident.  For 
256.7   purposes of this subdivision, the allowable payment rate is the 
256.8   total payment rate under section 256B.431 or 256B.434 including 
256.9   adjustments for enhanced rates during the first 30 days under 
256.10  section 256B.431, subdivision 32, and private room differentials 
256.11  under clause (1), item (i), and Minnesota Rules, part 9549.0060, 
256.12  subpart 11, item C.  Services covered by the payment rate must 
256.13  be the same regardless of payment source.  Special services, if 
256.14  offered, must be available to all residents in all areas of the 
256.15  nursing facility and charged separately at the same rate.  
256.16  Residents are free to select or decline special services.  
256.17  Special services must not include services which must be 
256.18  provided by the nursing facility in order to comply with 
256.19  licensure or certification standards and that if not provided 
256.20  would result in a deficiency or violation by the nursing 
256.21  facility.  Services beyond those required to comply with 
256.22  licensure or certification standards must not be charged 
256.23  separately as a special service if they were included in the 
256.24  payment rate for the previous reporting year.  A nursing 
256.25  facility that charges a private paying resident a rate in 
256.26  violation of this clause is subject to an action by the state of 
256.27  Minnesota or any of its subdivisions or agencies for civil 
256.28  damages.  A private paying resident or the resident's legal 
256.29  representative has a cause of action for civil damages against a 
256.30  nursing facility that charges the resident rates in violation of 
256.31  this clause.  The damages awarded shall include three times the 
256.32  payments that result from the violation, together with costs and 
256.33  disbursements, including reasonable attorneys' fees or their 
256.34  equivalent.  A private paying resident or the resident's legal 
256.35  representative, the state, subdivision or agency, or a nursing 
256.36  facility may request a hearing to determine the allowed rate or 
257.1   rates at issue in the cause of action.  Within 15 calendar days 
257.2   after receiving a request for such a hearing, the commissioner 
257.3   shall request assignment of an administrative law judge under 
257.4   sections 14.48 to 14.56 to conduct the hearing as soon as 
257.5   possible or according to agreement by the parties.  The 
257.6   administrative law judge shall issue a report within 15 calendar 
257.7   days following the close of the hearing.  The prohibition set 
257.8   forth in this clause shall not apply to facilities licensed as 
257.9   boarding care facilities which are not certified as skilled or 
257.10  intermediate care facilities level I or II for reimbursement 
257.11  through medical assistance. 
257.12     (b) Effective July 1, 2007, paragraph (a) no longer 
257.13  applies, except that special services, if offered, must be 
257.14  available to all residents in all areas of the nursing facility 
257.15  and charged separately at the same rate.  Residents are free to 
257.16  select or decline special services.  Special services must not 
257.17  include services which must be provided by the nursing facility 
257.18  in order to comply with licensure or certification standards and 
257.19  that if not provided would result in a deficiency or violation 
257.20  by the nursing facility. 
257.21     (b) (c)(1) Charging, soliciting, accepting, or receiving 
257.22  from an applicant for admission to the facility, or from anyone 
257.23  acting in behalf of the applicant, as a condition of admission, 
257.24  expediting the admission, or as a requirement for the 
257.25  individual's continued stay, any fee, deposit, gift, money, 
257.26  donation, or other consideration not otherwise required as 
257.27  payment under the state plan for residents on medical 
257.28  assistance, medical assistance payment according to the state 
257.29  plan must be accepted as payment in full for continued stay, 
257.30  except where otherwise provided for under statute; 
257.31     (2) requiring an individual, or anyone acting in behalf of 
257.32  the individual, to loan any money to the nursing facility; 
257.33     (3) requiring an individual, or anyone acting in behalf of 
257.34  the individual, to promise to leave all or part of the 
257.35  individual's estate to the facility; or 
257.36     (4) requiring a third-party guarantee of payment to the 
258.1   facility as a condition of admission, expedited admission, or 
258.2   continued stay in the facility.  
258.3   Nothing in this paragraph would prohibit discharge for 
258.4   nonpayment of services in accordance with state and federal 
258.5   regulations. 
258.6      (c) (d) Requiring any resident of the nursing facility to 
258.7   utilize a vendor of health care services chosen by the nursing 
258.8   facility.  A nursing facility may require a resident to use 
258.9   pharmacies that utilize unit dose packing systems approved by 
258.10  the Minnesota board of pharmacy, and may require a resident to 
258.11  use pharmacies that are able to meet the federal regulations for 
258.12  safe and timely administration of medications such as systems 
258.13  with specific number of doses, prompt delivery of medications, 
258.14  or access to medications on a 24-hour basis.  Notwithstanding 
258.15  the provisions of this paragraph, nursing facilities shall not 
258.16  restrict a resident's choice of pharmacy because the pharmacy 
258.17  utilizes a specific system of unit dose drug packing. 
258.18     (d) (e) Providing differential treatment on the basis of 
258.19  status with regard to public assistance.  
258.20     (e) (f) Discriminating in admissions, services offered, or 
258.21  room assignment on the basis of status with regard to public 
258.22  assistance or refusal to purchase special 
258.23  services.  Discrimination in admissions discrimination, services 
258.24  offered, or room assignment shall include, but is not limited to:
258.25     (1) basing admissions decisions upon assurance by the 
258.26  applicant to the nursing facility, or the applicant's guardian 
258.27  or conservator, that the applicant is neither eligible for nor 
258.28  will seek information or assurances regarding current or future 
258.29  eligibility for public assistance for payment of nursing 
258.30  facility care costs; and 
258.31     (2) engaging in preferential selection from waiting lists 
258.32  based on an applicant's ability to pay privately or an 
258.33  applicant's refusal to pay for a special service requiring a 
258.34  person who is eligible for public assistance to accept a room 
258.35  transfer from a single bed room to a multiple bed room. 
258.36     The collection and use by a nursing facility of financial 
259.1   information of any applicant pursuant to a preadmission 
259.2   screening program established by law shall not raise an 
259.3   inference that the nursing facility is utilizing that 
259.4   information for any purpose prohibited by this paragraph.  
259.5      (g) In a case where the commissioner determines that a 
259.6   nursing facility is not in compliance with the requirements in 
259.7   paragraphs (a) to (f), the commissioner shall provide to the 
259.8   facility notice of a finding of noncompliance.  If after 30 days 
259.9   the commissioner finds the facility is still not in compliance, 
259.10  the commissioner shall initiate withholding of ten percent of 
259.11  medical assistance payments due to the facility.  If, after 90 
259.12  days after the original notification, the nursing facility is 
259.13  still not in compliance, the commissioner shall not assume 
259.14  payments for any resident admitted after that date.  Upon 
259.15  determination by the commissioner that the facility is in 
259.16  compliance, these penalties shall be removed and payments of 
259.17  withheld amounts and for newly admitted residents shall be made 
259.18  retroactive for no more than 90 days. 
259.19     (f) (h) Requiring any vendor of medical care as defined by 
259.20  section 256B.02, subdivision 7, who is reimbursed by medical 
259.21  assistance under a separate fee schedule, to pay any amount 
259.22  based on utilization or service levels or any portion of the 
259.23  vendor's fee to the nursing facility except as payment for 
259.24  renting or leasing space or equipment or purchasing support 
259.25  services from the nursing facility as limited by section 
259.26  256B.433.  All agreements must be disclosed to the commissioner 
259.27  upon request of the commissioner.  Nursing facilities and 
259.28  vendors of ancillary services that are found to be in violation 
259.29  of this provision shall each be subject to an action by the 
259.30  state of Minnesota or any of its subdivisions or agencies for 
259.31  treble civil damages on the portion of the fee in excess of that 
259.32  allowed by this provision and section 256B.433.  Damages awarded 
259.33  must include three times the excess payments together with costs 
259.34  and disbursements including reasonable attorney's fees or their 
259.35  equivalent.  
259.36     (g) (i)  Refusing, for more than 24 hours, to accept a 
260.1   resident returning to the same bed or a bed certified for the 
260.2   same level of care, in accordance with a physician's order 
260.3   authorizing transfer, after receiving inpatient hospital 
260.4   services. 
260.5      For a period not to exceed 180 days, the commissioner may 
260.6   continue to make medical assistance payments to a nursing 
260.7   facility or boarding care home which is in violation of this 
260.8   section if extreme hardship to the residents would result.  In 
260.9   these cases the commissioner shall issue an order requiring the 
260.10  nursing facility to correct the violation.  The nursing facility 
260.11  shall have 20 days from its receipt of the order to correct the 
260.12  violation.  If the violation is not corrected within the 20-day 
260.13  period the commissioner may reduce the payment rate to the 
260.14  nursing facility by up to 20 percent.  The amount of the payment 
260.15  rate reduction shall be related to the severity of the violation 
260.16  and shall remain in effect until the violation is corrected.  
260.17  The nursing facility or boarding care home may appeal the 
260.18  commissioner's action pursuant to the provisions of chapter 14 
260.19  pertaining to contested cases.  An appeal shall be considered 
260.20  timely if written notice of appeal is received by the 
260.21  commissioner within 20 days of notice of the commissioner's 
260.22  proposed action.  
260.23     In the event that the commissioner determines that a 
260.24  nursing facility is not eligible for reimbursement for a 
260.25  resident who is eligible for medical assistance, the 
260.26  commissioner may authorize the nursing facility to receive 
260.27  reimbursement on a temporary basis until the resident can be 
260.28  relocated to a participating nursing facility.  
260.29     Certified beds in facilities which do not allow medical 
260.30  assistance intake on July 1, 1984, or after shall be deemed to 
260.31  be decertified for purposes of section 144A.071 only.  
260.32     Sec. 29.  Minnesota Statutes 2002, section 256I.02, is 
260.33  amended to read: 
260.34     256I.02 [PURPOSE.] 
260.35     The Group Residential Housing Act establishes a 
260.36  comprehensive system of rates and payments for persons who 
261.1   reside in a group residence the community and who meet the 
261.2   eligibility criteria under section 256I.04, subdivision 1. 
261.3      Sec. 30.  Minnesota Statutes 2002, section 256I.04, 
261.4   subdivision 3, is amended to read: 
261.5      Subd. 3.  [MORATORIUM ON THE DEVELOPMENT OF GROUP 
261.6   RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 
261.7   into agreements for new group residential housing beds with 
261.8   total rates in excess of the MSA equivalent rate except:  (1) 
261.9   for group residential housing establishments meeting the 
261.10  requirements of subdivision 2a, clause (2) with department 
261.11  approval; (2) for group residential housing establishments 
261.12  licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 
261.13  provided the facility is needed to meet the census reduction 
261.14  targets for persons with mental retardation or related 
261.15  conditions at regional treatment centers; (3) (2) to ensure 
261.16  compliance with the federal Omnibus Budget Reconciliation Act 
261.17  alternative disposition plan requirements for inappropriately 
261.18  placed persons with mental retardation or related conditions or 
261.19  mental illness; (4) (3) up to 80 beds in a single, specialized 
261.20  facility located in Hennepin county that will provide housing 
261.21  for chronic inebriates who are repetitive users of 
261.22  detoxification centers and are refused placement in emergency 
261.23  shelters because of their state of intoxication, and planning 
261.24  for the specialized facility must have been initiated before 
261.25  July 1, 1991, in anticipation of receiving a grant from the 
261.26  housing finance agency under section 462A.05, subdivision 20a, 
261.27  paragraph (b); (5) (4) notwithstanding the provisions of 
261.28  subdivision 2a, for up to 190 supportive housing units in Anoka, 
261.29  Dakota, Hennepin, or Ramsey county for homeless adults with a 
261.30  mental illness, a history of substance abuse, or human 
261.31  immunodeficiency virus or acquired immunodeficiency syndrome.  
261.32  For purposes of this section, "homeless adult" means a person 
261.33  who is living on the street or in a shelter or discharged from a 
261.34  regional treatment center, community hospital, or residential 
261.35  treatment program and has no appropriate housing available and 
261.36  lacks the resources and support necessary to access appropriate 
262.1   housing.  At least 70 percent of the supportive housing units 
262.2   must serve homeless adults with mental illness, substance abuse 
262.3   problems, or human immunodeficiency virus or acquired 
262.4   immunodeficiency syndrome who are about to be or, within the 
262.5   previous six months, has been discharged from a regional 
262.6   treatment center, or a state-contracted psychiatric bed in a 
262.7   community hospital, or a residential mental health or chemical 
262.8   dependency treatment program.  If a person meets the 
262.9   requirements of subdivision 1, paragraph (a), and receives a 
262.10  federal or state housing subsidy, the group residential housing 
262.11  rate for that person is limited to the supplementary rate under 
262.12  section 256I.05, subdivision 1a, and is determined by 
262.13  subtracting the amount of the person's countable income that 
262.14  exceeds the MSA equivalent rate from the group residential 
262.15  housing supplementary rate.  A resident in a demonstration 
262.16  project site who no longer participates in the demonstration 
262.17  program shall retain eligibility for a group residential housing 
262.18  payment in an amount determined under section 256I.06, 
262.19  subdivision 8, using the MSA equivalent rate.  Service funding 
262.20  under section 256I.05, subdivision 1a, will end June 30, 1997, 
262.21  if federal matching funds are available and the services can be 
262.22  provided through a managed care entity.  If federal matching 
262.23  funds are not available, then service funding will continue 
262.24  under section 256I.05, subdivision 1a; or (6) for group 
262.25  residential housing beds in settings meeting the requirements of 
262.26  subdivision 2a, clauses (1) and (3), which are used exclusively 
262.27  for recipients receiving home and community-based waiver 
262.28  services under sections 256B.0915, 256B.092, subdivision 5, 
262.29  256B.093, and 256B.49, and who resided in a nursing facility for 
262.30  the six months immediately prior to the month of entry into the 
262.31  group residential housing setting.  The group residential 
262.32  housing rate for these beds must be set so that the monthly 
262.33  group residential housing payment for an individual occupying 
262.34  the bed when combined with the nonfederal share of services 
262.35  delivered under the waiver for that person does not exceed the 
262.36  nonfederal share of the monthly medical assistance payment made 
263.1   for the person to the nursing facility in which the person 
263.2   resided prior to entry into the group residential housing 
263.3   establishment.  The rate may not exceed the MSA equivalent rate 
263.4   plus $426.37 for any case. 
263.5      (b) A county agency may enter into a group residential 
263.6   housing agreement for beds with rates in excess of the MSA 
263.7   equivalent rate in addition to those currently covered under a 
263.8   group residential housing agreement if the additional beds are 
263.9   only a replacement of beds with rates in excess of the MSA 
263.10  equivalent rate which have been made available due to closure of 
263.11  a setting, a change of licensure or certification which removes 
263.12  the beds from group residential housing payment, or as a result 
263.13  of the downsizing of a group residential housing setting.  The 
263.14  transfer of available beds from one county to another can only 
263.15  occur by the agreement of both counties. 
263.16     Sec. 31.  Minnesota Statutes 2002, section 256I.05, 
263.17  subdivision 1, is amended to read: 
263.18     Subdivision 1.  [MAXIMUM RATES.] (a) Monthly room and board 
263.19  rates negotiated by a county agency for a recipient living in 
263.20  group residential housing must not exceed the MSA equivalent 
263.21  rate specified under section 256I.03, subdivision 5,. with the 
263.22  exception that a county agency may negotiate a supplementary 
263.23  room and board rate that exceeds the MSA equivalent rate for 
263.24  recipients of waiver services under title XIX of the Social 
263.25  Security Act.  This exception is subject to the following 
263.26  conditions: 
263.27     (1) the setting is licensed by the commissioner of human 
263.28  services under Minnesota Rules, parts 9555.5050 to 9555.6265; 
263.29     (2) the setting is not the primary residence of the license 
263.30  holder and in which the license holder is not the primary 
263.31  caregiver; and 
263.32     (3) the average supplementary room and board rate in a 
263.33  county for a calendar year may not exceed the average 
263.34  supplementary room and board rate for that county in effect on 
263.35  January 1, 2000.  For calendar years beginning on or after 
263.36  January 1, 2002, within the limits of appropriations 
264.1   specifically for this purpose, the commissioner shall increase 
264.2   each county's supplemental room and board rate average on an 
264.3   annual basis by a factor consisting of the percentage change in 
264.4   the Consumer Price Index-All items, United States city average 
264.5   (CPI-U) for that calendar year compared to the preceding 
264.6   calendar year as forecasted by Data Resources, Inc., in the 
264.7   third quarter of the preceding calendar year.  If a county has 
264.8   not negotiated supplementary room and board rates for any 
264.9   facilities located in the county as of January 1, 2000, or has 
264.10  an average supplemental room and board rate under $100 per 
264.11  person as of January 1, 2000, it may submit a supplementary room 
264.12  and board rate request with budget information for a facility to 
264.13  the commissioner for approval. 
264.14  The county agency may at any time negotiate a higher or lower 
264.15  room and board rate than the average supplementary room and 
264.16  board rate. 
264.17     (b) Notwithstanding paragraph (a), clause (3), county 
264.18  agencies may negotiate a supplementary room and board rate that 
264.19  exceeds the MSA equivalent rate by up to $426.37 for up to five 
264.20  facilities, serving not more than 20 individuals in total, that 
264.21  were established to replace an intermediate care facility for 
264.22  persons with mental retardation and related conditions located 
264.23  in the city of Roseau that became uninhabitable due to flood 
264.24  damage in June 2002. 
264.25     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004, 
264.26  or upon receipt of federal approval of waiver amendment, 
264.27  whichever is later. 
264.28     Sec. 32.  Minnesota Statutes 2002, section 256I.05, 
264.29  subdivision 1a, is amended to read: 
264.30     Subd. 1a.  [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 
264.31  the provisions of section 256I.04, subdivision 3, in addition to 
264.32  the room and board rate specified in subdivision 1, the county 
264.33  agency may negotiate a payment not to exceed $426.37 for other 
264.34  services necessary to provide room and board provided by the 
264.35  group residence if the residence is licensed by or registered by 
264.36  the department of health, or licensed by the department of human 
265.1   services to provide services in addition to room and board, and 
265.2   if the provider of services is not also concurrently receiving 
265.3   funding for services for a recipient under a home and 
265.4   community-based waiver under title XIX of the Social Security 
265.5   Act; or funding from the medical assistance program under 
265.6   section 256B.0627, subdivision 4, for personal care services for 
265.7   residents in the setting; or residing in a setting which 
265.8   receives funding under Minnesota Rules, parts 9535.2000 to 
265.9   9535.3000.  If funding is available for other necessary services 
265.10  through a home and community-based waiver, or personal care 
265.11  services under section 256B.0627, subdivision 4, then the GRH 
265.12  rate is limited to the rate set in subdivision 1.  Unless 
265.13  otherwise provided in law, in no case may the supplementary 
265.14  service rate plus the supplementary room and board rate exceed 
265.15  $426.37.  The registration and licensure requirement does not 
265.16  apply to establishments which are exempt from state licensure 
265.17  because they are located on Indian reservations and for which 
265.18  the tribe has prescribed health and safety requirements.  
265.19  Service payments under this section may be prohibited under 
265.20  rules to prevent the supplanting of federal funds with state 
265.21  funds.  The commissioner shall pursue the feasibility of 
265.22  obtaining the approval of the Secretary of Health and Human 
265.23  Services to provide home and community-based waiver services 
265.24  under title XIX of the Social Security Act for residents who are 
265.25  not eligible for an existing home and community-based waiver due 
265.26  to a primary diagnosis of mental illness or chemical dependency 
265.27  and shall apply for a waiver if it is determined to be 
265.28  cost-effective.  
265.29     (b) The commissioner is authorized to make cost-neutral 
265.30  transfers from the GRH fund for beds under this section to other 
265.31  funding programs administered by the department after 
265.32  consultation with the county or counties in which the affected 
265.33  beds are located.  The commissioner may also make cost-neutral 
265.34  transfers from the GRH fund to county human service agencies for 
265.35  beds permanently removed from the GRH census under a plan 
265.36  submitted by the county agency and approved by the 
266.1   commissioner.  The commissioner shall report the amount of any 
266.2   transfers under this provision annually to the legislature. 
266.3      (c) The provisions of paragraph (b) do not apply to a 
266.4   facility that has its reimbursement rate established under 
266.5   section 256B.431, subdivision 4, paragraph (c). 
266.6      Sec. 33.  Minnesota Statutes 2002, section 256I.05, 
266.7   subdivision 2, is amended to read: 
266.8      Subd. 2.  [MONTHLY RATES; EXEMPTIONS.] The maximum group 
266.9   residential housing rate does not apply to a residence that on 
266.10  August 1, 1984, was licensed by the commissioner of health only 
266.11  as a boarding care home, certified by the commissioner of health 
266.12  as an intermediate care facility, and licensed by the 
266.13  commissioner of human services under Minnesota Rules, parts 
266.14  9520.0500 to 9520.0690.  Notwithstanding the provisions of 
266.15  subdivision 1c, the rate paid to a facility reimbursed under 
266.16  this subdivision shall be determined under section 256B.431, or 
266.17  under section 256B.434 if the facility is accepted by the 
266.18  commissioner for participation in the alternative payment 
266.19  demonstration project.  Section 256B.431, subdivision 39, 
266.20  paragraph (a), shall not apply to the monthly rates determined 
266.21  according to the provisions of this subdivision. 
266.22     Sec. 34.  Minnesota Statutes 2002, section 256I.05, 
266.23  subdivision 7c, is amended to read: 
266.24     Subd. 7c.  [DEMONSTRATION PROJECT.] The commissioner is 
266.25  authorized to pursue a demonstration project under federal food 
266.26  stamp regulation for the purpose of gaining federal 
266.27  reimbursement of food and nutritional costs currently paid by 
266.28  the state group residential housing program.  The commissioner 
266.29  shall seek approval no later than January 1, 2004.  Any 
266.30  reimbursement received is nondedicated revenue to the general 
266.31  fund. 
266.32     Sec. 35.  [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 
266.33     Subdivision 1.  [APPLICABILITY.] The definitions in this 
266.34  section apply to sections 514.991 to 514.995. 
266.35     Subd. 2.  [ALTERNATIVE CARE AGENCY, AGENCY, OR 
266.36  DEPARTMENT.] "Alternative care agency," "agency," or "department"
267.1   means the department of human services when it pays for or 
267.2   provides alternative care benefits for a nonmedical assistance 
267.3   recipient directly or through a county social services agency 
267.4   under chapter 256B according to section 256B.0913. 
267.5      Subd. 3.  [ALTERNATIVE CARE BENEFIT OR 
267.6   BENEFITS.] "Alternative care benefit" or "benefits" means a 
267.7   benefit provided to a nonmedical assistance recipient under 
267.8   chapter 256B according to section 256B.0913. 
267.9      Subd. 4.  [ALTERNATIVE CARE RECIPIENT OR 
267.10  RECIPIENT.] "Alternative care recipient" or "recipient" means a 
267.11  person who receives alternative care grant benefits. 
267.12     Subd. 5.  [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 
267.13  care lien" or "lien" means a lien filed under sections 514.992 
267.14  to 514.995. 
267.15     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
267.16  for services for persons first enrolling in the alternative care 
267.17  program on or after that date and on the first day of the first 
267.18  eligibility renewal period for persons enrolled in the 
267.19  alternative care program prior to July 1, 2003. 
267.20     Sec. 36.  [514.992] [ALTERNATIVE CARE LIEN.] 
267.21     Subdivision 1.  [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a)
267.22  Subject to sections 514.991 to 514.995, payments made by an 
267.23  alternative care agency to provide benefits to a recipient or to 
267.24  the recipient's spouse who owns property in this state 
267.25  constitute a lien in favor of the agency on all real property 
267.26  the recipient owns at and after the time the benefits are first 
267.27  paid. 
267.28     (b) The amount of the lien is limited to benefits paid for 
267.29  services provided to recipients over 55 years of age and 
267.30  provided on and after July 1, 2003. 
267.31     Subd. 2.  [ATTACHMENT.] (a) A lien attaches to and becomes 
267.32  enforceable against specific real property as of the date when 
267.33  all of the following conditions are met: 
267.34     (1) the agency has paid benefits for a recipient; 
267.35     (2) the recipient has been given notice and an opportunity 
267.36  for a hearing under paragraph (b); 
268.1      (3) the lien has been filed as provided for in section 
268.2   514.993 or memorialized on the certificate of title for the 
268.3   property it describes; and 
268.4      (4) all restrictions against enforcement have ceased to 
268.5   apply. 
268.6      (b) An agency may not file a lien until it has sent the 
268.7   recipient, their authorized representative, or their legal 
268.8   representative written notice of its lien rights by certified 
268.9   mail, return receipt requested, or registered mail and there has 
268.10  been an opportunity for a hearing under section 256.045.  No 
268.11  person other than the recipient shall have a right to a hearing 
268.12  under section 256.045 prior to the time the lien is filed.  The 
268.13  hearing shall be limited to whether the agency has met all of 
268.14  the prerequisites for filing the lien and whether any of the 
268.15  exceptions in this section apply. 
268.16     (c) An agency may not file a lien against the recipient's 
268.17  homestead when any of the following exceptions apply: 
268.18     (1) while the recipient's spouse is also physically present 
268.19  and lawfully and continuously residing in the homestead; 
268.20     (2) a child of the recipient who is under age 21 or who is 
268.21  blind or totally and permanently disabled according to 
268.22  supplemental security income criteria is also physically present 
268.23  on the property and lawfully and continuously residing on the 
268.24  property from and after the date the recipient first receives 
268.25  benefits; 
268.26     (3) a child of the recipient who has also lawfully and 
268.27  continuously resided on the property for a period beginning at 
268.28  least two years before the first day of the month in which the 
268.29  recipient began receiving alternative care, and who provided 
268.30  uncompensated care to the recipient which enabled the recipient 
268.31  to live without alternative care services for the two-year 
268.32  period; 
268.33     (4) a sibling of the recipient who has an ownership 
268.34  interest in the property of record in the office of the county 
268.35  recorder or registrar of titles for the county in which the real 
268.36  property is located and who has also continuously occupied the 
269.1   homestead for a period of at least one year immediately prior to 
269.2   the first day of the first month in which the recipient received 
269.3   benefits and continuously since that date. 
269.4      (d) A lien only applies to the real property it describes. 
269.5      Subd. 3.  [CONTINUATION OF LIEN.] A lien remains effective 
269.6   from the time it is filed until it is paid, satisfied, 
269.7   discharged, or becomes unenforceable under sections 514.991 to 
269.8   514.995. 
269.9      Subd. 4.  [PRIORITY OF LIEN.] (a) A lien which attaches to 
269.10  the real property it describes is subject to the rights of 
269.11  anyone else whose interest in the real property is perfected of 
269.12  record before the lien has been recorded or filed under section 
269.13  514.993, including: 
269.14     (1) an owner, other than the recipient or the recipient's 
269.15  spouse; 
269.16     (2) a good faith purchaser for value without notice of the 
269.17  lien; 
269.18     (3) a holder of a mortgage or security interest; or 
269.19     (4) a judgment lien creditor whose judgment lien has 
269.20  attached to the recipient's interest in the real property. 
269.21     (b) The rights of the other person have the same 
269.22  protections against an alternative care lien as are afforded 
269.23  against a judgment lien that arises out of an unsecured 
269.24  obligation and arises as of the time of the filing of an 
269.25  alternative care grant lien under section 514.993.  The lien 
269.26  shall be inferior to a lien for property taxes and special 
269.27  assessments and shall be superior to all other matters first 
269.28  appearing of record after the time and date the lien is filed or 
269.29  recorded. 
269.30     Subd. 5.  [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 
269.31  agency may, with absolute discretion, settle or subordinate the 
269.32  lien to any other lien or encumbrance of record upon the terms 
269.33  and conditions it deems appropriate. 
269.34     (b) The agency filing the lien shall release and discharge 
269.35  the lien: 
269.36     (1) if it has been paid, discharged, or satisfied; 
270.1      (2) if it has received reimbursement for the amounts 
270.2   secured by the lien, has entered into a binding and legally 
270.3   enforceable agreement under which it is reimbursed for the 
270.4   amount of the lien, or receives other collateral sufficient to 
270.5   secure payment of the lien; 
270.6      (3) against some, but not all, of the property it describes 
270.7   upon the terms, conditions, and circumstances the agency deems 
270.8   appropriate; 
270.9      (4) to the extent it cannot be lawfully enforced against 
270.10  the property it describes because of an error, omission, or 
270.11  other material defect in the legal description contained in the 
270.12  lien or a necessary prerequisite to enforcement of the lien; and 
270.13     (5) if, in its discretion, it determines the filing or 
270.14  enforcement of the lien is contrary to the public interest. 
270.15     (c) The agency executing the lien shall execute and file 
270.16  the release as provided for in section 514.993, subdivision 2. 
270.17     Subd. 6.  [LENGTH OF LIEN.] (a) A lien shall be a lien on 
270.18  the real property it describes for a period of ten years from 
270.19  the date it attaches according to subdivision 2, paragraph (a), 
270.20  except as otherwise provided for in sections 514.992 to 
270.21  514.995.  The agency filing the lien may renew the lien for one 
270.22  additional ten-year period from the date it would otherwise 
270.23  expire by recording or filing a certificate of renewal before 
270.24  the lien expires.  The certificate of renewal shall be recorded 
270.25  or filed in the office of the county recorder or registrar of 
270.26  titles for the county in which the lien is recorded or filed.  
270.27  The certificate must refer to the recording or filing data for 
270.28  the lien it renews.  The certificate need not be attested, 
270.29  certified, or acknowledged as a condition for recording or 
270.30  filing.  The recorder or registrar of titles shall record, file, 
270.31  index, and return the certificate of renewal in the same manner 
270.32  provided for liens in section 514.993, subdivision 2. 
270.33     (b) An alternative care lien is not enforceable against the 
270.34  real property of an estate to the extent there is a 
270.35  determination by a court of competent jurisdiction, or by an 
270.36  officer of the court designated for that purpose, that there are 
271.1   insufficient assets in the estate to satisfy the lien in whole 
271.2   or in part because of the homestead exemption under section 
271.3   256B.15, subdivision 4, the rights of a surviving spouse or a 
271.4   minor child under section 524.2-403, paragraphs (a) and (b), or 
271.5   claims with a priority under section 524.3-805, paragraph (a), 
271.6   clauses (1) to (4).  For purposes of this section, the rights of 
271.7   the decedent's adult children to exempt property under section 
271.8   524.2-403, paragraph (b), shall not be considered costs of 
271.9   administration under section 524.3-805, paragraph (a), clause 
271.10  (1). 
271.11     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
271.12  for services for persons first enrolling in the alternative care 
271.13  program on or after that date and on the first day of the first 
271.14  eligibility renewal period for persons enrolled in the 
271.15  alternative care program prior to July 1, 2003. 
271.16     Sec. 37.  [514.993] [LIEN; CONTENTS AND FILING.] 
271.17     Subdivision 1.  [CONTENTS.] A lien shall be dated and must 
271.18  contain: 
271.19     (1) the recipient's full name, last known address, and 
271.20  social security number; 
271.21     (2) a statement that benefits have been paid to or for the 
271.22  recipient's benefit; 
271.23     (3) a statement that all of the recipient's interests in 
271.24  the in the real property described in the lien may be subject to 
271.25  or affected by the agency's right to reimbursement for benefits; 
271.26     (4) a legal description of the real property subject to the 
271.27  lien and whether it is registered or abstract property; 
271.28     (5) such other contents, if any, as the agency deems 
271.29  appropriate. 
271.30     Subd. 2.  [FILING.] Any lien, release, or other document 
271.31  required or permitted to be filed under sections 514.991 to 
271.32  514.995 must be recorded or filed in the office of the county 
271.33  recorder or registrar of titles, as appropriate, in the county 
271.34  where the real property is located.  Notwithstanding section 
271.35  386.77, the agency shall pay the applicable filing fee for any 
271.36  documents filed under sections 514.991 to 514.995.  An 
272.1   attestation, certification, or acknowledgment is not required as 
272.2   a condition of filing.  If the property described in the lien is 
272.3   registered property, the registrar of titles shall record it on 
272.4   the certificate of title for each parcel of property described 
272.5   in the lien.  If the property described in the lien is abstract 
272.6   property, the recorder shall file the lien in the county's 
272.7   grantor-grantee indexes and any tract indexes the county 
272.8   maintains for each parcel of property described in the lien.  
272.9   The recorder or registrar shall return the recorded or filed 
272.10  lien to the agency at no cost.  If the agency provides a 
272.11  duplicate copy of the lien, the recorder or registrar of titles 
272.12  shall show the recording or filing data on the copy and return 
272.13  it to the agency at no cost.  The agency is responsible for 
272.14  filing any lien, release, or other documents under sections 
272.15  514.991 to 514.995. 
272.16     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
272.17  for services for persons first enrolling in the alternative care 
272.18  program on or after that date and on the first day of the first 
272.19  eligibility renewal period for persons enrolled in the 
272.20  alternative care program prior to July 1, 2003. 
272.21     Sec. 38.  [514.994] [ENFORCEMENT; OTHER REMEDIES.] 
272.22     Subdivision 1.  [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 
272.23  agency may enforce or foreclose a lien filed under sections 
272.24  514.991 to 514.995 in the manner provided for by law for 
272.25  enforcement of judgment liens against real estate or by a 
272.26  foreclosure by action under chapter 581.  The lien shall remain 
272.27  enforceable as provided for in sections 514.991 to 514.995 
272.28  notwithstanding any laws limiting the enforceability of 
272.29  judgments. 
272.30     Subd. 2.  [HOMESTEAD EXEMPTION.] The lien may not be 
272.31  enforced against the homestead property of the recipient or the 
272.32  spouse while they physically occupy it as their lawful residence.
272.33     Subd. 3.  [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 
272.34  514.995 do not limit the agency's right to file a claim against 
272.35  the recipient's estate or the estate of the recipient's spouse, 
272.36  do not limit any other claims for reimbursement the agency may 
273.1   have, and do not limit the availability of any other remedy to 
273.2   the agency. 
273.3      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
273.4   for services for persons first enrolling in the alternative care 
273.5   program on or after that date and on the first day of the first 
273.6   eligibility renewal period for persons enrolled in the 
273.7   alternative care program prior to July 1, 2003. 
273.8      Sec. 39.  [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 
273.9      Amounts the agency receives to satisfy the lien must be 
273.10  deposited in the state treasury and credited to the fund from 
273.11  which the benefits were paid. 
273.12     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
273.13  for services for persons first enrolling in the alternative care 
273.14  program on or after that date and on the first day of the first 
273.15  eligibility renewal period for persons enrolled in the 
273.16  alternative care program prior to July 1, 2003. 
273.17     Sec. 40.  Minnesota Statutes 2002, section 524.3-805, is 
273.18  amended to read: 
273.19     524.3-805 [CLASSIFICATION OF CLAIMS.] 
273.20     (a) If the applicable assets of the estate are insufficient 
273.21  to pay all claims in full, the personal representative shall 
273.22  make payment in the following order: 
273.23     (1) costs and expenses of administration; 
273.24     (2) reasonable funeral expenses; 
273.25     (3) debts and taxes with preference under federal law; 
273.26     (4) reasonable and necessary medical, hospital, or nursing 
273.27  home expenses of the last illness of the decedent, including 
273.28  compensation of persons attending the decedent, a claim filed 
273.29  under section 256B.15 for recovery of expenditures for 
273.30  alternative care for nonmedical assistance recipients under 
273.31  section 256B.0913, and including a claim filed pursuant to 
273.32  section 256B.15; 
273.33     (5) reasonable and necessary medical, hospital, and nursing 
273.34  home expenses for the care of the decedent during the year 
273.35  immediately preceding death; 
273.36     (6) debts with preference under other laws of this state, 
274.1   and state taxes; 
274.2      (7) all other claims. 
274.3      (b) No preference shall be given in the payment of any 
274.4   claim over any other claim of the same class, and a claim due 
274.5   and payable shall not be entitled to a preference over claims 
274.6   not due, except that if claims for expenses of the last illness 
274.7   involve only claims filed under section 256B.15 for recovery of 
274.8   expenditures for alternative care for nonmedical assistance 
274.9   recipients under section 256B.0913, section 246.53 for costs of 
274.10  state hospital care and claims filed under section 256B.15, 
274.11  claims filed to recover expenditures for alternative care for 
274.12  nonmedical assistance recipients under section 256B.0913 shall 
274.13  have preference over claims filed under both sections 246.53 and 
274.14  other claims filed under section 256B.15, and claims filed under 
274.15  section 246.53 have preference over claims filed under section 
274.16  256B.15 for recovery of amounts other than those for 
274.17  expenditures for alternative care for nonmedical assistance 
274.18  recipients under section 256B.0913. 
274.19     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003, 
274.20  for decedents dying on or after that date. 
274.21     Sec. 41.  [REVISOR'S INSTRUCTION.] 
274.22     For sections in Minnesota Statutes and Minnesota Rules 
274.23  affected by the repealed sections in this article, the revisor 
274.24  shall delete internal cross-references where appropriate and 
274.25  make changes necessary to correct the punctuation, grammar, or 
274.26  structure of the remaining text and preserve its meaning. 
274.27     Sec. 42.  [REPEALER.] 
274.28     (a) Minnesota Statutes 2002, sections 256.973; 256.9752; 
274.29  256.9753; 256.976; 256.977; 256.9772; 256B.0917; 256B.0928; and 
274.30  256B.437, subdivision 2, are repealed effective July 1, 2003. 
274.31     (b) Laws 1988, chapter 689, article 2, section 251, is 
274.32  repealed effective July 1, 2003. 
274.33                             ARTICLE 4 
274.34           CONTINUING CARE FOR PERSONS WITH DISABILITIES 
274.35     Section 1.  Minnesota Statutes 2002, section 245B.06, 
274.36  subdivision 8, is amended to read: 
275.1      Subd. 8.  [LEAVING THE RESIDENCE.] As specified in each 
275.2   consumer's individual service plan, each consumer requiring a 
275.3   24-hour plan of care must may leave the residence to participate 
275.4   in regular education, employment, or community activities.  
275.5   License holders, providing services to consumers living in a 
275.6   licensed site, shall ensure that they are prepared to care for 
275.7   consumers whenever they are at the residence during the day 
275.8   because of illness, work schedules, or other reasons. 
275.9      Sec. 2.  Minnesota Statutes 2002, section 246.54, is 
275.10  amended to read: 
275.11     246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 
275.12     Subdivision 1.  [COUNTY PORTION FOR COST OF CARE.] Except 
275.13  for chemical dependency services provided under sections 254B.01 
275.14  to 254B.09, the client's county shall pay to the state of 
275.15  Minnesota a portion of the cost of care provided in a regional 
275.16  treatment center or a state nursing facility to a client legally 
275.17  settled in that county.  A county's payment shall be made from 
275.18  the county's own sources of revenue and payments shall be paid 
275.19  as follows:  payments to the state from the county shall 
275.20  equal ten 20 percent of the cost of care, as determined by the 
275.21  commissioner, for each day, or the portion thereof, that the 
275.22  client spends at a regional treatment center or a state nursing 
275.23  facility.  If payments received by the state under sections 
275.24  246.50 to 246.53 exceed 90 80 percent of the cost of care, the 
275.25  county shall be responsible for paying the state only the 
275.26  remaining amount.  The county shall not be entitled to 
275.27  reimbursement from the client, the client's estate, or from the 
275.28  client's relatives, except as provided in section 246.53.  No 
275.29  such payments shall be made for any client who was last 
275.30  committed prior to July 1, 1947. 
275.31     Subd. 2.  [EXCEPTIONS.] Subdivision 1 does not apply to 
275.32  services provided at the Minnesota security hospital, the 
275.33  Minnesota sex offender program, or the Minnesota extended 
275.34  treatment options program.  For services at these facilities, a 
275.35  county's payment shall be made from the county's own sources of 
275.36  revenue and payments shall be paid as follows:  payments to the 
276.1   state from the county shall equal ten percent of the cost of 
276.2   care, as determined by the commissioner, for each day, or the 
276.3   portion thereof, that the client spends at the facility.  If 
276.4   payments received by the state under sections 246.50 to 246.53 
276.5   exceed 90 percent of the cost of care, the county shall be 
276.6   responsible for paying the state only the remaining amount.  The 
276.7   county shall not be entitled to reimbursement from the client, 
276.8   the client's estate, or from the client's relatives, except as 
276.9   provided in section 246.53. 
276.10     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2004.
276.11     Sec. 3.  Minnesota Statutes 2002, section 252.46, 
276.12  subdivision 1, is amended to read: 
276.13     Subdivision 1.  [RATES.] (a) Payment rates to vendors, 
276.14  except regional centers, for county-funded day training and 
276.15  habilitation services and transportation provided to persons 
276.16  receiving day training and habilitation services established by 
276.17  a county board are governed by subdivisions 2 to 19.  The 
276.18  commissioner shall approve the following three payment rates for 
276.19  services provided by a vendor: 
276.20     (1) a full-day service rate for persons who receive at 
276.21  least six service hours a day, including the time it takes to 
276.22  transport the person to and from the service site; 
276.23     (2) a partial-day service rate that must not exceed 75 
276.24  percent of the full-day service rate for persons who receive 
276.25  less than a full day of service; and 
276.26     (3) a transportation rate for providing, or arranging and 
276.27  paying for, transportation of a person to and from the person's 
276.28  residence to the service site.  
276.29     (b) The commissioner may also approve an hourly job-coach, 
276.30  follow-along rate for services provided by one employee at or en 
276.31  route to or from community locations to supervise, support, and 
276.32  assist one person receiving the vendor's services to learn 
276.33  job-related skills necessary to obtain or retain employment when 
276.34  and where no other persons receiving services are present and 
276.35  when all the following criteria are met: 
276.36     (1) the vendor requests and the county recommends the 
277.1   optional rate; 
277.2      (2) the service is prior authorized by the county on the 
277.3   Medicaid Management Information System for no more than 414 
277.4   hours in a 12-month period and the daily per person charge to 
277.5   medical assistance does not exceed the vendor's approved full 
277.6   day plus transportation rates; 
277.7      (3) separate full day, partial day, and transportation 
277.8   rates are not billed for the same person on the same day; 
277.9      (4) the approved hourly rate does not exceed the sum of the 
277.10  vendor's current average hourly direct service wage, including 
277.11  fringe benefits and taxes, plus a component equal to the 
277.12  vendor's average hourly nondirect service wage expenses; and 
277.13     (5) the actual revenue received for provision of hourly 
277.14  job-coach, follow-along services is subtracted from the vendor's 
277.15  total expenses for the same time period and those adjusted 
277.16  expenses are used for determining recommended full day and 
277.17  transportation payment rates under subdivision 5 in accordance 
277.18  with the limitations in subdivision 3. 
277.19     (b) Notwithstanding any law or rule to the contrary, the 
277.20  commissioner may authorize county participation in a voluntary 
277.21  individualized payment rate structure for day training and 
277.22  habilitation services to allow a county the flexibility to 
277.23  change from a site-based payment rate structure to an individual 
277.24  payment rate structure for the providers of day training and 
277.25  habilitation services in the county.  The commissioner shall 
277.26  establish procedures for determining the structure of voluntary 
277.27  individualized payment rates to ensure that there is no 
277.28  additional cost to the state. 
277.29     (c) Medical assistance rates for home and community-based 
277.30  service provided under section 256B.501, subdivision 4, by 
277.31  licensed vendors of day training and habilitation services must 
277.32  not be greater than the rates for the same services established 
277.33  by counties under sections 252.40 to 252.46.  For very dependent 
277.34  persons with special needs the commissioner may approve an 
277.35  exception to the approved payment rate under section 256B.501, 
277.36  subdivision 4 or 8. 
278.1      Sec. 4.  Minnesota Statutes 2002, section 256.476, 
278.2   subdivision 1, is amended to read: 
278.3      Subdivision 1.  [PURPOSE AND GOALS.] The commissioner of 
278.4   human services shall establish a consumer support grant program 
278.5   for individuals with functional limitations and their families 
278.6   who wish to purchase and secure their own supports.  The 
278.7   commissioner and local agencies shall jointly develop an 
278.8   implementation plan which must include a way to resolve the 
278.9   issues related to county liability.  The program shall: 
278.10     (1) make support grants or exception grants described in 
278.11  subdivision 11 available to individuals or families as an 
278.12  effective alternative to existing programs and services, such as 
278.13  the developmental disability family support program, personal 
278.14  care attendant services, home health aide services, and private 
278.15  duty nursing services; 
278.16     (2) provide consumers more control, flexibility, and 
278.17  responsibility over their services and supports; 
278.18     (3) promote local program management and decision making; 
278.19  and 
278.20     (4) encourage the use of informal and typical community 
278.21  supports. 
278.22     Sec. 5.  Minnesota Statutes 2002, section 256.476, 
278.23  subdivision 3, is amended to read: 
278.24     Subd. 3.  [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 
278.25  is eligible to apply for a consumer support grant if the person 
278.26  meets all of the following criteria: 
278.27     (1) the person is eligible for and has been approved to 
278.28  receive services under medical assistance as determined under 
278.29  sections 256B.055 and 256B.056 or the person has been approved 
278.30  to receive a grant under the developmental disability family 
278.31  support program under section 252.32; 
278.32     (2) the person is able to direct and purchase the person's 
278.33  own care and supports, or the person has a family member, legal 
278.34  representative, or other authorized representative who can 
278.35  purchase and arrange supports on the person's behalf; 
278.36     (3) the person has functional limitations, requires ongoing 
279.1   supports to live in the community, and is at risk of or would 
279.2   continue institutionalization without such supports; and 
279.3      (4) the person will live in a home.  For the purpose of 
279.4   this section, "home" means the person's own home or home of a 
279.5   person's family member.  These homes are natural home settings 
279.6   and are not licensed by the department of health or human 
279.7   services. 
279.8      (b) Persons may not concurrently receive a consumer support 
279.9   grant if they are: 
279.10     (1) receiving home and community-based services under 
279.11  United States Code, title 42, section 1396h(c); personal care 
279.12  attendant and home health aide services, or private duty nursing 
279.13  under section 256B.0625; a developmental disability family 
279.14  support grant; or alternative care services under section 
279.15  256B.0913; or 
279.16     (2) residing in an institutional or congregate care setting.
279.17     (c) A person or person's family receiving a consumer 
279.18  support grant shall not be charged a fee or premium by a local 
279.19  agency for participating in the program.  
279.20     (d) The commissioner may limit the participation of 
279.21  recipients of services from federal waiver programs in the 
279.22  consumer support grant program if the participation of these 
279.23  individuals will result in an increase in the cost to the 
279.24  state.  Individuals receiving home and community-based waivers 
279.25  under United States Code, title 42, section 1396h(c), are not 
279.26  eligible for the consumer support grant. 
279.27     (e) The commissioner shall establish a budgeted 
279.28  appropriation each fiscal year for the consumer support grant 
279.29  program.  The number of individuals participating in the program 
279.30  will be adjusted so the total amount allocated to counties does 
279.31  not exceed the amount of the budgeted appropriation.  The 
279.32  budgeted appropriation will be adjusted annually to accommodate 
279.33  changes in demand for the consumer support grants. 
279.34     Sec. 6.  Minnesota Statutes 2002, section 256.476, 
279.35  subdivision 4, is amended to read: 
279.36     Subd. 4.  [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 
280.1   county board may choose to participate in the consumer support 
280.2   grant program.  If a county has not chosen to participate by 
280.3   July 1, 2002, the commissioner shall contract with another 
280.4   county or other entity to provide access to residents of the 
280.5   nonparticipating county who choose the consumer support grant 
280.6   option.  The commissioner shall notify the county board in a 
280.7   county that has declined to participate of the commissioner's 
280.8   intent to enter into a contract with another county or other 
280.9   entity at least 30 days in advance of entering into the 
280.10  contract.  The local agency shall establish written procedures 
280.11  and criteria to determine the amount and use of support grants.  
280.12  These procedures must include, at least, the availability of 
280.13  respite care, assistance with daily living, and adaptive aids.  
280.14  The local agency may establish monthly or annual maximum amounts 
280.15  for grants and procedures where exceptional resources may be 
280.16  required to meet the health and safety needs of the person on a 
280.17  time-limited basis, however, the total amount awarded to each 
280.18  individual may not exceed the limits established in subdivision 
280.19  11. 
280.20     (b) Support grants to a person or a person's family will be 
280.21  provided through a monthly subsidy payment and be in the form of 
280.22  cash, voucher, or direct county payment to vendor.  Support 
280.23  grant amounts must be determined by the local agency.  Each 
280.24  service and item purchased with a support grant must meet all of 
280.25  the following criteria:  
280.26     (1) it must be over and above the normal cost of caring for 
280.27  the person if the person did not have functional limitations; 
280.28     (2) it must be directly attributable to the person's 
280.29  functional limitations; 
280.30     (3) it must enable the person or the person's family to 
280.31  delay or prevent out-of-home placement of the person; and 
280.32     (4) it must be consistent with the needs identified in the 
280.33  service plan agreement, when applicable. 
280.34     (c) Items and services purchased with support grants must 
280.35  be those for which there are no other public or private funds 
280.36  available to the person or the person's family.  Fees assessed 
281.1   to the person or the person's family for health and human 
281.2   services are not reimbursable through the grant. 
281.3      (d) In approving or denying applications, the local agency 
281.4   shall consider the following factors:  
281.5      (1) the extent and areas of the person's functional 
281.6   limitations; 
281.7      (2) the degree of need in the home environment for 
281.8   additional support; and 
281.9      (3) the potential effectiveness of the grant to maintain 
281.10  and support the person in the family environment or the person's 
281.11  own home. 
281.12     (e) At the time of application to the program or screening 
281.13  for other services, the person or the person's family shall be 
281.14  provided sufficient information to ensure an informed choice of 
281.15  alternatives by the person, the person's legal representative, 
281.16  if any, or the person's family.  The application shall be made 
281.17  to the local agency and shall specify the needs of the person 
281.18  and family, the form and amount of grant requested, the items 
281.19  and services to be reimbursed, and evidence of eligibility for 
281.20  medical assistance. 
281.21     (f) Upon approval of an application by the local agency and 
281.22  agreement on a support plan for the person or person's family, 
281.23  the local agency shall make grants to the person or the person's 
281.24  family.  The grant shall be in an amount for the direct costs of 
281.25  the services or supports outlined in the service agreement.  
281.26     (g) Reimbursable costs shall not include costs for 
281.27  resources already available, such as special education classes, 
281.28  day training and habilitation, case management, other services 
281.29  to which the person is entitled, medical costs covered by 
281.30  insurance or other health programs, or other resources usually 
281.31  available at no cost to the person or the person's family. 
281.32     (h) The state of Minnesota, the county boards participating 
281.33  in the consumer support grant program, or the agencies acting on 
281.34  behalf of the county boards in the implementation and 
281.35  administration of the consumer support grant program shall not 
281.36  be liable for damages, injuries, or liabilities sustained 
282.1   through the purchase of support by the individual, the 
282.2   individual's family, or the authorized representative under this 
282.3   section with funds received through the consumer support grant 
282.4   program.  Liabilities include but are not limited to:  workers' 
282.5   compensation liability, the Federal Insurance Contributions Act 
282.6   (FICA), or the Federal Unemployment Tax Act (FUTA).  For 
282.7   purposes of this section, participating county boards and 
282.8   agencies acting on behalf of county boards are exempt from the 
282.9   provisions of section 268.04. 
282.10     Sec. 7.  Minnesota Statutes 2002, section 256.476, 
282.11  subdivision 5, is amended to read: 
282.12     Subd. 5.  [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 
282.13  For the purpose of transferring persons to the consumer support 
282.14  grant program from specific programs or services, such as the 
282.15  developmental disability family support program and personal 
282.16  care assistant services, home health aide services, or private 
282.17  duty nursing services, the amount of funds transferred by the 
282.18  commissioner between the developmental disability family support 
282.19  program account, the medical assistance account, or the consumer 
282.20  support grant account shall be based on each county's 
282.21  participation in transferring persons to the consumer support 
282.22  grant program from those programs and services. 
282.23     (b) At the beginning of each fiscal year, county 
282.24  allocations for consumer support grants shall be based on: 
282.25     (1) the number of persons to whom the county board expects 
282.26  to provide consumer supports grants; 
282.27     (2) their eligibility for current program and services; 
282.28     (3) the amount of nonfederal dollars allowed under 
282.29  subdivision 11; and 
282.30     (4) projected dates when persons will start receiving 
282.31  grants.  County allocations shall be adjusted periodically by 
282.32  the commissioner based on the actual transfer of persons or 
282.33  service openings, and the nonfederal dollars associated with 
282.34  those persons or service openings, to the consumer support grant 
282.35  program. 
282.36     (c) The amount of funds transferred by the commissioner 
283.1   from the medical assistance account for an individual may be 
283.2   changed if it is determined by the county or its agent that the 
283.3   individual's need for support has changed. 
283.4      (d) The authority to utilize funds transferred to the 
283.5   consumer support grant account for the purposes of implementing 
283.6   and administering the consumer support grant program will not be 
283.7   limited or constrained by the spending authority provided to the 
283.8   program of origination. 
283.9      (e) The commissioner may use up to five percent of each 
283.10  county's allocation, as adjusted, for payments for 
283.11  administrative expenses, to be paid as a proportionate addition 
283.12  to reported direct service expenditures. 
283.13     (f) The county allocation for each individual or 
283.14  individual's family cannot exceed the amount allowed under 
283.15  subdivision 11. 
283.16     (g) The commissioner may recover, suspend, or withhold 
283.17  payments if the county board, local agency, or grantee does not 
283.18  comply with the requirements of this section. 
283.19     (h) Grant funds unexpended by consumers shall return to the 
283.20  state once a year.  The annual return of unexpended grant funds 
283.21  shall occur in the quarter following the end of the state fiscal 
283.22  year. 
283.23     Sec. 8.  Minnesota Statutes 2002, section 256.476, 
283.24  subdivision 11, is amended to read: 
283.25     Subd. 11.  [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 
283.26  2001.] (a) Effective July 1, 2001, the commissioner shall 
283.27  allocate consumer support grant resources to serve additional 
283.28  individuals based on a review of Medicaid authorization and 
283.29  payment information of persons eligible for a consumer support 
283.30  grant from the most recent fiscal year.  The commissioner shall 
283.31  use the following methodology to calculate maximum allowable 
283.32  monthly consumer support grant levels: 
283.33     (1) For individuals whose program of origination is medical 
283.34  assistance home care under section 256B.0627, the maximum 
283.35  allowable monthly grant levels are calculated by: 
283.36     (i) determining the nonfederal share of the average service 
284.1   authorization for each home care rating; 
284.2      (ii) calculating the overall ratio of actual payments to 
284.3   service authorizations by program; 
284.4      (iii) applying the overall ratio to the average service 
284.5   authorization level of each home care rating; 
284.6      (iv) adjusting the result for any authorized rate increases 
284.7   provided by the legislature; and 
284.8      (v) adjusting the result for the average monthly 
284.9   utilization per recipient; and. 
284.10     (2) for persons with programs of origination other than the 
284.11  program described in clause (1), the maximum grant level for an 
284.12  individual shall not exceed the total of the nonfederal dollars 
284.13  expended on the individual by the program of origination The 
284.14  commissioner may review and evaluate the methodology to reflect 
284.15  changes in the home care programs overall ratio of actual 
284.16  payments to service authorizations. 
284.17     (b) Effective July 1, 2003, persons previously receiving 
284.18  consumer support exception grants prior to July 1, 2001, may 
284.19  continue to receive the grant amount established prior to July 
284.20  1, 2001 will have their grants calculated using the methodology 
284.21  in paragraph (a), clause (1).  If a person currently receiving 
284.22  an exception grant wishes to have their home care rating 
284.23  reevaluated, they may request an assessment as defined in 
284.24  section 256B.0627, subdivision 1, paragraph (b). 
284.25     (c) The commissioner may provide up to 200 exception 
284.26  grants, including grants in use under paragraph (b).  Eligible 
284.27  persons shall be provided an exception grant in priority order 
284.28  based upon the date of the commissioner's receipt of the county 
284.29  request.  The maximum allowable grant level for an exception 
284.30  grant shall be based upon the nonfederal share of the average 
284.31  service authorization from the most recent fiscal year for each 
284.32  home care rating category.  The amount of each exception grant 
284.33  shall be based upon the commissioner's determination of the 
284.34  nonfederal dollars that would have been expended if services had 
284.35  been available for an individual who is unable to obtain the 
284.36  support needed from the program of origination due to the 
285.1   unavailability of qualified service providers at the time or the 
285.2   location where the supports are needed. 
285.3      Sec. 9.  [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 
285.4   HEALTH SERVICES.] 
285.5      Subdivision 1.  [SCOPE.] Subject to federal approval, 
285.6   medical assistance covers medically necessary, intensive 
285.7   nonresidential and residential rehabilitative mental health 
285.8   services as defined in subdivision 2, for recipients as defined 
285.9   in subdivision 3, when the services are provided by an entity 
285.10  meeting the standards in this section. 
285.11     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
285.12  following terms have the meanings given them.  
285.13     (a) "Intensive nonresidential rehabilitative mental health 
285.14  services" means adult rehabilitative mental health services as 
285.15  defined in section 256B.0623, subdivision 2, paragraph (a), 
285.16  except that these services are provided by a multidisciplinary 
285.17  staff using a total team approach consistent with assertive 
285.18  community treatment and other evidence-based practices, and 
285.19  directed to recipients with a serious mental illness who require 
285.20  intensive services. 
285.21     (b) "Intensive residential rehabilitative mental health 
285.22  services" means short-term, time-limited services provided in a 
285.23  residential setting to recipients who are in need of more 
285.24  restrictive settings and are at risk of significant functional 
285.25  deterioration if they do not receive these services.  Services 
285.26  are designed to develop and enhance psychiatric stability, 
285.27  personal and emotional adjustment, self-sufficiency, and skills 
285.28  to live in a more independent setting.  Services must be 
285.29  directed toward a targeted discharge date with specified client 
285.30  outcomes and must be consistent with evidence-based practices. 
285.31     (c) "Evidence-based practices" are nationally recognized 
285.32  mental health services that are proven by substantial research 
285.33  to be effective in helping individuals with serious mental 
285.34  illness obtain specific treatment goals. 
285.35     (d) "Overnight staff" means a member of the intensive 
285.36  residential rehabilitative mental health treatment team who is 
286.1   responsible during hours when recipients are typically asleep. 
286.2      (e) "Treatment team" means all staff who provide services 
286.3   under this section to recipients.  At a minimum, this includes 
286.4   the clinical supervisor, mental health professionals, mental 
286.5   health practitioners, and mental health rehabilitation workers. 
286.6      Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
286.7   individual who: 
286.8      (1) is age 18 or older; 
286.9      (2) is eligible for medical assistance; 
286.10     (3) is diagnosed with a mental illness; 
286.11     (4) because of a mental illness, has substantial disability 
286.12  and functional impairment in three or more of the areas listed 
286.13  in section 245.462, subdivision 11a, so that self-sufficiency is 
286.14  markedly reduced; 
286.15     (5) has one or more of the following:  a history of two or 
286.16  more inpatient hospitalizations in the past year, significant 
286.17  independent living instability, homelessness, or very frequent 
286.18  use of mental health and related services yielding poor 
286.19  outcomes; and 
286.20     (6) in the written opinion of a licensed mental health 
286.21  professional, has the need for mental health services that 
286.22  cannot be met with other available community-based services, or 
286.23  is likely to experience a mental health crisis or require a more 
286.24  restrictive setting if intensive rehabilitative mental health 
286.25  services are not provided. 
286.26     Subd. 4.  [PROVIDER CERTIFICATION AND CONTRACT 
286.27  REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 
286.28  mental health services provider must: 
286.29     (1) have a contract with the host county to provide 
286.30  intensive adult rehabilitative mental health services; and 
286.31     (2) be certified by the commissioner as being in compliance 
286.32  with this section and section 256B.0623. 
286.33     (b) The intensive residential rehabilitative mental health 
286.34  services provider must: 
286.35     (1) be licensed under Minnesota Rules, parts 9520.0500 to 
286.36  9520.0670; 
287.1      (2) not exceed 16 beds per site; 
287.2      (3) comply with the additional standards in this section; 
287.3   and 
287.4      (4) have a contract with the host county to provide these 
287.5   services. 
287.6      (c) The commissioner shall develop procedures for counties 
287.7   and providers to submit contracts and other documentation as 
287.8   needed to allow the commissioner to determine whether the 
287.9   standards in this section are met. 
287.10     Subd. 5.  [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 
287.11  RESIDENTIAL PROVIDERS.] (a) Services must be provided by 
287.12  qualified staff as defined in section 256B.0623, subdivision 5, 
287.13  who are trained and supervised according to section 256B.0623, 
287.14  subdivision 6, except that mental health rehabilitation workers 
287.15  acting as overnight staff are not required to comply with 
287.16  section 256B.0623, subdivision 5, clause (3)(iv). 
287.17     (b) The clinical supervisor must be an active member of the 
287.18  treatment team.  The treatment team must meet with the clinical 
287.19  supervisor at least weekly to discuss recipients' progress and 
287.20  make rapid adjustments to meet recipients' needs.  The team 
287.21  meeting shall include recipient-specific case reviews and 
287.22  general treatment discussions among team members.  
287.23  Recipient-specific case reviews and planning must be documented 
287.24  in the individual recipient's treatment record. 
287.25     (c) Treatment staff must have prompt access in person or by 
287.26  telephone to a mental health practitioner or mental health 
287.27  professional.  The provider must have the capacity to promptly 
287.28  and appropriately respond to emergent needs and make any 
287.29  necessary staffing adjustments to assure the health and safety 
287.30  of recipients. 
287.31     (d) The initial functional assessment must be completed 
287.32  within ten days of intake and updated at least every three 
287.33  months or prior to discharge from the service, whichever comes 
287.34  first. 
287.35     (e) The initial individual treatment plan must be completed 
287.36  within ten days of intake and reviewed and updated at least 
288.1   monthly with the recipient.  
288.2      Subd. 6.  [ADDITIONAL STANDARDS APPLICABLE ONLY TO 
288.3   INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 
288.4   SERVICES.] (a) The provider of intensive residential services 
288.5   must have sufficient staff to provide 24 hour per day coverage 
288.6   to deliver the rehabilitative services described in the 
288.7   treatment plan and to safely supervise and direct the activities 
288.8   of recipients given the recipient's level of behavioral and 
288.9   psychiatric stability, cultural needs, and vulnerability.  The 
288.10  provider must have the capacity within the facility to provide 
288.11  integrated services for chemical dependency, illness management 
288.12  services, and family education when appropriate. 
288.13     (b) At a minimum: 
288.14     (1) staff must be available and provide direction and 
288.15  supervision whenever recipients are present in the facility; 
288.16     (2) staff must remain awake during all work hours; 
288.17     (3) there must be a staffing ratio of at least one to eight 
288.18  recipients for each day and evening shift.  If more than eight 
288.19  recipients are present at the residential site, there must be a 
288.20  minimum of two staff during day and evening shifts, one of whom 
288.21  must be a mental health practitioner or mental health 
288.22  professional; 
288.23     (4) if services are provided to recipients who need the 
288.24  services of a medical professional, the provider shall assure 
288.25  that these services are provided either by the provider's own 
288.26  medical staff or through referral to a medical professional; and 
288.27     (5) the provider must employ or contract with a licensed 
288.28  registered nurse to ensure the effectiveness and safety of 
288.29  medication administration in the facility. 
288.30     Subd. 7.  [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 
288.31  SERVICES.] The standards in this subdivision apply to intensive 
288.32  nonresidential rehabilitative mental health services. 
288.33     (1) The treatment team must use team treatment, not an 
288.34  individual treatment model. 
288.35     (2) The clinical supervisor must function as a practicing 
288.36  clinician at least on a part-time basis. 
289.1      (3) The staffing ratio must not exceed ten recipients to 
289.2   one full-time equivalent treatment team position. 
289.3      (4) At a minimum, the team must operate Monday through 
289.4   Friday, eight hours per day, and be on call all other hours. 
289.5      (5) The treatment team must actively and assertively engage 
289.6   and reach out to the recipient's family members and significant 
289.7   others, after obtaining the recipient's permission.  
289.8      (6) The treatment team must establish ongoing communication 
289.9   and collaboration between the team, family, and significant 
289.10  others and educate the family and significant others about 
289.11  mental illness, symptom management, and the family's role in 
289.12  treatment. 
289.13     (7) The treatment team must provide interventions to 
289.14  promote positive interpersonal relationships. 
289.15     Subd. 8.  [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 
289.16  REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 
289.17  residential and nonresidential services in this section shall be 
289.18  based on one daily rate per provider inclusive of the following 
289.19  services received by an eligible recipient in a given calendar 
289.20  day:  all rehabilitative services under section 256B.0623 and 
289.21  crisis stabilization services under section 256B.0624. 
289.22     (b) Payment will not be made to more than one entity for 
289.23  each recipient for services provided under this section on a 
289.24  given day.  If services under this section are provided by a 
289.25  team that includes staff from more than one entity, the team 
289.26  must determine how to distribute the payment among the members. 
289.27     (c) The host county shall recommend to the commissioner one 
289.28  rate for each entity that will bill medical assistance for 
289.29  services under this section.  In developing this rate, the host 
289.30  county shall consider and document: 
289.31     (1) the cost for similar services in the local trade area; 
289.32     (2) actual costs incurred by entities providing the 
289.33  services; 
289.34     (3) the intensity and frequency of services to be provided 
289.35  to each recipient; 
289.36     (4) the degree to which recipients will receive services 
290.1   other than services under this section; 
290.2      (5) the costs of other services, such as case management, 
290.3   that will be separately reimbursed; and 
290.4      (6) input from the local planning process authorized by the 
290.5   adult mental health initiative under section 245.4661, regarding 
290.6   recipients' service needs. 
290.7      (d) The rate for intensive rehabilitative mental health 
290.8   services must exclude room and board, as defined in section 
290.9   256I.03, subdivision 6, and services not covered under this 
290.10  section, such as case management, physician services, partial 
290.11  hospitalization, home care, and inpatient services.  The 
290.12  county's recommendation shall specify the period for which the 
290.13  rate will be applicable, not to exceed two years. 
290.14     (e) When services under this section are provided by an 
290.15  assertive community team, case management functions must be an 
290.16  integral part of the team.  The county must allocate costs which 
290.17  are reimbursable under this section versus costs which are 
290.18  reimbursable through case management or other reimbursement, so 
290.19  that payment is not duplicated. 
290.20     (f) The rate for a provider must not exceed the rate 
290.21  charged by that provider for the same service to other payors. 
290.22     (g) The commissioner shall approve or reject the county's 
290.23  rate recommendation, based on the commissioner's own analysis of 
290.24  the criteria in paragraph (c). 
290.25     Subd. 9.  [PROVIDER ENROLLMENT; RATE SETTING FOR 
290.26  COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 
290.27  to provide services under this section shall apply directly to 
290.28  the commissioner for enrollment and rate setting.  In this case, 
290.29  a county contract is not required and the commissioner shall 
290.30  perform the program review and rate setting duties which would 
290.31  otherwise be required of counties under this section. 
290.32     Subd. 10.  [PROVIDER ENROLLMENT; RATE SETTING FOR 
290.33  SPECIALIZED PROGRAM.] A provider proposing to serve a 
290.34  subpopulation of eligible recipients may bypass the county 
290.35  approval procedures in this section and receive approval for 
290.36  provider enrollment and rate setting directly from the 
291.1   commissioner under the following circumstances: 
291.2      (1) the provider demonstrates that the subpopulation to be 
291.3   served requires a specialized program which is not available 
291.4   from county-approved entities; and 
291.5      (2) the subpopulation to be served is of such a low 
291.6   incidence that it is not feasible to develop a program serving a 
291.7   single county or regional group of counties. 
291.8      For providers meeting the criteria in clauses (1) and (2), 
291.9   the commissioner shall perform the program review and rate 
291.10  setting duties which would otherwise be required of counties 
291.11  under this section. 
291.12     Sec. 10.  Minnesota Statutes 2002, section 256B.0625, 
291.13  subdivision 23, is amended to read: 
291.14     Subd. 23.  [DAY TREATMENT SERVICES.] Medical assistance 
291.15  covers day treatment services as specified in sections 245.462, 
291.16  subdivision 8, and 245.4871, subdivision 10, that are provided 
291.17  under contract with the county board.  Medical assistance 
291.18  coverage for day treatment for adults ends on June 30, 2005. 
291.19     Sec. 11.  Minnesota Statutes 2002, section 256B.19, 
291.20  subdivision 1, is amended to read: 
291.21     Subdivision 1.  [DIVISION OF COST.] The state and county 
291.22  share of medical assistance costs not paid by federal funds 
291.23  shall be as follows:  
291.24     (1) beginning January 1, 1992, 50 percent state funds and 
291.25  50 percent county funds for the cost of placement of severely 
291.26  emotionally disturbed children in regional treatment centers; 
291.27  and 
291.28     (2) beginning January 1, 2003, 80 percent state funds and 
291.29  20 percent county funds for the costs of nursing facility 
291.30  placements of persons with disabilities under the age of 65 that 
291.31  have exceeded 90 days.  This clause shall be subject to chapter 
291.32  256G and shall not apply to placements in facilities not 
291.33  certified to participate in medical assistance.; 
291.34     (3) beginning January 1, 2004, 80 percent state funds and 
291.35  20 percent county funds for the costs of placements that have 
291.36  exceeded 90 days in intermediate care facilities for persons 
292.1   with mental retardation or a related condition that have seven 
292.2   or more beds.  This provision includes pass-through payments 
292.3   made under section 256B.5015; and 
292.4      (4) beginning January 1, 2004, when state funds are used to 
292.5   pay for a nursing facility placement due to the facility's 
292.6   status as an institution for mental diseases (IMD), the county 
292.7   shall pay 20 percent of the nonfederal share of costs that have 
292.8   exceeded 90 days.  This clause is subject to chapter 256G. 
292.9      For counties that participate in a Medicaid demonstration 
292.10  project under sections 256B.69 and 256B.71, the division of the 
292.11  nonfederal share of medical assistance expenses for payments 
292.12  made to prepaid health plans or for payments made to health 
292.13  maintenance organizations in the form of prepaid capitation 
292.14  payments, this division of medical assistance expenses shall be 
292.15  95 percent by the state and five percent by the county of 
292.16  financial responsibility.  
292.17     In counties where prepaid health plans are under contract 
292.18  to the commissioner to provide services to medical assistance 
292.19  recipients, the cost of court ordered treatment ordered without 
292.20  consulting the prepaid health plan that does not include 
292.21  diagnostic evaluation, recommendation, and referral for 
292.22  treatment by the prepaid health plan is the responsibility of 
292.23  the county of financial responsibility. 
292.24     Sec. 12.  Minnesota Statutes 2002, section 256B.501, 
292.25  subdivision 1, is amended to read: 
292.26     Subdivision 1.  [DEFINITIONS.] For the purposes of this 
292.27  section, the following terms have the meaning given them.  
292.28     (a) "Commissioner" means the commissioner of human services.
292.29     (b) "Facility" means a facility licensed as a mental 
292.30  retardation residential facility under section 252.28, licensed 
292.31  as a supervised living facility under chapter 144, and certified 
292.32  as an intermediate care facility for persons with mental 
292.33  retardation or related conditions.  The term does not include a 
292.34  state regional treatment center. 
292.35     (c) "Services during the day" means services or supports 
292.36  provided to a person that enables the person to be fully 
293.1   integrated into the community.  Services during the day may 
293.2   include a variety of supports to enable the person to exercise 
293.3   choices for community integration and inclusion activities.  
293.4   Services during the day may include, but are not limited to:  
293.5   supported work, support during community adult education, 
293.6   community volunteer opportunities, adult day care, recreational 
293.7   activities, and other individualized integrated supports. 
293.8      (d) "Waivered service" means home or community-based 
293.9   service authorized under United States Code, title 42, section 
293.10  1396n(c), as amended through December 31, 1987, and defined in 
293.11  the Minnesota state plan for the provision of medical assistance 
293.12  services.  Waivered services include, at a minimum, case 
293.13  management, family training and support, developmental training 
293.14  homes, supervised living arrangements, semi-independent living 
293.15  services, respite care, and training and habilitation services. 
293.16     Sec. 13.  Minnesota Statutes 2002, section 256B.501, is 
293.17  amended by adding a subdivision to read: 
293.18     Subd. 3m.  [SERVICES DURING THE DAY.] When establishing a 
293.19  rate for services during the day, the commissioner shall ensure 
293.20  that these services comply with active treatment requirements 
293.21  for persons residing in an ICF/MR as defined under federal 
293.22  regulations. 
293.23     Sec. 14.  Minnesota Statutes 2002, section 256B.5012, is 
293.24  amended by adding a subdivision to read: 
293.25     Subd. 5.  [PAYMENT RATE REDUCTION.] (a) Effective July 1, 
293.26  2003, the commissioner shall reduce payment rates for each 
293.27  facility reimbursed under this section by decreasing the total 
293.28  operating payment rate for intermediate care facilities for the 
293.29  mentally retarded by four percent. 
293.30     (b) For each facility, the commissioner shall apply the 
293.31  adjustment using the percentage specified in paragraph (a) 
293.32  multiplied by the total payment rate, excluding the 
293.33  property-related payment rate, in effect on June 30. 
293.34     (c) A facility whose payment rates are governed by closure 
293.35  agreements, receivership agreements, or Minnesota Rules, part 
293.36  9553.0075, is not eligible for an adjustment otherwise granted 
294.1   under this subdivision. 
294.2      Sec. 15.  Minnesota Statutes 2002, section 256B.5015, is 
294.3   amended to read: 
294.4      256B.5015 [PASS-THROUGH OF TRAINING AND HABILITATION OTHER 
294.5   SERVICES COSTS.] 
294.6      Subdivision 1.  [DAY TRAINING AND HABILITATION SERVICES.] 
294.7   Day training and habilitation services costs shall be paid as a 
294.8   pass-through payment at the lowest rate paid for the comparable 
294.9   services at that site under sections 252.40 to 252.46.  The 
294.10  pass-through payments for training and habilitation services 
294.11  shall be paid separately by the commissioner and shall not be 
294.12  included in the computation of the ICF/MR facility total payment 
294.13  rate. 
294.14     Subd. 2.  [SERVICES DURING THE DAY.] Services during the 
294.15  day, as defined in section 256B.501, shall be paid as a 
294.16  pass-through payment no later than January 1, 2004.  The 
294.17  commissioner shall establish rates for these services at levels 
294.18  that do not exceed 75 percent of a recipient's day training and 
294.19  habilitation costs prior to the service change. 
294.20     When establishing a rate for these services, the 
294.21  commissioner shall also consider:  an individual recipient's 
294.22  needs as identified in the individualized service plan and the 
294.23  person's need for active treatment as defined under federal 
294.24  regulations.  The pass-through payments for services during the 
294.25  day may be paid separately by the commissioner and may be 
294.26  included in the computation of the ICF/MR facility total payment 
294.27  rate. 
294.28     Sec. 16.  Minnesota Statutes 2002, section 256E.081, 
294.29  subdivision 3, is amended to read: 
294.30     Subd. 3.  [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 
294.31  county has made reasonable efforts, as defined in subdivision 2, 
294.32  to comply with all social services administrative rule 
294.33  requirements and is unable to meet all requirements, the county 
294.34  must provide services according to an amended community social 
294.35  services plan developed by the county and approved by the 
294.36  commissioner under section 256E.09, subdivision 6.  The plan 
295.1   must identify for the remainder of the calendar year the social 
295.2   services administrative rule requirements the county shall 
295.3   comply with within its fiscal limitations and identify the 
295.4   social services administrative rule requirements the county will 
295.5   not comply with due to fiscal limitations.  The plan must 
295.6   specify how the county intends to provide services required by 
295.7   federal law or state statute, including but not limited to:  
295.8      (1) providing services needed to protect children and 
295.9   vulnerable adults from maltreatment, abuse, and neglect; 
295.10     (2) providing emergency and crisis services needed to 
295.11  protect clients from physical, emotional, or psychological harm; 
295.12     (3) assessing and documenting the needs of persons applying 
295.13  for services; 
295.14     (4) providing case management services to developmentally 
295.15  disabled clients, adults with serious and persistent mental 
295.16  illness, and children with severe emotional disturbances; 
295.17     (5) providing day training and habilitation services for 
295.18  persons with developmental disabilities and family community 
295.19  support services for children with severe emotional 
295.20  disturbances; 
295.21     (6) providing subacute detoxification services; 
295.22     (7) providing public guardianship services; and 
295.23     (8) fulfilling licensing responsibilities delegated to the 
295.24  county by the commissioner under section 245A.16. 
295.25     Sec. 17.  [256I.08] [COUNTY SHARE FOR CERTAIN NURSING 
295.26  FACILITY STAYS.] 
295.27     Beginning January 1, 2004, if group residential housing is 
295.28  used to pay for a nursing facility placement due to the 
295.29  facility's status as an Institution for Mental Diseases, the 
295.30  county is liable for 20 percent of the nonfederal share of costs 
295.31  for persons under the age of 65 that have exceeded 90 days.  
295.32     Sec. 18.  [REVISOR'S INSTRUCTION.] 
295.33     For sections in Minnesota Statutes and Minnesota Rules 
295.34  affected by the repealed sections in this article, the revisor 
295.35  shall delete internal cross-references where appropriate and 
295.36  make changes necessary to correct the punctuation, grammar, or 
296.1   structure of the remaining text and preserve its meaning. 
296.2      Sec. 19.  [REPEALER.] 
296.3      (a) Minnesota Statutes 2002, sections 254A.17, subdivision 
296.4   3; 256B.095; 256B.0951; 256B.0952; 256B.0953; 256B.0954; 
296.5   256B.0955; and 256B.5013, subdivision 4, are repealed July 1, 
296.6   2003. 
296.7      (b) Minnesota Statutes 2002, section 245.4712, subdivision 
296.8   2, is repealed July 1, 2005. 
296.9      (c) Laws 2001, First Special Session chapter 9, article 13, 
296.10  section 24, is repealed July 1, 2003. 
296.11                             ARTICLE 5 
296.12                        CHILDREN'S SERVICES 
296.13     Section 1.  Minnesota Statutes 2002, section 144.551, 
296.14  subdivision 1, is amended to read: 
296.15     Subdivision 1.  [RESTRICTED CONSTRUCTION OR MODIFICATION.] 
296.16  (a) The following construction or modification may not be 
296.17  commenced:  
296.18     (1) any erection, building, alteration, reconstruction, 
296.19  modernization, improvement, extension, lease, or other 
296.20  acquisition by or on behalf of a hospital that increases the bed 
296.21  capacity of a hospital, relocates hospital beds from one 
296.22  physical facility, complex, or site to another, or otherwise 
296.23  results in an increase or redistribution of hospital beds within 
296.24  the state; and 
296.25     (2) the establishment of a new hospital.  
296.26     (b) This section does not apply to:  
296.27     (1) construction or relocation within a county by a 
296.28  hospital, clinic, or other health care facility that is a 
296.29  national referral center engaged in substantial programs of 
296.30  patient care, medical research, and medical education meeting 
296.31  state and national needs that receives more than 40 percent of 
296.32  its patients from outside the state of Minnesota; 
296.33     (2) a project for construction or modification for which a 
296.34  health care facility held an approved certificate of need on May 
296.35  1, 1984, regardless of the date of expiration of the 
296.36  certificate; 
297.1      (3) a project for which a certificate of need was denied 
297.2   before July 1, 1990, if a timely appeal results in an order 
297.3   reversing the denial; 
297.4      (4) a project exempted from certificate of need 
297.5   requirements by Laws 1981, chapter 200, section 2; 
297.6      (5) a project involving consolidation of pediatric 
297.7   specialty hospital services within the Minneapolis-St. Paul 
297.8   metropolitan area that would not result in a net increase in the 
297.9   number of pediatric specialty hospital beds among the hospitals 
297.10  being consolidated; 
297.11     (6) a project involving the temporary relocation of 
297.12  pediatric-orthopedic hospital beds to an existing licensed 
297.13  hospital that will allow for the reconstruction of a new 
297.14  philanthropic, pediatric-orthopedic hospital on an existing site 
297.15  and that will not result in a net increase in the number of 
297.16  hospital beds.  Upon completion of the reconstruction, the 
297.17  licenses of both hospitals must be reinstated at the capacity 
297.18  that existed on each site before the relocation; 
297.19     (7) the relocation or redistribution of hospital beds 
297.20  within a hospital building or identifiable complex of buildings 
297.21  provided the relocation or redistribution does not result in: 
297.22  (i) an increase in the overall bed capacity at that site; (ii) 
297.23  relocation of hospital beds from one physical site or complex to 
297.24  another; or (iii) redistribution of hospital beds within the 
297.25  state or a region of the state; 
297.26     (8) relocation or redistribution of hospital beds within a 
297.27  hospital corporate system that involves the transfer of beds 
297.28  from a closed facility site or complex to an existing site or 
297.29  complex provided that:  (i) no more than 50 percent of the 
297.30  capacity of the closed facility is transferred; (ii) the 
297.31  capacity of the site or complex to which the beds are 
297.32  transferred does not increase by more than 50 percent; (iii) the 
297.33  beds are not transferred outside of a federal health systems 
297.34  agency boundary in place on July 1, 1983; and (iv) the 
297.35  relocation or redistribution does not involve the construction 
297.36  of a new hospital building; 
298.1      (9) a construction project involving up to 35 new beds in a 
298.2   psychiatric hospital in Rice county that primarily serves 
298.3   adolescents and that receives more than 70 percent of its 
298.4   patients from outside the state of Minnesota; 
298.5      (10) a project to replace a hospital or hospitals with a 
298.6   combined licensed capacity of 130 beds or less if:  (i) the new 
298.7   hospital site is located within five miles of the current site; 
298.8   and (ii) the total licensed capacity of the replacement 
298.9   hospital, either at the time of construction of the initial 
298.10  building or as the result of future expansion, will not exceed 
298.11  70 licensed hospital beds, or the combined licensed capacity of 
298.12  the hospitals, whichever is less; 
298.13     (11) the relocation of licensed hospital beds from an 
298.14  existing state facility operated by the commissioner of human 
298.15  services to a new or existing facility, building, or complex 
298.16  operated by the commissioner of human services; from one 
298.17  regional treatment center site to another; or from one building 
298.18  or site to a new or existing building or site on the same 
298.19  campus; 
298.20     (12) the construction or relocation of hospital beds 
298.21  operated by a hospital having a statutory obligation to provide 
298.22  hospital and medical services for the indigent that does not 
298.23  result in a net increase in the number of hospital beds; 
298.24     (13) a construction project involving the addition of up to 
298.25  31 new beds in an existing nonfederal hospital in Beltrami 
298.26  county; or 
298.27     (14) a construction project involving the addition of up to 
298.28  eight new beds in an existing nonfederal hospital in Otter Tail 
298.29  county with 100 licensed acute care beds; or 
298.30     (15) a project for the construction or relocation of up to 
298.31  20 hospital beds for the operation of up to two psychiatric 
298.32  facilities or units for children provided that the operation of 
298.33  the facilities or units have received the approval of the 
298.34  commissioner of human services. 
298.35     Sec. 2.  Minnesota Statutes 2002, section 245.4874, is 
298.36  amended to read: 
299.1      245.4874 [DUTIES OF COUNTY BOARD.] 
299.2      The county board in each county shall use its share of 
299.3   mental health and Community Social Services Act funds allocated 
299.4   by the commissioner according to a biennial children's mental 
299.5   health component of the community social services plan required 
299.6   under section 245.4888, and approved by the commissioner.  The 
299.7   county board must: 
299.8      (1) develop a system of affordable and locally available 
299.9   children's mental health services according to sections 245.487 
299.10  to 245.4888; 
299.11     (2) establish a mechanism providing for interagency 
299.12  coordination as specified in section 245.4875, subdivision 6; 
299.13     (3) develop a biennial children's mental health component 
299.14  of the community social services plan required under section 
299.15  256E.09 which considers the assessment of unmet needs in the 
299.16  county as reported by the local children's mental health 
299.17  advisory council under section 245.4875, subdivision 5, 
299.18  paragraph (b), clause (3).  The county shall provide, upon 
299.19  request of the local children's mental health advisory council, 
299.20  readily available data to assist in the determination of unmet 
299.21  needs; 
299.22     (4) assure that parents and providers in the county receive 
299.23  information about how to gain access to services provided 
299.24  according to sections 245.487 to 245.4888; 
299.25     (5) coordinate the delivery of children's mental health 
299.26  services with services provided by social services, education, 
299.27  corrections, health, and vocational agencies to improve the 
299.28  availability of mental health services to children and the 
299.29  cost-effectiveness of their delivery; 
299.30     (6) assure that mental health services delivered according 
299.31  to sections 245.487 to 245.4888 are delivered expeditiously and 
299.32  are appropriate to the child's diagnostic assessment and 
299.33  individual treatment plan; 
299.34     (7) provide the community with information about predictors 
299.35  and symptoms of emotional disturbances and how to access 
299.36  children's mental health services according to sections 245.4877 
300.1   and 245.4878; 
300.2      (8) provide for case management services to each child with 
300.3   severe emotional disturbance according to sections 245.486; 
300.4   245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, 
300.5   and 5; 
300.6      (9) provide for screening of each child under section 
300.7   245.4885 upon admission to a residential treatment facility, 
300.8   acute care hospital inpatient treatment, or informal admission 
300.9   to a regional treatment center; 
300.10     (10) prudently administer grants and purchase-of-service 
300.11  contracts that the county board determines are necessary to 
300.12  fulfill its responsibilities under sections 245.487 to 245.4888; 
300.13     (11) assure that mental health professionals, mental health 
300.14  practitioners, and case managers employed by or under contract 
300.15  to the county to provide mental health services are qualified 
300.16  under section 245.4871; 
300.17     (12) assure that children's mental health services are 
300.18  coordinated with adult mental health services specified in 
300.19  sections 245.461 to 245.486 so that a continuum of mental health 
300.20  services is available to serve persons with mental illness, 
300.21  regardless of the person's age; and 
300.22     (13) assure that culturally informed mental health 
300.23  consultants are used as necessary to assist the county board in 
300.24  assessing and providing appropriate treatment for children of 
300.25  cultural or racial minority heritage; and 
300.26     (14) arrange for or provide a children's mental health 
300.27  screening to a child receiving child protective services or a 
300.28  child in out-of-home placement, a child for whom parental rights 
300.29  have been terminated, a child alleged or found to be delinquent, 
300.30  and a child found to have committed a juvenile petty offense for 
300.31  the third or subsequent time, unless a screening has been 
300.32  performed within the previous 180 days, or the child is 
300.33  currently under the care of a mental health professional.  The 
300.34  screening shall be conducted with a screening instrument 
300.35  approved by the commissioner of human services and shall be 
300.36  conducted by a mental health practitioner as defined in section 
301.1   245.4871, subdivision 26, or a probation officer or local social 
301.2   services agency staff person who is trained in the use of the 
301.3   screening instrument.  If the screen indicates a need for 
301.4   assessment, the child's family, or if the family lacks mental 
301.5   health insurance, the local social services agency, in 
301.6   consultation with the child's family, shall have conducted a 
301.7   diagnostic assessment, including a functional assessment, as 
301.8   defined in section 245.4871. 
301.9      Sec. 3.  Minnesota Statutes 2002, section 256B.0625, 
301.10  subdivision 20, is amended to read: 
301.11     Subd. 20.  [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 
301.12  extent authorized by rule of the state agency, medical 
301.13  assistance covers case management services to persons with 
301.14  serious and persistent mental illness and children with severe 
301.15  emotional disturbance.  Services provided under this section 
301.16  must meet the relevant standards in sections 245.461 to 
301.17  245.4888, the Comprehensive Adult and Children's Mental Health 
301.18  Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 
301.19  9505.0322, excluding subpart 10. 
301.20     (b) Entities meeting program standards set out in rules 
301.21  governing family community support services as defined in 
301.22  section 245.4871, subdivision 17, are eligible for medical 
301.23  assistance reimbursement for case management services for 
301.24  children with severe emotional disturbance when these services 
301.25  meet the program standards in Minnesota Rules, parts 9520.0900 
301.26  to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
301.27     (c) Medical assistance and MinnesotaCare payment for mental 
301.28  health case management shall be made on a monthly basis.  In 
301.29  order to receive payment for an eligible child, the provider 
301.30  must document at least a face-to-face contact with the child, 
301.31  the child's parents, or the child's legal representative.  To 
301.32  receive payment for an eligible adult, the provider must 
301.33  document: 
301.34     (1) at least a face-to-face contact with the adult or the 
301.35  adult's legal representative; or 
301.36     (2) at least a telephone contact with the adult or the 
302.1   adult's legal representative and document a face-to-face contact 
302.2   with the adult or the adult's legal representative within the 
302.3   preceding two months. 
302.4      (d) Payment for mental health case management provided by 
302.5   county or state staff shall be based on the monthly rate 
302.6   methodology under section 256B.094, subdivision 6, paragraph 
302.7   (b), with separate rates calculated for child welfare and mental 
302.8   health, and within mental health, separate rates for children 
302.9   and adults. 
302.10     (e) Payment for mental health case management provided by 
302.11  Indian health services or by agencies operated by Indian tribes 
302.12  may be made according to this section or other relevant 
302.13  federally approved rate setting methodology. 
302.14     (f) Payment for mental health case management provided by 
302.15  vendors who contract with a county or Indian tribe shall be 
302.16  based on a monthly rate negotiated by the host county or tribe.  
302.17  The negotiated rate must not exceed the rate charged by the 
302.18  vendor for the same service to other payers.  If the service is 
302.19  provided by a team of contracted vendors, the county or tribe 
302.20  may negotiate a team rate with a vendor who is a member of the 
302.21  team.  The team shall determine how to distribute the rate among 
302.22  its members.  No reimbursement received by contracted vendors 
302.23  shall be returned to the county or tribe, except to reimburse 
302.24  the county or tribe for advance funding provided by the county 
302.25  or tribe to the vendor. 
302.26     (g) If the service is provided by a team which includes 
302.27  contracted vendors, tribal staff, and county or state staff, the 
302.28  costs for county or state staff participation in the team shall 
302.29  be included in the rate for county-provided services.  In this 
302.30  case, the contracted vendor, the tribal agency, and the county 
302.31  may each receive separate payment for services provided by each 
302.32  entity in the same month.  In order to prevent duplication of 
302.33  services, each entity must document, in the recipient's file, 
302.34  the need for team case management and a description of the roles 
302.35  of the team members. 
302.36     (h) The commissioner shall calculate the nonfederal share 
303.1   of actual medical assistance and general assistance medical care 
303.2   payments for each county, based on the higher of calendar year 
303.3   1995 or 1996, by service date, project that amount forward to 
303.4   1999, and transfer one-half of the result from medical 
303.5   assistance and general assistance medical care to each county's 
303.6   mental health grants under sections 245.4886 and 256E.12 for 
303.7   calendar year 1999.  The annualized minimum amount added to each 
303.8   county's mental health grant shall be $3,000 per year for 
303.9   children and $5,000 per year for adults.  The commissioner may 
303.10  reduce the statewide growth factor in order to fund these 
303.11  minimums.  The annualized total amount transferred shall become 
303.12  part of the base for future mental health grants for each county.
303.13     (i) Any net increase in revenue to the county or tribe as a 
303.14  result of the change in this section must be used to provide 
303.15  expanded mental health services as defined in sections 245.461 
303.16  to 245.4888, the Comprehensive Adult and Children's Mental 
303.17  Health Acts, excluding inpatient and residential treatment.  For 
303.18  adults, increased revenue may also be used for services and 
303.19  consumer supports which are part of adult mental health projects 
303.20  approved under Laws 1997, chapter 203, article 7, section 25.  
303.21  For children, increased revenue may also be used for respite 
303.22  care and nonresidential individualized rehabilitation services 
303.23  as defined in section 245.492, subdivisions 17 and 23.  
303.24  "Increased revenue" has the meaning given in Minnesota Rules, 
303.25  part 9520.0903, subpart 3.  
303.26     (j) Notwithstanding section 256B.19, subdivision 1, the 
303.27  nonfederal share of costs for mental health case management 
303.28  shall be provided by the recipient's county of responsibility, 
303.29  as defined in sections 256G.01 to 256G.12, from sources other 
303.30  than federal funds or funds used to match other federal funds.  
303.31  If the service is provided by a tribal agency, the nonfederal 
303.32  share, if any, shall be provided by the recipient's tribe.  
303.33     (k) (j) The commissioner may suspend, reduce, or terminate 
303.34  the reimbursement to a provider that does not meet the reporting 
303.35  or other requirements of this section.  The county of 
303.36  responsibility, as defined in sections 256G.01 to 256G.12, or, 
304.1   if applicable, the tribal agency, is responsible for any federal 
304.2   disallowances.  The county or tribe may share this 
304.3   responsibility with its contracted vendors.  
304.4      (l) (k) The commissioner shall set aside a portion of the 
304.5   federal funds earned under this section to repay the special 
304.6   revenue maximization account under section 256.01, subdivision 
304.7   2, clause (15).  The repayment is limited to: 
304.8      (1) the costs of developing and implementing this section; 
304.9   and 
304.10     (2) programming the information systems. 
304.11     (m) (l) Payments to counties and tribal agencies for case 
304.12  management expenditures under this section shall only be made 
304.13  from federal earnings from services provided under this 
304.14  section.  Payments to county-contracted vendors shall include 
304.15  both the federal earnings and the county share. 
304.16     (n) (m) Notwithstanding section 256B.041, county payments 
304.17  for the cost of mental health case management services provided 
304.18  by county or state staff shall not be made to the state 
304.19  treasurer.  For the purposes of mental health case management 
304.20  services provided by county or state staff under this section, 
304.21  the centralized disbursement of payments to counties under 
304.22  section 256B.041 consists only of federal earnings from services 
304.23  provided under this section. 
304.24     (o) (n) Case management services under this subdivision do 
304.25  not include therapy, treatment, legal, or outreach services. 
304.26     (p) (o) If the recipient is a resident of a nursing 
304.27  facility, intermediate care facility, or hospital, and the 
304.28  recipient's institutional care is paid by medical assistance, 
304.29  payment for case management services under this subdivision is 
304.30  limited to the last 180 days of the recipient's residency in 
304.31  that facility and may not exceed more than six months in a 
304.32  calendar year. 
304.33     (q) (p) Payment for case management services under this 
304.34  subdivision shall not duplicate payments made under other 
304.35  program authorities for the same purpose. 
304.36     (r) (q) By July 1, 2000, the commissioner shall evaluate 
305.1   the effectiveness of the changes required by this section, 
305.2   including changes in number of persons receiving mental health 
305.3   case management, changes in hours of service per person, and 
305.4   changes in caseload size. 
305.5      (s) (r) For each calendar year beginning with the calendar 
305.6   year 2001, the annualized amount of state funds for each county 
305.7   determined under paragraph (h) shall be adjusted by the county's 
305.8   percentage change in the average number of clients per month who 
305.9   received case management under this section during the fiscal 
305.10  year that ended six months prior to the calendar year in 
305.11  question, in comparison to the prior fiscal year. 
305.12     (t) (s) For counties receiving the minimum allocation of 
305.13  $3,000 or $5,000 described in paragraph (h), the adjustment in 
305.14  paragraph (s) (r) shall be determined so that the county 
305.15  receives the higher of the following amounts: 
305.16     (1) a continuation of the minimum allocation in paragraph 
305.17  (h); or 
305.18     (2) an amount based on that county's average number of 
305.19  clients per month who received case management under this 
305.20  section during the fiscal year that ended six months prior to 
305.21  the calendar year in question, times the average statewide grant 
305.22  per person per month for counties not receiving the minimum 
305.23  allocation. 
305.24     (u) (t) The adjustments in paragraphs (s) (r) and 
305.25  (t) (s) shall be calculated separately for children and adults. 
305.26     Sec. 4.  Minnesota Statutes 2002, section 256B.0625, 
305.27  subdivision 23, is amended to read: 
305.28     Subd. 23.  [DAY TREATMENT SERVICES.] Medical assistance 
305.29  covers day treatment services for adults as specified in 
305.30  sections section 245.462, subdivision 8, and 245.4871, 
305.31  subdivision 10, that are provided under contract with the county 
305.32  board.  Medical assistance covers day treatment services for 
305.33  children as specified under section 256B.0943. 
305.34     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
305.35     Sec. 5.  Minnesota Statutes 2002, section 256B.0625, is 
305.36  amended by adding a subdivision to read: 
306.1      Subd. 35a.  [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 
306.2   SERVICES.] Medical assistance covers children's mental health 
306.3   crisis response services according to section 256B.0944. 
306.4      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
306.5      Sec. 6.  Minnesota Statutes 2002, section 256B.0625, is 
306.6   amended by adding a subdivision to read: 
306.7      Subd. 35b.  [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 
306.8   Medical assistance covers children's therapeutic services and 
306.9   supports according to section 256B.0943. 
306.10     Sec. 7.  Minnesota Statutes 2002, section 256B.0625, is 
306.11  amended by adding a subdivision to read: 
306.12     Subd. 45.  [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 
306.13  YEARS OF AGE.] Medical assistance covers subacute psychiatric 
306.14  care for person under 21 years of age when: 
306.15     (1) the services meet the requirements of Code of Federal 
306.16  Regulations, title 42, section 440.160; 
306.17     (2) the facility is accredited as a psychiatric treatment 
306.18  facility by the joint commission on accreditation of healthcare 
306.19  organizations, the commission on accreditation of rehabilitation 
306.20  facilities, or the council on accreditation; and 
306.21     (3) the facility is licensed by the commissioner of health 
306.22  under section 144.50. 
306.23     Sec. 8.  [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 
306.24  SUPPORTS.] 
306.25     Subdivision 1.  [SCOPE.] Children's therapeutic services 
306.26  and supports are an array of mental health services for children 
306.27  who require different therapeutic and rehabilitative levels of 
306.28  intervention. 
306.29     Subd. 2.  [DEFINITIONS.] For the purposes of this section, 
306.30  the following terms have the meanings given them. 
306.31     (a) [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 
306.32  "Children's therapeutic services and supports" means the array 
306.33  of mental health services for children who require different 
306.34  therapeutic and rehabilitative levels of intervention as 
306.35  identified in the client's individual treatment plan through a 
306.36  child-centered, family-driven planning process that identifies 
307.1   individualized, planned, and culturally appropriate 
307.2   interventions.  Children's therapeutic services and supports are 
307.3   time-limited interventions that are delivered using various 
307.4   treatment modalities and combinations of service to reach 
307.5   treatment outcomes identified in the individual treatment plan.  
307.6   Services such as psychotherapy, skills training, crisis 
307.7   assistance, and mental health behavioral aide services may be 
307.8   provided to a child in the child's home or a community setting.  
307.9   Community settings may include the child's preschool or school, 
307.10  the home of a relative of the child, a recreational or leisure 
307.11  setting, or a site where the child receives day care. 
307.12     (b) [CLINICAL SUPERVISION.] "Clinical supervision" means 
307.13  the overall responsibility of the mental health professional as 
307.14  defined in section 245.4871, subdivision 27, clauses (1) to (5), 
307.15  for the control and direction of individualized treatment 
307.16  planning, service delivery, and treatment review for each 
307.17  client.  The mental health professional who is an enrolled 
307.18  Minnesota health care program provider accepts full professional 
307.19  responsibility for the actions and decisions of the persons 
307.20  supervised, instructs the person in the person's work, and 
307.21  oversees or directs the work of the person supervised. 
307.22     (c) [COUNTY BOARD.] "County board" means the county board 
307.23  of commissioners or board established under sections 402.01 to 
307.24  402.10 or 471.59. 
307.25     (d) [CRISIS ASSISTANCE.] "Crisis assistance" has the 
307.26  meaning given in section 245.4871, subdivision 9a. 
307.27     (e) [CULTURAL COMPETENCE OR CULTURALLY COMPETENT.] 
307.28  "Cultural competence or culturally competent" means the ability 
307.29  and the capacity to respond to the unique needs of an individual 
307.30  client that arise from the client's culture and the ability to 
307.31  use the person's culture as a resource or tool to assist with 
307.32  the intervention and help meet the person's needs. 
307.33     (f) [CULTURALLY COMPETENT PROVIDER.] "Culturally competent 
307.34  provider" means a service professional who understands, and can 
307.35  utilize to the client's benefit, the client's culture either 
307.36  because the service professional is of the same cultural or 
308.1   ethnic group or because the provider has developed the knowledge 
308.2   and skills through training and personal growth to provide 
308.3   high-quality service to diverse clients.  
308.4      (g) [CULTURALLY SPECIFIC PROVIDER.] "Culturally specific 
308.5   provider" means one that is characteristically found or proven 
308.6   especially effective within a particular cultural or linguistic 
308.7   population. 
308.8      (h) [DAY TREATMENT PROGRAM FOR CHILDREN.] "Day treatment 
308.9   program for children" means a site-based structured program 
308.10  consisting of group psychotherapy for more than three 
308.11  individuals and other intensive therapeutic services provided by 
308.12  a multidisciplinary team, under the clinical supervision of a 
308.13  mental health professional.  Day treatment services stabilize 
308.14  the client's mental health status while developing and improving 
308.15  the client's independent living and socialization skills.  The 
308.16  goal is to reduce or relieve the effects of mental illness and 
308.17  provide training to enable the client to live in the community.  
308.18  Day treatment services are not part of inpatient or residential 
308.19  treatment services.  Day treatment services are provided to a 
308.20  client in and by:  an outpatient hospital accredited by the 
308.21  joint commission on accreditation of health organizations and 
308.22  licensed under sections 144.50 to 144.55; a community mental 
308.23  health center under section 245.62; or an entity that is under 
308.24  contract with the county board to operate a program that meets 
308.25  the requirements of sections 245.4712, subdivision 2, 245.4884, 
308.26  subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475.
308.27     (i) [DIAGNOSTIC ASSESSMENT.] "Diagnostic assessment" has 
308.28  the meaning given in section 245.4871, subdivision 11.  A 
308.29  written evaluation by a mental health professional of a person's 
308.30  current life situation and sources of stress, including the 
308.31  reasons for referral; history of the person's current mental 
308.32  health problem, including important developmental incidents, 
308.33  strengths, and vulnerabilities; current functioning and 
308.34  symptoms; diagnosis, including whether or not a person has an 
308.35  emotional disturbance or serious emotional disturbance; and 
308.36  mental health services needed by the client. 
309.1      (j) [DIRECTION OF MENTAL HEALTH BEHAVIORAL AIDE.] 
309.2   "Direction of mental health behavioral aide" means the 
309.3   activities of the mental health professional, or mental health 
309.4   practitioner under the clinical supervision of a mental health 
309.5   professional, to guide the work of the mental health behavioral 
309.6   aide.  Direction is based on the individualized treatment plan.  
309.7   The person giving direction begins with the goals on the 
309.8   individualized treatment plan, and instructs the mental health 
309.9   behavioral aide in how to construct therapeutic activities and 
309.10  interventions that will lead to goal attainment.  The person 
309.11  giving direction also instructs the mental health behavioral 
309.12  aide about the diagnosis, functional status, and other 
309.13  characteristics of the client that are likely to affect service 
309.14  delivery.  Direction must also include determining whether the 
309.15  mental health behavioral aide has the skills to interact with 
309.16  the client and the client's family in ways which convey personal 
309.17  and cultural respect and that the aide actively solicits 
309.18  information relevant to treatment from the family while being 
309.19  able to clearly explain the activities the aide is doing with 
309.20  the client and their relationship to treatment goals.  Direction 
309.21  is more didactic than is supervision, and requires the 
309.22  professional and practitioner providing direction to 
309.23  continuously evaluate the mental health behavioral aide's 
309.24  ability to carry out the activities of the individualized 
309.25  treatment plan and the individualized behavior plan. 
309.26     (k) [EMOTIONAL DISTURBANCE.] "Emotional disturbance" is 
309.27  defined in section 245.4871, subdivision 15, and, for persons 
309.28  age 18 to 20, a mental illness as defined in section 245.462, 
309.29  subdivision 20, paragraph (a). 
309.30     (l) [FACE-TO-FACE TIME.] "Face-to-face time" means time 
309.31  that a mental health professional, mental health practitioner, 
309.32  or mental health behavioral aide spends face-to-face with the 
309.33  client and the client's family.  This includes time in which the 
309.34  provider performs tasks such as obtaining a history, or 
309.35  providing service components of children's therapeutic services 
309.36  and supports.  Activities such as scheduling, maintaining 
310.1   clinical records, consulting with others about the client's 
310.2   mental health status, preparing reports, receiving clinical 
310.3   supervision directly related to the client's psychotherapy 
310.4   session, and revising the client's individual treatment plan are 
310.5   not included in the time component of services in this section. 
310.6      (m) [INDIVIDUAL BEHAVIORAL PLAN.] "Individual behavioral 
310.7   plan" means a plan of intervention, treatment, and services 
310.8   written by a mental health professional or mental health 
310.9   practitioner under the clinical supervision of a mental health 
310.10  professional, for a mental health behavioral aide to provide.  
310.11  The plan documents instruction for services to be provided by 
310.12  the mental health behavioral aide.  The individual behavior plan 
310.13  must include:  
310.14     (1) detailed instructions on the service to be provided; 
310.15     (2) time allocated to each service; 
310.16     (3) methods of documenting the child's behavior; 
310.17     (4) methods of monitoring the progress of the child in 
310.18  reaching objectives; and 
310.19     (5) goals to increase or decrease targeted behavior as 
310.20  identified in the individual treatment plan. 
310.21     (n) [INDIVIDUAL TREATMENT PLAN.] "Individual treatment plan"
310.22  has the meaning given in section 245.4871, subdivision 21. 
310.23     (o) [MENTAL HEALTH PROFESSIONAL.] "Mental health 
310.24  professional" means an individual as defined in section 
310.25  245.4871, subdivision 27, clauses (1) to (5), or tribal vendor 
310.26  as defined in section 256B.02, subdivision 7, paragraph (b). 
310.27     (p) [PRESCHOOL PROGRAM.] "Preschool program" means a day 
310.28  program licensed under Minnesota Rules, parts 9503.0005 to 
310.29  9503.0175, and enrolled as a children's therapeutic services and 
310.30  supports provider to provide a structured program of treatment 
310.31  that includes therapeutic and rehabilitative components of 
310.32  mental health services provided by a team of multidisciplinary 
310.33  staff under the clinical supervision of a mental health 
310.34  professional to a child who is at least 33 months old but who 
310.35  has not yet reached the first day of kindergarten.  The 
310.36  structured program of treatment must be available at least one 
311.1   day a week for a minimum two-hour time block.  The two-hour time 
311.2   block may include individual and group psychotherapy and any of 
311.3   the following developmentally and therapeutically appropriate 
311.4   activities:  recreation therapy, socialization therapy, and 
311.5   independent living skills therapy to the extent the activities 
311.6   are included in the child's individual treatment plan. 
311.7      (q) [RESIDENCE.] "Residence" means a person's own home, 
311.8   foster home, shelter, or a setting where a child resides that 
311.9   does not provide active mental health treatment services as part 
311.10  of the per diem charged by a residential program.  Residence 
311.11  does not include an acute care hospital licensed under chapter 
311.12  144, a regional treatment center, nursing home, ICF/MR facility, 
311.13  or facilities that provide active treatment services. 
311.14     (r) [SKILLS TRAINING.] "Skills training" means individual, 
311.15  family, or group skills training designed to improve the basic 
311.16  functioning of the child with severe emotional disturbance and 
311.17  the child's family in the activities of daily living and 
311.18  community living, and to improve the social functioning of the 
311.19  child and the child's family in areas important to the child's 
311.20  maintaining or reestablishing residency in the community.  The 
311.21  individual, family, and group skills training must: 
311.22     (1) consist of activities designed to promote skill 
311.23  development of the child and the child's family in the use of 
311.24  age-appropriate daily living skills, interpersonal and family 
311.25  relationships, and leisure and recreational services; 
311.26     (2) consist of activities which will assist the family in 
311.27  improving the family's understanding of normal child development 
311.28  and to use parenting skills that will help the child with 
311.29  emotional disturbance or severe emotional disturbance achieve 
311.30  the goals outlined in the child's individual treatment plan; and 
311.31     (3) promote family preservation and unification, promote 
311.32  the family's integration with the community, and reduce the use 
311.33  of unnecessary out-of-home placement or institutionalization of 
311.34  children with emotional disturbance or severe emotional 
311.35  disturbance. 
311.36     Subd. 3.  [COVERED SERVICE COMPONENTS OF CHILDREN'S 
312.1   THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 
312.2   approval, medical assistance covers medically necessary 
312.3   children's therapeutic services and supports as defined in this 
312.4   section for clients defined under subdivision 5, by providers 
312.5   under subdivisions 7 and 8.  The service components of 
312.6   children's therapeutic services and supports are: 
312.7      (1) individual, family, and group psychotherapy provided by 
312.8   a mental health professional; 
312.9      (2) individual, family, or group skills training provided 
312.10  by a mental health professional or mental health practitioner 
312.11  under the clinical supervision of a mental health professional; 
312.12     (3) crisis assistance as defined in this section; 
312.13     (4) mental health behavioral aide services as defined in 
312.14  this section; and 
312.15     (5) direction of a mental health behavioral aide or a 
312.16  program staff as defined in subdivision 2, paragraph (j).  
312.17     (b) Service components may be combined to constitute 
312.18  therapeutic programs, including day treatment programs, 
312.19  preschool programs, home-based mental health treatment, and 
312.20  therapeutic support of foster care.  While these programs have 
312.21  specific client and provider eligibility requirements and 
312.22  service standards, medical assistance only pays for the service 
312.23  components listed in paragraph (a). 
312.24     Subd. 4.  [DIAGNOSIS OF EMOTIONAL DISTURBANCE OR MENTAL 
312.25  ILLNESS.] A client's eligibility for mental health services 
312.26  under this section shall be based on a diagnostic assessment 
312.27  performed within 180 days that documents a diagnosis of 
312.28  emotional disturbance or mental illness.  A diagnostic 
312.29  assessment that includes current diagnoses on all five axes of 
312.30  the client's current mental health status and service needs, and 
312.31  determines whether the client has a diagnosis of emotional 
312.32  disturbance or mental illness, shall be used in the development 
312.33  of the individualized treatment plan.  A new diagnostic 
312.34  assessment must be completed yearly until the client reaches the 
312.35  age of 18.  The diagnostic assessment is necessary to verify 
312.36  diagnosis of emotional disturbance or mental illness, verify the 
313.1   need for mental health services, and to structure the individual 
313.2   treatment plan.  For individuals between the ages of 18 and 21, 
313.3   a diagnostic assessment which documents a diagnosis of emotional 
313.4   disturbance or mental illness must be performed within 180 
313.5   days.  For continuing services, an updated assessment must be 
313.6   done yearly.  Updating means a written summary by a mental 
313.7   health professional of the client's current mental health status 
313.8   and service needs including current diagnoses on all five axes.  
313.9   The client record must include the initial diagnostic assessment 
313.10  and all subsequent written updates or diagnostic assessments. 
313.11     Subd. 5.  [DETERMINATION OF CLIENT ELIGIBILITY.] The 
313.12  determination of a client's eligibility to receive children's 
313.13  therapeutic services and supports under this section shall be 
313.14  based on a diagnostic assessment by a mental health professional 
313.15  that documents mental health services are medically necessary to 
313.16  address identified disability, functional impairments, and 
313.17  individual client needs and goals.  An eligible client is a 
313.18  child under the age of 18 who has been diagnosed with emotional 
313.19  disturbance, or if the individual is between the ages of 18 and 
313.20  21, a person who has been diagnosed with mental illness. 
313.21     Subd. 6.  [DETERMINATION OF PROVIDER ENTITY ELIGIBILITY.] 
313.22  (a) The provider entity must complete the provider application 
313.23  and certification process as established by the commissioner to 
313.24  become a children's therapeutic services and supports provider.  
313.25  The process shall determine whether the entity meets the 
313.26  applicable requirements in subdivisions 7 to 10.  
313.27  Recertification must occur at least every two years.  The 
313.28  county, tribe, and the commissioner shall be equally responsible 
313.29  and accountable for certification.  A provider entity must be: 
313.30     (1) an Indian health services facility or a facility owned 
313.31  and operated by a tribe or tribal organization operating as a 
313.32  638 facility under Public Law 93-638 certified by the state; 
313.33     (2) a county-operated entity certified by the state; or 
313.34     (3) a noncounty entity certified by the provider's host 
313.35  county. 
313.36     (b) If a noncounty entity seeks to provide services outside 
314.1   the host county, it must obtain additional recommendations for 
314.2   certification from each county in which it will provide 
314.3   services.  The additional recommendations must be based on the 
314.4   adequacy of the entity's knowledge of that county's local health 
314.5   and human service system, and the ability of the entity to 
314.6   coordinate its services with the other services available in 
314.7   that county. 
314.8      (c) The commissioner may intervene at any time and 
314.9   decertify providers with cause.  The decertification is subject 
314.10  to appeal to the state.  A county board or tribal government may 
314.11  recommend that the state decertify a provider for cause, based 
314.12  on the decertification process as established by the 
314.13  commissioner.  The commissioner shall develop statewide 
314.14  procedures for provider certification, including timelines for 
314.15  counties to certify qualified providers. 
314.16     Subd. 7.  [PROVIDER ENTITY ADMINISTRATIVE STANDARDS.] (a) 
314.17  An entity shall have written policies and procedures regarding 
314.18  organizational operation and service provision.  These policies 
314.19  and procedures will be reviewed and updated every two years and 
314.20  distributed to staff initially and upon each subsequent update.  
314.21     (b) An entity's written policies and procedures must 
314.22  include: 
314.23     (1) organizational policies for clinical, ethical, 
314.24  administrative, fiscal, and quality assurance responsibilities 
314.25  that include: 
314.26     (i) clear lines of accountability, authority, and 
314.27  supervision of all clinical personnel and documentation of such 
314.28  supervision; 
314.29     (ii) a clinical and organizational code of ethics and 
314.30  procedures for investigating, reporting, and acting on 
314.31  violations of codes, policies, and procedures; 
314.32     (iii) data privacy policies regarding record keeping, 
314.33  communication, treatment, reporting, and reimbursement that are 
314.34  compliant with federal and state laws; 
314.35     (iv) fiscal policies and internal control practices; 
314.36     (v) a performance measurement system that includes 
315.1   monitoring to determine cultural appropriateness as determined 
315.2   by the client's culture, beliefs, values, and language as 
315.3   identified in the individual treatment plan and family-driven 
315.4   services; 
315.5      (vi) criteria for preservice and in-service training for 
315.6   all staff; 
315.7      (vii) criteria to ensure a flexible response to the 
315.8   changing and intermittent care needs of a client as identified 
315.9   by the client and in the individual treatment plan; 
315.10     (viii) service coordination policies and procedures that 
315.11  ensure services are coordinated with other service entities or 
315.12  providers and others after obtaining the consent of the client.  
315.13  If the client is receiving case management or care coordination 
315.14  services, services must also be coordinated with the client's 
315.15  case manager or care coordinator; 
315.16     (ix) criteria for health and safety of clients, employees, 
315.17  subcontractors, and volunteers; 
315.18     (x) documentation policies regarding client records, 
315.19  personnel records, and clinical supervision that are consistent 
315.20  with federal and state laws; and 
315.21     (xi) provider entities that offer site-based programs such 
315.22  as day treatment or therapeutic preschool programs must provide 
315.23  staffing and facilities to ensure the health, safety, and 
315.24  protection of rights of each client; 
315.25     (2) personnel policies for recruiting, hiring, training, 
315.26  and retention of individuals providing administrative and 
315.27  clinical services that include: 
315.28     (i) recruiting procedures that define a process to recruit, 
315.29  train, and retain culturally and linguistically competent 
315.30  providers; 
315.31     (ii) screening criteria for employees, subcontractors, and 
315.32  volunteers to determine whether the knowledge, skills, ability, 
315.33  and behaviors possessed by the individual are sufficient to 
315.34  allow the individual to perform the job correctly and skillfully 
315.35  and a process for criminal background checks for all direct 
315.36  service providers; 
316.1      (iii) the duties, responsibilities, and required minimum 
316.2   qualifications of personnel for various positions; 
316.3      (iv) standards governing the ethical conduct of staff and 
316.4   volunteers; 
316.5      (v) standards governing confidentiality of information 
316.6   regarding clients and client records; 
316.7      (vi) written policies and procedures governing volunteer 
316.8   services for entities that utilize volunteers that include 
316.9   screening of applicants, training, supervision, and 
316.10  documentation of the supervision and liability coverage for 
316.11  volunteers; and 
316.12     (vii) staff development and evaluation; and 
316.13     (3) documentation policies for client records, personnel 
316.14  files, and records of fiscal activities where individual 
316.15  providers are responsible to document service provisions that 
316.16  include: 
316.17     (i) for the individual personnel file of each employee or 
316.18  subcontractor:  the individual's name, birth date, address, and 
316.19  telephone number; documentation that the staff member or 
316.20  volunteer meets the qualifications required in this section and 
316.21  are included in the job description to provide children's 
316.22  therapeutic services and supports; evidence of academic degree 
316.23  and qualifications; a copy of any required professional license; 
316.24  documentation that includes a record of the dates and locations 
316.25  of work experience, education, and training; dates of employment 
316.26  or volunteer assignments; a copy of required licenses or 
316.27  certification; documentation of all clinical supervision or 
316.28  direction provided; an annual performance review; a summary of 
316.29  on-site service observations and charting review; a criminal 
316.30  background check of all direct service staff; any job 
316.31  performance recognition and disciplinary actions; any written 
316.32  input from individual staff; and documentation of compliance 
316.33  with continuing education requirements; and 
316.34     (ii) for the individual client file:  the client's name, 
316.35  address, telephone number, date of birth, primary language, and 
316.36  culture or ethnicity; diagnostic assessment and updates; 
317.1   individual treatment plan and individual behavior plan, if 
317.2   necessary; progress notes documenting delivery of services; 
317.3   telephone contacts; and discharge plan. 
317.4      Subd. 8.  [PROVIDER ENTITY CLINICAL STANDARDS.] An 
317.5   effective mental health system of care utilizes diagnostic 
317.6   assessment, individualized treatment plan, service delivery, and 
317.7   individual treatment plan review that is culturally competent, 
317.8   child-centered, and family-driven to achieve maximum benefit for 
317.9   the client.  The diagnostic assessment must identify acute and 
317.10  chronic clinical disorders, co-occurring medical conditions, 
317.11  sources of psychological and environmental problems, and 
317.12  functional assessment.  The functional assessment should clearly 
317.13  summarize the individual strengths and needs of the client.  The 
317.14  individual treatment plan is a written plan of intervention, 
317.15  treatment, and services developed on the basis of the diagnostic 
317.16  assessment.  Service delivery is the process of implementing the 
317.17  individual treatment plan in order to achieve the goals and 
317.18  objectives identified in it.  Individual treatment plan review 
317.19  determines the extent to which the services have met the goals 
317.20  and objectives and may lead to an updating of the individual 
317.21  treatment plan.  Clinical policies and procedures will be 
317.22  reviewed and updated every two years and distributed to staff 
317.23  initially and upon each subsequent update.  Services billed 
317.24  under children's therapeutic services and supports that are not 
317.25  documented according to this subdivision shall be subject to 
317.26  monetary recovery by the commissioner.  Clinical policies must: 
317.27     (1) define policies and procedures for providing or 
317.28  obtaining a diagnostic assessment for each client as required in 
317.29  this section; 
317.30     (2) define policies and procedures for development of an 
317.31  individual treatment plan to ensure that individual treatment 
317.32  plan standards are met.  The individualized treatment plan must: 
317.33     (i) be based on the information and outcome of the client's 
317.34  diagnostic assessment; 
317.35     (ii) be developed no later than the end of the first 
317.36  psychotherapy session or skills training after the completion of 
318.1   the client's diagnostic assessment by the mental health 
318.2   professional who provides the client's psychotherapy, or the 
318.3   mental health practitioner under the clinical supervision of a 
318.4   mental health professional who is a provider; 
318.5      (iii) be developed through a child-centered, family-driven 
318.6   planning process that identifies individualized, planned, and 
318.7   culturally appropriate interventions that contain specific 
318.8   treatment goals and objectives for the client and the client's 
318.9   family or foster family and identify service needs; 
318.10     (iv) be reviewed at least once every 90 days and revised, 
318.11  if necessary.  The treatment plan review assesses the client's 
318.12  progress and ensures that services and treatment goals continue 
318.13  to be necessary and appropriate to the client and the client's 
318.14  family or foster family.  Revision of the individual treatment 
318.15  plan does not require a new diagnostic assessment unless the 
318.16  client's mental health status has changed markedly; and 
318.17     (v) be signed by the client, as appropriate, the client's 
318.18  parent, primary caregiver, or other person authorized by statute 
318.19  to consent to mental health services for the child; 
318.20     (3) define a service coordination process to ensure 
318.21  services are provided in the most appropriate manner to achieve 
318.22  maximum benefit to the client if the client is receiving 
318.23  services from other providers or provider entities.  If it is 
318.24  determined that the client has a relationship with other 
318.25  providers, the children's therapeutic services and support 
318.26  provider shall ensure coordination and nonduplication of 
318.27  services consistent with the county board coordination 
318.28  procedures under section 245.4881, subdivision 5; 
318.29     (4) define caseload size for each direct service provider.  
318.30  The caseload of each provider must be of a size that recognizes 
318.31  both clients with severe, complex needs and clients with less 
318.32  intensive needs.  The size of each caseload should reasonably be 
318.33  expected to enable the provider to play a very active role in 
318.34  service planning, monitoring, and service delivery to meet the 
318.35  needs of the client and the client's family as specified in each 
318.36  client's individual treatment plan; 
319.1      (5) define clinical supervision policies and procedures 
319.2   that identify who will provide clinical supervision, who must 
319.3   have supervision, how supervision will be implemented, and how 
319.4   clinical supervision standards, as developed by the 
319.5   commissioner, will be met.  The mental health professional must 
319.6   document the clinical supervision by cosigning individual 
319.7   treatment plans and by making entries in the client's record on 
319.8   supervisory activities.  Clinical supervision does not include 
319.9   authority to make or terminate court-ordered placements of the 
319.10  child.  A clinical supervisor must be available for urgent 
319.11  consultation as needed by the individual client or the clinical 
319.12  situation necessitates.  Clinical supervision may occur 
319.13  individually or in a small group to discuss treatment and review 
319.14  of the client's progress toward goals.  The focus of supervision 
319.15  should be the client's treatment needs and progress and the 
319.16  supervised person's ability to effect the change; 
319.17     (6) define policies and procedures for providing direction 
319.18  to a mental health behavior aide.  For provider entities that 
319.19  employ mental health behavioral aides, the clinical supervisor 
319.20  must be employed by the provider entity to ensure necessary and 
319.21  appropriate oversight for the treatment and continuity of care 
319.22  for the client.  When providing direction, the mental health 
319.23  professional or the mental health practitioner under a mental 
319.24  health professional supervision must: 
319.25     (i) review progress notes prepared by the mental health 
319.26  behavioral aide for accuracy and consistency with diagnostic 
319.27  assessment, treatment plan, and behavior goals.  Progress notes 
319.28  must be approved and signed by the mental health professional or 
319.29  mental health practitioner; 
319.30     (ii) identify changes in treatment strategies, revise the 
319.31  individual behavior plan, and communicate treatment instructions 
319.32  and methodologies appropriate to ensure that treatment is 
319.33  implemented correctly; 
319.34     (iii) demonstrate family-friendly behaviors that support 
319.35  healthy collaboration among the child, the child's family, and 
319.36  providers as treatment is planned and implemented; 
320.1      (iv) ensure that the mental health behavioral aide is able 
320.2   to effectively communicate with the child, the child's family, 
320.3   and the provider; and 
320.4      (v) record the results of any evaluation and corrective 
320.5   actions taken to modify the work of the mental health behavioral 
320.6   aide; 
320.7      (7) ensure that documentation standards meet requirements 
320.8   of federal and state laws.  The individual mental health 
320.9   provider must maintain sufficient documentation to support each 
320.10  service for which billing is made.  Documentation in the 
320.11  client's record must include: 
320.12     (i) the specific service rendered, including the date, 
320.13  time, length, setting, and scope of the mental health service; 
320.14     (ii) the name of the person who gave the service; 
320.15     (iii) contact, including the name and date of the contact, 
320.16  made with other persons interested in the client such as 
320.17  representatives of the courts, corrections systems, or schools; 
320.18     (iv) any contact made with the client's other mental health 
320.19  providers, case manager, family members, primary caregiver, 
320.20  legal representative, or, if applicable, the reason the client's 
320.21  family members, primary caregiver, or legal representative was 
320.22  not contacted; and 
320.23     (v) as appropriate, required clinical supervision.  
320.24  Documentation must be completed promptly after the provision of 
320.25  service. 
320.26     Subd. 9.  [QUALIFICATIONS OF INDIVIDUAL AND TEAM 
320.27  PROVIDERS.] Children's therapeutic services and supports are 
320.28  provided by individual or team providers working within the 
320.29  scope of the provider's practice or qualifications to provide 
320.30  services identified as medically necessary by the individual 
320.31  treatment plan.  Providers and multidisciplinary teams include: 
320.32     (1) a mental health professional as defined in subdivision 
320.33  2; 
320.34     (2) a mental health practitioner as defined in section 
320.35  245.4871, subdivision 26.  The mental health practitioner must 
320.36  work under the clinical supervision of a mental health 
321.1   professional; 
321.2      (3) a mental health behavioral aide who is a 
321.3   paraprofessional working under the direction of a mental health 
321.4   professional or mental health practitioner who is under the 
321.5   clinical supervision of a mental health professional in the 
321.6   implementation of rehabilitative mental health services as 
321.7   identified in the client's individual treatment plan.  
321.8      (i) A level I mental health behavioral aide must: 
321.9      (A) be at least 18 years of age; 
321.10     (B) have a high school diploma or general equivalency 
321.11  diploma (GED) or two years of experience as a primary caregiver 
321.12  to a child with severe emotional disturbance within the previous 
321.13  ten years; and 
321.14     (C) meet preservices and continuing education requirements 
321.15  in subdivision 10.  
321.16     (ii) A level II mental health behavioral aide must:  
321.17     (A) be at least 18 years of age; 
321.18     (B) have an associate or bachelor's degree or 4,000 hours 
321.19  of experience in delivering clinical services in the treatment 
321.20  of mental illness concerning children or adolescents; and 
321.21     (C) meet the orientation and training requirements in 
321.22  subdivision 10; 
321.23     (4) a preschool program multidisciplinary team that 
321.24  includes at least one mental health professional and one or more 
321.25  of the following under the clinical supervision of a mental 
321.26  health professional:  a mental health practitioner or a program 
321.27  person such as a teacher, assistant teacher, or aide, who meets 
321.28  the qualifications and training standards of a level I mental 
321.29  health behavioral aid; and 
321.30     (5) a day treatment multidisciplinary team that includes 
321.31  mental health professionals and mental health practitioners as 
321.32  defined in this section. 
321.33     Subd. 10.  [REQUIRED PRESERVICE AND ONGOING TRAINING.] (a) 
321.34  A provider entity shall establish a plan to provide preservices 
321.35  and continuing education for staff that clearly describes the 
321.36  type of training necessary to maintain current skills, obtain 
322.1   new skills, and that relates to the goals and objectives of the 
322.2   provider entity program plan for services offered.  A provider 
322.3   that employs a mental health behavioral aide under this section 
322.4   shall require the aide to complete 30 hours of preservice 
322.5   training.  Topics covered during preservice training include 
322.6   those specified in Minnesota Rules, part 9535.4068, subparts 1 
322.7   and 2, and parent team training.  The preservice training must 
322.8   include 15 hours of face-to-face training in mental health 
322.9   services delivery and eight hours of parent team training.  
322.10  Components of parent team training include:  (1) partnering with 
322.11  parents; (2) fundamentals of family support; (3) fundamentals of 
322.12  policy and decision-making; (4) defining equal partnership; (5) 
322.13  complexities of parent and service provider partnership in 
322.14  multiple service delivery systems due to system strengths and 
322.15  weaknesses; (6) sibling impacts; (7) support networks; and (8) 
322.16  community resources. 
322.17     (b) A provider entity that employs a mental health 
322.18  practitioner and mental health behavioral aide to provide 
322.19  children's therapeutic services and supports under this section 
322.20  shall require the mental health practitioner and mental health 
322.21  behavioral aide to complete 20 hours of continuing education 
322.22  every two calendar years.  The continuing education must be 
322.23  related to serving the needs of a child with emotional 
322.24  disturbance or severe emotional disturbance in the child's home 
322.25  environment and the child's family.  The topics covered in 
322.26  orientation and training must conform to Minnesota Rules, part 
322.27  9535.4068.  The provider, as specified in subdivisions 6 and 7, 
322.28  shall document completion of the required continuing education 
322.29  on an annual basis.  The documentation must include: 
322.30     (1) documentation of staff development and training 
322.31  sessions, which shall be kept for each employee at a central 
322.32  location and in the employee's personnel file.  Documentation 
322.33  must include the:  date, number of hours, training subject, 
322.34  attendance as verified by the signature of a staff member with 
322.35  job title, and the instructor's name; and 
322.36     (2) records of attendance at professional workshops and 
323.1   conferences which shall be kept for each employee at a central 
323.2   location and in the employee's personnel file. 
323.3      Subd. 11.  [SERVICE DELIVERY REQUIREMENTS.] (a) Service 
323.4   delivery is the process of implementing the individual treatment 
323.5   plan to achieve the goals and objectives identified in it.  The 
323.6   commissioner shall develop procedures for disseminating 
323.7   information on evidence-based practices and for providing 
323.8   ongoing technical assistance and consultation to county, tribes, 
323.9   and certified provider entities in order to promote statewide 
323.10  development of appropriate, accessible, and cost-effective 
323.11  medical assistance services and related policy.  A provider 
323.12  entity must comply with the following service delivery 
323.13  requirements: 
323.14     (1) individual, family, and group psychotherapy must be 
323.15  delivered as specified in Minnesota Rules, part 9505.0323; and 
323.16     (2) individual, family, or group skills training must be 
323.17  designed as specified in subdivision 2 and delivered according 
323.18  to the goals and objectives of the individual treatment plan. 
323.19     (b) Up to 35 hours of children's therapeutic services and 
323.20  supports are eligible for medical assistance payment if the 
323.21  services and supports are part of the discharge plan and are 
323.22  provided within a six-month period to a child with severe 
323.23  emotional disturbance who is residing in a hospital, a group 
323.24  home, a licensed residential treatment facility, a regional 
323.25  treatment center, or other institutional group setting or is 
323.26  participating in a program of partial hospitalization. 
323.27     (c) Provider entities that offer site-based programs such 
323.28  as day treatment and therapeutic preschool programs must provide 
323.29  staffing and facilities to ensure the health, safety, and 
323.30  protection of rights of each client and be able to implement 
323.31  each client's individual treatment plan. 
323.32     (d) The structured treatment program offered by a licensed 
323.33  preschool program must be available at least one day per week 
323.34  for a minimum two-hour time block.  The structured treatment 
323.35  program may include individual or group psychotherapy and any of 
323.36  the following:  recreational therapy, socialization therapy, and 
324.1   independent living skills therapy that is necessary, 
324.2   appropriate, and included in the client's individual treatment 
324.3   plan.  Notwithstanding other requirements in this section, 
324.4   documentation of day treatment may be provided on a daily basis 
324.5   by use of a checklist of available therapies in which the client 
324.6   participated and on a weekly basis by a summary of the 
324.7   information required under this subdivision. 
324.8      (e) Crisis assistance for a child is an intense component 
324.9   of children's therapeutic services and supports designed to 
324.10  address abrupt or substantial changes in the functioning of the 
324.11  child or the child's family evidenced by a sudden change in 
324.12  behavior with negative consequences for well being, a loss of 
324.13  usual coping mechanisms, or the presentation of danger to self 
324.14  or others.  The services must focus on crisis prevention, 
324.15  identification, and management.  Crisis assistance may be used 
324.16  to reduce immediate personal distress and to assess factors that 
324.17  precipitated the crisis in order to reduce the chance of future 
324.18  crisis situations by implementing preventive strategies and 
324.19  plans.  These are time-limited services designed to resolve or 
324.20  stabilize crisis through the arrangement of direct intervention, 
324.21  support services to the child and family, and the utilization of 
324.22  more appropriate resources.  Crisis assistance service 
324.23  components are:  crisis risk assessment, screening for 
324.24  hospitalization, referral and follow up to suitable community 
324.25  resources, and planning for crisis intervention and counseling 
324.26  services with other service providers, the child, and the 
324.27  child's family.  Crisis assistance does not mean necessary 
324.28  emergency services or services designed to secure the safety of 
324.29  a child who is at risk of abuse or neglect. 
324.30     (f) Medically necessary services provided by a mental 
324.31  health behavioral aide are designed to improve the functioning 
324.32  of the child and support the family in activities of daily and 
324.33  community living.  Delivery of these services must be documented 
324.34  by the mental health behavioral aide by written progress notes.  
324.35  The mental health behavioral aide must implement goals in the 
324.36  treatment plan that allows the child to acquire developmentally 
325.1   and therapeutically appropriate daily living skills, social 
325.2   skills, and leisure and recreational skills through targeted 
325.3   activities.  These activities may include: 
325.4      (1) assisting the child with skill development in dressing, 
325.5   eating, and toileting; 
325.6      (2) assisting, monitoring, and guiding the child to 
325.7   complete tasks, including facilitating the child's participation 
325.8   in medical appointments; 
325.9      (3) observing and intervening to redirect inappropriate 
325.10  behavior; 
325.11     (4) assisting the child in using age-appropriate 
325.12  self-management skills as related to the child's emotional 
325.13  disorder or mental illness, including problem solving, decision 
325.14  making, communication, conflict resolution, anger management, 
325.15  social skills, and recreational skills; 
325.16     (5) implementing deescalation techniques as recommended by 
325.17  the mental health professional; 
325.18     (6) implementing any other mental health service that the 
325.19  mental health professional has approved as being within the 
325.20  scope of the behavioral aide's duties; or 
325.21     (7) assisting the parents to develop and use parenting 
325.22  skills that help the child achieve the goals outlined in the 
325.23  child's individual treatment plan or individual behavioral 
325.24  plan.  Parenting skills must be directed exclusively to the 
325.25  treatment of the child. 
325.26     (g) Direction for a mental health behavioral aide must be 
325.27  delivered as specified in subdivision 8, clause (6). 
325.28     (h) A day treatment program must be provided to a group of 
325.29  clients by a multidisciplinary staff under the clinical 
325.30  supervision of a mental health professional.  The program must 
325.31  be available at least one day per week for a minimum three-hour 
325.32  time block.  The three-hour time block must include at least one 
325.33  hour, but no more than two hours, of individual or group 
325.34  psychotherapy.  The remainder of the three-hour time block must 
325.35  consist of any of the following:  recreational therapy, 
325.36  socialization therapy, and independent living skills therapy.  
326.1   The remainder of the three-hour time block may include 
326.2   recreational therapy, socialization therapy, and independent 
326.3   living skills therapy only if they are included in the client's 
326.4   individual treatment plan as necessary and appropriate. 
326.5      Subd. 12.  [SERVICE AUTHORIZATION.] The commissioner shall 
326.6   publish in the State Register a list of health services that 
326.7   require prior authorization as well as the criteria and 
326.8   standards used to select health services on the list.  The list 
326.9   and the criteria and standards used to formulate the list are 
326.10  not subject to the requirements of sections 14.001 to 14.69.  
326.11  The commissioner's decision on whether prior authorization is 
326.12  required for a health service is not subject to administrative 
326.13  appeal. 
326.14     Subd. 13.  [EXCLUDED SERVICES.] The services specified in 
326.15  clauses (1) to (6) are not eligible for medical assistance 
326.16  payment as children's therapeutic services and supports: 
326.17     (1) children's therapeutic services and supports 
326.18  simultaneously provided by more than one provider entity unless 
326.19  prior authorization is obtained; 
326.20     (2) children's therapeutic services and supports provided 
326.21  to a child who, at the time of service provision, has not had a 
326.22  diagnostic assessment to determine if the child has an emotional 
326.23  disturbance, except that the first ten hours of children's 
326.24  therapeutic services and supports provided to a child who is 
326.25  later assessed and determined to have an emotional disturbance 
326.26  at the time services were initiated shall be eligible for 
326.27  medical assistance payments; 
326.28     (3) children's therapeutic services and supports provided 
326.29  in violation of medical assistance policy in Minnesota Rules, 
326.30  part 9505.0220; 
326.31     (4) mental health behavioral aide services provided by a 
326.32  personal care assistant who is not qualified as a mental health 
326.33  behavioral aide despite being employed by a certified children's 
326.34  therapeutic services and supports provider entity; 
326.35     (5) services that are the responsibility of a residential 
326.36  or program license holder, including foster care providers under 
327.1   the terms of a service agreement or administrative rules 
327.2   governing licensure; 
327.3      (6) adjunctive activities which otherwise may be offered by 
327.4   a provider entity but are not covered by medical assistance, 
327.5   including: 
327.6      (i) a service that is primarily recreation-oriented or that 
327.7   is provided in a setting that is not medically supervised.  This 
327.8   includes sports activities, exercise groups, activities such as 
327.9   craft hours, leisure time, social hours, meal or snack time, 
327.10  trips to community activities, and tours; 
327.11     (ii) a social or educational service that does not have or 
327.12  cannot reasonably be expected to have a therapeutic outcome 
327.13  related to the client's emotional disturbance; 
327.14     (iii) consultation with other providers or service agency 
327.15  staff about the care or progress of a client; 
327.16     (iv) prevention or education programs provided to the 
327.17  community; 
327.18     (v) treatment for clients with primary diagnoses of alcohol 
327.19  or other drug abuse; and 
327.20     (vi) psychotherapy in a day treatment program for more than 
327.21  two hours daily; and 
327.22     (7) activities such as recreational therapy, socialization 
327.23  therapy, and independent living skills therapy.  These 
327.24  activities may be authorized as components of skills training on 
327.25  an individual basis. 
327.26     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
327.27     Sec. 9.  [256B.0944] [COVERED SERVICE; CHILDREN'S MENTAL 
327.28  HEALTH CRISIS RESPONSE SERVICES.] 
327.29     Subdivision 1.  [SCOPE.] Medical assistance covers 
327.30  medically necessary children's mental health crisis response 
327.31  services as defined in subdivision 2, paragraphs (c) to (e), 
327.32  subject to federal approval, if provided to an eligible 
327.33  recipient and provided by a qualified provider entity and by a 
327.34  qualified individual provider working within the provider's 
327.35  scope of practice and identified in the recipient's individual 
327.36  crisis treatment plan as defined in subdivision 11. 
328.1      Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
328.2   following terms have the meanings given them. 
328.3      (a) "Mental health crisis" is a children's behavioral, 
328.4   emotional, or psychiatric situation which, but for the provision 
328.5   of crisis response services, would likely result in 
328.6   significantly reduced levels of functioning in primary 
328.7   activities of daily living, or in an emergency situation, or in 
328.8   the placement of the recipient in a more restrictive setting, 
328.9   including, but not limited to, inpatient hospitalization. 
328.10     (b) "Mental health emergency" is a children's behavioral, 
328.11  emotional, or psychiatric situation which causes an immediate 
328.12  need for mental health services and is consistent with section 
328.13  62Q.55.  A mental health crisis or emergency is determined for 
328.14  medical assistance service reimbursement by a physician, a 
328.15  mental health professional, or crisis mental health practitioner 
328.16  with input from the recipient whenever possible. 
328.17     (c) "Mental health crisis assessment" means an immediate 
328.18  face-to-face assessment by a physician, a mental health 
328.19  professional, or a mental health practitioner under the clinical 
328.20  supervision of a mental health professional, following a 
328.21  screening that suggests the child may be experiencing a mental 
328.22  health crisis or mental health emergency situation. 
328.23     (d) "Mental health mobile crisis intervention services" 
328.24  means face-to-face, short-term, intensive mental health services 
328.25  initiated during a mental health crisis or mental health 
328.26  emergency to help the recipient cope with immediate stressors, 
328.27  identify and utilize available resources and strengths, and 
328.28  begin to return to the recipient's baseline level of functioning.
328.29     (1) This service is provided on site by a mobile crisis 
328.30  intervention team outside of an inpatient hospital setting. 
328.31     (2) The initial screening must consider other available 
328.32  services to determine which service intervention would best 
328.33  address the recipient's needs and circumstances. 
328.34     (3) The mobile crisis intervention team must be available 
328.35  to meet promptly face-to-face with a person in a mental health 
328.36  crisis or mental health emergency in a community setting. 
329.1      (4) The intervention must be based on a mental health 
329.2   crisis assessment and a crisis treatment plan. 
329.3      (5) The treatment plan must include recommendations for any 
329.4   needed crisis stabilization services for the recipient. 
329.5      (e) "Mental health crisis stabilization services" means 
329.6   individualized mental health services provided to a recipient 
329.7   following crisis intervention services which are designed to 
329.8   restore the recipient to the recipient's prior functional 
329.9   level.  The individual treatment plan recommending mental health 
329.10  crisis stabilization must be completed by the intervention team 
329.11  or by staff after an inpatient or urgent care visit.  Mental 
329.12  health crisis stabilization services may be provided in the 
329.13  recipient's home, the home of a family member or friend of the 
329.14  recipient, another community setting, or a short-term 
329.15  supervised, licensed residential program (if the service is not 
329.16  included in the facilities cost pool or per diem).  Mental 
329.17  health crisis stabilization does not include partial 
329.18  hospitalization or day treatment. 
329.19     Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
329.20  individual who: 
329.21     (a) is under age 21; 
329.22     (b) is screened as possibly experiencing a mental health 
329.23  crisis or mental health emergency where a mental health crisis 
329.24  assessment is needed; and 
329.25     (c) is assessed as experiencing a mental health crisis or 
329.26  mental health emergency, and mental health crisis intervention 
329.27  or crisis intervention and stabilization services are determined 
329.28  to be medically necessary. 
329.29     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) A provider 
329.30  entity is an entity that meets the standards listed in paragraph 
329.31  (b) and: 
329.32     (1) is an Indian health service facility or a facility 
329.33  owned and operated by a tribe or a tribal organization operating 
329.34  as a 638 facility under Public Law 93-638 certified by the 
329.35  state; 
329.36     (2) is a county board operated facility; or 
330.1      (3) is a provider entity that is under contract with the 
330.2   county board in the county where the potential crisis or 
330.3   emergency is occurring.  To provide services under this section, 
330.4   the provider entity must directly provide the services; or if 
330.5   services are subcontracted, the provider entity must maintain 
330.6   clinical responsibility for services and billing. 
330.7      (b) The children's mental health crisis response services 
330.8   provider entity must meet the following standards: 
330.9      (1) has the capacity to recruit, hire, train, and retain 
330.10  culturally and linguistically competent mental health 
330.11  professionals and practitioners; 
330.12     (2) has adequate administrative ability to ensure 
330.13  availability of services; 
330.14     (3) is able to ensure adequate preservice and in-service 
330.15  training; 
330.16     (4) is able to ensure that staff providing these services 
330.17  are skilled in the delivery of mental health crisis response 
330.18  services to recipients; 
330.19     (5) is able to ensure that staff are capable of 
330.20  implementing culturally specific treatment identified in the 
330.21  individual treatment plan that is meaningful and appropriate as 
330.22  determined by the recipient's culture, beliefs, values, and 
330.23  language; 
330.24     (6) is able to ensure enough flexibility to respond to the 
330.25  changing intervention and care needs of a recipient as 
330.26  identified by the recipient during the service partnership 
330.27  between the recipient and providers; 
330.28     (7) is able to ensure that mental health professionals and 
330.29  mental health practitioners have the communication tools and 
330.30  procedures to communicate and consult promptly about crisis 
330.31  assessment and interventions as services occur; 
330.32     (8) is able to coordinate these services with county 
330.33  emergency services and mental health crisis services; 
330.34     (9) is able to ensure that mental health crisis assessment 
330.35  and mobile crisis intervention services are available 24 hours a 
330.36  day, seven days a week; 
331.1      (10) is able to ensure that services are coordinated with 
331.2   other mental health service providers, county mental health 
331.3   authorities, or federally recognized American Indian authorities 
331.4   and others as necessary, with the consent of the recipient or 
331.5   legal guardian.  Services must also be coordinated with the 
331.6   recipient's case manager if the child is receiving case 
331.7   management services; 
331.8      (11) is able to ensure that crisis intervention services 
331.9   are provided in a manner consistent with sections 245.487 to 
331.10  245.4888; 
331.11     (12) is able to submit information as required by the 
331.12  state; 
331.13     (13) maintains staff training and personnel files; 
331.14     (14) is able to establish and maintain a quality assurance 
331.15  and evaluation plan to evaluate the outcomes of services and 
331.16  recipient satisfaction; 
331.17     (15) is able to keep records as required by applicable 
331.18  laws; 
331.19     (16) is able to comply with all applicable laws and 
331.20  statutes; and 
331.21     (17) develops and maintains written policies and procedures 
331.22  regarding service provision and administration of the provider 
331.23  entity, including safety of staff and recipients in high-risk 
331.24  situations. 
331.25     Subd. 5.  [MOBILE CRISIS INTERVENTION STAFF 
331.26  QUALIFICATIONS.] For provision of children's mental health 
331.27  mobile crisis intervention services, a mobile crisis 
331.28  intervention team is comprised of at least two mental health 
331.29  professionals as defined in section 245.4871, subdivision 27, 
331.30  clauses (1) to (5), or a combination of at least one mental 
331.31  health professional and one mental health practitioner as 
331.32  defined in section 245.4871, subdivision 26, with the required 
331.33  mental health crisis training under the clinical supervision of 
331.34  a mental health professional on the team.  The team must have at 
331.35  least two people with at least one member providing on-site 
331.36  crisis intervention services when needed.  Team members must be 
332.1   experienced in mental health assessment, crisis intervention 
332.2   techniques, and clinical decision-making under emergency 
332.3   conditions and have knowledge of local services and resources.  
332.4   The team must recommend and coordinate the team's services with 
332.5   appropriate local resources such as the county social services 
332.6   agency, mental health services, and local law enforcement when 
332.7   necessary.  
332.8      Subd. 6.  [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 
332.9   INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 
332.10  crisis intervention services, a screening of the potential 
332.11  crisis situation must be conducted.  The screening may use the 
332.12  resources of crisis assistance and emergency services as defined 
332.13  in sections 245.4871, subdivision 14, and 245.4879, subdivisions 
332.14  1 and 2.  The screening must gather information, determine 
332.15  whether a crisis situation exists, identify parties involved, 
332.16  and determine an appropriate response. 
332.17     (b) If a crisis exists, a crisis assessment must be 
332.18  completed.  A crisis assessment evaluates any immediate needs 
332.19  for which emergency services are needed and, as time permits, 
332.20  the recipient's current life situation, sources of stress, 
332.21  mental health problems and symptoms, strengths, cultural 
332.22  considerations, support network, vulnerabilities, and current 
332.23  functioning. 
332.24     (c) If the crisis assessment determines mobile crisis 
332.25  intervention services are needed, the intervention services must 
332.26  be provided promptly.  As opportunity presents during the 
332.27  intervention, at least two members of the mobile crisis 
332.28  intervention team must confer directly or by telephone about the 
332.29  assessment, treatment plan, and actions taken and needed.  At 
332.30  least one of the team members must be on site providing crisis 
332.31  intervention services.  If providing on-site crisis intervention 
332.32  services, a mental health practitioner must seek clinical 
332.33  supervision as required in subdivision 9.  
332.34     (d) The mobile crisis intervention team must develop an 
332.35  initial, brief crisis treatment plan as soon as appropriate, but 
332.36  no later than 24 hours after the initial face-to-face 
333.1   intervention.  The plan must address the needs and problems 
333.2   noted in the crisis assessment and include measurable short-term 
333.3   goals, cultural considerations, and frequency and type of 
333.4   services to be provided to achieve the goals and reduce or 
333.5   eliminate the crisis.  The treatment plan must be updated as 
333.6   needed to reflect current goals and services.  The team must 
333.7   involve the child and the child's family in developing and 
333.8   implementing the plan. 
333.9      (e) The team must document which short-term goals have been 
333.10  met and when no further crisis intervention services are 
333.11  required. 
333.12     (f) If the recipient's crisis is stabilized, but the 
333.13  recipient needs a referral to other services, the team must 
333.14  provide referrals to these services.  If the recipient has a 
333.15  case manager, planning for other services must be coordinated 
333.16  with the case manager. 
333.17     Subd. 7.  [CRISIS STABILIZATION SERVICES.] Crisis 
333.18  stabilization services must be provided by qualified staff of a 
333.19  crisis stabilization services provider entity and must meet the 
333.20  following standards: 
333.21     (1) a crisis stabilization treatment plan must be developed 
333.22  which meets the criteria in subdivision 11; 
333.23     (2) staff must be qualified as defined in subdivision 8; 
333.24  and 
333.25     (3) services must be delivered according to the treatment 
333.26  plan and include face-to-face contact with the recipient by 
333.27  qualified staff for further assessment, help with referrals, 
333.28  updating of the crisis stabilization treatment plan, supportive 
333.29  counseling, skills training, and collaboration with other 
333.30  service providers in the community. 
333.31     Subd. 8.  [CHILDREN'S CRISIS STABILIZATION STAFF 
333.32  QUALIFICATIONS.] Children's mental health crisis stabilization 
333.33  services must be provided by qualified individual staff of a 
333.34  qualified provider entity.  Individual provider staff must have 
333.35  the following qualifications: 
333.36     (1) be a mental health professional as defined in section 
334.1   245.4871, subdivision 27, clauses (1) to (5); or 
334.2      (2) be a mental health practitioner as defined in section 
334.3   245.4871, subdivision 26.  The mental health practitioner must 
334.4   work under the clinical supervision of a mental health 
334.5   professional and have completed at least 30 hours of training in 
334.6   crisis intervention and stabilization during the past two years. 
334.7      Subd. 9.  [SUPERVISION.] (a) Mental health practitioners 
334.8   may provide crisis assessment and mobile crisis intervention 
334.9   services if the following clinical supervision requirements are 
334.10  met: 
334.11     (1) the mental health provider entity must accept full 
334.12  responsibility for the services provided; 
334.13     (2) the mental health professional who is supervising the 
334.14  mental health practitioner and is an employee or under contract 
334.15  with the provider entity, must be immediately available by 
334.16  telephone or in person for clinical supervision; and 
334.17     (3) the mental health professional is consulted, in person 
334.18  or by telephone, during the first three hours when a mental 
334.19  health practitioner provides on-site service. 
334.20     (b) The mental health professional must: 
334.21     (1) review and approve of the tentative crisis assessment 
334.22  and crisis treatment plan; 
334.23     (2) document the consultation; and 
334.24     (3) sign the crisis assessment and treatment plan within 
334.25  the next business day. 
334.26     (c) If the mobile crisis intervention services continue 
334.27  into a second calendar day, a mental health professional must 
334.28  contact the recipient face-to-face on the second day to provide 
334.29  services and update the crisis treatment plan.  The on-site 
334.30  observation must be documented in the recipient's record and 
334.31  signed by the mental health professional. 
334.32     Subd. 10.  [RECIPIENT FILE.] (a) Providers of mobile crisis 
334.33  intervention or crisis stabilization services must maintain a 
334.34  file for each recipient containing the following information: 
334.35     (1) individual crisis treatment plans signed by the 
334.36  recipient, mental health professional, and mental health 
335.1   practitioner who developed the crisis treatment plan, or if the 
335.2   recipient refused to sign the plan, the date and reason stated 
335.3   by the recipient as to why the recipient would not sign the 
335.4   plan; 
335.5      (2) signed release of information forms; 
335.6      (3) recipient health information and current medications; 
335.7      (4) emergency contacts for the recipient; 
335.8      (5) case records which document the date of service, place 
335.9   of service delivery, direct or telephone contact with the 
335.10  recipient's family or others, signature of the person providing 
335.11  the service, and the nature, extent, and units of service; 
335.12     (6) required clinical supervision by mental health 
335.13  professionals; 
335.14     (7) summary of the recipient's case reviews by staff; and 
335.15     (8) any written information by the recipient that the 
335.16  recipient wants in the file. 
335.17     (b) Documentation in the file must comply with all 
335.18  requirements of the commissioner. 
335.19     Subd. 11.  [TREATMENT PLAN.] (a) The individual crisis 
335.20  stabilization treatment plan must include, at a minimum: 
335.21     (1) a list of problems identified in the assessment; 
335.22     (2) a list of the recipient's strengths and resources; 
335.23     (3) concrete, measurable, short-term goals and tasks to be 
335.24  achieved, including time frames for achievement; 
335.25     (4) specific objectives directed toward the achievement of 
335.26  each of the goals; 
335.27     (5) documentation of the participants involved in the 
335.28  service planning; 
335.29     (6) planned frequency and type of services initiated; 
335.30     (7) a crisis response action plan if a crisis should occur; 
335.31  and 
335.32     (8) clear progress notes on outcome of goals. 
335.33     (b) The recipient, if possible, must be a participant.  The 
335.34  recipient or the recipient's legal guardian must sign the 
335.35  service plan or document why this was not possible.  A copy of 
335.36  the plan must be given to the recipient and the recipient's 
336.1   legal guardian.  The plan should include the services arranged, 
336.2   including specific providers where applicable. 
336.3      (c) A treatment plan must be developed by a mental health 
336.4   professional or mental health practitioner under the clinical 
336.5   supervision of a mental health professional.  A written plan 
336.6   must be completed within 24 hours of beginning services with the 
336.7   recipient.  The mental health professional must approve and sign 
336.8   all treatment plans. 
336.9      Subd. 12.  [EXCLUDED SERVICES.] (a) The following services 
336.10  are excluded from reimbursement under this section: 
336.11     (1) room and board services; 
336.12     (2) services delivered to a recipient while admitted to an 
336.13  inpatient hospital; 
336.14     (3) transportation services under children's mental health 
336.15  crisis response service; 
336.16     (4) services provided and billed by a provider who is not 
336.17  enrolled under medical assistance to provide children's mental 
336.18  health crisis response services; 
336.19     (5) crisis response services provided by a residential 
336.20  treatment center to recipients in their facility; 
336.21     (6) services performed by volunteers; 
336.22     (7) direct billing of time spent "on call" when not 
336.23  delivering services to a recipient; 
336.24     (8) provider service time included in case management 
336.25  reimbursement; 
336.26     (9) outreach services to potential recipients; and 
336.27     (10) a mental health service that is not medically 
336.28  necessary. 
336.29     (b) When a provider is eligible to provide more than one 
336.30  type of medical assistance service, the recipient must have a 
336.31  choice of provider for each service, unless otherwise provided 
336.32  by law. 
336.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
336.34     Sec. 10.  Minnesota Statutes 2002, section 256B.0945, 
336.35  subdivision 2, is amended to read: 
336.36     Subd. 2.  [COVERED SERVICES.] All services must be included 
337.1   in a child's individualized treatment or multiagency plan of 
337.2   care as defined in chapter 245.  
337.3      (a) For facilities that are institutions for mental 
337.4   diseases according to statute and regulation or are not 
337.5   institutions for mental diseases but are approved by the 
337.6   commissioner to provide services under this paragraph, medical 
337.7   assistance covers the full contract rate, including room and 
337.8   board if the services meet the requirements of Code of Federal 
337.9   Regulations, title 42, section 440.160.  
337.10     (b) For facilities that are not institutions for mental 
337.11  diseases according to federal statute and regulation and are not 
337.12  providing services under paragraph (a), medical assistance 
337.13  covers mental health related services that are required to be 
337.14  provided by a residential facility under section 245.4882 and 
337.15  administrative rules promulgated thereunder, except for room and 
337.16  board. 
337.17     Sec. 11.  Minnesota Statutes 2002, section 256B.0945, 
337.18  subdivision 4, is amended to read: 
337.19     Subd. 4.  [PAYMENT RATES.] (a) Notwithstanding sections 
337.20  256B.19 and 256B.041, payments to counties for residential 
337.21  services provided by a residential facility shall only be made 
337.22  of federal earnings for services provided under this section, 
337.23  and the nonfederal share of costs for services provided under 
337.24  this section shall be paid by the county from sources other than 
337.25  federal funds or funds used to match other federal funds.  
337.26  Payment to counties for services provided according to 
337.27  subdivision 2, paragraph (a), shall be the federal share of the 
337.28  contract rate.  Payment to counties for services provided 
337.29  according to subdivision 2, paragraph (b), this section shall be 
337.30  a proportion of the per day contract rate that relates to 
337.31  rehabilitative mental health services and shall not include 
337.32  payment for costs or services that are billed to the IV-E 
337.33  program as room and board.  
337.34     (b) The commissioner shall set aside a portion not to 
337.35  exceed five percent of the federal funds earned under this 
337.36  section to cover the state costs of administering this section.  
338.1   Any unexpended funds from the set-aside shall be distributed to 
338.2   the counties in proportion to their earnings under this section. 
338.3      Sec. 12.  Minnesota Statutes 2002, section 256F.10, 
338.4   subdivision 6, is amended to read: 
338.5      Subd. 6.  [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 
338.6   for portion set aside in paragraph (b), the federal funds earned 
338.7   under this section and section 256B.094 by providers shall be 
338.8   paid to each provider based on its earnings, and must be used by 
338.9   each provider to expand preventive child welfare services. 
338.10  If a county or tribal social services agency chooses to be a 
338.11  provider of child welfare targeted case management and if that 
338.12  county or tribal social services agency also joins a local 
338.13  children's mental health collaborative as authorized by the 1993 
338.14  legislature, then the federal reimbursement received by the 
338.15  county or tribal social services agency for providing child 
338.16  welfare targeted case management services to children served by 
338.17  the local collaborative shall be transferred by the county or 
338.18  tribal social services agency to the integrated fund.  The 
338.19  federal reimbursement transferred to the integrated fund by the 
338.20  county or tribal social services agency must not be used for 
338.21  residential care other than respite care described under 
338.22  subdivision 7, paragraph (d). 
338.23     (b) The commissioner shall set aside a portion of the 
338.24  federal funds earned under this section to repay the special 
338.25  revenue maximization account under section 256.01, subdivision 
338.26  2, clause (15).  The repayment is limited to: 
338.27     (1) the costs of developing and implementing this section 
338.28  and sections 256B.094 and 256J.48; 
338.29     (2) programming the information systems; and 
338.30     (3) the lost federal revenue for the central office claim 
338.31  directly caused by the implementation of these sections. 
338.32     Any unexpended funds from the set aside under this 
338.33  paragraph shall be distributed to providers according to 
338.34  paragraph (a). 
338.35     Sec. 13.  Minnesota Statutes 2002, section 259.67, 
338.36  subdivision 4, is amended to read: 
339.1      Subd. 4.  [ELIGIBILITY CONDITIONS.] (a) The placing agency 
339.2   shall use the AFDC requirements as specified in federal law as 
339.3   of July 16, 1996, when determining the child's eligibility for 
339.4   adoption assistance under title IV-E of the Social Security 
339.5   Act.  If the child does not qualify, the placing agency shall 
339.6   certify a child as eligible for state funded adoption assistance 
339.7   only if the following criteria are met:  
339.8      (1) Due to the child's characteristics or circumstances it 
339.9   would be difficult to provide the child an adoptive home without 
339.10  adoption assistance.  
339.11     (2)(i) A placement agency has made reasonable efforts to 
339.12  place the child for adoption without adoption assistance, but 
339.13  has been unsuccessful; or 
339.14     (ii) the child's licensed foster parents desire to adopt 
339.15  the child and it is determined by the placing agency that the 
339.16  adoption is in the best interest of the child. 
339.17     (3) The child has been a ward of the commissioner or, a 
339.18  Minnesota-licensed child-placing agency, or a tribal social 
339.19  service agency of Minnesota recognized by the Secretary of the 
339.20  Interior.  
339.21     (b) For purposes of this subdivision, the characteristics 
339.22  or circumstances that may be considered in determining whether a 
339.23  child is a child with special needs under United States Code, 
339.24  title 42, chapter 7, subchapter IV, part E, or meets the 
339.25  requirements of paragraph (a), clause (1), are the following: 
339.26     (1) The child is a member of a sibling group to be placed 
339.27  as one unit in which at least one sibling is older than 15 
339.28  months of age or is described in clause (2) or (3). 
339.29     (2) The child has documented physical, mental, emotional, 
339.30  or behavioral disabilities. 
339.31     (3) The child has a high risk of developing physical, 
339.32  mental, emotional, or behavioral disabilities. 
339.33     (4) The child is adopted according to tribal law without a 
339.34  termination of parental rights or relinquishment, provided that 
339.35  the tribe has documented the valid reason why the child cannot 
339.36  or should not be returned to the home of the child's parent. 
340.1      (c) When a child's eligibility for adoption assistance is 
340.2   based upon the high risk of developing physical, mental, 
340.3   emotional, or behavioral disabilities, payments shall not be 
340.4   made under the adoption assistance agreement unless and until 
340.5   the potential disability manifests itself as documented by an 
340.6   appropriate health care professional. 
340.7      Sec. 14.  Minnesota Statutes 2002, section 260B.157, 
340.8   subdivision 1, is amended to read: 
340.9      Subdivision 1.  [INVESTIGATION.] Upon request of the court 
340.10  the local social services agency or probation officer shall 
340.11  investigate the personal and family history and environment of 
340.12  any minor coming within the jurisdiction of the court under 
340.13  section 260B.101 and shall report its findings to the court.  
340.14  The court may order any minor coming within its jurisdiction to 
340.15  be examined by a duly qualified physician, psychiatrist, or 
340.16  psychologist appointed by the court.  
340.17     The court shall have a chemical use assessment conducted 
340.18  when a child is (1) found to be delinquent for violating a 
340.19  provision of chapter 152, or for committing a felony-level 
340.20  violation of a provision of chapter 609 if the probation officer 
340.21  determines that alcohol or drug use was a contributing factor in 
340.22  the commission of the offense, or (2) alleged to be delinquent 
340.23  for violating a provision of chapter 152, if the child is being 
340.24  held in custody under a detention order.  The assessor's 
340.25  qualifications and the assessment criteria shall comply with 
340.26  Minnesota Rules, parts 9530.6600 to 9530.6655.  If funds under 
340.27  chapter 254B are to be used to pay for the recommended 
340.28  treatment, the assessment and placement must comply with all 
340.29  provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 
340.30  9530.7000 to 9530.7030.  The commissioner of human services 
340.31  shall reimburse the court for the cost of the chemical use 
340.32  assessment, up to a maximum of $100. 
340.33     The court shall have a children's mental health screening 
340.34  conducted when a child is alleged to be delinquent or is found 
340.35  to be delinquent.  The screening shall be conducted with a 
340.36  screening instrument approved by the commissioner of human 
341.1   services and shall be conducted by a mental health practitioner 
341.2   as defined in section 245.4871, subdivision 26, or a probation 
341.3   officer who is trained in the use of the screening instrument.  
341.4   If the screening indicates a need for assessment, the local 
341.5   social services agency, in consultation with the child's family, 
341.6   shall have a diagnostic assessment conducted, including a 
341.7   functional assessment, as defined in section 245.4871. 
341.8      With the consent of the commissioner of corrections and 
341.9   agreement of the county to pay the costs thereof, the court may, 
341.10  by order, place a minor coming within its jurisdiction in an 
341.11  institution maintained by the commissioner for the detention, 
341.12  diagnosis, custody and treatment of persons adjudicated to be 
341.13  delinquent, in order that the condition of the minor be given 
341.14  due consideration in the disposition of the case.  Any funds 
341.15  received under the provisions of this subdivision shall not 
341.16  cancel until the end of the fiscal year immediately following 
341.17  the fiscal year in which the funds were received.  The funds are 
341.18  available for use by the commissioner of corrections during that 
341.19  period and are hereby appropriated annually to the commissioner 
341.20  of corrections as reimbursement of the costs of providing these 
341.21  services to the juvenile courts.  
341.22     Sec. 15.  Minnesota Statutes 2002, section 260B.176, 
341.23  subdivision 2, is amended to read: 
341.24     Subd. 2.  [REASONS FOR DETENTION.] (a) If the child is not 
341.25  released as provided in subdivision 1, the person taking the 
341.26  child into custody shall notify the court as soon as possible of 
341.27  the detention of the child and the reasons for detention.  
341.28     (b) No child may be detained in a juvenile secure detention 
341.29  facility or shelter care facility longer than 36 hours, 
341.30  excluding Saturdays, Sundays, and holidays, after being taken 
341.31  into custody for a delinquent act as defined in section 
341.32  260B.007, subdivision 6, unless a petition has been filed and 
341.33  the judge or referee determines pursuant to section 260B.178 
341.34  that the child shall remain in detention.  
341.35     (c) No child may be detained in an adult jail or municipal 
341.36  lockup longer than 24 hours, excluding Saturdays, Sundays, and 
342.1   holidays, or longer than six hours in an adult jail or municipal 
342.2   lockup in a standard metropolitan statistical area, after being 
342.3   taken into custody for a delinquent act as defined in section 
342.4   260B.007, subdivision 6, unless: 
342.5      (1) a petition has been filed under section 260B.141; and 
342.6      (2) a judge or referee has determined under section 
342.7   260B.178 that the child shall remain in detention. 
342.8      After August 1, 1991, no child described in this paragraph 
342.9   may be detained in an adult jail or municipal lockup longer than 
342.10  24 hours, excluding Saturdays, Sundays, and holidays, or longer 
342.11  than six hours in an adult jail or municipal lockup in a 
342.12  standard metropolitan statistical area, unless the requirements 
342.13  of this paragraph have been met and, in addition, a motion to 
342.14  refer the child for adult prosecution has been made under 
342.15  section 260B.125.  Notwithstanding this paragraph, continued 
342.16  detention of a child in an adult detention facility outside of a 
342.17  standard metropolitan statistical area county is permissible if: 
342.18     (i) the facility in which the child is detained is located 
342.19  where conditions of distance to be traveled or other ground 
342.20  transportation do not allow for court appearances within 24 
342.21  hours.  A delay not to exceed 48 hours may be made under this 
342.22  clause; or 
342.23     (ii) the facility is located where conditions of safety 
342.24  exist.  Time for an appearance may be delayed until 24 hours 
342.25  after the time that conditions allow for reasonably safe 
342.26  travel.  "Conditions of safety" include adverse life-threatening 
342.27  weather conditions that do not allow for reasonably safe travel. 
342.28     The continued detention of a child under clause (i) or (ii) 
342.29  must be reported to the commissioner of corrections. 
342.30     (d) If a child described in paragraph (c) is to be detained 
342.31  in a jail beyond 24 hours, excluding Saturdays, Sundays, and 
342.32  holidays, the judge or referee, in accordance with rules and 
342.33  procedures established by the commissioner of corrections, shall 
342.34  notify the commissioner of the place of the detention and the 
342.35  reasons therefor.  The commissioner shall thereupon assist the 
342.36  court in the relocation of the child in an appropriate juvenile 
343.1   secure detention facility or approved jail within the county or 
343.2   elsewhere in the state, or in determining suitable 
343.3   alternatives.  The commissioner shall direct that a child 
343.4   detained in a jail be detained after eight days from and 
343.5   including the date of the original detention order in an 
343.6   approved juvenile secure detention facility with the approval of 
343.7   the administrative authority of the facility.  If the court 
343.8   refers the matter to the prosecuting authority pursuant to 
343.9   section 260B.125, notice to the commissioner shall not be 
343.10  required.  
343.11     (e) When a child is detained for an alleged delinquent act 
343.12  in a state licensed juvenile facility or program, or when a 
343.13  child is detained in an adult jail or municipal lockup as 
343.14  provided in paragraph (c), the supervisor of the facility shall 
343.15  have a children's mental health screening conducted with a 
343.16  screening instrument approved by the commissioner of human 
343.17  services, unless a screening has been performed within the 
343.18  previous 180 days or the child is currently under the care of a 
343.19  mental health professional.  The screening shall be conducted by 
343.20  a mental health practitioner as defined in section 245.4871, 
343.21  subdivision 26, or a probation officer who is trained in the use 
343.22  of the screening instrument.  The screening shall be conducted 
343.23  after the child is taken into custody for a delinquent act but 
343.24  before any subsequent detention hearing, as defined in section 
343.25  260B.178, and the results of the screening shall be presented to 
343.26  the court at the detention hearing.  If the screening indicates 
343.27  a need for assessment, the local social services agency or 
343.28  probation officer, in consultation with the child's family, 
343.29  shall have a diagnostic assessment conducted, including a 
343.30  functional assessment, as defined in section 245.4871. 
343.31     Sec. 16.  Minnesota Statutes 2002, section 260B.178, 
343.32  subdivision 1, is amended to read: 
343.33     Subdivision 1.  [HEARING AND RELEASE REQUIREMENTS.] (a) The 
343.34  court shall hold a detention hearing: 
343.35     (1) within 36 hours of the time the child was taken into 
343.36  custody, excluding Saturdays, Sundays, and holidays, if the 
344.1   child is being held at a juvenile secure detention facility or 
344.2   shelter care facility; or 
344.3      (2) within 24 hours of the time the child was taken into 
344.4   custody, excluding Saturdays, Sundays, and holidays, if the 
344.5   child is being held at an adult jail or municipal lockup.  
344.6      (b) Unless there is reason to believe that the child would 
344.7   endanger self or others, not return for a court hearing, run 
344.8   away from the child's parent, guardian, or custodian or 
344.9   otherwise not remain in the care or control of the person to 
344.10  whose lawful custody the child is released, or that the child's 
344.11  health or welfare would be immediately endangered, the child 
344.12  shall be released to the custody of a parent, guardian, 
344.13  custodian, or other suitable person, subject to reasonable 
344.14  conditions of release including, but not limited to, a 
344.15  requirement that the child undergo a chemical use assessment as 
344.16  provided in section 260B.157, subdivision 1, and a children's 
344.17  mental health screening as provided in section 260B.176, 
344.18  subdivision 2, paragraph (e).  In determining whether the 
344.19  child's health or welfare would be immediately endangered, the 
344.20  court shall consider whether the child would reside with a 
344.21  perpetrator of domestic child abuse.  
344.22     Sec. 17.  Minnesota Statutes 2002, section 260B.193, 
344.23  subdivision 2, is amended to read: 
344.24     Subd. 2.  [CONSIDERATION OF REPORTS.] Before making a 
344.25  disposition in a case, or appointing a guardian for a child, the 
344.26  court may consider any report or recommendation made by the 
344.27  local social services agency, probation officer, licensed 
344.28  child-placing agency, foster parent, guardian ad litem, tribal 
344.29  representative, or other authorized advocate for the child or 
344.30  child's family, a school district concerning the effect on 
344.31  student transportation of placing a child in a school district 
344.32  in which the child is not a resident, or any other information 
344.33  deemed material by the court.  In addition, the court may 
344.34  consider the results of the children's mental health screening 
344.35  provided in section 260B.157, subdivision 1. 
344.36     Sec. 18.  Minnesota Statutes 2002, section 260B.235, 
345.1   subdivision 6, is amended to read: 
345.2      Subd. 6.  [ALTERNATIVE DISPOSITION.] In addition to 
345.3   dispositional alternatives authorized by subdivision 3 4, in the 
345.4   case of a third or subsequent finding by the court pursuant to 
345.5   an admission in court or after trial that a child has committed 
345.6   a juvenile alcohol or controlled substance offense, the juvenile 
345.7   court shall order a chemical dependency evaluation of the child 
345.8   and if warranted by the evaluation, the court may order 
345.9   participation by the child in an inpatient or outpatient 
345.10  chemical dependency treatment program, or any other treatment 
345.11  deemed appropriate by the court.  In the case of a third or 
345.12  subsequent finding that a child has committed any juvenile petty 
345.13  offense, the court shall order a children's mental health 
345.14  screening be conducted as provided in section 260B.157, 
345.15  subdivision 1, and if indicated by the screening, to undergo a 
345.16  diagnostic assessment, including a functional assessment, as 
345.17  defined in section 245.4871. 
345.18     Sec. 19.  Minnesota Statutes 2002, section 626.559, 
345.19  subdivision 5, is amended to read: 
345.20     Subd. 5.  [REVENUE.] The commissioner of human services 
345.21  shall add the following funds to the funds appropriated under 
345.22  section 626.5591, subdivision 2, to develop and support training:
345.23     (a) The commissioner of human services shall submit claims 
345.24  for federal reimbursement earned through the activities and 
345.25  services supported through department of human services child 
345.26  protection or child welfare training funds.  Federal revenue 
345.27  earned must be used to improve and expand training services by 
345.28  the department.  The department expenditures eligible for 
345.29  federal reimbursement under this section must not be made from 
345.30  federal funds or funds used to match other federal funds. 
345.31     (b) Each year, the commissioner of human services shall 
345.32  withhold from funds distributed to each county under Minnesota 
345.33  Rules, parts 9550.0300 to 9550.0370, an amount equivalent to 1.5 
345.34  percent of each county's annual title XX allocation under 
345.35  section 256E.07 256M.50.  The commissioner must use these funds 
345.36  to ensure decentralization of training. 
346.1      (c) The federal revenue under this subdivision is available 
346.2   for these purposes until the funds are expended. 
346.3      Sec. 20.  [CONFLICTS.] 
346.4      The amendments to Minnesota Statutes 2002, section 256F.10, 
346.5   subdivision 6, in this article prevail over any conflicting law 
346.6   that amends or repeals it regardless of the order or date of 
346.7   enactment. 
346.8      Sec. 21.  [REVISOR'S INSTRUCTION.] 
346.9      For sections in Minnesota Statutes and Minnesota Rules 
346.10  affected by the repealed sections in this article, the revisor 
346.11  shall delete internal cross-references where appropriate and 
346.12  make changes necessary to correct the punctuation, grammar, or 
346.13  structure of the remaining text and preserve its meaning. 
346.14     Sec. 22.  [REPEALER.] 
346.15     (a) Minnesota Statutes 2002, sections 256B.0945, 
346.16  subdivision 10; and 256F.10, subdivision 7, are repealed. 
346.17     (b) Minnesota Statutes 2002, section 256B.0625, 
346.18  subdivisions 35 and 36, are repealed effective July 1, 2004. 
346.19     (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 
346.20  9505.0327, are repealed effective July 1, 2004. 
346.21                             ARTICLE 6 
346.22                       COMMUNITY SERVICES ACT 
346.23     Section 1.  [256M.01] [CITATION.] 
346.24     Sections 256M.01 to 256M.80 may be cited as the "Children 
346.25  and Community Services Act."  This act establishes a fund to 
346.26  address the needs of children, adolescents, and young adults 
346.27  within each county in accordance with a service agreement 
346.28  entered into by the board of county commissioners of each county 
346.29  and the commissioner of human services.  The service agreement 
346.30  shall specify the outcomes to be achieved, the general 
346.31  strategies to be employed, and the respective state and county 
346.32  roles.  The service agreement shall be reviewed and updated 
346.33  every two years, or sooner if both the state and the county deem 
346.34  it necessary. 
346.35     Sec. 2.  [256M.10] [DEFINITIONS.] 
346.36     Subdivision 1.  [SCOPE.] For the purposes of sections 
347.1   256M.01 to 256M.80, the terms defined in this section have the 
347.2   meanings given them. 
347.3      Subd. 2.  [CHILDREN AND COMMUNITY SERVICES.] (a) "Children 
347.4   and community services" means services provided or arranged for 
347.5   by county boards for children, adolescents, and young adults who 
347.6   experience dependency, abuse, neglect, poverty, disability, 
347.7   chronic health conditions, or other factors, including ethnicity 
347.8   and race, that may result in poor outcomes or disparities, as 
347.9   well as services for family members to support those individuals.
347.10     (b) Services eligible as allowable expenditures under 
347.11  sections 256M.01 to 256M.80 include, but are not limited to, 
347.12  services that:  (1) protect a person from harm; (2) support 
347.13  permanent living arrangements; (3) provide treatment; (4) 
347.14  maintain family relationships; (5) increase parenting skills; 
347.15  (6) reduce substance abuse; and (7) reduce domestic violence.  
347.16  These services may be provided by professionals or 
347.17  nonprofessionals, including the person's natural supports in the 
347.18  community.  
347.19     (c) Services shall, to the extent possible:  (1) build on 
347.20  family and community strengths; (2) help prevent crisis by 
347.21  meeting needs early; (3) provide transitional supports to 
347.22  adolescents and young adults making the transition to adulthood; 
347.23  (4) offer help in basic needs, special needs, and referrals; (5) 
347.24  respond flexibly to the needs of the person and the family; (6) 
347.25  be culturally sensitive and responsive to the needs of the 
347.26  person; and (7) be offered in the family home as well as in 
347.27  other settings. 
347.28     (d) Children and community services do not include services 
347.29  under the public assistance programs known as the Minnesota 
347.30  family investment program, Minnesota supplemental aid, medical 
347.31  assistance, general assistance, general assistance medical care, 
347.32  MinnesotaCare, or community health services. 
347.33     Subd. 3.  [COMMISSIONER.] "Commissioner" means the 
347.34  commissioner of human services. 
347.35     Subd. 4.  [COUNTY BOARD.] "County board" means the board of 
347.36  county commissioners in each county. 
348.1      Subd. 5.  [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE 
348.2   GRANTS.] "Former children's services and community service 
348.3   grants" means allocations for the following grants: 
348.4      (1) community social service grants under sections 252.24, 
348.5   256E.06, and 256E.14; 
348.6      (2) family preservation grants under section 256F.05, 
348.7   subdivision 3; 
348.8      (3) concurrent permanency planning grants under section 
348.9   260C.213, subdivision 5; 
348.10     (4) social service block grants (Title XX) under section 
348.11  256E.07; 
348.12     (5) children's mental health grants under sections 245.4886 
348.13  and 260.152. 
348.14     Subd. 6.  [HUMAN SERVICES BOARD.] "Human services board" 
348.15  means a board established under section 402.02; Laws 1974, 
348.16  chapter 293; or Laws 1976, chapter 340.  
348.17     Subd. 7.  [YOUNG ADULT.] "Young adult" means a person 
348.18  between the ages of 18 and 25. 
348.19     Sec. 3.  [256M.20] [DUTIES OF COMMISSIONER OF HUMAN 
348.20  SERVICES.] 
348.21     Subdivision 1.  [GENERAL SUPERVISION.] Each year the 
348.22  commissioner shall allocate funds to each county according to 
348.23  section 256M.40 and service agreements under section 256M.30.  
348.24  The funds shall be used to address the needs of children, 
348.25  adolescents, and young adults.  The commissioner, in 
348.26  consultation with counties, shall establish performance 
348.27  standards, provide technical assistance, and evaluate county 
348.28  performance in achieving outcomes. 
348.29     Subd. 2.  [ADDITIONAL DUTIES.] The commissioner shall: 
348.30     (1) provide necessary information and instructions to each 
348.31  county for establishing baselines and desired improvements on 
348.32  safety, permanency, and well-being for children, adolescents, 
348.33  and young adults; 
348.34     (2) provide training, technical assistance, and other 
348.35  supports to each county board to assist in needs assessment, 
348.36  planning, implementation, and monitoring of outcomes and service 
349.1   quality; 
349.2      (3) design and implement a continuous quality improvement 
349.3   method, including site visits that utilize quality reviews and 
349.4   timely feedback to each county regarding the county's 
349.5   performance in the context of the service agreement under 
349.6   section 256M.30; 
349.7      (4) specify requirements for reports, including fiscal 
349.8   reports to account for funds distributed; 
349.9      (5) request waivers from federal programs as necessary to 
349.10  implement this act; and 
349.11     (6) have authority under sections 14.055 and 14.056 to 
349.12  grant a variance to existing state rules as needed to eliminate 
349.13  barriers to achieving desired outcomes. 
349.14     Subd. 3.  [SANCTIONS.] (a) The commissioner shall establish 
349.15  and maintain a monitoring program designed to reduce the 
349.16  possibility of noncompliance with federal laws and federal 
349.17  regulations that may result in federal fiscal sanctions.  If a 
349.18  county is not complying with federal law or federal regulation 
349.19  and the noncompliance may result in federal fiscal sanctions, 
349.20  the commissioner may withhold a portion of the county's share of 
349.21  state and federal funds for that program.  The amount withheld 
349.22  must be equal to the percentage difference between the level of 
349.23  compliance maintained by the county and the level of compliance 
349.24  required by the federal regulations, multiplied by the county's 
349.25  share of state and federal funds for the program.  The state and 
349.26  federal funds may be withheld until the county is found to be in 
349.27  compliance with all federal laws or federal regulations 
349.28  applicable to the program.  If a county remains out of 
349.29  compliance for more than six consecutive months, the 
349.30  commissioner may reallocate the withheld funds to counties that 
349.31  are in compliance with the federal regulations. 
349.32     (b) The commissioner may require a county to enter into a 
349.33  joint powers agreement with one or more counties in good 
349.34  standing if the commissioner determines that a county has failed 
349.35  to reach the targets identified in its approved service 
349.36  agreements over a four-year period for the core outcomes 
350.1   established for all counties. 
350.2      Subd. 4.  [CORRECTIVE ACTION PROCEDURE.] The commissioner 
350.3   must comply with the following procedures when reducing county 
350.4   funds under subdivision 3, paragraph (a), or requiring a joint 
350.5   powers agreement under subdivision 3, paragraph (b). 
350.6      (a) The commissioner shall notify the county, by certified 
350.7   mail, of the statute, rule, federal law, or federal regulation 
350.8   with which the county has not complied. 
350.9      (b) The commissioner shall give the county 30 days to 
350.10  demonstrate to the commissioner that the county is in compliance 
350.11  with the statute, rule, federal law, or federal regulation cited 
350.12  in the notice or to develop a corrective action plan to address 
350.13  the problem.  Upon request from the county, the commissioner 
350.14  shall provide technical assistance to the county in developing a 
350.15  corrective action plan.  The county shall have 30 days from the 
350.16  date the technical assistance is provided to develop the 
350.17  corrective action plan. 
350.18     (c) The commissioner shall take no further action if the 
350.19  county demonstrates compliance with the statute, rule, federal 
350.20  law, or federal regulation cited in the notice. 
350.21     (d) The commissioner shall review and approve or disapprove 
350.22  the corrective action plan within 30 days after the commissioner 
350.23  receives the corrective action plan. 
350.24     (e) If the commissioner approves the corrective action plan 
350.25  submitted by the county, the county has 90 days after the date 
350.26  of approval to implement the corrective action plan. 
350.27     (f) If the county fails to demonstrate compliance or fails 
350.28  to implement the corrective action plan approved by the 
350.29  commissioner, the commissioner may reduce the county's share of 
350.30  state or federal funds according to subdivision 3. 
350.31     Sec. 4.  [256M.30] [SERVICE AGREEMENT.] 
350.32     Subdivision 1.  [APPROVAL REQUIRED BY COMMISSIONER.] 
350.33  Effective January 1, 2004, and each two-year period thereafter, 
350.34  each county must have a biennial service agreement approved by 
350.35  the commissioner in order to receive funds.  Counties may submit 
350.36  multicounty or regional service agreements. 
351.1      Subd. 2.  [CONTENTS.] The service agreement shall be 
351.2   completed in a form prescribed by the commissioner.  The 
351.3   agreement must include: 
351.4      (1) a statement of the needs of the children, adolescents, 
351.5   and young adults who experience the conditions defined in 
351.6   section 256M.10, subdivision 2, paragraph (a), and strengths and 
351.7   resources available in the community to address those needs; 
351.8      (2) outcomes prescribed by the commissioner that set 
351.9   minimum performance standards for all counties, and additional 
351.10  outcomes, identified by the county, to improve the safety, 
351.11  permanency, and well-being of these individuals to be 
351.12  accomplished annually.  This information shall include current 
351.13  baseline information for each outcome and annual performance 
351.14  target to be reached; 
351.15     (3) strategies the county will pursue to achieve the 
351.16  performance targets.  Strategies must include specification of 
351.17  how funds under this section and other community resources will 
351.18  be used to achieve desired performance targets; and 
351.19     (4) description of the county's process to solicit public 
351.20  input and a summary of that input. 
351.21     Subd. 3.  [INFORMATION.] The commissioner shall provide 
351.22  each county with information and technical assistance needed to 
351.23  complete the service agreement, including:  information on child 
351.24  safety, permanency, and well-being in the county; comparisons 
351.25  with other counties; baseline performance on outcome measures; 
351.26  and promising program practices. 
351.27     Subd. 4.  [TIMELINES.] The preliminary service agreement 
351.28  must be submitted to the commissioner by October 15, 2003, and 
351.29  October 15 of every two years thereafter.  
351.30     Subd. 5.  [PUBLIC COMMENT.] The county board must determine 
351.31  how citizens in the county will participate in the development 
351.32  of the service agreement and provide opportunities for such 
351.33  participation.  The county must allow a period of no less than 
351.34  30 days prior to the submission of the agreement to the 
351.35  commissioner to solicit comments from the public on the contents 
351.36  of the agreement. 
352.1      Subd. 6.  [COMMISSIONER RESPONSIBILITIES.] The commissioner 
352.2   must, within 60 days of receiving each county service agreement, 
352.3   inform the county if the service agreement has been approved.  
352.4   If the service agreement is not approved, the commissioner must 
352.5   inform the county of any revisions needed prior to approval. 
352.6      Sec. 5.  [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES 
352.7   GRANT ALLOCATION.] 
352.8      Subdivision 1.  [FORMULA.] Exclusive of subdivision 3, the 
352.9   commissioner shall allocate state funds appropriated for 
352.10  children and community services grants to each county board on a 
352.11  calendar year basis in an amount determined according to the 
352.12  formula in paragraphs (a) to (c). 
352.13     (a) For July 1, 2003, through December 31, 2003, the 
352.14  commissioner shall allocate funds to each county equal to that 
352.15  county's allocation for the grants under section 256M.10, 
352.16  subdivision 5, for calendar year 2003 less payments made on or 
352.17  before June 30, 2003. 
352.18     (b) For calendar year 2004 and 2005, the commissioner shall 
352.19  allocate available funds to each county in proportion to that 
352.20  county's share of the calendar year 2003 allocations for the 
352.21  grants under section 256M.10, subdivision 5. 
352.22     (c) For calendar year 2006 and each calendar year 
352.23  thereafter, the commissioner shall allocate available funds to 
352.24  each county in proportion to that county's share in the 
352.25  preceding calendar year. 
352.26     Subd. 2.  [PERFORMANCE INCENTIVE.] Beginning with the 
352.27  calendar year 2006 allocation, the commissioner shall withhold 
352.28  five percent of the annual allocation for each county.  This 
352.29  portion shall be released to the county based on the 
352.30  commissioner's determination of the county's achievement of 
352.31  positive outcomes as agreed to in the service agreement.  Any 
352.32  funds not disbursed under this subdivision to a county shall be 
352.33  reallocated by the commissioner to other counties who, based on 
352.34  the commissioner's determination, have achieved positive 
352.35  outcomes as agreed to in the service agreements. 
352.36     Subd. 3.  [PROJECT OF REGIONAL SIGNIFICANCE.] Beginning 
353.1   with the calendar year 2006 allocation, $25,000,000 of the 
353.2   available annual funds are dedicated for projects of regional 
353.3   significance.  The commissioner shall publish a request to 
353.4   solicit proposals from groups of counties by region.  The 
353.5   regional groupings shall be designated by the commissioner, in 
353.6   consultation with counties.  These projects shall support the 
353.7   efforts in paragraphs (a) to (c). 
353.8      (a) Funds are available to regional consortia of counties 
353.9   to support cooperative regional projects between governments, 
353.10  schools, and nonprofit providers designed to put in place 
353.11  comprehensive health and developmental screening for all 
353.12  children below six years, and to support projects that address 
353.13  early identification of physical and mental health needs in 
353.14  children.  Project partners applying under this provision must 
353.15  show how local resources will also be aligned to meet project 
353.16  goals.  
353.17     (b) Funds are available to the different geographic regions 
353.18  to support efforts that lead to simplification and improve 
353.19  outcomes through regional administration of human services. 
353.20     (c) Funds are available to counties for innovative regional 
353.21  projects designed to improve outcomes for children, adolescents, 
353.22  young adults, and their families to reduce the cost of providing 
353.23  services through innovative delivery or service design 
353.24  strategies, to test alternative incentives within a support 
353.25  strategy, or to develop new strategies to engage communities in 
353.26  caring for risk populations especially populations with 
353.27  disparities in outcome indicators.  Up to five percent of funds 
353.28  for innovation may be made to organizations other than counties. 
353.29     Subd. 4.  [PAYMENTS.] Calendar year allocations under 
353.30  subdivisions 1 and 2 shall be paid to counties on or before July 
353.31  10 of each year.  Funds awarded under subdivision 3 shall be 
353.32  paid according to requirements in the contract between the 
353.33  commissioner and the contracting entities. 
353.34     Sec. 6.  [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES 
353.35  GRANT ALLOCATION.] 
353.36     In federal fiscal year 2004 and subsequent years, money for 
354.1   social services received from the federal government to 
354.2   reimburse counties for social service expenditures according to 
354.3   Title XX of the Social Security Act shall be allocated to each 
354.4   county according to section 256M.40, except for funds allocated 
354.5   for migrant day care. 
354.6      Sec. 7.  [256M.60] [DUTIES OF COUNTY BOARDS.] 
354.7      Subdivision 1.  [RESPONSIBILITIES.] The county board of 
354.8   each county shall be responsible for administration and funding 
354.9   of children and community services as defined in section 
354.10  256M.10, subdivisions 1 and 2.  Each county board shall singly 
354.11  or in combination with other county boards use funds available 
354.12  to the county under this act to carry out these responsibilities.
354.13  The county board shall coordinate and facilitate the effective 
354.14  use of formal and informal helping systems to best support and 
354.15  nurture children, adolescents, and young adults within the 
354.16  county who experience dependency, abuse, neglect, poverty, 
354.17  disability, chronic health conditions, or other factors, 
354.18  including ethnicity and race, that may result in poor outcomes 
354.19  or disparities, as well as services for family members to 
354.20  support such individuals.  This includes assisting individuals 
354.21  to function at the highest level of ability while maintaining 
354.22  family and community relationships to the greatest extent 
354.23  possible.  
354.24     Subd. 2.  [REPORTS.] The county board shall provide 
354.25  necessary reports and data as required by the commissioner. 
354.26     Subd. 3.  [CONTRACTS FOR SERVICES.] The county board may 
354.27  contract with a human services board, a multicounty board 
354.28  established by a joint powers agreement, other political 
354.29  subdivisions, a children's mental health collaborative, a family 
354.30  services collaborative, or private organizations in discharging 
354.31  its duties. 
354.32     Subd. 4.  [EXEMPTION FROM LIABILITY.] The state of 
354.33  Minnesota, the county boards, or the agencies acting on behalf 
354.34  of the county boards in the implementation and administration of 
354.35  children and community services shall not be liable for damages, 
354.36  injuries, or liabilities sustained through the purchase of 
355.1   services by the individual, the individual's family, or the 
355.2   authorized representative under this section. 
355.3      Sec. 8.  [256M.70] [FISCAL LIMITATIONS.] 
355.4      Subdivision 1.  [SERVICE LIMITATION.] If the county has met 
355.5   the requirements in subdivisions 2 to 4, the county shall not be 
355.6   required to provide children and community services beyond 
355.7   requirements in federal or state law. 
355.8      Subd. 2.  [DEMONSTRATION OF REASONABLE EFFORT.] The county 
355.9   shall make reasonable efforts to comply with all children and 
355.10  community services requirements.  For the purposes of this 
355.11  section, a county is making reasonable efforts if the county has 
355.12  made efforts to comply with requirements within the limits of 
355.13  available funding, including efforts to identify and apply for 
355.14  commonly available state and federal funding for services. 
355.15     Subd. 3.  [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 
355.16  county has made reasonable efforts to comply with all applicable 
355.17  administrative rule requirements and is unable to meet all 
355.18  requirements, the county must provide services using the 
355.19  following considerations: 
355.20     (1) providing services needed to protect children, 
355.21  adolescents, and young adults from maltreatment, abuse, and 
355.22  neglect; 
355.23     (2) providing emergency and crisis services needed to 
355.24  protect clients from physical, emotional, or psychological harm; 
355.25     (3) assessing and documenting the needs of persons applying 
355.26  for services and referring to appropriate services when 
355.27  necessary; 
355.28     (4) providing public guardianship services for children; 
355.29  and 
355.30     (5) fulfilling licensing responsibilities delegated to the 
355.31  county by the commissioner under section 245A.16. 
355.32     Subd. 4.  [DENIAL, REDUCTION, OR TERMINATION OF SERVICES 
355.33  DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or 
355.34  terminates services to an individual due to fiscal limitations, 
355.35  the county must meet the requirements in subdivisions 2 and 3.  
355.36  The county must notify the individual and the individual's 
356.1   guardian in writing of the reason for the denial, reduction, or 
356.2   termination of services and must inform the individual and the 
356.3   individual's guardian in writing that the county will, upon 
356.4   request, meet to discuss alternatives before services are 
356.5   terminated or reduced.  
356.6      Subd. 5.  [APPEAL RIGHTS.] An individual who applies for or 
356.7   receives children and community services under this chapter, 
356.8   whose application is denied, or whose services are reduced or 
356.9   terminated does not have the right to a fair hearing under 
356.10  section 256.045. 
356.11     Subd. 6.  [RIGHT TO PETITION FOR REVIEW.] Any individual 
356.12  who applies for or receives children and community services 
356.13  under this chapter, whose application is denied, or whose 
356.14  services are reduced or terminated may petition the commissioner 
356.15  to review the county's performance under the county service 
356.16  agreement.  The petition must be in writing and must be specific 
356.17  as to what action the individual believes is inconsistent with 
356.18  the county service agreement, and what action the individual 
356.19  believes should be required.  Upon receiving a petition, the 
356.20  commissioner shall have 60 days in which to make a reply in 
356.21  writing as to its determination and any corrective action 
356.22  required. 
356.23     Sec. 9.  [256M.80] [PROGRAM EVALUATION.] 
356.24     Subdivision 1.  [COUNTY EVALUATION.] Each county shall 
356.25  submit to the commissioner data from the past calendar year on 
356.26  the outcomes in the approved service agreement.  The 
356.27  commissioner shall prescribe standard methods to be used by the 
356.28  counties in providing the data.  The data shall be submitted no 
356.29  later than March 1 of each year, beginning with March 1, 2005. 
356.30     Subd. 2.  [STATEWIDE EVALUATION.] Six months after the end 
356.31  of the first full calendar year and annually thereafter, the 
356.32  commissioner shall prepare a report on the counties' progress in 
356.33  improving the outcomes of children, adolescents, and young 
356.34  adults related to safety, permanency, and well-being.  This 
356.35  report shall be disseminated throughout the state.  
356.36     Sec. 10.  [REVISOR'S INSTRUCTION.] 
357.1      For sections in Minnesota Statutes and Minnesota Rules 
357.2   affected by the repealed sections in this article, the revisor 
357.3   shall delete internal cross-references where appropriate and 
357.4   make changes necessary to correct the punctuation, grammar, or 
357.5   structure of the remaining text and preserve its meaning. 
357.6      Sec. 11.  [REPEALER.] 
357.7      (a) Minnesota Statutes 2002, sections 245.478; 245.4886; 
357.8   245.4888; 245.496; 254A.17; 256B.0945, subdivisions 6, 7, 8, 9, 
357.9   and 10; 256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 
357.10  256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 256E.11; 
357.11  256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02; 256F.03; 
357.12  256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 
357.13  256F.14; 257.075; 257.81; 260.152; and 626.562, are repealed. 
357.14     (b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030; 
357.15  9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080; 
357.16  9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed. 
357.17                             ARTICLE 7 
357.18                    HUMAN SERVICES MISCELLANEOUS 
357.19     Section 1.  Minnesota Statutes 2002, section 69.021, 
357.20  subdivision 11, is amended to read: 
357.21     Subd. 11.  [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a) 
357.22  The excess police state-aid holding account is established in 
357.23  the general fund.  The excess police state-aid holding account 
357.24  must be administered by the commissioner. 
357.25     (b) Excess police state aid determined according to 
357.26  subdivision 10, must be deposited in the excess police state-aid 
357.27  holding account. 
357.28     (c) From the balance in the excess police state-aid holding 
357.29  account, $1,000,000 $900,000 is appropriated to and must be 
357.30  transferred annually to the ambulance service personnel 
357.31  longevity award and incentive suspense account established by 
357.32  section 144E.42, subdivision 2. 
357.33     (d) If a police officer stress reduction program is created 
357.34  by law and money is appropriated for that program, an amount 
357.35  equal to that appropriation must be transferred from the balance 
357.36  in the excess police state-aid holding account. 
358.1      (e) On October 1, 1997, and annually on each subsequent 
358.2   October 1, one-half of the balance of the excess police 
358.3   state-aid holding account remaining after the deductions under 
358.4   paragraphs (c) and (d) is appropriated for additional 
358.5   amortization aid under section 423A.02, subdivision 1b. 
358.6      (f) Annually, the remaining balance in the excess police 
358.7   state-aid holding account, after the deductions under paragraphs 
358.8   (c), (d), and (e), cancels to the general fund. 
358.9      Sec. 2.  Minnesota Statutes 2002, section 245A.10, is 
358.10  amended to read: 
358.11     245A.10 [FEES.] 
358.12     Subdivision 1.  [APPLICATION OR LICENSE FEE REQUIRED, 
358.13  PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 
358.14  (b), the commissioner shall charge a fee for evaluation of 
358.15  applications and inspection of programs, other than family day 
358.16  care and foster care, which are licensed under this chapter.  
358.17  The commissioner may charge a fee for the licensing of school 
358.18  age child care programs, in an amount sufficient to cover the 
358.19  cost to the state agency of processing the license. 
358.20     (b) Notwithstanding paragraph (a), no application or 
358.21  license fee shall be charged for family child care, child foster 
358.22  care, adult foster care, or state-operated programs, unless the 
358.23  state-operated program is an intermediate care facility for 
358.24  persons with mental retardation or related conditions (ICF/MR). 
358.25     Subd. 2.  [APPLICATION FEE FOR INITIAL LICENSE OR 
358.26  CERTIFICATION.] (a) Unless exempt from paying a license fee 
358.27  under subdivision 1, an applicant for an initial license or 
358.28  certification issued by the commissioner shall submit a $500 
358.29  application fee with each new application required under this 
358.30  subdivision.  The application fee shall not be prorated, is 
358.31  nonrefundable, and is in lieu of the annual license or 
358.32  certification fee that expires on December 31.  The commissioner 
358.33  shall not process an application until the application fee is 
358.34  paid.  
358.35     (b) Except as provided in clauses (1) to (3), an applicant 
358.36  shall apply for a license to provide services at a specific 
359.1   location.  
359.2      (1) For a license to provide waivered services to persons 
359.3   with developmental disabilities or related conditions, an 
359.4   applicant shall submit an application for each county in which 
359.5   the waivered services will be provided.  
359.6      (2) For a license to provide semi-independent living 
359.7   services to persons with developmental disabilities or related 
359.8   conditions, an applicant shall submit a single application to 
359.9   provide services statewide. 
359.10     (3) For a license to provide independent living assistance 
359.11  for youth under section 245A.22, an applicant shall submit a 
359.12  single application to provide services statewide.  
359.13     Subd. 3.  [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 
359.14  WITH LICENSED CAPACITY.] (a) Child care centers and programs 
359.15  with a licensed capacity shall pay an annual nonrefundable 
359.16  license or certification fee based on the following schedule: 
359.17      Licensed Capacity          Child Care         Residential
359.18                                 Center             Program
359.19                                 License Fee        License Fee
359.20       1 to 24 persons               $300               $400
359.21       25 to 49 persons              $450               $600
359.22       50 to 74 persons              $600               $800
359.23       75 to 99 persons              $750             $1,000
359.24       100 to 124 persons            $900             $1,200
359.25       125 to 149 persons          $1,200             $1,400
359.26       150 to 174 persons          $1,400             $1,600
359.27       175 to 199 persons          $1,600             $1,800
359.28       200 to 224 persons          $1,800             $2,000
359.29       225 or more persons         $2,000             $2,500
359.30     (b) A day training and habilitation program serving persons 
359.31  with developmental disabilities or related conditions shall be 
359.32  assessed a license fee based on the schedule in paragraph (a) 
359.33  unless the license holder serves more than 50 percent of the 
359.34  same persons at two or more locations in the community.  When a 
359.35  day training and habilitation program serves more than 50 
359.36  percent of the same persons in two or more locations in a 
360.1   community, the day training and habilitation program shall pay a 
360.2   license fee based on the licensed capacity of the largest 
360.3   facility and the other facility or facilities shall be charged a 
360.4   license fee based on a licensed capacity of a residential 
360.5   program serving one to 24 persons. 
360.6      Subd. 4.  [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 
360.7   WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 
360.8   paragraph (b), a program without a stated licensed capacity 
360.9   shall pay a license or certification fee of $400.  
360.10     (b) A mental health center or mental health clinic 
360.11  requesting certification for purposes of insurance and 
360.12  subscriber contract reimbursement under Minnesota Rules, parts 
360.13  9520.0750 to 9520.0870 shall pay a certification fee of $1,000 
360.14  per year.  If the mental health center or mental health clinic 
360.15  provides services at a primary location with satellite 
360.16  facilities, the satellite facilities shall be certified with the 
360.17  primary location without an additional charge. 
360.18     Subd. 5.  [LICENSE NOT ISSUED UNTIL LICENSE OR 
360.19  CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 
360.20  license or certification until the license or certification fee 
360.21  is paid.  The commissioner shall send a bill for the license or 
360.22  certification fee to the billing address identified by the 
360.23  license holder.  If the license holder does not submit the 
360.24  license or certification fee payment by the due date, the 
360.25  commissioner shall send the license holder a past due notice.  
360.26  If the license holder fails to pay the license or certification 
360.27  fee by the due date on the past due notice, the commissioner 
360.28  shall send a final notice to the license holder informing the 
360.29  license holder that the program license will expire on December 
360.30  31 unless the license fee is paid before December 31.  If a 
360.31  license expires, the program is no longer licensed and, unless 
360.32  exempt from licensure under section 245A.03, subdivision 2, must 
360.33  not operate after the expiration date.  After a license expires, 
360.34  if the former license holder wishes to provide licensed 
360.35  services, the former license holder must submit a new license 
360.36  application and application fee under subdivision 2. 
361.1      Sec. 3.  Minnesota Statutes 2002, section 252.27, 
361.2   subdivision 2a, is amended to read: 
361.3      Subd. 2a.  [CONTRIBUTION AMOUNT.] (a) The natural or 
361.4   adoptive parents of a minor child, including a child determined 
361.5   eligible for medical assistance without consideration of 
361.6   parental income, must contribute monthly to the cost of 
361.7   services, unless the child is married or has been married, 
361.8   parental rights have been terminated, or the child's adoption is 
361.9   subsidized according to section 259.67 or through title IV-E of 
361.10  the Social Security Act. 
361.11     (b) For households with adjusted gross income equal to or 
361.12  greater than 100 percent of federal poverty guidelines, the 
361.13  parental contribution shall be the greater of a minimum monthly 
361.14  fee of $25 for households with adjusted gross income of $30,000 
361.15  and over, or an amount to be computed by applying the following 
361.16  schedule of rates to the adjusted gross income of the natural or 
361.17  adoptive parents that exceeds 150 percent of the federal poverty 
361.18  guidelines for the applicable household size, the following 
361.19  schedule of rates: 
361.20     (1) on the amount of adjusted gross income over 150 percent 
361.21  of poverty, but not over $50,000, ten percent if the adjusted 
361.22  gross income is equal to or greater than 100 percent of federal 
361.23  poverty guidelines and less than 175 percent of federal poverty 
361.24  guidelines, the parental contribution is $4 per month; 
361.25     (2) on if the amount of adjusted gross income over 150 
361.26  percent of poverty and over $50,000 but not over $60,000, 12 
361.27  percent is equal to or greater than 175 percent of federal 
361.28  poverty guidelines and less than or equal to 375 percent of 
361.29  federal poverty guidelines, the parental contribution shall be 
361.30  determined using a sliding fee scale established by the 
361.31  commissioner of human services which begins at one percent of 
361.32  adjusted gross income at 175 percent of federal poverty 
361.33  guidelines and increases to 7.5 percent of adjusted gross income 
361.34  for those with adjusted gross income up to 375 percent of 
361.35  federal poverty guidelines; 
361.36     (3) on if the amount of adjusted gross income over 150 is 
362.1   greater than 375 percent of federal poverty, and over $60,000 
362.2   but not over $75,000, 14 percent guidelines and less than 675 
362.3   percent of federal poverty guidelines, the parental contribution 
362.4   shall be 7.5 percent of adjusted gross income; and 
362.5      (4) on all if the adjusted gross income amounts over 150 is 
362.6   equal to or greater than 675 percent of federal poverty, and 
362.7   over $75,000, 15 percent guidelines and less than 975 percent of 
362.8   federal poverty guidelines, the parental contribution shall be 
362.9   ten percent of adjusted gross income; and 
362.10     (5) if the adjusted gross income is equal to or greater 
362.11  than 975 percent of federal poverty guidelines, the parental 
362.12  contribution shall be 12.5 percent of adjusted gross income. 
362.13     If the child lives with the parent, the parental 
362.14  contribution annual adjusted gross income is reduced by $200, 
362.15  except that the parent must pay the minimum monthly $25 fee 
362.16  under this paragraph $2,400 prior to calculating the parental 
362.17  contribution.  If the child resides in an institution specified 
362.18  in section 256B.35, the parent is responsible for the personal 
362.19  needs allowance specified under that section in addition to the 
362.20  parental contribution determined under this section.  The 
362.21  parental contribution is reduced by any amount required to be 
362.22  paid directly to the child pursuant to a court order, but only 
362.23  if actually paid. 
362.24     (c) The household size to be used in determining the amount 
362.25  of contribution under paragraph (b) includes natural and 
362.26  adoptive parents and their dependents under age 21, including 
362.27  the child receiving services.  Adjustments in the contribution 
362.28  amount due to annual changes in the federal poverty guidelines 
362.29  shall be implemented on the first day of July following 
362.30  publication of the changes. 
362.31     (d) For purposes of paragraph (b), "income" means the 
362.32  adjusted gross income of the natural or adoptive parents 
362.33  determined according to the previous year's federal tax form. 
362.34     (e) The contribution shall be explained in writing to the 
362.35  parents at the time eligibility for services is being 
362.36  determined.  The contribution shall be made on a monthly basis 
363.1   effective with the first month in which the child receives 
363.2   services.  Annually upon redetermination or at termination of 
363.3   eligibility, if the contribution exceeded the cost of services 
363.4   provided, the local agency or the state shall reimburse that 
363.5   excess amount to the parents, either by direct reimbursement if 
363.6   the parent is no longer required to pay a contribution, or by a 
363.7   reduction in or waiver of parental fees until the excess amount 
363.8   is exhausted. 
363.9      (f) The monthly contribution amount must be reviewed at 
363.10  least every 12 months; when there is a change in household size; 
363.11  and when there is a loss of or gain in income from one month to 
363.12  another in excess of ten percent.  The local agency shall mail a 
363.13  written notice 30 days in advance of the effective date of a 
363.14  change in the contribution amount.  A decrease in the 
363.15  contribution amount is effective in the month that the parent 
363.16  verifies a reduction in income or change in household size. 
363.17     (g) Parents of a minor child who do not live with each 
363.18  other shall each pay the contribution required under paragraph 
363.19  (a), except that a.  An amount equal to the annual court-ordered 
363.20  child support payment actually paid on behalf of the child 
363.21  receiving services shall be deducted from the contribution 
363.22  adjusted gross income of the parent making the payment prior to 
363.23  calculating the parental contribution under paragraph (b). 
363.24     (h) The contribution under paragraph (b) shall be increased 
363.25  by an additional five percent if the local agency determines 
363.26  that insurance coverage is available but not obtained for the 
363.27  child.  For purposes of this section, "available" means the 
363.28  insurance is a benefit of employment for a family member at an 
363.29  annual cost of no more than five percent of the family's annual 
363.30  income.  For purposes of this section, "insurance" means health 
363.31  and accident insurance coverage, enrollment in a nonprofit 
363.32  health service plan, health maintenance organization, 
363.33  self-insured plan, or preferred provider organization. 
363.34     Parents who have more than one child receiving services 
363.35  shall not be required to pay more than the amount for the child 
363.36  with the highest expenditures.  There shall be no resource 
364.1   contribution from the parents.  The parent shall not be required 
364.2   to pay a contribution in excess of the cost of the services 
364.3   provided to the child, not counting payments made to school 
364.4   districts for education-related services.  Notice of an increase 
364.5   in fee payment must be given at least 30 days before the 
364.6   increased fee is due.  
364.7      (i) The contribution under paragraph (b) shall be reduced 
364.8   by $300 per fiscal year if, in the 12 months prior to July 1: 
364.9      (1) the parent applied for insurance for the child; 
364.10     (2) the insurer denied insurance; 
364.11     (3) the parents submitted a complaint or appeal, in writing 
364.12  to the insurer, submitted a complaint or appeal, in writing, to 
364.13  the commissioner of health or the commissioner of commerce, or 
364.14  litigated the complaint or appeal; and 
364.15     (4) as a result of the dispute, the insurer reversed its 
364.16  decision and granted insurance. 
364.17     For purposes of this section, "insurance" has the meaning 
364.18  given in paragraph (h). 
364.19     A parent who has requested a reduction in the contribution 
364.20  amount under this paragraph shall submit proof in the form and 
364.21  manner prescribed by the commissioner or county agency, 
364.22  including, but not limited to, the insurer's denial of 
364.23  insurance, the written letter or complaint of the parents, court 
364.24  documents, and the written response of the insurer approving 
364.25  insurance.  The determinations of the commissioner or county 
364.26  agency under this paragraph are not rules subject to chapter 14. 
364.27     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
364.28     Sec. 4.  Minnesota Statutes 2002, section 256.482, 
364.29  subdivision 8, is amended to read: 
364.30     Subd. 8.  [SUNSET.] Notwithstanding section 15.059, 
364.31  subdivision 5, the council on disability shall not sunset until 
364.32  June 30, 2003 2005. 
364.33     Sec. 5.  Minnesota Statutes 2002, section 518.551, 
364.34  subdivision 7, is amended to read: 
364.35     Subd. 7.  [SERVICE FEE FEES AND COST RECOVERY FEES FOR IV-D 
364.36  SERVICES.] When the public agency responsible for child support 
365.1   enforcement provides child support collection services either to 
365.2   a public assistance recipient or to a party who does not receive 
365.3   public assistance, the public agency may upon written notice to 
365.4   the obligor charge a monthly collection fee equivalent to the 
365.5   full monthly cost to the county of providing collection 
365.6   services, in addition to the amount of the child support which 
365.7   was ordered by the court.  The fee shall be deposited in the 
365.8   county general fund.  The service fee assessed is limited to ten 
365.9   percent of the monthly court ordered child support and shall not 
365.10  be assessed to obligors who are current in payment of the 
365.11  monthly court ordered child support. (a) When a recipient of 
365.12  IV-D services is no longer receiving assistance under the 
365.13  state's plan for foster care, medical assistance, or 
365.14  MinnesotaCare programs, the public authority responsible for 
365.15  child support enforcement must notify the recipient, within five 
365.16  working days of the notification of ineligibility, that IV-D 
365.17  services will be continued unless the public authority is 
365.18  notified to the contrary by the recipient.  The notice must 
365.19  include the implications of continuing to receive IV-D services, 
365.20  including the available services and fees, cost recovery fees, 
365.21  and distribution policies relating to fees. 
365.22     (b) An application fee of $25 shall be paid by the person 
365.23  who applies for child support and maintenance collection 
365.24  services, except persons who are receiving public assistance as 
365.25  defined in section 256.741 and, if enacted, the diversionary 
365.26  work program under section 256J.95, persons who transfer from 
365.27  public assistance to nonpublic assistance status, and minor 
365.28  parents and parents enrolled in a public secondary school, area 
365.29  learning center, or alternative learning program approved by the 
365.30  commissioner of children, families, and learning.  
365.31     (c) When the public authority provides full IV-D services 
365.32  to an obligee who has applied for those services, upon written 
365.33  notice to the obligee, the public authority must charge a cost 
365.34  recovery fee of one percent of the amount collected.  This fee 
365.35  must be deducted from the amount of the child support and 
365.36  maintenance collected and not assigned under section 256.741, 
366.1   before disbursement to the obligee.  This fee applies to an 
366.2   obligee who: 
366.3      (1) has never received assistance under the state's title 
366.4   IV-A, IV-E foster care, medical assistance, or MinnesotaCare 
366.5   programs; 
366.6      (2) has received assistance under the state's medical 
366.7   assistance or MinnesotaCare programs.  The fee must be charged 
366.8   immediately upon becoming ineligible; or 
366.9      (3) has received assistance under the state's title IV-A or 
366.10  IV-E foster care programs.  The fee must not be charged until 
366.11  the person has not received these services for 24 consecutive 
366.12  months.  
366.13     (d) When the public authority provides full IV-D services 
366.14  to an obligor who has applied for such services, upon written 
366.15  notice to the obligor, the public authority must charge a cost 
366.16  recovery fee of one percent of the monthly court ordered child 
366.17  support and maintenance obligation and may be collected through 
366.18  income withholding, as well as by any other enforcement remedy 
366.19  available to the public authority responsible for child support 
366.20  enforcement. 
366.21     (e) Fees assessed by state and federal tax agencies for 
366.22  collection of overdue support owed to or on behalf of a person 
366.23  not receiving public assistance must be imposed on the person 
366.24  for whom these services are provided.  The public authority upon 
366.25  written notice to the obligee shall assess a fee of $25 to the 
366.26  person not receiving public assistance for each successful 
366.27  federal tax interception.  The fee must be withheld prior to the 
366.28  release of the funds received from each interception and 
366.29  deposited in the general fund. 
366.30     (f) Cost recovery fees collected under paragraphs (c) and 
366.31  (d) shall be considered child support program income according 
366.32  to Code of Federal Regulations, title 45, section 304.50, and 
366.33  shall be deposited in the cost recovery fee account established 
366.34  under paragraph (h).  The commissioner of human services must 
366.35  elect to recover costs based on either actual or standardized 
366.36  costs. 
367.1      However, (g) The limitations of this subdivision on the 
367.2   assessment of fees shall not apply to the extent inconsistent 
367.3   with the requirements of federal law for receiving funds for the 
367.4   programs under Title IV-A and Title IV-D of the Social Security 
367.5   Act, United States Code, title 42, sections 601 to 613 and 
367.6   United States Code, title 42, sections 651 to 662.  
367.7      (h) The commissioner of human services is authorized to 
367.8   establish a special revenue fund account to receive child 
367.9   support cost recovery fees.  A portion of the nonfederal share 
367.10  of these fees may be retained for expenditures necessary to 
367.11  administer the fee, and must be transferred to the child support 
367.12  system special revenue account.  The remaining nonfederal share 
367.13  of the cost recovery fee must be retained by the commissioner 
367.14  and dedicated to the child support general fund county 
367.15  performance based grant account authorized under sections 
367.16  256.979 and 256.9791. 
367.17     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004, 
367.18  except paragraph (d) is effective July 1, 2005. 
367.19     Sec. 6.  Minnesota Statutes 2002, section 518.6111, 
367.20  subdivision 2, is amended to read: 
367.21     Subd. 2.  [APPLICATION.] This section applies to all 
367.22  support orders issued by a court or an administrative tribunal 
367.23  and orders for or notices of withholding issued by the public 
367.24  authority according to section 518.5513, subdivision 5, 
367.25  paragraph (a), clause (5). 
367.26     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
367.27     Sec. 7.  Minnesota Statutes 2002, section 518.6111, 
367.28  subdivision 3, is amended to read: 
367.29     Subd. 3.  [ORDER.] Every support order must address income 
367.30  withholding.  Whenever a support order is initially entered or 
367.31  modified, the full amount of the support order must be 
367.32  withheld subject to income withholding from the income of the 
367.33  obligor.  If the obligee or obligor applies for either full IV-D 
367.34  services or for income withholding only services from the public 
367.35  authority responsible for child support enforcement, the full 
367.36  amount of the support order must be withheld from the income of 
368.1   the obligor and forwarded to the public authority.  Every order 
368.2   for support or maintenance shall provide for a conspicuous 
368.3   notice of the provisions of this section that complies with 
368.4   section 518.68, subdivision 2.  An order without this notice 
368.5   remains subject to this section.  This section applies 
368.6   regardless of the source of income of the person obligated to 
368.7   pay the support or maintenance. 
368.8      A payor of funds shall implement income withholding 
368.9   according to this section upon receipt of an order for or notice 
368.10  of withholding.  The notice of withholding shall be on a form 
368.11  provided by the commissioner of human services. 
368.12     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
368.13     Sec. 8.  Minnesota Statutes 2002, section 518.6111, 
368.14  subdivision 4, is amended to read: 
368.15     Subd. 4.  [COLLECTION SERVICES.] (a) The commissioner of 
368.16  human services shall prepare and make available to the courts a 
368.17  notice of services that explains child support and maintenance 
368.18  collection services available through the public authority, 
368.19  including income withholding, and the fees for such services.  
368.20  Upon receiving a petition for dissolution of marriage or legal 
368.21  separation, the court administrator shall promptly send the 
368.22  notice of services to the petitioner and respondent at the 
368.23  addresses stated in the petition. 
368.24     (b) Either the obligee or obligor may at any time apply to 
368.25  the public authority for either full IV-D services or for income 
368.26  withholding only services. 
368.27     Upon receipt of a support order requiring income 
368.28  withholding, a petitioner or respondent, who is not a recipient 
368.29  of public assistance and does not receive child support services 
368.30  from the public authority, shall apply to the public authority 
368.31  for either full child support collection services or for income 
368.32  withholding only services. 
368.33     (c) For those persons applying for income withholding only 
368.34  services, a monthly service fee of $15 must be charged to the 
368.35  obligor.  This fee is in addition to the amount of the support 
368.36  order and shall be withheld through income withholding.  The 
369.1   public authority shall explain the service options in this 
369.2   section to the affected parties and encourage the application 
369.3   for full child support collection services. 
369.4      (d) If the obligee is not a current recipient of public 
369.5   assistance as defined in section 256.741, the person who applied 
369.6   for services may at any time choose to terminate either full 
369.7   IV-D services or income withholding only services regardless of 
369.8   whether income withholding is currently in place.  The obligee 
369.9   or obligor may reapply for either full IV-D services or income 
369.10  withholding only services at any time.  Unless the applicant is 
369.11  a recipient of public assistance as defined in section 256.741, 
369.12  a $25 application fee shall be charged at the time of each 
369.13  application.  
369.14     (e) When a person terminates IV-D services, if an arrearage 
369.15  for public assistance as defined in section 256.741 exists, the 
369.16  public authority may continue income withholding, as well as use 
369.17  any other enforcement remedy for the collection of child 
369.18  support, until all public assistance arrears are paid in full.  
369.19  Income withholding shall be in an amount equal to 20 percent of 
369.20  the support order in effect at the time the services terminated. 
369.21     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
369.22     Sec. 9.  Minnesota Statutes 2002, section 518.6111, 
369.23  subdivision 16, is amended to read: 
369.24     Subd. 16.  [WAIVER.] (a) If the public authority is 
369.25  providing child support and maintenance enforcement services and 
369.26  child support or maintenance is not assigned under section 
369.27  256.741, the court may waive the requirements of this section if 
369.28  the court finds there is no arrearage in child support and 
369.29  maintenance as of the date of the hearing and: 
369.30     (1) one party demonstrates and the court finds determines 
369.31  there is good cause to waive the requirements of this section or 
369.32  to terminate an order for or notice of income withholding 
369.33  previously entered under this section.  The court must make 
369.34  written findings to include the reasons income withholding would 
369.35  not be in the best interests of the child.  In cases involving a 
369.36  modification of support, the court must also make a finding that 
370.1   support payments have been timely made; or 
370.2      (2) all parties reach an the obligee and obligor sign a 
370.3   written agreement and the agreement providing for an alternative 
370.4   payment arrangement which is approved reviewed and entered in 
370.5   the record by the court after a finding that the agreement is 
370.6   likely to result in regular and timely payments.  The court's 
370.7   findings waiving the requirements of this paragraph shall 
370.8   include a written explanation of the reasons why income 
370.9   withholding would not be in the best interests of the child. 
370.10     In addition to the other requirements in this subdivision, 
370.11  if the case involves a modification of support, the court shall 
370.12  make a finding that support has been timely made. 
370.13     (b) If the public authority is not providing child support 
370.14  and maintenance enforcement services and child support or 
370.15  maintenance is not assigned under section 256.741, the court may 
370.16  waive the requirements of this section if the parties sign a 
370.17  written agreement.  
370.18     (c) If the court waives income withholding, the obligee or 
370.19  obligor may at any time request income withholding under 
370.20  subdivision 7. 
370.21     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2004. 
370.22     Sec. 10.  [REVISOR'S INSTRUCTION.] 
370.23     For sections in Minnesota Statutes and Minnesota Rules 
370.24  affected by the repealed sections in this article, the revisor 
370.25  shall delete internal cross-references where appropriate and 
370.26  make changes necessary to correct the punctuation, grammar, or 
370.27  structure of the remaining text and preserve its meaning. 
370.28     Sec. 11.  [REPEALER.] 
370.29     Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020; 
370.30  9545.2030; and 9545.2040, are repealed. 
370.31                             ARTICLE 8 
370.32                  HEALTH DEPARTMENT MISCELLANEOUS 
370.33     Section 1.  Minnesota Statutes 2002, section 62J.692, 
370.34  subdivision 4, is amended to read: 
370.35     Subd. 4.  [DISTRIBUTION OF FUNDS.] (a) The commissioner 
370.36  shall annually distribute medical education funds to all 
371.1   qualifying applicants based on the following criteria:  
371.2      (1) total medical education funds available for 
371.3   distribution; 
371.4      (2) total number of eligible trainee FTEs in each clinical 
371.5   medical education program; and 
371.6      (3) the statewide average cost per trainee as determined by 
371.7   the application information provided in the first year of the 
371.8   biennium, by type of trainee, in each clinical medical education 
371.9   program.  
371.10     (b) Funds distributed shall not be used to displace current 
371.11  funding appropriations from federal or state sources.  
371.12     (c) Funds shall be distributed to the sponsoring 
371.13  institutions indicating the amount to be distributed to each of 
371.14  the sponsor's clinical medical education programs based on the 
371.15  criteria in this subdivision and in accordance with the 
371.16  commissioner's approval letter.  Each clinical medical education 
371.17  program must distribute funds to the training sites as specified 
371.18  in the commissioner's approval letter.  Sponsoring institutions, 
371.19  which are accredited through an organization recognized by the 
371.20  department of education or the Centers for Medicare and Medicaid 
371.21  Services, may contract directly with training sites to provide 
371.22  clinical training.  To ensure the quality of clinical training, 
371.23  those accredited sponsoring institutions must: 
371.24     (1) develop contracts specifying the terms, expectations, 
371.25  and outcomes of the clinical training conducted at sites; and 
371.26     (2) take necessary action if the contract requirements are 
371.27  not met.  Action may include the withholding of payments under 
371.28  this section or the removal of students from the site.  
371.29     (d) Any funds not distributed in accordance with the 
371.30  commissioner's approval letter must be returned to the medical 
371.31  education and research fund within 30 days of receiving notice 
371.32  from the commissioner.  The commissioner shall distribute 
371.33  returned funds to the appropriate training sites in accordance 
371.34  with the commissioner's approval letter. 
371.35     (e) The commissioner shall distribute by June 30 of each 
371.36  year an amount equal to the funds transferred under section 
372.1   62J.694, subdivision 2a, paragraph (b) subdivision 10, plus five 
372.2   percent interest to the University of Minnesota board of regents 
372.3   for the costs of the academic health center as specified under 
372.4   section 62J.694, subdivision 2a, paragraph (a). instructional 
372.5   costs of health professional programs at the academic health 
372.6   center and for interdisciplinary academic initiatives within the 
372.7   academic health center. 
372.8      (f) A maximum of $150,000 of the funds dedicated to the 
372.9   commissioner under section 297F.10, subdivision 1, paragraph 
372.10  (b), clause (2), may be used by the commissioner for 
372.11  administrative expenses associated with implementing this 
372.12  section. 
372.13     Sec. 2.  Minnesota Statutes 2002, section 62J.692, is 
372.14  amended by adding a subdivision to read: 
372.15     Subd. 10.  [TRANSFERS FROM UNIVERSITY OF MINNESOTA.] Of the 
372.16  funds dedicated to the academic health center under section 
372.17  297F.10, subdivision 1, paragraph (b), clause (1), $4,850,000 
372.18  shall be transferred annually to the commissioner of health no 
372.19  later than April 15 of each year for distribution under 
372.20  subdivision 4, paragraph (e). 
372.21     Sec. 3.  Minnesota Statutes 2002, section 62Q.19, 
372.22  subdivision 1, is amended to read: 
372.23     Subdivision 1.  [DESIGNATION.] (a) The commissioner shall 
372.24  designate essential community providers.  The criteria for 
372.25  essential community provider designation shall be the following: 
372.26     (1) a demonstrated ability to integrate applicable 
372.27  supportive and stabilizing services with medical care for 
372.28  uninsured persons and high-risk and special needs populations, 
372.29  underserved, and other special needs populations; and 
372.30     (2) a commitment to serve low-income and underserved 
372.31  populations by meeting the following requirements: 
372.32     (i) has nonprofit status in accordance with chapter 317A; 
372.33     (ii) has tax exempt status in accordance with the Internal 
372.34  Revenue Service Code, section 501(c)(3); 
372.35     (iii) charges for services on a sliding fee schedule based 
372.36  on current poverty income guidelines; and 
373.1      (iv) does not restrict access or services because of a 
373.2   client's financial limitation; 
373.3      (3) status as a local government unit as defined in section 
373.4   62D.02, subdivision 11, a hospital district created or 
373.5   reorganized under sections 447.31 to 447.37, an Indian tribal 
373.6   government, an Indian health service unit, or a community health 
373.7   board as defined in chapter 145A; 
373.8      (4) a former state hospital that specializes in the 
373.9   treatment of cerebral palsy, spina bifida, epilepsy, closed head 
373.10  injuries, specialized orthopedic problems, and other disabling 
373.11  conditions; or 
373.12     (5) a rural hospital that has qualified for a sole 
373.13  community hospital financial assistance grant in the past three 
373.14  years under section 144.1484, subdivision 1.  For these rural 
373.15  hospitals, the essential community provider designation applies 
373.16  to all health services provided, including both inpatient and 
373.17  outpatient services.  For purposes of this section, "sole 
373.18  community hospital" means a rural hospital that: 
373.19     (i) is eligible to be classified as a sole community 
373.20  hospital according to Code of Federal Regulations, title 42, 
373.21  section 412.92, or is located in a community with a population 
373.22  of less than 5,000 and located more than 25 miles from a like 
373.23  hospital currently providing acute short-term services; 
373.24     (ii) has experienced net operating income losses in two of 
373.25  the previous three most recent consecutive hospital fiscal years 
373.26  for which audited financial information is available; and 
373.27     (iii) consists of 40 or fewer licensed beds. 
373.28     (b) Prior to designation, the commissioner shall publish 
373.29  the names of all applicants in the State Register.  The public 
373.30  shall have 30 days from the date of publication to submit 
373.31  written comments to the commissioner on the application.  No 
373.32  designation shall be made by the commissioner until the 30-day 
373.33  period has expired. 
373.34     (c) The commissioner may designate an eligible provider as 
373.35  an essential community provider for all the services offered by 
373.36  that provider or for specific services designated by the 
374.1   commissioner. 
374.2      (d) For the purpose of this subdivision, supportive and 
374.3   stabilizing services include at a minimum, transportation, child 
374.4   care, cultural, and linguistic services where appropriate. 
374.5      Sec. 4.  Minnesota Statutes 2002, section 144.1222, is 
374.6   amended by adding a subdivision to read: 
374.7      Subd. 1a.  [FEES.] All plans and specifications for public 
374.8   swimming pool and spa construction, installation, or alteration 
374.9   or requests for a variance that are submitted to the 
374.10  commissioner according to Minnesota Rules, part 4717.3975, shall 
374.11  be accompanied by the appropriate fees.  If the commissioner 
374.12  determines, upon review of the plans, that inadequate fees were 
374.13  paid, the necessary additional fees shall be paid before plan 
374.14  approval.  For purposes of determining fees, a project is 
374.15  defined as a proposal to construct or install a public pool, 
374.16  spa, special purpose pool, or wading pool and all associated 
374.17  water treatment equipment and drains, gutters, decks, water 
374.18  recreation features, spray pads, and those design and safety 
374.19  features that are within five feet of any pool or spa.  The 
374.20  commissioner shall charge the following fees for plan review and 
374.21  inspection of public pools and spas and for requests for 
374.22  variance from the public pool and spa rules:  
374.23     (1) each spa pool, $500; 
374.24     (2) projects valued at $250,000 or less, a minimum of $800 
374.25  plus:  
374.26     (i) for each slide, an additional $400; and 
374.27     (ii) for each spa pool, an additional $500; 
374.28     (3) projects valued at $250,000 or more, 0.5 percent of 
374.29  documented estimated project cost to a maximum fee of $10,000; 
374.30     (4) alterations to an existing pool without changing the 
374.31  size or configuration of the pool, $400; 
374.32     (5) removal or replacement of pool disinfection equipment 
374.33  only, $75; and 
374.34     (6) request for variance from the public pool and spa 
374.35  rules, $500. 
374.36     Sec. 5.  Minnesota Statutes 2002, section 144.125, is 
375.1   amended to read: 
375.2      144.125 [TESTS OF INFANTS FOR INBORN METABOLIC ERRORS 
375.3   HERITABLE AND CONGENITAL DISORDERS.] 
375.4      Subdivision 1.  [DUTY TO PERFORM TESTING.] It is the duty 
375.5   of (1) the administrative officer or other person in charge of 
375.6   each institution caring for infants 28 days or less of age, (2) 
375.7   the person required in pursuance of the provisions of section 
375.8   144.215, to register the birth of a child, or (3) the nurse 
375.9   midwife or midwife in attendance at the birth, to arrange to 
375.10  have administered to every infant or child in its care tests for 
375.11  inborn errors of metabolism in accordance with heritable and 
375.12  congenital disorders according to subdivision 2 and rules 
375.13  prescribed by the state commissioner of health.  In determining 
375.14  which tests must be administered, the commissioner shall take 
375.15  into consideration the adequacy of laboratory methods to detect 
375.16  the inborn metabolic error, the ability to treat or prevent 
375.17  medical conditions caused by the inborn metabolic error, and the 
375.18  severity of the medical conditions caused by the inborn 
375.19  metabolic error.  Testing and the recording and reporting of 
375.20  test results shall be performed at the times and in the manner 
375.21  prescribed by the commissioner of health.  The commissioner 
375.22  shall charge laboratory service fees so that the total of fees 
375.23  collected will approximate the costs of conducting the tests and 
375.24  implementing and maintaining a system to follow-up infants with 
375.25  inborn metabolic errors heritable or congenital disorders.  The 
375.26  laboratory service fee is $61 per specimen.  Costs associated 
375.27  with capital expenditures and the development of new procedures 
375.28  may be prorated over a three-year period when calculating the 
375.29  amount of the fees. 
375.30     Subd. 2.  [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 
375.31  commissioner shall periodically revise the list of tests to be 
375.32  administered for determining the presence of a heritable or 
375.33  congenital disorder.  Revisions to the list shall reflect 
375.34  advances in medical science, new and improved testing methods, 
375.35  or other factors that will improve the public health.  In 
375.36  determining whether a test must be administered, the 
376.1   commissioner shall take into consideration the adequacy of 
376.2   laboratory methods to detect the heritable or congenital 
376.3   disorder, the ability to treat or prevent medical conditions 
376.4   caused by the heritable or congenital disorder, and the severity 
376.5   of the medical conditions caused by the heritable or congenital 
376.6   disorder.  The list of tests to be performed may be revised if 
376.7   the changes are recommended by the advisory committee 
376.8   established under section 144.1255, approved by the 
376.9   commissioner, and published in the State Register.  The revision 
376.10  is exempt from the rulemaking requirements in chapter 14 and 
376.11  sections 14.385 and 14.386 do not apply.  
376.12     Subd. 3.  [OBJECTION OF PARENTS TO TEST.] If the parents of 
376.13  an infant object in writing to testing for heritable and 
376.14  congenital disorders as being in conflict with their religious 
376.15  tenets and practice, the objection shall be recorded on a form 
376.16  that is signed by a parent or legal guardian and made part of 
376.17  the infant's medical record.  A written objection exempts an 
376.18  infant from the requirements of this section and section 144.128.
376.19     Sec. 6.  [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 
376.20  CONGENITAL DISORDERS.] 
376.21     Subdivision 1.  [CREATION AND MEMBERSHIP.] (a) By July 1, 
376.22  2003, the commissioner of health shall appoint an advisory 
376.23  committee to provide advice and recommendations to the 
376.24  commissioner concerning tests and treatments for heritable and 
376.25  congenital disorders found in newborn children.  Membership of 
376.26  the committee shall include, but not be limited to, at least one 
376.27  member from each of the following representative groups:  
376.28     (1) parents and other consumers; 
376.29     (2) primary care providers; 
376.30     (3) clinicians and researchers specializing in newborn 
376.31  diseases and disorders; 
376.32     (4) genetic counselors; 
376.33     (5) birth hospital representatives; 
376.34     (6) newborn screening laboratory professionals; 
376.35     (7) nutritionists; and 
376.36     (8) other experts as needed representing related fields 
377.1   such as emerging technologies and health insurance. 
377.2      (b) The terms and removal of members are governed by 
377.3   section 15.059.  Members shall not receive per diems but shall 
377.4   be compensated for expenses.  Notwithstanding section 15.059, 
377.5   subdivision 5, the advisory committee does not expire. 
377.6      Subd. 2.  [FUNCTION AND OBJECTIVES.] The committee's 
377.7   activities include, but are not limited to:  
377.8      (1) collection of information on the efficacy and 
377.9   reliability of various tests for heritable and congenital 
377.10  disorders; 
377.11     (2) collection of information on the availability and 
377.12  efficacy of treatments for heritable and congenital disorders; 
377.13     (3) collection of information on the severity of medical 
377.14  conditions caused by heritable and congenital disorders; 
377.15     (4) discussion and assessment of the benefits of performing 
377.16  tests for heritable or congenital disorders as compared to the 
377.17  costs, treatment limitations, or other potential disadvantages 
377.18  of requiring the tests; 
377.19     (5) discussion and assessment of ethical considerations 
377.20  surrounding the testing, treatment, and handling of data and 
377.21  specimens generated by the testing requirements of sections 
377.22  144.125 to 144.128; and 
377.23     (6) providing advice and recommendations to the 
377.24  commissioner concerning tests and treatments for heritable and 
377.25  congenital disorders found in newborn children. 
377.26     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
377.27  following final enactment. 
377.28     Sec. 7.  Minnesota Statutes 2002, section 144.128, is 
377.29  amended to read: 
377.30     144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF 
377.31  CASES COMMISSIONER'S DUTIES.] 
377.32     The commissioner shall: 
377.33     (1) make arrangements referrals for the necessary treatment 
377.34  of diagnosed cases of hemoglobinopathy, phenylketonuria, and 
377.35  other inborn errors of metabolism heritable or congenital 
377.36  disorders when treatment is indicated and the family is 
378.1   uninsured and, because of a lack of available income, is unable 
378.2   to pay the cost of the treatment; 
378.3      (2) maintain a registry of the cases of hemoglobinopathy, 
378.4   phenylketonuria, and other inborn errors of metabolism heritable 
378.5   and congenital disorders detected by the screening program for 
378.6   the purpose of follow-up services; and 
378.7      (3) adopt rules to carry out section 144.126 and this 
378.8   section sections 144.125 to 144.128. 
378.9      Sec. 8.  Minnesota Statutes 2002, section 144.1483, is 
378.10  amended to read: 
378.11     144.1483 [RURAL HEALTH INITIATIVES.] 
378.12     The commissioner of health, through the office of rural 
378.13  health, and consulting as necessary with the commissioner of 
378.14  human services, the commissioner of commerce, the higher 
378.15  education services office, and other state agencies, shall: 
378.16     (1) develop a detailed plan regarding the feasibility of 
378.17  coordinating rural health care services by organizing individual 
378.18  medical providers and smaller hospitals and clinics into 
378.19  referral networks with larger rural hospitals and clinics that 
378.20  provide a broader array of services; 
378.21     (2) develop and implement a program to assist rural 
378.22  communities in establishing community health centers, as 
378.23  required by section 144.1486; 
378.24     (3) administer the program of financial assistance 
378.25  established under section 144.1484 for rural hospitals in 
378.26  isolated areas of the state that are in danger of closing 
378.27  without financial assistance, and that have exhausted local 
378.28  sources of support; 
378.29     (4) develop recommendations regarding health education and 
378.30  training programs in rural areas, including but not limited to a 
378.31  physician assistants' training program, continuing education 
378.32  programs for rural health care providers, and rural outreach 
378.33  programs for nurse practitioners within existing training 
378.34  programs; 
378.35     (5) (4) develop a statewide, coordinated recruitment 
378.36  strategy for health care personnel and maintain a database on 
379.1   health care personnel as required under section 144.1485; 
379.2      (6) (5) develop and administer technical assistance 
379.3   programs to assist rural communities in:  (i) planning and 
379.4   coordinating the delivery of local health care services; and 
379.5   (ii) hiring physicians, nurse practitioners, public health 
379.6   nurses, physician assistants, and other health personnel; 
379.7      (7) (6) study and recommend changes in the regulation of 
379.8   health care personnel, such as nurse practitioners and physician 
379.9   assistants, related to scope of practice, the amount of on-site 
379.10  physician supervision, and dispensing of medication, to address 
379.11  rural health personnel shortages; 
379.12     (8) (7) support efforts to ensure continued funding for 
379.13  medical and nursing education programs that will increase the 
379.14  number of health professionals serving in rural areas; 
379.15     (9) (8) support efforts to secure higher reimbursement for 
379.16  rural health care providers from the Medicare and medical 
379.17  assistance programs; 
379.18     (10) (9) coordinate the development of a statewide plan for 
379.19  emergency medical services, in cooperation with the emergency 
379.20  medical services advisory council; 
379.21     (11) (10) establish a Medicare rural hospital flexibility 
379.22  program pursuant to section 1820 of the federal Social Security 
379.23  Act, United States Code, title 42, section 1395i-4, by 
379.24  developing a state rural health plan and designating, consistent 
379.25  with the rural health plan, rural nonprofit or public hospitals 
379.26  in the state as critical access hospitals.  Critical access 
379.27  hospitals shall include facilities that are certified by the 
379.28  state as necessary providers of health care services to 
379.29  residents in the area.  Necessary providers of health care 
379.30  services are designated as critical access hospitals on the 
379.31  basis of being more than 20 miles, defined as official mileage 
379.32  as reported by the Minnesota department of transportation, from 
379.33  the next nearest hospital, being the sole hospital in the 
379.34  county, being a hospital located in a county with a designated 
379.35  medically underserved area or health professional shortage area, 
379.36  or being a hospital located in a county contiguous to a county 
380.1   with a medically underserved area or health professional 
380.2   shortage area.  A critical access hospital located in a county 
380.3   with a designated medically underserved area or a health 
380.4   professional shortage area or in a county contiguous to a county 
380.5   with a medically underserved area or health professional 
380.6   shortage area shall continue to be recognized as a critical 
380.7   access hospital in the event the medically underserved area or 
380.8   health professional shortage area designation is subsequently 
380.9   withdrawn; and 
380.10     (12) (11) carry out other activities necessary to address 
380.11  rural health problems. 
380.12     Sec. 9.  Minnesota Statutes 2002, section 144.1488, 
380.13  subdivision 4, is amended to read: 
380.14     Subd. 4.  [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 
380.15  eligible to apply to the commissioner for the loan repayment 
380.16  program, health professionals must be citizens or nationals of 
380.17  the United States, must not have any unserved obligations for 
380.18  service to a federal, state, or local government, or other 
380.19  entity, must have a current and unrestricted Minnesota license 
380.20  to practice, and must be ready to begin full-time clinical 
380.21  practice upon signing a contract for obligated service. 
380.22     (b) Eligible providers are those specified by the federal 
380.23  Bureau of Primary Health Care Health Professions in the policy 
380.24  information notice for the state's current federal grant 
380.25  application.  A health professional selected for participation 
380.26  is not eligible for loan repayment until the health professional 
380.27  has an employment agreement or contract with an eligible loan 
380.28  repayment site and has signed a contract for obligated service 
380.29  with the commissioner. 
380.30     Sec. 10.  Minnesota Statutes 2002, section 144.1491, 
380.31  subdivision 1, is amended to read: 
380.32     Subdivision 1.  [PENALTIES FOR BREACH OF CONTRACT.] A 
380.33  program participant who fails to complete two the required years 
380.34  of obligated service shall repay the amount paid, as well as a 
380.35  financial penalty based upon the length of the service 
380.36  obligation not fulfilled.  If the participant has served at 
381.1   least one year, the financial penalty is the number of unserved 
381.2   months multiplied by $1,000.  If the participant has served less 
381.3   than one year, the financial penalty is the total number of 
381.4   obligated months multiplied by $1,000 specified by the federal 
381.5   Bureau of Health Professions in the policy information notice 
381.6   for the state's current federal grant application.  The 
381.7   commissioner shall report to the appropriate health-related 
381.8   licensing board a participant who fails to complete the service 
381.9   obligation and fails to repay the amount paid or fails to pay 
381.10  any financial penalty owed under this subdivision. 
381.11     Sec. 11.  [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 
381.12  FORGIVENESS PROGRAM.] 
381.13     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
381.14  section, the following definitions apply.  
381.15     (b) "Designated rural area" means:  
381.16     (1) an area in Minnesota outside the counties of Anoka, 
381.17  Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 
381.18  excluding the cities of Duluth, Mankato, Moorhead, Rochester, 
381.19  and St. Cloud; or 
381.20     (2) a municipal corporation, as defined under section 
381.21  471.634, that is physically located, in whole or in part, in an 
381.22  area defined as a designated rural area under clause (1).  
381.23     (c) "Emergency circumstances" means those conditions that 
381.24  make it impossible for the participant to fulfill the service 
381.25  commitment, including death, total and permanent disability, or 
381.26  temporary disability lasting more than two years. 
381.27     (d) "Medical resident" means an individual participating in 
381.28  a medical residency in family practice, internal medicine, 
381.29  obstetrics and gynecology, pediatrics, or psychiatry.  
381.30     (e) "Midlevel practitioner" means a nurse practitioner, 
381.31  nurse-midwife, nurse anesthetist, advanced clinical nurse 
381.32  specialist, or physician assistant.  
381.33     (f) "Nurse" means an individual who has completed training 
381.34  and received all licensing or certification necessary to perform 
381.35  duties as a licensed practical nurse or registered nurse.  
381.36     (g) "Nurse-midwife" means a registered nurse who has 
382.1   graduated from a program of study designed to prepare registered 
382.2   nurses for advanced practice as nurse-midwives.  
382.3      (h) "Nurse practitioner" means a registered nurse who has 
382.4   graduated from a program of study designed to prepare registered 
382.5   nurses for advanced practice as nurse practitioners.  
382.6      (i) "Physician" means an individual who is licensed to 
382.7   practice medicine in the areas of family practice, internal 
382.8   medicine, obstetrics and gynecology, pediatrics, or psychiatry.  
382.9      (j) "Physician assistant" means a person registered under 
382.10  chapter 147A.  
382.11     (k) "Qualified educational loan" means a government, 
382.12  commercial, or foundation loan for actual costs paid for 
382.13  tuition, reasonable education expenses, and reasonable living 
382.14  expenses related to the graduate or undergraduate education of a 
382.15  health care professional.  
382.16     (l) "Underserved urban community" means a Minnesota urban 
382.17  area or population included in the list of designated primary 
382.18  medical care health professional shortage areas (HPSAs), 
382.19  medically underserved areas (MUAs), or medically underserved 
382.20  populations (MUPs) maintained and updated by the United States 
382.21  Department of Health and Human Services.  
382.22     Subd. 2.  [CREATION OF ACCOUNT.] A health professional 
382.23  education loan forgiveness program account is established.  The 
382.24  commissioner of health shall use money from the account to 
382.25  establish a loan forgiveness program for medical residents 
382.26  agreeing to practice in designated rural areas or underserved 
382.27  urban communities, for midlevel practitioners agreeing to 
382.28  practice in designated rural areas, and for nurses who agree to 
382.29  practice in a Minnesota nursing home or intermediate care 
382.30  facility for persons with mental retardation or related 
382.31  conditions.  Appropriations made to the account do not cancel 
382.32  and are available until expended, except that at the end of each 
382.33  biennium, any remaining balance in the account that is not 
382.34  committed by contract and not needed to fulfill existing 
382.35  commitments shall cancel to the fund. 
382.36     Subd. 3.  [ELIGIBILITY.] (a) To be eligible to participate 
383.1   in the loan forgiveness program, an individual must: 
383.2      (1) be a medical resident or be enrolled in a midlevel 
383.3   practitioner, registered nurse, or a licensed practical nurse 
383.4   training program; and 
383.5      (2) submit an application to the commissioner of health.  
383.6      (b) An applicant selected to participate must sign a 
383.7   contract to agree to serve a minimum three-year full-time 
383.8   service obligation according to subdivision 2, which shall begin 
383.9   no later than March 31 following completion of required training.
383.10     Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
383.11  may select applicants each year for participation in the loan 
383.12  forgiveness program, within the limits of available funding.  
383.13  The commissioner shall distribute available funds for loan 
383.14  forgiveness proportionally among the eligible professions 
383.15  according to the vacancy rate for each profession in the 
383.16  required geographic area or facility type specified in 
383.17  subdivision 2.  The commissioner shall allocate funds for 
383.18  physician loan forgiveness so that 75 percent of the funds 
383.19  available are used for rural physician loan forgiveness and 25 
383.20  percent of the funds available are used for underserved urban 
383.21  communities loan forgiveness.  If the commissioner does not 
383.22  receive enough qualified applicants each year to use the entire 
383.23  allocation of funds for urban underserved communities, the 
383.24  remaining funds may be allocated for rural physician loan 
383.25  forgiveness.  Applicants are responsible for securing their own 
383.26  qualified educational loans.  The commissioner shall select 
383.27  participants based on their suitability for practice serving the 
383.28  required geographic area or facility type specified in 
383.29  subdivision 2, as indicated by experience or training.  The 
383.30  commissioner shall give preference to applicants closest to 
383.31  completing their training.  For each year that a participant 
383.32  meets the service obligation required under subdivision 3, up to 
383.33  a maximum of four years, the commissioner shall make annual 
383.34  disbursements directly to the participant equivalent to 15 
383.35  percent of the average educational debt for indebted graduates 
383.36  in their profession in the year closest to the applicant's 
384.1   selection for which information is available, not to exceed the 
384.2   balance of the participant's qualifying educational loans.  
384.3   Before receiving loan repayment disbursements and as requested, 
384.4   the participant must complete and return to the commissioner an 
384.5   affidavit of practice form provided by the commissioner 
384.6   verifying that the participant is practicing as required under 
384.7   subdivisions 2 and 3.  The participant must provide the 
384.8   commissioner with verification that the full amount of loan 
384.9   repayment disbursement received by the participant has been 
384.10  applied toward the designated loans.  After each disbursement, 
384.11  verification must be received by the commissioner and approved 
384.12  before the next loan repayment disbursement is made.  
384.13  Participants who move their practice remain eligible for loan 
384.14  repayment as long as they practice as required under subdivision 
384.15  2.  
384.16     Subd. 5.  [PENALTY FOR NONFULFILLMENT.] If a participant 
384.17  does not fulfill the required minimum commitment of service 
384.18  according to subdivision 3, the commissioner of health shall 
384.19  collect from the participant the total amount paid to the 
384.20  participant under the loan forgiveness program plus interest at 
384.21  a rate established according to section 270.75.  The 
384.22  commissioner shall deposit the money collected in the health 
384.23  care access fund to be credited to the health professional 
384.24  education loan forgiveness program account established in 
384.25  subdivision 2.  The commissioner shall allow waivers of all or 
384.26  part of the money owed the commissioner as a result of a 
384.27  nonfulfillment penalty if emergency circumstances prevented 
384.28  fulfillment of the minimum service commitment.  
384.29     Subd. 6.  [RULES.] The commissioner may adopt rules to 
384.30  implement this section.  
384.31     Sec. 12.  Minnesota Statutes 2002, section 144.1502, 
384.32  subdivision 4, is amended to read: 
384.33     Subd. 4.  [LOAN FORGIVENESS.] The commissioner of health 
384.34  may accept up to 14 applicants per each year for participation 
384.35  in the loan forgiveness program, within the limits of available 
384.36  funding.  Applicants are responsible for securing their own 
385.1   loans.  The commissioner shall select participants based on 
385.2   their suitability for practice serving public program patients, 
385.3   as indicated by experience or training.  The commissioner shall 
385.4   give preference to applicants who have attended a Minnesota 
385.5   dentistry educational institution and to applicants closest to 
385.6   completing their training.  For each year that a participant 
385.7   meets the service obligation required under subdivision 3, up to 
385.8   a maximum of four years, the commissioner shall make annual 
385.9   disbursements directly to the participant equivalent to $10,000 
385.10  per year of service, not to exceed $40,000 15 percent of the 
385.11  average educational debt for indebted dental school graduates in 
385.12  the year closest to the applicant's selection for which 
385.13  information is available or the balance of the qualifying 
385.14  educational loans, whichever is less.  Before receiving loan 
385.15  repayment disbursements and as requested, the participant must 
385.16  complete and return to the commissioner an affidavit of practice 
385.17  form provided by the commissioner verifying that the participant 
385.18  is practicing as required under subdivision 3.  The participant 
385.19  must provide the commissioner with verification that the full 
385.20  amount of loan repayment disbursement received by the 
385.21  participant has been applied toward the designated loans.  After 
385.22  each disbursement, verification must be received by the 
385.23  commissioner and approved before the next loan repayment 
385.24  disbursement is made.  Participants who move their practice 
385.25  remain eligible for loan repayment as long as they practice as 
385.26  required under subdivision 3. 
385.27     Sec. 13.  Minnesota Statutes 2002, section 147A.08, is 
385.28  amended to read: 
385.29     147A.08 [EXEMPTIONS.] 
385.30     (a) This chapter does not apply to, control, prevent, or 
385.31  restrict the practice, service, or activities of persons listed 
385.32  in section 147.09, clauses (1) to (6) and (8) to (13), persons 
385.33  regulated under section 214.01, subdivision 2, or persons 
385.34  defined in section 144.1495 144.1501, subdivision 1, 
385.35  paragraphs (a) to (d) (e), (g), and (h). 
385.36     (b) Nothing in this chapter shall be construed to require 
386.1   registration of: 
386.2      (1) a physician assistant student enrolled in a physician 
386.3   assistant or surgeon assistant educational program accredited by 
386.4   the Committee on Allied Health Education and Accreditation or by 
386.5   its successor agency approved by the board; 
386.6      (2) a physician assistant employed in the service of the 
386.7   federal government while performing duties incident to that 
386.8   employment; or 
386.9      (3) technicians, other assistants, or employees of 
386.10  physicians who perform delegated tasks in the office of a 
386.11  physician but who do not identify themselves as a physician 
386.12  assistant. 
386.13     Sec. 14.  Minnesota Statutes 2002, section 148.5194, 
386.14  subdivision 1, is amended to read: 
386.15     Subdivision 1.  [FEE PRORATION.] The commissioner shall 
386.16  prorate the registration fee for clinical fellowship, temporary, 
386.17  and first time registrants according to the number of months 
386.18  that have elapsed between the date registration is issued and 
386.19  the date registration expires or must be renewed under section 
386.20  148.5191, subdivision 4.  
386.21     Sec. 15.  Minnesota Statutes 2002, section 148.5194, 
386.22  subdivision 2, is amended to read: 
386.23     Subd. 2.  [BIENNIAL REGISTRATION FEE.] The fee for initial 
386.24  registration and biennial registration, clinical fellowship 
386.25  registration, temporary registration, or renewal is $200.  
386.26     Sec. 16.  Minnesota Statutes 2002, section 148.5194, 
386.27  subdivision 3, is amended to read: 
386.28     Subd. 3.  [BIENNIAL REGISTRATION FEE FOR DUAL 
386.29  REGISTRATION.] The fee for initial registration and biennial 
386.30  registration, clinical fellowship registration, temporary 
386.31  registration, or renewal is $200.  
386.32     Sec. 17.  Minnesota Statutes 2002, section 148.5194, is 
386.33  amended by adding a subdivision to read: 
386.34     Subd. 6.  [VERIFICATION OF CREDENTIAL.] The fee for written 
386.35  verification of credentialed status is $25. 
386.36     Sec. 18.  Minnesota Statutes 2002, section 148.6445, 
387.1   subdivision 7, is amended to read: 
387.2      Subd. 7.  [CERTIFICATION VERIFICATION TO OTHER STATES.] The 
387.3   fee for certification verification of licensure to other states 
387.4   is $25. 
387.5      Sec. 19.  [148C.12] [FEES.] 
387.6      Subdivision 1.  [APPLICATION.] The application fee for a 
387.7   license to practice alcohol and drug counseling is $295. 
387.8      Subd. 2.  [BIENNIAL RENEWAL.] The license renewal fee is 
387.9   $295.  If the commissioner changes the renewal schedule and the 
387.10  expiration date is less than two years, the fee must be prorated.
387.11     Subd. 3.  [TEMPORARY PRACTICE STATUS.] The initial fee for 
387.12  applicants under section 148C.04, subdivision 6, paragraph (a), 
387.13  clause (1), item (i), is $100.  The initial fee for applicants 
387.14  under section 148C.04, subdivision 6, paragraph (a), clause (1), 
387.15  item (ii) or (iii), is the license application fee under 
387.16  subdivision 1.  The fee for annual renewal of temporary practice 
387.17  status is $100.  
387.18     Subd. 4.  [EXAMINATION.] The examination fee is $95 for the 
387.19  written examination and $200 for the oral examination. 
387.20     Subd. 5.  [INACTIVE RENEWAL.] The inactive renewal fee is 
387.21  $150. 
387.22     Subd. 6.  [LATE FEE.] The late fee is 25 percent of the 
387.23  biennial renewal fee, the inactive renewal fee, or the annual 
387.24  fee for renewal of temporary practice status. 
387.25     Subd. 7.  [RENEWAL AFTER EXPIRATION.] The fee for renewal 
387.26  of a license that has expired is the total of the biennial 
387.27  renewal fee, the late fee, and a fee of $100 for review and 
387.28  approval of the continuing education report. 
387.29     Subd. 8.  [LICENSE VERIFICATION.] The fee for license 
387.30  verification to institutions and other jurisdictions is $25. 
387.31     Subd. 9.  [SURCHARGE.] Notwithstanding section 16A.1285, 
387.32  subdivision 2, a surcharge of $172 shall be paid at the time of 
387.33  application for or renewal of an alcohol and drug counseling 
387.34  license until June 30, 2009. 
387.35     Subd. 10.  [RENEWAL FOLLOWING LAPSE IN LICENSING 
387.36  STATUS.] Renewal applications received after the expiration date 
388.1   of the license shall include an amount equal to 50 percent of 
388.2   the renewal fee in addition to the late fee.  
388.3      Subd. 11.  [NONREFUNDABLE FEES.] All fees are nonrefundable.
388.4      Sec. 20.  Minnesota Statutes 2002, section 153A.17, is 
388.5   amended to read: 
388.6      153A.17 [EXPENSES; FEES.] 
388.7      The expenses for administering the certification 
388.8   requirements including the complaint handling system for hearing 
388.9   aid dispensers in sections 153A.14 and 153A.15 and the consumer 
388.10  information center under section 153A.18 must be paid from 
388.11  initial application and examination fees, renewal fees, 
388.12  penalties, and fines.  All fees are nonrefundable.  The 
388.13  certificate application fee is $165 for audiologists registered 
388.14  under section 148.511 and $490 for all others $350, the 
388.15  examination fee is $200 $250 for the written portion and 
388.16  $200 $250 for the practical portion each time one or the other 
388.17  is taken, and the trainee application fee 
388.18  is $100 $200.  Notwithstanding the policy set forth in section 
388.19  16A.1285, subdivision 2, a surcharge of $165 for audiologists 
388.20  registered under section 148.511 and $330 for all others shall 
388.21  be paid at the time of application or renewal until June 30, 
388.22  2003, to recover the commissioner's accumulated direct 
388.23  expenditures for administering the requirements of this 
388.24  chapter.  The penalty fee for late submission of a renewal 
388.25  application is $200.  The fee for verification of certification 
388.26  to other jurisdictions or entities is $25.  All fees, penalties, 
388.27  and fines received must be deposited in the state government 
388.28  special revenue fund.  The commissioner may prorate the 
388.29  certification fee for new applicants based on the number of 
388.30  quarters remaining in the annual certification period. 
388.31     Sec. 21.  Minnesota Statutes 2002, section 256B.69, 
388.32  subdivision 5c, is amended to read: 
388.33     Subd. 5c.  [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 
388.34  commissioner of human services shall transfer each year to the 
388.35  medical education and research fund established under section 
388.36  62J.692, the following: 
389.1      (1) an amount equal to the reduction in the prepaid medical 
389.2   assistance and prepaid general assistance medical care payments 
389.3   as specified in this clause.  Until January 1, 2002, the county 
389.4   medical assistance and general assistance medical care 
389.5   capitation base rate prior to plan specific adjustments and 
389.6   after the regional rate adjustments under section 256B.69, 
389.7   subdivision 5b, is reduced 6.3 percent for Hennepin county, two 
389.8   percent for the remaining metropolitan counties, and no 
389.9   reduction for nonmetropolitan Minnesota counties; and after 
389.10  January 1, 2002, the county medical assistance and general 
389.11  assistance medical care capitation base rate prior to plan 
389.12  specific adjustments is reduced 6.3 percent for Hennepin county, 
389.13  two percent for the remaining metropolitan counties, and 1.6 
389.14  percent for nonmetropolitan Minnesota counties.  Nursing 
389.15  facility and elderly waiver payments and demonstration project 
389.16  payments operating under subdivision 23 are excluded from this 
389.17  reduction.  The amount calculated under this clause shall not be 
389.18  adjusted for periods already paid due to subsequent changes to 
389.19  the capitation payments; 
389.20     (2) beginning July 1, 2001, $2,537,000 $2,157,000 from the 
389.21  capitation rates paid under this section plus any federal 
389.22  matching funds on this amount; 
389.23     (3) beginning July 1, 2002, an additional $12,700,000 from 
389.24  the capitation rates paid under this section; and 
389.25     (4) beginning July 1, 2003, an additional $4,700,000 from 
389.26  the capitation rates paid under this section. 
389.27     (b) This subdivision shall be effective upon approval of a 
389.28  federal waiver which allows federal financial participation in 
389.29  the medical education and research fund. 
389.30     Sec. 22.  Minnesota Statutes 2002, section 295.55, 
389.31  subdivision 2, is amended to read: 
389.32     Subd. 2.  [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a) 
389.33  Each hospital or surgical center must make estimated payments of 
389.34  the taxes for the calendar year in monthly installments to the 
389.35  commissioner within 15 days after the end of the month. 
389.36     (b) Estimated tax payments are not required of hospitals or 
390.1   surgical centers if:  (1) the tax for the current calendar year 
390.2   is less than $500; or (2) the tax for the previous calendar year 
390.3   is less than $500, if the taxpayer had a tax liability and was 
390.4   doing business the entire year; or (3) if a hospital has been 
390.5   allowed a grant under section 144.1484, subdivision 2, for the 
390.6   year. 
390.7      (c) Underpayment of estimated installments bear interest at 
390.8   the rate specified in section 270.75, from the due date of the 
390.9   payment until paid or until the due date of the annual return 
390.10  whichever comes first.  An underpayment of an estimated 
390.11  installment is the difference between the amount paid and the 
390.12  lesser of (1) 90 percent of one-twelfth of the tax for the 
390.13  calendar year or (2) one-twelfth of the total tax for the 
390.14  previous calendar year if the taxpayer had a tax liability and 
390.15  was doing business the entire year. 
390.16     Sec. 23.  Minnesota Statutes 2002, section 326.42, is 
390.17  amended to read: 
390.18     326.42 [APPLICATIONS, FEES.] 
390.19     Subdivision 1.  [APPLICATION.] Applications for plumber's 
390.20  license shall be made to the state commissioner of health, with 
390.21  fee.  Unless the applicant is entitled to a renewal, the 
390.22  applicant shall be licensed by the state commissioner of health 
390.23  only after passing a satisfactory examination by the examiners 
390.24  showing fitness.  Examination fees for both journeyman and 
390.25  master plumbers shall be in an amount prescribed by the state 
390.26  commissioner of health pursuant to section 144.122.  Upon being 
390.27  notified that of having successfully passed the examination for 
390.28  original license the applicant shall submit an application, with 
390.29  the license fee herein provided.  License fees shall be in an 
390.30  amount prescribed by the state commissioner of health pursuant 
390.31  to section 144.122.  Licenses shall expire and be renewed as 
390.32  prescribed by the commissioner pursuant to section 144.122. 
390.33     Subd. 2.  [FEES.] Plumbing system plans and specifications 
390.34  that are submitted to the commissioner for review shall be 
390.35  accompanied by the appropriate plan examination fees.  If the 
390.36  commissioner determines, upon review of the plans, that 
391.1   inadequate fees were paid, the necessary additional fees shall 
391.2   be paid prior to plan approval.  The commissioner shall charge 
391.3   the following fees for plan reviews and audits of plumbing 
391.4   installations for public, commercial, and industrial buildings:  
391.5      (1) systems with both water distribution and drain, waste, 
391.6   and vent systems and having:  
391.7      (i) 25 or fewer drainage fixture units, $150; 
391.8      (ii) 26 to 50 drainage fixture units, $250; 
391.9      (iii) 51 to 150 drainage fixture units, $350; 
391.10     (iv) 151 to 249 drainage fixture units, $500; 
391.11     (v) 250 or more drainage fixture units, $3 per drainage 
391.12  fixture unit to a maximum of $4,000; and 
391.13     (vi) interceptors, separators, or catch basins, $70 per 
391.14  interceptor, separator, or catch basin; 
391.15     (2) building sewer service only, $150; 
391.16     (3) building water service only, $150; 
391.17     (4) building water distribution system only, no drainage 
391.18  system, $5 per supply fixture unit or $150, whichever is 
391.19  greater; 
391.20     (5) storm drainage system, a minimum fee of $150 or: 
391.21     (i) $50 per drain opening, up to a maximum of $500; and 
391.22     (ii) $70 per interceptor, separator, or catch basin; 
391.23     (6) manufactured home park or campground, 1 to 25 sites, 
391.24  $300; 
391.25     (7) manufactured home park or campground, 26 to 50 sites, 
391.26  $350; 
391.27     (8) manufactured home park or campground, 51 to 125 sites, 
391.28  $400; 
391.29     (9) manufactured home park or campground, more than 125 
391.30  sites, $500; 
391.31     (10) accelerated review, double the regular fee, one-half 
391.32  to be refunded if no response from the commissioner within 15 
391.33  business days; and 
391.34     (11) revision to previously reviewed or incomplete plans: 
391.35     (i) review of plans for which commissioner has issued two 
391.36  or more requests for additional information, per review, $100 or 
392.1   ten percent of the original fee, whichever is greater; 
392.2      (ii) proposer-requested revision with no increase in 
392.3   project scope, $50 or ten percent of original fee, whichever is 
392.4   greater; and 
392.5      (iii) proposer-requested revision with an increase in 
392.6   project scope, $50 plus the difference between the original 
392.7   project fee and the revised project fee. 
392.8      Sec. 24.  [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 
392.9      (a) The commissioner's authority to collect the certificate 
392.10  application fee from hearing instrument dispensers under 
392.11  Minnesota Statutes, section 153A.17, is suspended for certified 
392.12  hearing instrument dispensers renewing certification in fiscal 
392.13  year 2004. 
392.14     (b) The commissioner's authority to collect the license 
392.15  renewal fee from occupational therapy practitioners under 
392.16  Minnesota Statutes, section 148.6445, subdivision 2, is 
392.17  suspended for fiscal years 2004 and 2005. 
392.18     Sec. 25.  [REVISOR'S INSTRUCTION.] 
392.19     (a) The revisor of statutes shall delete the reference to 
392.20  "144.1495" in Minnesota Statutes, section 62Q.145, and insert 
392.21  "144.1501." 
392.22     (b) For sections in Minnesota Statutes and Minnesota Rules 
392.23  affected by the repealed sections in this article, the revisor 
392.24  shall delete internal cross-references where appropriate and 
392.25  make changes necessary to correct the punctuation, grammar, or 
392.26  structure of the remaining text and preserve its meaning. 
392.27     Sec. 26.  [REPEALER.] 
392.28     (a) Minnesota Statutes 2002, sections 62J.694, subdivisions 
392.29  1, 2, 2a, and 3; 144.126; 144.1484; 144.1494; 144.1495; 
392.30  144.1496; 144.1497; 144.395, subdivisions 1 and 2; 144.396; 
392.31  144A.36; 144A.38; 148.5194, subdivision 3a; and 148.6445, 
392.32  subdivision 9, are repealed.  
392.33     (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 
392.34  4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 
392.35  4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 
392.36  4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270; 
393.1   4763.0285; 4763.0295; and 4763.0300, are repealed. 
393.2                              ARTICLE 9 
393.3                      LOCAL PUBLIC HEALTH GRANTS
393.4      Section 1.  Minnesota Statutes 2002, section 144E.11, 
393.5   subdivision 6, is amended to read: 
393.6      Subd. 6.  [REVIEW CRITERIA.] When reviewing an application 
393.7   for licensure, the board and administrative law judge shall 
393.8   consider the following factors: 
393.9      (1) the relationship of the proposed service or expansion 
393.10  in primary service area to the current community health plan as 
393.11  approved by the commissioner of health under section 145A.12, 
393.12  subdivision 4; 
393.13     (2) the recommendations or comments of the governing bodies 
393.14  of the counties, municipalities, community health boards as 
393.15  defined under section 145A.09, subdivision 2, and regional 
393.16  emergency medical services system designated under section 
393.17  144E.50 in which the service would be provided; 
393.18     (3) (2) the deleterious effects on the public health from 
393.19  duplication, if any, of ambulance services that would result 
393.20  from granting the license; 
393.21     (4) (3) the estimated effect of the proposed service or 
393.22  expansion in primary service area on the public health; and 
393.23     (5) (4) whether any benefit accruing to the public health 
393.24  would outweigh the costs associated with the proposed service or 
393.25  expansion in primary service area.  The administrative law judge 
393.26  shall recommend that the board either grant or deny a license or 
393.27  recommend that a modified license be granted.  The reasons for 
393.28  the recommendation shall be set forth in detail.  The 
393.29  administrative law judge shall make the recommendations and 
393.30  reasons available to any individual requesting them.  
393.31     Sec. 2.  Minnesota Statutes 2002, section 145.88, is 
393.32  amended to read: 
393.33     145.88 [PURPOSE.] 
393.34     The legislature finds that it is in the public interest to 
393.35  assure:  
393.36     (a) statewide planning and coordination of maternal and 
394.1   child health services through the acquisition and analysis of 
394.2   population-based health data, provision of technical support and 
394.3   training, and coordination of the various public and private 
394.4   maternal and child health efforts; and 
394.5      (b) support for targeted maternal and child health services 
394.6   in communities with significant populations of high risk, low 
394.7   income families through a grants process.  
394.8      Federal money received by the Minnesota department of 
394.9   health, pursuant to United States Code, title 42, sections 701 
394.10  to 709, shall be expended to:  
394.11     (1) assure access to quality maternal and child health 
394.12  services for mothers and children, especially those of low 
394.13  income and with limited availability to health services and 
394.14  those children at risk of physical, neurological, emotional, and 
394.15  developmental problems arising from chemical abuse by a mother 
394.16  during pregnancy; 
394.17     (2) reduce infant mortality and the incidence of 
394.18  preventable diseases and handicapping conditions among children; 
394.19     (3) reduce the need for inpatient and long-term care 
394.20  services and to otherwise promote the health of mothers and 
394.21  children, especially by providing preventive and primary care 
394.22  services for low-income mothers and children and prenatal, 
394.23  delivery and postpartum care for low-income mothers; 
394.24     (4) provide rehabilitative services for blind and disabled 
394.25  children under age 16 receiving benefits under title XVI of the 
394.26  Social Security Act; and 
394.27     (5) provide and locate medical, surgical, corrective and 
394.28  other service for children who are crippled or who are suffering 
394.29  from conditions that lead to crippling.  
394.30     Sec. 3.  Minnesota Statutes 2002, section 145.881, 
394.31  subdivision 2, is amended to read: 
394.32     Subd. 2.  [DUTIES.] The advisory task force shall meet on a 
394.33  regular basis to perform the following duties:  
394.34     (a) review and report on the health care needs of mothers 
394.35  and children throughout the state of Minnesota; 
394.36     (b) review and report on the type, frequency and impact of 
395.1   maternal and child health care services provided to mothers and 
395.2   children under existing maternal and child health care programs, 
395.3   including programs administered by the commissioner of health; 
395.4      (c) establish, review, and report to the commissioner a 
395.5   list of program guidelines and criteria which the advisory task 
395.6   force considers essential to providing an effective maternal and 
395.7   child health care program to low income populations and high 
395.8   risk persons and fulfilling the purposes defined in section 
395.9   145.88; 
395.10     (d) review staff recommendations of the department of 
395.11  health regarding maternal and child health grant awards before 
395.12  the awards are made; 
395.13     (e) make recommendations to the commissioner for the use of 
395.14  other federal and state funds available to meet maternal and 
395.15  child health needs; 
395.16     (f) (e) make recommendations to the commissioner of health 
395.17  on priorities for funding the following maternal and child 
395.18  health services:  (1) prenatal, delivery and postpartum care, (2)
395.19  comprehensive health care for children, especially from birth 
395.20  through five years of age, (3) adolescent health services, (4) 
395.21  family planning services, (5) preventive dental care, (6) 
395.22  special services for chronically ill and handicapped children 
395.23  and (7) any other services which promote the health of mothers 
395.24  and children; and 
395.25     (g) make recommendations to the commissioner of health on 
395.26  the process to distribute, award and administer the maternal and 
395.27  child health block grant funds; and 
395.28     (h) review the measures that are used to define the 
395.29  variables of the funding distribution formula in section 
395.30  145.882, subdivision 4, every two years and make recommendations 
395.31  to the commissioner of health for changes based upon principles 
395.32  established by the advisory task force for this purpose.  
395.33     (f) establish, in consultation with the commissioner and 
395.34  the state community health advisory committee established under 
395.35  section 145A.10, subdivision 10, paragraph (a), statewide 
395.36  outcomes that will improve the health status of mothers and 
396.1   children as required in section 145A.12, subdivision 7. 
396.2      Sec. 4.  Minnesota Statutes 2002, section 145.882, 
396.3   subdivision 1, is amended to read: 
396.4      Subdivision 1.  [FUNDING LEVELS AND ADVISORY TASK FORCE 
396.5   REVIEW.] Any decrease in the amount of federal funding to the 
396.6   state for the maternal and child health block grant must be 
396.7   apportioned to reflect a proportional decrease for each 
396.8   recipient.  Any increase in the amount of federal funding to the 
396.9   state must be distributed under subdivisions 2, and 3, and 4. 
396.10     The advisory task force shall review and recommend the 
396.11  proportion of maternal and child health block grant funds to be 
396.12  expended for indirect costs, direct services and special 
396.13  projects.  
396.14     Sec. 5.  Minnesota Statutes 2002, section 145.882, 
396.15  subdivision 2, is amended to read: 
396.16     Subd. 2.  [ALLOCATION TO THE COMMISSIONER OF HEALTH.] 
396.17  Beginning January 1, 1986, up to one-third of the total maternal 
396.18  and child health block grant money may be retained by the 
396.19  commissioner of health for administrative and technical 
396.20  assistance services, projects of regional or statewide 
396.21  significance, direct services to children with handicaps, and 
396.22  other activities of the commissioner. to: 
396.23     (1) meet federal maternal and child block grant 
396.24  requirements of a statewide needs assessment every five years 
396.25  and prepare the annual federal block grant application and 
396.26  report; 
396.27     (2) collect and disseminate statewide data on the health 
396.28  status of mothers and children; 
396.29     (3) provide technical assistance to community health boards 
396.30  in meeting statewide outcomes under section 145A.12, subdivision 
396.31  7; 
396.32     (4) evaluate the impact of maternal and child health 
396.33  activities on the health status of mothers and children; 
396.34     (5) provide services to children under age 16 receiving 
396.35  benefits under title XVI of the Social Security Act; and 
396.36     (6) perform other maternal and child health activities 
397.1   listed in section 145.88 and as deemed necessary by the 
397.2   commissioner. 
397.3      Sec. 6.  Minnesota Statutes 2002, section 145.882, 
397.4   subdivision 3, is amended to read: 
397.5      Subd. 3.  [ALLOCATION TO COMMUNITY HEALTH SERVICES 
397.6   AREAS BOARDS.] (a) The maternal and child health block grant 
397.7   money remaining after distributions made under subdivision 2 
397.8   must be allocated according to the formula in subdivision 4 to 
397.9   community health services areas section 145A.131, subdivision 2, 
397.10  for distribution by to community health boards. as defined in 
397.11  section 145A.02, subdivision 5, to qualified programs that 
397.12  provide essential services within the community health services 
397.13  area as long as:  
397.14     (1) the Minneapolis community health service area is 
397.15  allocated at least $1,626,215 per year; 
397.16     (2) the St. Paul community health service area is allocated 
397.17  at least $822,931 per year; and 
397.18     (3) all other community health service areas are allocated 
397.19  at least $30,000 per county per year or their 1988-1989 funding 
397.20  cycle award, whichever is less. 
397.21     (b) Notwithstanding paragraph (a), if the total amount of 
397.22  maternal and child health block grant funding decreases, the 
397.23  decrease must be apportioned to reflect a proportional decrease 
397.24  for each recipient, including recipients who would otherwise 
397.25  receive a guaranteed minimum allocation under paragraph (a). 
397.26     Sec. 7.  Minnesota Statutes 2002, section 145.882, is 
397.27  amended by adding a subdivision to read:  
397.28     Subd. 5a.  [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a 
397.29  community health board decides not to participate in maternal 
397.30  and child health block grant activities under subdivision 3 or 
397.31  the commissioner determines under section 145A.131, subdivision 
397.32  7, not to fund the community health board, the commissioner is 
397.33  responsible for directing maternal and child health block grant 
397.34  activities in that community health board's geographic area.  
397.35  The commissioner may elect to directly provide public health 
397.36  activities to meet the statewide outcomes or to contract with 
398.1   other governmental units or nonprofit organizations. 
398.2      Sec. 8.  Minnesota Statutes 2002, section 145.882, 
398.3   subdivision 7, is amended to read: 
398.4      Subd. 7.  [USE OF BLOCK GRANT MONEY.] (a) Maternal and 
398.5   child health block grant money allocated to a community health 
398.6   board or community health services area under this section must 
398.7   be used for qualified programs for high risk and low-income 
398.8   individuals.  Block grant money must be used for programs that: 
398.9      (1) specifically address the highest risk populations, 
398.10  particularly low-income and minority groups with a high rate of 
398.11  infant mortality and children with low birth weight, by 
398.12  providing services, including prepregnancy family planning 
398.13  services, calculated to produce measurable decreases in infant 
398.14  mortality rates, instances of children with low birth weight, 
398.15  and medical complications associated with pregnancy and 
398.16  childbirth, including infant mortality, low birth rates, and 
398.17  medical complications arising from chemical abuse by a mother 
398.18  during pregnancy; 
398.19     (2) specifically target pregnant women whose age, medical 
398.20  condition, maternal history, or chemical abuse substantially 
398.21  increases the likelihood of complications associated with 
398.22  pregnancy and childbirth or the birth of a child with an 
398.23  illness, disability, or special medical needs; 
398.24     (3) specifically address the health needs of young children 
398.25  who have or are likely to have a chronic disease or disability 
398.26  or special medical needs, including physical, neurological, 
398.27  emotional, and developmental problems that arise from chemical 
398.28  abuse by a mother during pregnancy; 
398.29     (4) provide family planning and preventive medical care for 
398.30  specifically identified target populations, such as minority and 
398.31  low-income teenagers, in a manner calculated to decrease the 
398.32  occurrence of inappropriate pregnancy and minimize the risk of 
398.33  complications associated with pregnancy and childbirth; or 
398.34     (5) specifically address the frequency and severity of 
398.35  childhood and adolescent health issues, including injuries in 
398.36  high risk target populations by providing services calculated to 
399.1   produce measurable decreases in mortality and morbidity.; 
399.2   However, money may be used for this purpose only if the 
399.3   community health board's application includes program components 
399.4   for the purposes in clauses (1) to (4) in the proposed 
399.5   geographic service area and the total expenditure for 
399.6   injury-related programs under this clause does not exceed ten 
399.7   percent of the total allocation under subdivision 3. 
399.8      (b) Maternal and child health block grant money may be used 
399.9   for purposes other than the purposes listed in this subdivision 
399.10  only under the following conditions:  
399.11     (1) the community health board or community health services 
399.12  area can demonstrate that existing programs fully address the 
399.13  needs of the highest risk target populations described in this 
399.14  subdivision; or 
399.15     (2) the money is used to continue projects that received 
399.16  funding before creation of the maternal and child health block 
399.17  grant in 1981. 
399.18     (c) Projects that received funding before creation of the 
399.19  maternal and child health block grant in 1981, must be allocated 
399.20  at least the amount of maternal and child health special project 
399.21  grant funds received in 1989, unless (1) the local board of 
399.22  health provides equivalent alternative funding for the project 
399.23  from another source; or (2) the local board of health 
399.24  demonstrates that the need for the specific services provided by 
399.25  the project has significantly decreased as a result of changes 
399.26  in the demographic characteristics of the population, or other 
399.27  factors that have a major impact on the demand for services.  If 
399.28  the amount of federal funding to the state for the maternal and 
399.29  child health block grant is decreased, these projects must 
399.30  receive a proportional decrease as required in subdivision 1.  
399.31  Increases in allocation amounts to local boards of health under 
399.32  subdivision 4 may be used to increase funding levels for these 
399.33  projects. 
399.34     (6) specifically address preventing child abuse and 
399.35  neglect, reducing juvenile delinquency, promoting positive 
399.36  parenting and resiliency in children, and promoting family 
400.1   health and economic sufficiency through public health nurse home 
400.2   visits under section 145A.17; or 
400.3      (7) specifically address nutritional issues of women, 
400.4   infants, and young children through WIC clinic services. 
400.5      Sec. 9.  [145.8821] [ACCOUNTABILITY.] 
400.6      (a) Coordinating with the statewide outcomes established 
400.7   under section 145A.12, subdivision 7, and with accountability 
400.8   measures outlined in section 145A.131, subdivision 7, each 
400.9   community health board that receives money under section 
400.10  145.882, subdivision 3, shall select by February 1, 2005, and 
400.11  every five years thereafter, up to two statewide maternal and 
400.12  child health outcomes. 
400.13     (b) For the period January 1, 2004, to December 31, 2005, 
400.14  each community health board must work to achieve the Healthy 
400.15  People 2010 goal to reduce the state's percentage of low birth 
400.16  weight infants to no more than five percent of all births. 
400.17     (c) The commissioner shall monitor and evaluate whether 
400.18  each community health board has made sufficient progress toward 
400.19  the statewide outcomes established in paragraph (b) and under 
400.20  section 145A.12, subdivision 7. 
400.21     (d) Community health boards shall provide the commissioner 
400.22  with annual information necessary to evaluate progress toward 
400.23  statewide outcomes and to meet federal reporting requirements. 
400.24     Sec. 10.  Minnesota Statutes 2002, section 145.883, 
400.25  subdivision 1, is amended to read: 
400.26     Subdivision 1.  [SCOPE.] For purposes of sections 145.881 
400.27  to 145.888 145.883, the terms defined in this section shall have 
400.28  the meanings given them.  
400.29     Sec. 11.  Minnesota Statutes 2002, section 145.883, 
400.30  subdivision 9, is amended to read: 
400.31     Subd. 9.  [COMMUNITY HEALTH SERVICES AREA BOARD.] 
400.32  "Community health services area board" means a city, county, or 
400.33  multicounty area that is organized as a community health board 
400.34  under section 145A.09 and for which a state subsidy is received 
400.35  under sections 145A.09 to 145A.13 a board of health established, 
400.36  operating, and eligible for a local public health grant under 
401.1   sections 145A.09 to 145A.131. 
401.2      Sec. 12.  Minnesota Statutes 2002, section 145A.02, 
401.3   subdivision 5, is amended to read: 
401.4      Subd. 5.  [COMMUNITY HEALTH BOARD.] "Community health 
401.5   board" means a board of health established, operating, and 
401.6   eligible for a subsidy local public health grant under sections 
401.7   145A.09 to 145A.13 145A.131. 
401.8      Sec. 13.  Minnesota Statutes 2002, section 145A.02, 
401.9   subdivision 6, is amended to read: 
401.10     Subd. 6.  [COMMUNITY HEALTH SERVICES.] "Community health 
401.11  services" means activities designed to protect and promote the 
401.12  health of the general population within a community health 
401.13  service area by emphasizing the prevention of disease, injury, 
401.14  disability, and preventable death through the promotion of 
401.15  effective coordination and use of community resources, and by 
401.16  extending health services into the community.  Program 
401.17  categories of community health services include disease 
401.18  prevention and control, emergency medical care, environmental 
401.19  health, family health, health promotion, and home health care. 
401.20     Sec. 14.  Minnesota Statutes 2002, section 145A.02, 
401.21  subdivision 7, is amended to read: 
401.22     Subd. 7.  [COMMUNITY HEALTH SERVICE AREA.] "Community 
401.23  health service area" means a city, county, or multicounty area 
401.24  that is organized as a community health board under section 
401.25  145A.09 and for which a subsidy local public health grant is 
401.26  received under sections 145A.09 to 145A.13 145A.131. 
401.27     Sec. 15.  Minnesota Statutes 2002, section 145A.06, 
401.28  subdivision 1, is amended to read: 
401.29     Subdivision 1.  [GENERALLY.] In addition to other powers 
401.30  and duties provided by law, the commissioner has the powers 
401.31  listed in subdivisions 2 to 4 5. 
401.32     Sec. 16.  Minnesota Statutes 2002, section 145A.09, 
401.33  subdivision 2, is amended to read: 
401.34     Subd. 2.  [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of 
401.35  health that meets the requirements of sections 145A.09 
401.36  to 145A.13 145A.131 is a community health board and is eligible 
402.1   for a community health subsidy local public health grant under 
402.2   section 145A.13 145A.131. 
402.3      Sec. 17.  Minnesota Statutes 2002, section 145A.09, 
402.4   subdivision 4, is amended to read: 
402.5      Subd. 4.  [CITIES.] A city that received a subsidy under 
402.6   section 145A.13 and that meets the requirements of sections 
402.7   145A.09 to 145A.13 145A.131 is eligible for a community health 
402.8   subsidy local public health grant under section 
402.9   145A.13 145A.131. 
402.10     Sec. 18.  Minnesota Statutes 2002, section 145A.09, 
402.11  subdivision 7, is amended to read: 
402.12     Subd. 7.  [WITHDRAWAL.] (a) A county or city that has 
402.13  established or joined a community health board may withdraw from 
402.14  the subsidy local public health grant program authorized by 
402.15  sections 145A.09 to 145A.13 145A.131 by resolution of its 
402.16  governing body in accordance with section 145A.03, subdivision 
402.17  3, and this subdivision. 
402.18     (b) A county or city may not withdraw from a joint powers 
402.19  community health board during the first two calendar years 
402.20  following that county's or city's initial adoption of the joint 
402.21  powers agreement.  
402.22     (c) The withdrawal of a county or city from a community 
402.23  health board does not affect the eligibility for the community 
402.24  health subsidy local public health grant of any remaining county 
402.25  or city for one calendar year following the effective date of 
402.26  withdrawal. 
402.27     (d) The amount of additional annual payment for calendar 
402.28  year 1985 made pursuant to Minnesota Statutes 1984, section 
402.29  145.921, subdivision 4, must be subtracted from the subsidy for 
402.30  a county that, due to withdrawal from a community health board, 
402.31  ceases to meet the terms and conditions under which that 
402.32  additional annual payment was made The local public health grant 
402.33  for a county that chooses to withdraw from a multicounty 
402.34  community health board shall be reduced by the amount of the 
402.35  local partnership incentive under section 145A.131, subdivision 
402.36  2, paragraph (c). 
403.1      Sec. 19.  Minnesota Statutes 2002, section 145A.10, 
403.2   subdivision 2, is amended to read: 
403.3      Subd. 2.  [PREEMPTION.] (a) Not later than 365 days after 
403.4   the approval of a community health plan by the 
403.5   commissioner formation of a community health board, any other 
403.6   board of health within the community health service area for 
403.7   which the plan has been prepared must cease operation, except as 
403.8   authorized in a joint powers agreement under section 145A.03, 
403.9   subdivision 2, or delegation agreement under section 145A.07, 
403.10  subdivision 2, or as otherwise allowed by this subdivision. 
403.11     (b) This subdivision does not preempt or otherwise change 
403.12  the powers and duties of any city or county eligible for subsidy 
403.13  a local public health grant under section 145A.09. 
403.14     (c) This subdivision does not preempt the authority to 
403.15  operate a community health services program of any city of the 
403.16  first or second class operating an existing program of community 
403.17  health services located within a county with a population of 
403.18  300,000 or more persons until the city council takes action to 
403.19  allow the county to preempt the city's powers and duties. 
403.20     Sec. 20.  Minnesota Statutes 2002, section 145A.10, is 
403.21  amended by adding a subdivision to read: 
403.22     Subd. 5a.  [DUTIES.] (a) Consistent with the guidelines and 
403.23  standards established under section 145A.12, and in consultation 
403.24  with the community health advisory committee established under 
403.25  subdivision 10, paragraph (b), the community health board shall: 
403.26     (1) establish local public health priorities based on an 
403.27  assessment of community health needs and assets; and 
403.28     (2) determine the mechanisms by which the community health 
403.29  board will address the local public health priorities 
403.30  established under clause (1) and achieve the statewide outcomes 
403.31  established under sections 145.8821 and 145A.12, subdivision 7, 
403.32  including leveraging local and regional partnerships and 
403.33  contracting with community-based organizations, private sector 
403.34  organizations, or other units of government, including tribal 
403.35  governments.  In determining the mechanisms to address local 
403.36  public health priorities and achieve statewide outcomes, the 
404.1   community health board shall consider the recommendations of the 
404.2   community health advisory committee and the following essential 
404.3   public health services: 
404.4      (i) monitor health status to identify community health 
404.5   problems; 
404.6      (ii) diagnose and investigate problems and health hazards 
404.7   in the community; 
404.8      (iii) inform, educate, and empower people about health 
404.9   issues; 
404.10     (iv) mobilize community partnerships to identify and solve 
404.11  health problems; 
404.12     (v) develop policies and plans that support individual and 
404.13  community health efforts; 
404.14     (vi) enforce laws and regulations that protect health and 
404.15  ensure safety; 
404.16     (vii) link people to needed personal health care services; 
404.17     (viii) ensure a competent public health and personal health 
404.18  care workforce; 
404.19     (ix) evaluate effectiveness, accessibility, and quality of 
404.20  personal and population-based health services; and 
404.21     (x) research for new insights and innovative solutions to 
404.22  health problems. 
404.23     (b) By February 1, 2005, and every five years thereafter, 
404.24  each community health board that receives a local public health 
404.25  grant under section 145A.131 shall notify the commissioner in 
404.26  writing of the statewide outcomes established under sections 
404.27  145.8821 and 145A.12, subdivision 7, that the board will address 
404.28  and the local priorities established under paragraph (a) that 
404.29  the board will address. 
404.30     (c) Each community health board receiving a local public 
404.31  health grant under section 145A.131 must submit an annual report 
404.32  to the commissioner documenting progress towards the achievement 
404.33  of statewide outcomes established under sections 145.8821 and 
404.34  145A.12, subdivision 7, and the local public health priorities 
404.35  established under paragraph (a), using reporting standards and 
404.36  procedures established by the commissioner and in compliance 
405.1   with all applicable federal requirements.  If a community health 
405.2   board has identified additional local priorities for use of the 
405.3   local public health grant since the last notification of 
405.4   outcomes and priorities under paragraph (b), the community 
405.5   health board shall notify the commissioner of the additional 
405.6   local public health priorities in the annual report. 
405.7      Sec. 21.  Minnesota Statutes 2002, section 145A.10, 
405.8   subdivision 10, is amended to read: 
405.9      Subd. 10.  [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 
405.10  state community health advisory committee is established to 
405.11  advise, consult with, and make recommendations to the 
405.12  commissioner on the development, maintenance, funding, and 
405.13  evaluation of community health services.  Each community health 
405.14  board may appoint a member to serve on the committee.  The 
405.15  committee must meet at least quarterly, and special meetings may 
405.16  be called by the committee chair or a majority of the members.  
405.17  Members or their alternates may receive a per diem and must be 
405.18  reimbursed for travel and other necessary expenses while engaged 
405.19  in their official duties.  
405.20     (b) The city councils or county boards that have 
405.21  established or are members of a community health board must 
405.22  appoint a community health advisory committee to advise, consult 
405.23  with, and make recommendations to the community health board on 
405.24  matters relating to the development, maintenance, funding, and 
405.25  evaluation of community health services.  The committee must 
405.26  consist of at least five members and must be generally 
405.27  representative of the population and health care providers of 
405.28  the community health service area.  The committee must meet at 
405.29  least three times a year and at the call of the chair or a 
405.30  majority of the members.  Members may receive a per diem and 
405.31  reimbursement for travel and other necessary expenses while 
405.32  engaged in their official duties. 
405.33     (c) State and local advisory committees must adopt bylaws 
405.34  or operating procedures that specify the length of terms of 
405.35  membership, procedures for assuring that no more than half of 
405.36  these terms expire during the same year, and other matters 
406.1   relating to the conduct of committee business.  Bylaws or 
406.2   operating procedures may allow one alternate to be appointed for 
406.3   each member of a state or local advisory committee.  Alternates 
406.4   may be given full or partial powers and duties of members the 
406.5   duties under subdivision 5a.  The committee must be broadly 
406.6   representative, including health care, nonprofit, private 
406.7   sector, and consumer members, and must reflect the racial and 
406.8   ethnic populations within the geographic area served by the 
406.9   community health board.  The community health advisory committee 
406.10  shall recommend to the community health board mechanisms by 
406.11  which community resources can most effectively be used to 
406.12  achieve local public health priorities and statewide outcomes 
406.13  with local public health grant funds, including leveraging local 
406.14  and regional partnerships and contracting with community-based 
406.15  organizations, private sector organizations, or other units of 
406.16  government, including tribal governments.  
406.17     Sec. 22.  Minnesota Statutes 2002, section 145A.11, 
406.18  subdivision 2, is amended to read: 
406.19     Subd. 2.  [CONSIDERATION OF COMMUNITY HEALTH PLAN LOCAL 
406.20  PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In 
406.21  levying taxes authorized under section 145A.08, subdivision 3, a 
406.22  city council or county board that has formed or is a member of a 
406.23  community health board must consider the income and expenditures 
406.24  required to meet the objectives of the community health plan for 
406.25  its area local public health priorities established under 
406.26  section 145A.10, subdivision 5a, and statewide outcomes 
406.27  established under section 145A.12, subdivision 7. 
406.28     Sec. 23.  Minnesota Statutes 2002, section 145A.11, 
406.29  subdivision 4, is amended to read: 
406.30     Subd. 4.  [ORDINANCES RELATING TO COMMUNITY HEALTH 
406.31  SERVICES.] A city council or county board that has established 
406.32  or is a member of a community health board may by ordinance 
406.33  adopt and enforce minimum standards for services provided 
406.34  according to sections 145A.02 and 145A.10, subdivision 5.  An 
406.35  ordinance must not conflict with state law or with more 
406.36  stringent standards established either by rule of an agency of 
407.1   state government or by the provisions of the charter or 
407.2   ordinances of any city organized under section 145A.09, 
407.3   subdivision 4. 
407.4      Sec. 24.  Minnesota Statutes 2002, section 145A.12, 
407.5   subdivision 1, is amended to read: 
407.6      Subdivision 1.  [ADMINISTRATIVE AND PROGRAM SUPPORT.] The 
407.7   commissioner must assist community health boards in the 
407.8   development, administration, and implementation of community 
407.9   health services.  This assistance may consist of but is not 
407.10  limited to: 
407.11     (1) informational resources, consultation, and training to 
407.12  help community health boards plan, develop, integrate, provide 
407.13  and evaluate community health services; and 
407.14     (2) administrative and program guidelines and standards, 
407.15  developed with the advice of the state community health advisory 
407.16  committee.  Adoption of these guidelines by a community health 
407.17  board is not a prerequisite for plan approval as prescribed in 
407.18  subdivision 4. 
407.19     Sec. 25.  Minnesota Statutes 2002, section 145A.12, 
407.20  subdivision 2, is amended to read: 
407.21     Subd. 2.  [PERSONNEL STANDARDS.] In accordance with chapter 
407.22  14, and in consultation with the state community health advisory 
407.23  committee, the commissioner may adopt rules to set standards for 
407.24  administrative and program personnel to ensure competence in 
407.25  administration and planning and in each program area defined in 
407.26  section 145A.02. 
407.27     Sec. 26.  Minnesota Statutes 2002, section 145A.12, is 
407.28  amended by adding a subdivision to read:  
407.29     Subd. 7.  [STATEWIDE OUTCOMES.] (a) The commissioner, in 
407.30  consultation with the state community health advisory committee 
407.31  established under section 145A.10, subdivision 10, paragraph 
407.32  (a), shall establish statewide outcomes for local public health 
407.33  grant funds allocated to community health boards between January 
407.34  1, 2004, and December 31, 2005. 
407.35     (b) At least one statewide outcome must be established in 
407.36  each of the following public health areas: 
408.1      (1) preventing diseases; 
408.2      (2) protecting against environmental hazards; 
408.3      (3) preventing injuries; 
408.4      (4) promoting healthy behavior; 
408.5      (5) responding to disasters; and 
408.6      (6) ensuring access to health services. 
408.7      (c) The commissioner shall use Minnesota's public health 
408.8   goals established under section 62J.212 and the essential public 
408.9   health services under section 145A.10, subdivision 5a, as a 
408.10  basis for the development of statewide outcomes. 
408.11     (d) The statewide maternal and child health outcomes 
408.12  established under section 145.8821 shall be included as 
408.13  statewide outcomes under this section. 
408.14     (e) By December 31, 2004, and every five years thereafter, 
408.15  the commissioner, in consultation with the state community 
408.16  health advisory committee established under section 145A.10, 
408.17  subdivision 10, paragraph (a), and the maternal and child health 
408.18  advisory task force established under section 145.881, shall 
408.19  develop statewide outcomes for the local public health grant 
408.20  established under section 145A.131, based on state and local 
408.21  assessment data regarding the health of Minnesota residents, the 
408.22  essential public health services under section 145A.10, and 
408.23  current Minnesota public health goals established under section 
408.24  62J.212. 
408.25     Sec. 27.  Minnesota Statutes 2002, section 145A.13, is 
408.26  amended by adding a subdivision to read: 
408.27     Subd. 4.  [EXPIRATION.] This section expires January 1, 
408.28  2004. 
408.29     Sec. 28.  [145A.131] [LOCAL PUBLIC HEALTH GRANT.] 
408.30     Subdivision 1.  [TRIBAL GOVERNMENTS.] (a) Of the funding 
408.31  available for local public health grants, $2,000,000 per year is 
408.32  available to tribal governments for: 
408.33     (1) maternal and child health activities under section 
408.34  145.882, subdivision 7; 
408.35     (2) activities to reduce health disparities under section 
408.36  145.928, subdivision 10; and 
409.1      (3) emergency preparedness. 
409.2      (b) The commissioner, in consultation with tribal 
409.3   governments, shall establish a formula for distributing the 
409.4   funds and developing the outcomes to be measured.  Any decrease 
409.5   or increase in the amount of funding available under the local 
409.6   public health grant must be apportioned to reflect a 
409.7   proportional change to both tribal governments and to community 
409.8   health boards. 
409.9      Subd. 2.  [FUNDING FORMULA FOR COMMUNITY HEALTH 
409.10  BOARDS.] (a) A local public health grant shall be distributed to 
409.11  community health boards organized and operating under section 
409.12  145A.09 to 145A.131 to achieve locally identified priorities 
409.13  under section 145A.10, subdivision 5a, and statewide outcomes 
409.14  under section 145A.12, subdivision 7. 
409.15     (b) A community health board eligible for a local public 
409.16  health grant under section 145A.09, subdivision 2, shall receive 
409.17  no less for any calendar year than 95 percent of the board's 
409.18  total 2002 community health services subsidy award and 95 
409.19  percent of the board's total 2002 maternal and child health 
409.20  special projects grant. 
409.21     (c) Multicounty community health boards shall receive a 
409.22  local partnership incentive of $25,000 per year for each county 
409.23  included in the community health board. 
409.24     (d) The remaining funds shall be distributed on a per 
409.25  capita basis using the population figures established according 
409.26  to section 145A.02, subdivision 16. 
409.27     Subd. 3.  [LOCAL MATCH.] (a) A community health board that 
409.28  receives a local public health grant shall provide a 50 percent 
409.29  match for the local public health grant funds described in 
409.30  subdivision 2, paragraph (b), subject to paragraphs (b) to (e). 
409.31     (b) Eligible funds must be used to meet match requirements. 
409.32  Eligible funds include funds from local property taxes, 
409.33  reimbursements from third parties, other state funds, and 
409.34  donations or nonfederal grants that are used for community 
409.35  health services described in section 145A.02, subdivision 6. 
409.36     (c) Community health boards must provide documentation that 
410.1   the 50 percent match for funds received under United States 
410.2   Code, title 42, sections 701 to 709, is used for maternal and 
410.3   child health activities as described in section 145.882, 
410.4   subdivision 7. 
410.5      (d) When the amount of local matching funds for a community 
410.6   health board is less than the amount required under paragraph 
410.7   (a), the local public health grant provided for that community 
410.8   health board under this section shall be reduced proportionally. 
410.9      (e) A city organized under the provision of sections 
410.10  145A.09 to 145A.131 that levies a tax for provision of community 
410.11  health services is exempt from any county levy for the same 
410.12  services to the extent of the levy imposed by the city. 
410.13     Subd. 4.  [ADDITIONAL FUNDS.] Additional state or federal 
410.14  funds distributed to community health boards to achieve specific 
410.15  outcomes shall be distributed as part of the local public health 
410.16  grant established in subdivision 2.  These funds may be 
410.17  distributed in proportion to the basic award described in 
410.18  subdivision 2.  Additional outcomes for these funds, if not 
410.19  specified by federal or state law, shall be developed by the 
410.20  commissioner in consultation with the state community health 
410.21  advisory committee established under section 145A.10, 
410.22  subdivision 10, and the maternal and child health advisory task 
410.23  force established under section 145.881. 
410.24     Subd. 5.  [SPECIAL PROJECT GRANTS.] Notwithstanding other 
410.25  requirements of this section, the commissioner may choose to 
410.26  fund noncompetitive special project grants for projects by 
410.27  select community health boards, according to state or federal 
410.28  law.  These special project grant funds shall be distributed as 
410.29  a part of a community health board's local public health grant 
410.30  established in subdivision 2. 
410.31     Subd. 6.  [RESPONSIBILITY OF COMMISSIONER TO ENSURE A 
410.32  STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a 
410.33  community health board and operates as a board of health or if a 
410.34  community health board elects not to accept the local public 
410.35  health grant, the commissioner shall retain the amount of 
410.36  funding that would have been allocated to the community health 
411.1   board using the formula described in subdivision 2 and assume 
411.2   responsibility for public health activities to meet the 
411.3   statewide outcomes in the geographic area served by the board of 
411.4   health or community health board.  The commissioner may elect to 
411.5   directly provide public health activities to meet the statewide 
411.6   outcomes or contract with other units of government or with 
411.7   community-based organizations.  If a city that is currently a 
411.8   community health board withdraws from a community health board 
411.9   or elects not to accept the local public health grant, the local 
411.10  public health grant funds that would have been allocated to that 
411.11  city shall be distributed to the county in which the city is 
411.12  located, if the county is part of a community health board.  
411.13     Subd. 7.  [ACCOUNTABILITY.] (a) Community health boards 
411.14  accepting local public health grants must demonstrate progress 
411.15  towards the statewide outcomes established in section 145A.12, 
411.16  subdivision 7, to maintain eligibility to receive the local 
411.17  public health grant. 
411.18     (b) If the commissioner determines that a community health 
411.19  board has not by the applicable deadline demonstrated progress 
411.20  in one or more of the statewide outcomes established under 
411.21  section 145.8821 or 145A.12, subdivision 7, then the 
411.22  commissioner may determine not to distribute future funds to the 
411.23  community health board under subdivision 2.  If the commissioner 
411.24  determines not to distribute future funds, the commissioner must 
411.25  give the community health board written notice of this 
411.26  determination.  In determining whether or not to distribute 
411.27  future funds to the community health board, the commissioner 
411.28  shall consider the following factors with respect to the 
411.29  statewide outcomes for which the community health board did not 
411.30  demonstrate sufficient progress: 
411.31     (1) the difficulty of meeting the statewide outcome; 
411.32     (2) the effort put forth by the community health board to 
411.33  meet the statewide outcome; 
411.34     (3) the number of statewide outcomes that the community 
411.35  health board did not meet; 
411.36     (4) whether the community health board has previously 
412.1   failed to meet statewide outcomes under this section; 
412.2      (5) the amount of funding received by the community health 
412.3   board to address the statewide outcomes; and 
412.4      (6) other factors as justice may require, if the 
412.5   commissioner specifically identifies the additional factors in 
412.6   the commissioner's written notice of determination. 
412.7      (c) If a community health board does not demonstrate 
412.8   progress towards the statewide outcomes, the commissioner may 
412.9   retain local public health grant funds and assume responsibility 
412.10  for directly carrying out activities to meet the statewide 
412.11  outcomes or contract with other units of government or 
412.12  community-based organizations to assume responsibility for the 
412.13  statewide outcomes.  If the community health board that does not 
412.14  demonstrate progress towards the statewide outcomes is a city, 
412.15  the commissioner shall distribute the local public health grant 
412.16  funds that would have been allocated to that city to the county 
412.17  in which the city is located, if the county is part of a 
412.18  community health board. 
412.19     (d) The commissioner shall establish a reporting system for 
412.20  community health boards to report their progress.  The system 
412.21  shall be developed in consultation with the state community 
412.22  health advisory committee established under section 145A.10, 
412.23  subdivision 10, paragraph (a), and the maternal and child health 
412.24  advisory task force established under section 145.881. 
412.25     Subd. 8.  [LOCAL PUBLIC HEALTH PRIORITIES.] Community 
412.26  health boards may use their local public health grant to address 
412.27  local public health priorities identified under section 145A.10, 
412.28  subdivision 5a. 
412.29     Sec. 29.  Minnesota Statutes 2002, section 145A.14, 
412.30  subdivision 2, is amended to read: 
412.31     Subd. 2.  [INDIAN HEALTH GRANTS.] (a) The commissioner may 
412.32  make special grants to community health boards to establish, 
412.33  operate, or subsidize clinic facilities and services to furnish 
412.34  health services for American Indians who reside off reservations.
412.35     (b) To qualify for a grant under this subdivision the 
412.36  community health plan submitted by the community health board 
413.1   must contain a proposal for the delivery of the services and 
413.2   documentation that representatives of the Indian community 
413.3   affected by the plan were involved in its development. 
413.4      (c) Applicants must submit for approval a plan and budget 
413.5   for the use of the funds in the form and detail specified by the 
413.6   commissioner. 
413.7      (d) (c) Applicants must keep records, including records of 
413.8   expenditures to be audited, as the commissioner specifies. 
413.9      Sec. 30.  [REVISOR'S INSTRUCTION.] 
413.10     (a) The revisor of statutes shall delete "145A.13" and 
413.11  insert "145A.131" in Minnesota Statutes, sections 145A.03, 
413.12  subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1; 
413.13  256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02, 
413.14  subdivision 2. 
413.15     (b) For sections in Minnesota Statutes and Minnesota Rules 
413.16  affected by the repealed sections in this article, the revisor 
413.17  shall delete internal cross-references where appropriate and 
413.18  make changes necessary to correct the punctuation, grammar, or 
413.19  structure of the remaining text and preserve its meaning. 
413.20     Sec. 31.  [REPEALER.] 
413.21     (a) Minnesota Statutes 2002, sections 144.401; 144.9507, 
413.22  subdivision 3; 145.56, subdivision 2; 145.882, subdivisions 4, 
413.23  5, 6, and 8; 145.883, subdivisions 4 and 7; 145.884; 145.885; 
413.24  145.886; 145.888; 145.889; 145.890; 145.9266, subdivisions 2, 4, 
413.25  5, 6, and 7; 145.928, subdivision 9; 145A.02, subdivisions 9, 
413.26  10, 11, 12, 13, and 14; 145A.10, subdivisions 5, 6, and 8; 
413.27  145A.11, subdivision 3; 145A.12, subdivisions 3, 4, and 5; 
413.28  145A.14, subdivisions 3 and 4; and 145A.17, subdivision 2, are 
413.29  repealed. 
413.30     (b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030; 
413.31  4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080; 
413.32  4736.0090; 4736.0120; and 4736.0130, are repealed effective 
413.33  January 1, 2004. 
413.34     (c) Minnesota Rules, parts 4705.0100; 4705.0200; 4705.0300; 
413.35  4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 
413.36  4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 
414.1   4705.1400; 4705.1500; and 4705.1600, are repealed effective June 
414.2   30, 2004. 
414.3                              ARTICLE 10 
414.4                            APPROPRIATIONS 
414.5   Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
414.6      The sums shown in the columns marked "APPROPRIATIONS" are 
414.7   appropriated from the general fund, or any other fund named, to 
414.8   the agencies and for the purposes specified in the sections of 
414.9   this article, to be available for the fiscal years indicated for 
414.10  each purpose.  The figures "2004" and "2005" where used in this 
414.11  article, mean that the appropriation or appropriations listed 
414.12  under them are available for the fiscal year ending June 30, 
414.13  2004, or June 30, 2005, respectively.  Where a dollar amount 
414.14  appears in parentheses, it means a reduction of an appropriation.
414.15                          SUMMARY BY FUND
414.16                                                       BIENNIAL
414.17                             2004          2005           TOTAL
414.18  General            $3,588,648,000 $3,499,118,000 $7,087,766,000
414.19  State Government
414.20  Special Revenue        45,162,000     44,899,000     90,061,000
414.21  Health Care 
414.22  Access                269,351,000    339,443,000    608,794,000
414.23  Federal TANF          267,482,000    267,161,000    534,643,000
414.24  Lottery Prize 
414.25  Fund                    1,306,000      1,306,000      2,612,000
414.26  TOTAL              $4,171,949,000 $4,151,927,000 $8,323,876,000
414.27                                             APPROPRIATIONS 
414.28                                         Available for the Year 
414.29                                             Ending June 30 
414.30                                            2004         2005 
414.31  Sec. 2.  COMMISSIONER OF
414.32  HUMAN SERVICES
414.33  Subdivision 1.  Total
414.34  Appropriation                     $    4,021,515 $    4,002,077
414.35                Summary by Fund
414.36  General               3,495,179     3,405,970
414.37  State Government 
414.38  Special Revenue             534           534
414.39  Health Care
414.40  Access                  263,014       333,106
414.41  Federal TANF            261,482       261,161
415.1   Lottery Cash
415.2   Flow                      1,306         1,306
415.3   [RECEIPTS FOR SYSTEMS PROJECTS.] 
415.4   Appropriations and federal receipts for 
415.5   information system projects for MAXIS, 
415.6   PRISM, MMIS, and SSIS must be deposited 
415.7   in the state system account authorized 
415.8   in Minnesota Statutes, section 
415.9   256.014.  Money appropriated for 
415.10  computer projects approved by the 
415.11  Minnesota office of technology, funded 
415.12  by the legislature, and approved by the 
415.13  commissioner of finance may be 
415.14  transferred from one project to another 
415.15  and from development to operations as 
415.16  the commissioner of human services 
415.17  considers necessary.  Any unexpended 
415.18  balance in the appropriation for these 
415.19  projects does not cancel but is 
415.20  available for ongoing development and 
415.21  operations. 
415.22  [GIFTS.] Notwithstanding Minnesota 
415.23  Statutes, chapter 7, the commissioner 
415.24  may accept on behalf of the state 
415.25  additional funding from sources other 
415.26  than state funds for the purpose of 
415.27  financing the cost of assistance 
415.28  program grants or nongrant 
415.29  administration.  All additional funding 
415.30  is appropriated to the commissioner for 
415.31  use as designated by the grantor of 
415.32  funding. 
415.33  [SYSTEMS CONTINUITY.] In the event of 
415.34  disruption of technical systems or 
415.35  computer operations, the commissioner 
415.36  may use available grant appropriations 
415.37  to ensure continuity of payments for 
415.38  maintaining the health, safety, and 
415.39  well-being of clients served by 
415.40  programs administered by the department 
415.41  of human services.  Grant funds must be 
415.42  used in a manner consistent with the 
415.43  original intent of the appropriation. 
415.44  [NONFEDERAL SHARE TRANSFERS.] The 
415.45  nonfederal share of activities for 
415.46  which federal administrative 
415.47  reimbursement is appropriated to the 
415.48  commissioner may be transferred to the 
415.49  special revenue fund. 
415.50  [TANF FUNDS APPROPRIATED TO OTHER 
415.51  ENTITIES.] Any expenditures from the 
415.52  TANF block grant shall be expended in 
415.53  accordance with the requirements and 
415.54  limitations of part A of title IV of 
415.55  the Social Security Act, as amended, 
415.56  and any other applicable federal 
415.57  requirement or limitation.  Prior to 
415.58  any expenditure of these funds, the 
415.59  commissioner shall assure that funds 
415.60  are expended in compliance with the 
415.61  requirements and limitations of federal 
415.62  law and that any reporting requirements 
415.63  of federal law are met.  It shall be 
415.64  the responsibility of any entity to 
415.65  which these funds are appropriated to 
415.66  implement a memorandum of understanding 
416.1   with the commissioner that provides the 
416.2   necessary assurance of compliance prior 
416.3   to any expenditure of funds.  The 
416.4   commissioner shall receipt TANF funds 
416.5   appropriated to other state agencies 
416.6   and coordinate all related interagency 
416.7   accounting transactions necessary to 
416.8   implement these appropriations.  
416.9   Unexpended TANF funds appropriated to 
416.10  any state, local, or nonprofit entity 
416.11  cancel at the end of the state fiscal 
416.12  year unless appropriating language 
416.13  permits otherwise. 
416.14  [TANF FUNDS TRANSFERRED TO OTHER 
416.15  FEDERAL GRANTS.] The commissioner must 
416.16  authorize transfers from TANF to other 
416.17  federal block grants so that funds are 
416.18  available to meet the annual 
416.19  expenditure needs as appropriated.  
416.20  Transfers may be authorized prior to 
416.21  the expenditure year with the agreement 
416.22  of the receiving entity.  Transferred 
416.23  funds must be expended in the year for 
416.24  which the funds were appropriated 
416.25  unless appropriation language permits 
416.26  otherwise.  In accelerating transfer 
416.27  authorizations, the commissioner must 
416.28  aim to preserve the future potential 
416.29  transfer capacity from TANF to other 
416.30  block grants. 
416.31  [TANF MAINTENANCE OF EFFORT.] (a) In 
416.32  order to meet the basic maintenance of 
416.33  effort (MOE) requirements of the TANF 
416.34  block grant specified under Code of 
416.35  Federal Regulations, title 45, section 
416.36  263.1, the commissioner may only report 
416.37  nonfederal money expended for allowable 
416.38  activities listed in the following 
416.39  clauses as TANF/MOE expenditures: 
416.40  (1) MFIP cash, diversionary work 
416.41  program, and food assistance benefits 
416.42  under Minnesota Statutes, chapter 256J; 
416.43  (2) the child care assistance programs 
416.44  under Minnesota Statutes, sections 
416.45  119B.03 and 119B.05, and county child 
416.46  care administrative costs under 
416.47  Minnesota Statutes, section 119B.15; 
416.48  (3) state and county MFIP 
416.49  administrative costs under Minnesota 
416.50  Statutes, chapters 256J and 256K; 
416.51  (4) state, county, and tribal MFIP 
416.52  employment services under Minnesota 
416.53  Statutes, chapters 256J and 256K; 
416.54  (5) expenditures made on behalf of 
416.55  noncitizen MFIP recipients who qualify 
416.56  for the medical assistance without 
416.57  federal financial participation program 
416.58  under Minnesota Statutes, section 
416.59  256B.06, subdivision 4, paragraphs (d), 
416.60  (e), and (j). 
416.61  (b) The commissioner shall ensure that 
416.62  sufficient qualified nonfederal 
416.63  expenditures are made each year to meet 
417.1   the state's TANF/MOE requirements.  For 
417.2   the activities listed in paragraph (a), 
417.3   clauses (2) to (5), the commissioner 
417.4   may only report expenditures that are 
417.5   excluded from the definition of 
417.6   assistance under Code of Federal 
417.7   Regulations, title 45, section 260.31. 
417.8   (c) By August 31 of each year, the 
417.9   commissioner shall make a preliminary 
417.10  calculation to determine the likelihood 
417.11  that the state will meet its annual 
417.12  federal work participation requirement 
417.13  under Code of Federal Regulations, 
417.14  title 45, sections 261.21 and 261.23, 
417.15  after adjustment for any caseload 
417.16  reduction credit under Code of Federal 
417.17  Regulations, title 45, section 261.41.  
417.18  If the commissioner determines that the 
417.19  state will meet its federal work 
417.20  participation rate for the federal 
417.21  fiscal year ending that September, the 
417.22  commissioner may reduce the expenditure 
417.23  under paragraph (a), clause (1), to the 
417.24  extent allowed under Code of Federal 
417.25  Regulations, title 45, section 
417.26  263.1(a)(2). 
417.27  (d) For fiscal years beginning with 
417.28  state fiscal year 2003, the 
417.29  commissioner shall assure that the 
417.30  maintenance of effort used by the 
417.31  commissioner of finance for the 
417.32  February and November forecasts 
417.33  required under Minnesota Statutes, 
417.34  section 16A.103, contains expenditures 
417.35  under paragraph (a), clause (1), equal 
417.36  to at least 25 percent of the total 
417.37  required under Code of Federal 
417.38  Regulations, title 45, section 263.1. 
417.39  (e) If nonfederal expenditures for the 
417.40  programs and purposes listed in 
417.41  paragraph (a) are insufficient to meet 
417.42  the state's TANF/MOE requirements, the 
417.43  commissioner shall recommend additional 
417.44  allowable sources of nonfederal 
417.45  expenditures to the legislature, if the 
417.46  legislature is or will be in session to 
417.47  take action to specify additional 
417.48  sources of nonfederal expenditures for 
417.49  TANF/MOE before a federal penalty is 
417.50  imposed.  The commissioner shall 
417.51  otherwise provide notice to the 
417.52  legislative commission on planning and 
417.53  fiscal policy under paragraph (g). 
417.54  (f) If the commissioner uses authority 
417.55  granted under section 9, or similar 
417.56  authority granted by a subsequent 
417.57  legislature, to meet the state's 
417.58  TANF/MOE requirement in a reporting 
417.59  period, the commissioner shall inform 
417.60  the chairs of the appropriate 
417.61  legislative committees about all 
417.62  transfers made under that authority for 
417.63  this purpose. 
417.64  (g) If the commissioner determines that 
417.65  nonfederal expenditures under paragraph 
417.66  (a) are insufficient to meet TANF/MOE 
418.1   expenditure requirements, and if the 
418.2   legislature is not or will not be in 
418.3   session to take timely action to avoid 
418.4   a federal penalty, the commissioner may 
418.5   report nonfederal expenditures from 
418.6   other allowable sources as TANF/MOE 
418.7   expenditures after the requirements of 
418.8   this paragraph are met.  The 
418.9   commissioner may report nonfederal 
418.10  expenditures in addition to those 
418.11  specified under paragraph (a) as 
418.12  nonfederal TANF/MOE expenditures, but 
418.13  only ten days after the commissioner of 
418.14  finance has first submitted the 
418.15  commissioner's recommendations for 
418.16  additional allowable sources of 
418.17  nonfederal TANF/MOE expenditures to the 
418.18  members of the legislative commission 
418.19  on planning and fiscal policy for their 
418.20  review. 
418.21  (h) The commissioner of finance shall 
418.22  not incorporate any changes in federal 
418.23  TANF expenditures or nonfederal 
418.24  expenditures for TANF/MOE that may 
418.25  result from reporting additional 
418.26  allowable sources of nonfederal 
418.27  TANF/MOE expenditures under the interim 
418.28  procedures in paragraph (g) into the 
418.29  February or November forecasts required 
418.30  under Minnesota Statutes, section 
418.31  16A.103, unless the commissioner of 
418.32  finance has approved the additional 
418.33  sources of expenditures under paragraph 
418.34  (g). 
418.35  (i) Minnesota Statutes, section 
418.36  256.011, subdivision 3, which requires 
418.37  that federal grants or aids secured or 
418.38  obtained under that subdivision be used 
418.39  to reduce any direct appropriations 
418.40  provided by law, do not apply if the 
418.41  grants or aids are federal TANF funds. 
418.42  (j) Notwithstanding section 12, 
418.43  paragraph (a), clauses (1) to (5), and 
418.44  paragraphs (b) to (j) expire June 30, 
418.45  2007. 
418.46  [SHIFT COUNTY PAYMENT.] The 
418.47  commissioner shall make up to 100 
418.48  percent of the calendar year 2005 
418.49  payments to counties for developmental 
418.50  disabilities semi-independent living 
418.51  services grants, developmental 
418.52  disabilities family support grants, and 
418.53  adult mental health grants from fiscal 
418.54  year 2006 appropriations.  This is a 
418.55  onetime payment shift.  Calendar year 
418.56  2006 and future payments for these 
418.57  grants are not affected by this shift.  
418.58  This provision expires June 30, 2006. 
418.59  [CAPITATION RATE INCREASE.] Of the 
418.60  health care access fund appropriations 
418.61  to the University of Minnesota in the 
418.62  higher education omnibus appropriation 
418.63  bill, $2,157,000 in fiscal year 2004 
418.64  and $2,157,000 in fiscal year 2005 are 
418.65  to be used to increase the capitation 
418.66  payments under Minnesota Statutes, 
419.1   section 256B.69.  Notwithstanding the 
419.2   provisions of section 11, this 
419.3   provision shall not expire. 
419.4   Subd. 2.  Agency Management        
419.5                 Summary by Fund
419.6   General                  41,473        27,868
419.7   State Government                             
419.8   Special Revenue             415           415
419.9   Health Care Access        3,673         3,673
419.10  Federal TANF                320           320
419.11  The amounts that may be spent from the 
419.12  appropriation for each purpose are as 
419.13  follows: 
419.14  (a) Financial Operations 
419.15  General                   8,751         9,056
419.16  Health Care Access          828           828
419.17  Federal TANF                220           220
419.18  (b) Legal and
419.19  Regulation Operations 
419.20  General                   7,896         8,168
419.21  State Government                             
419.22  Special Revenue             415           415
419.23  Health Care Access          244           244
419.24  Federal TANF                100           100
419.25  (c) Management Operations 
419.26  General                  17,373         3,076
419.27  Health Care Access        1,623         1,623
419.28  (d) Information Technology
419.29  Operations 
419.30  General                   7,453         7,568
419.31  Health Care Access          978           978
419.32  Subd. 3.  Revenue and Pass-Through 
419.33  Federal TANF             54,845        51,221
419.34  [TANF TRANSFER TO SOCIAL SERVICES BLOCK 
419.35  GRANT.] $6,000,000 in fiscal year 2004 
419.36  and $9,272,000 in fiscal year 2005 are 
419.37  appropriated to the commissioner for 
419.38  the purposes of providing services for 
419.39  families with children whose incomes 
419.40  are at or below 200 percent of the 
419.41  federal poverty guidelines.  The 
419.42  commissioner shall authorize a 
419.43  sufficient transfer of funds from the 
419.44  state's federal TANF block grant to the 
419.45  state's federal social services block 
419.46  grant to meet this appropriation.  The 
420.1   funds shall be distributed to counties 
420.2   for the children and community services 
420.3   grant according to the formula for the 
420.4   state appropriations in Minnesota 
420.5   Statutes, chapter 256M. 
420.6   [TANF FUNDS FOR FISCAL YEAR 2006 AND 
420.7   FISCAL YEAR 2007 REFINANCING.] 
420.8   $16,724,000 in fiscal year 2006 and 
420.9   $16,827,000 in fiscal year 2007 in TANF 
420.10  funds are available to the commissioner 
420.11  to replace general funds in the amount 
420.12  of $16,724,000 in fiscal year 2006 and 
420.13  $16,827,000 in fiscal year 2007 in 
420.14  expenditures that may be counted toward 
420.15  TANF maintenance of effort requirements 
420.16  or as an allowable TANF expenditure. 
420.17  [REDUCTION IN TANF TRANSFER TO CHILD 
420.18  CARE AND DEVELOPMENT FUND.] Transfers 
420.19  of TANF to the child care development 
420.20  fund for the purposes of MFIP child 
420.21  care assistance shall be reduced by 
420.22  $1,126,000 in fiscal year 2004 and 
420.23  $118,000 in fiscal year 2005. 
420.24  Subd. 4.  Children's Services Grants 
420.25                Summary by Fund
420.26  General                 111,760        94,256
420.27  Federal TANF            -0-             9,272
420.28  [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 
420.29  Federal funds available during fiscal 
420.30  year 2004 and fiscal year 2005, for 
420.31  adoption incentive grants are 
420.32  appropriated to the commissioner for 
420.33  these purposes. 
420.34  [ADOPTION ASSISTANCE AND RELATIVE 
420.35  CUSTODY ASSISTANCE.] The commissioner 
420.36  may transfer unencumbered appropriation 
420.37  balances for adoption assistance and 
420.38  relative custody assistance between 
420.39  fiscal years and between programs. 
420.40  Subd. 5.  Children's Services Management 
420.41  General                   5,221         5,283
420.42  Subd. 6.  Basic Health Care Grants 
420.43                Summary by Fund
420.44  General               1,490,406     1,465,637
420.45  Health Care Access      243,539       313,877
420.46  [UPDATING FEDERAL POVERTY GUIDELINES.] 
420.47  Annual updates to the federal poverty 
420.48  guidelines are effective each July 1, 
420.49  following publication by the United 
420.50  States Department of Health and Human 
420.51  Services for health care programs under 
420.52  Minnesota Statutes, chapters 256, 256B, 
420.53  256D, and 256L. 
420.54  The amounts that may be spent from this 
420.55  appropriation for each purpose are as 
421.1   follows: 
421.2   (a) MinnesotaCare Grants 
421.3   Health Care Access     242,789       313,127
421.4   [MINNESOTACARE FEDERAL RECEIPTS.] 
421.5   Receipts received as a result of 
421.6   federal participation pertaining to 
421.7   administrative costs of the Minnesota 
421.8   health care reform waiver shall be 
421.9   deposited as nondedicated revenue in 
421.10  the health care access fund.  Receipts 
421.11  received as a result of federal 
421.12  participation pertaining to grants 
421.13  shall be deposited in the federal fund 
421.14  and shall offset health care access 
421.15  funds for payments to providers. 
421.16  [MINNESOTACARE FUNDING.] The 
421.17  commissioner may expend money 
421.18  appropriated from the health care 
421.19  access fund for MinnesotaCare in either 
421.20  fiscal year of the biennium. 
421.21  (b) MA Basic Health Care Grants - 
421.22  Families and Children 
421.23  General                 560,470       574,389
421.24  (c) MA Basic Health Care Grants - Elderly 
421.25  and Disabled 
421.26  General                 687,945       759,657
421.27  [DELAY MA FEE FOR SERVICE - ACUTE 
421.28  CARE.] The last payment in fiscal year 
421.29  2005 from the Medicaid Management 
421.30  Information System that would otherwise 
421.31  have been made to providers for medical 
421.32  assistance and general assistance 
421.33  medical care services shall be delayed 
421.34  and included in the first payment in 
421.35  fiscal year 2006.  This payment delay 
421.36  shall not include payments to skilled 
421.37  nursing facilities, intermediate care 
421.38  facilities for mental retardation, 
421.39  prepaid health plans, home health 
421.40  agencies, personal care nursing 
421.41  providers, and providers of only waiver 
421.42  services.  The provisions of Minnesota 
421.43  Statutes, section 16A.124, shall not 
421.44  apply to these delayed payments.  
421.45  Notwithstanding section 12, this 
421.46  provision shall not expire. 
421.47  (d) General Assistance Medical Care 
421.48  Grants 
421.49  General                 228,293       115,756
421.50  (e) Health Care Grants - Other 
421.51  Assistance 
421.52  General                   3,067         3,123
421.53  Health Care Access          750           750
421.54  (f) Prescription Drug Program 
421.55  General                  10,631        12,712
422.1   Subd. 7.  Health Care Management 
422.2                 Summary by Fund
422.3   General                  23,684        24,202
422.4   Health Care Access       14,395        14,179
422.5   The amounts that may be spent from this 
422.6   appropriation for each purpose are as 
422.7   follows: 
422.8   (a) Health Care Policy Administration 
422.9   General                   4,532         5,226
422.10  Health Care Access          846           846
422.11  [MINNESOTACARE OUTREACH REIMBURSEMENT.] 
422.12  Federal administrative reimbursement 
422.13  resulting from MinnesotaCare outreach 
422.14  is appropriated to the commissioner for 
422.15  this activity. 
422.16  [MINNESOTA SENIOR HEALTH OPTIONS 
422.17  REIMBURSEMENT.] Federal administrative 
422.18  reimbursement resulting from the 
422.19  Minnesota senior health options project 
422.20  is appropriated to the commissioner for 
422.21  this activity. 
422.22  [UTILIZATION REVIEW.] Federal 
422.23  administrative reimbursement resulting 
422.24  from prior authorization and inpatient 
422.25  admission certification by a 
422.26  professional review organization shall 
422.27  be dedicated to the commissioner for 
422.28  these purposes.  A portion of these 
422.29  funds must be used for activities to 
422.30  decrease unnecessary pharmaceutical 
422.31  costs in medical assistance. 
422.32  (b) Health Care Options 
422.33  General                  19,152        18,976
422.34  Health Care Access       13,549        13,333
422.35  [PREPAID MEDICAL PROGRAMS.] For all 
422.36  counties in which the PMAP program has 
422.37  been operating for 12 or more months, 
422.38  state funding for the nonfederal share 
422.39  of prepaid medical assistance program 
422.40  administration costs for county managed 
422.41  care advocacy and enrollment operations 
422.42  is eliminated.  State funding will 
422.43  continue for these activities for 
422.44  counties and tribes establishing new 
422.45  PMAP programs for a maximum of 16 
422.46  months (four months prior to beginning 
422.47  PMAP enrollment and through the first 
422.48  12 months of their PMAP program 
422.49  operation).  Those counties operating 
422.50  PMAP programs for less than 12 months 
422.51  can continue to receive state funding 
422.52  for advocacy and enrollment activities 
422.53  through their first year of operation. 
422.54  Subd. 8.  State-operated Services 
422.55  General                 195,062       186,775
423.1   [MITIGATION RELATED TO STATE-OPERATED 
423.2   SERVICES RESTRUCTURING.] Money 
423.3   appropriated to finance mitigation 
423.4   expenses related to restructuring 
423.5   state-operated services programs and 
423.6   administrative services may be 
423.7   transferred between fiscal years within 
423.8   the biennium. 
423.9   [STATE-OPERATED SERVICES 
423.10  RESTRUCTURING.] For purposes of 
423.11  restructuring state-operated services, 
423.12  any state-operated services employee 
423.13  whose position is to be eliminated 
423.14  shall be afforded the options provided 
423.15  in applicable collective bargaining 
423.16  agreements.  All salary and mitigation 
423.17  allocations from fiscal year 2004 shall 
423.18  be carried forward into fiscal year 
423.19  2005.  Provided there is no conflict 
423.20  with any collective bargaining 
423.21  agreement, any state-operated services 
423.22  position reduction must only be 
423.23  accomplished through mitigation, 
423.24  attrition, transfer, and other measures 
423.25  as provided in state or applicable 
423.26  collective bargaining agreements and in 
423.27  Minnesota Statutes, section 252.50, 
423.28  subdivision 11, and not through layoff. 
423.29  [REPAIRS AND BETTERMENTS.] The 
423.30  commissioner may transfer unencumbered 
423.31  appropriation balances between fiscal 
423.32  years within the biennium for the state 
423.33  residential facilities repairs and 
423.34  betterments account and special 
423.35  equipment. 
423.36  Subd. 9.  Continuing Care Grants 
423.37                Summary by Fund
423.38  General               1,446,139     1,425,621
423.39  Lottery Prize Fund        1,158         1,158
423.40  The amounts that may be spent from this 
423.41  appropriation for each purpose are as 
423.42  follows: 
423.43  (a) Aging and Adult Service Grant 
423.44  General                   7,201         7,969
423.45  (b) Deaf and Hard-of-hearing 
423.46  Service Grants 
423.47  General                   1,702         1,468
423.48  (c) Mental Health Grants 
423.49  General                  53,744        34,955
423.50  Lottery Prize Fund        1,158         1,158
423.51  [RESTRUCTURING OF ADULT MENTAL HEALTH 
423.52  SERVICES.] The commissioner may make 
423.53  budget neutral transfers to effectively 
423.54  implement the restructuring of adult 
423.55  mental health services.  "Budget 
423.56  neutral transfers" means transfers 
424.1   which do not increase the state share 
424.2   of costs.  
424.3   (d) Community Support Grants 
424.4   General                  11,725         8,794
424.5   (e) Medical Assistance Long-term 
424.6   Care Waivers and Home Care Grants 
424.7   General                 643,530       694,967
424.8   [RATE AND ALLOCATION DECREASES FOR 
424.9   CONTINUING CARE PROGRAMS.] 
424.10  Notwithstanding any law or rule to the 
424.11  contrary, the commissioner of human 
424.12  services shall decrease reimbursement 
424.13  rates or reduce allocations to assure 
424.14  the necessary reductions in state 
424.15  spending for the providers or programs 
424.16  listed in (A) through (D).  The 
424.17  decreases are effective for services 
424.18  rendered on or after July 1, 2003. 
424.19  (A) Effective July 1, 2003, the 
424.20  commissioner shall reduce payment rates 
424.21  for services and individual or service 
424.22  limits by four percent.  The rate 
424.23  decreases described in this section 
424.24  must be applied to: 
424.25  (1) home and community-based waivered 
424.26  services for the elderly under 
424.27  Minnesota Statutes, section 256B.0915; 
424.28  (2) day training and habilitation 
424.29  services for adults with mental 
424.30  retardation or related conditions under 
424.31  Minnesota Statutes, sections 252.40 to 
424.32  252.46; 
424.33  (3) the group residential housing 
424.34  supplementary service rate under 
424.35  Minnesota Statutes, section 256I.05, 
424.36  subdivision 1a; 
424.37  (4) chemical dependency residential and 
424.38  nonresidential service rates under 
424.39  Minnesota Statutes, section 254B.03; 
424.40  (5) consumer support grants under 
424.41  Minnesota Statutes, section 256.476; 
424.42  and 
424.43  (6) home and community-based services 
424.44  for alternative care services under 
424.45  Minnesota Statutes, section 256B.0913. 
424.46  (B) Effective July 1, 2003, the 
424.47  commissioner shall reduce payment rates 
424.48  for services and individual or service 
424.49  limits by two percent to: 
424.50  (1) home health services under 
424.51  Minnesota Statutes, section 256B.0625, 
424.52  subdivision 6a; 
424.53  (2) personal care services and nursing 
424.54  supervision of personal care services 
424.55  under Minnesota Statutes, section 
424.56  256B.0625, subdivision 19a; and 
425.1   (3) private duty nursing services under 
425.2   Minnesota Statutes, section 256B.0625, 
425.3   subdivision 7. 
425.4   (C) The commissioner shall reduce 
425.5   allocations made available to county 
425.6   agencies for home and community-based 
425.7   waivered services to assure a four 
425.8   percent reduction in state spending for 
425.9   services rendered on or after July 1, 
425.10  2003.  The commissioner shall apply the 
425.11  allocation decreases described in this 
425.12  section to: 
425.13  (1) persons with mental retardation or 
425.14  related conditions under Minnesota 
425.15  Statutes, section 256B.501; 
425.16  (2) waivered services under community 
425.17  alternatives for disabled individuals 
425.18  under Minnesota Statutes, section 
425.19  256B.49; 
425.20  (3) community alternative care waivered 
425.21  services under Minnesota Statutes, 
425.22  section 256B.49; and 
425.23  (4) traumatic brain injury waivered 
425.24  services under Minnesota Statutes, 
425.25  section 256B.49. 
425.26  County agencies will be responsible for 
425.27  100 percent of any spending in excess 
425.28  of the allocation made by the 
425.29  commissioner.  Nothing in this section 
425.30  shall be construed as reducing the 
425.31  county's responsibility to offer and 
425.32  make available feasible home and 
425.33  community-based options to eligible 
425.34  waiver recipients within the resources 
425.35  allocated to them for that purpose. 
425.36  (D) The commissioner shall reduce deaf 
425.37  and hard-of-hearing grants by four 
425.38  percent on July 1, 2003. 
425.39  [REDUCE GROWTH IN MR/RC WAIVER.] The 
425.40  commissioner shall reduce the growth in 
425.41  the MR/RC waiver by not allocating the 
425.42  300 additional diversion allocations 
425.43  that are included in the February 2003 
425.44  forecast for the fiscal years that 
425.45  begin on July 1, 2003, and July 1, 2004.
425.46  [MANAGE THE GROWTH IN THE TBI WAIVER.] 
425.47  During the fiscal years beginning on 
425.48  July 1, 2003, and July 1, 2004, the 
425.49  commissioner shall allocate money for 
425.50  this program in such a way so that the 
425.51  caseload growth for this program does 
425.52  not exceed 150 in each year of the 
425.53  biennium.  Priorities for the 
425.54  allocation of funds shall be for 
425.55  individuals anticipated to be 
425.56  discharged from institutional settings 
425.57  or who are at imminent risk of a 
425.58  placement in an institutional setting. 
425.59  [TARGETED CASE MANAGEMENT FOR HOME CARE 
425.60  RECIPIENTS.] Implementation of the 
425.61  targeted case management benefit for 
426.1   home care recipients, according to 
426.2   Minnesota Statutes, section 256B.0621, 
426.3   subdivisions 2, 3, 5, 6, 7, 9, and 10, 
426.4   will be delayed until July 1, 2005. 
426.5   [COMMON SERVICE MENU.] Implementation 
426.6   of the common service menu option 
426.7   within the home and community-based 
426.8   waivers, according to Minnesota 
426.9   Statutes, section 256B.49, subdivision 
426.10  16, will be delayed until July 1, 2005. 
426.11  (f) Medical Assistance Long-term 
426.12  Care Facilities Grants 
426.13  General                 514,710       485,543
426.14  (g) Alternative Care Grants 
426.15  General                  70,705       62,930
426.16  [ALTERNATIVE CARE TRANSFER.] Any money 
426.17  allocated to the alternative care 
426.18  program that is not spent for the 
426.19  purposes indicated does not cancel but 
426.20  shall be transferred to the medical 
426.21  assistance account. 
426.22  [ALTERNATIVE CARE APPROPRIATION.] The 
426.23  commissioner may expend the money 
426.24  appropriated for the alternative care 
426.25  program for that purpose in either year 
426.26  of the biennium. 
426.27  [ALTERNATIVE CARE IMPLEMENTATION OF 
426.28  CHANGES TO PREMIUMS AND ELIGIBILITY.] 
426.29  Changes to Minnesota Statutes, section 
426.30  256B.0913, subdivision 4, paragraph 
426.31  (d), and subdivision 12, are effective 
426.32  July 1, 2003, for all persons found 
426.33  eligible for the alternative care 
426.34  program on or after July 1, 2003.  All 
426.35  recipients of alternative care funding 
426.36  as of June 30, 2003, shall be subject 
426.37  to Minnesota Statutes, section 
426.38  256B.0913, subdivision 4, paragraph 
426.39  (d), and subdivision 12, on the annual 
426.40  reassessment and review of their 
426.41  eligibility after July 1, 2003, but no 
426.42  later than January 1, 2004. 
426.43  (h) Group Residential Housing Grants 
426.44  General                  94,150        80,092
426.45  [GROUP RESIDENTIAL HOUSING COSTS 
426.46  REFINANCED.] Effective July 1, 2004, 
426.47  the commissioner shall increase the 
426.48  home and community-based service rates 
426.49  and county allocations provided to 
426.50  programs established under section 
426.51  1915(c) of the Social Security Act to 
426.52  the extent that these programs will be 
426.53  paying for the costs above the rate 
426.54  established in Minnesota Statutes, 
426.55  section 256I.05, subdivision 1. 
426.56  (i) Chemical Dependency
426.57  Entitlement Grants 
426.58  General                  47,617        47,848
427.1   (j) Chemical Dependency Nonentitlement 
427.2   Grants 
427.3   General                   1,055         1,055
427.4   Subd. 10.  Continuing Care Management 
427.5                 Summary by Fund
427.6   General                  21,484        21,014
427.7   State Government 
427.8   Special Revenue             119           119
427.9   Lottery Prize Fund          148           148
427.10  Subd. 11.  Economic Support Grants 
427.11                Summary by Fund
427.12  General                 120,922       116,011
427.13  Federal TANF            205,949       199,980
427.14  The amounts that may be spent from this 
427.15  appropriation for each purpose are as 
427.16  follows: 
427.17  (a) Minnesota Family Investment Program 
427.18  General                  50,947        44,938
427.19  Federal TANF            104,889        92,294
427.20  [MFIP SUPPORT SERVICES COUNTY AND 
427.21  TRIBAL ALLOCATION.] When determining 
427.22  the funds available for the 
427.23  consolidated MFIP support services 
427.24  grant in the 18-month period ending 
427.25  December 31, 2004, the commissioner 
427.26  shall apportion the funds appropriated 
427.27  for fiscal year 2005 in such manner as 
427.28  necessary to provide $14,000,000 more 
427.29  to counties and tribes for the period 
427.30  ending December 31, 2004, than would 
427.31  have been available had the funds been 
427.32  evenly divided within the fiscal year 
427.33  between the period before December 31, 
427.34  2004, and the period after December 31, 
427.35  2004. 
427.36  For allocations for the calendar years 
427.37  starting January 1, 2005, the 
427.38  commissioner shall apportion the funds 
427.39  appropriated for each fiscal year in 
427.40  such manner as necessary to provide 
427.41  $14,000,000 more to counties and tribes 
427.42  for the period ending December 31 of 
427.43  that year than would have been 
427.44  available had the funds been evenly 
427.45  divided within the fiscal year between 
427.46  the period before December 31 and the 
427.47  period after December 31. 
427.48  (b) Work Grants 
427.49  General                   8,666         8,678
427.50  Federal TANF            101,060       107,686
427.51  (c) Economic Support Grants - Other 
428.1   Assistance 
428.2   General                   2,858         2,963
428.3   (d) Child Support Enforcement Grants 
428.4   General                   3,571         3,503
428.5   (e) General Assistance Grants
428.6   General                  24,651        24,482
428.7   [GENERAL ASSISTANCE STANDARD.] The 
428.8   commissioner shall set the monthly 
428.9   standard of assistance for general 
428.10  assistance units consisting of an adult 
428.11  recipient who is childless and 
428.12  unmarried or living apart from parents 
428.13  or a legal guardian at $203.  The 
428.14  commissioner may reduce this amount 
428.15  according to Laws 1997, chapter 85, 
428.16  article 3, section 54. 
428.17  (f) Minnesota Supplemental Aid Grants 
428.18  General                  30,229        31,447
428.19  Subd. 12.  Economic Support
428.20  Management 
428.21                Summary by Fund
428.22  General                  39,028        39,303
428.23  Health Care Access        1,407         1,377
428.24  Federal TANF                368           368
428.25  The amounts that may be spent from this 
428.26  appropriation for each purpose are as 
428.27  follows: 
428.28  (a) Economic Support 
428.29  Policy Administration
428.30  General                   5,360         5,587
428.31  Federal TANF                368           368
428.32  (b) Economic Support 
428.33  Operations 
428.34  General                  33,668        33,716
428.35  Health Care Access        1,407         1,377
428.36  [CHILD SUPPORT PAYMENT CENTER.] 
428.37  Payments to the commissioner from other 
428.38  governmental units, private 
428.39  enterprises, and individuals for 
428.40  services performed by the child support 
428.41  payment center must be deposited in the 
428.42  state systems account authorized under 
428.43  Minnesota Statutes, section 256.014.  
428.44  These payments are appropriated to the 
428.45  commissioner for the operation of the 
428.46  child support payment center or system, 
428.47  according to Minnesota Statutes, 
428.48  section 256.014. 
428.49  [CHILD SUPPORT COST RECOVERY FEES.] The 
429.1   commissioner shall transfer $247,000 of 
429.2   child support cost recovery fees 
429.3   collected in fiscal year 2005 to the 
429.4   PRISM special revenue account to offset 
429.5   PRISM system costs of implementing the 
429.6   fee. 
429.7   [FINANCIAL INSTITUTION DATA MATCH AND 
429.8   PAYMENT OF FEES.] The commissioner is 
429.9   authorized to allocate up to $310,000 
429.10  each year in fiscal year 2004 and 
429.11  fiscal year 2005 from the PRISM special 
429.12  revenue account to make payments to 
429.13  financial institutions in exchange for 
429.14  performing data matches between account 
429.15  information held by financial 
429.16  institutions and the public authority's 
429.17  database of child support obligors as 
429.18  authorized by Minnesota Statutes, 
429.19  section 13B.06, subdivision 7. 
429.20  Sec. 3.  COMMISSIONER OF HEALTH
429.21  Subdivision 1.  Total
429.22  Appropriation                        104,875,000    104,292,000 
429.23                Summary by Fund
429.24  General              59,722,000    59,402,000
429.25  State Government
429.26  Special Revenue      32,880,000    32,617,000
429.27  Health Care Access    6,273,000     6,273,000
429.28  Federal TANF          6,000,000     6,000,000
429.29  Subd. 2.  Health Improvement 
429.30                Summary by Fund
429.31  General              44,750,000    44,490,000
429.32  State Government
429.33  Special Revenue       1,987,000     1,987,000
429.34  Health Care Access    3,510,000     3,510,000
429.35  Federal TANF          6,000,000     6,000,000
429.36  [TOBACCO PREVENTION ENDOWMENT FUND 
429.37  TRANSFERS.] (a) On July 1, 2003, the 
429.38  commissioner of finance shall transfer 
429.39  $4,000,000 from the tobacco use 
429.40  prevention and local public health 
429.41  endowment expendable trust fund to the 
429.42  general fund. 
429.43  (b) Notwithstanding Minnesota Statutes, 
429.44  section 16A.62, any remaining 
429.45  unexpended balance in the fund after 
429.46  the transfer in paragraph (a) shall be 
429.47  transferred to the miscellaneous 
429.48  special revenue fund and dedicated to 
429.49  the commissioner of health for a youth 
429.50  tobacco prevention program.  These 
429.51  funds are available until expended. 
429.52  [TANF APPROPRIATIONS.] TANF funds 
429.53  appropriated to the commissioner are 
429.54  available for home visiting and 
430.1   nutritional activities listed under 
430.2   Minnesota Statutes, section 145.882, 
430.3   subdivision 7, clauses (6) and (7), and 
430.4   eliminating health disparities 
430.5   activities under Minnesota Statutes, 
430.6   section 145.928, subdivision 10.  
430.7   Funding shall be distributed to 
430.8   community health boards and tribal 
430.9   governments based on the formula in 
430.10  Minnesota Statutes, section 145A.131, 
430.11  subdivisions 1 and 2. 
430.12  [TANF CARRYFORWARD.] Any unexpended 
430.13  balance of the TANF appropriation in 
430.14  the first year of the biennium does not 
430.15  cancel but is available for the second 
430.16  year. 
430.17  Subd. 3.  Health Quality and 
430.18  Access 
430.19                Summary by Fund
430.20  General                 868,000       814,000
430.21  State Government
430.22  Special Revenue       8,888,000     8,888,000
430.23  Health Care Access    2,763,000     2,763,000
430.24  [STATE GOVERNMENT SPECIAL REVENUE FUND 
430.25  TRANSFERS.] On July 1, 2003, the 
430.26  commissioner of finance shall transfer 
430.27  $3,000,000 from the state government 
430.28  special revenue fund to the general 
430.29  fund. 
430.30  [MEDICAL EDUCATION ENDOWMENT FUND 
430.31  TRANSFERS.] Notwithstanding Minnesota 
430.32  Statutes, section 16A.62, any remaining 
430.33  unexpended balances in the medical 
430.34  education expendable trust fund shall 
430.35  be transferred to the miscellaneous 
430.36  special revenue fund and dedicated to 
430.37  the commissioner for the purposes 
430.38  identified in Minnesota Statutes, 
430.39  section 62J.692.  These funds are 
430.40  available until expended. 
430.41  Subd. 4.  Health Protection 
430.42                Summary by Fund
430.43  General               8,855,000     8,855,000
430.44  State Government
430.45  Special Revenue      22,005,000    21,742,000
430.46  Subd. 5.  Management and Support 
430.47  Services 
430.48  General               5,249,000     5,243,000
430.49  Sec. 4.  VETERANS HOME BOARD 
430.50  General              30,030,000    30,030,000
430.51  Sec. 5.  HEALTH-RELATED BOARDS 
430.52  Subdivision 1.  Total
430.53  Appropriation                         11,266,000     11,266,000 
431.1   [STATE GOVERNMENT SPECIAL REVENUE 
431.2   FUND.] The appropriations in this 
431.3   section are from the state government 
431.4   special revenue fund, except where 
431.5   noted. 
431.6   [NO SPENDING IN EXCESS OF REVENUES.] 
431.7   The commissioner of finance shall not 
431.8   permit the allotment, encumbrance, or 
431.9   expenditure of money appropriated in 
431.10  this section in excess of the 
431.11  anticipated biennial revenues or 
431.12  accumulated surplus revenues from fees 
431.13  collected by the boards.  Neither this 
431.14  provision nor Minnesota Statutes, 
431.15  section 214.06, applies to transfers 
431.16  from the general contingent account. 
431.17  [STATE GOVERNMENT SPECIAL REVENUE FUND 
431.18  TRANSFERS.] On July 1, 2003, the 
431.19  commissioner of finance shall transfer 
431.20  $7,500,000 from the state government 
431.21  special revenue fund to the general 
431.22  fund. 
431.23  Subd. 2.  Board of Chiropractic
431.24  Examiners                                384,000        384,000 
431.25  Subd. 3.  Board of Dentistry                                    
431.26  State Government Special    
431.27  Revenue Fund                             858,000        858,000 
431.28  Health Care                 
431.29  Access Fund                               64,000         64,000 
431.30  Subd. 4.  Board of Dietetic and 
431.31  Nutrition Practice                       101,000        101,000 
431.32  Subd. 5.  Board of Marriage and
431.33  Family Therapy                           118,000        118,000 
431.34  Subd. 6.  Board of Medical
431.35  Practice                               3,498,000      3,498,000 
431.36  Subd. 7.  Board of Nursing             2,405,000      2,405,000 
431.37  Subd. 8.  Board of Nursing
431.38  Home Administrators                      198,000        198,000 
431.39  Subd. 9.  Board of Optometry              96,000         96,000 
431.40  Subd. 10.  Board of Pharmacy           1,386,000      1,386,000 
431.41  [ADMINISTRATIVE SERVICES UNIT.] Of this 
431.42  appropriation, $359,000 the first year 
431.43  and $359,000 the second year are for 
431.44  the health boards administrative 
431.45  services unit.  The administrative 
431.46  services unit may receive and expend 
431.47  reimbursements for services performed 
431.48  for other agencies. 
431.49  Subd. 11.  Board of Physical
431.50  Therapy                                  197,000        197,000 
431.51  Subd. 12.  Board of Podiatry              45,000         45,000 
431.52  Subd. 13.  Board of Psychology           680,000        680,000 
432.1   Subd. 14.  Board of Social 
432.2   Work                                   1,073,000      1,073,000 
432.3   Subd. 15.  Board of Veterinary
432.4   Medicine                                 163,000        163,000 
432.5   Sec. 6.  EMERGENCY MEDICAL SERVICES BOARD 
432.6   Subdivision 1.  Total
432.7   Appropriation                          2,850,000      2,850,000
432.8                 Summary by Fund
432.9   General               2,304,000     2,304,000
432.10  State Government
432.11  Special Revenue         546,000       546,000
432.12  [HEALTH PROFESSIONAL SERVICES 
432.13  ACTIVITY.] $546,000 each year from the 
432.14  state government special revenue fund 
432.15  is for the health professional services 
432.16  activity. 
432.17  Sec. 7.  COUNCIL ON DISABILITY 
432.18  General                                  500,000        500,000
432.19  Sec. 8.  OMBUDSMAN FOR MENTAL HEALTH 
432.20  AND MENTAL RETARDATION                                          
432.21  General                                1,243,000      1,242,000 
432.22  Sec. 9.  OMBUDSMAN FOR 
432.23  FAMILIES                                                        
432.24  General                                  170,000        170,000 
432.25     Sec. 10.  [TRANSFERS.] 
432.26     Subdivision 1.  [GRANTS.] The commissioner of human 
432.27  services, with the approval of the commissioner of finance, and 
432.28  after notification of the chair of the senate health, human 
432.29  services and corrections budget division and the chair of the 
432.30  house health and human services finance committee, may transfer 
432.31  unencumbered appropriation balances for the biennium ending June 
432.32  30, 2005, within fiscal years among the MFIP, general 
432.33  assistance, general assistance medical care, medical assistance, 
432.34  Minnesota supplemental aid, and group residential housing 
432.35  programs, and the entitlement portion of the chemical dependency 
432.36  consolidated treatment fund, and between fiscal years of the 
432.37  biennium. 
432.38     Subd. 2.  [ADMINISTRATION.] Positions, salary money, and 
432.39  nonsalary administrative money may be transferred within the 
432.40  departments of human services and health and within the programs 
432.41  operated by the veterans nursing homes board as the 
433.1   commissioners and the board consider necessary, with the advance 
433.2   approval of the commissioner of finance.  The commissioner or 
433.3   the board shall inform the chairs of the house health and human 
433.4   services finance committee and the senate health, human services 
433.5   and corrections budget division quarterly about transfers made 
433.6   under this provision. 
433.7      Subd. 3.  [PROHIBITED TRANSFERS.] Grant money shall not be 
433.8   transferred to operations within the departments of human 
433.9   services and health and within the programs operated by the 
433.10  veterans nursing homes board without the approval of the 
433.11  legislature. 
433.12     Sec. 11.  [INDIRECT COSTS NOT TO FUND PROGRAMS.] 
433.13     The commissioners of health and of human services shall not 
433.14  use indirect cost allocations to pay for the operational costs 
433.15  of any program for which they are responsible. 
433.16     Sec. 12.  [CARRYOVER LIMITATION.] 
433.17     The appropriations in this article which are allowed to be 
433.18  carried forward from fiscal year 2004 to fiscal year 2005 shall 
433.19  not become part of the base level funding for the 2006-2007 
433.20  biennial budget, unless specifically directed by the legislature.
433.21     Sec. 13.  [SUNSET OF UNCODIFIED LANGUAGE.] 
433.22     All uncodified language contained in this article expires 
433.23  on June 30, 2005, unless a different expiration date is explicit.
433.24     Sec. 14.  [REPEALER.] 
433.25     Laws 2002, chapter 374, article 9, section 8, is repealed 
433.26  effective upon final enactment. 
433.27     Sec. 15.  [EFFECTIVE DATE.] 
433.28     The provisions in this article are effective July 1, 2003, 
433.29  unless a different effective date is specified.