1.1 	A bill for an act
1.2 	relating to the operation of state government; making
1.3 	changes to health and human services programs;
1.4 	changing licensing and state-operated services
1.5 	provisions; changing provisions in state health care
1.6 	programs, changing MinnesotaCare to a forecasted
1.7 	program and changing eligibility requirements and
1.8 	payments, allowing transfer of excess health care
1.9 	access funds to the general fund, allowing the
1.10 	commissioner to withhold for delinquent nursing home
1.11 	provider surcharges, allowing reduction of excess
1.12 	assets for MA and changing other MA provisions,
1.13 	reducing payments to managed care plans, establishing
1.14 	medical necessity standards for state health care
1.15 	programs, allowing the state to recover payment for
1.16 	long-term care from trusts and life estates or joint
1.17 	tenancy interests, and establishing a health services
1.18 	policy committee and medication therapy management;
1.19 	establishing a value-based nursing facility
1.20 	reimbursement system and changing other provisions for
1.21 	nursing facilities; changing continuing care for the
1.22 	elderly and disabled provisions and establishing the
1.23 	Minnesota partnership for long-term care programs,
1.24 	increasing rate reimbursement for ICF/MR facilities,
1.25 	health care services, and provider rate increases,
1.26 	requiring a study for dental access, establishing an
1.27 	interagency work group on disability services;
1.28 	changing provisions for mental health services,
1.29 	allowing payment for mental health telemedicine,
1.30 	providing treatment foster care services and
1.31 	transitional youth intensive rehabilitative mental
1.32 	health services; modifying health policy, establishing
1.33 	a Health Information Technology and Infrastructure
1.34 	Advisory Committee, establishing a rural pharmacy
1.35 	planning and transition grant program, requiring a
1.36 	report from physicians and facilities performing
1.37 	abortions, classifying data in abortion notification
1.38 	reports, providing education on shaking infants and
1.39 	children, establishing a voluntary trauma system,
1.40 	trauma registry, and trauma advisory council,
1.41 	establishing a cancer drug repository program,
1.42 	prohibiting family grant funds to subsidize abortion
1.43 	services, promoting positive abortion alternatives,
1.44 	establishing the unborn child pain prevention act,
1.45 	providing education on postpartum depression,
1.46 	adjusting certain fees, providing civil and criminal
2.1 	penalties; making forecast adjustments; appropriating
2.2 	money; and providing for alternative funding; amending
2.3 	Minnesota Statutes 2004, sections 13.3806, by adding a
2.4 	subdivision; 16A.724; 103I.101, subdivision 6;
2.5 	103I.208, subdivisions 1, 2; 103I.235, subdivision 1;
2.6 	103I.601, subdivision 2; 144.122; 144.147,
2.7 	subdivisions 1, 2; 144.148, subdivision 1; 144.1483;
2.8 	144.1501, subdivisions 1, 2, 3, 4; 144.226,
2.9 	subdivisions 1, 4, by adding subdivisions; 144.3831,
2.10 	subdivision 1; 144.551, subdivision 1; 144.562,
2.11 	subdivision 2; 144.9504, subdivision 2; 144.98,
2.12 	subdivision 3; 144A.071, subdivision 4a; 144A.073, by
2.13 	adding a subdivision; 144E.101, by adding a
2.14 	subdivision; 145.56, subdivisions 2, 5; 145.924;
2.15 	145.9268; 146A.11, subdivision 1; 147A.08; 150A.22;
2.16 	157.011, by adding a subdivision; 157.15, by adding a
2.17 	subdivision; 157.16, subdivisions 2, 3, by adding
2.18 	subdivisions; 157.20, subdivisions 2, 2a; 214.01,
2.19 	subdivision 2; 214.06, subdivision 1, by adding a
2.20 	subdivision; 245.4661, subdivisions 2, 6; 245.4885,
2.21 	subdivisions 1, 2, by adding a subdivision; 245A.10,
2.22 	subdivision 5; 245C.10, subdivisions 2, 3; 245C.32,
2.23 	subdivision 2; 246.0136, subdivision 1; 252.27,
2.24 	subdivision 2a; 253.20; 253B.02, subdivision 7;
2.25 	256.01, subdivision 2, by adding subdivisions;
2.26 	256.019, subdivision 1; 256.045, subdivisions 3, 3a;
2.27 	256.046, subdivision 1; 256.9657, by adding a
2.28 	subdivision; 256.969, subdivisions 3a, 26; 256B.02,
2.29 	subdivision 12; 256B.04, by adding a subdivision;
2.30 	256B.056, subdivisions 5, 5a, 5b, 7, by adding
2.31 	subdivisions; 256B.057, subdivision 9; 256B.0575;
2.32 	256B.0595, subdivision 2; 256B.06, subdivision 4;
2.33 	256B.0621, subdivisions 2, 3, 4, 5, 6, 7, by adding a
2.34 	subdivision; 256B.0625, subdivisions 2, 3a, 13, 13a,
2.35 	13c, 13e, 13f, 17, by adding subdivisions; 256B.0644;
2.36 	256B.075, subdivision 2; 256B.0913, subdivisions 2, 4;
2.37 	256B.0916, by adding a subdivision; 256B.0943,
2.38 	subdivision 3; 256B.095; 256B.0951, subdivision 1;
2.39 	256B.0952, subdivision 5; 256B.0953, subdivision 1;
2.40 	256B.15, subdivision 1; 256B.19, subdivision 1;
2.41 	256B.195, subdivision 3; 256B.32, subdivision 1;
2.42 	256B.431, subdivisions 28, 29, 35, by adding
2.43 	subdivisions; 256B.432, subdivisions 1, 2, 5, by
2.44 	adding subdivisions; 256B.434, subdivisions 3, 4, 4a,
2.45 	4b, 4c, 4d, by adding subdivisions; 256B.438,
2.46 	subdivision 3; 256B.47, subdivision 2; 256B.49,
2.47 	subdivision 16; 256B.5012, by adding a subdivision;
2.48 	256B.69, subdivisions 4, 23, by adding a subdivision;
2.49 	256B.75; 256B.765; 256D.03, subdivisions 3, 4, by
2.50 	adding subdivisions; 256D.045; 256L.01, subdivisions
2.51 	1a, 4, 5; 256L.03, subdivisions 1, 3, 5, by adding a
2.52 	subdivision; 256L.04, subdivisions 1, 2, 8, by adding
2.53 	subdivisions; 256L.05, subdivisions 2, 3, 3a, 5;
2.54 	256L.06, subdivision 3; 256L.07, subdivisions 1, 3, by
2.55 	adding a subdivision; 256L.09, subdivision 2; 256L.11,
2.56 	subdivision 6; 256L.12, subdivision 6, by adding a
2.57 	subdivision; 256L.15, subdivisions 2, 3; 326.42,
2.58 	subdivision 2; 471.61, by adding a subdivision;
2.59 	514.981, subdivision 6; Laws 2003, First Special
2.60 	Session chapter 14, article 12, section 93; proposing
2.61 	coding for new law in Minnesota Statutes, chapters
2.62 	62J; 144; 145; 245A; 256B; 501B; repealing Minnesota
2.63 	Statutes 2004, sections 13.383, subdivision 3; 13.411,
2.64 	subdivision 3; 144.1486; 144.1502; 145.925; 146A.01,
2.65 	subdivisions 2, 5; 146A.02; 146A.03; 146A.04; 146A.05;
2.66 	146A.06; 146A.07; 146A.08; 146A.09; 146A.10; 157.215;
2.67 	256.955; 256B.075, subdivision 5; 256L.035; 256L.04,
2.68 	subdivisions 7, 11; 256L.09, subdivisions 1, 4, 5, 6,
2.69 	7; 295.581; Minnesota Rules, parts 4700.1900;
2.70 	4700.2000; 4700.2100; 4700.2200; 4700.2210; 4700.2300;
2.71 	4700.2400; 4700.2410; 4700.2420; 4700.2500.
3.1 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.2 	ARTICLE 1
3.3 	LICENSING

3.4 	Section 1. Minnesota Statutes 2004, section 245A.10,
3.5 	subdivision 5, is amended to read:
3.6 		Subd. 5.Annual license or certification fee for programs
3.7 	without a licensed capacity.  (a) Except as provided
3.8 	in paragraph paragraphs (b) and (c), a program without a stated
3.9 	licensed capacity shall pay a license or certification fee of
3.10 	$400.
3.11 	(b) A mental health center or mental health clinic
3.12 	requesting certification for purposes of insurance and
3.13 	subscriber contract reimbursement under Minnesota Rules, parts
3.14 	9520.0750 to 9520.0870, shall pay a certification fee of $1,000
3.15 	per year.  If the mental health center or mental health clinic
3.16 	provides services at a primary location with satellite
3.17 	facilities, the satellite facilities shall be certified with the
3.18 	primary location without an additional charge.
3.19 	(c) A program licensed to provide residential-based
3.20 	habilitation services under the home and community-based waiver
3.21 	for persons with developmental disabilities shall pay an annual
3.22 	license fee that includes a base rate of $250 plus $38 times the
3.23 	number of clients served on the first day of August of the
3.24 	current license year.  State-operated programs are exempt from
3.25 	the license fee under this paragraph.

3.26 	Sec. 2. Minnesota Statutes 2004, section 245C.10,
3.27 	subdivision 2, is amended to read:
3.28 		Subd. 2.Supplemental nursing services agencies.  The
3.29 	commissioner shall recover the cost of the background studies
3.30 	initiated by supplemental nursing services agencies registered
3.31 	under section 144A.71, subdivision 1, through a fee of no more
3.32 	than $8 $20 per study charged to the agency.  The fees collected
3.33 	under this subdivision are appropriated to the commissioner for
3.34 	the purpose of conducting background studies.

3.35 	Sec. 3. Minnesota Statutes 2004, section 245C.10,
3.36 	subdivision 3, is amended to read:
4.1 		Subd. 3.Personal care provider organizations.  The
4.2 	commissioner shall recover the cost of background studies
4.3 	initiated by a personal care provider organization under section
4.4 	256B.0627 through a fee of no more than $12 $20 per study
4.5 	charged to the organization responsible for submitting the
4.6 	background study form.  The fees collected under this
4.7 	subdivision are appropriated to the commissioner for the purpose
4.8 	of conducting background studies.

4.9 	Sec. 4. Minnesota Statutes 2004, section 245C.32,
4.10 	subdivision 2, is amended to read:
4.11 		Subd. 2.Use.  (a) The commissioner may also use these
4.12 	systems and records to obtain and provide criminal history data
4.13 	from the Bureau of Criminal Apprehension, criminal history data
4.14 	held by the commissioner, and data about substantiated
4.15 	maltreatment under section 626.556 or 626.557, for other
4.16 	purposes, provided that:
4.17 	(1) the background study is specifically authorized in
4.18 	statute; or
4.19 	(2) the request is made with the informed consent of the
4.20 	subject of the study as provided in section 13.05, subdivision 4.
4.21 	(b) An individual making a request under paragraph (a),
4.22 	clause (2), must agree in writing not to disclose the data to
4.23 	any other individual without the consent of the subject of the
4.24 	data.
4.25 	(c) The commissioner may recover the cost of obtaining and
4.26 	providing background study data by charging the individual or
4.27 	entity requesting the study a fee of no more than $12 $20 per
4.28 	study.  The fees collected under this paragraph are appropriated
4.29 	to the commissioner for the purpose of conducting background
4.30 	studies.

4.31 	ARTICLE 2
4.32 	STATE-OPERATED SERVICES

4.33 	Section 1. Minnesota Statutes 2004, section 245.4661,
4.34 	subdivision 2, is amended to read:
4.35 		Subd. 2.Program design and implementation.  (a) The
4.36 	pilot projects shall be established to design, plan, and improve
5.1 	the mental health service delivery system for adults with
5.2 	serious and persistent mental illness that would:
5.3 	(1) provide an expanded array of services from which
5.4 	clients can choose services appropriate to their needs;
5.5 	(2) be based on purchasing strategies that improve access
5.6 	and coordinate services without cost shifting;
5.7 	(3) incorporate existing state facilities and resources
5.8 	into the community mental health infrastructure through creative
5.9 	partnerships with local vendors; and
5.10 	(4) utilize existing categorical funding streams and
5.11 	reimbursement sources in combined and creative ways, except
5.12 	appropriations to regional treatment centers and all funds that
5.13 	are attributable to the operation of state-operated services are
5.14 	excluded unless appropriated specifically by the legislature for
5.15 	a purpose consistent with this section or section 246.0136,
5.16 	subdivision 1.
5.17 	(b) All projects funded by January 1, 1997, must complete
5.18 	the planning phase and be operational by June 30, 1997; all
5.19 	projects funded by January 1, 1998, must be operational by June
5.20 	30, 1998.

5.21 	Sec. 2. Minnesota Statutes 2004, section 245.4661,
5.22 	subdivision 6, is amended to read:
5.23 		Subd. 6.Duties of commissioner.  (a) For purposes of the
5.24 	pilot projects, the commissioner shall facilitate integration of
5.25 	funds or other resources as needed and requested by each
5.26 	project.  These resources may include:
5.27 	(1) residential services funds administered under Minnesota
5.28 	Rules, parts 9535.2000 to 9535.3000, in an amount to be
5.29 	determined by mutual agreement between the project's managing
5.30 	entity and the commissioner of human services after an
5.31 	examination of the county's historical utilization of facilities
5.32 	located both within and outside of the county and licensed under
5.33 	Minnesota Rules, parts 9520.0500 to 9520.0690;
5.34 	(2) community support services funds administered under
5.35 	Minnesota Rules, parts 9535.1700 to 9535.1760;
5.36 	(3) other mental health special project funds;
6.1 	(4) medical assistance, general assistance medical care,
6.2 	MinnesotaCare and group residential housing if requested by the
6.3 	project's managing entity, and if the commissioner determines
6.4 	this would be consistent with the state's overall health care
6.5 	reform efforts; and
6.6 	(5) regional treatment center nonfiscal resources to the
6.7 	extent agreed to by the project's managing entity and the
6.8 	regional treatment center consistent with section 246.0136,
6.9 	subdivision 1.
6.10 	(b) The commissioner shall consider the following criteria
6.11 	in awarding start-up and implementation grants for the pilot
6.12 	projects:
6.13 	(1) the ability of the proposed projects to accomplish the
6.14 	objectives described in subdivision 2;
6.15 	(2) the size of the target population to be served; and
6.16 	(3) geographical distribution.
6.17 	(c) The commissioner shall review overall status of the
6.18 	projects initiatives at least every two years and recommend any
6.19 	legislative changes needed by January 15 of each odd-numbered
6.20 	year.
6.21 	(d) The commissioner may waive administrative rule
6.22 	requirements which are incompatible with the implementation of
6.23 	the pilot project.
6.24 	(e) The commissioner may exempt the participating counties
6.25 	from fiscal sanctions for noncompliance with requirements in
6.26 	laws and rules which are incompatible with the implementation of
6.27 	the pilot project.
6.28 	(f) The commissioner may award grants to an entity
6.29 	designated by a county board or group of county boards to pay
6.30 	for start-up and implementation costs of the pilot project.

6.31 	Sec. 3. Minnesota Statutes 2004, section 246.0136,
6.32 	subdivision 1, is amended to read:
6.33 		Subdivision 1.Planning for enterprise activities.  The
6.34 	commissioner of human services is directed to study and make
6.35 	recommendations to the legislature on establishing enterprise
6.36 	activities within state-operated services.  Before implementing
7.1 	an enterprise activity, the commissioner must obtain statutory
7.2 	authorization for its implementation, except that the
7.3 	commissioner has authority to implement enterprise activities
7.4 	for adult mental health,adolescent services,and to establish a
7.5 	public group practice without statutory authorization.
7.6 	Enterprise activities are defined as the range of services,
7.7 	which are delivered by state employees, needed by people with
7.8 	disabilities and are fully funded by public or private
7.9 	third-party health insurance or other revenue sources available
7.10 	to clients that provide reimbursement for the services
7.11 	provided.  Enterprise activities within state-operated services
7.12 	shall specialize in caring for vulnerable people for whom no
7.13 	other providers are available or for whom state-operated
7.14 	services may be the provider selected by the payer.  In
7.15 	subsequent biennia after an enterprise activity is established
7.16 	within a state-operated service, the base state appropriation
7.17 	for that state-operated service shall be reduced proportionate
7.18 	to the size of the enterprise activity.

7.19 	Sec. 4. Minnesota Statutes 2004, section 253.20, is
7.20 	amended to read:
7.21 	253.20 MINNESOTA SECURITY HOSPITAL.
7.22 	The commissioner of human services shall erect, equip, and
7.23 	maintain in St. Peter a and other geographic locations under the
7.24 	control of the commissioner of human services suitable
7.25 	building buildings to be known as the Minnesota Security
7.26 	Hospital, for the purpose of providing a secure treatment
7.27 	facility as defined in section 253B.02, subdivision 18a, for
7.28 	persons who may be committed there by courts, or otherwise, or
7.29 	transferred there by the commissioner of human services, and for
7.30 	persons who are found to be mentally ill while confined in any
7.31 	correctional facility, or who may be found to be mentally ill
7.32 	and dangerous, and the commissioner shall supervise and manage
7.33 	the same as in the case of other state hospitals.

7.34 	ARTICLE 3
7.35 	HEALTH CARE

7.36 	Section 1. Minnesota Statutes 2004, section 16A.724, is
8.1 	amended to read:
8.2 	16A.724 HEALTH CARE ACCESS FUND.
8.3 		Subdivision 1.Creation of fund. (a) A health care
8.4 	access fund is created in the state treasury.  The fund is a
8.5 	direct appropriated special revenue fund.  The commissioner
8.6 	shall deposit to the credit of the fund money made available to
8.7 	the fund.  Notwithstanding section 11A.20, after June 30, 1997,
8.8 	all investment income and all investment losses attributable to
8.9 	the investment of the health care access fund not currently
8.10 	needed shall be credited to the health care access fund.
8.11 	(b) Effective July 1, 2006, the commissioner of finance
8.12 	shall deposit revenues collected from section 256.9657,
8.13 	subdivisions 2 and 3, into the health care access fund.
8.14 		Subd. 2.Transfers. To the extent available resources in
8.15 	the health care access fund exceed expenditures in that fund,
8.16 	starting in fiscal year 2005, the commissioner of finance shall
8.17 	transfer the excess funds from the health care access fund to
8.18 	the general fund on June 30 of each year.
8.19 	(a) In fiscal year 2005, transfers may not exceed
8.20 	$192,442,000.  For fiscal year 2008 and thereafter, the transfer
8.21 	may not exceed $50,000,000.
8.22 	(b) For fiscal years 2005 to 2007, MinnesotaCare shall be a
8.23 	forecasted program and, if necessary, the commissioner shall
8.24 	reduce transfers to meet expenditures and shall transfer
8.25 	sufficient funds from the general fund to the health care access
8.26 	fund to meet annual expenditures.
8.27 	
EFFECTIVE DATE. This section is effective the day
8.28 	following final enactment.

8.29 	Sec. 2. Minnesota Statutes 2004, section 256.01,
8.30 	subdivision 2, is amended to read:
8.31 		Subd. 2.Specific powers.  Subject to the provisions of
8.32 	section 241.021, subdivision 2, the commissioner of human
8.33 	services shall carry out the specific duties in paragraphs (a)
8.34 	through (aa) (cc):
8.35 	(a) Administer and supervise all forms of public assistance
8.36 	provided for by state law and other welfare activities or
9.1 	services as are vested in the commissioner.  Administration and
9.2 	supervision of human services activities or services includes,
9.3 	but is not limited to, assuring timely and accurate distribution
9.4 	of benefits, completeness of service, and quality program
9.5 	management.  In addition to administering and supervising human
9.6 	services activities vested by law in the department, the
9.7 	commissioner shall have the authority to:
9.8 	(1) require county agency participation in training and
9.9 	technical assistance programs to promote compliance with
9.10 	statutes, rules, federal laws, regulations, and policies
9.11 	governing human services;
9.12 	(2) monitor, on an ongoing basis, the performance of county
9.13 	agencies in the operation and administration of human services,
9.14 	enforce compliance with statutes, rules, federal laws,
9.15 	regulations, and policies governing welfare services and promote
9.16 	excellence of administration and program operation;
9.17 	(3) develop a quality control program or other monitoring
9.18 	program to review county performance and accuracy of benefit
9.19 	determinations;
9.20 	(4) require county agencies to make an adjustment to the
9.21 	public assistance benefits issued to any individual consistent
9.22 	with federal law and regulation and state law and rule and to
9.23 	issue or recover benefits as appropriate;
9.24 	(5) delay or deny payment of all or part of the state and
9.25 	federal share of benefits and administrative reimbursement
9.26 	according to the procedures set forth in section 256.017;
9.27 	(6) make contracts with and grants to public and private
9.28 	agencies and organizations, both profit and nonprofit, and
9.29 	individuals, using appropriated funds; and
9.30 	(7) enter into contractual agreements with federally
9.31 	recognized Indian tribes with a reservation in Minnesota to the
9.32 	extent necessary for the tribe to operate a federally approved
9.33 	family assistance program or any other program under the
9.34 	supervision of the commissioner.  The commissioner shall consult
9.35 	with the affected county or counties in the contractual
9.36 	agreement negotiations, if the county or counties wish to be
10.1 	included, in order to avoid the duplication of county and tribal
10.2 	assistance program services.  The commissioner may establish
10.3 	necessary accounts for the purposes of receiving and disbursing
10.4 	funds as necessary for the operation of the programs.
10.5 	(b) Inform county agencies, on a timely basis, of changes
10.6 	in statute, rule, federal law, regulation, and policy necessary
10.7 	to county agency administration of the programs.
10.8 	(c) Administer and supervise all child welfare activities;
10.9 	promote the enforcement of laws protecting handicapped,
10.10 	dependent, neglected and delinquent children, and children born
10.11 	to mothers who were not married to the children's fathers at the
10.12 	times of the conception nor at the births of the children;
10.13 	license and supervise child-caring and child-placing agencies
10.14 	and institutions; supervise the care of children in boarding and
10.15 	foster homes or in private institutions; and generally perform
10.16 	all functions relating to the field of child welfare now vested
10.17 	in the State Board of Control.
10.18 	(d) Administer and supervise all noninstitutional service
10.19 	to handicapped persons, including those who are visually
10.20 	impaired, hearing impaired, or physically impaired or otherwise
10.21 	handicapped.  The commissioner may provide and contract for the
10.22 	care and treatment of qualified indigent children in facilities
10.23 	other than those located and available at state hospitals when
10.24 	it is not feasible to provide the service in state hospitals.
10.25 	(e) Assist and actively cooperate with other departments,
10.26 	agencies and institutions, local, state, and federal, by
10.27 	performing services in conformity with the purposes of Laws
10.28 	1939, chapter 431.
10.29 	(f) Act as the agent of and cooperate with the federal
10.30 	government in matters of mutual concern relative to and in
10.31 	conformity with the provisions of Laws 1939, chapter 431,
10.32 	including the administration of any federal funds granted to the
10.33 	state to aid in the performance of any functions of the
10.34 	commissioner as specified in Laws 1939, chapter 431, and
10.35 	including the promulgation of rules making uniformly available
10.36 	medical care benefits to all recipients of public assistance, at
11.1 	such times as the federal government increases its participation
11.2 	in assistance expenditures for medical care to recipients of
11.3 	public assistance, the cost thereof to be borne in the same
11.4 	proportion as are grants of aid to said recipients.
11.5 	(g) Establish and maintain any administrative units
11.6 	reasonably necessary for the performance of administrative
11.7 	functions common to all divisions of the department.
11.8 	(h) Act as designated guardian of both the estate and the
11.9 	person of all the wards of the state of Minnesota, whether by
11.10 	operation of law or by an order of court, without any further
11.11 	act or proceeding whatever, except as to persons committed as
11.12 	mentally retarded.  For children under the guardianship of the
11.13 	commissioner whose interests would be best served by adoptive
11.14 	placement, the commissioner may contract with a licensed
11.15 	child-placing agency or a Minnesota tribal social services
11.16 	agency to provide adoption services.  A contract with a licensed
11.17 	child-placing agency must be designed to supplement existing
11.18 	county efforts and may not replace existing county programs,
11.19 	unless the replacement is agreed to by the county board and the
11.20 	appropriate exclusive bargaining representative or the
11.21 	commissioner has evidence that child placements of the county
11.22 	continue to be substantially below that of other counties.
11.23 	Funds encumbered and obligated under an agreement for a specific
11.24 	child shall remain available until the terms of the agreement
11.25 	are fulfilled or the agreement is terminated.
11.26 	(i) Act as coordinating referral and informational center
11.27 	on requests for service for newly arrived immigrants coming to
11.28 	Minnesota.
11.29 	(j) The specific enumeration of powers and duties as
11.30 	hereinabove set forth shall in no way be construed to be a
11.31 	limitation upon the general transfer of powers herein contained.
11.32 	(k) Establish county, regional, or statewide schedules of
11.33 	maximum fees and charges which may be paid by county agencies
11.34 	for medical, dental, surgical, hospital, nursing and nursing
11.35 	home care and medicine and medical supplies under all programs
11.36 	of medical care provided by the state and for congregate living
12.1 	care under the income maintenance programs.
12.2 	(l) Have the authority to conduct and administer
12.3 	experimental projects to test methods and procedures of
12.4 	administering assistance and services to recipients or potential
12.5 	recipients of public welfare.  To carry out such experimental
12.6 	projects, it is further provided that the commissioner of human
12.7 	services is authorized to waive the enforcement of existing
12.8 	specific statutory program requirements, rules, and standards in
12.9 	one or more counties.  The order establishing the waiver shall
12.10 	provide alternative methods and procedures of administration,
12.11 	shall not be in conflict with the basic purposes, coverage, or
12.12 	benefits provided by law, and in no event shall the duration of
12.13 	a project exceed four years.  It is further provided that no
12.14 	order establishing an experimental project as authorized by the
12.15 	provisions of this section shall become effective until the
12.16 	following conditions have been met:
12.17 	(1) the secretary of health and human services of the
12.18 	United States has agreed, for the same project, to waive state
12.19 	plan requirements relative to statewide uniformity; and
12.20 	(2) a comprehensive plan, including estimated project
12.21 	costs, shall be approved by the Legislative Advisory Commission
12.22 	and filed with the commissioner of administration.
12.23 	(m) According to federal requirements, establish procedures
12.24 	to be followed by local welfare boards in creating citizen
12.25 	advisory committees, including procedures for selection of
12.26 	committee members.
12.27 	(n) Allocate federal fiscal disallowances or sanctions
12.28 	which are based on quality control error rates for the aid to
12.29 	families with dependent children program formerly codified in
12.30 	sections 256.72 to 256.87, medical assistance, or food stamp
12.31 	program in the following manner:
12.32 	(1) one-half of the total amount of the disallowance shall
12.33 	be borne by the county boards responsible for administering the
12.34 	programs.  For the medical assistance and the AFDC program
12.35 	formerly codified in sections 256.72 to 256.87, disallowances
12.36 	shall be shared by each county board in the same proportion as
13.1 	that county's expenditures for the sanctioned program are to the
13.2 	total of all counties' expenditures for the AFDC program
13.3 	formerly codified in sections 256.72 to 256.87, and medical
13.4 	assistance programs.  For the food stamp program, sanctions
13.5 	shall be shared by each county board, with 50 percent of the
13.6 	sanction being distributed to each county in the same proportion
13.7 	as that county's administrative costs for food stamps are to the
13.8 	total of all food stamp administrative costs for all counties,
13.9 	and 50 percent of the sanctions being distributed to each county
13.10 	in the same proportion as that county's value of food stamp
13.11 	benefits issued are to the total of all benefits issued for all
13.12 	counties.  Each county shall pay its share of the disallowance
13.13 	to the state of Minnesota.  When a county fails to pay the
13.14 	amount due hereunder, the commissioner may deduct the amount
13.15 	from reimbursement otherwise due the county, or the attorney
13.16 	general, upon the request of the commissioner, may institute
13.17 	civil action to recover the amount due; and
13.18 	(2) notwithstanding the provisions of clause (1), if the
13.19 	disallowance results from knowing noncompliance by one or more
13.20 	counties with a specific program instruction, and that knowing
13.21 	noncompliance is a matter of official county board record, the
13.22 	commissioner may require payment or recover from the county or
13.23 	counties, in the manner prescribed in clause (1), an amount
13.24 	equal to the portion of the total disallowance which resulted
13.25 	from the noncompliance, and may distribute the balance of the
13.26 	disallowance according to clause (1).
13.27 	(o) Develop and implement special projects that maximize
13.28 	reimbursements and result in the recovery of money to the
13.29 	state.  For the purpose of recovering state money, the
13.30 	commissioner may enter into contracts with third parties.  Any
13.31 	recoveries that result from projects or contracts entered into
13.32 	under this paragraph shall be deposited in the state treasury
13.33 	and credited to a special account until the balance in the
13.34 	account reaches $1,000,000.  When the balance in the account
13.35 	exceeds $1,000,000, the excess shall be transferred and credited
13.36 	to the general fund.  All money in the account is appropriated
14.1 	to the commissioner for the purposes of this paragraph.
14.2 	(p) Have the authority to make direct payments to
14.3 	facilities providing shelter to women and their children
14.4 	according to section 256D.05, subdivision 3.  Upon the written
14.5 	request of a shelter facility that has been denied payments
14.6 	under section 256D.05, subdivision 3, the commissioner shall
14.7 	review all relevant evidence and make a determination within 30
14.8 	days of the request for review regarding issuance of direct
14.9 	payments to the shelter facility.  Failure to act within 30 days
14.10 	shall be considered a determination not to issue direct payments.
14.11 	(q) Have the authority to establish and enforce the
14.12 	following county reporting requirements:
14.13 	(1) the commissioner shall establish fiscal and statistical
14.14 	reporting requirements necessary to account for the expenditure
14.15 	of funds allocated to counties for human services programs.
14.16 	When establishing financial and statistical reporting
14.17 	requirements, the commissioner shall evaluate all reports, in
14.18 	consultation with the counties, to determine if the reports can
14.19 	be simplified or the number of reports can be reduced;
14.20 	(2) the county board shall submit monthly or quarterly
14.21 	reports to the department as required by the commissioner.
14.22 	Monthly reports are due no later than 15 working days after the
14.23 	end of the month.  Quarterly reports are due no later than 30
14.24 	calendar days after the end of the quarter, unless the
14.25 	commissioner determines that the deadline must be shortened to
14.26 	20 calendar days to avoid jeopardizing compliance with federal
14.27 	deadlines or risking a loss of federal funding.  Only reports
14.28 	that are complete, legible, and in the required format shall be
14.29 	accepted by the commissioner;
14.30 	(3) if the required reports are not received by the
14.31 	deadlines established in clause (2), the commissioner may delay
14.32 	payments and withhold funds from the county board until the next
14.33 	reporting period.  When the report is needed to account for the
14.34 	use of federal funds and the late report results in a reduction
14.35 	in federal funding, the commissioner shall withhold from the
14.36 	county boards with late reports an amount equal to the reduction
15.1 	in federal funding until full federal funding is received;
15.2 	(4) a county board that submits reports that are late,
15.3 	illegible, incomplete, or not in the required format for two out
15.4 	of three consecutive reporting periods is considered
15.5 	noncompliant.  When a county board is found to be noncompliant,
15.6 	the commissioner shall notify the county board of the reason the
15.7 	county board is considered noncompliant and request that the
15.8 	county board develop a corrective action plan stating how the
15.9 	county board plans to correct the problem.  The corrective
15.10 	action plan must be submitted to the commissioner within 45 days
15.11 	after the date the county board received notice of
15.12 	noncompliance;
15.13 	(5) the final deadline for fiscal reports or amendments to
15.14 	fiscal reports is one year after the date the report was
15.15 	originally due.  If the commissioner does not receive a report
15.16 	by the final deadline, the county board forfeits the funding
15.17 	associated with the report for that reporting period and the
15.18 	county board must repay any funds associated with the report
15.19 	received for that reporting period;
15.20 	(6) the commissioner may not delay payments, withhold
15.21 	funds, or require repayment under clause (3) or (5) if the
15.22 	county demonstrates that the commissioner failed to provide
15.23 	appropriate forms, guidelines, and technical assistance to
15.24 	enable the county to comply with the requirements.  If the
15.25 	county board disagrees with an action taken by the commissioner
15.26 	under clause (3) or (5), the county board may appeal the action
15.27 	according to sections 14.57 to 14.69; and
15.28 	(7) counties subject to withholding of funds under clause
15.29 	(3) or forfeiture or repayment of funds under clause (5) shall
15.30 	not reduce or withhold benefits or services to clients to cover
15.31 	costs incurred due to actions taken by the commissioner under
15.32 	clause (3) or (5).
15.33 	(r) Allocate federal fiscal disallowances or sanctions for
15.34 	audit exceptions when federal fiscal disallowances or sanctions
15.35 	are based on a statewide random sample for the foster care
15.36 	program under title IV-E of the Social Security Act, United
16.1 	States Code, title 42, in direct proportion to each county's
16.2 	title IV-E foster care maintenance claim for that period.
16.3 	(s) Be responsible for ensuring the detection, prevention,
16.4 	investigation, and resolution of fraudulent activities or
16.5 	behavior by applicants, recipients, and other participants in
16.6 	the human services programs administered by the department.
16.7 	(t) Require county agencies to identify overpayments,
16.8 	establish claims, and utilize all available and cost-beneficial
16.9 	methodologies to collect and recover these overpayments in the
16.10 	human services programs administered by the department.
16.11 	(u) Have the authority to administer a drug rebate program
16.12 	for drugs purchased pursuant to the prescription drug program
16.13 	established under section 256.955 after the beneficiary's
16.14 	satisfaction of any deductible established in the program.  The
16.15 	commissioner shall require a rebate agreement from all
16.16 	manufacturers of covered drugs as defined in section 256B.0625,
16.17 	subdivision 13.  Rebate agreements for prescription drugs
16.18 	delivered on or after July 1, 2002, must include rebates for
16.19 	individuals covered under the prescription drug program who are
16.20 	under 65 years of age.  For each drug, the amount of the rebate
16.21 	shall be equal to the rebate as defined for purposes of the
16.22 	federal rebate program in United States Code, title 42, section
16.23 	1396r-8.  The manufacturers must provide full payment within 30
16.24 	days of receipt of the state invoice for the rebate within the
16.25 	terms and conditions used for the federal rebate program
16.26 	established pursuant to section 1927 of title XIX of the Social
16.27 	Security Act.  The manufacturers must provide the commissioner
16.28 	with any information necessary to verify the rebate determined
16.29 	per drug.  The rebate program shall utilize the terms and
16.30 	conditions used for the federal rebate program established
16.31 	pursuant to section 1927 of title XIX of the Social Security Act.
16.32 	(v) Have the authority to administer the federal drug
16.33 	rebate program for drugs purchased under the medical assistance
16.34 	program as allowed by section 1927 of title XIX of the Social
16.35 	Security Act and according to the terms and conditions of
16.36 	section 1927.  Rebates shall be collected for all drugs that
17.1 	have been dispensed or administered in an outpatient setting and
17.2 	that are from manufacturers who have signed a rebate agreement
17.3 	with the United States Department of Health and Human Services.
17.4 	(w) Have the authority to administer a supplemental drug
17.5 	rebate program for drugs purchased under the medical assistance
17.6 	program.  The commissioner may enter into supplemental rebate
17.7 	contracts with pharmaceutical manufacturers and may require
17.8 	prior authorization for drugs that are from manufacturers that
17.9 	have not signed a supplemental rebate contract.  Prior
17.10 	authorization of drugs shall be subject to the provisions of
17.11 	section 256B.0625, subdivision 13.
17.12 	(x) Operate the department's communication systems account
17.13 	established in Laws 1993, First Special Session chapter 1,
17.14 	article 1, section 2, subdivision 2, to manage shared
17.15 	communication costs necessary for the operation of the programs
17.16 	the commissioner supervises.  A communications account may also
17.17 	be established for each regional treatment center which operates
17.18 	communications systems.  Each account must be used to manage
17.19 	shared communication costs necessary for the operations of the
17.20 	programs the commissioner supervises.  The commissioner may
17.21 	distribute the costs of operating and maintaining communication
17.22 	systems to participants in a manner that reflects actual usage.
17.23 	Costs may include acquisition, licensing, insurance,
17.24 	maintenance, repair, staff time and other costs as determined by
17.25 	the commissioner.  Nonprofit organizations and state, county,
17.26 	and local government agencies involved in the operation of
17.27 	programs the commissioner supervises may participate in the use
17.28 	of the department's communications technology and share in the
17.29 	cost of operation.  The commissioner may accept on behalf of the
17.30 	state any gift, bequest, devise or personal property of any
17.31 	kind, or money tendered to the state for any lawful purpose
17.32 	pertaining to the communication activities of the department.
17.33 	Any money received for this purpose must be deposited in the
17.34 	department's communication systems accounts.  Money collected by
17.35 	the commissioner for the use of communication systems must be
17.36 	deposited in the state communication systems account and is
18.1 	appropriated to the commissioner for purposes of this section.
18.2 	(y) Receive any federal matching money that is made
18.3 	available through the medical assistance program for the
18.4 	consumer satisfaction survey.  Any federal money received for
18.5 	the survey is appropriated to the commissioner for this
18.6 	purpose.  The commissioner may expend the federal money received
18.7 	for the consumer satisfaction survey in either year of the
18.8 	biennium.
18.9 	(z) Designate community information and referral call
18.10 	centers and incorporate cost reimbursement claims from the
18.11 	designated community information and referral call centers into
18.12 	the federal cost reimbursement claiming processes of the
18.13 	department according to federal law, rule, and regulations.
18.14 	Existing information and referral centers provided by Greater
18.15 	Twin Cities United Way or existing call centers for which
18.16 	Greater Twin Cities United Way has legal authority to represent,
18.17 	shall be included in these designations upon review by the
18.18 	commissioner and assurance that these services are accredited
18.19 	and in compliance with national standards.  Any reimbursement is
18.20 	appropriated to the commissioner and all designated information
18.21 	and referral centers shall receive payments according to normal
18.22 	department schedules established by the commissioner upon final
18.23 	approval of allocation methodologies from the United States
18.24 	Department of Health and Human Services Division of Cost
18.25 	Allocation or other appropriate authorities.
18.26 	(aa) Develop recommended standards for foster care homes
18.27 	that address the components of specialized therapeutic services
18.28 	to be provided by foster care homes with those services.
18.29 	(bb) Have the authority to administer a drug rebate program
18.30 	for drugs purchased for persons eligible for general assistance
18.31 	medical care under section 256D.03, subdivision 3.  The
18.32 	commissioner shall require a rebate agreement from all
18.33 	manufacturers of covered drugs as defined in section 256B.0625,
18.34 	subdivisions 13 and 13d.  For each drug, the amount of the
18.35 	rebate shall be equal to the rebate as defined for purposes of
18.36 	the federal rebate program in United States Code, title 42,
19.1 	section 1396r-8.  The manufacturers must provide payment within
19.2 	the terms and conditions used for the federal rebate program
19.3 	established under section 1927 of title XIX of the Social
19.4 	Security Act.  The manufacturers must provide the commissioner
19.5 	with any information necessary to verify the rebate determined
19.6 	per drug.  The rebate program shall utilize the terms and
19.7 	conditions used for the federal rebate program established under
19.8 	section 1927 of title XIX of the Social Security Act.
19.9 	Effective January 1, 2006, drug coverage under general
19.10 	assistance medical care shall be limited to those prescription
19.11 	drugs that:
19.12 	(1) are covered under the medical assistance program as
19.13 	described in section 256B.0625, subdivisions 13 and 13d; and 
19.14 	(2) are provided by manufacturers that have fully executed
19.15 	general assistance medical care rebate agreements with the
19.16 	commissioner and comply with such agreements.  Prescription drug
19.17 	coverage under general assistance medical care shall conform to
19.18 	coverage under the medical assistance program according to
19.19 	section 256B.0625, subdivisions 13 to 13g.
19.20 	The rebate revenues collected under the drug rebate program
19.21 	are dedicated to funding the pharmaceutical assistance program
19.22 	established under paragraph (cc).
19.23 	(cc) Have the authority to administer a pharmaceutical
19.24 	assistance program.  The pharmaceutical assistance program may
19.25 	include:
19.26 	(1) a drug discount card;
19.27 	(2) assistance to the program administered by the Minnesota
19.28 	Board on Aging under section 256.975, subdivision 9; and 
19.29 	(3) other efforts designed to assist citizens of the state
19.30 	who are not eligible for prescription drug coverage to obtain
19.31 	free or discounted prescription drugs.
19.32 	The commissioner shall have authority to administer a drug
19.33 	rebate program for any discount card program established under
19.34 	this paragraph.  The rebates collected under this paragraph
19.35 	shall be used to provide a discount on the prescription drugs
19.36 	dispensed to enrollees of the discount card program.

20.1 	Sec. 3. Minnesota Statutes 2004, section 256.01, is
20.2 	amended by adding a subdivision to read:
20.3 		Subd. 2a.Authorization for test sites for health care
20.4 	programs. In coordination with the development and
20.5 	implementation of HealthMatch, an automated eligibility system
20.6 	for medical assistance, general assistance medical care, and
20.7 	MinnesotaCare, the commissioner, in cooperation with county
20.8 	agencies, is authorized to test and compare a variety of
20.9 	administrative models to demonstrate and evaluate outcomes of
20.10 	integrating health care program business processes and points of
20.11 	access.  The models will be evaluated for ease of enrollment for
20.12 	health care program applicants and recipients and administrative
20.13 	efficiencies.  Test sites will combine the administration of all
20.14 	three programs and will include both local county and
20.15 	centralized statewide customer assistance.  The duration of each
20.16 	approved test site shall be no more than one year.  Based on the
20.17 	evaluation, the commissioner shall recommend the most efficient
20.18 	and effective administrative model for statewide implementation.

20.19 	Sec. 4. Minnesota Statutes 2004, section 256.019,
20.20 	subdivision 1, is amended to read:
20.21 		Subdivision 1.Retention rates.  When an assistance
20.22 	recovery amount is collected and posted by a county agency under
20.23 	the provisions governing public assistance programs including
20.24 	general assistance medical care, general assistance, and
20.25 	Minnesota supplemental aid, the county may keep one-half of the
20.26 	recovery made by the county agency using any method other than
20.27 	recoupment.  For medical assistance, if the recovery is made by
20.28 	a county agency using any method other than recoupment, the
20.29 	county may keep one-half of the nonfederal share of the recovery.
20.30 	For MinnesotaCare, if the recovery is collected and posted by
20.31 	the county agency, the county may keep one-half of the
20.32 	nonfederal share of the recovery.
20.33 	This does not apply to recoveries from medical providers or
20.34 	to recoveries begun by the Department of Human Services'
20.35 	Surveillance and Utilization Review Division, State Hospital
20.36 	Collections Unit, and the Benefit Recoveries Division or, by the
21.1 	attorney general's office, or child support collections.  In the
21.2 	food stamp or food support program, the nonfederal share of
21.3 	recoveries in the federal tax offset program only will be
21.4 	divided equally between the state agency and the involved county
21.5 	agency.

21.6 	Sec. 5. Minnesota Statutes 2004, section 256.045,
21.7 	subdivision 3, is amended to read:
21.8 		Subd. 3.State agency hearings.  (a) State agency
21.9 	hearings are available for the following:  (1) any person
21.10 	applying for, receiving or having received public assistance,
21.11 	medical care, or a program of social services granted by the
21.12 	state agency or a county agency or the federal Food Stamp Act
21.13 	whose application for assistance is denied, not acted upon with
21.14 	reasonable promptness, or whose assistance is suspended,
21.15 	reduced, terminated, or claimed to have been incorrectly paid;
21.16 	(2) any patient or relative aggrieved by an order of the
21.17 	commissioner under section 252.27; (3) a party aggrieved by a
21.18 	ruling of a prepaid health plan; (4) except as provided under
21.19 	chapter 245C, any individual or facility determined by a lead
21.20 	agency to have maltreated a vulnerable adult under section
21.21 	626.557 after they have exercised their right to administrative
21.22 	reconsideration under section 626.557; (5) any person whose
21.23 	claim for foster care payment according to a placement of the
21.24 	child resulting from a child protection assessment under section
21.25 	626.556 is denied or not acted upon with reasonable promptness,
21.26 	regardless of funding source; (6) any person to whom a right of
21.27 	appeal according to this section is given by other provision of
21.28 	law; (7) an applicant aggrieved by an adverse decision to an
21.29 	application for a hardship waiver under section 256B.15; (8) an
21.30 	applicant aggrieved by an adverse decision to an application or
21.31 	redetermination for a Medicare Part D prescription drug subsidy
21.32 	under section 256B.04, subdivision 4a; (9) except as provided
21.33 	under chapter 245A, an individual or facility determined to have
21.34 	maltreated a minor under section 626.556, after the individual
21.35 	or facility has exercised the right to administrative
21.36 	reconsideration under section 626.556; or (9) (10) except as
22.1 	provided under chapter 245C, an individual disqualified under
22.2 	sections 245C.14 and 245C.15, on the basis of serious or
22.3 	recurring maltreatment; a preponderance of the evidence that the
22.4 	individual has committed an act or acts that meet the definition
22.5 	of any of the crimes listed in section 245C.15, subdivisions 1
22.6 	to 4; or for failing to make reports required under section
22.7 	626.556, subdivision 3, or 626.557, subdivision 3.  Hearings
22.8 	regarding a maltreatment determination under clause (4)
22.9 	or (8) (9) and a disqualification under this clause in which the
22.10 	basis for a disqualification is serious or recurring
22.11 	maltreatment, which has not been set aside under sections
22.12 	245C.22 and 245C.23, shall be consolidated into a single fair
22.13 	hearing.  In such cases, the scope of review by the human
22.14 	services referee shall include both the maltreatment
22.15 	determination and the disqualification.  The failure to exercise
22.16 	the right to an administrative reconsideration shall not be a
22.17 	bar to a hearing under this section if federal law provides an
22.18 	individual the right to a hearing to dispute a finding of
22.19 	maltreatment.  Individuals and organizations specified in this
22.20 	section may contest the specified action, decision, or final
22.21 	disposition before the state agency by submitting a written
22.22 	request for a hearing to the state agency within 30 days after
22.23 	receiving written notice of the action, decision, or final
22.24 	disposition, or within 90 days of such written notice if the
22.25 	applicant, recipient, patient, or relative shows good cause why
22.26 	the request was not submitted within the 30-day time limit.
22.27 	The hearing for an individual or facility under clause (4),
22.28 	(8) (9), or (9) (10) is the only administrative appeal to the
22.29 	final agency determination specifically, including a challenge
22.30 	to the accuracy and completeness of data under section 13.04.
22.31 	Hearings requested under clause (4) apply only to incidents of
22.32 	maltreatment that occur on or after October 1, 1995.  Hearings
22.33 	requested by nursing assistants in nursing homes alleged to have
22.34 	maltreated a resident prior to October 1, 1995, shall be held as
22.35 	a contested case proceeding under the provisions of chapter 14.
22.36 	Hearings requested under clause (8) (9) apply only to incidents
23.1 	of maltreatment that occur on or after July 1, 1997.  A hearing
23.2 	for an individual or facility under clause (8) (9) is only
23.3 	available when there is no juvenile court or adult criminal
23.4 	action pending.  If such action is filed in either court while
23.5 	an administrative review is pending, the administrative review
23.6 	must be suspended until the judicial actions are completed.  If
23.7 	the juvenile court action or criminal charge is dismissed or the
23.8 	criminal action overturned, the matter may be considered in an
23.9 	administrative hearing.
23.10 	For purposes of this section, bargaining unit grievance
23.11 	procedures are not an administrative appeal.
23.12 	The scope of hearings involving claims to foster care
23.13 	payments under clause (5) shall be limited to the issue of
23.14 	whether the county is legally responsible for a child's
23.15 	placement under court order or voluntary placement agreement
23.16 	and, if so, the correct amount of foster care payment to be made
23.17 	on the child's behalf and shall not include review of the
23.18 	propriety of the county's child protection determination or
23.19 	child placement decision.
23.20 	(b) A vendor of medical care as defined in section 256B.02,
23.21 	subdivision 7, or a vendor under contract with a county agency
23.22 	to provide social services is not a party and may not request a
23.23 	hearing under this section, except if assisting a recipient as
23.24 	provided in subdivision 4.
23.25 	(c) An applicant or recipient is not entitled to receive
23.26 	social services beyond the services included in the amended
23.27 	community social services plan.
23.28 	(d) The commissioner may summarily affirm the county or
23.29 	state agency's proposed action without a hearing when the sole
23.30 	issue is an automatic change due to a change in state or federal
23.31 	law.

23.32 	Sec. 6. Minnesota Statutes 2004, section 256.045,
23.33 	subdivision 3a, is amended to read:
23.34 		Subd. 3a.Prepaid health plan appeals.  (a) All prepaid
23.35 	health plans under contract to the commissioner under chapter
23.36 	256B or 256D must provide for a complaint system according to
24.1 	section 62D.11.  When a prepaid health plan denies, reduces, or
24.2 	terminates a health service or denies a request to authorize a
24.3 	previously authorized health service, the prepaid health plan
24.4 	must notify the recipient of the right to file a complaint or an
24.5 	appeal.  The notice must include the name and telephone number
24.6 	of the ombudsman and notice of the recipient's right to request
24.7 	a hearing under paragraph (b). When a complaint is filed, the
24.8 	prepaid health plan must notify the ombudsman within three
24.9 	working days.Recipients may request the assistance of the
24.10 	ombudsman in the complaint system process.  The prepaid health
24.11 	plan must issue a written resolution of the complaint to the
24.12 	recipient within 30 days after the complaint is filed with the
24.13 	prepaid health plan.  A recipient is not required to exhaust the
24.14 	complaint system procedures in order to request a hearing under
24.15 	paragraph (b).
24.16 	(b) Recipients enrolled in a prepaid health plan under
24.17 	chapter 256B or 256D may contest a prepaid health plan's denial,
24.18 	reduction, or termination of health services, a prepaid health
24.19 	plan's denial of a request to authorize a previously authorized
24.20 	health service, or the prepaid health plan's written resolution
24.21 	of a complaint by submitting a written request for a hearing
24.22 	according to subdivision 3.  A state human services referee
24.23 	shall conduct a hearing on the matter and shall recommend an
24.24 	order to the commissioner of human services.  The commissioner
24.25 	need not grant a hearing if the sole issue raised by a recipient
24.26 	is the commissioner's authority to require mandatory enrollment
24.27 	in a prepaid health plan in a county where prepaid health plans
24.28 	are under contract with the commissioner.  The state human
24.29 	services referee may order a second medical opinion from the
24.30 	prepaid health plan or may order a second medical opinion from a
24.31 	nonprepaid health plan provider at the expense of the prepaid
24.32 	health plan.  Recipients may request the assistance of the
24.33 	ombudsman in the appeal process.
24.34 	(c) In the written request for a hearing to appeal from a
24.35 	prepaid health plan's denial, reduction, or termination of a
24.36 	health service, a prepaid health plan's denial of a request to
25.1 	authorize a previously authorized service, or the prepaid health
25.2 	plan's written resolution to a complaint, a recipient may
25.3 	request an expedited hearing.  If an expedited appeal is
25.4 	warranted, the state human services referee shall hear the
25.5 	appeal and render a decision within a time commensurate with the
25.6 	level of urgency involved, based on the individual circumstances
25.7 	of the case.

25.8 	Sec. 7. Minnesota Statutes 2004, section 256.046,
25.9 	subdivision 1, is amended to read:
25.10 		Subdivision 1.Hearing authority.  A local agency must
25.11 	initiate an administrative fraud disqualification hearing for
25.12 	individuals, including child care providers caring for children
25.13 	receiving child care assistance, accused of wrongfully obtaining
25.14 	assistance or intentional program violations, in lieu of a
25.15 	criminal action when it has not been pursued, in the aid to
25.16 	families with dependent children program formerly codified in
25.17 	sections 256.72 to 256.87, MFIP, the diversionary work program,
25.18 	child care assistance programs, general assistance, family
25.19 	general assistance program formerly codified in section 256D.05,
25.20 	subdivision 1, clause (15), Minnesota supplemental aid, food
25.21 	stamp programs, general assistance medical care, MinnesotaCare
25.22 	for adults without children, and upon federal approval, all
25.23 	categories of medical assistance and remaining categories of
25.24 	MinnesotaCare except for children through age 18. The
25.25 	Department of Human Services, in lieu of a local agency, may
25.26 	initiate an administrative fraud disqualification hearing when
25.27 	the state agency is directly responsible for administration of
25.28 	the health care program for which benefits were wrongfully
25.29 	obtained.The hearing is subject to the requirements of section
25.30 	256.045 and the requirements in Code of Federal Regulations,
25.31 	title 7, section 273.16, for the food stamp program and title
25.32 	45, section 235.112, as of September 30, 1995, for the cash
25.33 	grant, medical care programs, and child care assistance under
25.34 	chapter 119B.

25.35 	Sec. 8. Minnesota Statutes 2004, section 256.9657, is
25.36 	amended by adding a subdivision to read:
26.1 		Subd. 7a.Withholding. If any provider obligated to pay
26.2 	an annual surcharge under this section is more than two months
26.3 	delinquent in the timely payment of a monthly surcharge
26.4 	installment payment, the provisions in paragraphs (a) to (f)
26.5 	apply.
26.6 	(a) The department may withhold some or all of the amount
26.7 	of the delinquent surcharge, together with any interest and
26.8 	penalties due and owing on those amounts, from any money the
26.9 	department owes to the provider.  The department may, at its
26.10 	discretion, also withhold future surcharge installment payments
26.11 	from any money the department owes the provider as those
26.12 	installments become due and owing.  The department may continue
26.13 	this withholding until the department determines there in no
26.14 	longer any need to do so.
26.15 	(b) The department shall give prior notice of the
26.16 	department's intention to withhold by mailing a written notice
26.17 	to the provider at the address to which remittance advices are
26.18 	mailed or faxing a copy of the notice to the provider at least
26.19 	ten business days before the date of the first payment period
26.20 	for which the withholding begins.  The notice may be sent by
26.21 	ordinary or certified mail, or facsimile, and shall be deemed
26.22 	received as of the date of mailing or receipt of the facsimile.
26.23 	The notice shall:
26.24 	(i) state the amount of the delinquent surcharge;
26.25 	(ii) state the amount of the withholding per payment
26.26 	period;
26.27 	(iii) state the date on which the withholding is to begin;
26.28 	(iv) state whether the department intends to withhold
26.29 	future installments of the provider's surcharge payments;
26.30 	(v) inform the provider of their rights to informally
26.31 	object to the proposed withholding and to appeal the withholding
26.32 	as provided for in this subdivision;
26.33 	(vi) state that the provider may prevent the withholding
26.34 	during the pendancy of their appeal by posting a bond; and 
26.35 	(vii) state other contents as the department deems
26.36 	appropriate.
27.1 	(c) The provider may informally object to the withholding
27.2 	in writing anytime before the withholding begins.  An informal
27.3 	objection shall not stay or delay the commencement of the
27.4 	withholding.  The department may postpone the commencement of
27.5 	the withholding as deemed appropriate and shall not be required
27.6 	to give another notice at the end of the postponement and before
27.7 	commencing the withholding.  The provider shall have the right
27.8 	to appeal any withholding from remittances by filing an appeal
27.9 	with Ramsey County District Court and serving notice of the
27.10 	appeal on the department within 30 days of the date of the
27.11 	written notice of the withholding.  Notice shall be given and
27.12 	the appeal shall be heard no later than 45 days after the appeal
27.13 	is filed.  In a hearing of the appeal, the department's action
27.14 	shall be sustained if the department proves the amount of the
27.15 	delinquent surcharges or overpayment the provider owes, plus any
27.16 	accrued interest and penalties, has not been repaid.  The
27.17 	department may continue withholding for delinquent and current
27.18 	surcharge installment payments during the pendancy of an appeal
27.19 	unless the provider posts a bond from a surety company licensed
27.20 	to do business in Minnesota in favor of the department in an
27.21 	amount equal to two times the provider's total annual surcharge
27.22 	payment for the fiscal year in which the appeal is filed with
27.23 	the department.
27.24 	(d) The department shall refund any amounts due to the
27.25 	provider under any final administrative or judicial order or
27.26 	decree which fully and finally resolves the appeal together with
27.27 	interest on those amounts at the rate of three percent per annum
27.28 	simple interest computed from the date of each withholding, as
27.29 	soon as practical after entry of the order or decree.
27.30 	(e) The commissioner, or the commissioner's designee, may
27.31 	enter into written settlement agreements with a provider to
27.32 	resolve disputes and other matters involving unpaid surcharge
27.33 	installment payments or future surcharge installment payments.
27.34 	(f) Notwithstanding any law to the contrary, all unpaid
27.35 	surcharges, plus any accrued interest and penalties, shall be
27.36 	overpayments for purposes of section 256B.0641.

28.1 	Sec. 9. Minnesota Statutes 2004, section 256.969,
28.2 	subdivision 3a, is amended to read:
28.3 		Subd. 3a.Payments.  (a) Acute care hospital billings
28.4 	under the medical assistance program must not be submitted until
28.5 	the recipient is discharged.  However, the commissioner shall
28.6 	establish monthly interim payments for inpatient hospitals that
28.7 	have individual patient lengths of stay over 30 days regardless
28.8 	of diagnostic category.  Except as provided in section 256.9693,
28.9 	medical assistance reimbursement for treatment of mental illness
28.10 	shall be reimbursed based on diagnostic classifications.
28.11 	Individual hospital payments established under this section and
28.12 	sections 256.9685, 256.9686, and 256.9695, in addition to third
28.13 	party and recipient liability, for discharges occurring during
28.14 	the rate year shall not exceed, in aggregate, the charges for
28.15 	the medical assistance covered inpatient services paid for the
28.16 	same period of time to the hospital.  This payment limitation
28.17 	shall be calculated separately for medical assistance and
28.18 	general assistance medical care services.  The limitation on
28.19 	general assistance medical care shall be effective for
28.20 	admissions occurring on or after July 1, 1991.  Services that
28.21 	have rates established under subdivision 11 or 12, must be
28.22 	limited separately from other services.  After consulting with
28.23 	the affected hospitals, the commissioner may consider related
28.24 	hospitals one entity and may merge the payment rates while
28.25 	maintaining separate provider numbers.  The operating and
28.26 	property base rates per admission or per day shall be derived
28.27 	from the best Medicare and claims data available when rates are
28.28 	established.  The commissioner shall determine the best Medicare
28.29 	and claims data, taking into consideration variables of recency
28.30 	of the data, audit disposition, settlement status, and the
28.31 	ability to set rates in a timely manner.  The commissioner shall
28.32 	notify hospitals of payment rates by December 1 of the year
28.33 	preceding the rate year.  The rate setting data must reflect the
28.34 	admissions data used to establish relative values.  Base year
28.35 	changes from 1981 to the base year established for the rate year
28.36 	beginning January 1, 1991, and for subsequent rate years, shall
29.1 	not be limited to the limits ending June 30, 1987, on the
29.2 	maximum rate of increase under subdivision 1.  The commissioner
29.3 	may adjust base year cost, relative value, and case mix index
29.4 	data to exclude the costs of services that have been
29.5 	discontinued by the October 1 of the year preceding the rate
29.6 	year or that are paid separately from inpatient services.
29.7 	Inpatient stays that encompass portions of two or more rate
29.8 	years shall have payments established based on payment rates in
29.9 	effect at the time of admission unless the date of admission
29.10 	preceded the rate year in effect by six months or more.  In this
29.11 	case, operating payment rates for services rendered during the
29.12 	rate year in effect and established based on the date of
29.13 	admission shall be adjusted to the rate year in effect by the
29.14 	hospital cost index.
29.15 	(b) For fee-for-service admissions occurring on or after
29.16 	July 1, 2002, the total payment, before third-party liability
29.17 	and spenddown, made to hospitals for inpatient services is
29.18 	reduced by .5 percent from the current statutory rates.
29.19 	(c) In addition to the reduction in paragraph (b), the
29.20 	total payment for fee-for-service admissions occurring on or
29.21 	after July 1, 2003, made to hospitals for inpatient services
29.22 	before third-party liability and spenddown, is reduced five
29.23 	percent from the current statutory rates.  Mental health
29.24 	services within diagnosis related groups 424 to 432, and
29.25 	facilities defined under subdivision 16 are excluded from this
29.26 	paragraph.
29.27 	(d) In addition to the reduction in paragraphs (b) and (c)
29.28 	and section 256D.03, subdivision 4, paragraph (k), the total
29.29 	payment for fee-for-service admissions occurring on or after
29.30 	July 1, 2005, made to hospitals for inpatient services before
29.31 	third-party liability and spenddown, is reduced five percent
29.32 	from the current statutory rates.  Mental health services within
29.33 	diagnosis related groups 424 to 432 and facilities defined under
29.34 	subdivision 16 are excluded from this paragraph.

29.35 	Sec. 10. Minnesota Statutes 2004, section 256.969,
29.36 	subdivision 26, is amended to read:
30.1 		Subd. 26.Greater minnesota payment adjustment after june
30.2 	30, 2001.  (a) For admissions occurring after June 30, 2001, the
30.3 	commissioner shall pay fee-for-service inpatient admissions for
30.4 	the diagnosis-related groups specified in paragraph (b) at
30.5 	hospitals located outside of the seven-county metropolitan area
30.6 	at the higher of:
30.7 	(1) the hospital's current payment rate for the diagnostic
30.8 	category to which the diagnosis-related group belongs, exclusive
30.9 	of disproportionate population adjustments received under
30.10 	subdivision 9 and hospital payment adjustments received under
30.11 	subdivision 23; or
30.12 	(2) 90 percent of the average payment rate for that
30.13 	diagnostic category for hospitals located within the
30.14 	seven-county metropolitan area, exclusive of disproportionate
30.15 	population adjustments received under subdivision 9 and hospital
30.16 	payment adjustments received under subdivisions 20 and 23. The
30.17 	commissioner may adjust this percentage each year so that the
30.18 	estimated payment increases under this paragraph are equal to
30.19 	the funding provided under section 256B.195 for this purpose.
30.20 	(b) The payment increases provided in paragraph (a) apply
30.21 	to the following diagnosis-related groups, as they fall within
30.22 	the diagnostic categories:
30.23 	(1) 370 cesarean section with complicating diagnosis;
30.24 	(2) 371 cesarean section without complicating diagnosis;
30.25 	(3) 372 vaginal delivery with complicating diagnosis;
30.26 	(4) 373 vaginal delivery without complicating diagnosis;
30.27 	(5) 386 extreme immaturity and respiratory distress
30.28 	syndrome, neonate;
30.29 	(6) 388 full-term neonates with other problems;
30.30 	(7) 390 prematurity without major problems;
30.31 	(8) 391 normal newborn;
30.32 	(9) 385 neonate, died or transferred to another acute care
30.33 	facility;
30.34 	(10) 425 acute adjustment reaction and psychosocial
30.35 	dysfunction;
30.36 	(11) 430 psychoses;
31.1 	(12) 431 childhood mental disorders; and
31.2 	(13) 164-167 appendectomy.

31.3 	Sec. 11. Minnesota Statutes 2004, section 256B.02,
31.4 	subdivision 12, is amended to read:
31.5 		Subd. 12.Third-party payer.  "Third-party payer" means a
31.6 	person, entity, or agency or government program that has a
31.7 	probable obligation to pay all or part of the costs of a medical
31.8 	assistance recipient's health services. Third-party payer
31.9 	includes an entity under contract with the recipient to cover
31.10 	all or part of the recipient's medical costs.

31.11 	Sec. 12. Minnesota Statutes 2004, section 256B.04, is
31.12 	amended by adding a subdivision to read:
31.13 		Subd. 4a.Medicare prescription drug subsidy. The
31.14 	commissioner shall perform all duties necessary to administer
31.15 	eligibility determinations for the Medicare Part D prescription
31.16 	drug subsidy and facilitate the enrollment of eligible medical
31.17 	assistance recipients into Medicare prescription drug plans as
31.18 	required by the Medicare Prescription Drug, Improvement and
31.19 	Modernization Act of 2003 (MMA), Public Law 108-173, and Code of
31.20 	Federal Regulations, title 42, sections 423.30 through 423.56
31.21 	and 423.771 through 423.800.

31.22 	Sec. 13. Minnesota Statutes 2004, section 256B.056, is
31.23 	amended by adding a subdivision to read:
31.24 		Subd. 3d.Reduction of excess assets. Assets in excess
31.25 	of the limits set forth in subdivisions 3 to 3c may be reduced
31.26 	to allowable limits as follows:
31.27 	(a) Assets may be reduced in any of the three calendar
31.28 	months before the month of application in which the applicant
31.29 	seeks coverage by:
31.30 	(1) designating burial funds up to $1500 for each
31.31 	applicant, spouse, and MA-eligible dependent child; and 
31.32 	(2) paying health service bills incurred in the retroactive
31.33 	period for which the applicant seeks eligibility, starting with
31.34 	the oldest bill.  After assets are reduced to allowable limits,
31.35 	eligibility begins with the next dollar of MA-covered health
31.36 	services incurred in the retroactive period.  Applicants
32.1 	reducing assets under this subdivision who also have excess
32.2 	income shall first spend excess assets to pay health service
32.3 	bills and may meet the income spenddown on remaining bills.
32.4 	(b) Assets may be reduced beginning the month of
32.5 	application by:
32.6 	(1) paying bills for health services that would otherwise
32.7 	be paid by medical assistance; and 
32.8 	(2) using any means other than a transfer of assets for
32.9 	less than fair market value as defined in section 256B.0595,
32.10 	subdivision 1, paragraph (b).

32.11 	Sec. 14. Minnesota Statutes 2004, section 256B.056,
32.12 	subdivision 5, is amended to read:
32.13 		Subd. 5.Excess income.  A person who has excess income
32.14 	is eligible for medical assistance if the person has expenses
32.15 	for medical care that are more than the amount of the person's
32.16 	excess income, computed by deducting incurred medical expenses
32.17 	from the excess income to reduce the excess to the income
32.18 	standard specified in subdivision 5c.  The person shall elect to
32.19 	have the medical expenses deducted at the beginning of a
32.20 	one-month budget period or at the beginning of a six-month
32.21 	budget period.  The commissioner shall allow persons eligible
32.22 	for assistance on a one-month spenddown basis under this
32.23 	subdivision to elect to pay the monthly spenddown amount in
32.24 	advance of the month of eligibility to the state agency in order
32.25 	to maintain eligibility on a continuous basis.  If the recipient
32.26 	does not pay the spenddown amount on or before the 20th last
32.27 	business day of the month, the recipient is ineligible for this
32.28 	option for the following month.  The local agency shall code the
32.29 	Medicaid Management Information System (MMIS) to indicate that
32.30 	the recipient has elected this option.  The state agency shall
32.31 	convey recipient eligibility information relative to the
32.32 	collection of the spenddown to providers through the Electronic
32.33 	Verification System (EVS).  A recipient electing advance payment
32.34 	must pay the state agency the monthly spenddown amount on or
32.35 	before noon on the 20th last business day of the month in order
32.36 	to be eligible for this option in the following month.
33.1 	
EFFECTIVE DATE. This section is effective March 1, 2006,
33.2 	or upon HealthMatch implementation, whichever is later.

33.3 	Sec. 15. Minnesota Statutes 2004, section 256B.056,
33.4 	subdivision 5a, is amended to read:
33.5 		Subd. 5a.Individuals on fixed or excluded income.
 33.6 	Recipients of medical assistance who receive only fixed unearned
33.7 	or excluded income, when that income is excluded from
33.8 	consideration as income or unvarying in amount and timing of
33.9 	receipt throughout the year, shall report and verify their
33.10 	income annually every 12 months.  The 12-month period begins
33.11 	with the month of application.
33.12 	
EFFECTIVE DATE. This section is effective March 1, 2006,
33.13 	or upon HealthMatch implementation, whichever is later.

33.14 	Sec. 16. Minnesota Statutes 2004, section 256B.056,
33.15 	subdivision 5b, is amended to read:
33.16 		Subd. 5b.Individuals with low income.  Recipients of
33.17 	medical assistance not residing in a long-term care facility who
33.18 	have slightly fluctuating income which is below the medical
33.19 	assistance income limit shall report and verify their income on
33.20 	a semiannual basis every six months.  The six-month period
33.21 	begins the month of application.
33.22 	
EFFECTIVE DATE. This section is effective March 1, 2006,
33.23 	or upon HealthMatch implementation, whichever is later.

33.24 	Sec. 17. Minnesota Statutes 2004, section 256B.056,
33.25 	subdivision 7, is amended to read:
33.26 		Subd. 7.Period of eligibility.  Eligibility is available
33.27 	for the month of application and for three months prior to
33.28 	application if the person was eligible in those prior
33.29 	months. Eligibility for months prior to application is
33.30 	determined independently from eligibility for the month of
33.31 	application and future months.A redetermination of eligibility
33.32 	must occur every 12 months. The 12-month period begins with the
33.33 	month of application.
33.34 	
EFFECTIVE DATE. This section is effective March 1, 2006,
33.35 	or upon HealthMatch implementation, whichever is later.

33.36 	Sec. 18. Minnesota Statutes 2004, section 256B.056, is
34.1 	amended by adding a subdivision to read:
34.2 		Subd. 9.Notice. The state agency must be given notice
34.3 	of monetary claims against a person, entity, or corporation that
34.4 	may be liable to pay all or part of the cost of medical care
34.5 	when the state agency has paid or becomes liable for the cost of
34.6 	that care.  Notice must be given according to paragraphs (a) to
34.7 	(d).
34.8 	(a) An applicant for medical assistance shall notify the
34.9 	state or local agency of any possible claims when the applicant
34.10 	submits the application.  A recipient of medical assistance
34.11 	shall notify the state or local agency of any possible claims
34.12 	when those claims arise.
34.13 	(b) A person providing medical care services to a recipient
34.14 	of medical assistance shall notify the state agency when the
34.15 	person has reason to believe that a third party may be liable
34.16 	for payment of the cost of medical care.
34.17 	(c) A party to a claim that may be assigned to the state
34.18 	agency under this section shall notify the state agency of its
34.19 	potential assignment claim in writing at each of the following
34.20 	stages of a claim:
34.21 	(1) when a claim is filed;
34.22 	(2) when an action is commenced; and 
34.23 	(3) when a claim is concluded by payment, award, judgment,
34.24 	settlement, or otherwise.
34.25 	(d) Every party involved in any stage of a claim under this
34.26 	subdivision is required to provide notice to the state agency at
34.27 	that stage of the claim.  However, when one of the parties to
34.28 	the claim provides notice at that stage, every other party to
34.29 	the claim is deemed to have provided the required notice for
34.30 	that stage of the claim.  If the required notice under this
34.31 	paragraph is not provided to the state agency, all parties to
34.32 	the claim are deemed to have failed to provide the required
34.33 	notice.  A party to the claim includes the injured person or the
34.34 	person's legal representative, the plaintiff, the defendants, or
34.35 	persons alleged to be responsible for compensating the injured
34.36 	person or plaintiff, and any other party to the cause of action
35.1 	or claim, regardless of whether the party knows the state agency
35.2 	has a potential or actual assignment claim.

35.3 	Sec. 19. Minnesota Statutes 2004, section 256B.056, is
35.4 	amended by adding a subdivision to read:
35.5 		Subd. 10.Eligibility verification. (a) The commissioner
35.6 	shall require women who are applying for the continuation of
35.7 	medical assistance coverage following the end of the 60-day
35.8 	postpartum period to complete a renewal form and verify assets.
35.9 	(b) The commissioner shall determine the eligibility of
35.10 	private-sector health care coverage for infants less than one
35.11 	year of age eligible under section 256B.055, subdivision 10, or
35.12 	256B.057, subdivision 1, paragraph (d), and shall pay for
35.13 	private-sector coverage if this is determined to be
35.14 	cost-effective.
35.15 	(c) The commissioner shall modify the application for
35.16 	Minnesota health care programs to require more detailed
35.17 	information related to verification of assets and income, and
35.18 	shall verify assets and income for all applicants, and for all
35.19 	recipients upon renewal.
35.20 	(d) The commissioner shall require recipients to report and
35.21 	verify new employment income within ten days of the change, and
35.22 	shall disenroll recipients who fail to provide verification.
35.23 	
EFFECTIVE DATE. This section is effective July 1, 2005.
35.24 	Prior to the implementation of HealthMatch, the commissioner
35.25 	shall implement this section to the fullest extent possible,
35.26 	including the use of manual processing.  Upon implementation of
35.27 	HealthMatch, the commissioner shall implement this section in a
35.28 	manner consistent with the procedures and requirements of
35.29 	HealthMatch.

35.30 	Sec. 20. Minnesota Statutes 2004, section 256B.0575, is
35.31 	amended to read:
35.32 	256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
35.33 	PERSONS.
35.34 	When an institutionalized person is determined eligible for
35.35 	medical assistance, the income that exceeds the deductions in
35.36 	paragraphs (a) and (b) must be applied to the cost of
36.1 	institutional care.
36.2 	(a) The following amounts must be deducted from the
36.3 	institutionalized person's income in the following order:
36.4 	(1) the personal needs allowance under section 256B.35 or,
36.5 	for a veteran who does not have a spouse or child, or a
36.6 	surviving spouse of a veteran having no child, the amount of an
36.7 	improved pension received from the veteran's administration not
36.8 	exceeding $90 per month;
36.9 	(2) the personal allowance for disabled individuals under
36.10 	section 256B.36;
36.11 	(3) if the institutionalized person has a legally appointed
36.12 	guardian or conservator, five percent of the recipient's gross
36.13 	monthly income up to $100 as reimbursement for guardianship or
36.14 	conservatorship services;
36.15 	(4) a monthly income allowance determined under section
36.16 	256B.058, subdivision 2, but only to the extent income of the
36.17 	institutionalized spouse is made available to the community
36.18 	spouse;
36.19 	(5) a monthly allowance for children under age 18 which,
36.20 	together with the net income of the children, would provide
36.21 	income equal to the medical assistance standard for families and
36.22 	children according to section 256B.056, subdivision 4, for a
36.23 	family size that includes only the minor children.  This
36.24 	deduction applies only if the children do not live with the
36.25 	community spouse and only to the extent that the deduction is
36.26 	not included in the personal needs allowance under section
36.27 	256B.35, subdivision 1, as child support garnished under a court
36.28 	order;
36.29 	(6) a monthly family allowance for other family members,
36.30 	equal to one-third of the difference between 122 percent of the
36.31 	federal poverty guidelines and the monthly income for that
36.32 	family member;
36.33 	(7) reparations payments made by the Federal Republic of
36.34 	Germany and reparations payments made by the Netherlands for
36.35 	victims of Nazi persecution between 1940 and 1945;
36.36 	(8) all other exclusions from income for institutionalized
37.1 	persons as mandated by federal law; and
37.2 	(9) amounts for reasonable expenses incurred for necessary
37.3 	medical or remedial care for the institutionalized person that
37.4 	are not medical assistance covered expenses and that are not
37.5 	subject to payment by a third party.
37.6 	Reasonable expenses are limited to expenses that have not
37.7 	been previously used as a deduction from income and are incurred
37.8 	during the enrollee's current period of eligibility, including
37.9 	retroactive months associated with the current period of
37.10 	eligibility, for medical assistance payment of long-term care
37.11 	services.
37.12 	For purposes of clause (6), "other family member" means a
37.13 	person who resides with the community spouse and who is a minor
37.14 	or dependent child, dependent parent, or dependent sibling of
37.15 	either spouse.  "Dependent" means a person who could be claimed
37.16 	as a dependent for federal income tax purposes under the
37.17 	Internal Revenue Code.
37.18 	(b) Income shall be allocated to an institutionalized
37.19 	person for a period of up to three calendar months, in an amount
37.20 	equal to the medical assistance standard for a family size of
37.21 	one if:
37.22 	(1) a physician certifies that the person is expected to
37.23 	reside in the long-term care facility for three calendar months
37.24 	or less;
37.25 	(2) if the person has expenses of maintaining a residence
37.26 	in the community; and
37.27 	(3) if one of the following circumstances apply:
37.28 	(i) the person was not living together with a spouse or a
37.29 	family member as defined in paragraph (a) when the person
37.30 	entered a long-term care facility; or
37.31 	(ii) the person and the person's spouse become
37.32 	institutionalized on the same date, in which case the allocation
37.33 	shall be applied to the income of one of the spouses.
37.34 	For purposes of this paragraph, a person is determined to be
37.35 	residing in a licensed nursing home, regional treatment center,
37.36 	or medical institution if the person is expected to remain for a
38.1 	period of one full calendar month or more.

38.2 	Sec. 21. Minnesota Statutes 2004, section 256B.0595,
38.3 	subdivision 2, is amended to read:
38.4 		Subd. 2.Period of ineligibility.  (a) For any
38.5 	uncompensated transfer occurring on or before August 10, 1993,
38.6 	the number of months of ineligibility for long-term care
38.7 	services shall be the lesser of 30 months, or the uncompensated
38.8 	transfer amount divided by the average medical assistance rate
38.9 	for nursing facility services in the state in effect on the date
38.10 	of application.  The amount used to calculate the average
38.11 	medical assistance payment rate shall be adjusted each July 1 to
38.12 	reflect payment rates for the previous calendar year.  The
38.13 	period of ineligibility begins with the month in which the
38.14 	assets were transferred.  If the transfer was not reported to
38.15 	the local agency at the time of application, and the applicant
38.16 	received long-term care services during what would have been the
38.17 	period of ineligibility if the transfer had been reported, a
38.18 	cause of action exists against the transferee for the cost of
38.19 	long-term care services provided during the period of
38.20 	ineligibility, or for the uncompensated amount of the transfer,
38.21 	whichever is less.  The action may be brought by the state or
38.22 	the local agency responsible for providing medical assistance
38.23 	under chapter 256G.  The uncompensated transfer amount is the
38.24 	fair market value of the asset at the time it was given away,
38.25 	sold, or disposed of, less the amount of compensation received.
38.26 	(b) For uncompensated transfers made after August 10, 1993,
38.27 	the number of months of ineligibility for long-term care
38.28 	services shall be the total uncompensated value of the resources
38.29 	transferred divided by the average medical assistance rate for
38.30 	nursing facility services in the state in effect on the date of
38.31 	application.  The amount used to calculate the average medical
38.32 	assistance payment rate shall be adjusted each July 1 to reflect
38.33 	payment rates for the previous calendar year.  The period of
38.34 	ineligibility begins with the first day of the month after the
38.35 	month in which the assets were transferred except that if one or
38.36 	more uncompensated transfers are made during a period of
39.1 	ineligibility, the total assets transferred during the
39.2 	ineligibility period shall be combined and a penalty period
39.3 	calculated to begin on the first day of the month after the
39.4 	month in which the first uncompensated transfer was made.  If
39.5 	the transfer was reported to the local agency after the date
39.6 	that advance notice of a period of ineligibility that affects
39.7 	the next month could be provided to the recipient and the
39.8 	recipient received medical assistance services or the transfer
39.9 	was not reported to the local agency, and the applicant or
39.10 	recipient received medical assistance services during what would
39.11 	have been the period of ineligibility if the transfer had been
39.12 	reported, a cause of action exists against the transferee for
39.13 	the cost of medical assistance services provided during the
39.14 	period of ineligibility, or for the uncompensated amount of the
39.15 	transfer, whichever is less.  The action may be brought by the
39.16 	state or the local agency responsible for providing medical
39.17 	assistance under chapter 256G.  The uncompensated transfer
39.18 	amount is the fair market value of the asset at the time it was
39.19 	given away, sold, or disposed of, less the amount of
39.20 	compensation received.  Effective for transfers made on or after
39.21 	March 1, 1996, involving persons who apply for medical
39.22 	assistance on or after April 13, 1996, no cause of action exists
39.23 	for a transfer unless:
39.24 	(1) the transferee knew or should have known that the
39.25 	transfer was being made by a person who was a resident of a
39.26 	long-term care facility or was receiving that level of care in
39.27 	the community at the time of the transfer;
39.28 	(2) the transferee knew or should have known that the
39.29 	transfer was being made to assist the person to qualify for or
39.30 	retain medical assistance eligibility; or
39.31 	(3) the transferee actively solicited the transfer with
39.32 	intent to assist the person to qualify for or retain eligibility
39.33 	for medical assistance.
39.34 	(c) If a calculation of a penalty period results in a
39.35 	partial month, payments for long-term care services shall be
39.36 	reduced in an amount equal to the fraction, except that in
40.1 	calculating the value of uncompensated transfers, if the total
40.2 	value of all uncompensated transfers made in a month not
40.3 	included in an existing penalty period does not exceed $200,
40.4 	then such transfers shall be disregarded for each month prior to
40.5 	the month of application for or during receipt of medical
40.6 	assistance.
40.7 	
EFFECTIVE DATE. This section is effective for transfers
40.8 	occurring on or after July 1, 2005.

40.9 	Sec. 22. Minnesota Statutes 2004, section 256B.06,
40.10 	subdivision 4, is amended to read:
40.11 		Subd. 4.Citizenship requirements.  (a) Eligibility for
40.12 	medical assistance is limited to citizens of the United States,
40.13 	qualified noncitizens as defined in this subdivision, and other
40.14 	persons residing lawfully in the United States.
40.15 	(b) "Qualified noncitizen" means a person who meets one of
40.16 	the following immigration criteria:
40.17 	(1) admitted for lawful permanent residence according to
40.18 	United States Code, title 8;
40.19 	(2) admitted to the United States as a refugee according to
40.20 	United States Code, title 8, section 1157;
40.21 	(3) granted asylum according to United States Code, title
40.22 	8, section 1158;
40.23 	(4) granted withholding of deportation according to United
40.24 	States Code, title 8, section 1253(h);
40.25 	(5) paroled for a period of at least one year according to
40.26 	United States Code, title 8, section 1182(d)(5);
40.27 	(6) granted conditional entrant status according to United
40.28 	States Code, title 8, section 1153(a)(7);
40.29 	(7) determined to be a battered noncitizen by the United
40.30 	States Attorney General according to the Illegal Immigration
40.31 	Reform and Immigrant Responsibility Act of 1996, title V of the
40.32 	Omnibus Consolidated Appropriations Bill, Public Law 104-200;
40.33 	(8) is a child of a noncitizen determined to be a battered
40.34 	noncitizen by the United States Attorney General according to
40.35 	the Illegal Immigration Reform and Immigrant Responsibility Act
40.36 	of 1996, title V, of the Omnibus Consolidated Appropriations
41.1 	Bill, Public Law 104-200; or
41.2 	(9) determined to be a Cuban or Haitian entrant as defined
41.3 	in section 501(e) of Public Law 96-422, the Refugee Education
41.4 	Assistance Act of 1980.
41.5 	(c) All qualified noncitizens who were residing in the
41.6 	United States before August 22, 1996, who otherwise meet the
41.7 	eligibility requirements of this chapter, are eligible for
41.8 	medical assistance with federal financial participation.
41.9 	(d) All qualified noncitizens who entered the United States
41.10 	on or after August 22, 1996, and who otherwise meet the
41.11 	eligibility requirements of this chapter, are eligible for
41.12 	medical assistance with federal financial participation through
41.13 	November 30, 1996.
41.14 	Beginning December 1, 1996, qualified noncitizens who
41.15 	entered the United States on or after August 22, 1996, and who
41.16 	otherwise meet the eligibility requirements of this chapter are
41.17 	eligible for medical assistance with federal participation for
41.18 	five years if they meet one of the following criteria:
41.19 	(i) refugees admitted to the United States according to
41.20 	United States Code, title 8, section 1157;
41.21 	(ii) persons granted asylum according to United States
41.22 	Code, title 8, section 1158;
41.23 	(iii) persons granted withholding of deportation according
41.24 	to United States Code, title 8, section 1253(h);
41.25 	(iv) veterans of the United States armed forces with an
41.26 	honorable discharge for a reason other than noncitizen status,
41.27 	their spouses and unmarried minor dependent children; or
41.28 	(v) persons on active duty in the United States armed
41.29 	forces, other than for training, their spouses and unmarried
41.30 	minor dependent children.
41.31 	Beginning December 1, 1996, qualified noncitizens who do
41.32 	not meet one of the criteria in items (i) to (v) are eligible
41.33 	for medical assistance without federal financial participation
41.34 	as described in paragraph (j).
41.35 	(e) Noncitizens who are not qualified noncitizens as
41.36 	defined in paragraph (b), who are lawfully residing in the
42.1 	United States and who otherwise meet the eligibility
42.2 	requirements of this chapter, are eligible for medical
42.3 	assistance under clauses (1) to (3).  These individuals must
42.4 	cooperate with the Immigration and Naturalization Service to
42.5 	pursue any applicable immigration status, including citizenship,
42.6 	that would qualify them for medical assistance with federal
42.7 	financial participation.
42.8 	(1) Persons who were medical assistance recipients on
42.9 	August 22, 1996, are eligible for medical assistance with
42.10 	federal financial participation through December 31, 1996.
42.11 	(2) Beginning January 1, 1997, persons described in clause
42.12 	(1) are eligible for medical assistance without federal
42.13 	financial participation as described in paragraph (j).
42.14 	(3) Beginning December 1, 1996, persons residing in the
42.15 	United States prior to August 22, 1996, who were not receiving
42.16 	medical assistance and persons who arrived on or after August
42.17 	22, 1996, are eligible for medical assistance without federal
42.18 	financial participation as described in paragraph (j).
42.19 	(f) Nonimmigrants who otherwise meet the eligibility
42.20 	requirements of this chapter are eligible for the benefits as
42.21 	provided in paragraphs (g) to (i).  For purposes of this
42.22 	subdivision, a "nonimmigrant" is a person in one of the classes
42.23 	listed in United States Code, title 8, section 1101(a)(15).
42.24 	(g) Payment shall also be made for care and services that
42.25 	are furnished to noncitizens, regardless of immigration status,
42.26 	who otherwise meet the eligibility requirements of this chapter,
42.27 	if such care and services are necessary for the treatment of an
42.28 	emergency medical condition, except for organ transplants and
42.29 	related care and services and routine prenatal care.
42.30 	(h) For purposes of this subdivision, the term "emergency
42.31 	medical condition" means a medical condition that meets the
42.32 	requirements of United States Code, title 42, section 1396b(v).
42.33 	(i) Pregnant noncitizens who are undocumented or ,
42.34 	nonimmigrants, or eligible for medical assistance as described
42.35 	in paragraph (j), and who are not covered by a group health plan
42.36 	or health insurance coverage according to Code of Federal
43.1 	Regulations, title 42, section 457.310, and who otherwise meet
43.2 	the eligibility requirements of this chapter, are eligible for
43.3 	medical assistance payment without federal financial
43.4 	participation for care and services through the period of
43.5 	pregnancy, and including labor and delivery, to the extent
43.6 	federal funds are available under Title XXI of the Social
43.7 	Security Act, and the state children's health insurance program,
43.8 	followed by 60 days postpartum, except for labor and
43.9 	delivery without federal financial participation.
43.10 	(j) Qualified noncitizens as described in paragraph (d),
43.11 	and all other noncitizens lawfully residing in the United States
43.12 	as described in paragraph (e), who are ineligible for medical
43.13 	assistance with federal financial participation and who
43.14 	otherwise meet the eligibility requirements of chapter 256B and
43.15 	of this paragraph, are eligible for medical assistance without
43.16 	federal financial participation.  Qualified noncitizens as
43.17 	described in paragraph (d) are only eligible for medical
43.18 	assistance without federal financial participation for five
43.19 	years from their date of entry into the United States.
43.20 	(k) Beginning October 1, 2003, persons who are receiving
43.21 	care and rehabilitation services from a nonprofit center
43.22 	established to serve victims of torture and are otherwise
43.23 	ineligible for medical assistance under this chapter are
43.24 	eligible for medical assistance without federal financial
43.25 	participation.  These individuals are eligible only for the
43.26 	period during which they are receiving services from the
43.27 	center.  Individuals eligible under this paragraph shall not be
43.28 	required to participate in prepaid medical assistance.

43.29 	Sec. 23. Minnesota Statutes 2004, section 256B.0625, is
43.30 	amended by adding a subdivision to read:
43.31 		Subd. 1a.Services provided in a hospital emergency
43.32 	room. Medical assistance does not cover visits to a hospital
43.33 	emergency room that are not for emergency and emergency
43.34 	poststabilization care or urgent care, and does not pay for any
43.35 	services provided in a hospital emergency room that are not for
43.36 	emergency and emergency poststabilization care or urgent care.

44.1 	Sec. 24. Minnesota Statutes 2004, section 256B.0625,
44.2 	subdivision 3a, is amended to read:
44.3 		Subd. 3a.gender sex reassignment surgery. Gender Sex 
44.4 	reassignment surgery and other gender reassignment medical
44.5 	procedures including drug therapy for gender reassignment are is 
44.6 	not covered unless the individual began receiving gender
44.7 	reassignment services prior to July 1, 1998.

44.8 	Sec. 25. Minnesota Statutes 2004, section 256B.0625, is
44.9 	amended by adding a subdivision to read:
44.10 		Subd. 3c.Circumcision for newborns. Newborn
44.11 	circumcision is not covered, unless the procedure is medically
44.12 	necessary or required because of a well-established religious
44.13 	practice.
44.14 	
EFFECTIVE DATE. This section is effective July 1, 2005,
44.15 	and applies to services provided on or after that date.

44.16 	Sec. 26. Minnesota Statutes 2004, section 256B.0625, is
44.17 	amended by adding a subdivision to read:
44.18 		Subd. 3d.Health services policy committee. The
44.19 	commissioner, after receiving recommendations from professional
44.20 	physician associations, professional associations representing
44.21 	licensed nonphysician health care professionals, and consumer
44.22 	groups, shall establish an 11-member Health Services Policy
44.23 	Committee which will consist of ten voting members and one
44.24 	nonvoting member.  The Health Services Policy Committee will
44.25 	advise the commissioner regarding health services issues
44.26 	pertaining to the administration of health care benefits covered
44.27 	under the medical assistance, general assistance medical care,
44.28 	and MinnesotaCare programs.  The Health Services Policy
44.29 	Committee shall meet at least quarterly.  The Health Services
44.30 	Policy Committee shall annually elect a physician chair from
44.31 	among its members, who will work directly with the
44.32 	commissioner's medical director, to establish the agenda for
44.33 	each meeting.

44.34 	Sec. 27. Minnesota Statutes 2004, section 256B.0625, is
44.35 	amended by adding a subdivision to read:
44.36 		Subd. 3e.Health services policy committee members. The
45.1 	Health Services Policy Committee shall be comprised of:
45.2 	(1) six voting members who are licensed physicians actively
45.3 	engaged in the practice of medicine in Minnesota, one of whom
45.4 	must be actively engaged in the treatment of persons with mental
45.5 	illness and three of whom must represent health plans currently
45.6 	under contract to serve medical assistance recipients;
45.7 	(2) three voting members who are nonphysician health care
45.8 	professionals licensed in their profession and actively engaged
45.9 	in the practice of their profession in Minnesota;
45.10 	(3) the commissioner's medical director who will serve as a
45.11 	nonvoting member; and 
45.12 	(4) one consumer who shall serve as a voting member.
45.13 	Members of the Health Services Policy Committee shall not
45.14 	be employed by the Department of Human Services, except for the
45.15 	medical director.

45.16 	Sec. 28. Minnesota Statutes 2004, section 256B.0625, is
45.17 	amended by adding a subdivision to read:
45.18 		Subd. 3f.Health services policy committee terms and
45.19 	compensation. Committee members shall serve staggered
45.20 	three-year terms, with one-third of the voting members' terms
45.21 	expiring annually.  Members may be reappointed by the
45.22 	commissioner.  The commissioner may require more frequent Health
45.23 	Services Policy Committee meetings as needed.  An honorarium of
45.24 	$200 per meeting and reimbursement for mileage and parking shall
45.25 	be paid to each committee member in attendance except the
45.26 	medical director.  The Health Services Policy Committee does not
45.27 	expire as provided in section 15.059, subdivision 6.

45.28 	Sec. 29. Minnesota Statutes 2004, section 256B.0625,
45.29 	subdivision 13, is amended to read:
45.30 		Subd. 13.Drugs.  (a) Medical assistance covers drugs,
45.31 	except for fertility drugs when specifically used to enhance
45.32 	fertility, if prescribed by a licensed practitioner and
45.33 	dispensed by a licensed pharmacist, by a physician enrolled in
45.34 	the medical assistance program as a dispensing physician, or by
45.35 	a physician or a nurse practitioner employed by or under
45.36 	contract with a community health board as defined in section
46.1 	145A.02, subdivision 5, for the purposes of communicable disease
46.2 	control.
46.3 	(b) The dispensed quantity of a prescription drug must not
46.4 	exceed a 34-day supply, unless authorized by the commissioner.
46.5 	(c) Medical assistance covers the following
46.6 	over-the-counter drugs when prescribed by a licensed
46.7 	practitioner or by a licensed pharmacist who meets standards
46.8 	established by the commissioner, in consultation with the board
46.9 	of pharmacy:  antacids, acetaminophen, family planning products,
46.10 	aspirin, insulin, products for the treatment of lice, vitamins
46.11 	for adults with documented vitamin deficiencies, vitamins for
46.12 	children under the age of seven and pregnant or nursing women,
46.13 	and any other over-the-counter drug identified by the
46.14 	commissioner, in consultation with the formulary committee, as
46.15 	necessary, appropriate, and cost-effective for the treatment of
46.16 	certain specified chronic diseases, conditions, or disorders,
46.17 	and this determination shall not be subject to the requirements
46.18 	of chapter 14.  A pharmacist may prescribe over-the-counter
46.19 	medications as provided under this paragraph for purposes of
46.20 	receiving reimbursement under Medicaid.  When prescribing
46.21 	over-the-counter drugs under this paragraph, licensed
46.22 	pharmacists must consult with the recipient to determine
46.23 	necessity, provide drug counseling, review drug therapy for
46.24 	potential adverse interactions, and make referrals as needed to
46.25 	other health care professionals.
46.26 	(d) Effective January 1, 2006, medical assistance shall not
46.27 	cover drugs that are coverable under Medicare Part D as defined
46.28 	in the Medicare Prescription Drug, Improvement, and
46.29 	Modernization Act of 2003, Public Law 108-173, section
46.30 	1860D-2(e), for individuals eligible for drug coverage as
46.31 	defined in the Medicare Prescription Drug, Improvement, and
46.32 	Modernization Act of 2003, Public Law 108-173, section
46.33 	1860D-1(a)(3)(A).  For such individuals, medical assistance may
46.34 	cover drugs from the drug classes listed in United States Code,
46.35 	title 42, section 1396r-8(d)(2), subject to the provisions of
46.36 	this subdivision and subdivisions 13a to 13g, except that drugs
47.1 	listed in United States Code, title 42, section
47.2 	1396r-8(d)(2)(E), shall not be covered.

47.3 	Sec. 30. Minnesota Statutes 2004, section 256B.0625,
47.4 	subdivision 13a, is amended to read:
47.5 		Subd. 13a.Drug utilization review board. The
47.6 	commissioner, after receiving recommendations from professional
47.7 	medical associations, professional pharmacy associations, and
47.8 	consumer groups shall designate a nine-member Drug Utilization
47.9 	Review Board is established.  The board is shall be comprised of
47.10 	at least three but no more than four licensed physicians
47.11 	actively engaged in the practice of medicine in Minnesota; at
47.12 	least three licensed pharmacists actively engaged in the
47.13 	practice of pharmacy in Minnesota; and one consumer
47.14 	representative; the remainder to be made up of health care
47.15 	professionals who are licensed in their field and have
47.16 	recognized knowledge in the clinically appropriate prescribing,
47.17 	dispensing, and monitoring of covered outpatient drugs.  The
47.18 	board shall be staffed by an employee of the department who
47.19 	shall serve as an ex officio nonvoting member of the board. The
47.20 	department's medical director shall also serve as an ex officio,
47.21 	nonvoting member of the board.The members of the board shall
47.22 	be appointed by the commissioner and shall serve three-year
47.23 	terms. The members shall be selected from lists submitted by
47.24 	professional associations.The commissioner shall appoint the
47.25 	initial members of the board for terms expiring as follows:
47.26 	three members for terms expiring June 30, 1996; three members
47.27 	for terms expiring June 30, 1997; and three members for terms
47.28 	expiring June 30, 1998.  Members may be reappointed once by the
47.29 	commissioner.  The board shall annually elect a chair from among
47.30 	the members.
47.31 	The commissioner shall, with the advice of the board:
47.32 	(1) implement a medical assistance retrospective and
47.33 	prospective drug utilization review program as required by
47.34 	United States Code, title 42, section 1396r-8(g)(3);
47.35 	(2) develop and implement the predetermined criteria and
47.36 	practice parameters for appropriate prescribing to be used in
48.1 	retrospective and prospective drug utilization review;
48.2 	(3) develop, select, implement, and assess interventions
48.3 	for physicians, pharmacists, and patients that are educational
48.4 	and not punitive in nature;
48.5 	(4) establish a grievance and appeals process for
48.6 	physicians and pharmacists under this section;
48.7 	(5) publish and disseminate educational information to
48.8 	physicians and pharmacists regarding the board and the review
48.9 	program;
48.10 	(6) adopt and implement procedures designed to ensure the
48.11 	confidentiality of any information collected, stored, retrieved,
48.12 	assessed, or analyzed by the board, staff to the board, or
48.13 	contractors to the review program that identifies individual
48.14 	physicians, pharmacists, or recipients;
48.15 	(7) establish and implement an ongoing process to (i)
48.16 	receive public comment regarding drug utilization review
48.17 	criteria and standards, and (ii) consider the comments along
48.18 	with other scientific and clinical information in order to
48.19 	revise criteria and standards on a timely basis; and
48.20 	(8) adopt any rules necessary to carry out this section.
48.21 	The board may establish advisory committees.  The
48.22 	commissioner may contract with appropriate organizations to
48.23 	assist the board in carrying out the board's duties.  The
48.24 	commissioner may enter into contracts for services to develop
48.25 	and implement a retrospective and prospective review program.
48.26 	The board shall report to the commissioner annually on the
48.27 	date the Drug Utilization Review Annual Report is due to the
48.28 	Centers for Medicare and Medicaid Services.  This report is to
48.29 	cover the preceding federal fiscal year.  The commissioner shall
48.30 	make the report available to the public upon request.  The
48.31 	report must include information on the activities of the board
48.32 	and the program; the effectiveness of implemented interventions;
48.33 	administrative costs; and any fiscal impact resulting from the
48.34 	program.  An honorarium of $100 per meeting and reimbursement
48.35 	for mileage shall be paid to each board member in attendance.

48.36 	Sec. 31. Minnesota Statutes 2004, section 256B.0625,
49.1 	subdivision 13c, is amended to read:
49.2 		Subd. 13c.Formulary committee.  The commissioner, after
49.3 	receiving recommendations from professional medical associations
49.4 	and professional pharmacy associations, and consumer groups
49.5 	shall designate a Formulary Committee to carry out duties as
49.6 	described in subdivisions 13 to 13g.  The Formulary Committee
49.7 	shall be comprised of four licensed physicians actively engaged
49.8 	in the practice of medicine in Minnesota one of whom must be
49.9 	actively engaged in the treatment of persons with mental
49.10 	illness; at least three licensed pharmacists actively engaged in
49.11 	the practice of pharmacy in Minnesota; and one consumer
49.12 	representative; the remainder to be made up of health care
49.13 	professionals who are licensed in their field and have
49.14 	recognized knowledge in the clinically appropriate prescribing,
49.15 	dispensing, and monitoring of covered outpatient drugs.  Members
49.16 	of the Formulary Committee shall not be employed by the
49.17 	Department of Human Services, but the committee shall be staffed
49.18 	by an employee of the department who shall serve as an ex
49.19 	officio, nonvoting member of the board.  The department's
49.20 	medical director shall also serve as an ex officio, nonvoting
49.21 	member for the committee.  Committee members shall serve
49.22 	three-year terms and may be reappointed by the commissioner.
49.23 	The Formulary Committee shall meet at least quarterly.  The
49.24 	commissioner may require more frequent Formulary Committee
49.25 	meetings as needed.  An honorarium of $100 per meeting and
49.26 	reimbursement for mileage shall be paid to each committee member
49.27 	in attendance.

49.28 	Sec. 32. Minnesota Statutes 2004, section 256B.0625,
49.29 	subdivision 13e, is amended to read:
49.30 		Subd. 13e.Payment rates.  (a) The basis for determining
49.31 	the amount of payment shall be the lower of the actual
49.32 	acquisition costs of the drugs plus a fixed dispensing fee; the
49.33 	maximum allowable cost set by the federal government or by the
49.34 	commissioner plus the fixed dispensing fee; or the usual and
49.35 	customary price charged to the public.  The amount of payment
49.36 	basis must be reduced to reflect all discount amounts applied to
50.1 	the charge by any provider/insurer agreement or contract for
50.2 	submitted charges to medical assistance programs.  The net
50.3 	submitted charge may not be greater than the patient liability
50.4 	for the service.  The pharmacy dispensing fee shall be $3.65,
50.5 	except that the dispensing fee for intravenous solutions which
50.6 	must be compounded by the pharmacist shall be $8 per bag, $14
50.7 	per bag for cancer chemotherapy products, and $30 per bag for
50.8 	total parenteral nutritional products dispensed in one liter
50.9 	quantities, or $44 per bag for total parenteral nutritional
50.10 	products dispensed in quantities greater than one liter.  Actual
50.11 	acquisition cost includes quantity and other special discounts
50.12 	except time and cash discounts.  The actual acquisition cost of
50.13 	a drug shall be estimated by the commissioner, at average
50.14 	wholesale price minus 11.5 12 percent, except that where a drug
50.15 	has had its wholesale price reduced as a result of the actions
50.16 	of the National Association of Medicaid Fraud Control Units, the
50.17 	estimated actual acquisition cost shall be the reduced average
50.18 	wholesale price, without the 11.5 percent deduction.  The
50.19 	maximum allowable cost of a multisource drug may be set by the
50.20 	commissioner and it shall be comparable to, but no higher than,
50.21 	the maximum amount paid by other third-party payors in this
50.22 	state who have maximum allowable cost programs.  Establishment
50.23 	of the amount of payment for drugs shall not be subject to the
50.24 	requirements of the Administrative Procedure Act.
50.25 	(b) An additional dispensing fee of $.30 may be added to
50.26 	the dispensing fee paid to pharmacists for legend drug
50.27 	prescriptions dispensed to residents of long-term care
50.28 	facilities when a unit dose blister card system, approved by the
50.29 	department, is used.  Under this type of dispensing system, the
50.30 	pharmacist must dispense a 30-day supply of drug.  The National
50.31 	Drug Code (NDC) from the drug container used to fill the blister
50.32 	card must be identified on the claim to the department.  The
50.33 	unit dose blister card containing the drug must meet the
50.34 	packaging standards set forth in Minnesota Rules, part
50.35 	6800.2700, that govern the return of unused drugs to the
50.36 	pharmacy for reuse.  The pharmacy provider will be required to
51.1 	credit the department for the actual acquisition cost of all
51.2 	unused drugs that are eligible for reuse.  Over-the-counter
51.3 	medications must be dispensed in the manufacturer's unopened
51.4 	package.  The commissioner may permit the drug clozapine to be
51.5 	dispensed in a quantity that is less than a 30-day supply.
51.6 	(c) Whenever a generically equivalent product is available,
51.7 	payment shall be on the basis of the actual acquisition cost of
51.8 	the generic drug, or on the maximum allowable cost established
51.9 	by the commissioner.
51.10 	(d) The basis for determining the amount of payment for
51.11 	drugs administered in an outpatient setting shall be the lower
51.12 	of the usual and customary cost submitted by the provider, the
51.13 	average wholesale price minus five percent, or the maximum
51.14 	allowable cost set by the federal government under United States
51.15 	Code, title 42, chapter 7, section 1396r-8(e), and Code of
51.16 	Federal Regulations, title 42, section 447.332, or by the
51.17 	commissioner under paragraphs (a) to (c) or the amount
51.18 	established for Medicare by the United States Department of
51.19 	Health and Human Services pursuant to the Social Security Act,
51.20 	title XVIII, section 1847a.
51.21 	(e) The commissioner may negotiate lower reimbursement
51.22 	rates for specialty pharmacy products than the rates specified
51.23 	in paragraph (a).  The commissioner may require individuals
51.24 	enrolled in the health care programs administered by the
51.25 	department to obtain specialty pharmacy products from providers
51.26 	with whom the commissioner has negotiated lower reimbursement
51.27 	rates.  Specialty pharmacy products are defined as those used by
51.28 	a small number of recipients or recipients with complex and
51.29 	chronic diseases that require expensive and challenging drug
51.30 	regimens.  Examples of such conditions include, but are not
51.31 	limited to:  multiple sclerosis, HIV/AIDS, transplantation,
51.32 	hepatitis C, growth hormone deficiency, Crohn's Disease,
51.33 	rheumatoid arthritis, and certain forms of cancer.  Specialty
51.34 	pharmaceutical products commonly include injectable and infusion
51.35 	therapies, biotechnology drugs, high-cost therapies, and
51.36 	therapies that require complex care.  The commissioner shall
52.1 	consult with the formulary committee to develop a list of
52.2 	specialty pharmacy products subject to this paragraph.
52.3 	(f) The commissioner may require individuals enrolled in
52.4 	the health care programs administered by the department to
52.5 	obtain drugs used to treat hemophilia from a comprehensive
52.6 	hemophilia diagnostic treatment center as defined in United
52.7 	States Code, title 42, section 256b(a)(4)(G); provided that the
52.8 	hemophilia treatment center is enrolled as a covered entity in
52.9 	the drug pricing program, commonly known as the 340B program,
52.10 	that is established under that section.

52.11 	Sec. 33. Minnesota Statutes 2004, section 256B.0625,
52.12 	subdivision 13f, is amended to read:
52.13 		Subd. 13f.Prior authorization.  (a) The Formulary
52.14 	Committee shall review and recommend drugs which require prior
52.15 	authorization.  The Formulary Committee shall establish general
52.16 	criteria to be used for the prior authorization of brand-name
52.17 	drugs for which generically equivalent drugs are available, but
52.18 	the committee is not required to review each brand-name drug for
52.19 	which a generically equivalent drug is available.
52.20 	(b) Prior authorization may be required by the commissioner
52.21 	before certain formulary drugs are eligible for payment.  The
52.22 	Formulary Committee may recommend drugs for prior authorization
52.23 	directly to the commissioner.  The commissioner may also request
52.24 	that the Formulary Committee review a drug for prior
52.25 	authorization.  Before the commissioner may require prior
52.26 	authorization for a drug:
52.27 	(1) the commissioner must provide information to the
52.28 	Formulary Committee on the impact that placing the drug on prior
52.29 	authorization may have on the quality of patient care and on
52.30 	program costs, information regarding whether the drug is subject
52.31 	to clinical abuse or misuse, and relevant data from the state
52.32 	Medicaid program if such data is available;
52.33 	(2) the Formulary Committee must review the drug, taking
52.34 	into account medical and clinical data and the information
52.35 	provided by the commissioner; and
52.36 	(3) the Formulary Committee must hold a public forum and
53.1 	receive public comment for an additional 15 days.
53.2 	The commissioner must provide a 15-day notice period before
53.3 	implementing the prior authorization.
53.4 	(c) Prior authorization shall not be required or utilized
53.5 	for any atypical antipsychotic drug prescribed for the treatment
53.6 	of mental illness if:
53.7 	(1) there is no generically equivalent drug available; and
53.8 	(2) the drug was initially prescribed for the recipient
53.9 	prior to July 1, 2003; or
53.10 	(3) the drug is part of the recipient's current course of
53.11 	treatment.
53.12 	This paragraph applies to any multistate preferred drug list or
53.13 	supplemental drug rebate program established or administered by
53.14 	the commissioner. Prior authorization shall automatically be
53.15 	granted for 60 days for brand name drugs prescribed for
53.16 	treatment of mental illness within 60 days of when a generically
53.17 	equivalent drug becomes available.
53.18 	(d) Prior authorization shall not be required or utilized
53.19 	for any antihemophilic factor drug prescribed for the treatment
53.20 	of hemophilia and blood disorders where there is no generically
53.21 	equivalent drug available if the prior authorization is used in
53.22 	conjunction with any supplemental drug rebate program or
53.23 	multistate preferred drug list established or administered by
53.24 	the commissioner. This paragraph expires July 1, 2005.
53.25 	(e) The commissioner may require prior authorization for
53.26 	brand name drugs whenever a generically equivalent product is
53.27 	available, even if the prescriber specifically indicates
53.28 	"dispense as written-brand necessary" on the prescription as
53.29 	required by section 151.21, subdivision 2.
53.30 	(f) Notwithstanding the provisions of this subdivision, the
53.31 	commissioner may automatically require prior authorization, for
53.32 	a period not to exceed 180 days, for any drug that is approved
53.33 	by the United States Food and Drug Administration on or after
53.34 	July 1, 2005.  The 180-day period shall begin no later than the
53.35 	first day that a drug is available for shipment to pharmacies
53.36 	within the state.  The Formulary Committee shall recommend to
54.1 	the commissioner general criteria to be used for the prior
54.2 	authorization of such drugs, but the committee is not required
54.3 	to review each individual drug.  In order to continue prior
54.4 	authorizations for a drug after the 180-day period has expired,
54.5 	the commissioner must follow the provisions of this subdivision.
54.6 	
EFFECTIVE DATE. The amendment to paragraph (d) is
54.7 	effective June 30, 2005.

54.8 	Sec. 34. Minnesota Statutes 2004, section 256B.0625, is
54.9 	amended by adding a subdivision to read:
54.10 		Subd. 13h.Medication therapy management care. (a)
54.11 	Medical assistance and general assistance medical care cover
54.12 	medication therapy management services for a recipient taking
54.13 	four or more prescriptions to treat or prevent two or more
54.14 	chronic medical conditions, or a recipient with a drug therapy
54.15 	problem that is identified or prior authorized by the
54.16 	commissioner that has resulted or is likely to result in
54.17 	significant nondrug program costs.  The commissioner may cover
54.18 	medical therapy management services under MinnesotaCare if the
54.19 	commissioner determines this is cost-effective.  For purposes of
54.20 	this subdivision, "medication therapy management" means the
54.21 	provision of the following pharmaceutical care services by a
54.22 	licensed pharmacist to optimize the therapeutic outcomes of the
54.23 	patient's medications:
54.24 	(1) performing or obtaining necessary assessments of the
54.25 	patient's health status;
54.26 	(2) formulating a medication treatment plan;
54.27 	(3) monitoring and evaluating the patient's response to
54.28 	therapy, including safety and effectiveness;
54.29 	(4) performing a comprehensive medication review to
54.30 	identify, resolve, and prevent medication-related problems,
54.31 	including adverse drug events;
54.32 	(5) documenting the care delivered and communicating
54.33 	essential information to the patient's other primary care
54.34 	providers;
54.35 	(6) providing verbal education and training designed to
54.36 	enhance patient understanding and appropriate use of the
55.1 	patient's medications;
55.2 	(7) providing information, support services, and resources
55.3 	designed to enhance patient adherence with the patient's
55.4 	therapeutic regimens; and 
55.5 	(8) coordinating and integrating medication therapy
55.6 	management services within the broader health care management
55.7 	services being provided to the patient.
55.8 	Nothing in this subdivision shall be construed to expand or
55.9 	modify the scope of practice of the pharmacist as defined in
55.10 	section 151.01, subdivision 27.
55.11 	(b) To be eligible for reimbursement for services under
55.12 	this subdivision, a pharmacist must meet the following
55.13 	requirements:
55.14 	(1) have a valid license issued under chapter 151;
55.15 	(2) have graduated from an accredited college of pharmacy
55.16 	on or after May 1996, or completed a structured and
55.17 	comprehensive education program approved by the Board of
55.18 	Pharmacy and the American Council of Pharmaceutical Education
55.19 	for the provision and documentation of pharmaceutical care
55.20 	management services that has both clinical and didactic
55.21 	elements;
55.22 	(3) be practicing in an ambulatory care setting as part of
55.23 	a multidisciplinary team or have developed a structured patient
55.24 	care process that is offered in a private or semiprivate patient
55.25 	care area that is separate from the commercial business that
55.26 	also occurs in the setting; and 
55.27 	(4) make use of an electronic patient record system that
55.28 	meets state standards.
55.29 	(c) For purposes of reimbursement for medication therapy
55.30 	management services, the commissioner may enroll individual
55.31 	pharmacists as medical assistance and general assistance medical
55.32 	care providers.  The commissioner may also establish contact
55.33 	requirements between the pharmacist and recipient, including
55.34 	limiting the number of reimbursable consultations per recipient.
55.35 	(d) The commissioner, after receiving recommendations from
55.36 	professional medical associations, professional pharmacy
56.1 	associations, and consumer groups, shall convene an 11-member
56.2 	Medication Therapy Management Advisory Committee to advise the
56.3 	commissioner on the implementation and administration of
56.4 	medication therapy management services.  The committee shall be
56.5 	comprised of:  two licensed physicians; two licensed
56.6 	pharmacists; two consumer representatives; two health plan
56.7 	company representatives; and three members with expertise in the
56.8 	area of medication therapy management, who may be licensed
56.9 	physicians or licensed pharmacists.  The committee is governed
56.10 	by section 15.059, except that committee members do not receive
56.11 	compensation or reimbursement for expenses.  The advisory
56.12 	committee expires on June 30, 2007.
56.13 	(e) The commissioner shall evaluate the effect of
56.14 	medication therapy management on quality of care, patient
56.15 	outcomes, and program costs, and shall include a description of
56.16 	any savings generated in the medical assistance and general
56.17 	assistance medical care programs that can be attributable to
56.18 	this coverage.  The evaluation shall be submitted to the
56.19 	legislature by December 15, 2007.  The commissioner may contract
56.20 	with a vendor or an academic institution that has expertise in
56.21 	evaluating health care outcomes for the purpose of completing
56.22 	the evaluation.

56.23 	Sec. 35. Minnesota Statutes 2004, section 256B.0625,
56.24 	subdivision 17, is amended to read:
56.25 		Subd. 17.Transportation costs.  (a) Medical assistance
56.26 	covers transportation costs incurred solely for obtaining
56.27 	emergency medical care or transportation costs incurred by
56.28 	eligible persons in obtaining emergency or nonemergency medical
56.29 	care when paid directly to an ambulance company, common carrier,
56.30 	or other recognized providers of transportation services.
56.31 	(b) Medical assistance covers special transportation, as
56.32 	defined in Minnesota Rules, part 9505.0315, subpart 1, item F,
56.33 	if the recipient has a physical or mental impairment that would
56.34 	prohibit the recipient from safely accessing and using a bus,
56.35 	taxi, other commercial transportation, or private automobile.
56.36 	The commissioner may use an order by the recipient's attending
57.1 	physician to certify that the recipient requires special
57.2 	transportation services.  Special transportation includes
57.3 	driver-assisted service to eligible individuals.
57.4 	Driver-assisted service includes passenger pickup at and return
57.5 	to the individual's residence or place of business, assistance
57.6 	with admittance of the individual to the medical facility, and
57.7 	assistance in passenger securement or in securing of wheelchairs
57.8 	or stretchers in the vehicle.  Special transportation providers
57.9 	must obtain written documentation from the health care service
57.10 	provider who is serving the recipient being transported,
57.11 	identifying the time that the recipient arrived.  Special
57.12 	transportation providers may not bill for separate base rates
57.13 	for the continuation of a trip beyond the original destination.
57.14 	Special transportation providers must take recipients to the
57.15 	nearest appropriate health care provider, using the most direct
57.16 	route available.  The maximum medical assistance reimbursement
57.17 	rates for special transportation services are:
57.18 	(1) $18 for the base rate and $1.40 per mile for services
57.19 	to eligible persons who need a wheelchair-accessible van;
57.20 	(2) $12 for the base rate and $1.35 per mile for services
57.21 	to eligible persons who do not need a wheelchair-accessible van;
57.22 	and
57.23 	(3) $36 $60 for the base rate and $1.40 $2.40 per mile, and
57.24 	an attendant rate of $9 per trip, for services to eligible
57.25 	persons who need a stretcher-accessible vehicle.

57.26 	Sec. 36. [256B.0632] MEDICALLY NECESSARY ITEMS AND
57.27 	SERVICES.
57.28 		Subdivision 1.General requirement for
57.29 	coverage. Enrollees under the medical assistance program are
57.30 	eligible to receive, and medical assistance shall provide
57.31 	payment for, only those medical items and services that are:
57.32 	(1) within the scope of defined benefits for which the
57.33 	enrollee is eligible under the medical assistance program; and 
57.34 	(2) determined by the medical assistance program to be
57.35 	medically necessary.
57.36 		Subd. 2.Medical necessity. (a) To be determined to be
58.1 	medically necessary, a medical item or service must be
58.2 	recommended by a physician who is treating the enrollee or other
58.3 	licensed health care provider practicing within the scope of
58.4 	their practice and must satisfy each of the criteria in this
58.5 	section.
58.6 	(b) It must be required in order to diagnose or treat an
58.7 	enrollee's medical condition.  The convenience of an enrollee,
58.8 	the enrollee's family, or a provider, shall not be a factor or
58.9 	justification in determining that a medical item or service is
58.10 	medically necessary.
58.11 	(c) It must be safe and effective.  To qualify as safe and
58.12 	effective, the type and level of medical item or service must be
58.13 	consistent with the symptoms or diagnosis and treatment of the
58.14 	particular medical condition, and the reasonably anticipated
58.15 	medical benefits of the item or service must outweigh the
58.16 	reasonably anticipated medical risks based on the enrollee's
58.17 	condition and scientifically supported evidence.
58.18 	(d) It must be the least costly alternative course of
58.19 	diagnosis or treatment that is adequate for the medical
58.20 	condition of the enrollee.  When applied to medical items or
58.21 	services delivered in an inpatient setting, it further means
58.22 	that the medical item or service cannot be safely provided for
58.23 	the same or lesser cost to the person in an outpatient setting.
58.24 	Where there are less costly alternative courses of diagnosis or
58.25 	treatment, including less costly alternative settings, that are
58.26 	adequate for the medical condition of the enrollee, more costly
58.27 	alternative courses of diagnosis or treatment are not medically
58.28 	necessary.  An alternative course of diagnosis or treatment may
58.29 	include observation, lifestyle or behavioral changes, or where
58.30 	appropriate, no treatment at all.
58.31 		Subd. 3.Determination of commissioner. It is the
58.32 	responsibility of the commissioner ultimately to determine what
58.33 	medical items and services are medically necessary for the
58.34 	medical assistance program.  The fact that a provider has
58.35 	prescribed, recommended, or approved a medical item or service
58.36 	does not, in itself, make such item or service medically
59.1 	necessary.
59.2 		Subd. 4.Applicability. The medical necessity standard
59.3 	in this section shall govern the delivery of all services and
59.4 	items to all enrollees or classes of beneficiaries in the
59.5 	medical assistance program.  The commissioner is authorized to
59.6 	make limited special provisions for particular items or
59.7 	services, such as long-term care, or such as may be required for
59.8 	compliance with federal law.
59.9 		Subd. 5.Medical protocols. Medical protocols developed
59.10 	using evidence-based medicine that are authorized by the
59.11 	commissioner shall satisfy the standard of medical necessity.
59.12 	Such protocols shall be appropriately published to all medical
59.13 	assistance providers and managed care organizations.
59.14 		Subd. 6.Rulemaking. The commissioner is authorized to
59.15 	adopt any rules necessary to implement this section.
59.16 		Subd. 7.Application. This section does not apply if the
59.17 	medical necessity standard, or medical protocols authorized
59.18 	under subdivision 5, authorize or recommend denial of treatment,
59.19 	food, or fluids necessary to sustain life on the basis of the
59.20 	patient's age or expected length of life, or the patient's
59.21 	present or predicted disability, degree of medical dependency,
59.22 	or quality of life.

59.23 	Sec. 37. [256B.0633] LIMITING COVERAGE OF HEALTH CARE
59.24 	SERVICES FOR PUBLIC PROGRAMS.
59.25 		Subdivision 1.Prior authorization of services. (a)
59.26 	Effective July 1, 2005, prior authorization is required for the
59.27 	services described in subdivision 2 for reimbursement under
59.28 	chapters 256B, 256D, and 256L.  Effective July 1, 2005, prepaid
59.29 	health plans shall use prior authorization for the services
59.30 	described in subdivision 2 unless the prepaid health plan is
59.31 	otherwise using evidence-based practices to address these
59.32 	services.
59.33 	(b) Prior authorization shall be conducted under the
59.34 	direction of the medical director of the Department of Human
59.35 	Services in conjunction with the Health Services Policy
59.36 	Committee.  To the extent available, the medical director shall
60.1 	use publicly available evidence-based guidelines developed by an
60.2 	independent, nonprofit organization or by the professional
60.3 	association of the specialty that typically provides the service
60.4 	or by a multistate Medicaid evidence-based practice center.  If
60.5 	the commissioner does not have a medical director and medical
60.6 	policy in place, the commissioner shall contract prior
60.7 	authorization to a Minnesota-licensed utilization review
60.8 	organization or an organization federally certified as a peer
60.9 	review organization-like entity eligible to operate in Minnesota.
60.10 		Subd. 2.Services requiring prior authorization. The
60.11 	following services require prior authorization:
60.12 	(1) elective outpatient high technology imaging to include
60.13 	positive emission tomography (PET) scans, magnetic resonance
60.14 	imaging (MRI), computed tomography (CT), and nuclear cardiology;
60.15 	(2) spinal fusion, unless in an emergency situation related
60.16 	to trauma;
60.17 	(3) bariatric surgery;
60.18 	(4) orthodontia;
60.19 	(5) cesarean section or insertion of tympanostomy tubes
60.20 	except in an emergency situation; and 
60.21 	(6) hysterectomy.

60.22 	Sec. 38. Minnesota Statutes 2004, section 256B.0644, is
60.23 	amended to read:
60.24 	256B.0644 PARTICIPATION REQUIRED FOR REIMBURSEMENT UNDER
60.25 	OTHER STATE HEALTH CARE PROGRAMS.
60.26 	A vendor of medical care, as defined in section 256B.02,
60.27 	subdivision 7, and a health maintenance organization, as defined
60.28 	in chapter 62D, must participate as a provider or contractor in
60.29 	the medical assistance program, general assistance medical care
60.30 	program, and MinnesotaCare as a condition of participating as a
60.31 	provider in health insurance plans and programs or contractor
60.32 	for state employees established under section 43A.18, the public
60.33 	employees insurance program under section 43A.316, for health
60.34 	insurance plans offered to local statutory or home rule charter
60.35 	city, county, and school district employees, the workers'
60.36 	compensation system under section 176.135, and insurance plans
61.1 	provided through the Minnesota Comprehensive Health Association
61.2 	under sections 62E.01 to 62E.19. This section does not apply to
61.3 	any person providing dental services.The limitations on
61.4 	insurance plans offered to local government employees shall not
61.5 	be applicable in geographic areas where provider participation
61.6 	is limited by managed care contracts with the Department of
61.7 	Human Services.  For providers other than health maintenance
61.8 	organizations, participation in the medical assistance program
61.9 	means that (1) the provider accepts new medical assistance,
61.10 	general assistance medical care, and MinnesotaCare patients or
61.11 	(2) for providers other than dental service providers, and at
61.12 	least 20 percent of the provider's patients are covered by
61.13 	medical assistance, general assistance medical care, and
61.14 	MinnesotaCare as their primary source of coverage, or (3) for
61.15 	dental service providers, at least ten percent of the provider's
61.16 	patients are covered by medical assistance, general assistance
61.17 	medical care, and MinnesotaCare as their primary source of
61.18 	coverage.  Patients seen on a volunteer basis by the provider at
61.19 	a location other than the provider's usual place of practice may
61.20 	be considered in meeting this participation requirement.  The
61.21 	commissioner shall establish participation requirements for
61.22 	health maintenance organizations.  The commissioner shall
61.23 	provide lists of participating medical assistance providers on a
61.24 	quarterly basis to the commissioner of employee relations, the
61.25 	commissioner of labor and industry, and the commissioner of
61.26 	commerce.  Each of the commissioners shall develop and implement
61.27 	procedures to exclude as participating providers in the program
61.28 	or programs under their jurisdiction those providers who do not
61.29 	participate in the medical assistance program.  The commissioner
61.30 	of employee relations shall implement this section through
61.31 	contracts with participating health and dental carriers.

61.32 	Sec. 39. Minnesota Statutes 2004, section 256B.075,
61.33 	subdivision 2, is amended to read:
61.34 		Subd. 2.Fee-for-service.  (a) The commissioner shall
61.35 	develop and implement a disease management program for medical
61.36 	assistance and general assistance medical care recipients who
62.1 	are not enrolled in the prepaid medical assistance or prepaid
62.2 	general assistance medical care programs and who are receiving
62.3 	services on a fee-for-service basis.  The commissioner may
62.4 	contract with an outside organization to provide these services.
62.5 	(b) The commissioner shall seek any federal approval
62.6 	necessary to implement this section and to obtain federal
62.7 	matching funds.
62.8 	(c) The commissioner shall develop and implement a pilot
62.9 	intensive care management program for medical assistance
62.10 	children with complex and chronic medical issues who are not
62.11 	able to participate in the metro-based U Special Kids program
62.12 	due to geographic distance.

62.13 	Sec. 40. Minnesota Statutes 2004, section 256B.15,
62.14 	subdivision 1, is amended to read:
62.15 		Subdivision 1.Policy, applicability, purpose, and
62.16 	construction; definition.  (a) It is the policy of this state
62.17 	that individuals or couples, either or both of whom participate
62.18 	in the medical assistance program, use their own assets to pay
62.19 	their share of the total cost of their care during or after
62.20 	their enrollment in the program according to applicable federal
62.21 	law and the laws of this state.  The following provisions apply:
62.22 	(1) subdivisions 1c to 1k shall not apply to claims arising
62.23 	under this section which are presented under section 525.313;
62.24 	(2) the provisions of subdivisions 1c to 1k expanding the
62.25 	interests included in an estate for purposes of recovery under
62.26 	this section give effect to the provisions of United States
62.27 	Code, title 42, section 1396p, governing recoveries, but do not
62.28 	give rise to any express or implied liens in favor of any other
62.29 	parties not named in these provisions;
62.30 	(3) the continuation of a recipient's life estate or joint
62.31 	tenancy interest in real property after the recipient's death
62.32 	for the purpose of recovering medical assistance under this
62.33 	section modifies common law principles holding that these
62.34 	interests terminate on the death of the holder;
62.35 	(4) all laws, rules, and regulations governing or involved
62.36 	with a recovery of medical assistance shall be liberally
63.1 	construed to accomplish their intended purposes;
63.2 	(5) a deceased recipient's life estate and joint tenancy
63.3 	interests continued under this section shall be owned by the
63.4 	remaindermen or surviving joint tenants as their interests may
63.5 	appear on the date of the recipient's death.  They shall not be
63.6 	merged into the remainder interest or the interests of the
63.7 	surviving joint tenants by reason of ownership.  They shall be
63.8 	subject to the provisions of this section.  Any conveyance,
63.9 	transfer, sale, assignment, or encumbrance by a remainderman, a
63.10 	surviving joint tenant, or their heirs, successors, and assigns
63.11 	shall be deemed to include all of their interest in the deceased
63.12 	recipient's life estate or joint tenancy interest continued
63.13 	under this section; and
63.14 	(6) the provisions of subdivisions 1c to 1k continuing a
63.15 	recipient's joint tenancy interests in real property after the
63.16 	recipient's death do not apply to a homestead owned of record,
63.17 	on the date the recipient dies, by the recipient and the
63.18 	recipient's spouse as joint tenants with a right of
63.19 	survivorship.  Homestead means the real property occupied by the
63.20 	surviving joint tenant spouse as their sole residence on the
63.21 	date the recipient dies and classified and taxed to the
63.22 	recipient and surviving joint tenant spouse as homestead
63.23 	property for property tax purposes in the calendar year in which
63.24 	the recipient dies.  For purposes of this exemption, real
63.25 	property the recipient and their surviving joint tenant spouse
63.26 	purchase solely with the proceeds from the sale of their prior
63.27 	homestead, own of record as joint tenants, and qualify as
63.28 	homestead property under section 273.124 in the calendar year in
63.29 	which the recipient dies and prior to the recipient's death
63.30 	shall be deemed to be real property classified and taxed to the
63.31 	recipient and their surviving joint tenant spouse as homestead
63.32 	property in the calendar year in which the recipient dies.  The
63.33 	surviving spouse, or any person with personal knowledge of the
63.34 	facts, may provide an affidavit describing the homestead
63.35 	property affected by this clause and stating facts showing
63.36 	compliance with this clause.  The affidavit shall be prima facie
64.1 	evidence of the facts it states.
64.2 	(b) For purposes of this section, "medical assistance"
64.3 	includes the medical assistance program under this chapter and
64.4 	the general assistance medical care program under chapter 256D
64.5 	and alternative care for nonmedical assistance recipients under
64.6 	section 256B.0913.
64.7 	(c) All provisions in this subdivision, and subdivisions
64.8 	1d, 1f, 1g, 1h, 1i, and 1j, related to the continuation of a
64.9 	recipient's life estate or joint tenancy interests in real
64.10 	property after the recipient's death for the purpose of
64.11 	recovering medical assistance, are effective only for life
64.12 	estates and joint tenancy interests established on or after
64.13 	August 1, 2003.
64.14 	
EFFECTIVE DATE. This section is effective retroactively
64.15 	from August 1, 2003.

64.16 	Sec. 41. Minnesota Statutes 2004, section 256B.195,
64.17 	subdivision 3, is amended to read:
64.18 		Subd. 3.Payments to certain safety net providers.  (a)
64.19 	Effective July 15, 2001, the commissioner shall make the
64.20 	following payments to the hospitals indicated after noon on the
64.21 	15th of each month:
64.22 	(1) to Hennepin County Medical Center, any federal matching
64.23 	funds available to match the payments received by the medical
64.24 	center under subdivision 2, to increase payments for medical
64.25 	assistance admissions and to recognize higher medical assistance
64.26 	costs in institutions that provide high levels of charity care;
64.27 	and
64.28 	(2) to Regions Hospital, any federal matching funds
64.29 	available to match the payments received by the hospital under
64.30 	subdivision 2, to increase payments for medical assistance
64.31 	admissions and to recognize higher medical assistance costs in
64.32 	institutions that provide high levels of charity care.
64.33 	(b) Effective July 15, 2001, the following percentages of
64.34 	the transfers under subdivision 2 shall be retained by the
64.35 	commissioner for deposit each month into the general fund:
64.36 	(1) 18 percent, plus any federal matching funds, shall be
65.1 	allocated for the following purposes:
65.2 	(i) during the fiscal year beginning July 1, 2001, of the
65.3 	amount available under this clause, 39.7 percent shall be
65.4 	allocated to make increased hospital payments under section
65.5 	256.969, subdivision 26; 34.2 percent shall be allocated to fund
65.6 	the amounts due from small rural hospitals, as defined in
65.7 	section 144.148, for overpayments under section 256.969,
65.8 	subdivision 5a, resulting from a determination that medical
65.9 	assistance and general assistance payments exceeded the charge
65.10 	limit during the period from 1994 to 1997; and 26.1 percent
65.11 	shall be allocated to the commissioner of health for rural
65.12 	hospital capital improvement grants under section 144.148; and
65.13 	(ii) during fiscal years beginning on or after July 1,
65.14 	2002, of the amount available under this clause, 55 percent
65.15 	shall be allocated to make increased hospital payments under
65.16 	section 256.969, subdivision 26, and 45 percent shall be
65.17 	allocated to the commissioner of health for rural hospital
65.18 	capital improvement grants under section 144.148; and
65.19 	(2) 11 percent shall be allocated to the commissioner of
65.20 	health to fund community clinic grants under section 145.9268.
65.21 	(c) This subdivision shall apply to fee-for-service
65.22 	payments only and shall not increase capitation payments or
65.23 	payments made based on average rates. The allocation in
65.24 	paragraph (b), clause (1), item (ii), to increase hospital
65.25 	payments under section 256.969, subdivision 26, shall not limit
65.26 	payments under that section.
65.27 	(d) Medical assistance rate or payment changes, including
65.28 	those required to obtain federal financial participation under
65.29 	section 62J.692, subdivision 8, shall precede the determination
65.30 	of intergovernmental transfer amounts determined in this
65.31 	subdivision.  Participation in the intergovernmental transfer
65.32 	program shall not result in the offset of any health care
65.33 	provider's receipt of medical assistance payment increases other
65.34 	than limits resulting from hospital-specific charge limits and
65.35 	limits on disproportionate share hospital payments.
65.36 	(e) Effective July 1, 2003, if the amount available for
66.1 	allocation under paragraph (b) is greater than the amounts
66.2 	available during March 2003, after any increase in
66.3 	intergovernmental transfers and payments that result from
66.4 	section 256.969, subdivision 3a, paragraph (c), are paid to the
66.5 	general fund, any additional amounts available under this
66.6 	subdivision after reimbursement of the transfers under
66.7 	subdivision 2 shall be allocated to increase medical assistance
66.8 	payments, subject to hospital-specific charge limits and limits
66.9 	on disproportionate share hospital payments, as follows:
66.10 	(1) if the payments under subdivision 5 are approved, the
66.11 	amount shall be paid to the largest ten percent of hospitals as
66.12 	measured by 2001 payments for medical assistance, general
66.13 	assistance medical care, and MinnesotaCare in the nonstate
66.14 	government hospital category.  Payments shall be allocated
66.15 	according to each hospital's proportionate share of the 2001
66.16 	payments; or
66.17 	(2) if the payments under subdivision 5 are not approved,
66.18 	the amount shall be paid to the largest ten percent of hospitals
66.19 	as measured by 2001 payments for medical assistance, general
66.20 	assistance medical care, and MinnesotaCare in the nonstate
66.21 	government category and to the largest ten percent of hospitals
66.22 	as measured by payments for medical assistance, general
66.23 	assistance medical care, and MinnesotaCare in the nongovernment
66.24 	hospital category.  Payments shall be allocated according to
66.25 	each hospital's proportionate share of the 2001 payments in
66.26 	their respective category of nonstate government and
66.27 	nongovernment.  The commissioner shall determine which hospitals
66.28 	are in the nonstate government and nongovernment hospital
66.29 	categories.

66.30 	Sec. 42. Minnesota Statutes 2004, section 256B.32,
66.31 	subdivision 1, is amended to read:
66.32 		Subdivision 1.Facility fee payment.  (a) The
66.33 	commissioner shall establish a facility fee payment mechanism
66.34 	that will pay a facility fee to all enrolled outpatient
66.35 	hospitals for each emergency room or outpatient clinic visit
66.36 	provided on or after July 1, 1989.  This payment mechanism may
67.1 	not result in an overall increase in outpatient payment rates.
67.2 	This section does not apply to federally mandated maximum
67.3 	payment limits, department-approved program packages, or
67.4 	services billed using a nonoutpatient hospital provider number.
67.5 	(b) For fee-for-service services provided on or after July
67.6 	1, 2002, the total payment, before third-party liability and
67.7 	spenddown, made to hospitals for outpatient hospital facility
67.8 	services is reduced by .5 percent from the current statutory
67.9 	rates.
67.10 	(c) In addition to the reduction in paragraph (b), the
67.11 	total payment for fee-for-service services provided on or after
67.12 	July 1, 2003, made to hospitals for outpatient hospital facility
67.13 	services before third-party liability and spenddown, is reduced
67.14 	five percent from the current statutory rates.  Facilities
67.15 	defined under section 256.969, subdivision 16, are excluded from
67.16 	this paragraph.
67.17 	(d) In addition to the reduction in paragraphs (b) and (c)
67.18 	and section 256D.03, subdivision 4, paragraph (k), the total
67.19 	payment for fee-for-service services provided on or after July
67.20 	1, 2005, made to hospitals for outpatient hospital facility
67.21 	services before third-party liability and spenddown, is reduced
67.22 	five percent from the current statutory rates.  Facilities
67.23 	defined under section 256.969, subdivision 16, are excluded from
67.24 	this paragraph.

67.25 	Sec. 43. Minnesota Statutes 2004, section 256B.69,
67.26 	subdivision 4, is amended to read:
67.27 		Subd. 4.Limitation of choice.  (a) The commissioner
67.28 	shall develop criteria to determine when limitation of choice
67.29 	may be implemented in the experimental counties.  The criteria
67.30 	shall ensure that all eligible individuals in the county have
67.31 	continuing access to the full range of medical assistance
67.32 	services as specified in subdivision 6.
67.33 	(b) The commissioner shall exempt the following persons
67.34 	from participation in the project, in addition to those who do
67.35 	not meet the criteria for limitation of choice:
67.36 	(1) persons eligible for medical assistance according to
68.1 	section 256B.055, subdivision 1;
68.2 	(2) persons eligible for medical assistance due to
68.3 	blindness or disability as determined by the Social Security
68.4 	Administration or the state medical review team, unless:
68.5 	(i) they are 65 years of age or older; or
68.6 	(ii) they reside in Itasca County or they reside in a
68.7 	county in which the commissioner conducts a pilot project under
68.8 	a waiver granted pursuant to section 1115 of the Social Security
68.9 	Act;
68.10 	(3) recipients who currently have private coverage through
68.11 	a health maintenance organization;
68.12 	(4) recipients who are eligible for medical assistance by
68.13 	spending down excess income for medical expenses other than the
68.14 	nursing facility per diem expense;
68.15 	(5) recipients who receive benefits under the Refugee
68.16 	Assistance Program, established under United States Code, title
68.17 	8, section 1522(e);
68.18 	(6) children who are both determined to be severely
68.19 	emotionally disturbed and receiving case management services
68.20 	according to section 256B.0625, subdivision 20;
68.21 	(7) adults who are both determined to be seriously and
68.22 	persistently mentally ill and received case management services
68.23 	according to section 256B.0625, subdivision 20;
68.24 	(8) persons eligible for medical assistance according to
68.25 	section 256B.057, subdivision 10; and
68.26 	(9) persons with access to cost-effective
68.27 	employer-sponsored private health insurance or persons enrolled
68.28 	in an a non-Medicare individual health plan determined to be
68.29 	cost-effective according to section 256B.0625, subdivision 15.
68.30 	Children under age 21 who are in foster placement may enroll in
68.31 	the project on an elective basis.  Individuals excluded under
68.32 	clauses (1), (6), and (7) may choose to enroll on an elective
68.33 	basis.  The commissioner may enroll recipients in the prepaid
68.34 	medical assistance program for seniors who are (1) age 65 and
68.35 	over, and (2) eligible for medical assistance by spending down
68.36 	excess income.
69.1 	(c) The commissioner may allow persons with a one-month
69.2 	spenddown who are otherwise eligible to enroll to voluntarily
69.3 	enroll or remain enrolled, if they elect to prepay their monthly
69.4 	spenddown to the state.
69.5 	(d) The commissioner may require those individuals to
69.6 	enroll in the prepaid medical assistance program who otherwise
69.7 	would have been excluded under paragraph (b), clauses (1), (3),
69.8 	and (8), and under Minnesota Rules, part 9500.1452, subpart 2,
69.9 	items H, K, and L.
69.10 	(e) Before limitation of choice is implemented, eligible
69.11 	individuals shall be notified and after notification, shall be
69.12 	allowed to choose only among demonstration providers.  The
69.13 	commissioner may assign an individual with private coverage
69.14 	through a health maintenance organization, to the same health
69.15 	maintenance organization for medical assistance coverage, if the
69.16 	health maintenance organization is under contract for medical
69.17 	assistance in the individual's county of residence.  After
69.18 	initially choosing a provider, the recipient is allowed to
69.19 	change that choice only at specified times as allowed by the
69.20 	commissioner.  If a demonstration provider ends participation in
69.21 	the project for any reason, a recipient enrolled with that
69.22 	provider must select a new provider but may change providers
69.23 	without cause once more within the first 60 days after
69.24 	enrollment with the second provider.
69.25 	(f) An infant born to a woman who is eligible for and
69.26 	receiving medical assistance and who is enrolled in the prepaid
69.27 	medical assistance program shall be retroactively enrolled to
69.28 	the month of birth in the same managed care plan as the mother
69.29 	once the child is enrolled in medical assistance unless the
69.30 	child is determined to be excluded from enrollment in a prepaid
69.31 	plan under this section.

69.32 	Sec. 44. Minnesota Statutes 2004, section 256B.69, is
69.33 	amended by adding a subdivision to read:
69.34 		Subd. 5i.Payment reduction. In addition to the
69.35 	reduction in subdivisions 5g and 5h and section 256D.03,
69.36 	subdivision 4, paragraph (m), the total payment made to managed
70.1 	care plans is reduced 2.01 percent under the medical assistance
70.2 	program and 2.20 percent under the general assistance medical
70.3 	care program for services provided on or after January 1, 2006.
70.4 	This provision excludes payments for nursing home services, home
70.5 	and community-based waivers, and payments to demonstration
70.6 	projects for persons with disabilities.

70.7 	Sec. 45. Minnesota Statutes 2004, section 256B.75, is
70.8 	amended to read:
70.9 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
70.10 	(a) For outpatient hospital facility fee payments for
70.11 	services rendered on or after October 1, 1992, the commissioner
70.12 	of human services shall pay the lower of (1) submitted charge,
70.13 	or (2) 32 percent above the rate in effect on June 30, 1992,
70.14 	except for those services for which there is a federal maximum
70.15 	allowable payment.  Effective for services rendered on or after
70.16 	January 1, 2000, payment rates for nonsurgical outpatient
70.17 	hospital facility fees and emergency room facility fees shall be
70.18 	increased by eight percent over the rates in effect on December
70.19 	31, 1999, except for those services for which there is a federal
70.20 	maximum allowable payment.  Services for which there is a
70.21 	federal maximum allowable payment shall be paid at the lower of
70.22 	(1) submitted charge, or (2) the federal maximum allowable
70.23 	payment.  Total aggregate payment for outpatient hospital
70.24 	facility fee services shall not exceed the Medicare upper
70.25 	limit.  If it is determined that a provision of this section
70.26 	conflicts with existing or future requirements of the United
70.27 	States government with respect to federal financial
70.28 	participation in medical assistance, the federal requirements
70.29 	prevail.  The commissioner may, in the aggregate, prospectively
70.30 	reduce payment rates to avoid reduced federal financial
70.31 	participation resulting from rates that are in excess of the
70.32 	Medicare upper limitations.
70.33 	(b) Notwithstanding paragraph (a), payment for outpatient,
70.34 	emergency, and ambulatory surgery hospital facility fee services
70.35 	for critical access hospitals designated under section 144.1483,
70.36 	clause (11), shall be paid on a cost-based payment system that
71.1 	is based on the cost-finding methods and allowable costs of the
71.2 	Medicare program.
71.3 	(c) Effective for services provided on or after July 1,
71.4 	2003, rates that are based on the Medicare outpatient
71.5 	prospective payment system shall be replaced by a budget neutral
71.6 	prospective payment system that is derived using medical
71.7 	assistance data.  The commissioner shall provide a proposal to
71.8 	the 2003 legislature to define and implement this provision.
71.9 	(d) For fee-for-service services provided on or after July
71.10 	1, 2002, the total payment, before third-party liability and
71.11 	spenddown, made to hospitals for outpatient hospital facility
71.12 	services is reduced by .5 percent from the current statutory
71.13 	rate.
71.14 	(e) In addition to the reduction in paragraph (d), the
71.15 	total payment for fee-for-service services provided on or after
71.16 	July 1, 2003, made to hospitals for outpatient hospital facility
71.17 	services before third-party liability and spenddown, is reduced
71.18 	five percent from the current statutory rates.  Facilities
71.19 	defined under section 256.969, subdivision 16, are excluded from
71.20 	this paragraph.
71.21 	(f) In addition to the reduction in paragraphs (d) and (e)
71.22 	and section 256D.03, subdivision 4, paragraph (k), the total
71.23 	payment for fee-for-service services provided on or after July
71.24 	1, 2005, made to hospitals for outpatient hospital facility
71.25 	services before third-party liability and spenddown, is reduced
71.26 	five percent from the current statutory rates.  Facilities
71.27 	defined under section 256.969, subdivision 16, are excluded from
71.28 	this paragraph.

71.29 	Sec. 46. Minnesota Statutes 2004, section 256D.03,
71.30 	subdivision 3, is amended to read:
71.31 		Subd. 3.General assistance medical care; eligibility.
 71.32 	(a) General assistance medical care may be paid for any person
71.33 	who is not eligible for medical assistance under chapter 256B,
71.34 	including eligibility for medical assistance based on a
71.35 	spenddown of excess income according to section 256B.056,
71.36 	subdivision 5, or MinnesotaCare as defined in paragraph (b),
72.1 	except as provided in paragraph (c), and:
72.2 	(1) who is receiving assistance under section 256D.05,
72.3 	except for families with children who are eligible under
72.4 	Minnesota family investment program (MFIP), or who is having a
72.5 	payment made on the person's behalf under sections 256I.01 to
72.6 	256I.06, or who resides in group residential housing as defined
72.7 	in chapter 256I and can meet a spenddown using the cost of
72.8 	remedial services received through group residential housing; or
72.9 	(2) (i) who is a resident of Minnesota;and
72.10 	(i) who has gross countable income not in excess of 75
72.11 	percent of the federal poverty guidelines for the family size,
72.12 	using a six-month budget period and whose equity in assets is
72.13 	not in excess of $1,000 per assistance unit.  Exempt assets, the
72.14 	reduction of excess assets, and the waiver of excess assets must
72.15 	conform to the medical assistance program in section 256B.056,
72.16 	subdivision 3, with the following exception:  the maximum amount
72.17 	of undistributed funds in a trust that could be distributed to
72.18 	or on behalf of the beneficiary by the trustee, assuming the
72.19 	full exercise of the trustee's discretion under the terms of the
72.20 	trust, must be applied toward the asset maximum; or and 
72.21 	(ii) who has gross countable income above 75 percent not in
72.22 	excess of 75 percent of the federal poverty guidelines but not
72.23 	in excess of 175 percent of the federal poverty guidelines for
72.24 	the family size, using a six-month budget period, or whose
72.25 	equity in assets is not in excess of the limits in section
72.26 	256B.056, subdivision 3c, and who applies during an inpatient
72.27 	hospitalization excess income is spent down to 50 percent of the
72.28 	federal poverty guidelines using a six-month budget period.
72.29 	(b) General assistance medical care may not be paid for
72.30 	applicants or recipients who meet all eligibility requirements
72.31 	of MinnesotaCare as defined in sections 256L.01 to 256L.16, and
72.32 	are adults with dependent children under 21 whose gross family
72.33 	income is equal to or less than 275 175 percent of the federal
72.34 	poverty guidelines.
72.35 	(c) For applications received on or after October 1, 2003,
72.36 	Eligibility may begin no earlier than the date of application.
73.1 	For individuals eligible under paragraph (a), clause (2), item
73.2 	(i),a redetermination of eligibility must occur every 12
73.3 	months. Individuals are eligible under paragraph (a), clause
73.4 	(2), item (ii), only during inpatient hospitalization but may
73.5 	reapply if there is a subsequent period of inpatient
73.6 	hospitalization.Beginning January 1, 2000, Minnesota health
73.7 	care program applications completed by recipients and applicants
73.8 	who are persons described in paragraph (b), may be returned to
73.9 	the county agency to be forwarded to the Department of Human
73.10 	Services or sent directly to the Department of Human Services
73.11 	for enrollment in MinnesotaCare.  If all other eligibility
73.12 	requirements of this subdivision are met, eligibility for
73.13 	general assistance medical care shall be available in any month
73.14 	during which a MinnesotaCare eligibility determination and
73.15 	enrollment are pending.  Upon notification of eligibility for
73.16 	MinnesotaCare, notice of termination for eligibility for general
73.17 	assistance medical care shall be sent to an applicant or
73.18 	recipient.  If all other eligibility requirements of this
73.19 	subdivision are met, eligibility for general assistance medical
73.20 	care shall be available until enrollment in MinnesotaCare
73.21 	subject to the provisions of paragraph (e).
73.22 	(d) The date of an initial Minnesota health care program
73.23 	application necessary to begin a determination of eligibility
73.24 	shall be the date the applicant has provided a name, address,
73.25 	and Social Security number, signed and dated, to the county
73.26 	agency or the Department of Human Services.  If the applicant is
73.27 	unable to provide a name, address, Social Security number, and
73.28 	signature when health care is delivered due to a medical
73.29 	condition or disability, a health care provider may act on an
73.30 	applicant's behalf to establish the date of an initial Minnesota
73.31 	health care program application by providing the county agency
73.32 	or Department of Human Services with provider identification and
73.33 	a temporary unique identifier for the applicant.  The applicant
73.34 	must complete the remainder of the application and provide
73.35 	necessary verification before eligibility can be determined.
73.36 	The county agency must assist the applicant in obtaining
74.1 	verification if necessary.
74.2 	(e) County agencies are authorized to use all automated
74.3 	databases containing information regarding recipients' or
74.4 	applicants' income in order to determine eligibility for general
74.5 	assistance medical care or MinnesotaCare.  Such use shall be
74.6 	considered sufficient in order to determine eligibility and
74.7 	premium payments by the county agency.
74.8 	(f) General assistance medical care is not available for a
74.9 	person in a correctional facility unless the person is detained
74.10 	by law for less than one year in a county correctional or
74.11 	detention facility as a person accused or convicted of a crime,
74.12 	or admitted as an inpatient to a hospital on a criminal hold
74.13 	order, and the person is a recipient of general assistance
74.14 	medical care at the time the person is detained by law or
74.15 	admitted on a criminal hold order and as long as the person
74.16 	continues to meet other eligibility requirements of this
74.17 	subdivision.
74.18 	(g) General assistance medical care is not available for
74.19 	applicants or recipients who do not cooperate with the county
74.20 	agency to meet the requirements of medical assistance.
74.21 	(h) In determining the amount of assets of an individual
74.22 	eligible under paragraph (a), clause (2), item (i),there shall
74.23 	be included any asset or interest in an asset, including an
74.24 	asset excluded under paragraph (a), that was given away, sold,
74.25 	or disposed of for less than fair market value within the 60
74.26 	months preceding application for general assistance medical care
74.27 	or during the period of eligibility.  Any transfer described in
74.28 	this paragraph shall be presumed to have been for the purpose of
74.29 	establishing eligibility for general assistance medical care,
74.30 	unless the individual furnishes convincing evidence to establish
74.31 	that the transaction was exclusively for another purpose.  For
74.32 	purposes of this paragraph, the value of the asset or interest
74.33 	shall be the fair market value at the time it was given away,
74.34 	sold, or disposed of, less the amount of compensation received.
74.35 	For any uncompensated transfer, the number of months of
74.36 	ineligibility, including partial months, shall be calculated by
75.1 	dividing the uncompensated transfer amount by the average
75.2 	monthly per person payment made by the medical assistance
75.3 	program to skilled nursing facilities for the previous calendar
75.4 	year.  The individual shall remain ineligible until this fixed
75.5 	period has expired.  The period of ineligibility may exceed 30
75.6 	months, and a reapplication for benefits after 30 months from
75.7 	the date of the transfer shall not result in eligibility unless
75.8 	and until the period of ineligibility has expired.  The period
75.9 	of ineligibility begins in the month the transfer was reported
75.10 	to the county agency, or if the transfer was not reported, the
75.11 	month in which the county agency discovered the transfer,
75.12 	whichever comes first.  For applicants, the period of
75.13 	ineligibility begins on the date of the first approved
75.14 	application.
75.15 	(i) When determining eligibility for any state benefits
75.16 	under this subdivision, the income and resources of all
75.17 	noncitizens shall be deemed to include their sponsor's income
75.18 	and resources as defined in the Personal Responsibility and Work
75.19 	Opportunity Reconciliation Act of 1996, title IV, Public Law
75.20 	104-193, sections 421 and 422, and subsequently set out in
75.21 	federal rules.
75.22 	(j) Undocumented noncitizens and nonimmigrants are
75.23 	ineligible for general assistance medical care.  For purposes of
75.24 	this subdivision, a nonimmigrant is an individual in one or more
75.25 	of the classes listed in United States Code, title 8, section
75.26 	1101(a)(15), and an undocumented noncitizen is an individual who
75.27 	resides in the United States without the approval or
75.28 	acquiescence of the Immigration and Naturalization Service.
75.29 	(k) Notwithstanding any other provision of law, a
75.30 	noncitizen who is ineligible for medical assistance due to the
75.31 	deeming of a sponsor's income and resources, is ineligible for
75.32 	general assistance medical care.
75.33 	(l) Effective July 1, 2003, general assistance medical care
75.34 	emergency services end.
75.35 	
EFFECTIVE DATE. This section is effective October 1, 2005.

75.36 	Sec. 47. Minnesota Statutes 2004, section 256D.03,
76.1 	subdivision 4, is amended to read:
76.2 		Subd. 4.General assistance medical care; services.
 76.3 	(a) (i) For a person who is eligible under subdivision 3,
76.4 	paragraph (a), clause (2), item (i),general assistance medical
76.5 	care covers, except as provided in paragraph (c):
76.6 	(1) inpatient hospital services;
76.7 	(2) outpatient hospital services;
76.8 	(3) services provided by Medicare certified rehabilitation
76.9 	agencies;
76.10 	(4) prescription drugs and other products recommended
76.11 	through the process established in section 256B.0625,
76.12 	subdivision 13;
76.13 	(5) equipment necessary to administer insulin and
76.14 	diagnostic supplies and equipment for diabetics to monitor blood
76.15 	sugar level;
76.16 	(6) eyeglasses and eye examinations provided by a physician
76.17 	or optometrist;
76.18 	(7) hearing aids;
76.19 	(8) prosthetic devices;
76.20 	(9) laboratory and X-ray services;
76.21 	(10) physician's services;
76.22 	(11) medical transportation except special transportation;
76.23 	(12) chiropractic services as covered under the medical
76.24 	assistance program;
76.25 	(13) podiatric services;
76.26 	(14) dental services and dentures, subject to the
76.27 	limitations specified in section 256B.0625, subdivision 9;
76.28 	(15) outpatient services provided by a mental health center
76.29 	or clinic that is under contract with the county board and is
76.30 	established under section 245.62;
76.31 	(16) day treatment services for mental illness provided
76.32 	under contract with the county board;
76.33 	(17) prescribed medications for persons who have been
76.34 	diagnosed as mentally ill as necessary to prevent more
76.35 	restrictive institutionalization;
76.36 	(18) psychological services, medical supplies and
77.1 	equipment, and Medicare premiums, coinsurance and deductible
77.2 	payments;
77.3 	(19) medical equipment not specifically listed in this
77.4 	paragraph when the use of the equipment will prevent the need
77.5 	for costlier services that are reimbursable under this
77.6 	subdivision;
77.7 	(20) services performed by a certified pediatric nurse
77.8 	practitioner, a certified family nurse practitioner, a certified
77.9 	adult nurse practitioner, a certified obstetric/gynecological
77.10 	nurse practitioner, a certified neonatal nurse practitioner, or
77.11 	a certified geriatric nurse practitioner in independent
77.12 	practice, if (1) the service is otherwise covered under this
77.13 	chapter as a physician service, (2) the service provided on an
77.14 	inpatient basis is not included as part of the cost for
77.15 	inpatient services included in the operating payment rate, and
77.16 	(3) the service is within the scope of practice of the nurse
77.17 	practitioner's license as a registered nurse, as defined in
77.18 	section 148.171;
77.19 	(21) services of a certified public health nurse or a
77.20 	registered nurse practicing in a public health nursing clinic
77.21 	that is a department of, or that operates under the direct
77.22 	authority of, a unit of government, if the service is within the
77.23 	scope of practice of the public health nurse's license as a
77.24 	registered nurse, as defined in section 148.171; and
77.25 	(22) telemedicine consultations, to the extent they are
77.26 	covered under section 256B.0625, subdivision 3b.
77.27 	(ii) Effective October 1, 2003, for a person who is
77.28 	eligible under subdivision 3, paragraph (a), clause (2), item
77.29 	(ii), general assistance medical care coverage is limited to
77.30 	inpatient hospital services, including physician services
77.31 	provided during the inpatient hospital stay.  A $1,000
77.32 	deductible is required for each inpatient hospitalization.
77.33 	(b) Gender Sex reassignment surgery and related services
77.34 	are is not covered services under this subdivision unless the
77.35 	individual began receiving gender reassignment services prior to
77.36 	July 1, 1995.
78.1 	(c) In order to contain costs, the commissioner of human
78.2 	services shall select vendors of medical care who can provide
78.3 	the most economical care consistent with high medical standards
78.4 	and shall where possible contract with organizations on a
78.5 	prepaid capitation basis to provide these services.  The
78.6 	commissioner shall consider proposals by counties and vendors
78.7 	for prepaid health plans, competitive bidding programs, block
78.8 	grants, or other vendor payment mechanisms designed to provide
78.9 	services in an economical manner or to control utilization, with
78.10 	safeguards to ensure that necessary services are provided.
78.11 	Before implementing prepaid programs in counties with a county
78.12 	operated or affiliated public teaching hospital or a hospital or
78.13 	clinic operated by the University of Minnesota, the commissioner
78.14 	shall consider the risks the prepaid program creates for the
78.15 	hospital and allow the county or hospital the opportunity to
78.16 	participate in the program in a manner that reflects the risk of
78.17 	adverse selection and the nature of the patients served by the
78.18 	hospital, provided the terms of participation in the program are
78.19 	competitive with the terms of other participants considering the
78.20 	nature of the population served.  Payment for services provided
78.21 	pursuant to this subdivision shall be as provided to medical
78.22 	assistance vendors of these services under sections 256B.02,
78.23 	subdivision 8, and 256B.0625.  For payments made during fiscal
78.24 	year 1990 and later years, the commissioner shall consult with
78.25 	an independent actuary in establishing prepayment rates, but
78.26 	shall retain final control over the rate methodology.
78.27 	(d) Recipients eligible under subdivision 3, paragraph (a),
78.28 	clause (2), item (i),shall pay the following co-payments for
78.29 	services provided on or after October 1, 2003:
78.30 	(1) $3 per nonpreventive visit.  For purposes of this
78.31 	subdivision, a visit means an episode of service which is
78.32 	required because of a recipient's symptoms, diagnosis, or
78.33 	established illness, and which is delivered in an ambulatory
78.34 	setting by a physician or physician ancillary, chiropractor,
78.35 	podiatrist, nurse midwife, advanced practice nurse, audiologist,
78.36 	optician, or optometrist;
79.1 	(2) $25 for eyeglasses;
79.2 	(3) $25 for nonemergency visits to a hospital-based
79.3 	emergency room;
79.4 	(4) $3 per brand-name drug prescription and $1 per generic
79.5 	drug prescription, subject to a $20 per month maximum for
79.6 	prescription drug co-payments.  No co-payments shall apply to
79.7 	antipsychotic drugs when used for the treatment of mental
79.8 	illness; and
79.9 	(5) 50 percent coinsurance on restorative dental services.
79.10 	(e) Co-payments shall be limited to one per day per
79.11 	provider for nonpreventive visits, eyeglasses, and nonemergency
79.12 	visits to a hospital-based emergency room.  Recipients of
79.13 	general assistance medical care are responsible for all
79.14 	co-payments in this subdivision.  The general assistance medical
79.15 	care reimbursement to the provider shall be reduced by the
79.16 	amount of the co-payment, except that reimbursement for
79.17 	prescription drugs shall not be reduced once a recipient has
79.18 	reached the $20 per month maximum for prescription drug
79.19 	co-payments.  The provider collects the co-payment from the
79.20 	recipient.  Providers may not deny services to recipients who
79.21 	are unable to pay the co-payment, except as provided in
79.22 	paragraph (f).
79.23 	(f) If it is the routine business practice of a provider to
79.24 	refuse service to an individual with uncollected debt, the
79.25 	provider may include uncollected co-payments under this
79.26 	section.  A provider must give advance notice to a recipient
79.27 	with uncollected debt before services can be denied.
79.28 	(g) Any county may, from its own resources, provide medical
79.29 	payments for which state payments are not made.
79.30 	(h) Chemical dependency services that are reimbursed under
79.31 	chapter 254B must not be reimbursed under general assistance
79.32 	medical care.
79.33 	(i) The maximum payment for new vendors enrolled in the
79.34 	general assistance medical care program after the base year
79.35 	shall be determined from the average usual and customary charge
79.36 	of the same vendor type enrolled in the base year.
80.1 	(j) The conditions of payment for services under this
80.2 	subdivision are the same as the conditions specified in rules
80.3 	adopted under chapter 256B governing the medical assistance
80.4 	program, unless otherwise provided by statute or rule.
80.5 	(k) Inpatient and outpatient payments shall be reduced by
80.6 	five percent, effective July 1, 2003.  This reduction is in
80.7 	addition to the five percent reduction effective July 1, 2003,
80.8 	and incorporated by reference in paragraph (i).
80.9 	(l) Payments for all other health services except
80.10 	inpatient, outpatient, and pharmacy services shall be reduced by
80.11 	five percent, effective July 1, 2003.
80.12 	(m) Payments to managed care plans shall be reduced by five
80.13 	percent for services provided on or after October 1, 2003.
80.14 	(n) A hospital receiving a reduced payment as a result of
80.15 	this section may apply the unpaid balance toward satisfaction of
80.16 	the hospital's bad debts.
80.17 	
EFFECTIVE DATE. This section is effective July 1, 2005,
80.18 	except the amendment to paragraph (a), item (ii), is effective
80.19 	October 1, 2005.

80.20 	Sec. 48. Minnesota Statutes 2004, section 256D.03, is
80.21 	amended by adding a subdivision to read:
80.22 		Subd. 4a.General assistance medical care; medical
80.23 	necessity. In order to be covered under general assistance
80.24 	medical care, a medical item or service must meet the medical
80.25 	necessity standards in section 256B.0632.

80.26 	Sec. 49. Minnesota Statutes 2004, section 256D.03, is
80.27 	amended by adding a subdivision to read:
80.28 		Subd. 10.Payments after october 1, 2005. General
80.29 	assistance medical care payments made on or after October 1,
80.30 	2005, shall be made from the health care access fund.

80.31 	Sec. 50. Minnesota Statutes 2004, section 256D.045, is
80.32 	amended to read:
80.33 	256D.045 SOCIAL SECURITY NUMBER REQUIRED.
80.34 	To be eligible for general assistance under sections
80.35 	256D.01 to 256D.21, an individual must provide the individual's
80.36 	Social Security number to the county agency or submit proof that
81.1 	an application has been made. An individual who refuses to
81.2 	provide a Social Security number because of a well-established
81.3 	religious objection as described in Code of Federal Regulations,
81.4 	title 42, section 435.910, may be eligible for general
81.5 	assistance medical care under section 256D.03.The provisions
81.6 	of this section do not apply to the determination of eligibility
81.7 	for emergency general assistance under section 256D.06,
81.8 	subdivision 2.  This provision applies to eligible children
81.9 	under the age of 18 effective July 1, 1997.

81.10 	EFFECTIVE DATE. This section is effective March 1, 2006,
81.11 	or upon HealthMatch implementation, whichever is later.

81.12 	Sec. 51. Minnesota Statutes 2004, section 256L.01,
81.13 	subdivision 1a, is amended to read:
81.14 		Subd. 1a.Child. (a) "Child" means an individual under
81.15 	21 years of age who is not enrolled in a program of study at a
81.16 	postsecondary education institution, including the unborn child
81.17 	of a pregnant woman, an emancipated minor, and an emancipated
81.18 	minor's spouse.
81.19 	(b) For an individual enrolled in a program of study at a
81.20 	postsecondary education institution, child means an individual
81.21 	under 19 years of age, including an emancipated minor, and an
81.22 	emancipated minor's spouse, except that an individual with
81.23 	access to health coverage through the postsecondary education
81.24 	institution or the individual's parent does not qualify as a
81.25 	child under this paragraph.
81.26 	
EFFECTIVE DATE. This section is effective July 1, 2005,
81.27 	or upon federal approval, whichever is later.  Prior to the
81.28 	implementation of HealthMatch, the commissioner shall implement
81.29 	this section to the fullest extent possible, including the use
81.30 	of manual processing.  Upon implementation of HealthMatch, the
81.31 	commissioner shall implement this section in a manner consistent
81.32 	with the procedures and requirements of HealthMatch.

81.33 	Sec. 52. Minnesota Statutes 2004, section 256L.01,
81.34 	subdivision 4, is amended to read:
81.35 		Subd. 4.Gross individual or gross family income.  (a)
81.36 	"Gross individual or gross family income" for nonfarm
82.1 	self-employed means income calculated for the six-month period
82.2 	of eligibility using as the baseline the adjusted gross income
82.3 	reported on the applicant's federal income tax form for the
82.4 	previous year and adding back in reported depreciation,
82.5 	carryover loss, and net operating loss amounts that apply to the
82.6 	business in which the family is currently engaged using the
82.7 	medical assistance families with children methodology for
82.8 	determining allowable and nonallowable self-employment expenses
82.9 	and countable income.
82.10 	(b) "Gross individual or gross family income" for farm
82.11 	self-employed means income calculated for the six-month period
82.12 	of eligibility using as the baseline the adjusted gross income
82.13 	reported on the applicant's federal income tax form for the
82.14 	previous year and adding back in reported depreciation amounts
82.15 	that apply to the business in which the family is currently
82.16 	engaged.
82.17 	(c) Applicants shall report the most recent financial
82.18 	situation of the family if it has changed from the period of
82.19 	time covered by the federal income tax form.  The report may be
82.20 	in the form of percentage increase or decrease "Gross individual
82.21 	or gross family income" means the total income for all family
82.22 	members, calculated for the six-month period of eligibility.
82.23 	
EFFECTIVE DATE. This section is effective March 1, 2006,
82.24 	or upon HealthMatch implementation, whichever is later.

82.25 	Sec. 53. Minnesota Statutes 2004, section 256L.01,
82.26 	subdivision 5, is amended to read:
82.27 		Subd. 5.Income. (a) "Income" has the meaning given for
82.28 	earned and unearned income for families and children in the
82.29 	medical assistance program, according to the state's aid to
82.30 	families with dependent children plan in effect as of July 16,
82.31 	1996.  The definition does not include medical assistance income
82.32 	methodologies and deeming requirements.  The earned income of
82.33 	full-time and part-time students under age 19 is not counted as
82.34 	income.  Public assistance payments and supplemental security
82.35 	income are not excluded income.
82.36 	(b) For purposes of this subdivision, and unless otherwise
83.1 	specified in this section, the commissioner shall use reasonable
83.2 	methods to calculate gross earned and unearned income including,
83.3 	but not limited to, projecting income based on income received
83.4 	within the past 30 days, the last 90 days, or the last 12 months.
83.5 	
EFFECTIVE DATE. This section is effective July 1, 2005.

83.6 	Sec. 54. Minnesota Statutes 2004, section 256L.03,
83.7 	subdivision 1, is amended to read:
83.8 		Subdivision 1.Covered health services. For individuals
83.9 	under section 256L.04, subdivision 7, with income no greater
83.10 	than 75 percent of the federal poverty guidelines or For
83.11 	families with children under section 256L.04, subdivision 1, all
83.12 	subdivisions of this section apply.  "Covered health services"
83.13 	means the health services reimbursed under chapter 256B, with
83.14 	the exception of inpatient hospital services, special education
83.15 	services, private duty nursing services, adult dental care
83.16 	services other than services covered under section 256B.0625,
83.17 	subdivision 9, paragraph (b), orthodontic services, nonemergency
83.18 	medical transportation services, personal care assistant and
83.19 	case management services, nursing home or intermediate care
83.20 	facilities services, inpatient mental health services, and
83.21 	chemical dependency services.  Outpatient mental health services
83.22 	covered under the MinnesotaCare program are limited to
83.23 	diagnostic assessments, psychological testing, explanation of
83.24 	findings, medication management by a physician, day treatment,
83.25 	partial hospitalization, and individual, family, and group
83.26 	psychotherapy.
83.27 	No public funds shall be used for coverage of abortion
83.28 	under MinnesotaCare except where the life of the female would be
83.29 	endangered or substantial and irreversible impairment of a major
83.30 	bodily function would result if the fetus were carried to term;
83.31 	or where the pregnancy is the result of rape or incest.
83.32 	Covered health services shall be expanded as provided in
83.33 	this section.
83.34 	
EFFECTIVE DATE. This section is effective October 1, 2005.

83.35 	Sec. 55. Minnesota Statutes 2004, section 256L.03,
83.36 	subdivision 3, is amended to read:
84.1 		Subd. 3.Inpatient hospital services.  (a) Covered health
84.2 	services shall include inpatient hospital services, including
84.3 	inpatient hospital mental health services and inpatient hospital
84.4 	and residential chemical dependency treatment, subject to those
84.5 	limitations necessary to coordinate the provision of these
84.6 	services with eligibility under the medical assistance
84.7 	spenddown. Prior to July 1, 1997, the inpatient hospital
84.8 	benefit for adult enrollees is subject to an annual benefit
84.9 	limit of $10,000.  The inpatient hospital benefit for adult
84.10 	enrollees who qualify under section 256L.04, subdivision 7, or
84.11 	who qualify under section 256L.04, subdivisions 1 and 2, with
84.12 	family gross income that exceeds 175 percent of the federal
84.13 	poverty guidelines and who are not pregnant, is subject to an
84.14 	annual limit of $10,000.
84.15 	(b) Admissions for inpatient hospital services paid for
84.16 	under section 256L.11, subdivision 3, must be certified as
84.17 	medically necessary in accordance with Minnesota Rules, parts
84.18 	9505.0500 to 9505.0540, except as provided in clauses (1) and
84.19 	(2):
84.20 	(1) all admissions must be certified, except those
84.21 	authorized under rules established under section 254A.03,
84.22 	subdivision 3, or approved under Medicare; and
84.23 	(2) payment under section 256L.11, subdivision 3, shall be
84.24 	reduced by five percent for admissions for which certification
84.25 	is requested more than 30 days after the day of admission.  The
84.26 	hospital may not seek payment from the enrollee for the amount
84.27 	of the payment reduction under this clause.
84.28 	
EFFECTIVE DATE. This section is effective October 1, 2005.

84.29 	Sec. 56. Minnesota Statutes 2004, section 256L.03,
84.30 	subdivision 5, is amended to read:
84.31 		Subd. 5.Co-payments and coinsurance.  (a) Except as
84.32 	provided in paragraphs (b) and (c), the MinnesotaCare benefit
84.33 	plan shall include the following co-payments and coinsurance
84.34 	requirements for all enrollees:
84.35 	(1) ten percent of the paid charges for inpatient hospital
84.36 	services for adult enrollees, subject to an annual inpatient
85.1 	out-of-pocket maximum of $1,000 per individual and $3,000 per
85.2 	family;
85.3 	(2) $3 per prescription for adult enrollees;
85.4 	(3) $25 for eyeglasses for adult enrollees; and 
85.5 	(4) $3 per nonpreventive visit.  For purposes of this
85.6 	subdivision, a visit means an episode of service which is
85.7 	required because of an enrollee's symptoms, diagnosis, or
85.8 	established illness, and which is delivered in an ambulatory
85.9 	setting by a physician or physician ancillary, chiropractor,
85.10 	podiatrist, advanced practice nurse, audiologist, optician, or
85.11 	optometrist;
85.12 	(5) $6 for nonemergency visits to a hospital-based
85.13 	emergency room; and 
85.14 	(6) 50 percent of the fee-for-service rate for adult dental
85.15 	care services other than preventive care services for persons
85.16 	eligible under section 256L.04, subdivisions 1 to 7, with income
85.17 	equal to or less than 175 percent of the federal poverty
85.18 	guidelines.
85.19 	(b) Paragraph (a), clause (1), does not apply to parents
85.20 	and relative caretakers of children under the age of 21 in
85.21 	households with family income equal to or less than 175 percent
85.22 	of the federal poverty guidelines. Paragraph (a), clause (1),
85.23 	does not apply to parents and relative caretakers of children
85.24 	under the age of 21 in households with family income greater
85.25 	than 175 percent of the federal poverty guidelines for inpatient
85.26 	hospital admissions occurring on or after January 1, 2001.
85.27 	(c) Paragraph (a), clauses (1) to (4) (6), do not apply to
85.28 	pregnant women and children under the age of 21.
85.29 	(d) Adult enrollees with family gross income that exceeds
85.30 	175 percent of the federal poverty guidelines and who are not
85.31 	pregnant shall be financially responsible for the coinsurance
85.32 	amount, if applicable, and amounts which exceed the $10,000
85.33 	inpatient hospital benefit limit.
85.34 	(e) When a MinnesotaCare enrollee becomes a member of a
85.35 	prepaid health plan, or changes from one prepaid health plan to
85.36 	another during a calendar year, any charges submitted towards
86.1 	the $10,000 annual inpatient benefit limit, and any
86.2 	out-of-pocket expenses incurred by the enrollee for inpatient
86.3 	services, that were submitted or incurred prior to enrollment,
86.4 	or prior to the change in health plans, shall be disregarded.
86.5 	(f) Paragraph (a), clauses (4) and (5), are limited to one
86.6 	co-payment per day per provider.
86.7 	
EFFECTIVE DATE. This section is effective January 1,
86.8 	2006, except the amendment to paragraph (b) is effective October
86.9 	1, 2005.

86.10 	Sec. 57. Minnesota Statutes 2004, section 256L.03, is
86.11 	amended by adding a subdivision to read:
86.12 		Subd. 7.Medical necessity. In order to be covered under
86.13 	MinnesotaCare, a medical item or service must meet the medical
86.14 	necessity standards in section 256B.0632.

86.15 	Sec. 58. Minnesota Statutes 2004, section 256L.04,
86.16 	subdivision 1, is amended to read:
86.17 		Subdivision 1.Families with children.  (a) Through
86.18 	September 30, 2005,families with children with family income
86.19 	equal to or less than 275 percent of the federal poverty
86.20 	guidelines for the applicable family size shall be eligible for
86.21 	MinnesotaCare according to this section. Beginning October 1,
86.22 	2005, children and pregnant women with family income equal to or
86.23 	less than 275 percent of the federal poverty guidelines for the
86.24 	applicable family size shall be eligible for MinnesotaCare
86.25 	according to this section.  Beginning October 1, 2005, parents,
86.26 	grandparents, foster parents, relative caretakers, and legal
86.27 	guardians ages 21 and over are not eligible for MinnesotaCare if
86.28 	their gross income exceeds 175 percent of the federal poverty
86.29 	guidelines for the applicable family size.All other provisions
86.30 	of sections 256L.01 to 256L.18, including the insurance-related
86.31 	barriers to enrollment under section 256L.07, shall apply unless
86.32 	otherwise specified.
86.33 	(b) Parents who enroll in the MinnesotaCare program must
86.34 	also enroll their children, if the children are eligible.
86.35 	Children may be enrolled separately without enrollment by
86.36 	parents.  However, if one parent in the household enrolls, both
87.1 	parents must enroll, unless other insurance is available.  If
87.2 	one child from a family is enrolled, all children must be
87.3 	enrolled, unless other insurance is available.  If one spouse in
87.4 	a household enrolls, the other spouse in the household must also
87.5 	enroll, unless other insurance is available.  Families cannot
87.6 	choose to enroll only certain uninsured members.
87.7 	(c) Beginning October 1, 2003, the dependent sibling
87.8 	definition no longer applies to the MinnesotaCare program.
87.9 	These persons are no longer counted in the parental household
87.10 	and may apply as a separate household.
87.11 	(d) Beginning July 1, 2003, or upon federal approval,
87.12 	whichever is later, parents are not eligible for MinnesotaCare
87.13 	if their gross income exceeds $50,000.

87.14 	Sec. 59. Minnesota Statutes 2004, section 256L.04, is
87.15 	amended by adding a subdivision to read:
87.16 		Subd. 1a.Social security number required. (a)
87.17 	Individuals and families applying for MinnesotaCare coverage
87.18 	must provide a Social Security number.
87.19 	(b) The commissioner shall not deny eligibility to an
87.20 	otherwise eligible applicant who has applied for a Social
87.21 	Security number and is awaiting issuance of that Social Security
87.22 	number.
87.23 	(c) Newborns enrolled under section 256L.05, subdivision 3,
87.24 	are exempt from the requirements of this subdivision.
87.25 	(d) Individuals who refuse to provide a Social Security
87.26 	number because of well-established religious objections are
87.27 	exempt from the requirements of this subdivision.  The term
87.28 	"well-established religious objections" has the meaning given in
87.29 	Code of Federal Regulations, title 42, section 435.910.
87.30 	
EFFECTIVE DATE. This section is effective March 1, 2006,
87.31 	or upon HealthMatch implementation, whichever is later.

87.32 	Sec. 60. Minnesota Statutes 2004, section 256L.04,
87.33 	subdivision 2, is amended to read:
87.34 		Subd. 2.Cooperation in establishing third-party
87.35 	liability, paternity, and other medical support.  (a) To be
87.36 	eligible for MinnesotaCare, individuals and families must
88.1 	cooperate with the state agency to identify potentially liable
88.2 	third-party payers and assist the state in obtaining third-party
88.3 	payments.  "Cooperation" includes, but is not limited
88.4 	to, complying with the notice requirements in section 256B.056,
88.5 	subdivision 9,identifying any third party who may be liable for
88.6 	care and services provided under MinnesotaCare to the enrollee,
88.7 	providing relevant information to assist the state in pursuing a
88.8 	potentially liable third party, and completing forms necessary
88.9 	to recover third-party payments.
88.10 	(b) A parent, guardian, relative caretaker, or child
88.11 	enrolled in the MinnesotaCare program must cooperate with the
88.12 	Department of Human Services and the local agency in
88.13 	establishing the paternity of an enrolled child and in obtaining
88.14 	medical care support and payments for the child and any other
88.15 	person for whom the person can legally assign rights, in
88.16 	accordance with applicable laws and rules governing the medical
88.17 	assistance program.  A child shall not be ineligible for or
88.18 	disenrolled from the MinnesotaCare program solely because the
88.19 	child's parent, relative caretaker, or guardian fails to
88.20 	cooperate in establishing paternity or obtaining medical support.

88.21 	Sec. 61. Minnesota Statutes 2004, section 256L.04, is
88.22 	amended by adding a subdivision to read:
88.23 		Subd. 2a.Applications for other benefits. To be
88.24 	eligible for MinnesotaCare, individuals and families must take
88.25 	all necessary steps to obtain other benefits as described in
88.26 	Code of Federal Regulations, title 42, section 435.608.
88.27 	Applicants and enrollees must apply for other benefits within 30
88.28 	days of notification.
88.29 	
EFFECTIVE DATE. This section is effective March 1, 2006,
88.30 	or upon HealthMatch implementation, whichever is later.

88.31 	Sec. 62. Minnesota Statutes 2004, section 256L.04,
88.32 	subdivision 8, is amended to read:
88.33 		Subd. 8.Applicants potentially eligible for medical
88.34 	assistance. (a) Individuals who receive supplemental security
88.35 	income or retirement, survivors, or disability benefits due to a
88.36 	disability, or other disability-based pension, who qualify under
89.1 	subdivision 7, but who are potentially eligible for medical
89.2 	assistance without a spenddown shall be allowed to enroll in
89.3 	MinnesotaCare for a period of 60 days, so long as the applicant
89.4 	meets all other conditions of eligibility.  The commissioner
89.5 	shall identify and refer the applications of such individuals to
89.6 	their county social service agency.  The county and the
89.7 	commissioner shall cooperate to ensure that the individuals
89.8 	obtain medical assistance coverage for any months for which they
89.9 	are eligible.
89.10 	(b) The enrollee must cooperate with the county social
89.11 	service agency in determining medical assistance eligibility
89.12 	within the 60-day enrollment period.  Enrollees who do not
89.13 	cooperate with medical assistance within the 60-day enrollment
89.14 	period shall be disenrolled from the plan within one calendar
89.15 	month.  Persons disenrolled for nonapplication for medical
89.16 	assistance may not reenroll until they have obtained a medical
89.17 	assistance eligibility determination.  Persons disenrolled for
89.18 	noncooperation with medical assistance may not reenroll until
89.19 	they have cooperated with the county agency and have obtained a
89.20 	medical assistance eligibility determination.
89.21 	(c) Beginning January 1, 2000, counties that choose to
89.22 	become MinnesotaCare enrollment sites shall consider
89.23 	MinnesotaCare applications to also be applications for medical
89.24 	assistance.  Applicants who are potentially eligible for medical
89.25 	assistance, except for those described in paragraph (a),may
89.26 	choose to enroll in either MinnesotaCare or medical assistance.
89.27 	(d) The commissioner shall redetermine provider payments
89.28 	made under MinnesotaCare to the appropriate medical assistance
89.29 	payments for those enrollees who subsequently become eligible
89.30 	for medical assistance.
89.31 	
EFFECTIVE DATE. This section is effective October 1, 2005.

89.32 	Sec. 63. Minnesota Statutes 2004, section 256L.05,
89.33 	subdivision 2, is amended to read:
89.34 		Subd. 2.Commissioner's duties. (a) The commissioner or
89.35 	county agency shall use electronic verification as the primary
89.36 	method of income verification.  If there is a discrepancy
90.1 	between reported income and electronically verified income, an
90.2 	individual may be required to submit additional verification.
90.3 	In addition, the commissioner shall perform random audits to
90.4 	verify reported income and eligibility.  The commissioner may
90.5 	execute data sharing arrangements with the Department of Revenue
90.6 	and any other governmental agency in order to perform income
90.7 	verification related to eligibility and premium payment under
90.8 	the MinnesotaCare program.
90.9 	(b) In determining eligibility for MinnesotaCare, the
90.10 	commissioner shall require applicants and enrollees seeking
90.11 	renewal of eligibility to verify both earned and unearned
90.12 	income.  The commissioner shall also require applicants and
90.13 	enrollees to submit to their employers, if employed, a form to
90.14 	verify whether the applicant or enrollee, and any dependents,
90.15 	are eligible for employer subsidized coverage.
90.16 	
EFFECTIVE DATE. This section is effective July 1, 2005.
90.17 	Prior to the implementation of HealthMatch, the commissioner
90.18 	shall implement this section to the fullest extent possible,
90.19 	including the use of manual processing.  Upon implementation of
90.20 	HealthMatch, the commissioner shall implement this section in a
90.21 	manner consistent with the procedures and requirements of
90.22 	HealthMatch.

90.23 	Sec. 64. Minnesota Statutes 2004, section 256L.05,
90.24 	subdivision 3, is amended to read:
90.25 		Subd. 3.Effective date of coverage.  (a) The effective
90.26 	date of coverage is the first day of the month following the
90.27 	month in which eligibility is approved and the first premium
90.28 	payment has been received.  As provided in section 256B.057,
90.29 	coverage for newborns is automatic from the date of birth and
90.30 	must be coordinated with other health coverage.  The effective
90.31 	date of coverage for eligible newly adoptive children added to a
90.32 	family receiving covered health services is the date of entry
90.33 	into the family month of placement or the month placement is
90.34 	reported, whichever is later.  The effective date of coverage
90.35 	for other new recipients members added to the family receiving
90.36 	covered health services is the first day of the month following
91.1 	the month in which eligibility is approved or at renewal,
91.2 	whichever the family receiving covered health services
91.3 	prefers the change is reported.  All eligibility criteria must
91.4 	be met by the family at the time the new family member is
91.5 	added.  The income of the new family member is included with the
91.6 	family's gross income and the adjusted premium begins in the
91.7 	month the new family member is added.
91.8 	(b) The initial premium must be received by the last
91.9 	working day of the month for coverage to begin the first day of
91.10 	the following month.
91.11 	(c) Benefits are not available until the day following
91.12 	discharge if an enrollee is hospitalized on the first day of
91.13 	coverage.
91.14 	(d) Notwithstanding any other law to the contrary, benefits
91.15 	under sections 256L.01 to 256L.18 are secondary to a plan of
91.16 	insurance or benefit program under which an eligible person may
91.17 	have coverage and the commissioner shall use cost avoidance
91.18 	techniques to ensure coordination of any other health coverage
91.19 	for eligible persons.  The commissioner shall identify eligible
91.20 	persons who may have coverage or benefits under other plans of
91.21 	insurance or who become eligible for medical assistance.
91.22 	
EFFECTIVE DATE. This section is effective March 1, 2006,
91.23 	or upon HealthMatch implementation, whichever is later.

91.24 	Sec. 65. Minnesota Statutes 2004, section 256L.05,
91.25 	subdivision 3a, is amended to read:
91.26 		Subd. 3a.Renewal of eligibility.  (a) Beginning January
91.27 	1, 1999, an enrollee's eligibility must be renewed every 12
91.28 	months.  The 12-month period begins in the month after the month
91.29 	the application is approved.
91.30 	(b) Beginning October 1, 2004, an enrollee's eligibility
91.31 	must be renewed every six months.  The first six-month period of
91.32 	eligibility begins in the month after the month the application
91.33 	is approved received by the commissioner. The effective date of
91.34 	coverage within the first six-month period of eligibility is as
91.35 	provided in section 256L.05, subdivision 3.Each new period of
91.36 	eligibility must take into account any changes in circumstances
92.1 	that impact eligibility and premium amount.  An enrollee must
92.2 	provide all the information needed to redetermine eligibility by
92.3 	the first day of the month that ends the eligibility period.
92.4 	The premium for the new period of eligibility must be received
92.5 	as provided in section 256L.06 in order for eligibility to
92.6 	continue.
92.7 	
EFFECTIVE DATE. This section is effective March 1, 2006,
92.8 	or upon HealthMatch implementation, whichever is later.

92.9 	Sec. 66. Minnesota Statutes 2004, section 256L.05,
92.10 	subdivision 5, is amended to read:
92.11 		Subd. 5.Availability of private insurance.  The
92.12 	commissioner, in consultation with the commissioners of health
92.13 	and commerce, shall provide information regarding the
92.14 	availability of private health insurance coverage and the
92.15 	possibility of disenrollment under section 256L.07, subdivision
92.16 	1, paragraphs (b) and (c), to all:  (1) to families enrolled in
92.17 	the MinnesotaCare program whose gross family income is equal to
92.18 	or more than 225 percent of the federal poverty guidelines; and
92.19 	(2) single adults and households without children enrolled in
92.20 	the MinnesotaCare program whose gross family income is equal to
92.21 	or more than 165 percent of the federal poverty guidelines.
92.22 	This information must be provided upon initial enrollment and
92.23 	annually thereafter.  The commissioner shall also include
92.24 	information regarding the availability of private health
92.25 	insurance coverage in the notice of ineligibility provided to
92.26 	persons subject to disenrollment under section 256L.07,
92.27 	subdivision 1, paragraphs (b) and (c).
92.28 	
EFFECTIVE DATE. This section is effective October 1, 2005.

92.29 	Sec. 67. Minnesota Statutes 2004, section 256L.06,
92.30 	subdivision 3, is amended to read:
92.31 		Subd. 3.Commissioner's duties and payment.  (a) Premiums
92.32 	are dedicated to the commissioner for MinnesotaCare.
92.33 	(b) The commissioner shall develop and implement procedures
92.34 	to:  (1) require enrollees to report changes in income; (2)
92.35 	adjust sliding scale premium payments, based upon changes both
92.36 	increases and decreases in enrollee income, at the time the
93.1 	change in income is reported; and (3) disenroll enrollees from
93.2 	MinnesotaCare for failure to pay required premiums.  Failure to
93.3 	pay includes payment with a dishonored check, a returned
93.4 	automatic bank withdrawal, or a refused credit card or debit
93.5 	card payment.  The commissioner may demand a guaranteed form of
93.6 	payment, including a cashier's check or a money order, as the
93.7 	only means to replace a dishonored, returned, or refused payment.
93.8 	(c) Premiums are calculated on a calendar month basis and
93.9 	may be paid on a monthly, quarterly, or semiannual basis, with
93.10 	the first payment due upon notice from the commissioner of the
93.11 	premium amount required.  The commissioner shall inform
93.12 	applicants and enrollees of these premium payment options.
93.13 	Premium payment is required before enrollment is complete and to
93.14 	maintain eligibility in MinnesotaCare.  Premium payments
93.15 	received before noon are credited the same day.  Premium
93.16 	payments received after noon are credited on the next working
93.17 	day.
93.18 	(d) Nonpayment of the premium will result in disenrollment
93.19 	from the plan effective for the calendar month for which the
93.20 	premium was due.  Persons disenrolled for nonpayment or who
93.21 	voluntarily terminate coverage from the program may not reenroll
93.22 	until four calendar months have elapsed.  Persons disenrolled
93.23 	for nonpayment who pay all past due premiums as well as current
93.24 	premiums due, including premiums due for the period of
93.25 	disenrollment, within 20 days of disenrollment, shall be
93.26 	reenrolled retroactively to the first day of disenrollment.
93.27 	Persons disenrolled for nonpayment or who voluntarily terminate
93.28 	coverage from the program may not reenroll for four calendar
93.29 	months unless the person demonstrates good cause for
93.30 	nonpayment.  Good cause does not exist if a person chooses to
93.31 	pay other family expenses instead of the premium.  The
93.32 	commissioner shall define good cause in rule.
93.33 	
EFFECTIVE DATE. This section is effective July 1, 2005.
93.34 	Prior to the implementation of HealthMatch, the commissioner
93.35 	shall implement this section to the fullest extent possible,
93.36 	including the use of manual processing.  Upon implementation of
94.1 	HealthMatch, the commissioner shall implement this section in a
94.2 	manner consistent with the procedures and requirements of
94.3 	HealthMatch.

94.4 	Sec. 68. Minnesota Statutes 2004, section 256L.07,
94.5 	subdivision 1, is amended to read:
94.6 		Subdivision 1.General requirements.  (a) Children
94.7 	enrolled in the original children's health plan as of September
94.8 	30, 1992, children who enrolled in the MinnesotaCare program
94.9 	after September 30, 1992, pursuant to Laws 1992, chapter 549,
94.10 	article 4, section 17, and children who have family gross
94.11 	incomes that are equal to or less than 150 percent of the
94.12 	federal poverty guidelines are eligible without meeting the
94.13 	requirements of subdivision 2 and the four-month requirement in
94.14 	subdivision 3, as long as they maintain continuous coverage in
94.15 	the MinnesotaCare program or medical assistance.  Children who
94.16 	apply for MinnesotaCare on or after the implementation date of
94.17 	the employer-subsidized health coverage program as described in
94.18 	Laws 1998, chapter 407, article 5, section 45, who have family
94.19 	gross incomes that are equal to or less than 150 percent of the
94.20 	federal poverty guidelines, must meet the requirements of
94.21 	subdivision 2 to be eligible for MinnesotaCare.
94.22 	(b) Through September 30, 2005,families enrolled in
94.23 	MinnesotaCare under section 256L.04, subdivision 1, whose income
94.24 	increases above 275 percent of the federal poverty guidelines,
94.25 	are no longer eligible for the program and shall be disenrolled
94.26 	by the commissioner. Individuals Beginning October 1, 2005,
94.27 	children enrolled in MinnesotaCare under section 256L.04,
94.28 	subdivision 7 1, whose income increases above 175 275 percent of
94.29 	the federal poverty guidelines,are no longer eligible for the
94.30 	program and shall be disenrolled by the commissioner. Pregnant
94.31 	women enrolled in MinnesotaCare whose income increases above 275
94.32 	percent of the federal poverty guidelines remain eligible
94.33 	through the end of the 60-day postpartum period.  Beginning
94.34 	October 1, 2005, parents, grandparents, foster parents, relative
94.35 	caretakers, and legal guardians ages 21 and over are no longer
94.36 	eligible for MinnesotaCare if their gross income exceeds 175
95.1 	percent of the federal poverty guidelines for the applicable
95.2 	family size.For persons disenrolled under this subdivision,
95.3 	MinnesotaCare coverage terminates the last day of the calendar
95.4 	month following the month in which the commissioner determines
95.5 	that the income of a family or individual exceeds program income
95.6 	limits.
95.7 	(c) (1) Notwithstanding paragraph (b), families enrolled in
95.8 	MinnesotaCare under section 256L.04, subdivision 1, may remain
95.9 	enrolled in MinnesotaCare if ten percent of their annual income
95.10 	is less than the annual premium for a policy with a $500
95.11 	deductible available through the Minnesota Comprehensive Health
95.12 	Association.  Families who are no longer eligible for
95.13 	MinnesotaCare under this subdivision shall be given an 18-month
95.14 	notice period from the date that ineligibility is determined
95.15 	before disenrollment.  This clause expires February 1, 2004.
95.16 	(2) Effective February 1, 2004, notwithstanding paragraph
95.17 	(b), children may remain enrolled in MinnesotaCare if ten
95.18 	percent of their annual gross individual or gross family income
95.19 	as defined in section 256L.01, subdivision 4,is less than the
95.20 	annual premium for a six-month policy with a $500 deductible
95.21 	available through the Minnesota Comprehensive Health
95.22 	Association.  Children who are no longer eligible for
95.23 	MinnesotaCare under this clause shall be given a 12-month 
95.24 	six-month notice period from the date that ineligibility is
95.25 	determined before disenrollment.  The premium for children
95.26 	remaining eligible under this clause shall be the maximum
95.27 	premium determined under section 256L.15, subdivision 2,
95.28 	paragraph (b).
95.29 	(d) Effective July 1, 2003, notwithstanding paragraphs (b)
95.30 	and (c), parents are no longer eligible for MinnesotaCare if
95.31 	gross household income exceeds $50,000 $25,000 for the six-month
95.32 	period of eligibility.
95.33 	
EFFECTIVE DATE. This section is effective March 1, 2006,
95.34 	or upon HealthMatch implementation, whichever is later.

95.35 	Sec. 69. Minnesota Statutes 2004, section 256L.07,
95.36 	subdivision 3, is amended to read:
96.1 		Subd. 3.Other health coverage.  (a) Families and
96.2 	individuals enrolled in the MinnesotaCare program must have no
96.3 	health coverage while enrolled or for at least four months prior
96.4 	to application and renewal.  Children enrolled in the original
96.5 	children's health plan and children in families with income
96.6 	equal to or less than 150 percent of the federal poverty
96.7 	guidelines, who have other health insurance, are eligible if the
96.8 	coverage:
96.9 	(1) lacks two or more of the following:
96.10 	(i) basic hospital insurance;
96.11 	(ii) medical-surgical insurance;
96.12 	(iii) prescription drug coverage;
96.13 	(iv) dental coverage; or
96.14 	(v) vision coverage;
96.15 	(2) requires a deductible of $100 or more per person per
96.16 	year; or
96.17 	(3) lacks coverage because the child has exceeded the
96.18 	maximum coverage for a particular diagnosis or the policy
96.19 	excludes a particular diagnosis.
96.20 	The commissioner may change this eligibility criterion for
96.21 	sliding scale premiums in order to remain within the limits of
96.22 	available appropriations.  The requirement of no health coverage
96.23 	does not apply to newborns.
96.24 	(b) Medical assistance, general assistance medical care,
96.25 	and the Civilian Health and Medical Program of the Uniformed
96.26 	Service, CHAMPUS, or other coverage provided under United States
96.27 	Code, title 10, subtitle A, part II, chapter 55, are not
96.28 	considered insurance or health coverage for purposes of the
96.29 	four-month requirement described in this subdivision.
96.30 	(c) For purposes of this subdivision, an applicant or
96.31 	enrollee who is entitled to Medicare Part A or enrolled in
96.32 	Medicare Part B coverage under title XVIII of the Social
96.33 	Security Act, United States Code, title 42, sections 1395c
96.34 	to 1395w-4 1395w-152, is considered to have health coverage.  An
96.35 	applicant or enrollee who is entitled to premium free Medicare
96.36 	Part A may not refuse to apply for or enroll in Medicare
97.1 	coverage to establish eligibility for MinnesotaCare.
97.2 	(d) Applicants who were recipients of medical assistance or
97.3 	general assistance medical care within one month of application
97.4 	must meet the provisions of this subdivision and subdivision 2.
97.5 	(e) Effective October 1, 2003, applicants who were
97.6 	recipients of medical assistance and had Cost-effective health
97.7 	insurance which that was paid for by medical assistance are
97.8 	exempt from is not considered health coverage for purposes of 
97.9 	the four-month requirement under this section, except if the
97.10 	insurance continued after medical assistance no longer
97.11 	considered it cost-effective or after medical assistance closed.

97.12 	Sec. 70. Minnesota Statutes 2004, section 256L.07, is
97.13 	amended by adding a subdivision to read:
97.14 		Subd. 5.Voluntary disenrollment for members of
97.15 	military. Notwithstanding section 256L.05, subdivision 3b,
97.16 	MinnesotaCare enrollees who are members of the military and
97.17 	their families, who choose to voluntarily disenroll from the
97.18 	program when one or more family members are called to active
97.19 	duty, may reenroll during or following that member's tour of
97.20 	active duty.  Those individuals and families shall be considered
97.21 	to have good cause for voluntary termination under section
97.22 	256L.06, subdivision 3, paragraph (d).  Income and asset
97.23 	increases reported at the time of reenrollment shall be
97.24 	disregarded.  All provisions of sections 256L.01 to 256L.18,
97.25 	shall apply to individuals and families enrolled under this
97.26 	subdivision upon six-month renewal.
97.27 	
EFFECTIVE DATE. This section is effective July 1, 2005.

97.28 	Sec. 71. Minnesota Statutes 2004, section 256L.09,
97.29 	subdivision 2, is amended to read:
97.30 		Subd. 2.Residency requirement. (a) To be eligible for
97.31 	health coverage under the MinnesotaCare program, adults without
97.32 	children must be permanent residents of Minnesota.
97.33 	(b) To be eligible for health coverage under the
97.34 	MinnesotaCare program, pregnant women, families, and children
97.35 	must meet the residency requirements as provided by Code of
97.36 	Federal Regulations, title 42, section 435.403, except that the
98.1 	provisions of section 256B.056, subdivision 1, shall apply upon
98.2 	receipt of federal approval.
98.3 	
EFFECTIVE DATE. This section is effective October 1, 2005.

98.4 	Sec. 72. Minnesota Statutes 2004, section 256L.11,
98.5 	subdivision 6, is amended to read:
98.6 		Subd. 6.Enrollees 18 or older. Payment by the
98.7 	MinnesotaCare program for inpatient hospital services provided
98.8 	to MinnesotaCare enrollees eligible under section 256L.04,
98.9 	subdivision 7, or who qualify under section 256L.04,
98.10 	subdivisions 1 and 2, with family gross income that exceeds 175
98.11 	percent of the federal poverty guidelines and who are not
98.12 	pregnant, who are 18 years old or older on the date of admission
98.13 	to the inpatient hospital must be in accordance with paragraphs
98.14 	(a) and (b).Payment for adults who are not pregnant and are
98.15 	eligible under section 256L.04, subdivisions 1 and 2, and whose
98.16 	incomes are equal to or less than 175 percent of the federal
98.17 	poverty guidelines, shall be as provided for under paragraph (c) 
98.18 	this subdivision.
98.19 	(a) If the medical assistance rate minus any co-payment
98.20 	required under section 256L.03, subdivision 4, is less than or
98.21 	equal to the amount remaining in the enrollee's benefit limit
98.22 	under section 256L.03, subdivision 3, payment must be the
98.23 	medical assistance rate minus any co-payment required under
98.24 	section 256L.03, subdivision 4.  The hospital must not seek
98.25 	payment from the enrollee in addition to the co-payment.  The
98.26 	MinnesotaCare payment plus the co-payment must be treated as
98.27 	payment in full.
98.28 	(b) If the medical assistance rate minus any co-payment
98.29 	required under section 256L.03, subdivision 4, is greater than
98.30 	the amount remaining in the enrollee's benefit limit under
98.31 	section 256L.03, subdivision 3, payment must be the lesser of:
98.32 	(1) the amount remaining in the enrollee's benefit limit;
98.33 	or 
98.34 	(2) charges submitted for the inpatient hospital services
98.35 	less any co-payment established under section 256L.03,
98.36 	subdivision 4.
99.1 	The hospital may seek payment from the enrollee for the
99.2 	amount by which usual and customary charges exceed the payment
99.3 	under this paragraph.  If payment is reduced under section
99.4 	256L.03, subdivision 3, paragraph (b), the hospital may not seek
99.5 	payment from the enrollee for the amount of the reduction.
99.6 	(c) For admissions occurring during the period of July 1,
99.7 	1997, through June 30, 1998, for adults who are not pregnant and
99.8 	are eligible under section 256L.04, subdivisions 1 and 2, and
99.9 	whose incomes are equal to or less than 175 percent of the
99.10 	federal poverty guidelines, the commissioner shall pay hospitals
99.11 	directly, up to the medical assistance payment rate, for
99.12 	inpatient hospital benefits in excess of the $10,000 annual
99.13 	inpatient benefit limit.
99.14 	
EFFECTIVE DATE. This section is effective October 1, 2005.

99.15 	Sec. 73. Minnesota Statutes 2004, section 256L.12,
99.16 	subdivision 6, is amended to read:
99.17 		Subd. 6.Co-payments and benefit limits.  Enrollees are
99.18 	responsible for all co-payments in sections section 256L.03,
99.19 	subdivision 5, and 256L.035,and shall pay co-payments to the
99.20 	managed care plan or to its participating providers.  The
99.21 	enrollee is also responsible for payment of inpatient hospital
99.22 	charges which exceed the MinnesotaCare benefit limit.
99.23 	
EFFECTIVE DATE. This section is effective October 1, 2005.

99.24 	Sec. 74. Minnesota Statutes 2004, section 256L.12, is
99.25 	amended by adding a subdivision to read:
99.26 		Subd. 9b.Rate setting; ratable reduction. In addition
99.27 	to the reduction in subdivision 9a, the total payment made to
99.28 	managed care plans under the MinnesotaCare program is reduced
99.29 	1.83 percent for services provided on or after January 1, 2006.

99.30 	Sec. 75. Minnesota Statutes 2004, section 256L.15,
99.31 	subdivision 2, is amended to read:
99.32 		Subd. 2.Sliding fee scale to determine percentage of
99.33 	monthly gross individual or family income.  (a) The commissioner
99.34 	shall establish a sliding fee scale to determine the percentage
99.35 	of monthly gross individual or family income that households at
99.36 	different income levels must pay to obtain coverage through the
100.1 	MinnesotaCare program.  The sliding fee scale must be based on
100.2 	the enrollee's monthly gross individual or family income.  The
100.3 	sliding fee scale must contain separate tables based on
100.4 	enrollment of one, two, or three or more persons.  The sliding
100.5 	fee scale begins with a premium of 1.5 percent of monthly gross
100.6 	individual or family income for individuals or families with
100.7 	incomes below the limits for the medical assistance program for
100.8 	families and children in effect on January 1, 1999, and proceeds
100.9 	through the following evenly spaced steps:  1.8, 2.3, 3.1, 3.8,
100.10 	4.8, 5.9, 7.4, and 8.8 percent.  These percentages are matched
100.11 	to evenly spaced income steps ranging from the medical
100.12 	assistance income limit for families and children in effect on
100.13 	January 1, 1999, to 275 percent of the federal poverty
100.14 	guidelines for the applicable family size, up to a family size
100.15 	of five.  The sliding fee scale for a family of five must be
100.16 	used for families of more than five.  Effective October 1, 2003,
100.17 	the commissioner shall increase each percentage by 0.5
100.18 	percentage points for enrollees with income greater than 100
100.19 	percent but not exceeding 200 percent of the federal poverty
100.20 	guidelines and shall increase each percentage by 1.0 percentage
100.21 	points for families and children with incomes greater than 200
100.22 	percent of the federal poverty guidelines.  The sliding fee
100.23 	scale and percentages are not subject to the provisions of
100.24 	chapter 14.  If a family or individual reports increased income
100.25 	after enrollment, premiums shall not be adjusted until
100.26 	eligibility renewal at the time the change in income is reported.
100.27 	(b)(1) Enrolled families whose gross annual income
100.28 	increases above 275 percent of the federal poverty guideline
100.29 	shall pay the maximum premium.  This clause expires effective
100.30 	February 1, 2004.
100.31 	(2) Effective February 1, 2004, children in families whose
100.32 	gross income is above 275 percent of the federal poverty
100.33 	guidelines shall pay the maximum premium.
100.34 	(3) The maximum premium is defined as a base charge for
100.35 	one, two, or three or more enrollees so that if all
100.36 	MinnesotaCare cases paid the maximum premium, the total revenue
101.1 	would equal the total cost of MinnesotaCare medical coverage and
101.2 	administration.  In this calculation, administrative costs shall
101.3 	be assumed to equal ten percent of the total.  The costs of
101.4 	medical coverage for pregnant women and children under age two
101.5 	and the enrollees in these groups shall be excluded from the
101.6 	total.  The maximum premium for two enrollees shall be twice the
101.7 	maximum premium for one, and the maximum premium for three or
101.8 	more enrollees shall be three times the maximum premium for one.
101.9 	(c) After calculating the percentage of premium each
101.10 	enrollee shall pay under paragraph (a), ten percent shall be
101.11 	added to the premium effective July 1, 2005.
101.12 	
EFFECTIVE DATE. The amendment to paragraph (a) changing
101.13 	gross family or individual income to monthly gross family or
101.14 	individual income is effective March 1, 2006, or upon
101.15 	implementation of HealthMatch, whichever is later.  The
101.16 	amendment to paragraph (a) related to premium adjustments and
101.17 	changes of income is effective July 1, 2005.  Prior to the
101.18 	implementation of HealthMatch, the commissioner shall implement
101.19 	this section to the fullest extent possible, including the use
101.20 	of manual processing.  Upon implementation of HealthMatch, the
101.21 	commissioner shall implement this section in a manner consistent
101.22 	with the procedures and requirements of HealthMatch.

101.23 	Sec. 76. Minnesota Statutes 2004, section 256L.15,
101.24 	subdivision 3, is amended to read:
101.25 		Subd. 3.Exceptions to sliding scale. An annual premium
101.26 	of $48 is required for all Children in families with income at
101.27 	or less than below 150 percent of the federal poverty guidelines
101.28 	pay a monthly premium of $5.
101.29 	
EFFECTIVE DATE. This section is effective March 1, 2006,
101.30 	or upon implementation of HealthMatch, whichever is later,
101.31 	except that the increase in the monthly premium shall be
101.32 	effective July 1, 2005.

101.33 	Sec. 77. [501B.895] PUBLIC HEALTH CARE PROGRAMS AND
101.34 	CERTAIN TRUSTS.
101.35 	(a) It is the public policy of this state that individuals
101.36 	use all available resources to pay for the cost of long-term
102.1 	care services, as defined in section 256B.0595, before turning
102.2 	to Minnesota health care program funds, and that trust
102.3 	instruments should not be permitted to shield available
102.4 	resources of an individual or an individual's spouse from such
102.5 	use.  Any irrevocable inter-vivos trust or any legal instrument,
102.6 	device, or arrangement similar to an irrevocable inter-vivos
102.7 	trust created on or after July 1, 2005, containing assets or
102.8 	income of an individual or an individual's spouse, including
102.9 	those created by a person, court, or administrative body with
102.10 	legal authority to act in place of, at the direction of, upon
102.11 	the request of, or on behalf of the individual or individual's
102.12 	spouse, becomes revocable by operation of law for the sole
102.13 	purpose of a state or local human services agency determination
102.14 	on an application by the individual or the individual's spouse
102.15 	for payment of long-term care services through a Minnesota
102.16 	public health care program pursuant to chapter 256B.  For
102.17 	purposes of this section, any inter-vivos trust and any legal
102.18 	instrument, device, or arrangement similar to an inter-vivos
102.19 	trust:
102.20 	(1) shall be deemed to be located in and subject to the
102.21 	laws of this state; and 
102.22 	(2) is created as of the date it is fully executed by or on
102.23 	behalf of all of the settlors or others.
102.24 	(b) For purposes of this section, a legal instrument,
102.25 	device, or arrangement similar to an irrevocable inter-vivos
102.26 	trust means any instrument, device, or arrangement which
102.27 	involves a grantor who transfers or whose property is
102.28 	transferred by another including, but not limited to, any court,
102.29 	administrative body, or anyone else with authority to act on
102.30 	their behalf or at their direction, to an individual or entity
102.31 	with fiduciary, contractual, or legal obligations to the grantor
102.32 	or others to be held, managed, or administered by the individual
102.33 	or entity for the benefit of the grantor or others.  These legal
102.34 	instruments, devices, or other arrangements are irrevocable
102.35 	inter-vivos trusts for purposes of this section.
102.36 	(c) In the event of a conflict between this section and the
103.1 	provisions of an irrevocable trust created on or after July 1,
103.2 	2005, this section shall control.
103.3 	(d) This section does not apply to trusts that qualify as
103.4 	supplemental needs trusts under section 501B.89 or to trusts
103.5 	meeting the criteria of United States Code, title 42, section
103.6 	1396p (d)(4)(a) and (c) for purposes of eligibility for medical
103.7 	assistance.
103.8 	(e) This section applies to all trusts first created on or
103.9 	after July 1, 2005, and to all interests in real or personal
103.10 	property regardless of the date on which the interest was
103.11 	created, reserved, or acquired.

103.12 	Sec. 78. Minnesota Statutes 2004, section 514.981,
103.13 	subdivision 6, is amended to read:
103.14 		Subd. 6.Time limits; claim limits; liens on life estates
103.15 	and joint tenancies.  (a) A medical assistance lien is a lien on
103.16 	the real property it describes for a period of ten years from
103.17 	the date it attaches according to section 514.981, subdivision
103.18 	2, paragraph (a), except as otherwise provided for in sections
103.19 	514.980 to 514.985.  The agency may renew a medical assistance
103.20 	lien for an additional ten years from the date it would
103.21 	otherwise expire by recording or filing a certificate of renewal
103.22 	before the lien expires.  The certificate shall be recorded or
103.23 	filed in the office of the county recorder or registrar of
103.24 	titles for the county in which the lien is recorded or filed.
103.25 	The certificate must refer to the recording or filing data for
103.26 	the medical assistance lien it renews.  The certificate need not
103.27 	be attested, certified, or acknowledged as a condition for
103.28 	recording or filing.  The registrar of titles or the recorder
103.29 	shall file, record, index, and return the certificate of renewal
103.30 	in the same manner as provided for medical assistance liens in
103.31 	section 514.982, subdivision 2.
103.32 	(b) A medical assistance lien is not enforceable against
103.33 	the real property of an estate to the extent there is a
103.34 	determination by a court of competent jurisdiction, or by an
103.35 	officer of the court designated for that purpose, that there are
103.36 	insufficient assets in the estate to satisfy the agency's
104.1 	medical assistance lien in whole or in part because of the
104.2 	homestead exemption under section 256B.15, subdivision 4, the
104.3 	rights of the surviving spouse or minor children under section
104.4 	524.2-403, paragraphs (a) and (b), or claims with a priority
104.5 	under section 524.3-805, paragraph (a), clauses (1) to (4).  For
104.6 	purposes of this section, the rights of the decedent's adult
104.7 	children to exempt property under section 524.2-403, paragraph
104.8 	(b), shall not be considered costs of administration under
104.9 	section 524.3-805, paragraph (a), clause (1).
104.10 	(c) Notwithstanding any law or rule to the contrary, the
104.11 	provisions in clauses (1) to (7) apply if a life estate subject
104.12 	to a medical assistance lien ends according to its terms, or if
104.13 	a medical assistance recipient who owns a life estate or any
104.14 	interest in real property as a joint tenant that is subject to a
104.15 	medical assistance lien dies.
104.16 	(1) The medical assistance recipient's life estate or joint
104.17 	tenancy interest in the real property shall not end upon the
104.18 	recipient's death but shall merge into the remainder interest or
104.19 	other interest in real property the medical assistance recipient
104.20 	owned in joint tenancy with others.  The medical assistance lien
104.21 	shall attach to and run with the remainder or other interest in
104.22 	the real property to the extent of the medical assistance
104.23 	recipient's interest in the property at the time of the
104.24 	recipient's death as determined under this section.
104.25 	(2) If the medical assistance recipient's interest was a
104.26 	life estate in real property, the lien shall be a lien against
104.27 	the portion of the remainder equal to the percentage factor for
104.28 	the life estate of a person the medical assistance recipient's
104.29 	age on the date the life estate ended according to its terms or
104.30 	the date of the medical assistance recipient's death as listed
104.31 	in the Life Estate Mortality Table in the health care program's
104.32 	manual.
104.33 	(3) If the medical assistance recipient owned the interest
104.34 	in real property in joint tenancy with others, the lien shall be
104.35 	a lien against the portion of that interest equal to the
104.36 	fractional interest the medical assistance recipient would have
105.1 	owned in the jointly owned interest had the medical assistance
105.2 	recipient and the other owners held title to that interest as
105.3 	tenants in common on the date the medical assistance recipient
105.4 	died.
105.5 	(4) The medical assistance lien shall remain a lien against
105.6 	the remainder or other jointly owned interest for the length of
105.7 	time and be renewable as provided in paragraph (a).
105.8 	(5) Subdivision 5, paragraph (a), clause (4), paragraph
105.9 	(b), clauses (1) and (2); and subdivision 6, paragraph (b), do
105.10 	not apply to medical assistance liens which attach to interests
105.11 	in real property as provided under this subdivision.
105.12 	(6) The continuation of a medical assistance recipient's
105.13 	life estate or joint tenancy interest in real property after the
105.14 	medical assistance recipient's death for the purpose of
105.15 	recovering medical assistance provided for in sections 514.980
105.16 	to 514.985 modifies common law principles holding that these
105.17 	interests terminate on the death of the holder.
105.18 	(7) Notwithstanding any law or rule to the contrary, no
105.19 	release, satisfaction, discharge, or affidavit under section
105.20 	256B.15 shall extinguish or terminate the life estate or joint
105.21 	tenancy interest of a medical assistance recipient subject to a
105.22 	lien under sections 514.980 to 514.985 on the date the recipient
105.23 	dies.
105.24 	(8) The provisions of clauses (1) to (7) do not apply to a
105.25 	homestead owned of record, on the date the recipient dies, by
105.26 	the recipient and the recipient's spouse as joint tenants with a
105.27 	right of survivorship.  Homestead means the real property
105.28 	occupied by the surviving joint tenant spouse as their sole
105.29 	residence on the date the recipient dies and classified and
105.30 	taxed to the recipient and surviving joint tenant spouse as
105.31 	homestead property for property tax purposes in the calendar
105.32 	year in which the recipient dies.  For purposes of this
105.33 	exemption, real property the recipient and their surviving joint
105.34 	tenant spouse purchase solely with the proceeds from the sale of
105.35 	their prior homestead, own of record as joint tenants, and
105.36 	qualify as homestead property under section 273.124 in the
106.1 	calendar year in which the recipient dies and prior to the
106.2 	recipient's death shall be deemed to be real property classified
106.3 	and taxed to the recipient and their surviving joint tenant
106.4 	spouse as homestead property in the calendar year in which the
106.5 	recipient dies.  The surviving spouse, or any person with
106.6 	personal knowledge of the facts, may provide an affidavit
106.7 	describing the homestead property affected by this clause and
106.8 	stating facts showing compliance with this clause.  The
106.9 	affidavit shall be prima facie evidence of the facts it states.
106.10 	All provisions in this paragraph related to the continuation of
106.11 	a recipient's life estate or joint tenancy interests in real
106.12 	property after the recipient's death, for the purpose of
106.13 	recovering medical assistance, are effective only for life
106.14 	estates and joint tenancy interests established on or after
106.15 	August 1, 2003.
106.16 	
EFFECTIVE DATE. This section is effective retroactively
106.17 	from August 1, 2003.

106.18 	Sec. 79. Laws 2003, First Special Session chapter 14,
106.19 	article 12, section 93, is amended to read:
106.20 	Sec. 93REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY
106.21 	CRITERIA AND POTENTIAL COST SAVINGS USE OF A BROKER TO MANAGE
106.22 	SPECIAL TRANSPORTATION SERVICES.
 106.23 	The commissioner of human services, in consultation with
106.24 	the commissioner of transportation and special transportation
106.25 	service providers, shall review eligibility criteria for medical
106.26 	assistance special transportation services and shall evaluate
106.27 	whether the level of special transportation services provided
106.28 	should be based on the degree of impairment of the client, as
106.29 	well as the medical diagnosis.  The commissioner shall also
106.30 	evaluate methods for reducing the cost of special transportation
106.31 	services, including, but not limited to:
106.32 	(1) requiring providers to maintain a daily log book
106.33 	confirming delivery of clients to medical facilities;
106.34 	(2) requiring providers to implement commercially available
106.35 	computer mapping programs to calculate mileage for purposes of
106.36 	reimbursement;
107.1 	(3) restricting special transportation service from being
107.2 	provided solely for trips to pharmacies;
107.3 	(4) modifying eligibility for special transportation;
107.4 	(5) expanding alternatives to the use of special
107.5 	transportation services;
107.6 	(6) improving the process of certifying persons as eligible
107.7 	for special transportation services; and 
107.8 	(7) examining the feasibility and benefits of licensing
107.9 	special transportation providers.
107.10 	The commissioner shall present recommendations for changes
107.11 	in the eligibility criteria and potential cost-savings for
107.12 	special transportation services to the chairs and ranking
107.13 	minority members of the house and senate committees having
107.14 	jurisdiction over health and human services spending by January
107.15 	15, 2004.The commissioner is prohibited from using a broker or
107.16 	coordinator to manage special transportation services for
107.17 	fee-for-service enrollees residing in a nursing home licensed
107.18 	under Minnesota Statutes, chapter 144A, until July 1, 2006, and
107.19 	for all other fee-for-service enrollees until July 1, 2005,
107.20 	except for the purposes of checking for recipient eligibility,
107.21 	authorizing recipients for appropriate level of transportation,
107.22 	and monitoring provider compliance with Minnesota Statutes,
107.23 	section 256B.0625, subdivision 17.  This prohibition does not
107.24 	apply to the purchase or management of common carrier
107.25 	transportation.

107.26 	Sec. 80. ADVISORY COMMITTEE ON NONEMERGENCY
107.27 	TRANSPORTATION SERVICES.
 107.28 	The commissioner of human services shall establish a
107.29 	seven-member advisory committee on medical assistance
107.30 	nonemergency transportation services.  The committee shall
107.31 	consist of:  a representative of the commissioner of human
107.32 	services, who shall serve as chair; two special transportation
107.33 	service providers, appointed by the trade associations
107.34 	representing special transportation service providers; one
107.35 	representative of nursing facilities; one representative of the
107.36 	disability community; and one house and one senate member,
108.1 	appointed respectively by the chairs of the house and senate
108.2 	committees with jurisdiction over medical assistance funding.
108.3 	The advisory committee shall monitor and evaluate the provision
108.4 	of medical assistance nonemergency medical transportation
108.5 	services, and present recommendations for any necessary changes
108.6 	to the commissioner.

108.7 	Sec. 81. PLANNING PROCESS FOR MANAGED CARE.
 108.8 	The commissioner of human services shall develop a planning
108.9 	process for the purposes of implementing at least one additional
108.10 	managed care arrangement to provide medical assistance services,
108.11 	excluding continuing care services, to recipients enrolled in
108.12 	the medical assistance fee-for-service program, effective
108.13 	January 1, 2007.  This planning process shall include an
108.14 	advisory committee composed of current fee-for-service
108.15 	consumers, consumer advocates, and providers, as well as
108.16 	representatives of health plans and other provider organizations
108.17 	qualified to provide basic health care services to persons with
108.18 	disabilities.  The department shall seek any additional federal
108.19 	authority necessary to provide basic health care services
108.20 	through contracted managed care arrangements.

108.21 	Sec. 82. FEDERAL APPROVAL RELATED TO MEDICAL ASSISTANCE
108.22 	INCOME LIMIT FOR PREGNANT WOMEN AND SPECIAL WORK EXPENSE
108.23 	DEDUCTION.
 108.24 	The commissioner of human services, by July 1, 2005, shall
108.25 	apply for any federal waivers and approvals necessary to retain
108.26 	the medical assistance income limit for pregnant women at 200
108.27 	percent of the federal poverty guidelines, and to not apply the
108.28 	special work expense deductions for infants and pregnant women,
108.29 	while continuing to receive federal funding under the state
108.30 	children's health insurance program (SCHIP).  The commissioner
108.31 	shall update the chairs and ranking minority members of the
108.32 	house and senate committees with jurisdiction over the medical
108.33 	assistance program of the status of the request for federal
108.34 	waivers and approvals.

108.35 	Sec. 83. FEDERAL APPROVAL.
 108.36 	(a) The commissioner of human services shall seek federal
109.1 	waivers and approvals necessary to allow the commissioner to
109.2 	charge medical assistance recipients sliding scale premiums,
109.3 	based on the sliding scale used for the MinnesotaCare program
109.4 	under Minnesota Statutes, section 256L.15.
109.5 	(b) The commissioner of human services shall seek federal
109.6 	waivers and approvals necessary to modify the definition of
109.7 	household and family income under MinnesotaCare, to include the
109.8 	earned and unearned income of all persons residing in the
109.9 	household or family, including unrelated persons.

109.10 	Sec. 84. HEALTH CARE FINANCING REPORT.
 109.11 	The commissioner of human services shall develop
109.12 	recommendations on simplifying publicly funded health care
109.13 	program financing.  The commissioner shall report the
109.14 	recommendations to the chairs of the house and senate committees
109.15 	with jurisdiction over health care financing during the 2007
109.16 	legislative session.

109.17 	Sec. 85. GENERAL PROVISIONS GOVERNING CHANGE IN EFFECTIVE
109.18 	DATE FOR LIFE ESTATE AND JOINT TENANCY INTEREST PROVISIONS.
 109.19 		Subdivision 1.Establishment of life estate or joint
109.20 	tenancy interest. For purposes of the amendments to Minnesota
109.21 	Statutes, sections 256B.15, subdivision 1, and 514.981,
109.22 	subdivision 6, a life estate or joint tenancy interest is
109.23 	established upon the earlier of:
109.24 	(1) the date the instrument creating the interest is
109.25 	recorded or filed in the office of the county recorder or
109.26 	registrar of titles where the real estate interest it describes
109.27 	is located;
109.28 	(2) the date of delivery by the grantor to the grantee of
109.29 	the signed instrument as stated in an affidavit made by a person
109.30 	with knowledge of the facts;
109.31 	(3) the date on which the judicial order creating the
109.32 	interest was issued by the court; or 
109.33 	(4) the date upon which the interest devolves under
109.34 	Minnesota Statutes, section 524.3-101.
109.35 		Subd. 2.Medical assistance. For purposes of the
109.36 	amendments to Minnesota Statutes, sections 256B.15, subdivision
110.1 	1, and 514.981, subdivision 6, the term medical assistance means
110.2 	medical assistance as defined in Minnesota Statutes 2004,
110.3 	section 256B.15, subdivision 1.
110.4 		Subd. 3.Lien notices. Medical assistance liens and
110.5 	liens under notices of potential claims that are of record
110.6 	against life estate or joint tenancy interests established prior
110.7 	to August 1, 2003, shall end and become unenforceable upon the
110.8 	death of the person named in the lien, or a notice of potential
110.9 	claim shall be disregarded by examiners of title after the death
110.10 	of the life tenant or joint tenant, and shall not be carried
110.11 	forward to a subsequent certificate of title.  This subdivision
110.12 	shall not apply to life estates that continue to exist after the
110.13 	death of the person named in the lien or notice of potential
110.14 	claim under the terms of the instrument creating or reserving
110.15 	the life estate until the life estate ends as provided for in
110.16 	the instrument.
110.17 	
EFFECTIVE DATE. This section is effective retroactively
110.18 	from August 1, 2003.

110.19 	Sec. 86. COMMISSIONER'S DUTIES RELATED TO CHANGE IN
110.20 	EFFECTIVE DATE FOR LIFE ESTATE AND JOINT TENANCY INTEREST
110.21 	PROVISIONS.
 110.22 	(a) The commissioner of human services or a county agency
110.23 	that has recovered medical assistance or alternative care
110.24 	payments for recipients after they die from their life estates
110.25 	or jointly owned interests in real property that were
110.26 	established prior to August 1, 2003, and that were continued in
110.27 	existence or merged into another interest in real property after
110.28 	their death due solely to the provisions of section 256B.15 or
110.29 	514.981, subdivision 6, paragraph (c), as those provisions
110.30 	existed prior to the amendments in this act, shall refund those
110.31 	recoveries, without interest.  The refunds shall be paid to the
110.32 	surviving record owners of the real property in which the
110.33 	recipient had a life estate or a jointly owned interest on the
110.34 	date of the recipient's death in proportion to their record
110.35 	interests on that date.  The commissioner and a county agency
110.36 	are not required to refund any other recoveries attributable to
111.1 	any other interests or assets of the deceased recipient.
111.2 	(b) If the commissioner of human services or a county
111.3 	agency determines a person entitled to any refund under this act
111.4 	is dead, they may pay the refund due that person to their estate
111.5 	if it is still open.  If the person's estate is closed or if a
111.6 	court has entered a decree of distribution for that person under
111.7 	section 525.312 that is a final decree, the commissioner or the
111.8 	county agency may, in their absolute discretion, pay the
111.9 	person's refund to their heirs or devisees as finally determined
111.10 	in any completed probate or under any final decree of
111.11 	distribution.  In all other cases including, but not limited to,
111.12 	those in which the commissioner or a county agency determines
111.13 	they cannot identify or locate a person entitled to a refund
111.14 	under this section, they may, at their discretion, declare such
111.15 	person's refund to be abandoned property and pay and deliver it
111.16 	to the commissioner of commerce.  The commissioner of commerce
111.17 	shall administer and dispose of the refunds according to
111.18 	sections 345.31 to 345.60.  Neither the commissioner of human
111.19 	services, the Department of Human Services, a county agency, or
111.20 	the employees of the department or agency, shall be liable to
111.21 	anyone with respect to the refund after paying or delivering the
111.22 	refund as provided for in this section.

111.23 	EFFECTIVE DATE. This section is effective retroactively
111.24 	from August 1, 2003.

111.25 	Sec. 87. IMMUNITY.
 111.26 	The commissioner of human services, county agencies, and
111.27 	elected officials and their employees are immune from all
111.28 	liability for any action taken implementing Laws 2003, First
111.29 	Special Session chapter 14, article 12, sections 40 to 52 and
111.30 	90, as those laws existed at the time the action was taken, and
111.31 	sections 1 to 4 of this act.

111.32 	EFFECTIVE DATE. This section is effective retroactively
111.33 	from August 1, 2003.

111.34 	Sec. 88. REPEALER.
 111.35 	(a) Minnesota Statutes 2004, sections 256L.035; 256L.04,
111.36 	subdivision 7; and 256L.09, subdivisions 1, 4, 5, 6, and 7, are
112.1 	repealed effective October 1, 2005.
112.2 	(b) Minnesota Statutes 2004, section 256.955, is repealed
112.3 	effective January 1, 2006.
112.4 	(c) Minnesota Statutes 2004, sections 256B.075, subdivision
112.5 	5, and 295.581, are repealed the day following final enactment.
112.6 	(d) Minnesota Statutes 2004, section 256L.04, subdivision
112.7 	11, MinnesotaCare outreach grants, is repealed effective July 1,
112.8 	2005.

112.9 	ARTICLE 4
112.10 	NURSING FACILITY REIMBURSEMENT SYSTEM
112.11 	AND OTHER PROVISIONS

112.12 	Section 1. Minnesota Statutes 2004, section 144A.071,
112.13 	subdivision 4a, is amended to read:
112.14 		Subd. 4a.Exceptions for replacement beds.  It is in the
112.15 	best interest of the state to ensure that nursing homes and
112.16 	boarding care homes continue to meet the physical plant
112.17 	licensing and certification requirements by permitting certain
112.18 	construction projects.  Facilities should be maintained in
112.19 	condition to satisfy the physical and emotional needs of
112.20 	residents while allowing the state to maintain control over
112.21 	nursing home expenditure growth.
112.22 	The commissioner of health in coordination with the
112.23 	commissioner of human services, may approve the renovation,
112.24 	replacement, upgrading, or relocation of a nursing home or
112.25 	boarding care home, under the following conditions:
112.26 	(a) to license or certify beds in a new facility
112.27 	constructed to replace a facility or to make repairs in an
112.28 	existing facility that was destroyed or damaged after June 30,
112.29 	1987, by fire, lightning, or other hazard provided:
112.30 	(i) destruction was not caused by the intentional act of or
112.31 	at the direction of a controlling person of the facility;
112.32 	(ii) at the time the facility was destroyed or damaged the
112.33 	controlling persons of the facility maintained insurance
112.34 	coverage for the type of hazard that occurred in an amount that
112.35 	a reasonable person would conclude was adequate;
112.36 	(iii) the net proceeds from an insurance settlement for the
113.1 	damages caused by the hazard are applied to the cost of the new
113.2 	facility or repairs;
113.3 	(iv) the new facility is constructed on the same site as
113.4 	the destroyed facility or on another site subject to the
113.5 	restrictions in section 144A.073, subdivision 5;
113.6 	(v) the number of licensed and certified beds in the new
113.7 	facility does not exceed the number of licensed and certified
113.8 	beds in the destroyed facility; and
113.9 	(vi) the commissioner determines that the replacement beds
113.10 	are needed to prevent an inadequate supply of beds.
113.11 	Project construction costs incurred for repairs authorized under
113.12 	this clause shall not be considered in the dollar threshold
113.13 	amount defined in subdivision 2;
113.14 	(b) to license or certify beds that are moved from one
113.15 	location to another within a nursing home facility, provided the
113.16 	total costs of remodeling performed in conjunction with the
113.17 	relocation of beds does not exceed $1,000,000;
113.18 	(c) to license or certify beds in a project recommended for
113.19 	approval under section 144A.073;
113.20 	(d) to license or certify beds that are moved from an
113.21 	existing state nursing home to a different state facility,
113.22 	provided there is no net increase in the number of state nursing
113.23 	home beds;
113.24 	(e) to certify and license as nursing home beds boarding
113.25 	care beds in a certified boarding care facility if the beds meet
113.26 	the standards for nursing home licensure, or in a facility that
113.27 	was granted an exception to the moratorium under section
113.28 	144A.073, and if the cost of any remodeling of the facility does
113.29 	not exceed $1,000,000.  If boarding care beds are licensed as
113.30 	nursing home beds, the number of boarding care beds in the
113.31 	facility must not increase beyond the number remaining at the
113.32 	time of the upgrade in licensure.  The provisions contained in
113.33 	section 144A.073 regarding the upgrading of the facilities do
113.34 	not apply to facilities that satisfy these requirements;
113.35 	(f) to license and certify up to 40 beds transferred from
113.36 	an existing facility owned and operated by the Amherst H. Wilder
114.1 	Foundation in the city of St. Paul to a new unit at the same
114.2 	location as the existing facility that will serve persons with
114.3 	Alzheimer's disease and other related disorders.  The transfer
114.4 	of beds may occur gradually or in stages, provided the total
114.5 	number of beds transferred does not exceed 40.  At the time of
114.6 	licensure and certification of a bed or beds in the new unit,
114.7 	the commissioner of health shall delicense and decertify the
114.8 	same number of beds in the existing facility.  As a condition of
114.9 	receiving a license or certification under this clause, the
114.10 	facility must make a written commitment to the commissioner of
114.11 	human services that it will not seek to receive an increase in
114.12 	its property-related payment rate as a result of the transfers
114.13 	allowed under this paragraph;
114.14 	(g) to license and certify nursing home beds to replace
114.15 	currently licensed and certified boarding care beds which may be
114.16 	located either in a remodeled or renovated boarding care or
114.17 	nursing home facility or in a remodeled, renovated, newly
114.18 	constructed, or replacement nursing home facility within the
114.19 	identifiable complex of health care facilities in which the
114.20 	currently licensed boarding care beds are presently located,
114.21 	provided that the number of boarding care beds in the facility
114.22 	or complex are decreased by the number to be licensed as nursing
114.23 	home beds and further provided that, if the total costs of new
114.24 	construction, replacement, remodeling, or renovation exceed ten
114.25 	percent of the appraised value of the facility or $200,000,
114.26 	whichever is less, the facility makes a written commitment to
114.27 	the commissioner of human services that it will not seek to
114.28 	receive an increase in its property-related payment rate by
114.29 	reason of the new construction, replacement, remodeling, or
114.30 	renovation.  The provisions contained in section 144A.073
114.31 	regarding the upgrading of facilities do not apply to facilities
114.32 	that satisfy these requirements;
114.33 	(h) to license as a nursing home and certify as a nursing
114.34 	facility a facility that is licensed as a boarding care facility
114.35 	but not certified under the medical assistance program, but only
114.36 	if the commissioner of human services certifies to the
115.1 	commissioner of health that licensing the facility as a nursing
115.2 	home and certifying the facility as a nursing facility will
115.3 	result in a net annual savings to the state general fund of
115.4 	$200,000 or more;
115.5 	(i) to certify, after September 30, 1992, and prior to July
115.6 	1, 1993, existing nursing home beds in a facility that was
115.7 	licensed and in operation prior to January 1, 1992;
115.8 	(j) to license and certify new nursing home beds to replace
115.9 	beds in a facility acquired by the Minneapolis Community
115.10 	Development Agency as part of redevelopment activities in a city
115.11 	of the first class, provided the new facility is located within
115.12 	three miles of the site of the old facility.  Operating and
115.13 	property costs for the new facility must be determined and
115.14 	allowed under section 256B.431 or 256B.434;
115.15 	(k) to license and certify up to 20 new nursing home beds
115.16 	in a community-operated hospital and attached convalescent and
115.17 	nursing care facility with 40 beds on April 21, 1991, that
115.18 	suspended operation of the hospital in April 1986.  The
115.19 	commissioner of human services shall provide the facility with
115.20 	the same per diem property-related payment rate for each
115.21 	additional licensed and certified bed as it will receive for its
115.22 	existing 40 beds;
115.23 	(l) to license or certify beds in renovation, replacement,
115.24 	or upgrading projects as defined in section 144A.073,
115.25 	subdivision 1, so long as the cumulative total costs of the
115.26 	facility's remodeling projects do not exceed $1,000,000;
115.27 	(m) to license and certify beds that are moved from one
115.28 	location to another for the purposes of converting up to five
115.29 	four-bed wards to single or double occupancy rooms in a nursing
115.30 	home that, as of January 1, 1993, was county-owned and had a
115.31 	licensed capacity of 115 beds;
115.32 	(n) to allow a facility that on April 16, 1993, was a
115.33 	106-bed licensed and certified nursing facility located in
115.34 	Minneapolis to layaway all of its licensed and certified nursing
115.35 	home beds.  These beds may be relicensed and recertified in a
115.36 	newly constructed teaching nursing home facility affiliated with
116.1 	a teaching hospital upon approval by the legislature.  The
116.2 	proposal must be developed in consultation with the interagency
116.3 	committee on long-term care planning.  The beds on layaway
116.4 	status shall have the same status as voluntarily delicensed and
116.5 	decertified beds, except that beds on layaway status remain
116.6 	subject to the surcharge in section 256.9657.  This layaway
116.7 	provision expires July 1, 1998;
116.8 	(o) to allow a project which will be completed in
116.9 	conjunction with an approved moratorium exception project for a
116.10 	nursing home in southern Cass County and which is directly
116.11 	related to that portion of the facility that must be repaired,
116.12 	renovated, or replaced, to correct an emergency plumbing problem
116.13 	for which a state correction order has been issued and which
116.14 	must be corrected by August 31, 1993;
116.15 	(p) to allow a facility that on April 16, 1993, was a
116.16 	368-bed licensed and certified nursing facility located in
116.17 	Minneapolis to layaway, upon 30 days prior written notice to the
116.18 	commissioner, up to 30 of the facility's licensed and certified
116.19 	beds by converting three-bed wards to single or double
116.20 	occupancy.  Beds on layaway status shall have the same status as
116.21 	voluntarily delicensed and decertified beds except that beds on
116.22 	layaway status remain subject to the surcharge in section
116.23 	256.9657, remain subject to the license application and renewal
116.24 	fees under section 144A.07 and shall be subject to a $100 per
116.25 	bed reactivation fee.  In addition, at any time within three
116.26 	years of the effective date of the layaway, the beds on layaway
116.27 	status may be:
116.28 	(1) relicensed and recertified upon relocation and
116.29 	reactivation of some or all of the beds to an existing licensed
116.30 	and certified facility or facilities located in Pine River,
116.31 	Brainerd, or International Falls; provided that the total
116.32 	project construction costs related to the relocation of beds
116.33 	from layaway status for any facility receiving relocated beds
116.34 	may not exceed the dollar threshold provided in subdivision 2
116.35 	unless the construction project has been approved through the
116.36 	moratorium exception process under section 144A.073;
117.1 	(2) relicensed and recertified, upon reactivation of some
117.2 	or all of the beds within the facility which placed the beds in
117.3 	layaway status, if the commissioner has determined a need for
117.4 	the reactivation of the beds on layaway status.
117.5 	The property-related payment rate of a facility placing
117.6 	beds on layaway status must be adjusted by the incremental
117.7 	change in its rental per diem after recalculating the rental per
117.8 	diem as provided in section 256B.431, subdivision 3a, paragraph
117.9 	(c).  The property-related payment rate for a facility
117.10 	relicensing and recertifying beds from layaway status must be
117.11 	adjusted by the incremental change in its rental per diem after
117.12 	recalculating its rental per diem using the number of beds after
117.13 	the relicensing to establish the facility's capacity day
117.14 	divisor, which shall be effective the first day of the month
117.15 	following the month in which the relicensing and recertification
117.16 	became effective.  Any beds remaining on layaway status more
117.17 	than three years after the date the layaway status became
117.18 	effective must be removed from layaway status and immediately
117.19 	delicensed and decertified;
117.20 	(q) to license and certify beds in a renovation and
117.21 	remodeling project to convert 12 four-bed wards into 24 two-bed
117.22 	rooms, expand space, and add improvements in a nursing home
117.23 	that, as of January 1, 1994, met the following conditions:  the
117.24 	nursing home was located in Ramsey County; had a licensed
117.25 	capacity of 154 beds; and had been ranked among the top 15
117.26 	applicants by the 1993 moratorium exceptions advisory review
117.27 	panel.  The total project construction cost estimate for this
117.28 	project must not exceed the cost estimate submitted in
117.29 	connection with the 1993 moratorium exception process;
117.30 	(r) to license and certify up to 117 beds that are
117.31 	relocated from a licensed and certified 138-bed nursing facility
117.32 	located in St. Paul to a hospital with 130 licensed hospital
117.33 	beds located in South St. Paul, provided that the nursing
117.34 	facility and hospital are owned by the same or a related
117.35 	organization and that prior to the date the relocation is
117.36 	completed the hospital ceases operation of its inpatient
118.1 	hospital services at that hospital.  After relocation, the
118.2 	nursing facility's status under section 256B.431, subdivision
118.3 	2j, shall be the same as it was prior to relocation.  The
118.4 	nursing facility's property-related payment rate resulting from
118.5 	the project authorized in this paragraph shall become effective
118.6 	no earlier than April 1, 1996.  For purposes of calculating the
118.7 	incremental change in the facility's rental per diem resulting
118.8 	from this project, the allowable appraised value of the nursing
118.9 	facility portion of the existing health care facility physical
118.10 	plant prior to the renovation and relocation may not exceed
118.11 	$2,490,000;
118.12 	(s) to license and certify two beds in a facility to
118.13 	replace beds that were voluntarily delicensed and decertified on
118.14 	June 28, 1991;
118.15 	(t) to allow 16 licensed and certified beds located on July
118.16 	1, 1994, in a 142-bed nursing home and 21-bed boarding care home
118.17 	facility in Minneapolis, notwithstanding the licensure and
118.18 	certification after July 1, 1995, of the Minneapolis facility as
118.19 	a 147-bed nursing home facility after completion of a
118.20 	construction project approved in 1993 under section 144A.073, to
118.21 	be laid away upon 30 days' prior written notice to the
118.22 	commissioner.  Beds on layaway status shall have the same status
118.23 	as voluntarily delicensed or decertified beds except that they
118.24 	shall remain subject to the surcharge in section 256.9657.  The
118.25 	16 beds on layaway status may be relicensed as nursing home beds
118.26 	and recertified at any time within five years of the effective
118.27 	date of the layaway upon relocation of some or all of the beds
118.28 	to a licensed and certified facility located in Watertown,
118.29 	provided that the total project construction costs related to
118.30 	the relocation of beds from layaway status for the Watertown
118.31 	facility may not exceed the dollar threshold provided in
118.32 	subdivision 2 unless the construction project has been approved
118.33 	through the moratorium exception process under section 144A.073.
118.34 	The property-related payment rate of the facility placing
118.35 	beds on layaway status must be adjusted by the incremental
118.36 	change in its rental per diem after recalculating the rental per
119.1 	diem as provided in section 256B.431, subdivision 3a, paragraph
119.2 	(c).  The property-related payment rate for the facility
119.3 	relicensing and recertifying beds from layaway status must be
119.4 	adjusted by the incremental change in its rental per diem after
119.5 	recalculating its rental per diem using the number of beds after
119.6 	the relicensing to establish the facility's capacity day
119.7 	divisor, which shall be effective the first day of the month
119.8 	following the month in which the relicensing and recertification
119.9 	became effective.  Any beds remaining on layaway status more
119.10 	than five years after the date the layaway status became
119.11 	effective must be removed from layaway status and immediately
119.12 	delicensed and decertified;
119.13 	(u) to license and certify beds that are moved within an
119.14 	existing area of a facility or to a newly constructed addition
119.15 	which is built for the purpose of eliminating three- and
119.16 	four-bed rooms and adding space for dining, lounge areas,
119.17 	bathing rooms, and ancillary service areas in a nursing home
119.18 	that, as of January 1, 1995, was located in Fridley and had a
119.19 	licensed capacity of 129 beds;
119.20 	(v) to relocate 36 beds in Crow Wing County and four beds
119.21 	from Hennepin County to a 160-bed facility in Crow Wing County,
119.22 	provided all the affected beds are under common ownership;
119.23 	(w) to license and certify a total replacement project of
119.24 	up to 49 beds located in Norman County that are relocated from a
119.25 	nursing home destroyed by flood and whose residents were
119.26 	relocated to other nursing homes.  The operating cost payment
119.27 	rates for the new nursing facility shall be determined based on
119.28 	the interim and settle-up payment provisions of Minnesota Rules,
119.29 	part 9549.0057, and the reimbursement provisions of section
119.30 	256B.431, except that subdivision 26, paragraphs (a) and (b),
119.31 	shall not apply until the second rate year after the settle-up
119.32 	cost report is filed.  Property-related reimbursement rates
119.33 	shall be determined under section 256B.431, taking into account
119.34 	any federal or state flood-related loans or grants provided to
119.35 	the facility;
119.36 	(x) to license and certify a total replacement project of
120.1 	up to 129 beds located in Polk County that are relocated from a
120.2 	nursing home destroyed by flood and whose residents were
120.3 	relocated to other nursing homes.  The operating cost payment
120.4 	rates for the new nursing facility shall be determined based on
120.5 	the interim and settle-up payment provisions of Minnesota Rules,
120.6 	part 9549.0057, and the reimbursement provisions of section
120.7 	256B.431, except that subdivision 26, paragraphs (a) and (b),
120.8 	shall not apply until the second rate year after the settle-up
120.9 	cost report is filed.  Property-related reimbursement rates
120.10 	shall be determined under section 256B.431, taking into account
120.11 	any federal or state flood-related loans or grants provided to
120.12 	the facility;
120.13 	(y) to license and certify beds in a renovation and
120.14 	remodeling project to convert 13 three-bed wards into 13 two-bed
120.15 	rooms and 13 single-bed rooms, expand space, and add
120.16 	improvements in a nursing home that, as of January 1, 1994, met
120.17 	the following conditions:  the nursing home was located in
120.18 	Ramsey County, was not owned by a hospital corporation, had a
120.19 	licensed capacity of 64 beds, and had been ranked among the top
120.20 	15 applicants by the 1993 moratorium exceptions advisory review
120.21 	panel.  The total project construction cost estimate for this
120.22 	project must not exceed the cost estimate submitted in
120.23 	connection with the 1993 moratorium exception process;
120.24 	(z) to license and certify up to 150 nursing home beds to
120.25 	replace an existing 285 bed nursing facility located in St.
120.26 	Paul.  The replacement project shall include both the renovation
120.27 	of existing buildings and the construction of new facilities at
120.28 	the existing site.  The reduction in the licensed capacity of
120.29 	the existing facility shall occur during the construction
120.30 	project as beds are taken out of service due to the construction
120.31 	process.  Prior to the start of the construction process, the
120.32 	facility shall provide written information to the commissioner
120.33 	of health describing the process for bed reduction, plans for
120.34 	the relocation of residents, and the estimated construction
120.35 	schedule.  The relocation of residents shall be in accordance
120.36 	with the provisions of law and rule;
121.1 	(aa) to allow the commissioner of human services to license
121.2 	an additional 36 beds to provide residential services for the
121.3 	physically handicapped under Minnesota Rules, parts 9570.2000 to
121.4 	9570.3400, in a 198-bed nursing home located in Red Wing,
121.5 	provided that the total number of licensed and certified beds at
121.6 	the facility does not increase;
121.7 	(bb) to license and certify a new facility in St. Louis
121.8 	county with 44 beds constructed to replace an existing facility
121.9 	in St. Louis County with 31 beds, which has resident rooms on
121.10 	two separate floors and an antiquated elevator that creates
121.11 	safety concerns for residents and prevents nonambulatory
121.12 	residents from residing on the second floor.  The project shall
121.13 	include the elimination of three- and four-bed rooms;
121.14 	(cc) to license and certify four beds in a 16-bed certified
121.15 	boarding care home in Minneapolis to replace beds that were
121.16 	voluntarily delicensed and decertified on or before March 31,
121.17 	1992.  The licensure and certification is conditional upon the
121.18 	facility periodically assessing and adjusting its resident mix
121.19 	and other factors which may contribute to a potential
121.20 	institution for mental disease declaration.  The commissioner of
121.21 	human services shall retain the authority to audit the facility
121.22 	at any time and shall require the facility to comply with any
121.23 	requirements necessary to prevent an institution for mental
121.24 	disease declaration, including delicensure and decertification
121.25 	of beds, if necessary;
121.26 	(dd) to license and certify 72 beds in an existing facility
121.27 	in Mille Lacs County with 80 beds as part of a renovation
121.28 	project.  The renovation must include construction of an
121.29 	addition to accommodate ten residents with beginning and
121.30 	midstage dementia in a self-contained living unit; creation of
121.31 	three resident households where dining, activities, and support
121.32 	spaces are located near resident living quarters; designation of
121.33 	four beds for rehabilitation in a self-contained area;
121.34 	designation of 30 private rooms; and other improvements;
121.35 	(ee) to license and certify beds in a facility that has
121.36 	undergone replacement or remodeling as part of a planned closure
122.1 	under section 256B.437;
122.2 	(ff) to license and certify a total replacement project of
122.3 	up to 124 beds located in Wilkin County that are in need of
122.4 	relocation from a nursing home significantly damaged by flood.
122.5 	The operating cost payment rates for the new nursing facility
122.6 	shall be determined based on the interim and settle-up payment
122.7 	provisions of Minnesota Rules, part 9549.0057, and the
122.8 	reimbursement provisions of section 256B.431, except that
122.9 	section 256B.431, subdivision 26, paragraphs (a) and (b), shall
122.10 	not apply until the second rate year after the settle-up cost
122.11 	report is filed.  Property-related reimbursement rates shall be
122.12 	determined under section 256B.431, taking into account any
122.13 	federal or state flood-related loans or grants provided to the
122.14 	facility;
122.15 	(gg) to allow the commissioner of human services to license
122.16 	an additional nine beds to provide residential services for the
122.17 	physically handicapped under Minnesota Rules, parts 9570.2000 to
122.18 	9570.3400, in a 240-bed nursing home located in Duluth, provided
122.19 	that the total number of licensed and certified beds at the
122.20 	facility does not increase;
122.21 	(hh) to license and certify up to 120 new nursing facility
122.22 	beds to replace beds in a facility in Anoka County, which was
122.23 	licensed for 98 beds as of July 1, 2000, provided the new
122.24 	facility is located within four miles of the existing facility
122.25 	and is in Anoka County.  Operating and property rates shall be
122.26 	determined and allowed under section 256B.431 and Minnesota
122.27 	Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or
122.28 	256B.435.  The provisions of section 256B.431, subdivision 26,
122.29 	paragraphs (a) and (b), do not apply until the second rate year
122.30 	following settle-up; or
122.31 	(ii) to transfer up to 98 beds of a 129-licensed bed
122.32 	facility located in Anoka County that, as of March 25, 2001, is
122.33 	in the active process of closing, to a 122-licensed bed
122.34 	nonprofit nursing facility located in the city of Columbia
122.35 	Heights or its affiliate.  The transfer is effective when the
122.36 	receiving facility notifies the commissioner in writing of the
123.1 	number of beds accepted.  The commissioner shall place all
123.2 	transferred beds on layaway status held in the name of the
123.3 	receiving facility.  The layaway adjustment provisions of
123.4 	section 256B.431, subdivision 30, do not apply to this layaway.
123.5 	The receiving facility may only remove the beds from layaway for
123.6 	recertification and relicensure at the receiving facility's
123.7 	current site, or at a newly constructed facility located in
123.8 	Anoka County.  The receiving facility must receive statutory
123.9 	authorization before removing these beds from layaway status.
123.10 	(jj)(1) A facility in Columbia Heights with 122 beds on
123.11 	January 1, 2005, may remove from layaway status up to 35 of 98
123.12 	beds placed in layaway status in paragraph (ii), and relicense
123.13 	and recertify these beds in stages in a newly constructed
123.14 	nursing facility in Ramsey located on a long-term care campus
123.15 	that provides a continuum of housing and health care options and
123.16 	services, ranging from independent living to skilled nursing
123.17 	services.  The beds may be relicensed and recertified in two
123.18 	stages.
123.19 	(2) A facility in Anoka with 57 beds on January 1, 2005,
123.20 	may remove from layaway status an additional 33 of the 98 beds
123.21 	placed in layaway status in paragraph (ii) and relicense and
123.22 	recertify these beds in a newly constructed nursing facility
123.23 	located in Anoka County, north of State Highway 242 and at a
123.24 	site not closer than five miles from any other licensed and
123.25 	certified nursing facility, along with up to 57 beds that may be
123.26 	relocated from the facility in Anoka.
123.27 	(3) Notwithstanding the five-year duration after which beds
123.28 	may no longer remain in layaway and still be placed in active
123.29 	service, as specified in subdivision 4b, the beds must be
123.30 	relicensed and recertified prior to June 30, 2009.
123.31 	(4) For the facility in clause (1), the total payment rates
123.32 	shall be equal to those of the 122-bed facility in Columbia
123.33 	Heights.  For the facility in clause (2), the total payment
123.34 	rates shall be equal to those of the 57-bed facility in Anoka.
123.35 	(5) The facilities in clauses (1) and (2) may annually
123.36 	certify to the commissioner of human services, on a form and in
124.1 	a manner specified by the commissioner, beginning no later than
124.2 	one year after they are licensed and certified, that they are
124.3 	discharging eight or more individuals per year for each newly
124.4 	licensed bed.  If, in the certification, the facility reports
124.5 	that they are discharging fewer than eight individuals per year
124.6 	for each newly licensed bed, the commissioner shall reduce the
124.7 	facility's payment rates under medical assistance by three
124.8 	percent for each one discharge per year for each newly licensed
124.9 	bed, or portion thereof, less than eight, times the portion of
124.10 	the facility's licensed and certified beds that are newly
124.11 	licensed and certified.  If the facility fails to provide this
124.12 	annual certification, the commissioner shall assume two
124.13 	discharges per year for each newly licensed bed and reduce the
124.14 	facility's payment rates under medical assistance by three
124.15 	percent for each one discharge per year for each newly licensed
124.16 	bed, less than eight.

124.17 	Sec. 2. Minnesota Statutes 2004, section 144A.073, is
124.18 	amended by adding a subdivision to read:
124.19 		Subd. 10a.Extension of approval for a facility in otter
124.20 	tail county. Notwithstanding subdivisions 3 and 10, the
124.21 	commissioner of health shall extend project approval for an
124.22 	additional 24 months for an exception to the nursing home
124.23 	licensure and certification moratorium proposed by a nursing
124.24 	facility in Otter Tail County and originally approved by the
124.25 	commissioner on December 20, 2002.

124.26 	Sec. 3. Minnesota Statutes 2004, section 256B.431,
124.27 	subdivision 28, is amended to read:
124.28 		Subd. 28.Nursing facility rate increases beginning july
124.29 	1, 1999, and july 1, 2000.  (a) For the rate years beginning
124.30 	July 1, 1999, and July 1, 2000, the commissioner shall make
124.31 	available to each nursing facility reimbursed under this section
124.32 	or section 256B.434 an adjustment to the total operating payment
124.33 	rate.  For nursing facilities reimbursed under this section or
124.34 	section 256B.434, the July 1, 2000, operating payment rate
124.35 	increases provided in this subdivision shall be applied to each
124.36 	facility's June 30, 2000, operating payment rate.  For each
125.1 	facility, total operating costs shall be separated into costs
125.2 	that are compensation related and all other costs.
125.3 	Compensation-related costs include salaries, payroll taxes, and
125.4 	fringe benefits for all employees except management fees, the
125.5 	administrator, and central office staff.
125.6 	(b) For the rate year beginning July 1, 1999, the
125.7 	commissioner shall make available a rate increase for
125.8 	compensation-related costs of 4.843 percent and a rate increase
125.9 	for all other operating costs of 3.446 percent.
125.10 	(c) For the rate year beginning July 1, 2000, the
125.11 	commissioner shall make available:
125.12 	(1) a rate increase for compensation-related costs of 3.632
125.13 	percent;
125.14 	(2) an additional rate increase for each case mix payment
125.15 	rate which must be used to increase the per-hour pay rate of all
125.16 	employees except management fees, the administrator, and central
125.17 	office staff by an equal dollar amount and to pay associated
125.18 	costs for FICA, the Medicare tax, workers' compensation
125.19 	premiums, and federal and state unemployment insurance, to be
125.20 	calculated according to clauses (i) to (iii):
125.21 	(i) the commissioner shall calculate the arithmetic mean of
125.22 	the 11 June 30, 2000, operating rates for each facility;
125.23 	(ii) the commissioner shall construct an array of nursing
125.24 	facilities from highest to lowest, according to the arithmetic
125.25 	mean calculated in clause (i).  A numerical rank shall be
125.26 	assigned to each facility in the array.  The facility with the
125.27 	highest mean shall be assigned a numerical rank of one.  The
125.28 	facility with the lowest mean shall be assigned a numerical rank
125.29 	equal to the total number of nursing facilities in the array.
125.30 	All other facilities shall be assigned a numerical rank in
125.31 	accordance with their position in the array;
125.32 	(iii) the amount of the additional rate increase shall be
125.33 	$1 plus an amount equal to $3.13 multiplied by the ratio of the
125.34 	facility's numeric rank divided by the number of facilities in
125.35 	the array; and
125.36 	(3) a rate increase for all other operating costs of 2.585
126.1 	percent.
126.2 	Money received by a facility as a result of the additional
126.3 	rate increase provided under clause (2) shall be used only for
126.4 	wage increases implemented on or after July 1, 2000, and shall
126.5 	not be used for wage increases implemented prior to that date.
126.6 	(d) The payment rate adjustment for each nursing facility
126.7 	must be determined under clause (1) or (2):
126.8 	(1) for each nursing facility that reports salaries for
126.9 	registered nurses, licensed practical nurses, aides, orderlies,
126.10 	and attendants separately, the commissioner shall determine the
126.11 	payment rate adjustment using the categories specified in
126.12 	paragraph (a) multiplied by the rate increases specified in
126.13 	paragraph (b) or (c), and then dividing the resulting amount by
126.14 	the nursing facility's actual resident days.  In determining the
126.15 	amount of a payment rate adjustment for a nursing facility
126.16 	reimbursed under section 256B.434, the commissioner shall
126.17 	determine the proportions of the facility's rates that are
126.18 	compensation-related costs and all other operating costs based
126.19 	on the facility's most recent cost report; and
126.20 	(2) for each nursing facility that does not report salaries
126.21 	for registered nurses, licensed practical nurses, aides,
126.22 	orderlies, and attendants separately, the payment rate
126.23 	adjustment shall be computed using the facility's total
126.24 	operating costs, separated into the categories specified in
126.25 	paragraph (a) in proportion to the weighted average of all
126.26 	facilities determined under clause (1), multiplied by the rate
126.27 	increases specified in paragraph (b) or (c), and then dividing
126.28 	the resulting amount by the nursing facility's actual resident
126.29 	days.
126.30 	(e) A nursing facility may apply for the
126.31 	compensation-related payment rate adjustment calculated under
126.32 	this subdivision.  The application must be made to the
126.33 	commissioner and contain a plan by which the nursing facility
126.34 	will distribute the compensation-related portion of the payment
126.35 	rate adjustment to employees of the nursing facility.  For
126.36 	nursing facilities in which the employees are represented by an
127.1 	exclusive bargaining representative, an agreement negotiated and
127.2 	agreed to by the employer and the exclusive bargaining
127.3 	representative constitutes the plan.  For the second rate year,
127.4 	a negotiated agreement constitutes the plan only if the
127.5 	agreement is finalized after the date of enactment of all rate
127.6 	increases for the second rate year.  The commissioner shall
127.7 	review the plan to ensure that the payment rate adjustment per
127.8 	diem is used as provided in paragraphs (a) to (c).  To be
127.9 	eligible, a facility must submit its plan for the compensation
127.10 	distribution by December 31 each year.  A facility may amend its
127.11 	plan for the second rate year by submitting a revised plan by
127.12 	December 31, 2000.  If a facility's plan for compensation
127.13 	distribution is effective for its employees after July 1 of the
127.14 	year that the funds are available, the payment rate adjustment
127.15 	per diem shall be effective the same date as its plan.
127.16 	(f) A copy of the approved distribution plan must be made
127.17 	available to all employees.  This must be done by giving each
127.18 	employee a copy or by posting it in an area of the nursing
127.19 	facility to which all employees have access.  If an employee
127.20 	does not receive the compensation adjustment described in their
127.21 	facility's approved plan and is unable to resolve the problem
127.22 	with the facility's management or through the employee's union
127.23 	representative, the employee may contact the commissioner at an
127.24 	address or phone number provided by the commissioner and
127.25 	included in the approved plan.
127.26 	(g) If the reimbursement system under section 256B.435 is
127.27 	not implemented until July 1, 2001, the salary adjustment per
127.28 	diem authorized in subdivision 2i, paragraph (c), shall continue
127.29 	until June 30, 2001.
127.30 	(h) For the rate year beginning July 1, 1999, the following
127.31 	nursing facilities shall be allowed a rate increase equal to 67
127.32 	percent of the rate increase that would be allowed if
127.33 	subdivision 26, paragraph (a), was not applied:
127.34 	(1) a nursing facility in Carver County licensed for 33
127.35 	nursing home beds and four boarding care beds;
127.36 	(2) a nursing facility in Faribault County licensed for 159
128.1 	nursing home beds on September 30, 1998; and
128.2 	(3) a nursing facility in Houston County licensed for 68
128.3 	nursing home beds on September 30, 1998.
128.4 	(i) For the rate year beginning July 1, 1999, the following
128.5 	nursing facilities shall be allowed a rate increase equal to 67
128.6 	percent of the rate increase that would be allowed if
128.7 	subdivision 26, paragraphs (a) and (b), were not applied:
128.8 	(1) a nursing facility in Chisago County licensed for 135
128.9 	nursing home beds on September 30, 1998; and
128.10 	(2) a nursing facility in Murray County licensed for 62
128.11 	nursing home beds on September 30, 1998.
128.12 	(j) For the rate year beginning July 1, 1999, a nursing
128.13 	facility in Hennepin County licensed for 134 beds on September
128.14 	30, 1998, shall:
128.15 	(1) have the prior year's allowable care-related per diem
128.16 	increased by $3.93 and the prior year's other operating cost per
128.17 	diem increased by $1.69 before adding the inflation in
128.18 	subdivision 26, paragraph (d), clause (2); and
128.19 	(2) be allowed a rate increase equal to 67 percent of the
128.20 	rate increase that would be allowed if subdivision 26,
128.21 	paragraphs (a) and (b), were not applied.
128.22 	The increases provided in paragraphs (h), (i), and (j)
128.23 	shall be included in the facility's total payment rates for the
128.24 	purposes of determining future rates under this section or any
128.25 	other section.
128.26 	(k) For the rate years beginning on or after July 1, 2000,
128.27 	a nursing home facility in Goodhue County that was licensed for
128.28 	104 beds on February 1, 2000, shall have its employee pension
128.29 	benefit costs reported on its Rule 50 cost report treated as
128.30 	PERA contributions for the purpose of computing its payment
128.31 	rates.

128.32 	Sec. 4. Minnesota Statutes 2004, section 256B.431,
128.33 	subdivision 29, is amended to read:
128.34 		Subd. 29.Facility rate increases effective july 1,
128.35 	2000.  Following the determination under subdivision 28 of the
128.36 	payment rate for the rate year beginning July 1, 2000, for a
129.1 	facility in Roseau County licensed for 49 beds, the facility's
129.2 	operating cost per diem shall be increased by the following
129.3 	amounts:
129.4 	(1) case mix class A, $1.97;
129.5 	(2) case mix class B, $2.11;
129.6 	(3) case mix class C, $2.26;
129.7 	(4) case mix class D, $2.39;
129.8 	(5) case mix class E, $2.54;
129.9 	(6) case mix class F, $2.55;
129.10 	(7) case mix class G, $2.66;
129.11 	(8) case mix class H, $2.90;
129.12 	(9) case mix class I, $2.97;
129.13 	(10) case mix class J, $3.10; and
129.14 	(11) case mix class K, $3.36.
129.15 	These increases shall be included in the facility's total
129.16 	payment rates for the purpose of determining future rates under
129.17 	this section or any other section.

129.18 	Sec. 5. Minnesota Statutes 2004, section 256B.431,
129.19 	subdivision 35, is amended to read:
129.20 		Subd. 35.Exclusion of raw food cost adjustment.  For
129.21 	rate years beginning on or after July 1, 2001, in calculating a
129.22 	nursing facility's operating cost per diem for the purposes of
129.23 	constructing an array, determining a median, or otherwise
129.24 	performing a statistical measure of nursing facility payment
129.25 	rates to be used to determine future rate increases under this
129.26 	section, section 256B.434, or any other section, the
129.27 	commissioner shall exclude adjustments for raw food costs under
129.28 	subdivision 2b, paragraph (h), that are related to providing
129.29 	special diets based on religious beliefs. For rates determined
129.30 	under section 256B.441, the amount determined under subdivision
129.31 	2b, paragraph (h), shall not be included in the support services
129.32 	per diem cost determined in section 256B.441, subdivision 45,
129.33 	and shall be added to the external fixed cost costs payment rate
129.34 	determined in section 256B.441, subdivision 52, paragraph (i).

129.35 	Sec. 6. Minnesota Statutes 2004, section 256B.431, is
129.36 	amended by adding a subdivision to read:
130.1 		Subd. 41.Nursing facility rate increases beginning
130.2 	october 1, 2005, and october 1, 2006. (a) For the rate year
130.3 	beginning October 1, 2005, the commissioner shall provide
130.4 	nursing facilities reimbursed under this section or section
130.5 	256B.434 and for rates determined under section 256B.441 with an
130.6 	adjustment to the total operating payment rate of 2.2 percent.
130.7 	For the rate year beginning October 1, 2006, the commissioner
130.8 	shall provide nursing facilities reimbursed under this section
130.9 	or section 256B.434, and for rates determined under section
130.10 	256B.431, with an adjustment to the total operating payment rate
130.11 	of one percent.  At least two-thirds of each year's adjustment
130.12 	must be used for increased costs of employee salaries and
130.13 	benefits and associated costs for FICA, the Medicare tax,
130.14 	workers' compensation premiums, and federal and state
130.15 	unemployment insurance.  Each facility receiving an adjustment
130.16 	shall report to the commissioner, in the form and manner
130.17 	specified by the commissioner, on how the additional funding was
130.18 	used.
130.19 	(b) Costs for salary and employee benefits increases
130.20 	incurred by nursing facilities since July 1, 2003, can be
130.21 	counted towards the amount required to be spent on salaries and
130.22 	benefits under paragraph (a).  These costs should be reported in
130.23 	the form and manner specified by the commissioner along with the
130.24 	information required under paragraph (a).

130.25 	Sec. 7. Minnesota Statutes 2004, section 256B.431, is
130.26 	amended by adding a subdivision to read:
130.27 		Subd. 42.Rate increase for facilities in stearns,
130.28 	sherburne, and benton counties. Effective October 1, 2005,
130.29 	before determining any other rate adjustment effective on that
130.30 	date, operating payment rates of nursing facilities in Stearns
130.31 	County, Sherburne County, and Benton County, reimbursed under
130.32 	this section or section 256B.434, shall be increased to be
130.33 	equal, for a RUGs rate with a weight of 1.00, to the 30th
130.34 	percentile of the geographic group III rate for the same RUGs
130.35 	weight.  The percentage of the operating payment rate for each
130.36 	facility to be case-mix adjusted shall be equal to the
131.1 	percentage that is case-mix adjusted in that facility's
131.2 	September 30, 2005, operating payment rate.  This subdivision
131.3 	shall apply only if it results in a rate increase.  Increases
131.4 	provided by this subdivision shall be added to the rate
131.5 	determined under any new reimbursement system established under
131.6 	section 256B.440.

131.7 	Sec. 8. Minnesota Statutes 2004, section 256B.432,
131.8 	subdivision 1, is amended to read:
131.9 		Subdivision 1.Definitions.  For purposes of this
131.10 	section, the following terms have the meanings given them.
131.11 	(a) "Management agreement" means an agreement in which one
131.12 	or more of the following criteria exist:
131.13 	(1) the central, affiliated, or corporate office has or is
131.14 	authorized to assume day-to-day operational control of the
131.15 	nursing facility for any six-month period within a 24-month
131.16 	period.  "Day-to-day operational control" means that the
131.17 	central, affiliated, or corporate office has the authority to
131.18 	require, mandate, direct, or compel the employees of the nursing
131.19 	facility to perform or refrain from performing certain acts, or
131.20 	to supplant or take the place of the top management of the
131.21 	nursing facility.  "Day-to-day operational control" includes the
131.22 	authority to hire or terminate employees or to provide an
131.23 	employee of the central, affiliated, or corporate office to
131.24 	serve as administrator of the nursing facility;
131.25 	(2) the central, affiliated, or corporate office performs
131.26 	or is authorized to perform two or more of the following:  the
131.27 	execution of contracts; authorization of purchase orders;
131.28 	signature authority for checks, notes, or other financial
131.29 	instruments; requiring the nursing facility to use the group or
131.30 	volume purchasing services of the central, affiliated, or
131.31 	corporate office; or the authority to make annual capital
131.32 	expenditures for the nursing facility exceeding $50,000, or $500
131.33 	per licensed bed, whichever is less, without first securing the
131.34 	approval of the nursing facility board of directors;
131.35 	(3) the central, affiliated, or corporate office becomes or
131.36 	is required to become the licensee under applicable state law;
132.1 	(4) the agreement provides that the compensation for
132.2 	services provided under the agreement is directly related to any
132.3 	profits made by the nursing facility; or
132.4 	(5) the nursing facility entering into the agreement is
132.5 	governed by a governing body that meets fewer than four times a
132.6 	year, that does not publish notice of its meetings, or that does
132.7 	not keep formal records of its proceedings.
132.8 	(b) "Consulting agreement" means any agreement the purpose
132.9 	of which is for a central, affiliated, or corporate office to
132.10 	advise, counsel, recommend, or suggest to the owner or operator
132.11 	of the nonrelated nursing facility measures and methods for
132.12 	improving the operations of the nursing facility.
132.13 	(c) "Nursing facility" means a nursing facility whose
132.14 	medical assistance rates are determined according to section
132.15 	256B.431 with a medical assistance provider agreement that is
132.16 	licensed as a nursing home under chapter 144A or as a boarding
132.17 	care home under sections 144.50 to 144.56.

132.18 	Sec. 9. Minnesota Statutes 2004, section 256B.432,
132.19 	subdivision 2, is amended to read:
132.20 		Subd. 2.Effective date.  For rate years beginning on or
132.21 	after July 1, 1990, the central, affiliated, or corporate office
132.22 	cost allocations in subdivisions 3 to 6 must be used when
132.23 	determining medical assistance rates under section 256B.431,
132.24 	256B.434, or 256B.441.

132.25 	Sec. 10. Minnesota Statutes 2004, section 256B.432, is
132.26 	amended by adding a subdivision to read:
132.27 		Subd. 4a.Allocation; costs allocable on a functional
132.28 	basis. (a) Costs that have not been directly identified must be
132.29 	allocated to nursing facilities on a basis designed to equitably
132.30 	allocate the costs to the nursing facilities or activities
132.31 	receiving the benefits of the costs.  This allocation must be
132.32 	made in a manner reasonably related to the services received by
132.33 	the nursing facilities.  Where practical and the amounts are
132.34 	material, these costs must be allocated on a functional basis.
132.35 	The functions, or cost centers used to allocate central office
132.36 	costs, and the unit bases used to allocate the costs, including
133.1 	those central office costs allocated according to subdivision 5,
133.2 	must be used consistently from one central office accounting
133.3 	period to another.
133.4 	(b) If the central office wishes to change its allocation
133.5 	bases and believes the change will result in more appropriate
133.6 	and more accurate allocations, the central office must make a
133.7 	written request, with its justification, to the commissioner for
133.8 	approval of the change no later than 120 days after the
133.9 	beginning of the central office accounting period to which the
133.10 	change is to apply.  The commissioner's approval of a central
133.11 	office request will be furnished to the central office in
133.12 	writing.  Where the commissioner approves the central office
133.13 	request, the change must be applied to the accounting period for
133.14 	which the request was made, and to all subsequent central office
133.15 	accounting periods unless the commissioner approves a subsequent
133.16 	request for change by the central office.  The effective date of
133.17 	the change will be the beginning of the accounting period for
133.18 	which the request was made.

133.19 	Sec. 11. Minnesota Statutes 2004, section 256B.432,
133.20 	subdivision 5, is amended to read:
133.21 		Subd. 5.Allocation of remaining costs; allocation
133.22 	ratio.  (a) After the costs that can be directly identified
133.23 	according to subdivisions 3 and 4 have been allocated, the
133.24 	remaining central, affiliated, or corporate office costs must be
133.25 	allocated between the nursing facility operations and the other
133.26 	activities or facilities unrelated to the nursing facility
133.27 	operations based on the ratio of total operating
133.28 	costs. However, in the event that these remaining costs are
133.29 	partially attributable to the start-up of home and
133.30 	community-based services intended to fill a gap identified by
133.31 	the local agency, the facility may assign these remaining costs
133.32 	to the appropriate cost category of the facility for a period
133.33 	not to exceed two years.
133.34 	(b) For purposes of allocating these remaining central,
133.35 	affiliated, or corporate office costs, the numerator for the
133.36 	allocation ratio shall be determined as follows:
134.1 	(1) for nursing facilities that are related organizations
134.2 	or are controlled by a central, affiliated, or corporate office
134.3 	under a management agreement, the numerator of the allocation
134.4 	ratio shall be equal to the sum of the total operating costs
134.5 	incurred by each related organization or controlled nursing
134.6 	facility;
134.7 	(2) for a central, affiliated, or corporate office
134.8 	providing goods or services to related organizations that are
134.9 	not nursing facilities, the numerator of the allocation ratio
134.10 	shall be equal to the sum of the total operating costs incurred
134.11 	by the nonnursing facility related organizations;
134.12 	(3) for a central, affiliated, or corporate office
134.13 	providing goods or services to unrelated nursing facilities
134.14 	under a consulting agreement, the numerator of the allocation
134.15 	ratio shall be equal to the greater of directly identified
134.16 	central, affiliated, or corporate costs or the contracted
134.17 	amount; or
134.18 	(4) for business activities that involve the providing of
134.19 	goods or services to unrelated parties which are not nursing
134.20 	facilities, the numerator of the allocation ratio shall be equal
134.21 	to the greater of directly identified costs or revenues
134.22 	generated by the activity or function.
134.23 	(c) The denominator for the allocation ratio is the sum of
134.24 	the numerators in paragraph (b), clauses (1) to (4).

134.25 	Sec. 12. Minnesota Statutes 2004, section 256B.432, is
134.26 	amended by adding a subdivision to read:
134.27 		Subd. 6a.Related organization costs. (a) Costs
134.28 	applicable to services, capital assets, and supplies directly or
134.29 	indirectly furnished to the nursing facility by any related
134.30 	organization are includable in the allowable cost of the nursing
134.31 	facility at the purchase price paid by the related organization
134.32 	for capital assets or supplies and at the cost incurred by the
134.33 	related organization for the provision of services to the
134.34 	nursing facility if these prices or costs do not exceed the
134.35 	price of comparable services, capital assets, or supplies that
134.36 	could be purchased elsewhere.  For this purpose, the related
135.1 	organization's costs must not include an amount for markup or
135.2 	profit.
135.3 	(b) If the related organization in the normal course of
135.4 	business sells services, capital assets, or supplies to
135.5 	nonrelated organizations, the cost to the nursing facility shall
135.6 	be the nonrelated organization's price provided that sales to
135.7 	nonrelated organizations constitute at least 50 percent of total
135.8 	annual sales of similar services, capital assets, or supplies.

135.9 	Sec. 13. Minnesota Statutes 2004, section 256B.434,
135.10 	subdivision 3, is amended to read:
135.11 		Subd. 3.Duration and termination of contracts.  (a)
135.12 	Subject to available resources, the commissioner may begin to
135.13 	execute contracts with nursing facilities November 1, 1995.
135.14 	(b) All contracts entered into under this section are for a
135.15 	term of one year not to exceed four years.  Either party may
135.16 	terminate a contract at any time without cause by providing 90
135.17 	calendar days advance written notice to the other party.  The
135.18 	decision to terminate a contract is not appealable.
135.19 	Notwithstanding section 16C.05, subdivision 2, paragraph (a),
135.20 	clause (5), the contract shall be renegotiated for
135.21 	additional one-year four-year terms, unless either party
135.22 	provides written notice of termination.  The provisions of the
135.23 	contract shall be renegotiated annually at a minimum of every
135.24 	four years by the parties prior to the expiration date of the
135.25 	contract.  The parties may voluntarily renegotiate the terms of
135.26 	the contract at any time by mutual agreement.
135.27 	(c) If a nursing facility fails to comply with the terms of
135.28 	a contract, the commissioner shall provide reasonable notice
135.29 	regarding the breach of contract and a reasonable opportunity
135.30 	for the facility to come into compliance.  If the facility fails
135.31 	to come into compliance or to remain in compliance, the
135.32 	commissioner may terminate the contract.  If a contract is
135.33 	terminated, the contract payment remains in effect for the
135.34 	remainder of the rate year in which the contract was terminated,
135.35 	but in all other respects the provisions of this section do not
135.36 	apply to that facility effective the date the contract is
136.1 	terminated.  The contract shall contain a provision governing
136.2 	the transition back to the cost-based reimbursement system
136.3 	established under section 256B.431 and Minnesota Rules, parts
136.4 	9549.0010 to 9549.0080.  A contract entered into under this
136.5 	section may be amended by mutual agreement of the parties.

136.6 	Sec. 14. Minnesota Statutes 2004, section 256B.434,
136.7 	subdivision 4, is amended to read:
136.8 		Subd. 4.Alternate rates for nursing facilities.  (a) For
136.9 	nursing facilities which have their payment rates determined
136.10 	under this section rather than section 256B.431, the
136.11 	commissioner shall establish a rate under this subdivision.  The
136.12 	nursing facility must enter into a written contract with the
136.13 	commissioner.
136.14 	(b) A nursing facility's case mix payment rate for the
136.15 	first rate year of a facility's contract under this section is
136.16 	the payment rate the facility would have received under section
136.17 	256B.431.
136.18 	(c) A nursing facility's case mix payment rates for the
136.19 	second and subsequent years of a facility's contract under this
136.20 	section are the previous rate year's contract payment rates plus
136.21 	an inflation adjustment and, for facilities reimbursed under
136.22 	this section or section 256B.431, an adjustment to include the
136.23 	cost of any increase in Health Department licensing fees for the
136.24 	facility taking effect on or after July 1, 2001.  The index for
136.25 	the inflation adjustment must be based on the change in the
136.26 	Consumer Price Index-All Items (United States City average)
136.27 	(CPI-U) forecasted by the commissioner of finance's national
136.28 	economic consultant, as forecasted in the fourth quarter of the
136.29 	calendar year preceding the rate year.  The inflation adjustment
136.30 	must be based on the 12-month period from the midpoint of the
136.31 	previous rate year to the midpoint of the rate year for which
136.32 	the rate is being determined.  For the rate years beginning on
136.33 	July 1, 1999, July 1, 2000, July 1, 2001, July 1, 2002, July 1,
136.34 	2003, and July 1, 2004, July 1, 2005, July 1, 2006, July 1,
136.35 	2007, July 1, 2008, and July 1, 2009, this paragraph shall apply
136.36 	only to the property-related payment rate, except that
137.1 	adjustments to include the cost of any increase in Health
137.2 	Department licensing fees taking effect on or after July 1,
137.3 	2001, shall be provided. Beginning in 2005, adjustment to the
137.4 	property payment rate under this section and section 256B.431
137.5 	shall be effective on October 1.In determining the amount of
137.6 	the property-related payment rate adjustment under this
137.7 	paragraph, the commissioner shall determine the proportion of
137.8 	the facility's rates that are property-related based on the
137.9 	facility's most recent cost report. Facilities reimbursed under
137.10 	this section shall be allowed to receive a property rate
137.11 	adjustment for building projects under section 144A.071,
137.12 	subdivision 2.
137.13 	(d) The commissioner shall develop additional
137.14 	incentive-based payments of up to five percent above the
137.15 	standard contract rate for achieving outcomes specified in each
137.16 	contract.  The specified facility-specific outcomes must be
137.17 	measurable and approved by the commissioner.  The commissioner
137.18 	may establish, for each contract, various levels of achievement
137.19 	within an outcome.  After the outcomes have been specified the
137.20 	commissioner shall assign various levels of payment associated
137.21 	with achieving the outcome.  Any incentive-based payment cancels
137.22 	if there is a termination of the contract.  In establishing the
137.23 	specified outcomes and related criteria the commissioner shall
137.24 	consider the following state policy objectives:
137.25 	(1) improved cost effectiveness and quality of life as
137.26 	measured by improved clinical outcomes;
137.27 	(2) successful diversion or discharge to community
137.28 	alternatives;
137.29 	(3) decreased acute care costs;
137.30 	(4) improved consumer satisfaction;
137.31 	(5) the achievement of quality; or
137.32 	(6) any additional outcomes proposed by a nursing facility
137.33 	that the commissioner finds desirable.

137.34 	Sec. 15. Minnesota Statutes 2004, section 256B.434,
137.35 	subdivision 4a, is amended to read:
137.36 		Subd. 4a.Facility rate increases.  For the rate year
138.1 	beginning July 1, 1999, the nursing facilities described in
138.2 	clauses (1) to (5) shall receive the rate increases indicated.
138.3 	The increases provided under this subdivision shall be included
138.4 	in the facility's total payment rates for the purpose of
138.5 	determining future rates under this section or any other section:
138.6 	(1) a nursing facility in Becker County licensed for 102
138.7 	nursing home beds on September 30, 1998, shall receive an
138.8 	increase of $1.30 in its case mix class A payment rate; an
138.9 	increase of $1.33 in its case mix class B payment rate; an
138.10 	increase of $1.36 in its case mix class C payment rate; an
138.11 	increase of $1.39 in its case mix class D payment rate; an
138.12 	increase of $1.42 in its case mix class E payment rate; an
138.13 	increase of $1.42 in its case mix class F payment rate; an
138.14 	increase of $1.45 in its case mix class G payment rate; an
138.15 	increase of $1.49 in its case mix class H payment rate; an
138.16 	increase of $1.51 in its case mix class I payment rate; an
138.17 	increase of $1.54 in its case mix class J payment rate; and an
138.18 	increase of $1.59 in its case mix class K payment rate;
138.19 	(2) a nursing facility in Chisago County licensed for 101
138.20 	nursing home beds on September 30, 1998, shall receive an
138.21 	increase of $3.67 in each case mix payment rate;
138.22 	(3) a nursing facility in Canby, licensed for 75 beds shall
138.23 	have its property-related per diem rate increased by $1.21.
138.24 	This increase shall be recognized in the facility's contract
138.25 	payment rate under this section;
138.26 	(4) a nursing facility in Golden Valley with all its beds
138.27 	licensed to provide residential rehabilitative services to young
138.28 	adults under Minnesota Rules, parts 9570.2000 to 9570.3400,
138.29 	shall have the payment rate computed according to this section
138.30 	increased by $14.83; and
138.31 	(5) a county-owned 130-bed nursing facility in Park Rapids
138.32 	shall have its per diem contract payment rate increased by $1.02
138.33 	for costs related to compliance with comparable worth
138.34 	requirements.

138.35 	Sec. 16. Minnesota Statutes 2004, section 256B.434,
138.36 	subdivision 4b, is amended to read:
139.1 		Subd. 4b.Facility rate increases effective july 1,
139.2 	2000.  For the rate year beginning July 1, 2000, the nursing
139.3 	facilities described in clauses (1) to (6) shall receive the
139.4 	rate increases indicated.  The increases under this subdivision
139.5 	shall be added following the determination under section
139.6 	256B.431, subdivision 28, of the payment rate for the rate year
139.7 	beginning July 1, 2000, and shall be included in the facility's
139.8 	total payment rates for the purposes of determining future rates
139.9 	under this section or any other section:
139.10 	(1) a nursing facility in Hennepin County licensed for 290
139.11 	beds shall receive an operating cost per diem increase of 5.9
139.12 	percent, provided that the facility delicenses, decertifies, or
139.13 	places on layaway status, if that status is otherwise permitted
139.14 	by law, 70 beds;
139.15 	(2) a nursing facility in Goodhue County licensed for 84
139.16 	beds shall receive an increase of $1.54 in each case mix payment
139.17 	rate;
139.18 	(3) a nursing facility located in Rochester and licensed
139.19 	for 103 beds on January 1, 2000, shall receive an increase in
139.20 	its case mix resident class A payment of $3.78, and an increase
139.21 	in the payment rate for all other case mix classes of that
139.22 	amount multiplied by the class weight for that case mix class
139.23 	established in Minnesota Rules, part 9549.0058, subpart 3;
139.24 	(4) a nursing facility in Wright County licensed for 154
139.25 	beds shall receive an increase of $2.03 in each case mix payment
139.26 	rate to be used for employee wage and benefit enhancements;
139.27 	(5) a facility in Todd County licensed for 78 beds, shall
139.28 	have its operating cost per diem increased by the following
139.29 	amounts:
139.30 	(i) case mix class A, $1.16;
139.31 	(ii) case mix class B, $1.50;
139.32 	(iii) case mix class C, $1.89;
139.33 	(iv) case mix class D, $2.26;
139.34 	(v) case mix class E, $2.63;
139.35 	(vi) case mix class F, $2.65;
139.36 	(vii) case mix class G, $2.96;
140.1 	(viii) case mix class H, $3.55;
140.2 	(ix) case mix class I, $3.76;
140.3 	(x) case mix class J, $4.08; and
140.4 	(xi) case mix class K, $4.76; and
140.5 	(6) a nursing facility in Pine City that decertified 22
140.6 	beds in calendar year 1999 shall have its property-related per
140.7 	diem payment rate increased by $1.59.

140.8 	Sec. 17. Minnesota Statutes 2004, section 256B.434,
140.9 	subdivision 4c, is amended to read:
140.10 		Subd. 4c.Facility rate increases effective january 1,
140.11 	2002.  For the rate period beginning January 1, 2002, and for
140.12 	the rate year beginning July 1, 2002, a nursing facility in
140.13 	Morrison County licensed for 83 beds as of March 1, 2001, shall
140.14 	receive an increase of $2.54 in each case mix payment rate to
140.15 	offset property tax payments due as a result of the facility's
140.16 	conversion from nonprofit to for-profit status.  The increase
140.17 	under this subdivision shall be added following the
140.18 	determination under this chapter of the payment rate for the
140.19 	rate year beginning July 1, 2001, and shall be included in the
140.20 	facility's total payment rates for the purposes of determining
140.21 	future rates under this section or any other section.

140.22 	Sec. 18. Minnesota Statutes 2004, section 256B.434,
140.23 	subdivision 4d, is amended to read:
140.24 		Subd. 4d.Facility rate increases effective july 1,
140.25 	2001.  For the rate year beginning July 1, 2001, a nursing
140.26 	facility in Hennepin County licensed for 302 beds shall receive
140.27 	an increase of 29 cents in each case mix payment rate to correct
140.28 	an error in the cost-reporting system that occurred prior to the
140.29 	date that the facility entered the alternative payment
140.30 	demonstration project.  The increase under this subdivision
140.31 	shall be added following the determination under this chapter of
140.32 	the payment rate for the rate year beginning July 1, 2001, and
140.33 	shall be included in the facility's total payment rates for the
140.34 	purposes of determining future rates under this section or any
140.35 	other section.

140.36 	Sec. 19. Minnesota Statutes 2004, section 256B.434, is
141.1 	amended by adding a subdivision to read:
141.2 		Subd. 18.Phase-out of alternative payment system
141.3 	contracts. Nursing facilities that have entered into a contract
141.4 	with the commissioner under the provisions of this section will
141.5 	cease their contractual agreement with the commissioner
141.6 	effective October 1, 2009.  Nursing facilities with a contract
141.7 	in effect on September 30, 2006, shall be paid the contract
141.8 	payment rate for the remainder of the phase-in period according
141.9 	to the provisions of section 256B.441, subdivision 53.

141.10 	Sec. 20. Minnesota Statutes 2004, section 256B.434, is
141.11 	amended by adding a subdivision to read:
141.12 		Subd. 19.Phase-out of rule 50 property rates. Effective
141.13 	October 1, 2006, payment rates for property shall no longer be
141.14 	determined under section 256B.431.  A facility that does not
141.15 	have a contract with the commissioner under this section shall
141.16 	be construed as being reimbursed under neither section 256B.431
141.17 	nor this section.

141.18 	Sec. 21. Minnesota Statutes 2004, section 256B.438,
141.19 	subdivision 3, is amended to read:
141.20 		Subd. 3.Case mix indices.  (a) The commissioner of human
141.21 	services shall assign a case mix index to each resident class
141.22 	based on the Centers for Medicare and Medicaid Services staff
141.23 	time measurement study and adjusted for Minnesota-specific wage
141.24 	indices.  The case mix indices assigned to each resident class
141.25 	shall be published in the Minnesota State Register at least 120
141.26 	days prior to the implementation of the 34 group, RUG-III
141.27 	resident classification system.
141.28 	(b) An index maximization approach shall be used to
141.29 	classify residents.
141.30 	(c) After implementation of the revised case mix system,
141.31 	the commissioner of human services may annually rebase case mix
141.32 	indices and base rates using more current data on average wage
141.33 	rates and staff time measurement studies.  This rebasing shall
141.34 	be calculated under subdivision 7, paragraph (b).  The
141.35 	commissioner shall publish in the Minnesota State Register
141.36 	adjusted case mix indices at least 45 days prior to the
142.1 	effective date of the adjusted case mix indices. In the event
142.2 	that new case mix indices are implemented together with a new
142.3 	payment system, rebasing of rates under subdivision 7, paragraph
142.4 	(b), shall not apply.

142.5 	Sec. 22. [256B.441] NURSING FACILITY REIMBURSEMENT SYSTEM
142.6 	EFFECTIVE OCTOBER 1, 2005.
142.7 		Subdivision 1.In general. (a) The commissioner shall
142.8 	establish a value-based nursing facility reimbursement system
142.9 	which will provide facility-specific, prospective rates for
142.10 	nursing facilities participating in the medical assistance
142.11 	program.  The rates shall be determined using an annual
142.12 	statistical and cost report filed by each nursing facility.  The
142.13 	total payment rate shall be composed of four rate components:
142.14 	direct care services, support services, external fixed, and
142.15 	property-related rate components.  The payment rate shall be
142.16 	derived from statistical measures of actual costs incurred in
142.17 	facility operation of nursing facilities.  From this cost basis,
142.18 	the components of the total payment rate shall be adjusted for
142.19 	quality of services provided, recognition of staffing levels,
142.20 	geographic variation in labor costs, and resident acuity.
142.21 	(b) Rates shall be rebased annually.  Each cost reporting
142.22 	year shall begin on October 1 and end on the following September
142.23 	30.  Beginning in 2006, a statistical and cost report shall be
142.24 	filed by each nursing facility by January 15.  Notice of rates
142.25 	shall be distributed by August 15 and the rates shall go into
142.26 	effect on October 1 for one year.
142.27 	(c)  The commissioner shall begin to phase in the new
142.28 	reimbursement system beginning October 1, 2006.  Full phase-in
142.29 	shall be completed by October 1, 2010.
142.30 		Subd. 2.Definitions. For purposes of this section, the
142.31 	terms in subdivisions 3 to 42 have the meanings given unless
142.32 	otherwise provided for in this section.
142.33 		Subd. 3.Active beds. "Active beds" means licensed beds
142.34 	that are not currently in layaway status.
142.35 		Subd. 4.Activities costs. "Activities costs" means the
142.36 	costs for the salaries and wages of the supervisor and other
143.1 	activities workers, associated fringe benefits and payroll
143.2 	taxes, supplies, services, and consultants.
143.3 		Subd. 5.Administrative costs. "Administrative costs"
143.4 	means the direct costs for administering the overall activities
143.5 	of the nursing home.  These costs include salaries and wages of
143.6 	the administrator, assistant administrator, business office
143.7 	employees, security guards, and associated fringe benefits and
143.8 	payroll taxes, fees, contracts, or purchases related to business
143.9 	office functions, licenses, and permits except as provided in
143.10 	the external fixed costs category, employee recognition, travel
143.11 	including meals and lodging, training, voice and data
143.12 	communication or transmission, office supplies, liability
143.13 	insurance and other forms of insurance not designated to other
143.14 	areas, personnel recruitment, legal services, accounting
143.15 	services, management or business consultants, data processing,
143.16 	central or home office costs, business meetings and seminars,
143.17 	postage, fees for professional organizations, subscriptions,
143.18 	security services, advertising, board of director's fees,
143.19 	working capital interest expense, and bad debts and bad debt
143.20 	collection fees.
143.21 		Subd. 6.Allowed costs. "Allowed costs" means the
143.22 	amounts reported by the facility which are necessary for the
143.23 	operation of the facility and the care of residents and which
143.24 	are reviewed by the department for accuracy, reasonableness, and
143.25 	compliance with this section and generally accepted accounting
143.26 	principles.
143.27 		Subd. 7.Center for medicare and medicaid
143.28 	services. "Center for Medicare and Medicaid services" means the
143.29 	federal agency, in the United States Department of Health and
143.30 	Human Services that administers Medicaid, also referred to as
143.31 	"CMS." 
143.32 		Subd. 8.Commissioner. "Commissioner" means the
143.33 	commissioner of human services unless specified otherwise.
143.34 		Subd. 9.Desk audit. "Desk audit" means the
143.35 	establishment of the payment rate based on the commissioner's
143.36 	review and analysis of required reports, supporting
144.1 	documentation, and work sheets submitted by the nursing facility.
144.2 		Subd. 10.Dietary costs. "Dietary costs" means the costs
144.3 	for the salaries and wages of the dietary supervisor,
144.4 	dietitians, chefs, cooks, dishwashers, and other employees
144.5 	assigned to the kitchen and dining room, and associated fringe
144.6 	benefits and payroll taxes.  Dietary costs also includes the
144.7 	salaries or fees of dietary consultants, direct costs of raw
144.8 	food (both normal and special diet food), dietary supplies, and
144.9 	food preparation and serving.  Also included are special dietary
144.10 	supplements used for tube feeding or oral feeding, such as
144.11 	elemental high nitrogen diet, even if written as a prescription
144.12 	item by a physician.
144.13 		Subd. 11.Direct care costs category. "Direct care costs
144.14 	category" means costs for nursing services, activities, and
144.15 	social services.
144.16 		Subd. 12.Economic development regions. "Economic
144.17 	development regions" are as defined in section 462.385,
144.18 	subdivision 1.
144.19 		Subd. 13.External fixed costs category. "External fixed
144.20 	costs category" means costs related to the nursing home
144.21 	surcharge under section 256.9657, subdivision 1; licensure fees
144.22 	under section 144.122; long-term care consultation fees under
144.23 	section 256B.0911, subdivision 6; family advisory council fee
144.24 	under section 144A.35; scholarships under section 256B.431,
144.25 	subdivision 36; planned closure rate adjustments under section
144.26 	256B.437; property taxes and property insurance; and PERA.
144.27 	Subd. 14.[FACILITY AVERAGE CASE MIX INDEX
144.28 	(CMI).] "Facility average case mix index" or "CMI" means a
144.29 	numerical value score that describes the relative resource use
144.30 	for all residents within the groups under the resource
144.31 	utilization group (RUG-III) classification system prescribed by
144.32 	the commissioner based on an assessment of each resident.  The
144.33 	facility average CMI shall be computed as the standardized days
144.34 	divided by total days for all residents in the facility.
144.35 		Subd. 15.Field audit. "Field audit" means the
144.36 	examination, verification, and review of the financial records,
145.1 	statistical records, and related supporting documentation on the
145.2 	nursing home and any related organization.
145.3 		Subd. 16.Final rate. "Final rate" means the rate
145.4 	established after any adjustment by the commissioner, including,
145.5 	but not limited to, adjustments resulting from audits.
145.6 		Subd. 17.Fringe benefit costs. "Fringe benefit costs"
145.7 	means the costs for group life, health, dental, workers'
145.8 	compensation, and other employee insurances and pension,
145.9 	profit-sharing, and retirement plans for which the employer pays
145.10 	all or a portion of the costs and that are available to at least
145.11 	all employees who work at least 20 hours per week.
145.12 		Subd. 18.Generally accepted accounting principles.
 145.13 	"Generally Accepted Accounting Principles" means the body of
145.14 	pronouncements adopted by the American Institute of Certified
145.15 	Public Accountants regarding proper accounting procedures,
145.16 	guidelines, and rules.
145.17 		Subd. 19.Hospital-attached nursing facility status. (a)
145.18 	For the purpose of setting rates under this section, for rate
145.19 	years beginning after September 30, 2006, "hospital-attached
145.20 	nursing facility" means a nursing facility which meets the
145.21 	requirements of clauses (1) and (2); or (3); or (4), or had
145.22 	hospital-attached status prior to January 1, 1995, and has been
145.23 	recognized as having hospital-attached status by CMS
145.24 	continuously since that date:
145.25 	(1) the nursing facility is recognized by the federal
145.26 	Medicare program to be a hospital-based nursing facility;
145.27 	(2) the hospital and nursing facility are physically
145.28 	attached or connected by a corridor;
145.29 	(3) a nursing facility and hospital, which have applied for
145.30 	hospital-based nursing facility status under the federal
145.31 	Medicare program during the reporting year, shall be considered
145.32 	a hospital-attached nursing facility for purposes of setting
145.33 	payment rates under this section.  The nursing facility must
145.34 	file its cost report for that reporting year using Medicare
145.35 	principles and Medicare's recommended cost allocation methods
145.36 	had the Medicare program's hospital-based nursing facility
146.1 	status been granted to the nursing facility.  For each
146.2 	subsequent rate year, the nursing facility must meet the
146.3 	definition requirements in clauses (1) and (2).  If the nursing
146.4 	facility is denied hospital-based nursing facility status under
146.5 	the Medicare program, the nursing facility's payment rates for
146.6 	the rate years the nursing facility was considered to be a
146.7 	hospital-attached nursing facility according to this paragraph
146.8 	shall be recalculated treating the nursing facility as a
146.9 	non-hospital-attached nursing facility;
146.10 	(4) if a nonprofit or community-operated hospital and
146.11 	attached nursing facility suspend operation of the hospital, the
146.12 	remaining nursing facility must be allowed to continue its
146.13 	status as hospital-attached for rate calculations in the three
146.14 	rate years subsequent to the one in which the hospital ceased
146.15 	operations.
146.16 	(b) The nursing facility's cost report filed as
146.17 	hospital-attached facility shall use the same cost allocation
146.18 	principles and methods used in the reports filed for the
146.19 	Medicare program.  Direct identification of costs to the nursing
146.20 	facility cost center will be permitted only when the comparable
146.21 	hospital costs have also been directly identified to a cost
146.22 	center which is not allocated to the nursing facility.
146.23 		Subd. 20.Housekeeping costs. "Housekeeping costs" means
146.24 	the costs for the salaries and wages of the housekeeping
146.25 	supervisor, housekeepers, and other cleaning employees and
146.26 	associated fringe benefits and payroll taxes.  It also includes
146.27 	the cost of housekeeping supplies, including cleaning and
146.28 	lavatory supplies and contract services.
146.29 		Subd. 21.Labor-related portion. The "labor-related
146.30 	portion" of direct care costs and of support service costs shall
146.31 	be that portion of costs that is attributable to wages for all
146.32 	compensated hours, payroll taxes, and fringe benefits.
146.33 		Subd. 22.Laundry costs. "Laundry costs" means the costs
146.34 	for the salaries and wages of the laundry supervisor and other
146.35 	laundry employees, associated fringe benefits, and payroll
146.36 	taxes.  It also includes the costs of linen and bedding, the
147.1 	laundering of resident clothing, laundry supplies, and contract
147.2 	services.
147.3 		Subd. 23.Licensee. "Licensee" means the individual or
147.4 	organization listed on the form issued by the Minnesota
147.5 	Department of Health under chapter 144A or sections 144.50 to
147.6 	144.56.
147.7 		Subd. 24.Maintenance and plant operations
147.8 	costs. "Maintenance and plant operations costs" means the costs
147.9 	for the salaries and wages of the maintenance supervisor,
147.10 	engineers, heating-plant employees, and other maintenance
147.11 	employees and associated fringe benefits and payroll taxes.  It
147.12 	also includes direct costs for maintenance and operation of the
147.13 	building and grounds, including fuel, electricity, medical waste
147.14 	and garbage removal, water, sewer, supplies, tools, and repairs.
147.15 		Subd. 25.Normalized direct care costs per
147.16 	day. "Normalized direct care costs per day" means direct care
147.17 	costs divided by standardized days.  It is the costs per day for
147.18 	direct care services associated with a RUG's index of 1.00.
147.19 		Subd. 26.Nursing costs. "Nursing costs" means the costs
147.20 	for the wages of nursing administration, staff education, and
147.21 	direct care registered nurses, licensed practical nurses,
147.22 	certified nursing assistants, and trained medication aides;
147.23 	mental health workers and other direct care employees, and
147.24 	associated fringe benefits and payroll taxes; services from a
147.25 	supplemental nursing services agency and supplies that are
147.26 	stocked at nursing stations or on the floor and distributed or
147.27 	used individually, including:  alcohol, applicators, cotton
147.28 	balls, incontinence pads, disposable ice bags, dressings,
147.29 	bandages, water pitchers, tongue depressors, disposable gloves,
147.30 	enemas, enema equipment, soap, medication cups, diapers, plastic
147.31 	waste bags, sanitary products, thermometers, hypodermic needles
147.32 	and syringes, and clinical reagents or similar diagnostic
147.33 	agents, and drugs which are not paid on a separate fee schedule
147.34 	by the medical assistance program or any other payer.
147.35 		Subd. 27.Nursing facility. "Nursing facility" means a
147.36 	facility with a medical assistance provider agreement that is
148.1 	licensed as a nursing home under chapter 144A or as a boarding
148.2 	care home under sections 144.50 to 144.56.
148.3 		Subd. 28.Operating costs. "Operating costs" means costs
148.4 	associated with the direct care costs category and the support
148.5 	services costs category.
148.6 		Subd. 29.Payroll taxes. "Payroll taxes" means the costs
148.7 	for the employer's share of the FICA and Medicare withholding
148.8 	tax, and state and federal unemployment compensation taxes.
148.9 		Subd. 30.Peer groups. Facilities shall be classified
148.10 	into three groups, called "peer groups," which shall consist of:
148.11 	(1) C&NC/Short Stay/R80 - facilities that have three or
148.12 	more admissions per bed per year, are hospital-attached, or are
148.13 	licensed under Minnesota Rules, parts 9570.2000 to 9570.3600;
148.14 	(2) boarding care homes - facilities that have more than 50
148.15 	percent of their beds licensed as boarding care homes; and 
148.16 	(3) standard - all other facilities.
148.17 		Subd. 31.Prior rate-setting method. "Prior rate-setting
148.18 	method" means the rate determination process in effect prior to
148.19 	October 1, 2006, under Minnesota Rules and Minnesota Statutes.
148.20 		Subd. 32.Private paying resident. "Private paying
148.21 	resident" means a nursing facility resident who is not a medical
148.22 	assistance recipient and whose payment rate is not established
148.23 	by another third party, including the veterans administration or
148.24 	Medicare.
148.25 		Subd. 33.Rate year. "Rate year" means the 12-month
148.26 	period beginning on October 1 following the second most recent
148.27 	reporting year.
148.28 		Subd. 34.Related organization. "Related organization"
148.29 	means a person that furnishes goods or services to a nursing
148.30 	facility and that is a close relative of a nursing facility, an
148.31 	affiliate of a nursing facility, a close relative of an
148.32 	affiliate of a nursing facility, or an affiliate of a close
148.33 	relative of an affiliate of a nursing facility.  As used in this
148.34 	subdivision, paragraphs (a) to (d) apply:
148.35 	(a) "Affiliate" means a person that directly, or indirectly
148.36 	through one or more intermediaries, controls or is controlled
149.1 	by, or is under common control with another person.
149.2 	(b) "Person" means an individual, a corporation, a
149.3 	partnership, an association, a trust, an unincorporated
149.4 	organization, or a government or political subdivision.
149.5 	(c) "Close relative of an affiliate of a nursing facility"
149.6 	means an individual whose relationship by blood, marriage, or
149.7 	adoption to an individual who is an affiliate of a nursing
149.8 	facility is no more remote than first cousin.
149.9 	(d) "Control" including the terms "controlling,"
149.10 	"controlled by," and "under common control with" means the
149.11 	possession, direct or indirect, of the power to direct or cause
149.12 	the direction of the management, operations, or policies of a
149.13 	person, whether through the ownership of voting securities, by
149.14 	contract, or otherwise, or to influence in any manner other than
149.15 	through an arms length, legal transaction.
149.16 		Subd. 35.Reporting period. "Reporting period" means the
149.17 	one-year period beginning on October 1 and ending on the
149.18 	following September 30 during which incurred costs are
149.19 	accumulated and then reported on the statistical and cost report.
149.20 		Subd. 36.Resident day or actual resident day. "Resident
149.21 	day" or "actual resident day" means a day for which nursing
149.22 	services are rendered and billable, or a day for which a bed is
149.23 	held and billed.  The day of admission is considered a resident
149.24 	day, regardless of the time of admission.  The day of discharge
149.25 	is not considered a resident day, regardless of the time of
149.26 	discharge.
149.27 		Subd. 37.Salaries and wages. "Salaries and wages" means
149.28 	amounts earned by and paid to employees or on behalf of
149.29 	employees to compensate for necessary services provided.
149.30 	Salaries and wages include accrued vested vacation and accrued
149.31 	vested sick leave pay.  Salaries and wages must be paid within
149.32 	30 days of the end of the reporting period in order to be
149.33 	allowable costs of the reporting period.
149.34 		Subd. 38.Social services costs. "Social services costs"
149.35 	means the costs for the salaries and wages of the supervisor and
149.36 	other social work employees, associated fringe benefits and
150.1 	payroll taxes, supplies, services, and consultants.
150.2 		Subd. 39.Stakeholders. "Stakeholders" means individuals
150.3 	and representatives of organizations interested in long-term
150.4 	care, including nursing homes, consumers, and labor unions.
150.5 		Subd. 40.Standardized days. "Standardized days" means
150.6 	the sum of resident days by case mix category multiplied by the
150.7 	RUG index for each category.
150.8 		Subd. 41.Statistical and cost report. "Statistical and
150.9 	cost report" means the forms supplied by the commissioner for
150.10 	annual reporting of nursing facility expenses and statistics,
150.11 	including instructions and definitions of items in the report.
150.12 		Subd. 42.Support services costs category. "Support
150.13 	services costs category" means the costs for dietary,
150.14 	housekeeping, laundry, maintenance, and administration.
150.15 		Subd. 43.Reporting of statistical and cost
150.16 	information. (a) Beginning in 2006, all nursing facilities
150.17 	shall provide information annually to the commissioner on a form
150.18 	and in a manner determined by the commissioner.  The
150.19 	commissioner may also require nursing facilities to provide
150.20 	statistical and cost information for a subset of the items in
150.21 	the annual report on a semiannual basis.  Nursing facilities
150.22 	shall report only costs directly related to the operation of the
150.23 	nursing facility.  The facility shall not include costs which
150.24 	are separately reimbursed by residents, medical assistance, or
150.25 	other payors.  Allocations of costs from central, affiliated, or
150.26 	corporate office and related organization transactions shall be
150.27 	reported according to section 256B.432.  The commissioner may
150.28 	grant to facilities one extension of up to 15 days for the
150.29 	filing of this report if the extension is requested by December
150.30 	15 and the commissioner determines that the extension will not
150.31 	prevent the commissioner from establishing rates in a timely
150.32 	manner required by law.  The commissioner may separately require
150.33 	facilities to submit in a manner specified by the commissioner
150.34 	documentation of statistical and cost information included in
150.35 	the report to ensure accuracy in establishing payment rates and
150.36 	to perform audit and appeal review functions under this section.
151.1 	Facilities shall retain all records necessary to document
151.2 	statistical and cost information on the report for a period of
151.3 	no less than seven years.  The commissioner may amend
151.4 	information in the report according to subdivision 54.  The
151.5 	commissioner may reject a report filed by a nursing facility
151.6 	under this section if the commissioner determines that the
151.7 	report has been filed in a form that is incomplete or inaccurate
151.8 	and the information is insufficient to establish accurate
151.9 	payment rates.  In the event that a complete report is not
151.10 	submitted in a timely manner, the commissioner shall reduce the
151.11 	reimbursement payments to a nursing facility to 85 percent of
151.12 	amounts due until the information is filed.  The release of
151.13 	withheld payments shall be retroactive for no more than 90
151.14 	days.  A nursing facility that does not submit a report or whose
151.15 	report is filed in a timely manner but determined to be
151.16 	incomplete shall be given written notice that a payment
151.17 	reduction is to be implemented and allowed ten days to complete
151.18 	the report prior to any payment reduction.  The commissioner may
151.19 	delay the payment withhold under exceptional circumstances to be
151.20 	determined at the sole discretion of the commissioner.
151.21 	(b) Nursing facilities may, within 12 months of the due
151.22 	date of a statistical and cost report, file an amendment when
151.23 	errors or omissions in the annual statistical and cost report
151.24 	are discovered and an amendment would result in a rate increase
151.25 	of at least 0.15 percent of the statewide weighted average
151.26 	operating payment rate and shall, at any time, file an amendment
151.27 	which would result in a rate reduction of at least 0.15 percent
151.28 	of the statewide weighted average operating payment rate.  The
151.29 	commissioner shall make retroactive adjustments to the total
151.30 	payment rate of a nursing facility if an amendment is accepted.
151.31 	Where a retroactive adjustment is to be made as a result of an
151.32 	amended report, audit findings, or other determination of an
151.33 	incorrect payment rate, the commissioner may settle the payment
151.34 	error through a negotiated agreement with the facility and a
151.35 	gross adjustment of the payments to the facility.  Retroactive
151.36 	adjustments shall not be applied to private pay residents.  An
152.1 	error or omission for purposes of this item does not include a
152.2 	nursing facility's determination that an election between
152.3 	permissible alternatives was not advantageous and should be
152.4 	changed.
152.5 	(c) If the commissioner determines that a nursing facility
152.6 	knowingly supplied inaccurate or false information or failed to
152.7 	file an amendment to a statistical and cost report that resulted
152.8 	in or would result in an overpayment, the commissioner shall
152.9 	immediately adjust the nursing facility's payment rate and
152.10 	recover the entire overpayment.  The commissioner may also
152.11 	terminate the commissioner's agreement with the nursing facility
152.12 	and prosecute under applicable state or federal law.
152.13 		Subd. 44.Calculation of direct care per diem costs. The
152.14 	commissioner shall calculate, for each nursing facility, the
152.15 	normalized per diem cost for direct care services by dividing
152.16 	the total allowable reported costs for direct care services by
152.17 	the number of standardized days for the same reporting period.
152.18 		Subd. 45.Calculation of support services per diem
152.19 	costs. The commissioner shall calculate, for each nursing
152.20 	facility, the per diem cost for support services by dividing the
152.21 	total allowable reported costs for support services by the
152.22 	number of resident days for the same reporting period.
152.23 		Subd. 46.Calculation of a quality score. (a) The
152.24 	commissioner shall determine a quality score for each nursing
152.25 	facility using quality measures established in section 256B.439,
152.26 	according to methods determined by the commissioner in
152.27 	consultation with stakeholders and experts.  These methods shall
152.28 	be exempt from the rulemaking requirements under chapter 14.
152.29 	(b) For each quality measure, a score shall be determined
152.30 	with a maximum number of points available and number of points
152.31 	assigned as determined by the commissioner using the methodology
152.32 	established according to this subdivision.  The scores
152.33 	determined for all quality measures shall be totaled.  The
152.34 	determination of the quality measures to be used and the methods
152.35 	of calculating scores may be revised annually by the
152.36 	commissioner.
153.1 	(c) For the initial rate year under the new payment system,
153.2 	the quality measures shall include:
153.3 	(1) staff turnover;
153.4 	(2) staff retention;
153.5 	(3) use of pool staff;
153.6 	(4) quality indicators from the minimum data set; and 
153.7 	(5) survey deficiencies.
153.8 	(d) For rate years beginning after October 1, 2006, when
153.9 	making revisions to the quality measures or method for
153.10 	calculating scores, the commissioner shall publish the
153.11 	methodology in the State Register at least 15 months prior to
153.12 	the start of the rate year for which the revised methodology is
153.13 	to be used for rate-setting purposes.  The quality score used to
153.14 	determine payment rates shall be established for a rate year
153.15 	using data submitted in the statistical and cost report from the
153.16 	associated reporting year, and using data from other sources
153.17 	related to a period beginning no more than six months prior to
153.18 	the associated reporting year.
153.19 		Subd. 47.Calculation of payment rate for direct care
153.20 	services. The commissioner shall provide recommendations to the
153.21 	legislature by February 15, 2006, on specific methodology for
153.22 	the establishment of the payment rate for direct care services
153.23 	under the new system.  The recommendations must not increase
153.24 	expenditures for the new payment system beyond the limits of the
153.25 	appropriation.  The commissioner shall include recommendations
153.26 	on options for recognizing changes in direct care staff hours
153.27 	that may require a supplemental appropriation in the future.
153.28 		Subd. 48.Calculation of payment rate for support
153.29 	services. The payment rate for support services shall be a
153.30 	fixed amount adjusted for the facility's peer group and
153.31 	geography.
153.32 	(a) For each facility, determine the geographic normalized
153.33 	support services costs per standardized day according to clauses
153.34 	(1) to (7):
153.35 	(1) for the costs determined in subdivision 45, for each
153.36 	facility, determine the portion, as a percent, that is
154.1 	labor-related;
154.2 	(2) array the values in clause (1) by peer group and select
154.3 	the median for each peer group;
154.4 	(3) for each facility, multiply the costs determined in
154.5 	subdivision 45 by the value determined in clause (2) for its
154.6 	peer group;
154.7 	(4) divide the value determined in clause (3) by the
154.8 	geographic adjuster determined in subdivision 50;
154.9 	(5) for each facility, multiply the costs determined in
154.10 	subdivision 45 by the value of one minus the value determined in
154.11 	clause (2) for its peer group;
154.12 	(6) add the value determined in clause (4) to the value
154.13 	determined in clause (5);
154.14 	(7) array the values determined in clause (6) for each peer
154.15 	group, and select the 40th percentile; and 
154.16 	(8) the commissioner is authorized to apply multipliers to
154.17 	the values determined in clause (7) to assure that expenditures
154.18 	are within the limits of the appropriation and that funds are
154.19 	not shifted between peer groups.  These values shall be the
154.20 	unadjusted support services payment rate for the three peer
154.21 	groups.
154.22 	(b) The support services price for each facility shall be
154.23 	the value determined in paragraph (a), clause (8), adjusted by
154.24 	the geographic adjuster of the facility according to clauses (1)
154.25 	to (4):
154.26 	(1) the value determined in paragraph (a), clause (8),
154.27 	shall be multiplied by the value determined in paragraph (a),
154.28 	clause (2), for the facility's peer group;
154.29 	(2) multiply the value determined in clause (1) by the
154.30 	geographic adjuster determined in subdivision 50;
154.31 	(3) for each facility, multiply the value determined in
154.32 	paragraph (a), clause (8), by the value of one minus the value
154.33 	determined in paragraph (a), clause (2), for the facility's peer
154.34 	group;
154.35 	(4) add the value determined in clause (2) to the value
154.36 	determined in clause (3).  This value shall be the support
155.1 	services payment rate for each facility; and 
155.2 	(c) For rate years beginning on or after October 1, 2007,
155.3 	the value determined in paragraph (b), clause (4), shall not be
155.4 	less than the value used for the rate year beginning October 1,
155.5 	2006.
155.6 		Subd. 49.Calculation of quality add-on. The payment
155.7 	rate for the quality add-on shall be a variable amount based on
155.8 	each facility's quality score.
155.9 	(a) For the rate year beginning October 1, 2006, the
155.10 	maximum quality add-on percent shall be three percent and this
155.11 	add-on shall not be subject to the phase-in under subdivision
155.12 	53.  When new quality measures are incorporated into the quality
155.13 	score methodology and when existing quality measures are updated
155.14 	or improved, the commissioner may increase the maximum quality
155.15 	add-on percent.
155.16 	(b) For each facility, determine the sum of the values
155.17 	determined in subdivisions 47 and 48.
155.18 	(c) For each facility determine a ratio of the quality
155.19 	score of the facility determined in subdivision 46, less 40 and
155.20 	then divided by 60.  If this value is less than zero, use the
155.21 	value zero.
155.22 	(d) For each facility, the quality add-on shall be the
155.23 	value determined in paragraph (b) times the value determined in
155.24 	paragraph (c) times the maximum quality add-on percent.
155.25 		Subd. 50.Geographic adjustments of labor-related costs.
 155.26 	The commissioner shall determine adjusters for the labor-related
155.27 	share of the operating rate which shall be the ratio calculated
155.28 	in paragraphs (a) to (c), using data reported under subdivision
155.29 	43.  In paragraphs (a) and (b), use direct care costs and direct
155.30 	care compensated hours and use only facilities that have
155.31 	reported both.
155.32 	(a) Calculate the sum of compensation for all facilities in
155.33 	each economic development region divided by the facilities total
155.34 	compensated hours.
155.35 	(b) Calculate the sum of compensation for all facilities in
155.36 	the state divided by total reported compensated hours of all
156.1 	facilities in the state.
156.2 	(c) For each economic development region, divide the value
156.3 	in paragraph (a) by the value in paragraph (b).  These ratios
156.4 	shall be the geographic adjusters for the economic development
156.5 	regions.
156.6 		Subd. 51.Adjuster for operating payment rates. (a) The
156.7 	commissioner shall provide information to the appropriate
156.8 	committee chairs of the legislature by January 15 of each year
156.9 	specifying adjusters that may be multiplied by the uninflated
156.10 	payment rates, or by any other factor the commissioner deems
156.11 	appropriate, for direct care and support service costs
156.12 	determined in subdivisions 47 and 48.  The information shall
156.13 	include:
156.14 	(1) the projected change in the CPI-U, between the midpoint
156.15 	of the reporting year and the midpoint of the rate year, as
156.16 	determined by the national economic consultant used by the
156.17 	commissioner of finance, for the next rate year; and 
156.18 	(2) the costs or savings to the state of adjusting payment
156.19 	rates according to clause (1).
156.20 	(b) The commissioner may also describe other factors or
156.21 	methods that may be considered in adjusting rates.
156.22 		Subd. 52.Calculation of payment rate for external fixed
156.23 	costs. The commissioner shall calculate a payment rate for
156.24 	external fixed costs.
156.25 	(a) For facilities licensed as nursing homes, the portion
156.26 	related to section 256.9657 shall be equal to $8.86.  For
156.27 	facilities licensed as both nursing homes and boarding care
156.28 	homes, the portion related to section 256.9657 shall be equal to
156.29 	$8.86 multiplied by the ratio of their number of nursing home
156.30 	beds divided by their total number of active licensed and
156.31 	certified nursing home and boarding care beds.
156.32 	(b) The portion related to the licensure fee under section
156.33 	144.122, paragraph (d), shall be the amount of the fee divided
156.34 	by actual resident days.
156.35 	(c) The portion related to scholarships shall be determined
156.36 	under section 256B.431, subdivision 36.
157.1 	(d) The portion related to long-term care consultation
157.2 	shall be determined according to section 256B.0911, subdivision
157.3 	6.
157.4 	(e) The portion related to development and education of
157.5 	resident and family advisory councils under section 144A.33
157.6 	shall be $5 divided by 365.
157.7 	(f) The portion related to planned closure rate adjustments
157.8 	shall be as determined under section 256B.437.
157.9 	(g) The portions related to property insurance, real estate
157.10 	taxes, special assessments, and payments made in lieu of real
157.11 	estate taxes directly identified or allocated to the nursing
157.12 	facility shall be the actual amounts divided by actual resident
157.13 	days.
157.14 	(h) The portion related to PERA shall be actual costs
157.15 	divided by actual resident days.
157.16 	(i) The payment rate for external fixed costs shall be the
157.17 	sum of the amounts in paragraphs (a) to (h).
157.18 		Subd. 53.Phase-in. The commissioner shall implement the
157.19 	operating payment rate-setting methods in this section according
157.20 	to paragraphs (a) to (j).
157.21 	(a) Total payment rates effective on June 30, 2006, shall
157.22 	remain in effect through September 30, 2006.
157.23 	(b) By August 15 of 2006, 2007, and 2008, the commissioner
157.24 	shall notify nursing facilities of the operating payment rates
157.25 	they will receive under both this section and under the prior
157.26 	rate-setting method, of the blended operating payment rates that
157.27 	will apply based on paragraphs (c) to (i), and the actual
157.28 	operating payment rate that will result from application of
157.29 	paragraph (j).  For purposes of determining payment rates under
157.30 	the prior rate-setting method, the RUG's indices determined
157.31 	under section 256B.438, subdivision 3, paragraph (a), shall be
157.32 	used.  For purposes of determining payment rates under the new
157.33 	rate-setting method, the RUG's indices determined under section
157.34 	256B.438, subdivision 3, paragraph (c), shall be used.
157.35 	(c) For facilities reimbursed under section 256B.434 on
157.36 	September 30, 2006, for purposes of determining payment rates
158.1 	under the prior rate-setting method, and under this section for
158.2 	rate years beginning after June 30, 2006, the rate adjustment
158.3 	under section 256B.434, subdivision 4, paragraph (c), shall
158.4 	apply only to the property-related payment rate.  For facilities
158.5 	reimbursed under section 256B.431 on September 30, 2006, for
158.6 	rate years beginning on and after October 1, 2006, property
158.7 	rates shall continue to be determined under Minnesota Rules,
158.8 	parts 9549.0010 to 9549.0080.
158.9 	(d) For the rate year beginning October 1, 2006, for the
158.10 	operating rate components under the prior rate-setting method,
158.11 	the commissioner shall use the amounts in effect on June 30,
158.12 	2006.  For the rate years beginning on October 1, 2007, and
158.13 	October 1, 2008, the commissioner shall use the amounts in
158.14 	effect on the prior September 30.
158.15 	(e) For RUG's classifications with an effective date prior
158.16 	to October 1, 2007, the commissioner of health shall apply index
158.17 	maximization using the indices determined under section
158.18 	256B.438, subdivision 3, paragraph (a).  For RUG's
158.19 	classifications with an effective date on or after October 1,
158.20 	2007, the commissioner of health shall apply index maximization
158.21 	using the indices determined under section 256B.438, subdivision
158.22 	3, paragraph (c).
158.23 	(f) The blended total payment rate that will apply on
158.24 	October 1, 2006, shall consist of ten percent of the amount
158.25 	determined under this section and 90 percent of the amount
158.26 	determined under the prior rate-setting method.
158.27 	(g) The blended total payment rate that will apply on
158.28 	October 1, 2007, shall consist of 40 percent of the amount
158.29 	determined under this section and 60 percent of the amount
158.30 	determined under the prior rate-setting method.
158.31 	(h) The blended total payment rate that will apply on
158.32 	October 1, 2008, shall consist of 70 percent of the amount
158.33 	determined under this section and 30 percent of the amount
158.34 	determined under the prior rate-setting method.
158.35 	(i) The blended total payment rate that will apply on
158.36 	October 1, 2009, shall be the amount determined under this
159.1 	section.
159.2 	(j) For rate years beginning October 1 of 2006, 2007, and
159.3 	2008, for facilities for which the rate determined under this
159.4 	subdivision as adjusted according to section 256B.431,
159.5 	subdivision 41, is less than the rate that was in effect on
159.6 	September 30, 2006, the actual operating payment rate shall be
159.7 	the rate that was in effect on September 30, 2006.  For the rate
159.8 	year beginning October 1, 2009, for facilities for which the
159.9 	rate determined under this section is less than the rate
159.10 	determined under the prior rate-setting method, the actual
159.11 	operating payment rate shall be the rate determined under this
159.12 	section but shall be no more than $10 less than the rate that
159.13 	was in effect on September 30, 2006.  For rate years beginning
159.14 	on or after October 1, 2010, for facilities for which the rate
159.15 	determined under this section is less than the rate that was in
159.16 	effect on September 30, 2010, the actual operating payment rate
159.17 	shall be the rate determined under this section.
159.18 		Subd. 54.Audit authority. (a) The commissioner may
159.19 	subject reports and supporting documentation to desk and field
159.20 	audits to determine compliance with this section.  Retroactive
159.21 	adjustments shall be made as a result of desk or field audit
159.22 	findings if the cumulative impact of the finding would result in
159.23 	a rate adjustment of at least 0.15 percent of the statewide
159.24 	weighted average operating payment rate.  If a field audit
159.25 	reveals inadequacies in a nursing facility's record keeping or
159.26 	accounting practices, the commissioner may require the nursing
159.27 	facility to engage competent professional assistance to correct
159.28 	those inadequacies within 90 days so that the field audit may
159.29 	proceed.
159.30 	(b) Field audits may cover the four most recent annual
159.31 	statistical and cost reports for which desk audits have been
159.32 	completed and payment rates have been established.  The field
159.33 	audit must be an independent review of the nursing facility's
159.34 	statistical and cost report.  All transactions, invoices, or
159.35 	other documentation that support or relate to the statistics and
159.36 	costs claimed on the annual statistical and cost reports are
160.1 	subject to review by the field auditor.  If the provider fails
160.2 	to provide the field auditor access to supporting documentation
160.3 	related to the information reported on the statistical and cost
160.4 	report within the time period specified by the commissioner, the
160.5 	commissioner shall calculate the total payment rate by
160.6 	disallowing the cost of the items for which access to the
160.7 	supporting documentation is not provided.
160.8 	(c) Changes in the total payment rate which result from
160.9 	desk or field audit adjustments to statistical and cost reports
160.10 	for reporting years earlier than the four most recent annual
160.11 	cost reports must be made to the four most recent annual
160.12 	statistical and cost reports, the current statistical and cost
160.13 	report, and future statistical and cost reports to the extent
160.14 	that those adjustments affect the total payment rate established
160.15 	by those reporting years.
160.16 	(d) The commissioner shall extend the period for retention
160.17 	of records under subdivision 43 for purposes of performing field
160.18 	audits as necessary to enforce section 256B.48 with written
160.19 	notice to the facility postmarked no later than 90 days prior to
160.20 	the expiration of the record retention requirement.
160.21 		Subd. 55.Remedies for disputes. The commissioner shall
160.22 	provide remedies for disputes under this section.
160.23 	(a) A provider may appeal a determination of a payment rate
160.24 	established under this section if the appeal, if successful,
160.25 	would result in a change to the provider's payment rate of at
160.26 	least 0.15 percent of the statewide weighted average operating
160.27 	payment rate.  Appeals must be filed according to procedures in
160.28 	this subdivision.
160.29 	(b) To appeal, the provider shall file with the
160.30 	commissioner a written notice of appeal and the appeal must be
160.31 	postmarked or received by the commissioner within 60 days of the
160.32 	date the determination of the payment rate was mailed or
160.33 	personally received by a provider, whichever is earlier.
160.34 	(c) The notice of appeal must specify:
160.35 	(1) each disputed item;
160.36 	(2) the reason for the dispute;
161.1 	(3) the computation that the provider believes is correct;
161.2 	(4) the impact upon the facility's payment rate if the
161.3 	appeal is successful;
161.4 	(5) the authority in statute or rule upon which the
161.5 	provider relies for each disputed item;
161.6 	(6) the name and address of the person or firm with whom
161.7 	contacts may be made regarding the appeal; and 
161.8 	(7) additional information the provider wishes to offer
161.9 	with the appeal to support the provider's position.  The
161.10 	commissioner may request additional information to clarify the
161.11 	provider's position.
161.12 	(d) The commissioner shall review appeals and issue a
161.13 	written appeal determination on each appealed item within 180
161.14 	days of the due date of the appeal.  Upon mutual agreement, the
161.15 	commissioner and the provider may extend the time for issuing a
161.16 	determination for a specified period.  The appeal determination
161.17 	takes effect 30 days following the date of issuance specified in
161.18 	the determination.
161.19 	(e) For an appeal item on which the provider disagrees with
161.20 	the appeal determination, the provider may request
161.21 	reconsideration.  A request for reconsideration must be
161.22 	postmarked or received by the commissioner within 30 days of the
161.23 	date of issuance of the determination.  A request for
161.24 	reconsideration delays the date on which the determination takes
161.25 	effect.  The appeal determination and any changes resulting from
161.26 	reconsideration shall be implemented 30 days following the
161.27 	issuance of the reconsideration response.
161.28 	(f) For an appeal item on which the provider disagrees with
161.29 	the appeal determination and the reconsideration response, if
161.30 	any, the provider may file with the commissioner a written
161.31 	demand for a contested case hearing to determine the proper
161.32 	resolution of specified appeal items.  The demand must be
161.33 	postmarked or received by the commissioner within 30 days of the
161.34 	date of issuance specified in the determination or within 30
161.35 	days of the issuance of the reconsideration response, if
161.36 	reconsideration was requested.  A demand for a contested case
162.1 	hearing for an appeal item nullifies the written appeal
162.2 	determination issued by the commissioner for that appeal item.
162.3 	The commissioner shall refer any demand for a contested case
162.4 	hearing to the Office of the Attorney General.
162.5 	(g) A contested case hearing shall be heard by an
162.6 	administrative law judge according to sections 14.48 to 14.56.
162.7 	In any proceeding under this section, the appealing party must
162.8 	demonstrate by a preponderance of the evidence that the
162.9 	determination of a payment rate is incorrect.
162.10 	(h) Regardless of any rate appeal, the rate established
162.11 	must be the rate paid and must remain in effect until final
162.12 	resolution of the appeal or a subsequent rate determination.
162.13 	(i) A provider shall not use this process to challenge the
162.14 	method of determining a quality score under subdivision 46; or
162.15 	the commissioner's determination under subdivision 56 to
162.16 	negotiate rates.  This process does not apply to a request from
162.17 	a resident or nursing facility for reconsideration of the
162.18 	classification of a resident under section 144.0722 or 144.0724.
162.19 		Subd. 56.Interim rates. (a) The commissioner shall
162.20 	determine interim payment rates for nursing facilities that have
162.21 	no cost history.  The facilities shall provide statistical and
162.22 	cost information, according to subdivision 43, on a prospective
162.23 	basis.  The commissioner shall establish an interim rate using
162.24 	the quality score of the nursing facility at the 60th
162.25 	percentile, direct care costs according to a budget negotiated
162.26 	with the provider and the methods provided in subdivision 47.
162.27 	The interim rate shall apply until a rate can be established
162.28 	under this section.  Upon providing final information under
162.29 	subdivision 43 for the interim rate period, the commissioner
162.30 	shall determine that an overpayment has occurred if the interim
162.31 	payment rate for direct care costs exceeded the final rate for
162.32 	direct care costs by an amount greater than four percent, and
162.33 	shall recover any overpayment.
162.34 	In the event of an overpayment, the commissioner may allow
162.35 	up to six months for complete repayment if the provider
162.36 	demonstrates that immediate repayment of the overpayment would
163.1 	result in an undue hardship to the operation of the facility.
163.2 	(b) The commissioner may negotiate an interim rate with a
163.3 	nursing facility, according to the process in paragraph (a),
163.4 	when that facility has been purchased by an unrelated party
163.5 	within the last six months.  In determining if negotiations
163.6 	shall be initiated, the commissioner shall consider:
163.7 	(1) the potential inadequacy of current rates as evidenced
163.8 	by the position in the arrays of operating costs of the rates of
163.9 	the requesting facility;
163.10 	(2) preventing closure of facilities in under-bedded areas
163.11 	of the state, as measured by the number of beds per 1,000
163.12 	elderly in the county or in contiguous counties in which the
163.13 	facility is located;
163.14 	(3) the ability of the purchaser to provide high quality
163.15 	services as evidenced by high quality scores of any other
163.16 	facility under the control of the purchaser operating in
163.17 	Minnesota;
163.18 	(4) the ability of the purchasing entity to operate
163.19 	efficiently as evidenced by the difference between the operating
163.20 	costs and target prices of the other facility or facilities
163.21 	under the control of the purchaser operating in Minnesota;
163.22 	(5) previous success of the purchaser with negotiated
163.23 	interim rates;
163.24 	(6) the financial soundness of the purchaser;
163.25 	(7) avoiding negotiating interim rates with purchasers who
163.26 	have sold facilities that then requested interim rate
163.27 	negotiation; and 
163.28 	(8) avoiding too much consolidation of the nursing facility
163.29 	industry within any small number of providers.

163.30 	Sec. 23. Minnesota Statutes 2004, section 256B.47,
163.31 	subdivision 2, is amended to read:
163.32 		Subd. 2.Notice to residents.  (a) No increase in nursing
163.33 	facility rates for private paying residents shall be effective
163.34 	unless the nursing facility notifies the resident or person
163.35 	responsible for payment of the increase in writing 30 days
163.36 	before the increase takes effect.
164.1 	A nursing facility may adjust its rates without giving the
164.2 	notice required by this subdivision when the purpose of the rate
164.3 	adjustment is to reflect a change in the case-mix classification
164.4 	of the resident.  If the state fails to set rates as required by
164.5 	section 256B.431 256B.441, subdivision 1,the time required for
164.6 	giving notice is decreased by the number of days by which the
164.7 	state was late in setting the rates.
164.8 	(b) If the state does not set rates by the date required in
164.9 	section 256B.431 256B.441, subdivision 1,nursing facilities
164.10 	shall meet the requirement for advance notice by informing the
164.11 	resident or person responsible for payments, on or before the
164.12 	effective date of the increase, that a rate increase will be
164.13 	effective on that date.  If the exact amount has not yet been
164.14 	determined, the nursing facility may raise the rates by the
164.15 	amount anticipated to be allowed.  Any amounts collected from
164.16 	private pay residents in excess of the allowable rate must be
164.17 	repaid to private pay residents with interest at the rate used
164.18 	by the commissioner of revenue for the late payment of taxes and
164.19 	in effect on the date the rate increase is effective.

164.20 	Sec. 24. MORATORIUM PROJECT DEADLINE EXTENSION IN AITKIN
164.21 	COUNTY.
 164.22 	Notwithstanding Minnesota Statutes, section 144A.073,
164.23 	subdivisions 3 and 10, the commissioner of health shall extend
164.24 	the project approval until December 31, 2006, for a nursing home
164.25 	moratorium exception project that was approved under Minnesota
164.26 	Statutes, section 144A.073, in 2002 to remodel a 48-bed facility
164.27 	in Aitkin County.

164.28 	Sec. 25. MORATORIUM PROJECT DEADLINE EXTENSION IN
164.29 	RENVILLE COUNTY.
 164.30 	Notwithstanding Minnesota Statutes, section 144A.073,
164.31 	subdivisions 3 and 10, the commissioner of health shall extend
164.32 	the project approval until December 31, 2006, for a nursing home
164.33 	moratorium exception project that was approved under Minnesota
164.34 	Statutes, section 144A.073, in 2002 to remodel a 60-bed facility
164.35 	in Renville County.

164.36 	Sec. 26. RECOMMENDATIONS ON CRITERIA AND RATE
165.1 	NEGOTIATIONS FOR NURSING FACILITIES.
 165.2 	The commissioner of human services shall provide
165.3 	recommendations to the legislature by December 15, 2006,
165.4 	defining criteria and rate negotiations for nursing facilities
165.5 	that provide specialized care or that have extenuating
165.6 	circumstances requiring a negotiated rate.  The commissioner
165.7 	shall also provide recommendations to the legislature on changes
165.8 	to the current nursing facility property system by December 15,
165.9 	2006.

165.10 	ARTICLE 5
165.11 	CONTINUING CARE FOR THE ELDERLY AND DISABLED

165.12 	Section 1. Minnesota Statutes 2004, section 252.27,
165.13 	subdivision 2a, is amended to read:
165.14 		Subd. 2a.Contribution amount.  (a) The natural or
165.15 	adoptive parents of a minor child, including a child determined
165.16 	eligible for medical assistance without consideration of
165.17 	parental income, must contribute to the cost of services used by
165.18 	making monthly payments on a sliding scale based on income,
165.19 	unless the child is married or has been married, parental rights
165.20 	have been terminated, or the child's adoption is subsidized
165.21 	according to section 259.67 or through title IV-E of the Social
165.22 	Security Act.
165.23 	(b) For households with adjusted gross income equal to or
165.24 	greater than 100 percent of federal poverty guidelines, the
165.25 	parental contribution shall be computed by applying the
165.26 	following schedule of rates to the adjusted gross income of the
165.27 	natural or adoptive parents:
165.28 	(1) if the adjusted gross income is equal to or greater
165.29 	than 100 percent of federal poverty guidelines and less than 175
165.30 	percent of federal poverty guidelines, the parental contribution
165.31 	is $4 per month;
165.32 	(2) if the adjusted gross income is equal to or greater
165.33 	than 175 percent of federal poverty guidelines and less than or
165.34 	equal to 375 545 percent of federal poverty guidelines, the
165.35 	parental contribution shall be determined using a sliding fee
165.36 	scale established by the commissioner of human services which
166.1 	begins at one percent of adjusted gross income at 175 percent of
166.2 	federal poverty guidelines and increases to 7.5 percent of
166.3 	adjusted gross income for those with adjusted gross income up to
166.4 	375 545 percent of federal poverty guidelines;
166.5 	(3) if the adjusted gross income is greater than 375 545 
166.6 	percent of federal poverty guidelines and less than 675 percent
166.7 	of federal poverty guidelines, the parental contribution shall
166.8 	be 7.5 percent of adjusted gross income;
166.9 	(4) if the adjusted gross income is equal to or greater
166.10 	than 675 percent of federal poverty guidelines and less than 975
166.11 	percent of federal poverty guidelines, the parental contribution
166.12 	shall be determined using a sliding fee scale established by the
166.13 	commissioner of human services which begins at 7.5 percent of
166.14 	adjusted gross income at 675 percent of federal poverty
166.15 	guidelines and increases to ten percent of adjusted gross income
166.16 	for those with adjusted gross income up to 975 percent of
166.17 	federal poverty guidelines; and
166.18 	(5) if the adjusted gross income is equal to or greater
166.19 	than 975 percent of federal poverty guidelines, the parental
166.20 	contribution shall be 12.5 percent of adjusted gross income.
166.21 	If the child lives with the parent, the annual adjusted
166.22 	gross income is reduced by $2,400 prior to calculating the
166.23 	parental contribution.  If the child resides in an institution
166.24 	specified in section 256B.35, the parent is responsible for the
166.25 	personal needs allowance specified under that section in
166.26 	addition to the parental contribution determined under this
166.27 	section.  The parental contribution is reduced by any amount
166.28 	required to be paid directly to the child pursuant to a court
166.29 	order, but only if actually paid.
166.30 	(c) The household size to be used in determining the amount
166.31 	of contribution under paragraph (b) includes natural and
166.32 	adoptive parents and their dependents, including the child
166.33 	receiving services.  Adjustments in the contribution amount due
166.34 	to annual changes in the federal poverty guidelines shall be
166.35 	implemented on the first day of July following publication of
166.36 	the changes.
167.1 	(d) For purposes of paragraph (b), "income" means the
167.2 	adjusted gross income of the natural or adoptive parents
167.3 	determined according to the previous year's federal tax form,
167.4 	except, effective retroactive to July 1, 2003, taxable capital
167.5 	gains to the extent the funds have been used to purchase a home
167.6 	shall not be counted as income.
167.7 	(e) The contribution shall be explained in writing to the
167.8 	parents at the time eligibility for services is being
167.9 	determined.  The contribution shall be made on a monthly basis
167.10 	effective with the first month in which the child receives
167.11 	services.  Annually upon redetermination or at termination of
167.12 	eligibility, if the contribution exceeded the cost of services
167.13 	provided, the local agency or the state shall reimburse that
167.14 	excess amount to the parents, either by direct reimbursement if
167.15 	the parent is no longer required to pay a contribution, or by a
167.16 	reduction in or waiver of parental fees until the excess amount
167.17 	is exhausted.
167.18 	(f) The monthly contribution amount must be reviewed at
167.19 	least every 12 months; when there is a change in household size;
167.20 	and when there is a loss of or gain in income from one month to
167.21 	another in excess of ten percent.  The local agency shall mail a
167.22 	written notice 30 days in advance of the effective date of a
167.23 	change in the contribution amount.  A decrease in the
167.24 	contribution amount is effective in the month that the parent
167.25 	verifies a reduction in income or change in household size.
167.26 	(g) Parents of a minor child who do not live with each
167.27 	other shall each pay the contribution required under paragraph
167.28 	(a).  An amount equal to the annual court-ordered child support
167.29 	payment actually paid on behalf of the child receiving services
167.30 	shall be deducted from the adjusted gross income of the parent
167.31 	making the payment prior to calculating the parental
167.32 	contribution under paragraph (b).
167.33 	(h) The contribution under paragraph (b) shall be increased
167.34 	by an additional five percent if the local agency determines
167.35 	that insurance coverage is available but not obtained for the
167.36 	child.  For purposes of this section, "available" means the
168.1 	insurance is a benefit of employment for a family member at an
168.2 	annual cost of no more than five percent of the family's annual
168.3 	income.  For purposes of this section, "insurance" means health
168.4 	and accident insurance coverage, enrollment in a nonprofit
168.5 	health service plan, health maintenance organization,
168.6 	self-insured plan, or preferred provider organization.
168.7 	Parents who have more than one child receiving services
168.8 	shall not be required to pay more than the amount for the child
168.9 	with the highest expenditures.  There shall be no resource
168.10 	contribution from the parents.  The parent shall not be required
168.11 	to pay a contribution in excess of the cost of the services
168.12 	provided to the child, not counting payments made to school
168.13 	districts for education-related services.  Notice of an increase
168.14 	in fee payment must be given at least 30 days before the
168.15 	increased fee is due.
168.16 	(i) The contribution under paragraph (b) shall be reduced
168.17 	by $300 per fiscal year if, in the 12 months prior to July 1:
168.18 	(1) the parent applied for insurance for the child;
168.19 	(2) the insurer denied insurance;
168.20 	(3) the parents submitted a complaint or appeal, in writing
168.21 	to the insurer, submitted a complaint or appeal, in writing, to
168.22 	the commissioner of health or the commissioner of commerce, or
168.23 	litigated the complaint or appeal; and
168.24 	(4) as a result of the dispute, the insurer reversed its
168.25 	decision and granted insurance.
168.26 	For purposes of this section, "insurance" has the meaning
168.27 	given in paragraph (h).
168.28 	A parent who has requested a reduction in the contribution
168.29 	amount under this paragraph shall submit proof in the form and
168.30 	manner prescribed by the commissioner or county agency,
168.31 	including, but not limited to, the insurer's denial of
168.32 	insurance, the written letter or complaint of the parents, court
168.33 	documents, and the written response of the insurer approving
168.34 	insurance.  The determinations of the commissioner or county
168.35 	agency under this paragraph are not rules subject to chapter 14.

168.36 	Sec. 2. [256B.0185] REQUIRED REPORT.
169.1 		Subdivision 1.Pending application. By December 15 of
169.2 	both 2005 and 2006, the commissioner must deliver to the
169.3 	legislature a report that identifies:
169.4 	(1) each county in which an application for medical
169.5 	assistance from a person identified as residing in a long-term
169.6 	care facility is or was pending, at any time between January 1
169.7 	and December 1 of the calendar year to which the report relates,
169.8 	for more than 60 days in the case of a person who is disabled,
169.9 	or for more than 45 days in the case of a person who is age 65
169.10 	or older; and 
169.11 	(2) for each of the identified counties:  the number of
169.12 	applications described in clause (1), the average number of days
169.13 	the applications were pending, the distribution of days for
169.14 	applications that were pending, and what percentage of the
169.15 	applications, respectively, the county approved and denied.
169.16 		Subd. 2.Time to process application. The report must
169.17 	include specific recommendations for how counties, as a group,
169.18 	could shorten the time it takes to act on the applications
169.19 	described in subdivision 1, clause (1).

169.20 	Sec. 3. Minnesota Statutes 2004, section 256B.057,
169.21 	subdivision 9, is amended to read:
169.22 		Subd. 9.Employed persons with disabilities.  (a) Medical
169.23 	assistance may be paid for a person who is employed and who:
169.24 	(1) meets the definition of disabled under the supplemental
169.25 	security income program;
169.26 	(2) is at least 16 but less than 65 years of age;
169.27 	(3) meets the asset limits in paragraph (b); and
169.28 	(4) effective November 1, 2003, pays a premium and other
169.29 	obligations under paragraph (d).
169.30 	Any spousal income or assets shall be disregarded for purposes
169.31 	of eligibility and premium determinations.
169.32 	After the month of enrollment, a person enrolled in medical
169.33 	assistance under this subdivision who:
169.34 	(1) is temporarily unable to work and without receipt of
169.35 	earned income due to a medical condition, as verified by a
169.36 	physician, may retain eligibility for up to four calendar
170.1 	months; or
170.2 	(2) effective January 1, 2004, loses employment for reasons
170.3 	not attributable to the enrollee, may retain eligibility for up
170.4 	to four consecutive months after the month of job loss.  To
170.5 	receive a four-month extension, enrollees must verify the
170.6 	medical condition or provide notification of job loss.  All
170.7 	other eligibility requirements must be met and the enrollee must
170.8 	pay all calculated premium costs for continued eligibility.
170.9 	(b) For purposes of determining eligibility under this
170.10 	subdivision, a person's assets must not exceed $20,000,
170.11 	excluding:
170.12 	(1) all assets excluded under section 256B.056;
170.13 	(2) retirement accounts, including individual accounts,
170.14 	401(k) plans, 403(b) plans, Keogh plans, and pension plans; and
170.15 	(3) medical expense accounts set up through the person's
170.16 	employer.
170.17 	(c)(1) Effective January 1, 2004, for purposes of
170.18 	eligibility, there will be a $65 earned income disregard.  To be
170.19 	eligible, a person applying for medical assistance under this
170.20 	subdivision must have earned income above the disregard level.
170.21 	(2) Effective January 1, 2004, to be considered earned
170.22 	income, Medicare, Social Security, and applicable state and
170.23 	federal income taxes must be withheld.  To be eligible, a person
170.24 	must document earned income tax withholding.
170.25 	(d)(1) A person whose earned and unearned income is equal
170.26 	to or greater than 100 percent of federal poverty guidelines for
170.27 	the applicable family size must pay a premium to be eligible for
170.28 	medical assistance under this subdivision.  The premium shall be
170.29 	based on the person's gross earned and unearned income and the
170.30 	applicable family size using a sliding fee scale established by
170.31 	the commissioner, which begins at one percent of income at 100
170.32 	percent of the federal poverty guidelines and increases to 7.5
170.33 	percent of income for those with incomes at or above 300 percent
170.34 	of the federal poverty guidelines.  Annual adjustments in the
170.35 	premium schedule based upon changes in the federal poverty
170.36 	guidelines shall be effective for premiums due in July of each
171.1 	year.
171.2 	(2) Effective January 1, 2004, all enrollees must pay a
171.3 	premium to be eligible for medical assistance under this
171.4 	subdivision.  An enrollee shall pay the greater of a $35 premium
171.5 	or the premium calculated in clause (1).
171.6 	(3) Effective November 1, 2003, all enrollees who receive
171.7 	unearned income must pay one-half of one percent of unearned
171.8 	income in addition to the premium amount.
171.9 	(4) Effective November 1, 2003 July 1, 2005, for
171.10 	enrollees whose income does not exceed 200 percent of the
171.11 	federal poverty guidelines and who are also enrolled in
171.12 	Medicare, the commissioner must reimburse the enrollee for
171.13 	Medicare Part B premiums under section 256B.0625, subdivision
171.14 	15, paragraph (a).
171.15 	(5) Increases in benefits under title II of the Social
171.16 	Security Act shall not be counted as income for purposes of this
171.17 	subdivision until July 1 of each year.
171.18 	(e) A person's eligibility and premium shall be determined
171.19 	by the local county agency.  Premiums must be paid to the
171.20 	commissioner.  All premiums are dedicated to the commissioner.
171.21 	(f) Any required premium shall be determined at application
171.22 	and redetermined at the enrollee's six-month income review or
171.23 	when a change in income or household size is reported.
171.24 	Enrollees must report any change in income or household size
171.25 	within ten days of when the change occurs.  A decreased premium
171.26 	resulting from a reported change in income or household size
171.27 	shall be effective the first day of the next available billing
171.28 	month after the change is reported.  Except for changes
171.29 	occurring from annual cost-of-living increases, a change
171.30 	resulting in an increased premium shall not affect the premium
171.31 	amount until the next six-month review.
171.32 	(g) Premium payment is due upon notification from the
171.33 	commissioner of the premium amount required.  Premiums may be
171.34 	paid in installments at the discretion of the commissioner.
171.35 	(h) Nonpayment of the premium shall result in denial or
171.36 	termination of medical assistance unless the person demonstrates
172.1 	good cause for nonpayment.  Good cause exists if the
172.2 	requirements specified in Minnesota Rules, part 9506.0040,
172.3 	subpart 7, items B to D, are met.  Except when an installment
172.4 	agreement is accepted by the commissioner, all persons
172.5 	disenrolled for nonpayment of a premium must pay any past due
172.6 	premiums as well as current premiums due prior to being
172.7 	reenrolled.  Nonpayment shall include payment with a returned,
172.8 	refused, or dishonored instrument.  The commissioner may require
172.9 	a guaranteed form of payment as the only means to replace a
172.10 	returned, refused, or dishonored instrument.

172.11 	Sec. 4. [256B.0571] LONG-TERM CARE PARTNERSHIP.
172.12 		Subdivision 1.Definitions. For purposes of this
172.13 	section, the following terms have the meanings given them.
172.14 		Subd. 2.Home care service. "Home care service" means
172.15 	care described in section 144A.43.
172.16 		Subd. 3.Long-term care insurance. "Long-term care
172.17 	insurance" means a policy described in section 62S.01.
172.18 		Subd. 4.Medical assistance. "Medical assistance" means
172.19 	the program of medical assistance established under section
172.20 	256B.01.
172.21 		Subd. 5.Nursing home. "Nursing home" means a nursing
172.22 	home as described in section 144A.01.
172.23 		Subd. 6.Partnership policy. "Partnership policy" means
172.24 	a long-term care insurance policy that meets the requirements
172.25 	under subdivision 10.
172.26 		Subd. 7.Partnership program. "Partnership program"
172.27 	means the Minnesota partnership for long-term care program
172.28 	established under this section.
172.29 		Subd. 8.Program established. (a) The commissioner, in
172.30 	cooperation with the commissioner of commerce, shall establish
172.31 	the Minnesota partnership for long-term care program to provide
172.32 	for the financing of long-term care through a combination of
172.33 	private insurance and medical assistance.
172.34 	(b) An individual who meets the requirements in this
172.35 	paragraph is eligible to participate in the partnership
172.36 	program.  The individual must:
173.1 	(1) be a Minnesota resident;
173.2 	(2) purchase a partnership policy that is delivered, issued
173.3 	for delivery, or renewed on or after the effective date of this
173.4 	section, and maintain the partnership policy in effect
173.5 	throughout the period of participation in the partnership
173.6 	program; and 
173.7 	(3) exhaust the minimum benefits under the partnership
173.8 	policy as described in this section.  Benefits received under a
173.9 	long-term care insurance policy before the effective date of
173.10 	this section do not count toward the exhaustion of benefits
173.11 	required in this subdivision.
173.12 		Subd. 9.Medical assistance eligibility. (a) Upon
173.13 	application of an individual who meets the requirements
173.14 	described in subdivision 8, the commissioner shall determine the
173.15 	individual's eligibility for medical assistance according to
173.16 	paragraphs (b) and (c).
173.17 	(b) After disregarding financial assets exempted under
173.18 	medical assistance eligibility requirements, the commissioner
173.19 	shall disregard an additional amount of financial assets equal
173.20 	to the dollar amount of coverage utilized under the partnership
173.21 	policy.
173.22 	(c) The commissioner shall consider the individual's income
173.23 	according to medical assistance eligibility requirements.
173.24 		Subd. 10.Approved policies. (a) A partnership policy
173.25 	must meet all of the requirements in paragraphs (b) to (h).
173.26 	(b) Minimum coverage shall be for a period of not less than
173.27 	three years and for a dollar amount equal to 36 months of
173.28 	nursing home care at the minimum daily benefit rate determined
173.29 	and adjusted under paragraph (c).  The policy shall provide for
173.30 	home health care benefits to be substituted for nursing home
173.31 	care benefits on the basis of two home health care days for one
173.32 	nursing home care day.
173.33 	(c) Minimum daily benefits shall be $150 for nursing home
173.34 	care or $75 for home care, with inflation protection provided in
173.35 	the policy as described in section 62S.23, subdivision 1, clause
173.36 	(1).  These minimum daily benefit amounts shall also be adjusted
174.1 	by the commissioner on October 1 of each year by a percentage
174.2 	equal to the inflation protection feature described in section
174.3 	62S.23, subdivision 1, clause (1), for purposes of setting
174.4 	minimum requirements that a policy must meet in future years in
174.5 	order to initially qualify as an approved policy under this
174.6 	subdivision.  Adjusted minimum daily benefit amounts shall be
174.7 	rounded to the nearest whole dollar.
174.8 	(d) A third party designated by the insured shall be
174.9 	entitled to receive notice if the policy is about to lapse for
174.10 	nonpayment of premium, and an additional 30-day grace period for
174.11 	payment of premium shall be granted following notification to
174.12 	that person.
174.13 	(e) The policy must cover all of the following services:
174.14 	(1) nursing home stay;
174.15 	(2) home care service;
174.16 	(3) care management; and 
174.17 	(4) up to 14 days of nursing care in a hospital while the
174.18 	individual is waiting for long-term care placement.
174.19 	(f) Payment for service under paragraph (e), clause (4),
174.20 	must not exceed the daily benefit amount for nursing home care.
174.21 	(g) A partnership policy must offer, as an option for an
174.22 	adjusted premium, an elimination period of not more than 180
174.23 	days.
174.24 	(h) An issuer of a partnership policy must comply with any
174.25 	federal law authorizing partnership policies in Minnesota,
174.26 	including any federal regulations, as amended, adopted under
174.27 	that law.  This paragraph does not require compliance with any
174.28 	provision of this federal law until the date upon which the law
174.29 	requires compliance with the provision.  The commissioner has
174.30 	authority to enforce this paragraph.
174.31 		Subd. 11.Limitations on estate recovery. For an
174.32 	individual determined eligible for medical assistance under
174.33 	subdivision 9, the state shall not seek recovery under the
174.34 	provisions of section 256B.15 against the estate of the
174.35 	individual or individual's spouse for medical assistance
174.36 	benefits received by that individual.
175.1 		Subd. 12.Effective date. (a) If any provision of this
175.2 	section is prohibited by federal law, no provision shall become
175.3 	effective until federal law is changed to permit its full
175.4 	implementation.  The commissioner of human services shall notify
175.5 	the revisor of statutes when federal law is enacted or other
175.6 	federal approval is received and publish a notice in the State
175.7 	Register.  The commissioner must include the notice in the first
175.8 	State Register published after the effective date of the federal
175.9 	changes.
175.10 	(b) If federal law is changed to permit a waiver of any
175.11 	provisions prohibited by federal law, the commissioner of human
175.12 	services shall apply to the federal government for a waiver of
175.13 	those prohibitions or other federal authority, and that
175.14 	provision shall become effective upon receipt of a federal
175.15 	waiver or other federal approval, notification to the revisor of
175.16 	statutes, and publication of a notice in the State Register to
175.17 	that effect.

175.18 	Sec. 5. Minnesota Statutes 2004, section 256B.0621,
175.19 	subdivision 2, is amended to read:
175.20 		Subd. 2.Targeted case management; definitions.  For
175.21 	purposes of subdivisions 3 to 10, the following terms have the
175.22 	meanings given them:
175.23 	(1) "home care service recipients" means those individuals
175.24 	receiving the following services under section 256B.0627:
175.25 	skilled nursing visits, home health aide visits, private duty
175.26 	nursing, personal care assistants, or therapies provided through
175.27 	a home health agency;
175.28 	(2) "home care targeted case management" means the
175.29 	provision of targeted case management services for the purpose
175.30 	of assisting home care service recipients to gain access to
175.31 	needed services and supports so that they may remain in the
175.32 	community;
175.33 	(3) "institutions" means hospitals, consistent with Code of
175.34 	Federal Regulations, title 42, section 440.10; regional
175.35 	treatment center inpatient services, consistent with section
175.36 	245.474; nursing facilities; and intermediate care facilities
176.1 	for persons with mental retardation;
176.2 	(4) "relocation targeted case management" means includes 
176.3 	the provision of both county targeted case management and public
176.4 	or private vendor service coordination services for the purpose
176.5 	of assisting recipients to gain access to needed services and
176.6 	supports if they choose to move from an institution to the
176.7 	community.  Relocation targeted case management may be provided
176.8 	during the last 180 consecutive days of an eligible recipient's
176.9 	institutional stay; and
176.10 	(5) "targeted case management" means case management
176.11 	services provided to help recipients gain access to needed
176.12 	medical, social, educational, and other services and supports.

176.13 	Sec. 6. Minnesota Statutes 2004, section 256B.0621,
176.14 	subdivision 3, is amended to read:
176.15 		Subd. 3.Eligibility.  The following persons are eligible
176.16 	for relocation targeted case management or home care-targeted 
176.17 	care targeted case management:
176.18 	(1) medical assistance eligible persons residing in
176.19 	institutions who choose to move into the community are eligible
176.20 	for relocation targeted case management services; and
176.21 	(2) medical assistance eligible persons receiving home care
176.22 	services, who are not eligible for any other medical assistance
176.23 	reimbursable case management service, are eligible for home
176.24 	care-targeted care targeted case management services beginning
176.25 	January 1, 2003 July 1, 2005.

176.26 	Sec. 7. Minnesota Statutes 2004, section 256B.0621,
176.27 	subdivision 4, is amended to read:
176.28 		Subd. 4.Relocation targeted county case management
176.29 	provider qualifications.  (a) A relocation targeted county case
176.30 	management provider is an enrolled medical assistance provider
176.31 	who is determined by the commissioner to have all of the
176.32 	following characteristics:
176.33 	(1) the legal authority to provide public welfare under
176.34 	sections 393.01, subdivision 7; and 393.07; or a federally
176.35 	recognized Indian tribe;
176.36 	(2) the demonstrated capacity and experience to provide the
177.1 	components of case management to coordinate and link community
177.2 	resources needed by the eligible population;
177.3 	(3) the administrative capacity and experience to serve the
177.4 	target population for whom it will provide services and ensure
177.5 	quality of services under state and federal requirements;
177.6 	(4) the legal authority to provide complete investigative
177.7 	and protective services under section 626.556, subdivision 10;
177.8 	and child welfare and foster care services under section 393.07,
177.9 	subdivisions 1 and 2; or a federally recognized Indian tribe;
177.10 	(5) a financial management system that provides accurate
177.11 	documentation of services and costs under state and federal
177.12 	requirements; and
177.13 	(6) the capacity to document and maintain individual case
177.14 	records under state and federal requirements.
177.15 	(b) A provider of targeted case management under section
177.16 	256B.0625, subdivision 20, may be deemed a certified provider of
177.17 	relocation targeted case management.
177.18 	(c) A relocation targeted county case management provider
177.19 	may subcontract with another provider to deliver relocation
177.20 	targeted case management services.  Subcontracted providers must
177.21 	demonstrate the ability to provide the services outlined in
177.22 	subdivision 6, and have a procedure in place that notifies the
177.23 	recipient and the recipient's legal representative of any
177.24 	conflict of interest if the contracted targeted case management
177.25 	provider also provides, or will provide, the recipient's
177.26 	services and supports. Counties must require that contracted
177.27 	providers must provide information on all conflicts of interest
177.28 	and obtain the recipient's informed consent or provide the
177.29 	recipient with alternatives.

177.30 	Sec. 8. Minnesota Statutes 2004, section 256B.0621,
177.31 	subdivision 5, is amended to read:
177.32 		Subd. 5.Home care targeted case management and
177.33 	relocation service coordination provider qualifications. The
177.34 	following qualifications and certification standards must be met
177.35 	by Providers of home care targeted case management and
177.36 	relocation service coordination must meet the qualifications
178.1 	under subdivision 4 for county vendors or the qualifications and
178.2 	certification standards under paragraphs (a) and (b) for private
178.3 	vendors.
178.4 	(a) The commissioner must certify each provider of home
178.5 	care targeted case management and relocation service
178.6 	coordination before enrollment.  The certification process shall
178.7 	examine the provider's ability to meet the requirements in this
178.8 	subdivision and other state and federal requirements of this
178.9 	service.
178.10 	(b) A Both home care targeted case management provider is
178.11 	an providers and relocation service coordination providers are 
178.12 	enrolled medical assistance provider providers who has have a
178.13 	minimum of a bachelor's degree or a license in a health or human
178.14 	services field, or comparable training and two years of
178.15 	experience in human services,and is have been determined by the
178.16 	commissioner to have all of the following characteristics:
178.17 	(1) the demonstrated capacity and experience to provide the
178.18 	components of case management to coordinate and link community
178.19 	resources needed by the eligible population;
178.20 	(2) the administrative capacity and experience to serve the
178.21 	target population for whom it will provide services and ensure
178.22 	quality of services under state and federal requirements;
178.23 	(3) a financial management system that provides accurate
178.24 	documentation of services and costs under state and federal
178.25 	requirements;
178.26 	(4) the capacity to document and maintain individual case
178.27 	records under state and federal requirements; and 
178.28 	(5) the capacity to coordinate with county administrative
178.29 	functions;
178.30 	(6) have no financial interest in the provision of
178.31 	out-of-home residential services to persons for whom home care
178.32 	targeted case management or relocation service coordination is
178.33 	provided; and 
178.34 	(7) if a provider has a financial interest in services
178.35 	other than out-of-home residential services provided to persons
178.36 	for whom home care targeted case management or relocation
179.1 	service coordination is also provided, the county must determine
179.2 	each year that:
179.3 	(i) any possible conflict of interest is explained annually
179.4 	at a face-to-face meeting and in writing and the person provides
179.5 	written informed consent consistent with section 256B.77,
179.6 	subdivision 2, paragraph (p); and 
179.7 	(ii) information on a range of other feasible service
179.8 	provider options has been provided.

179.9 	Sec. 9. Minnesota Statutes 2004, section 256B.0621,
179.10 	subdivision 6, is amended to read:
179.11 		Subd. 6.Eligible services. (a) Services eligible for
179.12 	medical assistance reimbursement as targeted case management
179.13 	include:
179.14 	(1) assessment of the recipient's need for targeted case
179.15 	management services and for persons choosing to relocate, the
179.16 	county must provide service coordination provider options at the
179.17 	first contact and upon request;
179.18 	(2) development, completion, and regular review of a
179.19 	written individual service plan, which is based upon the
179.20 	assessment of the recipient's needs and choices, and which will
179.21 	ensure access to medical, social, educational, and other related
179.22 	services and supports;
179.23 	(3) routine contact or communication with the recipient,
179.24 	recipient's family, primary caregiver, legal representative,
179.25 	substitute care provider, service providers, or other relevant
179.26 	persons identified as necessary to the development or
179.27 	implementation of the goals of the individual service plan;
179.28 	(4) coordinating referrals for, and the provision of, case
179.29 	management services for the recipient with appropriate service
179.30 	providers, consistent with section 1902(a)(23) of the Social
179.31 	Security Act;
179.32 	(5) coordinating and monitoring the overall service
179.33 	delivery and engaging in advocacy as needed to ensure quality of
179.34 	services, appropriateness, and continued need;
179.35 	(6) completing and maintaining necessary documentation that
179.36 	supports and verifies the activities in this subdivision;
180.1 	(7) traveling assisting individuals in order to access
180.2 	needed services, including travel to conduct a visit with the
180.3 	recipient or other relevant person necessary to develop or
180.4 	implement the goals of the individual service plan; and
180.5 	(8) coordinating with the institution discharge planner in
180.6 	the 180-day period before the recipient's discharge.
180.7 	(b) Relocation targeted county case management includes
180.8 	services under paragraph (a), clauses (1), (2), and (4).
180.9 	Relocation service coordination includes services under
180.10 	paragraph (a), clauses (3) and (5) to (8).  Home care targeted
180.11 	case management includes services under paragraph (a), clauses
180.12 	(1) to (8).

180.13 	Sec. 10. Minnesota Statutes 2004, section 256B.0621,
180.14 	subdivision 7, is amended to read:
180.15 		Subd. 7.Time lines.  The following time lines must be
180.16 	met for assigning a case manager:
180.17 	(a) For relocation targeted case management, an eligible
180.18 	recipient must be assigned a county case manager who visits the
180.19 	person within 20 working days of requesting a case manager from
180.20 	their county of financial responsibility as determined under
180.21 	chapter 256G.
180.22 	(1) If a county agency, its contractor, or federally
180.23 	recognized tribe does not provide case management services as
180.24 	required, the recipient may obtain targeted relocation case
180.25 	management services relocation service coordination from an
180.26 	alternative a provider of targeted case management services
180.27 	enrolled by the commissioner qualified under subdivision 5.
180.28 	(2) The commissioner may waive the provider requirements in
180.29 	subdivision 4, paragraph (a), clauses (1) and (4), to ensure
180.30 	recipient access to the assistance necessary to move from an
180.31 	institution to the community.  The recipient or the recipient's
180.32 	legal guardian shall provide written notice to the county or
180.33 	tribe of the decision to obtain services from an alternative
180.34 	provider.
180.35 	(3) Providers of relocation targeted case management
180.36 	enrolled under this subdivision shall:
181.1 	(i) meet the provider requirements under subdivision 4 that
181.2 	are not waived by the commissioner;
181.3 	(ii) be qualified to provide the services specified in
181.4 	subdivision 6;
181.5 	(iii) coordinate efforts with local social service agencies
181.6 	and tribes; and
181.7 	(iv) comply with the conflict of interest provisions
181.8 	established under subdivision 4, paragraph (c).
181.9 	(4) Local social service agencies and federally recognized
181.10 	tribes shall cooperate with providers certified by the
181.11 	commissioner under this subdivision to facilitate the
181.12 	recipient's successful relocation from an institution to the
181.13 	community.
181.14 	(b) For home care targeted case management, an eligible
181.15 	recipient must be assigned a case manager within 20 working days
181.16 	of requesting a case manager from a home care targeted case
181.17 	management provider, as defined in subdivision 5.

181.18 	Sec. 11. Minnesota Statutes 2004, section 256B.0621, is
181.19 	amended by adding a subdivision to read:
181.20 		Subd. 11.Data use agreement and notice of relocation
181.21 	targeted case management availability. The commissioner shall
181.22 	execute a data use agreement with the Centers for Medicare and
181.23 	Medicaid Services to obtain the long-term care minimum data set
181.24 	data to assist residents of nursing facilities who have
181.25 	indicated a desire to live in the community.  The commissioner
181.26 	shall in turn enter into agreements with the Centers for
181.27 	Independent Living to provide information about assistance for
181.28 	persons who want to move to the community.

181.29 	Sec. 12. Minnesota Statutes 2004, section 256B.0625,
181.30 	subdivision 2, is amended to read:
181.31 		Subd. 2.Skilled and intermediate nursing care.  Medical
181.32 	assistance covers skilled nursing home services and services of
181.33 	intermediate care facilities, including training and
181.34 	habilitation services, as defined in section 252.41, subdivision
181.35 	3, for persons with mental retardation or related conditions who
181.36 	are residing in intermediate care facilities for persons with
182.1 	mental retardation or related conditions.  Medical assistance
182.2 	must not be used to pay the costs of nursing care provided to a
182.3 	patient in a swing bed as defined in section 144.562, unless (a)
182.4 	the facility in which the swing bed is located is eligible as a
182.5 	sole community provider, as defined in Code of Federal
182.6 	Regulations, title 42, section 412.92, or the facility is a
182.7 	public hospital owned by a governmental entity with 15 or fewer
182.8 	licensed acute care beds; (b) the Centers for Medicare and
182.9 	Medicaid Services approves the necessary state plan amendments;
182.10 	(c) the patient was screened as provided by law; (d) the patient
182.11 	no longer requires acute care services; and (e) no nursing home
182.12 	beds are available within 25 miles of the facility. The
182.13 	commissioner shall exempt a facility from compliance with the
182.14 	sole community provider requirement in clause (a) if, as of
182.15 	January 1, 2004, the facility had an agreement with the
182.16 	commissioner to provide medical assistance swing bed services.
182.17 	Medical assistance also covers up to ten days of nursing care
182.18 	provided to a patient in a swing bed if:  (1) the patient's
182.19 	physician certifies that the patient has a terminal illness or
182.20 	condition that is likely to result in death within 30 days and
182.21 	that moving the patient would not be in the best interests of
182.22 	the patient and patient's family; (2) no open nursing home beds
182.23 	are available within 25 miles of the facility; and (3) no open
182.24 	beds are available in any Medicare hospice program within 50
182.25 	miles of the facility.  The daily medical assistance payment for
182.26 	nursing care for the patient in the swing bed is the statewide
182.27 	average medical assistance skilled nursing care per diem as
182.28 	computed annually by the commissioner on July 1 of each year.
182.29 	
EFFECTIVE DATE. This section is effective the day
182.30 	following final enactment and applies to medical assistance
182.31 	payments for swing bed services provided on or after March 5,
182.32 	2005.

182.33 	Sec. 13. Minnesota Statutes 2004, section 256B.0913,
182.34 	subdivision 2, is amended to read:
182.35 		Subd. 2.Eligibility for services.  Alternative care
182.36 	services are available to Minnesotans age 65 or older who would
183.1 	be eligible for medical assistance within 180 120 days of
183.2 	admission to a nursing facility and subject to subdivisions 4 to
183.3 	13.

183.4 	Sec. 14. Minnesota Statutes 2004, section 256B.0913,
183.5 	subdivision 4, is amended to read:
183.6 		Subd. 4.Eligibility for funding for services for
183.7 	nonmedical assistance recipients.  (a) Funding for services
183.8 	under the alternative care program is available to persons who
183.9 	meet the following criteria:
183.10 	(1) the person has been determined by a community
183.11 	assessment under section 256B.0911 to be a person who would
183.12 	require the level of care provided in a nursing facility, but
183.13 	for the provision of services under the alternative care
183.14 	program;
183.15 	(2) the person is age 65 or older;
183.16 	(3) the person would be eligible for medical assistance
183.17 	within 180 120 days of admission to a nursing facility;
183.18 	(4) the person is not ineligible for the medical assistance
183.19 	program due to an asset transfer penalty;
183.20 	(5) the person needs services that are not funded through
183.21 	other state or federal funding;
183.22 	(6) the monthly cost of the alternative care services
183.23 	funded by the program for this person does not exceed 75 percent
183.24 	of the monthly limit described under section 256B.0915,
183.25 	subdivision 3a.  This monthly limit does not prohibit the
183.26 	alternative care client from payment for additional services,
183.27 	but in no case may the cost of additional services purchased
183.28 	under this section exceed the difference between the client's
183.29 	monthly service limit defined under section 256B.0915,
183.30 	subdivision 3, and the alternative care program monthly service
183.31 	limit defined in this paragraph.  If medical supplies and
183.32 	equipment or environmental modifications are or will be
183.33 	purchased for an alternative care services recipient, the costs
183.34 	may be prorated on a monthly basis for up to 12 consecutive
183.35 	months beginning with the month of purchase.  If the monthly
183.36 	cost of a recipient's other alternative care services exceeds
184.1 	the monthly limit established in this paragraph, the annual cost
184.2 	of the alternative care services shall be determined.  In this
184.3 	event, the annual cost of alternative care services shall not
184.4 	exceed 12 times the monthly limit described in this paragraph;
184.5 	and
184.6 	(7) the person is making timely payments of the assessed
184.7 	monthly fee.
184.8 	A person is ineligible if payment of the fee is over 60 days
184.9 	past due, unless the person agrees to:
184.10 	(i) the appointment of a representative payee;
184.11 	(ii) automatic payment from a financial account;
184.12 	(iii) the establishment of greater family involvement in
184.13 	the financial management of payments; or
184.14 	(iv) another method acceptable to the county to ensure
184.15 	prompt fee payments.
184.16 	The county shall extend the client's eligibility as
184.17 	necessary while making arrangements to facilitate payment of
184.18 	past-due amounts and future premium payments.  Following
184.19 	disenrollment due to nonpayment of a monthly fee, eligibility
184.20 	shall not be reinstated for a period of 30 days.
184.21 	(b) Alternative care funding under this subdivision is not
184.22 	available for a person who is a medical assistance recipient or
184.23 	who would be eligible for medical assistance without a spenddown
184.24 	or waiver obligation.  A person whose initial application for
184.25 	medical assistance and the elderly waiver program is being
184.26 	processed may be served under the alternative care program for a
184.27 	period up to 60 days.  If the individual is found to be eligible
184.28 	for medical assistance, medical assistance must be billed for
184.29 	services payable under the federally approved elderly waiver
184.30 	plan and delivered from the date the individual was found
184.31 	eligible for the federally approved elderly waiver plan.
184.32 	Notwithstanding this provision, alternative care funds may not
184.33 	be used to pay for any service the cost of which:  (i) is
184.34 	payable by medical assistance; (ii) is used by a recipient to
184.35 	meet a waiver obligation; or (iii) is used to pay a medical
184.36 	assistance income spenddown for a person who is eligible to
185.1 	participate in the federally approved elderly waiver program
185.2 	under the special income standard provision.
185.3 	(c) Alternative care funding is not available for a person
185.4 	who resides in a licensed nursing home, certified boarding care
185.5 	home, hospital, or intermediate care facility, except for case
185.6 	management services which are provided in support of the
185.7 	discharge planning process for a nursing home resident or
185.8 	certified boarding care home resident to assist with a
185.9 	relocation process to a community-based setting.
185.10 	(d) Alternative care funding is not available for a person
185.11 	whose income is greater than the maintenance needs allowance
185.12 	under section 256B.0915, subdivision 1d, but equal to or less
185.13 	than 120 percent of the federal poverty guideline effective July
185.14 	1 in the year for which alternative care eligibility is
185.15 	determined, who would be eligible for the elderly waiver with a
185.16 	waiver obligation.

185.17 	Sec. 15. Minnesota Statutes 2004, section 256B.0916, is
185.18 	amended by adding a subdivision to read:
185.19 		Subd. 10.Transitional supports allowance. A
185.20 	transitional supports allowance shall be available to all
185.21 	persons under a home and community-based waiver who are moving
185.22 	from a licensed setting to a community setting.  "Transitional
185.23 	supports allowance" means a onetime payment of up to $3,000, to
185.24 	cover the costs, not covered by other sources, associated with
185.25 	moving from a licensed setting to a community setting.  Covered
185.26 	costs include:
185.27 	(1) lease or rent deposits;
185.28 	(2) security deposits;
185.29 	(3) utilities set-up costs, including telephone;
185.30 	(4) essential furnishings and supplies; and 
185.31 	(5) personal supports and transports needed to locate and
185.32 	transition to community settings.
185.33 	
EFFECTIVE DATE. This section is effective upon federal
185.34 	approval and to the extent approved as a federal waiver
185.35 	amendment.

185.36 	Sec. 16. Minnesota Statutes 2004, section 256B.095, is
186.1 	amended to read:
186.2 	256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
186.3 	(a) Effective July 1, 1998, a quality assurance system for
186.4 	persons with developmental disabilities, which includes an
186.5 	alternative quality assurance licensing system for programs, is
186.6 	established in Dodge, Fillmore, Freeborn, Goodhue, Houston,
186.7 	Mower, Olmsted, Rice, Steele, Wabasha, and Winona Counties for
186.8 	the purpose of improving the quality of services provided to
186.9 	persons with developmental disabilities.  A county, at its
186.10 	option, may choose to have all programs for persons with
186.11 	developmental disabilities located within the county licensed
186.12 	under chapter 245A using standards determined under the
186.13 	alternative quality assurance licensing system or may continue
186.14 	regulation of these programs under the licensing system operated
186.15 	by the commissioner.  The project expires on June 30, 2007 2009.
186.16 	(b) Effective July 1, 2003, a county not listed in
186.17 	paragraph (a) may apply to participate in the quality assurance
186.18 	system established under paragraph (a).  The commission
186.19 	established under section 256B.0951 may, at its option, allow
186.20 	additional counties to participate in the system.
186.21 	(c) Effective July 1, 2003, any county or group of counties
186.22 	not listed in paragraph (a) may establish a quality assurance
186.23 	system under this section.  A new system established under this
186.24 	section shall have the same rights and duties as the system
186.25 	established under paragraph (a).  A new system shall be governed
186.26 	by a commission under section 256B.0951.  The commissioner shall
186.27 	appoint the initial commission members based on recommendations
186.28 	from advocates, families, service providers, and counties in the
186.29 	geographic area included in the new system.  Counties that
186.30 	choose to participate in a new system shall have the duties
186.31 	assigned under section 256B.0952.  The new system shall
186.32 	establish a quality assurance process under section 256B.0953.
186.33 	The provisions of section 256B.0954 shall apply to a new system
186.34 	established under this paragraph.  The commissioner shall
186.35 	delegate authority to a new system established under this
186.36 	paragraph according to section 256B.0955.

187.1 	Sec. 17. Minnesota Statutes 2004, section 256B.0951,
187.2 	subdivision 1, is amended to read:
187.3 		Subdivision 1.Membership.  The Quality Assurance
187.4 	Commission is established.  The commission consists of at least
187.5 	14 but not more than 21 members as follows:  at least three but
187.6 	not more than five members representing advocacy organizations;
187.7 	at least three but not more than five members representing
187.8 	consumers, families, and their legal representatives; at least
187.9 	three but not more than five members representing service
187.10 	providers; at least three but not more than five members
187.11 	representing counties; and the commissioner of human services or
187.12 	the commissioner's designee.  The first commission shall
187.13 	establish membership guidelines for the transition and
187.14 	recruitment of membership for the commission's ongoing
187.15 	existence.  Members of the commission who do not receive a
187.16 	salary or wages from an employer for time spent on commission
187.17 	duties may receive a per diem payment when performing commission
187.18 	duties and functions.  All members may be reimbursed for
187.19 	expenses related to commission activities.  Notwithstanding the
187.20 	provisions of section 15.059, subdivision 5, the commission
187.21 	expires on June 30, 2007 2009.

187.22 	Sec. 18. Minnesota Statutes 2004, section 256B.0952,
187.23 	subdivision 5, is amended to read:
187.24 		Subd. 5.Quality assurance teams.  Quality assurance
187.25 	teams shall be comprised of county staff; providers; consumers,
187.26 	families, and their legal representatives; members of advocacy
187.27 	organizations; and other involved community members.  Team
187.28 	members must satisfactorily complete the training program
187.29 	approved by the commission and must demonstrate
187.30 	performance-based competency.  Team members are not considered
187.31 	to be county employees for purposes of workers' compensation,
187.32 	unemployment insurance, or state retirement laws solely on the
187.33 	basis of participation on a quality assurance team.  The county
187.34 	may pay a per diem to team members who do not receive a salary
187.35 	or wages from an employer for time spent on alternative quality
187.36 	assurance process matters.  All team members may be reimbursed
188.1 	for expenses related to their participation in the alternative
188.2 	process.

188.3 	Sec. 19. Minnesota Statutes 2004, section 256B.0953,
188.4 	subdivision 1, is amended to read:
188.5 		Subdivision 1.Process components.  (a) The quality
188.6 	assurance licensing process consists of an evaluation by a
188.7 	quality assurance team of the facility, program, or service
188.8 	according to outcome-based measurements.  The process must
188.9 	include an evaluation of a random sample of program consumers.
188.10 	The sample must be representative of each service provided.  The
188.11 	sample size must be at least five percent of consumers but not
188.12 	less than three two consumers.
188.13 	(b) All consumers must be given the opportunity to be
188.14 	included in the quality assurance process in addition to those
188.15 	chosen for the random sample.

188.16 	Sec. 20. Minnesota Statutes 2004, section 256B.19,
188.17 	subdivision 1, is amended to read:
188.18 		Subdivision 1.Division of cost.  The state and county
188.19 	share of medical assistance costs not paid by federal funds
188.20 	shall be as follows:
188.21 	(1) beginning January 1, 1992, 50 percent state funds and
188.22 	50 percent county funds for the cost of placement of severely
188.23 	emotionally disturbed children in regional treatment centers;
188.24 	(2) beginning January 1, 2003, 80 percent state funds and
188.25 	20 percent county funds for the costs of nursing facility
188.26 	placements of persons with disabilities under the age of 65 that
188.27 	have exceeded 90 days.  This clause shall be subject to chapter
188.28 	256G and shall not apply to placements in facilities not
188.29 	certified to participate in medical assistance;
188.30 	(3) beginning July 1, 2004, 80 95 percent state funds and
188.31 	20 five percent county funds for the costs of placements that
188.32 	have exceeded 90 days in intermediate care facilities for
188.33 	persons with mental retardation or a related condition that have
188.34 	seven or more beds.  This provision includes pass-through
188.35 	payments made under section 256B.5015; and
188.36 	(4) beginning July 1, 2004, when state funds are used to
189.1 	pay for a nursing facility placement due to the facility's
189.2 	status as an institution for mental diseases (IMD), the county
189.3 	shall pay 20 percent of the nonfederal share of costs that have
189.4 	exceeded 90 days.  This clause is subject to chapter 256G.
189.5 	For counties that participate in a Medicaid demonstration
189.6 	project under sections 256B.69 and 256B.71, the division of the
189.7 	nonfederal share of medical assistance expenses for payments
189.8 	made to prepaid health plans or for payments made to health
189.9 	maintenance organizations in the form of prepaid capitation
189.10 	payments, this division of medical assistance expenses shall be
189.11 	95 percent by the state and five percent by the county of
189.12 	financial responsibility.
189.13 	In counties where prepaid health plans are under contract
189.14 	to the commissioner to provide services to medical assistance
189.15 	recipients, the cost of court ordered treatment ordered without
189.16 	consulting the prepaid health plan that does not include
189.17 	diagnostic evaluation, recommendation, and referral for
189.18 	treatment by the prepaid health plan is the responsibility of
189.19 	the county of financial responsibility.
189.20 	
EFFECTIVE DATE. This section is effective the day
189.21 	following final enactment.

189.22 	Sec. 21. Minnesota Statutes 2004, section 256B.49,
189.23 	subdivision 16, is amended to read:
189.24 		Subd. 16.Services and supports.  (a) Services and
189.25 	supports included in the home and community-based waivers for
189.26 	persons with disabilities shall meet the requirements set out in
189.27 	United States Code, title 42, section 1396n.  The services and
189.28 	supports, which are offered as alternatives to institutional
189.29 	care, shall promote consumer choice, community inclusion,
189.30 	self-sufficiency, and self-determination.
189.31 	(b) Beginning January 1, 2003, the commissioner shall
189.32 	simplify and improve access to home and community-based waivered
189.33 	services, to the extent possible, through the establishment of a
189.34 	common service menu that is available to eligible recipients
189.35 	regardless of age, disability type, or waiver program.
189.36 	(c) Consumer directed community support services shall be
190.1 	offered as an option to all persons eligible for services under
190.2 	subdivision 11, by January 1, 2002.
190.3 	(d) Services and supports shall be arranged and provided
190.4 	consistent with individualized written plans of care for
190.5 	eligible waiver recipients.
190.6 	(e) A transitional supports allowance shall be available to
190.7 	all persons under a home and community-based waiver who are
190.8 	moving from a licensed setting to a community setting.
190.9 	"Transitional supports allowance" means a onetime payment of up
190.10 	to $3,000, to cover the costs, not covered by other sources,
190.11 	associated with moving from a licensed setting to a community
190.12 	setting.  Covered costs include:
190.13 	(1) lease or rent deposits;
190.14 	(2) security deposits;
190.15 	(3) utilities set-up costs, including telephone;
190.16 	(4) essential furnishings and supplies; and 
190.17 	(5) personal supports and transports needed to locate and
190.18 	transition to community settings.
190.19 	(f) The state of Minnesota and county agencies that
190.20 	administer home and community-based waivered services for
190.21 	persons with disabilities, shall not be liable for damages,
190.22 	injuries, or liabilities sustained through the purchase of
190.23 	supports by the individual, the individual's family, legal
190.24 	representative, or the authorized representative with funds
190.25 	received through the consumer-directed community support service
190.26 	under this section.  Liabilities include but are not limited
190.27 	to:  workers' compensation liability, the Federal Insurance
190.28 	Contributions Act (FICA), or the Federal Unemployment Tax Act
190.29 	(FUTA).
190.30 	
EFFECTIVE DATE. This section is effective upon federal
190.31 	approval and to the extent approved as a federal waiver
190.32 	amendment.

190.33 	Sec. 22. Minnesota Statutes 2004, section 256B.5012, is
190.34 	amended by adding a subdivision to read:
190.35 		Subd. 6.Icf/mr rate increases beginning october 1, 2005,
190.36 	and october 1, 2006. For the rate years beginning October 1,
191.1 	2005, and October 1, 2006, the commissioner shall provide
191.2 	facilities reimbursed under this section an adjustment to the
191.3 	total operating payment rate of two percent.  At least
191.4 	two-thirds of each year's adjustment must be used for increased
191.5 	costs of employee salaries and benefits and associated costs for
191.6 	FICA, the Medicare tax, workers' compensation premiums, and
191.7 	federal and state unemployment insurance.  Each facility
191.8 	receiving an adjustment shall report to the commissioner, in the
191.9 	form and manner specified by the commissioner, on how the
191.10 	additional funding was used.

191.11 	Sec. 23. Minnesota Statutes 2004, section 256B.69,
191.12 	subdivision 23, is amended to read:
191.13 		Subd. 23.Alternative integrated long-term care services;
191.14 	elderly and disabled persons.  (a) The commissioner may
191.15 	implement demonstration projects to create alternative
191.16 	integrated delivery systems for acute and long-term care
191.17 	services to elderly persons and persons with disabilities as
191.18 	defined in section 256B.77, subdivision 7a, that provide
191.19 	increased coordination, improve access to quality services, and
191.20 	mitigate future cost increases.  The commissioner may seek
191.21 	federal authority to combine Medicare and Medicaid capitation
191.22 	payments for the purpose of such demonstrations.  Medicare funds
191.23 	and services shall be administered according to the terms and
191.24 	conditions of the federal waiver and demonstration provisions.
191.25 	For the purpose of administering medical assistance funds,
191.26 	demonstrations under this subdivision are subject to
191.27 	subdivisions 1 to 22.  The provisions of Minnesota Rules, parts
191.28 	9500.1450 to 9500.1464, apply to these demonstrations, with the
191.29 	exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457,
191.30 	subpart 1, items B and C, which do not apply to persons
191.31 	enrolling in demonstrations under this section.  An initial open
191.32 	enrollment period may be provided.  Persons who disenroll from
191.33 	demonstrations under this subdivision remain subject to
191.34 	Minnesota Rules, parts 9500.1450 to 9500.1464.  When a person is
191.35 	enrolled in a health plan under these demonstrations and the
191.36 	health plan's participation is subsequently terminated for any
192.1 	reason, the person shall be provided an opportunity to select a
192.2 	new health plan and shall have the right to change health plans
192.3 	within the first 60 days of enrollment in the second health
192.4 	plan.  Persons required to participate in health plans under
192.5 	this section who fail to make a choice of health plan shall not
192.6 	be randomly assigned to health plans under these demonstrations.
192.7 	Notwithstanding section 256L.12, subdivision 5, and Minnesota
192.8 	Rules, part 9505.5220, subpart 1, item A, if adopted, for the
192.9 	purpose of demonstrations under this subdivision, the
192.10 	commissioner may contract with managed care organizations,
192.11 	including counties, to serve only elderly persons eligible for
192.12 	medical assistance, elderly and disabled persons, or disabled
192.13 	persons only.  For persons with primary diagnoses of mental
192.14 	retardation or a related condition, serious and persistent
192.15 	mental illness, or serious emotional disturbance, the
192.16 	commissioner must ensure that the county authority has approved
192.17 	the demonstration and contracting design.  Enrollment in these
192.18 	projects for persons with disabilities shall be voluntary.  The
192.19 	commissioner shall not implement any demonstration project under
192.20 	this subdivision for persons with primary diagnoses of mental
192.21 	retardation or a related condition, serious and persistent
192.22 	mental illness, or serious emotional disturbance, without
192.23 	approval of the county board of the county in which the
192.24 	demonstration is being implemented.
192.25 	(b) Notwithstanding chapter 245B, sections 252.40 to
192.26 	252.46, 256B.092, 256B.501 to 256B.5015, and Minnesota Rules,
192.27 	parts 9525.0004 to 9525.0036, 9525.1200 to 9525.1330, 9525.1580,
192.28 	and 9525.1800 to 9525.1930, the commissioner may implement under
192.29 	this section projects for persons with developmental
192.30 	disabilities.  The commissioner may capitate payments for ICF/MR
192.31 	services, waivered services for mental retardation or related
192.32 	conditions, including case management services, day training and
192.33 	habilitation and alternative active treatment services, and
192.34 	other services as approved by the state and by the federal
192.35 	government.  Case management and active treatment must be
192.36 	individualized and developed in accordance with a
193.1 	person-centered plan.  Costs under these projects may not exceed
193.2 	costs that would have been incurred under fee-for-service.
193.3 	Beginning July 1, 2003, and until two years after the pilot
193.4 	project implementation date, subcontractor participation in the
193.5 	long-term care developmental disability pilot is limited to a
193.6 	nonprofit long-term care system providing ICF/MR services, home
193.7 	and community-based waiver services, and in-home services to no
193.8 	more than 120 consumers with developmental disabilities in
193.9 	Carver, Hennepin, and Scott Counties.  The commissioner shall
193.10 	report to the legislature prior to expansion of the
193.11 	developmental disability pilot project.  This paragraph expires
193.12 	two years after the implementation date of the pilot project.
193.13 	(c) Before implementation of a demonstration project for
193.14 	disabled persons, the commissioner must provide information to
193.15 	appropriate committees of the house of representatives and
193.16 	senate and must involve representatives of affected disability
193.17 	groups in the design of the demonstration projects.
193.18 	(d) A nursing facility reimbursed under the alternative
193.19 	reimbursement methodology in section 256B.434 may, in
193.20 	collaboration with a hospital, clinic, or other health care
193.21 	entity provide services under paragraph (a).  The commissioner
193.22 	shall amend the state plan and seek any federal waivers
193.23 	necessary to implement this paragraph.
193.24 	(e) The commissioner, in consultation with the
193.25 	commissioners of commerce and health, may approve and implement
193.26 	programs for all-inclusive care for the elderly (PACE) according
193.27 	to federal laws and regulations governing that program and state
193.28 	laws or rules applicable to participating providers.  The
193.29 	process for approval of these programs shall begin only after
193.30 	the commissioner receives grant money in an amount sufficient to
193.31 	cover the state share of the administrative and actuarial costs
193.32 	to implement the programs during state fiscal years 2006 through
193.33 	2009.  Grants for this purpose shall be deposited in an account
193.34 	in the special revenue fund and are appropriated to the
193.35 	commissioner to be used solely for the purpose of PACE
193.36 	administrative and actuarial costs.  A PACE provider is not
194.1 	required to be licensed or certified as a health plan company as
194.2 	defined in section 62Q.01, subdivision 4.  Persons age 55 and
194.3 	older who have been screened by the county and found to be
194.4 	eligible for services under the elderly waiver or community
194.5 	alternatives for disabled individuals or who are already
194.6 	eligible for Medicaid but meet level of care criteria for
194.7 	receipt of waiver services may choose to enroll in the PACE
194.8 	program.  Medicare and Medicaid services will be provided
194.9 	according to this subdivision and federal Medicare and Medicaid
194.10 	requirements governing PACE providers and programs.  PACE
194.11 	enrollees will receive Medicaid home and community-based
194.12 	services through the PACE provider as an alternative to services
194.13 	for which they would otherwise be eligible through home and
194.14 	community-based waiver programs and Medicaid State Plan
194.15 	Services.  The commissioner shall establish Medicaid rates for
194.16 	PACE providers that do not exceed costs that would have been
194.17 	incurred under fee-for-service or other relevant managed care
194.18 	programs operated by the state.
194.19 	(f) The commissioner shall seek federal approval to expand
194.20 	the Minnesota disability health options (MnDHO) program
194.21 	established under this subdivision in stages, first to regional
194.22 	population centers outside the seven-county metro area and then
194.23 	to all areas of the state.
194.24 	(g) Notwithstanding section 256B.0261, health plans
194.25 	providing services under this section are responsible for home
194.26 	care targeted case management and relocation targeted case
194.27 	management.  Services must be provided according to the terms of
194.28 	the waivers and contracts approved by the federal government.

194.29 	Sec. 24. [256B.762] REIMBURSEMENT FOR HEALTH CARE
194.30 	SERVICES.
194.31 	Effective for services provided on or after October 1,
194.32 	2005, payment rates for the following services shall be
194.33 	increased by five percent over the rates in effect on September
194.34 	30, 2005, when these services are provided as home health
194.35 	services under section 256B.0625, subdivision 6a:
194.36 	(1) skilled nursing visit;
195.1 	(2) physical therapy visit;
195.2 	(3) occupational therapy visit;
195.3 	(4) speech therapy visit; and 
195.4 	(5) home health aide visit.

195.5 	Sec. 25. Minnesota Statutes 2004, section 256B.765, is
195.6 	amended to read:
195.7 	256B.765 PROVIDER RATE INCREASES.
195.8 		Subdivision 1.Annual inflation adjustments. (a)
195.9 	Effective July 1, 2001, within the limits of appropriations
195.10 	specifically for this purpose, the commissioner shall provide an
195.11 	annual inflation adjustment for the providers listed
195.12 	in paragraph (c) subdivision 2.  The index for the inflation
195.13 	adjustment must be based on the change in the Employment Cost
195.14 	Index for Private Industry Workers - Total Compensation
195.15 	forecasted by Data Resources, Inc., as forecasted in the fourth
195.16 	quarter of the calendar year preceding the fiscal year.  The
195.17 	commissioner shall increase reimbursement or allocation rates by
195.18 	the percentage of this adjustment, and county boards shall
195.19 	adjust provider contracts as needed.
195.20 	(b) The commissioner of finance shall include an annual
195.21 	inflationary adjustment in reimbursement rates for the providers
195.22 	listed in paragraph (c) subdivision 2 using the inflation factor
195.23 	specified in paragraph (a) as a budget change request in each
195.24 	biennial detailed expenditure budget submitted to the
195.25 	legislature under section 16A.11.
195.26 	(c) Subd. 2.[ELIGIBLE PROVIDERS.] The annual adjustment
195.27 	under subdivision 1,paragraph (a),shall be provided for home
195.28 	and community-based waiver services for persons with mental
195.29 	retardation or related conditions under section 256B.501; home
195.30 	and community-based waiver services for the elderly under
195.31 	section 256B.0915; waivered services under community
195.32 	alternatives for disabled individuals under section 256B.49;
195.33 	community alternative care waivered services under section
195.34 	256B.49; traumatic brain injury waivered services under section
195.35 	256B.49; nursing services and home health services under section
195.36 	256B.0625, subdivision 6a; personal care services and nursing
196.1 	supervision of personal care services under section 256B.0625,
196.2 	subdivision 19a; private duty nursing services under section
196.3 	256B.0625, subdivision 7; day training and habilitation services
196.4 	for adults with mental retardation or related conditions under
196.5 	sections 252.40 to 252.46; physical therapy services under
196.6 	sections 256B.0625, subdivision 8, and 256D.03, subdivision 4;
196.7 	occupational therapy services under sections 256B.0625,
196.8 	subdivision 8a, and 256D.03, subdivision 4; speech-language
196.9 	therapy services under section 256D.03, subdivision 4, and
196.10 	Minnesota Rules, part 9505.0390; respiratory therapy services
196.11 	under section 256D.03, subdivision 4, and Minnesota Rules, part
196.12 	9505.0295; alternative care services under section 256B.0913;
196.13 	adult residential program grants under Minnesota Rules, parts
196.14 	9535.2000 to 9535.3000; adult and family community support
196.15 	grants under Minnesota Rules, parts 9535.1700 to 9535.1760;
196.16 	semi-independent living services under section 252.275 including
196.17 	SILS funding under county social services grants formerly funded
196.18 	under chapter 256I; and community support services for deaf and
196.19 	hard-of-hearing adults with mental illness who use or wish to
196.20 	use sign language as their primary means of communication.
196.21 		Subd. 3.Rate increase for rate periods beginning october
196.22 	1, 2005. For the rate periods beginning October 1, 2005, and
196.23 	October 1, 2006, the commissioner shall increase reimbursement
196.24 	rates for the providers listed in subdivision 2 by two percent.
196.25 	At least two-thirds of each year's adjustment must be used for
196.26 	increased costs of employee salaries and benefits and associated
196.27 	costs for FICA, the Medicare tax, workers' compensation
196.28 	premiums, and federal and state unemployment insurance.  Each
196.29 	provider receiving an adjustment shall report to the
196.30 	commissioner, in the form and manner specified by the
196.31 	commissioner, on how the additional funding was used.

196.32 	Sec. 26. ICF/MR PLAN.
 196.33 	The commissioner of human services shall consult with
196.34 	ICF/MR providers, advocates, counties, and consumer families to
196.35 	develop recommendations and legislation concerning the future
196.36 	services provided to people now served in ICFs/MR.  The
197.1 	recommendations shall be reported to the house and senate
197.2 	committees with jurisdiction over health and human services
197.3 	policy and finance issues by January 15, 2006.  In preparing the
197.4 	recommendations, the commissioner shall consider:
197.5 	(1) consumer choice of services;
197.6 	(2) consumers' service needs, including, but not limited
197.7 	to, active treatment;
197.8 	(3) the total cost of providing services in ICFs/MR and
197.9 	alternative delivery systems for individuals currently residing
197.10 	in ICFs/MR;
197.11 	(4) whether it is the policy of the state to maintain an
197.12 	ICF/MR system and, if so, the recommendations shall:
197.13 	(i) define the purpose, types of services, and intended
197.14 	recipients of ICF/MR services;
197.15 	(ii) define the capacity needed to maintain ICF/MR services
197.16 	for designated populations; and 
197.17 	(iii) assure that mechanisms are provided to adequately
197.18 	fund the transition to the defined services, maintain the
197.19 	designated capacity, and are adjustable to meet increased
197.20 	service demands; and 
197.21 	(5) if alternative services are recommended to support the
197.22 	people now receiving services in an ICF/MR, the recommendations
197.23 	shall provide for transition planning and ensure adequate state
197.24 	and federal financial resources are available to meet the needs
197.25 	of ICF/MR recipients.

197.26 	EFFECTIVE DATE. This section is effective the day
197.27 	following final enactment.

197.28 	Sec. 27. DIRECTION TO THE COMMISSIONER; LICENSING AND
197.29 	ALTERNATIVE QUALITY ASSURANCE STUDY.
 197.30 	The commissioner of human services shall arrange for a
197.31 	study, including recommendations for statewide development and
197.32 	implementation of regional or local quality assurance models for
197.33 	disability services.  The study shall include a review of
197.34 	current projects or models; make findings regarding the best
197.35 	components, role, and function of such models within a statewide
197.36 	quality assurance system; and shall estimate the cost and
198.1 	sources of funding for regional and local quality assurance
198.2 	models on a statewide basis.  The study shall be done in
198.3 	consultation with counties, consumers of service, providers, and
198.4 	representatives of the Quality Assurance Commission under
198.5 	Minnesota Statutes, section 256B.0951, subdivision 1.
198.6 	The study shall be submitted to the chairs of the
198.7 	legislative committees with jurisdiction over health and human
198.8 	services with recommendations on implementation of a statewide
198.9 	system of quality assurance and licensing by July 1, 2006.  The
198.10 	commissioner shall submit proposed legislation for
198.11 	implementation of a statewide system of quality assurance to the
198.12 	chairs of the legislative committees with jurisdiction over
198.13 	health and human services by December 15, 2006.

198.14 	Sec. 28. CONSUMER-DIRECTED COMMUNITY SUPPORTS EXCEPTION.
 198.15 	(a) Effective upon federal approval, for persons using the
198.16 	home and community-based waiver for persons with developmental
198.17 	disabilities consumer-directed community supports option whose
198.18 	budgets were reduced by the October 2004 state set budget
198.19 	methodology, the commissioner must allow exceptions to exceed
198.20 	the state set budget formula amount up to the daily average cost
198.21 	during calendar year 2004 or for persons who graduated from
198.22 	school during 2004, the average daily cost during July through
198.23 	December 2004, less one-half case management and home
198.24 	modifications over $5,000, when the person's county of financial
198.25 	responsibility determines that:  (1) necessary alternative
198.26 	services will cost the same or more than the person's current
198.27 	budget, and (2) administrative expenses or provider rates will
198.28 	result in fewer hours of needed staffing for the person than
198.29 	under the consumer-directed community supports option.  Any
198.30 	exceptions the county grants must be within the county's
198.31 	allowable aggregate amount for the home and community-based
198.32 	waiver for persons with developmental disabilities.
198.33 	(b) This section expires on the date the Department of
198.34 	Human Services implements a new consumer-directed community
198.35 	supports budget methodology that is based on reliable and
198.36 	accurate information about the services and supports intensity
199.1 	needs of persons using the option which adequately accounts for
199.2 	the increased costs of adults who graduate from school and need
199.3 	services funded by the waiver during the day.

199.4 	Sec. 29. COSTS ASSOCIATED WITH PHYSICAL ACTIVITIES.
 199.5 	Effective upon federal approval, the expenses allowed for
199.6 	adults under the consumer-directed community supports option
199.7 	shall include the costs at the lowest rate available considering
199.8 	daily, monthly, semi-annual, annual, or membership rates,
199.9 	including transportation, associated with physical exercise or
199.10 	other physical activities to maintain or improve the person's
199.11 	health and functioning.

199.12 	Sec. 30. WAIVER AMENDMENT.
 199.13 	The commissioner of human services shall submit an
199.14 	amendment to the Centers for Medicare and Medicaid Services
199.15 	consistent with sections 28 and 29 by August 1, 2005.

199.16 	EFFECTIVE DATE. This section is effective the day
199.17 	following final enactment.

199.18 	Sec. 31. INDEPENDENT EVALUATION AND REVIEW OF UNALLOWABLE
199.19 	ITEMS.
 199.20 	The commissioner of human services shall include in the
199.21 	independent evaluation of the consumer-directed community
199.22 	supports option provided through the home and community-based
199.23 	services waivers for persons with disabilities under 65 years of
199.24 	age:  (1) provisions for ongoing, regular stakeholder
199.25 	representatives participation through June 30, 2007; (2)
199.26 	recommendations to the legislative committees with jurisdiction
199.27 	over human services policy and finance issues by January 15,
199.28 	2006, on whether changes to the unallowable items should be made
199.29 	to meet the health, safety, or welfare needs of participants in
199.30 	the consumer-directed community supports option within the
199.31 	allowed budget amounts; and (3) a review of the statewide
199.32 	caseload changes for the disability waiver programs for persons
199.33 	under 65 years of age, which occurred after the state set budget
199.34 	methodology implementation on October 1, 2004, and
199.35 	recommendations on the fiscal impact of the budget methodology
199.36 	on use of the consumer-directed community supports option.

200.1 	EFFECTIVE DATE. This section is effective the day
200.2 	following final enactment.

200.3 	Sec. 32. FEDERAL APPROVAL.
 200.4 	By August 1, 2005, the commissioner of human services shall
200.5 	request any federal approval and plan amendments necessary to
200.6 	implement (1) the transitional supports allowance under
200.7 	Minnesota Statutes, sections 256B.0916, subdivision 10, and
200.8 	256B.49, subdivision 16; and (2) the choice of case management
200.9 	service coordination provisions under Minnesota Statutes,
200.10 	section 256B.0621, subdivisions 4, 5, 6, and 7.

200.11 	Sec. 33. DENTAL ACCESS FOR PERSONS WITH DISABILITIES.
 200.12 	The commissioner of human services shall study access to
200.13 	dental services for persons with disabilities and shall present
200.14 	recommendations for improving access to dental services to the
200.15 	legislature by January 15, 2006.  The study must examine
200.16 	physical and geographic access, the willingness of dentists to
200.17 	serve persons with disabilities enrolled in state health care
200.18 	programs, reimbursement rates for dental service providers, and
200.19 	other factors identified by the commissioner as potential
200.20 	barriers to accessing dental services.  The commissioner shall
200.21 	direct the Dental Access Advisory Committee, established under
200.22 	Minnesota Statutes, section 256B.55, to assist in this study.

200.23 	Sec. 34. DISABILITY SERVICES INTERAGENCY WORK GROUP.
 200.24 		Subdivision 1.Membership. The Department of Human
200.25 	Services, the Minnesota Housing Finance Agency, and the
200.26 	Minnesota State Council on Disability shall convene an
200.27 	interagency work group which includes interested stakeholders
200.28 	including other state agencies, counties, public housing
200.29 	authorities, the Metropolitan Council, disability service
200.30 	providers, and representatives from disability advocacy
200.31 	organizations to identify barriers, strengthen coordination,
200.32 	recommend policy and funding changes, and pursue federal
200.33 	financing that will assist Minnesotans with disabilities who are
200.34 	attempting to relocate from or avoid placement in institutional
200.35 	settings.
200.36 		Subd. 2.Work group activities. The work group shall
201.1 	make recommendations to the state agencies and the legislature
201.2 	related to:
201.3 	(1) coordinating the availability of housing,
201.4 	transportation, and support services needed to discharge persons
201.5 	with disabilities from institutions;
201.6 	(2) improving information and assistance needed to make an
201.7 	informed choice about relocating from an institutional placement
201.8 	to community-based services;
201.9 	(3) identifying gaps in human services, transportation, or
201.10 	housing access which are barriers to moving to community
201.11 	services;
201.12 	(4) identifying strategies which would result in earlier
201.13 	identification of persons most at risk of institutional
201.14 	placement in order to promote diversion to community service or
201.15 	reduce length of stay in an institutional facility;
201.16 	(5) identifying funding mechanisms and financial strategies
201.17 	to assure a financially sustainable community support system
201.18 	that diverts and relocates individuals from institutional
201.19 	placement; and 
201.20 	(6) identifying state changes needed to address any federal
201.21 	changes affecting policies, benefits, or funding used to support
201.22 	persons with disabilities to avoid institutional placement.
201.23 		Subd. 3.Recommendations. Recommendations of the work
201.24 	group will be submitted to each participating state agency and
201.25 	to the chairs of the health and human services policy and
201.26 	finance committees of the senate and house of representatives by
201.27 	October 15, 2006.  This section expires October 15, 2006.

201.28 	Sec. 35. REPORT TO LEGISLATURE.
 201.29 	The commissioner shall report to the legislature on the
201.30 	redesign of case management services.  In preparing the report,
201.31 	the commissioner shall consult with representatives for
201.32 	consumers, consumer advocates, counties, and service providers.
201.33 	The report shall include draft legislation for case management
201.34 	changes that will:
201.35 	(1) streamline administration;
201.36 	(2) improve consumer access to case management services;
202.1 	(3) address the use of a comprehensive universal assessment
202.2 	protocol for persons seeking community supports;
202.3 	(4) establish case management performance measures;
202.4 	(5) provide for consumer choice of the case management
202.5 	service vendor; and 
202.6 	(6) provide a method of payment for case management
202.7 	services that is cost-effective and best supports the draft
202.8 	legislation in clauses (1) to (5).

202.9 	ARTICLE 6
202.10 	MISCELLANEOUS

202.11 	Section 1. Minnesota Statutes 2004, section 256.01,
202.12 	subdivision 2, is amended to read:
202.13 		Subd. 2.Specific powers.  Subject to the provisions of
202.14 	section 241.021, subdivision 2, the commissioner of human
202.15 	services shall carry out the specific duties in paragraphs (a)
202.16 	through (aa) (bb):
202.17 	(a) Administer and supervise all forms of public assistance
202.18 	provided for by state law and other welfare activities or
202.19 	services as are vested in the commissioner.  Administration and
202.20 	supervision of human services activities or services includes,
202.21 	but is not limited to, assuring timely and accurate distribution
202.22 	of benefits, completeness of service, and quality program
202.23 	management.  In addition to administering and supervising human
202.24 	services activities vested by law in the department, the
202.25 	commissioner shall have the authority to:
202.26 	(1) require county agency participation in training and
202.27 	technical assistance programs to promote compliance with
202.28 	statutes, rules, federal laws, regulations, and policies
202.29 	governing human services;
202.30 	(2) monitor, on an ongoing basis, the performance of county
202.31 	agencies in the operation and administration of human services,
202.32 	enforce compliance with statutes, rules, federal laws,
202.33 	regulations, and policies governing welfare services and promote
202.34 	excellence of administration and program operation;
202.35 	(3) develop a quality control program or other monitoring
202.36 	program to review county performance and accuracy of benefit
203.1 	determinations;
203.2 	(4) require county agencies to make an adjustment to the
203.3 	public assistance benefits issued to any individual consistent
203.4 	with federal law and regulation and state law and rule and to
203.5 	issue or recover benefits as appropriate;
203.6 	(5) delay or deny payment of all or part of the state and
203.7 	federal share of benefits and administrative reimbursement
203.8 	according to the procedures set forth in section 256.017;
203.9 	(6) make contracts with and grants to public and private
203.10 	agencies and organizations, both profit and nonprofit, and
203.11 	individuals, using appropriated funds; and
203.12 	(7) enter into contractual agreements with federally
203.13 	recognized Indian tribes with a reservation in Minnesota to the
203.14 	extent necessary for the tribe to operate a federally approved
203.15 	family assistance program or any other program under the
203.16 	supervision of the commissioner.  The commissioner shall consult
203.17 	with the affected county or counties in the contractual
203.18 	agreement negotiations, if the county or counties wish to be
203.19 	included, in order to avoid the duplication of county and tribal
203.20 	assistance program services.  The commissioner may establish
203.21 	necessary accounts for the purposes of receiving and disbursing
203.22 	funds as necessary for the operation of the programs.
203.23 	(b) Inform county agencies, on a timely basis, of changes
203.24 	in statute, rule, federal law, regulation, and policy necessary
203.25 	to county agency administration of the programs.
203.26 	(c) Administer and supervise all child welfare activities;
203.27 	promote the enforcement of laws protecting handicapped,
203.28 	dependent, neglected and delinquent children, and children born
203.29 	to mothers who were not married to the children's fathers at the
203.30 	times of the conception nor at the births of the children;
203.31 	license and supervise child-caring and child-placing agencies
203.32 	and institutions; supervise the care of children in boarding and
203.33 	foster homes or in private institutions; and generally perform
203.34 	all functions relating to the field of child welfare now vested
203.35 	in the State Board of Control.
203.36 	(d) Administer and supervise all noninstitutional service
204.1 	to handicapped persons, including those who are visually
204.2 	impaired, hearing impaired, or physically impaired or otherwise
204.3 	handicapped.  The commissioner may provide and contract for the
204.4 	care and treatment of qualified indigent children in facilities
204.5 	other than those located and available at state hospitals when
204.6 	it is not feasible to provide the service in state hospitals.
204.7 	(e) Assist and actively cooperate with other departments,
204.8 	agencies and institutions, local, state, and federal, by
204.9 	performing services in conformity with the purposes of Laws
204.10 	1939, chapter 431.
204.11 	(f) Act as the agent of and cooperate with the federal
204.12 	government in matters of mutual concern relative to and in
204.13 	conformity with the provisions of Laws 1939, chapter 431,
204.14 	including the administration of any federal funds granted to the
204.15 	state to aid in the performance of any functions of the
204.16 	commissioner as specified in Laws 1939, chapter 431, and
204.17 	including the promulgation of rules making uniformly available
204.18 	medical care benefits to all recipients of public assistance, at
204.19 	such times as the federal government increases its participation
204.20 	in assistance expenditures for medical care to recipients of
204.21 	public assistance, the cost thereof to be borne in the same
204.22 	proportion as are grants of aid to said recipients.
204.23 	(g) Establish and maintain any administrative units
204.24 	reasonably necessary for the performance of administrative
204.25 	functions common to all divisions of the department.
204.26 	(h) Act as designated guardian of both the estate and the
204.27 	person of all the wards of the state of Minnesota, whether by
204.28 	operation of law or by an order of court, without any further
204.29 	act or proceeding whatever, except as to persons committed as
204.30 	mentally retarded.  For children under the guardianship of the
204.31 	commissioner whose interests would be best served by adoptive
204.32 	placement, the commissioner may contract with a licensed
204.33 	child-placing agency or a Minnesota tribal social services
204.34 	agency to provide adoption services.  A contract with a licensed
204.35 	child-placing agency must be designed to supplement existing
204.36 	county efforts and may not replace existing county programs,
205.1 	unless the replacement is agreed to by the county board and the
205.2 	appropriate exclusive bargaining representative or the
205.3 	commissioner has evidence that child placements of the county
205.4 	continue to be substantially below that of other counties.
205.5 	Funds encumbered and obligated under an agreement for a specific
205.6 	child shall remain available until the terms of the agreement
205.7 	are fulfilled or the agreement is terminated.
205.8 	(i) Act as coordinating referral and informational center
205.9 	on requests for service for newly arrived immigrants coming to
205.10 	Minnesota.
205.11 	(j) The specific enumeration of powers and duties as
205.12 	hereinabove set forth shall in no way be construed to be a
205.13 	limitation upon the general transfer of powers herein contained.
205.14 	(k) Establish county, regional, or statewide schedules of
205.15 	maximum fees and charges which may be paid by county agencies
205.16 	for medical, dental, surgical, hospital, nursing and nursing
205.17 	home care and medicine and medical supplies under all programs
205.18 	of medical care provided by the state and for congregate living
205.19 	care under the income maintenance programs.
205.20 	(l) Have the authority to conduct and administer
205.21 	experimental projects to test methods and procedures of
205.22 	administering assistance and services to recipients or potential
205.23 	recipients of public welfare.  To carry out such experimental
205.24 	projects, it is further provided that the commissioner of human
205.25 	services is authorized to waive the enforcement of existing
205.26 	specific statutory program requirements, rules, and standards in
205.27 	one or more counties.  The order establishing the waiver shall
205.28 	provide alternative methods and procedures of administration,
205.29 	shall not be in conflict with the basic purposes, coverage, or
205.30 	benefits provided by law, and in no event shall the duration of
205.31 	a project exceed four years.  It is further provided that no
205.32 	order establishing an experimental project as authorized by the
205.33 	provisions of this section shall become effective until the
205.34 	following conditions have been met:
205.35 	(1) the secretary of health and human services of the
205.36 	United States has agreed, for the same project, to waive state
206.1 	plan requirements relative to statewide uniformity; and
206.2 	(2) a comprehensive plan, including estimated project
206.3 	costs, shall be approved by the Legislative Advisory Commission
206.4 	and filed with the commissioner of administration.
206.5 	(m) According to federal requirements, establish procedures
206.6 	to be followed by local welfare boards in creating citizen
206.7 	advisory committees, including procedures for selection of
206.8 	committee members.
206.9 	(n) Allocate federal fiscal disallowances or sanctions
206.10 	which are based on quality control error rates for the aid to
206.11 	families with dependent children program formerly codified in
206.12 	sections 256.72 to 256.87, medical assistance, or food stamp
206.13 	program in the following manner:
206.14 	(1) one-half of the total amount of the disallowance shall
206.15 	be borne by the county boards responsible for administering the
206.16 	programs.  For the medical assistance and the AFDC program
206.17 	formerly codified in sections 256.72 to 256.87, disallowances
206.18 	shall be shared by each county board in the same proportion as
206.19 	that county's expenditures for the sanctioned program are to the
206.20 	total of all counties' expenditures for the AFDC program
206.21 	formerly codified in sections 256.72 to 256.87, and medical
206.22 	assistance programs.  For the food stamp program, sanctions
206.23 	shall be shared by each county board, with 50 percent of the
206.24 	sanction being distributed to each county in the same proportion
206.25 	as that county's administrative costs for food stamps are to the
206.26 	total of all food stamp administrative costs for all counties,
206.27 	and 50 percent of the sanctions being distributed to each county
206.28 	in the same proportion as that county's value of food stamp
206.29 	benefits issued are to the total of all benefits issued for all
206.30 	counties.  Each county shall pay its share of the disallowance
206.31 	to the state of Minnesota.  When a county fails to pay the
206.32 	amount due hereunder, the commissioner may deduct the amount
206.33 	from reimbursement otherwise due the county, or the attorney
206.34 	general, upon the request of the commissioner, may institute
206.35 	civil action to recover the amount due; and
206.36 	(2) notwithstanding the provisions of clause (1), if the
207.1 	disallowance results from knowing noncompliance by one or more
207.2 	counties with a specific program instruction, and that knowing
207.3 	noncompliance is a matter of official county board record, the
207.4 	commissioner may require payment or recover from the county or
207.5 	counties, in the manner prescribed in clause (1), an amount
207.6 	equal to the portion of the total disallowance which resulted
207.7 	from the noncompliance, and may distribute the balance of the
207.8 	disallowance according to clause (1).
207.9 	(o) Develop and implement special projects that maximize
207.10 	reimbursements and result in the recovery of money to the
207.11 	state.  For the purpose of recovering state money, the
207.12 	commissioner may enter into contracts with third parties.  Any
207.13 	recoveries that result from projects or contracts entered into
207.14 	under this paragraph shall be deposited in the state treasury
207.15 	and credited to a special account until the balance in the
207.16 	account reaches $1,000,000.  When the balance in the account
207.17 	exceeds $1,000,000, the excess shall be transferred and credited
207.18 	to the general fund.  All money in the account is appropriated
207.19 	to the commissioner for the purposes of this paragraph.
207.20 	(p) Have the authority to make direct payments to
207.21 	facilities providing shelter to women and their children
207.22 	according to section 256D.05, subdivision 3.  Upon the written
207.23 	request of a shelter facility that has been denied payments
207.24 	under section 256D.05, subdivision 3, the commissioner shall
207.25 	review all relevant evidence and make a determination within 30
207.26 	days of the request for review regarding issuance of direct
207.27 	payments to the shelter facility.  Failure to act within 30 days
207.28 	shall be considered a determination not to issue direct payments.
207.29 	(q) Have the authority to establish and enforce the
207.30 	following county reporting requirements:
207.31 	(1) the commissioner shall establish fiscal and statistical
207.32 	reporting requirements necessary to account for the expenditure
207.33 	of funds allocated to counties for human services programs.
207.34 	When establishing financial and statistical reporting
207.35 	requirements, the commissioner shall evaluate all reports, in
207.36 	consultation with the counties, to determine if the reports can
208.1 	be simplified or the number of reports can be reduced;
208.2 	(2) the county board shall submit monthly or quarterly
208.3 	reports to the department as required by the commissioner.
208.4 	Monthly reports are due no later than 15 working days after the
208.5 	end of the month.  Quarterly reports are due no later than 30
208.6 	calendar days after the end of the quarter, unless the
208.7 	commissioner determines that the deadline must be shortened to
208.8 	20 calendar days to avoid jeopardizing compliance with federal
208.9 	deadlines or risking a loss of federal funding.  Only reports
208.10 	that are complete, legible, and in the required format shall be
208.11 	accepted by the commissioner;
208.12 	(3) if the required reports are not received by the
208.13 	deadlines established in clause (2), the commissioner may delay
208.14 	payments and withhold funds from the county board until the next
208.15 	reporting period.  When the report is needed to account for the
208.16 	use of federal funds and the late report results in a reduction
208.17 	in federal funding, the commissioner shall withhold from the
208.18 	county boards with late reports an amount equal to the reduction
208.19 	in federal funding until full federal funding is received;
208.20 	(4) a county board that submits reports that are late,
208.21 	illegible, incomplete, or not in the required format for two out
208.22 	of three consecutive reporting periods is considered
208.23 	noncompliant.  When a county board is found to be noncompliant,
208.24 	the commissioner shall notify the county board of the reason the
208.25 	county board is considered noncompliant and request that the
208.26 	county board develop a corrective action plan stating how the
208.27 	county board plans to correct the problem.  The corrective
208.28 	action plan must be submitted to the commissioner within 45 days
208.29 	after the date the county board received notice of
208.30 	noncompliance;
208.31 	(5) the final deadline for fiscal reports or amendments to
208.32 	fiscal reports is one year after the date the report was
208.33 	originally due.  If the commissioner does not receive a report
208.34 	by the final deadline, the county board forfeits the funding
208.35 	associated with the report for that reporting period and the
208.36 	county board must repay any funds associated with the report
209.1 	received for that reporting period;
209.2 	(6) the commissioner may not delay payments, withhold
209.3 	funds, or require repayment under clause (3) or (5) if the
209.4 	county demonstrates that the commissioner failed to provide
209.5 	appropriate forms, guidelines, and technical assistance to
209.6 	enable the county to comply with the requirements.  If the
209.7 	county board disagrees with an action taken by the commissioner
209.8 	under clause (3) or (5), the county board may appeal the action
209.9 	according to sections 14.57 to 14.69; and
209.10 	(7) counties subject to withholding of funds under clause
209.11 	(3) or forfeiture or repayment of funds under clause (5) shall
209.12 	not reduce or withhold benefits or services to clients to cover
209.13 	costs incurred due to actions taken by the commissioner under
209.14 	clause (3) or (5).
209.15 	(r) Allocate federal fiscal disallowances or sanctions for
209.16 	audit exceptions when federal fiscal disallowances or sanctions
209.17 	are based on a statewide random sample for the foster care
209.18 	program under title IV-E of the Social Security Act, United
209.19 	States Code, title 42, in direct proportion to each county's
209.20 	title IV-E foster care maintenance claim for that period.
209.21 	(s) Be responsible for ensuring the detection, prevention,
209.22 	investigation, and resolution of fraudulent activities or
209.23 	behavior by applicants, recipients, and other participants in
209.24 	the human services programs administered by the department.
209.25 	(t) Require county agencies to identify overpayments,
209.26 	establish claims, and utilize all available and cost-beneficial
209.27 	methodologies to collect and recover these overpayments in the
209.28 	human services programs administered by the department.
209.29 	(u) Have the authority to administer a drug rebate program
209.30 	for drugs purchased pursuant to the prescription drug program
209.31 	established under section 256.955 after the beneficiary's
209.32 	satisfaction of any deductible established in the program.  The
209.33 	commissioner shall require a rebate agreement from all
209.34 	manufacturers of covered drugs as defined in section 256B.0625,
209.35 	subdivision 13.  Rebate agreements for prescription drugs
209.36 	delivered on or after July 1, 2002, must include rebates for
210.1 	individuals covered under the prescription drug program who are
210.2 	under 65 years of age.  For each drug, the amount of the rebate
210.3 	shall be equal to the rebate as defined for purposes of the
210.4 	federal rebate program in United States Code, title 42, section
210.5 	1396r-8.  The manufacturers must provide full payment within 30
210.6 	days of receipt of the state invoice for the rebate within the
210.7 	terms and conditions used for the federal rebate program
210.8 	established pursuant to section 1927 of title XIX of the Social
210.9 	Security Act.  The manufacturers must provide the commissioner
210.10 	with any information necessary to verify the rebate determined
210.11 	per drug.  The rebate program shall utilize the terms and
210.12 	conditions used for the federal rebate program established
210.13 	pursuant to section 1927 of title XIX of the Social Security Act.
210.14 	(v) Have the authority to administer the federal drug
210.15 	rebate program for drugs purchased under the medical assistance
210.16 	program as allowed by section 1927 of title XIX of the Social
210.17 	Security Act and according to the terms and conditions of
210.18 	section 1927.  Rebates shall be collected for all drugs that
210.19 	have been dispensed or administered in an outpatient setting and
210.20 	that are from manufacturers who have signed a rebate agreement
210.21 	with the United States Department of Health and Human Services.
210.22 	(w) Have the authority to administer a supplemental drug
210.23 	rebate program for drugs purchased under the medical assistance
210.24 	program.  The commissioner may enter into supplemental rebate
210.25 	contracts with pharmaceutical manufacturers and may require
210.26 	prior authorization for drugs that are from manufacturers that
210.27 	have not signed a supplemental rebate contract.  Prior
210.28 	authorization of drugs shall be subject to the provisions of
210.29 	section 256B.0625, subdivision 13.
210.30 	(x) Operate the department's communication systems account
210.31 	established in Laws 1993, First Special Session chapter 1,
210.32 	article 1, section 2, subdivision 2, to manage shared
210.33 	communication costs necessary for the operation of the programs
210.34 	the commissioner supervises.  A communications account may also
210.35 	be established for each regional treatment center which operates
210.36 	communications systems.  Each account must be used to manage
211.1 	shared communication costs necessary for the operations of the
211.2 	programs the commissioner supervises.  The commissioner may
211.3 	distribute the costs of operating and maintaining communication
211.4 	systems to participants in a manner that reflects actual usage.
211.5 	Costs may include acquisition, licensing, insurance,
211.6 	maintenance, repair, staff time and other costs as determined by
211.7 	the commissioner.  Nonprofit organizations and state, county,
211.8 	and local government agencies involved in the operation of
211.9 	programs the commissioner supervises may participate in the use
211.10 	of the department's communications technology and share in the
211.11 	cost of operation.  The commissioner may accept on behalf of the
211.12 	state any gift, bequest, devise or personal property of any
211.13 	kind, or money tendered to the state for any lawful purpose
211.14 	pertaining to the communication activities of the department.
211.15 	Any money received for this purpose must be deposited in the
211.16 	department's communication systems accounts.  Money collected by
211.17 	the commissioner for the use of communication systems must be
211.18 	deposited in the state communication systems account and is
211.19 	appropriated to the commissioner for purposes of this section.
211.20 	(y) Receive any federal matching money that is made
211.21 	available through the medical assistance program for the
211.22 	consumer satisfaction survey.  Any federal money received for
211.23 	the survey is appropriated to the commissioner for this
211.24 	purpose.  The commissioner may expend the federal money received
211.25 	for the consumer satisfaction survey in either year of the
211.26 	biennium.
211.27 	(z) Designate community information and referral call
211.28 	centers and incorporate cost reimbursement claims from the
211.29 	designated community information and referral call centers into
211.30 	the federal cost reimbursement claiming processes of the
211.31 	department according to federal law, rule, and regulations.
211.32 	Existing information and referral centers provided by Greater
211.33 	Twin Cities United Way or existing call centers for which
211.34 	Greater Twin Cities United Way has legal authority to represent,
211.35 	shall be included in these designations upon review by the
211.36 	commissioner and assurance that these services are accredited
212.1 	and in compliance with national standards.  Any reimbursement is
212.2 	appropriated to the commissioner and all designated information
212.3 	and referral centers shall receive payments according to normal
212.4 	department schedules established by the commissioner upon final
212.5 	approval of allocation methodologies from the United States
212.6 	Department of Health and Human Services Division of Cost
212.7 	Allocation or other appropriate authorities.
212.8 	(aa) Develop recommended standards for foster care homes
212.9 	that address the components of specialized therapeutic services
212.10 	to be provided by foster care homes with those services.
212.11 	(bb) Authorize the method of payment to or from the
212.12 	department as part of the human services programs administered
212.13 	by the department.  This authorization includes the receipt or
212.14 	disbursement of funds held by the department in a fiduciary
212.15 	capacity as part of the human services programs administered by
212.16 	the department.

212.17 	Sec. 2. Minnesota Statutes 2004, section 256.01, is
212.18 	amended by adding a subdivision to read:
212.19 		Subd. 23.Annual report. Effective August 1, 2006, or on
212.20 	the date HealthMatch is fully implemented, whichever is later,
212.21 	the commissioner shall prepare an annual report of the number of
212.22 	eligible applicants who applied in the prior calendar year for
212.23 	Minnesota health care programs under chapters 256B, 256D, and
212.24 	256L, and had not lived in Minnesota for the 12 months prior to
212.25 	the application month.  The report shall indicate the number of
212.26 	applicants by state of prior residence or by the general
212.27 	category of foreign country.

212.28 	Sec. 3. DIRECTION TO COMMISSIONER; STUDY ON DEEMED INCOME
212.29 	OF SPONSORS OF NONCITIZENS.
 212.30 	The commissioner of human services shall assess county
212.31 	compliance with deeming the income and assets of sponsors of
212.32 	noncitizens under Minnesota Statutes, sections 256B.06,
212.33 	subdivision 5; 256D.03, subdivision 3, paragraph (i); 256D.05,
212.34 	subdivision 3; 256J.37, subdivision 2; and 256L.04, subdivision
212.35 	10a.  The commissioner shall report findings on county
212.36 	compliance with these provisions and make recommendations to
213.1 	ensure compliance to the legislative committees with
213.2 	jurisdiction over human services by January 15, 2006.

213.3 	ARTICLE 7
213.4 	MENTAL HEALTH SERVICES

213.5 	Section 1. Minnesota Statutes 2004, section 245.4885,
213.6 	subdivision 1, is amended to read:
213.7 		Subdivision 1.screening required admission criteria.
 213.8 	The county board shall, prior to admission, except in the case
213.9 	of emergency admission, screen determine the needed level of
213.10 	care for all children referred for treatment of severe emotional
213.11 	disturbance to in a treatment foster care setting,residential
213.12 	treatment facility,or informally admitted to a regional
213.13 	treatment center if public funds are used to pay for the
213.14 	services.  The county board shall also screen determine the
213.15 	needed level of care for all children admitted to an acute care
213.16 	hospital for treatment of severe emotional disturbance if public
213.17 	funds other than reimbursement under chapters 256B and 256D are
213.18 	used to pay for the services. If a child is admitted to a
213.19 	residential treatment facility or acute care hospital for
213.20 	emergency treatment or held for emergency care by a regional
213.21 	treatment center under section 253B.05, subdivision 1, screening
213.22 	must occur within three working days of admission.
213.23 	Screening The level of care determination shall determine
213.24 	whether the proposed treatment:
213.25 	(1) is necessary;
213.26 	(2) is appropriate to the child's individual treatment
213.27 	needs;
213.28 	(3) cannot be effectively provided in the child's home; and
213.29 	(4) provides a length of stay as short as possible
213.30 	consistent with the individual child's need.
213.31 	When a screening level of care determination is conducted,
213.32 	the county board may not determine that referral or admission to
213.33 	a treatment foster care setting,residential treatment facility,
213.34 	or acute care hospital is not appropriate solely because
213.35 	services were not first provided to the child in a less
213.36 	restrictive setting and the child failed to make progress toward
214.1 	or meet treatment goals in the less restrictive
214.2 	setting. Screening shall include both The level of care
214.3 	determination must be based on a diagnostic assessment and that
214.4 	includes a functional assessment which evaluates family, school,
214.5 	and community living situations; and an assessment of the
214.6 	child's need for care out of the home using a validated tool
214.7 	which assesses a child's functional status and assigns an
214.8 	appropriate level of care.  The validated tool must be approved
214.9 	by the commissioner of human services.  If a diagnostic
214.10 	assessment or including a functional assessment has been
214.11 	completed by a mental health professional within the past 180
214.12 	days, a new diagnostic or functional assessment need not be
214.13 	completed unless in the opinion of the current treating mental
214.14 	health professional the child's mental health status has changed
214.15 	markedly since the assessment was completed.  The child's parent
214.16 	shall be notified if an assessment will not be completed and of
214.17 	the reasons.  A copy of the notice shall be placed in the
214.18 	child's file.  Recommendations developed as part of
214.19 	the screening level of care determination process shall include
214.20 	specific community services needed by the child and, if
214.21 	appropriate, the child's family, and shall indicate whether or
214.22 	not these services are available and accessible to the child and
214.23 	family.
214.24 	During the screening level of care determination process,
214.25 	the child, child's family, or child's legal representative, as
214.26 	appropriate, must be informed of the child's eligibility for
214.27 	case management services and family community support services
214.28 	and that an individual family community support plan is being
214.29 	developed by the case manager, if assigned.
214.30 	Screening The level of care determination shall be in
214.31 	compliance comply with section 260C.212.  Wherever possible, the
214.32 	parent shall be consulted in the screening process, unless
214.33 	clinically inappropriate.
214.34 	The screening process level of care determination, and
214.35 	placement decision, and recommendations for mental health
214.36 	services must be documented in the child's record.
215.1 	An alternate review process may be approved by the
215.2 	commissioner if the county board demonstrates that an alternate
215.3 	review process has been established by the county board and the
215.4 	times of review, persons responsible for the review, and review
215.5 	criteria are comparable to the standards in clauses (1) to (4).
215.6 	
EFFECTIVE DATE. This section is effective July 1, 2006.

215.7 	Sec. 2. Minnesota Statutes 2004, section 245.4885, is
215.8 	amended by adding a subdivision to read:
215.9 		Subd. 1a.Emergency admission. Effective July 1, 2006,
215.10 	if a child is admitted to a treatment foster care setting,
215.11 	residential treatment facility, or acute care hospital for
215.12 	emergency treatment or held for emergency care by a regional
215.13 	treatment center under section 253B.05, subdivision 1, the level
215.14 	of care determination must occur within three working days of
215.15 	admission.

215.16 	Sec. 3. Minnesota Statutes 2004, section 245.4885,
215.17 	subdivision 2, is amended to read:
215.18 		Subd. 2.Qualifications. No later than July 1, 1991,
215.19 	Screening Level of care determination of children for treatment
215.20 	foster care,residential,and inpatient services must be
215.21 	conducted by a mental health professional.  Where appropriate
215.22 	and available, culturally informed mental health consultants
215.23 	must participate in the screening level of care determination.
215.24 	Mental health professionals providing screening level of care
215.25 	determination for treatment foster care,inpatient,and
215.26 	residential services must not be financially affiliated with any
215.27 	acute care inpatient hospital, residential treatment facility,
215.28 	or regional treatment center nongovernment entity which may be
215.29 	providing those services. The commissioner may waive this
215.30 	requirement for mental health professional participation after
215.31 	July 1, 1991, if the county documents that:
215.32 	(1) mental health professionals or mental health
215.33 	practitioners are unavailable to provide this service; and 
215.34 	(2) services are provided by a designated person with
215.35 	training in human services who receives clinical supervision
215.36 	from a mental health professional.
216.1 	
EFFECTIVE DATE. This section is effective July 1, 2006.

216.2 	Sec. 4. Minnesota Statutes 2004, section 253B.02,
216.3 	subdivision 7, is amended to read:
216.4 		Subd. 7.Examiner.  "Examiner" means a person who is
216.5 	knowledgeable, trained, and practicing in the diagnosis and
216.6 	assessment or in the treatment of the alleged impairment, and
216.7 	who is:
216.8 	(1) a licensed physician; or 
216.9 	(2) a licensed psychologist who has a doctoral degree in
216.10 	psychology or who became a licensed consulting psychologist
216.11 	before July 2, 1975; or 
216.12 	(3) an advanced practice registered nurse certified in
216.13 	mental health, except that only a physician or psychologist
216.14 	meeting these requirements may be appointed by the court to
216.15 	conduct an evaluation.

216.16 	Sec. 5. Minnesota Statutes 2004, section 256B.0625, is
216.17 	amended by adding a subdivision to read:
216.18 		Subd. 46.Mental health telemedicine. Effective January
216.19 	1, 2006, and subject to federal approval, mental health services
216.20 	that are otherwise covered by medical assistance as direct
216.21 	face-to-face services may be provided via two-way interactive
216.22 	video.  Use of two-way interactive video must be medically
216.23 	appropriate to the condition and needs of the person being
216.24 	served.  Reimbursement is at the same rates and under the same
216.25 	conditions that would otherwise apply to the service.  The
216.26 	interactive video equipment and connection must comply with
216.27 	Medicare standards in effect at the time the service is provided.

216.28 	Sec. 6. Minnesota Statutes 2004, section 256B.0625, is
216.29 	amended by adding a subdivision to read:
216.30 		Subd. 47.Treatment foster care services. Effective July
216.31 	1, 2006, and subject to federal approval, medical assistance
216.32 	covers treatment foster care services according to section
216.33 	256B.0946.

216.34 	Sec. 7. Minnesota Statutes 2004, section 256B.0625, is
216.35 	amended by adding a subdivision to read:
216.36 		Subd. 48.Psychiatric consultation to primary care
217.1 	practitioners. Effective January 1, 2006, medical assistance
217.2 	covers consultation provided by a psychiatrist via telephone,
217.3 	e-mail, facsimile, or other means of communication to primary
217.4 	care practitioners, including pediatricians.  The need for
217.5 	consultation and the receipt of the consultation must be
217.6 	documented in the patient record maintained by the primary care
217.7 	practitioner.  If the patient consents, and subject to federal
217.8 	limitations and data privacy provisions, the consultation may be
217.9 	provided without the patient present.

217.10 	Sec. 8. Minnesota Statutes 2004, section 256B.0943,
217.11 	subdivision 3, is amended to read:
217.12 		Subd. 3.Determination of client eligibility.  A client's
217.13 	eligibility to receive children's therapeutic services and
217.14 	supports under this section shall be determined based on a
217.15 	diagnostic assessment by a mental health professional that is
217.16 	performed within 180 days of the initial start of service.  The
217.17 	diagnostic assessment must:
217.18 	(1) include current diagnoses on all five axes of the
217.19 	client's current mental health status;
217.20 	(2) determine whether a child under age 18 has a diagnosis
217.21 	of emotional disturbance or, if the person is between the ages
217.22 	of 18 and 21, whether the person has a mental illness;
217.23 	(3) document children's therapeutic services and supports
217.24 	as medically necessary to address an identified disability,
217.25 	functional impairment, and the individual client's needs and
217.26 	goals;
217.27 	(4) be used in the development of the individualized
217.28 	treatment plan; and
217.29 	(5) be completed annually until age 18. A child with
217.30 	autism spectrum disorder may receive a diagnostic assessment
217.31 	once every three years, at the request of the parent, to
217.32 	determine continued eligibility for therapeutic support services
217.33 	under this section.For individuals between age 18 and 21,
217.34 	unless a client's mental health condition has changed markedly
217.35 	since the client's most recent diagnostic assessment, annual
217.36 	updating is necessary.  For the purpose of this section,
218.1 	"updating" means a written summary, including current diagnoses
218.2 	on all five axes, by a mental health professional of the
218.3 	client's current mental health status and service needs.

218.4 	Sec. 9. [256B.0946] TREATMENT FOSTER CARE.
218.5 		Subdivision 1.Covered service. (a) Effective July 1,
218.6 	2006, and subject to federal approval, medical assistance covers
218.7 	medically necessary services described under paragraph (b) that
218.8 	are provided by a provider entity eligible under subdivision 3
218.9 	to a client eligible under subdivision 2 who is placed in a
218.10 	treatment foster home licensed under Minnesota Rules, parts
218.11 	2960.3000 to 2960.3340.
218.12 	(b) Services to children with severe emotional disturbance
218.13 	residing in treatment foster care settings must meet the
218.14 	relevant standards for mental health services under sections
218.15 	245.487 to 245.4887.  In addition, specific service components
218.16 	reimbursed by medical assistance must meet the following
218.17 	standards:
218.18 	(1) case management service component must meet the
218.19 	standards in Minnesota Rules, parts 9520.0900 to 9520.0926 and
218.20 	9505.0322, excluding subparts 6 and 10;
218.21 	(2) psychotherapy and skills training components must meet
218.22 	the standards for children's therapeutic services and supports
218.23 	in section 256B.0943; and 
218.24 	(3) family psychoeducation services under supervision of a
218.25 	mental health professional.
218.26 		Subd. 2.Determination of client eligibility. A client's
218.27 	eligibility to receive treatment foster care under this section
218.28 	shall be determined by a diagnostic assessment, an evaluation of
218.29 	level of care needed, and development of an individual treatment
218.30 	plan, as defined in paragraphs (a) to (c).
218.31 	(a) The diagnostic assessment must:
218.32 	(1) be conducted by a psychiatrist, licensed psychologist,
218.33 	or licensed independent clinical social worker that is performed
218.34 	within 180 days prior to the start of service;
218.35 	(2) include current diagnoses on all five axes of the
218.36 	client's current mental health status;
219.1 	(3) determine whether or not a child meets the criteria for
219.2 	severe emotional disturbance in section 245.4871, subdivision 6,
219.3 	or for serious and persistent mental illness in section 245.462,
219.4 	subdivision 20; and 
219.5 	(4) be completed annually until age 18.  For individuals
219.6 	between age 18 and 21, unless a client's mental health condition
219.7 	has changed markedly since the client's most recent diagnostic
219.8 	assessment, annual updating is necessary.  For the purpose of
219.9 	this section, "updating" means a written summary, including
219.10 	current diagnoses on all five axes, by a mental health
219.11 	professional of the client's current mental status and service
219.12 	needs.
219.13 	(b) The evaluation of level of care must be conducted by
219.14 	the placing county with an instrument approved by the
219.15 	commissioner of human services.  The commissioner shall update
219.16 	the list of approved level of care instruments annually.
219.17 	(c) The individual treatment plan must be:
219.18 	(1) based on the information in the client's diagnostic
219.19 	assessment;
219.20 	(2) developed through a child-centered, family driven
219.21 	planning process that identifies service needs and
219.22 	individualized, planned, and culturally appropriate
219.23 	interventions that contain specific measurable treatment goals
219.24 	and objectives for the client and treatment strategies for the
219.25 	client's family and foster family;
219.26 	(3) reviewed at least once every 90 days and revised; and 
219.27 	(4) signed by the client or, if appropriate, by the
219.28 	client's parent or other person authorized by statute to consent
219.29 	to mental health services for the client.
219.30 		Subd. 3.Eligible providers. For purposes of this
219.31 	section, a provider agency must have an individual placement
219.32 	agreement for each recipient and must be a licensed child
219.33 	placing agency, under Minnesota Rules, parts 9543.0010 to
219.34 	9543.0150, and either:
219.35 	(1) a county;
219.36 	(2) an Indian Health Services facility operated by a tribe
220.1 	or tribal organization under funding authorized by United States
220.2 	Code, title 25, sections 450f to 450n, or title 3 of the Indian
220.3 	Self-Determination Act, Public Law 93-638, section 638
220.4 	(facilities or providers); or 
220.5 	(3) a noncounty entity under contract with a county board.
220.6 		Subd. 4.Eligible provider responsibilities. (a) To be
220.7 	an eligible provider under this section, a provider must develop
220.8 	written policies and procedures for treatment foster care
220.9 	services consistent with subdivision 1, paragraph (b), clauses
220.10 	(1), (2), and (3).
220.11 	(b) In delivering services under this section, a treatment
220.12 	foster care provider must ensure that staff caseload size
220.13 	reasonably enables the provider to play an active role in
220.14 	service planning, monitoring, delivering, and reviewing for
220.15 	discharge planning to meet the needs of the client, the client's
220.16 	foster family, and the birth family, as specified in each
220.17 	client's individual treatment plan.
220.18 		Subd. 5.Service authorization. The commissioner will
220.19 	administer authorizations for services under this section in
220.20 	compliance with section 256B.0625, subdivision 25.
220.21 		Subd. 6.Excluded services. (a) Services in clauses (1)
220.22 	to (4) are not eligible as components of treatment foster care
220.23 	services:
220.24 	(1) treatment foster care services provided in violation of
220.25 	medical assistance policy in Minnesota Rules, part 9505.0220;
220.26 	(2) service components of children's therapeutic services
220.27 	and supports simultaneously provided by more than one treatment
220.28 	foster care provider;
220.29 	(3) home and community-based waiver services; and 
220.30 	(4) treatment foster care services provided to a child
220.31 	without a level of care determination according to section
220.32 	245.4885, subdivision 1.
220.33 	(b) Children receiving treatment foster care services are
220.34 	not eligible for medical assistance reimbursement for the
220.35 	following services while receiving treatment foster care:
220.36 	(1) mental health case management services under section
221.1 	256B.0625, subdivision 20; and 
221.2 	(2) psychotherapy and skill training components of
221.3 	children's therapeutic services and supports under section
221.4 	256B.0625, subdivision 35b.

221.5 	Sec. 10. [256B.0947] TRANSITIONAL YOUTH INTENSIVE
221.6 	REHABILITATIVE MENTAL HEALTH SERVICES.
221.7 		Subdivision 1.Scope. Subject to federal approval,
221.8 	medical assistance covers medically necessary, intensive
221.9 	nonresidential rehabilitative mental health services as defined
221.10 	in subdivision 2, for recipients as defined in subdivision 3,
221.11 	when the services are provided by an entity meeting the
221.12 	standards in this section.
221.13 		Subd. 2.Definitions. For purposes of this section, the
221.14 	following terms have the meanings given them.
221.15 	(a) "Intensive nonresidential rehabilitative mental health
221.16 	services" means child rehabilitative mental health services as
221.17 	defined in section 256B.0943, except that these services are
221.18 	provided by a multidisciplinary staff using a total team
221.19 	approach consistent with assertive community treatment, or other
221.20 	evidence-based practices, and directed to recipients with a
221.21 	serious mental illness who require intensive services.
221.22 	(b) "Evidence-based practices" are nationally recognized
221.23 	mental health services that are proven by substantial research
221.24 	to be effective in helping individuals with serious mental
221.25 	illness obtain specific treatment goals.
221.26 	(c) "Treatment team" means all staff who provide services
221.27 	to recipients under this section.  At a minimum, this includes
221.28 	the clinical supervisor, mental health professionals, mental
221.29 	health practitioners, mental health behavioral aides, and a
221.30 	school representative familiar with the recipient's individual
221.31 	education plan (IEP) if applicable.
221.32 		Subd. 3.Eligibility for transitional youth. An eligible
221.33 	recipient under the age of 18 is an individual who:
221.34 	(1) is age 16 or 17;
221.35 	(2) is diagnosed with a medical condition, such as an
221.36 	emotional disturbance or traumatic brain injury, for which
222.1 	intensive nonresidential rehabilitative mental health services
222.2 	are needed;
222.3 	(3) has substantial disability and functional impairment in
222.4 	three or more of the areas listed in section 245.462,
222.5 	subdivision 11a, so that self-sufficiency upon adulthood or
222.6 	emancipation is unlikely; and 
222.7 	(4) has had a recent diagnostic assessment by a qualified
222.8 	professional that documents that intensive nonresidential
222.9 	rehabilitative mental health services are medically necessary to
222.10 	address identified disability and functional impairments and
222.11 	individual recipient goals.
222.12 		Subd. 4.Provider certification and contract
222.13 	requirements. (a) The intensive nonresidential rehabilitative
222.14 	mental health services provider must:
222.15 	(1) have a contract with the host county to provide
222.16 	intensive transition youth rehabilitative mental health
222.17 	services; and 
222.18 	(2) be certified by the commissioner as being in compliance
222.19 	with this section and section 256B.0943.
222.20 	(b) The commissioner shall develop procedures for counties
222.21 	and providers to submit contracts and other documentation as
222.22 	needed to allow the commissioner to determine whether the
222.23 	standards in this section are met.
222.24 		Subd. 5.Standards applicable to nonresidential
222.25 	providers. (a) Services must be provided by a certified
222.26 	provider entity as defined in section 256B.0943, subdivision 4
222.27 	that meets the requirements in section 245B.0943, subdivisions 5
222.28 	and 6.
222.29 	(b) The clinical supervisor must be an active member of the
222.30 	treatment team.  The treatment team must meet with the clinical
222.31 	supervisor at least weekly to discuss recipients' progress and
222.32 	make rapid adjustments to meet recipients' needs.  The team
222.33 	meeting shall include recipient-specific case reviews and
222.34 	general treatment discussions among team members.
222.35 	Recipient-specific case reviews and planning must be documented
222.36 	in the individual recipient's treatment record.
223.1 	(c) Treatment staff must have prompt access in person or by
223.2 	telephone to a mental health practitioner or mental health
223.3 	professional.  The provider must have the capacity to promptly
223.4 	and appropriately respond to emergent needs and make any
223.5 	necessary staffing adjustments to assure the health and safety
223.6 	of recipients.
223.7 	(d) The initial functional assessment must be completed
223.8 	within ten days of intake and updated at least every three
223.9 	months or prior to discharge from the service, whichever comes
223.10 	first.
223.11 	(e) The initial individual treatment plan must be completed
223.12 	within ten days of intake and reviewed and updated at least
223.13 	monthly with the recipient.
223.14 		Subd. 6.Additional standards for nonresidential
223.15 	services. The standards in this subdivision apply to intensive
223.16 	nonresidential rehabilitative mental health services.
223.17 	(1) The treatment team must use team treatment, not an
223.18 	individual treatment model.
223.19 	(2) The clinical supervisor must function as a practicing
223.20 	clinician at least on a part-time basis.
223.21 	(3) The staffing ratio must not exceed ten recipients to
223.22 	one full-time equivalent treatment team position.
223.23 	(4) Services must be available at times that meet client
223.24 	needs.
223.25 	(5) The treatment team must actively and assertively engage
223.26 	and reach out to the recipient's family members and significant
223.27 	others, after obtaining the recipient's permission.
223.28 	(6) The treatment team must establish ongoing communication
223.29 	and collaboration between the team, family, and significant
223.30 	others and educate the family and significant others about
223.31 	mental illness, symptom management, and the family's role in
223.32 	treatment.
223.33 	(7) The treatment team must provide interventions to
223.34 	promote positive interpersonal relationships.
223.35 		Subd. 7.Medical assistance payment for intensive
223.36 	rehabilitative mental health services. (a) Payment for
224.1 	nonresidential services in this section shall be based on one
224.2 	daily rate per provider inclusive of the following services
224.3 	received by an eligible recipient in a given calendar day: all
224.4 	rehabilitative services under this section, staff travel time to
224.5 	provide rehabilitative services under this section, and
224.6 	nonresidential crisis stabilization services under section
224.7 	256B.0944.
224.8 	(b) Except as indicated in paragraph (c), payment will not
224.9 	be made to more than one entity for each recipient for services
224.10 	provided under this section on a given day.  If services under
224.11 	this section are provided by a team that includes staff from
224.12 	more than one entity, the team must determine how to distribute
224.13 	the payment among the members.
224.14 	(c) The host county shall recommend to the commissioner one
224.15 	rate for each entity that will bill medical assistance for
224.16 	nonresidential intensive rehabilitative mental health services.
224.17 	In developing these rates, the host county shall consider and
224.18 	document:
224.19 	(1) the cost for similar services in the local trade area;
224.20 	(2) actual costs incurred by entities providing the
224.21 	services;
224.22 	(3) the intensity and frequency of services to be provided
224.23 	to each recipient;
224.24 	(4) the degree to which recipients will receive services
224.25 	other than services under this section; and 
224.26 	(5) the costs of other services that will be separately
224.27 	reimbursed.
224.28 	(d) The rate for intensive rehabilitative mental health
224.29 	services must exclude medical assistance room and board rate, as
224.30 	defined in section 256I.03, subdivision 6, and services not
224.31 	covered under this section, such as partial hospitalization and
224.32 	inpatient services.  Physician services are not a component of
224.33 	the treatment team and may be billed separately.  The county's
224.34 	recommendation shall specify the period for which the rate will
224.35 	be applicable, not to exceed two years.
224.36 	(e) When services under this section are provided by an
225.1 	assertive community team, case management functions must be an
225.2 	integral part of the team.
225.3 	(f) The rate for a provider must not exceed the rate
225.4 	charged by that provider for the same service to other payors.
225.5 	(g) The commissioner shall approve or reject the county's
225.6 	rate recommendation, based on the commissioner's own analysis of
225.7 	the criteria in paragraph (c).
225.8 		Subd. 8.Provider enrollment; rate setting for
225.9 	county-operated entities. Effective July 1, 2006, counties that
225.10 	employ their own staff to provide services under this section
225.11 	shall apply directly to the commissioner for enrollment and rate
225.12 	setting.  In this case, a county contract is not required and
225.13 	the commissioner shall perform the program review and rate
225.14 	setting duties which would otherwise be required of counties
225.15 	under this section.

225.16 	Sec. 11. Minnesota Statutes 2004, section 256D.03,
225.17 	subdivision 4, is amended to read:
225.18 		Subd. 4.General assistance medical care; services.
 225.19 	(a)(i) For a person who is eligible under subdivision 3,
225.20 	paragraph (a), clause (2), item (i), general assistance medical
225.21 	care covers, except as provided in paragraph (c):
225.22 	(1) inpatient hospital services;
225.23 	(2) outpatient hospital services;
225.24 	(3) services provided by Medicare certified rehabilitation
225.25 	agencies;
225.26 	(4) prescription drugs and other products recommended
225.27 	through the process established in section 256B.0625,
225.28 	subdivision 13;
225.29 	(5) equipment necessary to administer insulin and
225.30 	diagnostic supplies and equipment for diabetics to monitor blood
225.31 	sugar level;
225.32 	(6) eyeglasses and eye examinations provided by a physician
225.33 	or optometrist;
225.34 	(7) hearing aids;
225.35 	(8) prosthetic devices;
225.36 	(9) laboratory and X-ray services;
226.1 	(10) physician's services;
226.2 	(11) medical transportation except special transportation;
226.3 	(12) chiropractic services as covered under the medical
226.4 	assistance program;
226.5 	(13) podiatric services;
226.6 	(14) dental services and dentures, subject to the
226.7 	limitations specified in section 256B.0625, subdivision 9;
226.8 	(15) outpatient services provided by a mental health center
226.9 	or clinic that is under contract with the county board and is
226.10 	established under section 245.62;
226.11 	(16) day treatment services for mental illness provided
226.12 	under contract with the county board;
226.13 	(17) prescribed medications for persons who have been
226.14 	diagnosed as mentally ill as necessary to prevent more
226.15 	restrictive institutionalization;
226.16 	(18) psychological services, medical supplies and
226.17 	equipment, and Medicare premiums, coinsurance and deductible
226.18 	payments;
226.19 	(19) medical equipment not specifically listed in this
226.20 	paragraph when the use of the equipment will prevent the need
226.21 	for costlier services that are reimbursable under this
226.22 	subdivision;
226.23 	(20) services performed by a certified pediatric nurse
226.24 	practitioner, a certified family nurse practitioner, a certified
226.25 	adult nurse practitioner, a certified obstetric/gynecological
226.26 	nurse practitioner, a certified neonatal nurse practitioner, or
226.27 	a certified geriatric nurse practitioner in independent
226.28 	practice, if (1) the service is otherwise covered under this
226.29 	chapter as a physician service, (2) the service provided on an
226.30 	inpatient basis is not included as part of the cost for
226.31 	inpatient services included in the operating payment rate, and
226.32 	(3) the service is within the scope of practice of the nurse
226.33 	practitioner's license as a registered nurse, as defined in
226.34 	section 148.171;
226.35 	(21) services of a certified public health nurse or a
226.36 	registered nurse practicing in a public health nursing clinic
227.1 	that is a department of, or that operates under the direct
227.2 	authority of, a unit of government, if the service is within the
227.3 	scope of practice of the public health nurse's license as a
227.4 	registered nurse, as defined in section 148.171; and 
227.5 	(22) telemedicine consultations, to the extent they are
227.6 	covered under section 256B.0625, subdivision 3b; and 
227.7 	(23) mental health telemedicine and psychiatric
227.8 	consultation as covered under section 256B.0625, subdivisions 46
227.9 	and 48.
227.10 	(ii) Effective October 1, 2003, for a person who is
227.11 	eligible under subdivision 3, paragraph (a), clause (2), item
227.12 	(ii), general assistance medical care coverage is limited to
227.13 	inpatient hospital services, including physician services
227.14 	provided during the inpatient hospital stay.  A $1,000
227.15 	deductible is required for each inpatient hospitalization.
227.16 	(b) Gender reassignment surgery and related services are
227.17 	not covered services under this subdivision unless the
227.18 	individual began receiving gender reassignment services prior to
227.19 	July 1, 1995.
227.20 	(c) In order to contain costs, the commissioner of human
227.21 	services shall select vendors of medical care who can provide
227.22 	the most economical care consistent with high medical standards
227.23 	and shall where possible contract with organizations on a
227.24 	prepaid capitation basis to provide these services.  The
227.25 	commissioner shall consider proposals by counties and vendors
227.26 	for prepaid health plans, competitive bidding programs, block
227.27 	grants, or other vendor payment mechanisms designed to provide
227.28 	services in an economical manner or to control utilization, with
227.29 	safeguards to ensure that necessary services are provided.
227.30 	Before implementing prepaid programs in counties with a county
227.31 	operated or affiliated public teaching hospital or a hospital or
227.32 	clinic operated by the University of Minnesota, the commissioner
227.33 	shall consider the risks the prepaid program creates for the
227.34 	hospital and allow the county or hospital the opportunity to
227.35 	participate in the program in a manner that reflects the risk of
227.36 	adverse selection and the nature of the patients served by the
228.1 	hospital, provided the terms of participation in the program are
228.2 	competitive with the terms of other participants considering the
228.3 	nature of the population served.  Payment for services provided
228.4 	pursuant to this subdivision shall be as provided to medical
228.5 	assistance vendors of these services under sections 256B.02,
228.6 	subdivision 8, and 256B.0625.  For payments made during fiscal
228.7 	year 1990 and later years, the commissioner shall consult with
228.8 	an independent actuary in establishing prepayment rates, but
228.9 	shall retain final control over the rate methodology.
228.10 	(d) Recipients eligible under subdivision 3, paragraph (a),
228.11 	clause (2), item (i), shall pay the following co-payments for
228.12 	services provided on or after October 1, 2003:
228.13 	(1) $3 per nonpreventive visit.  For purposes of this
228.14 	subdivision, a visit means an episode of service which is
228.15 	required because of a recipient's symptoms, diagnosis, or
228.16 	established illness, and which is delivered in an ambulatory
228.17 	setting by a physician or physician ancillary, chiropractor,
228.18 	podiatrist, nurse midwife, advanced practice nurse, audiologist,
228.19 	optician, or optometrist;
228.20 	(2) $25 for eyeglasses;
228.21 	(3) $25 for nonemergency visits to a hospital-based
228.22 	emergency room;
228.23 	(4) $3 per brand-name drug prescription and $1 per generic
228.24 	drug prescription, subject to a $20 per month maximum for
228.25 	prescription drug co-payments.  No co-payments shall apply to
228.26 	antipsychotic drugs when used for the treatment of mental
228.27 	illness; and
228.28 	(5) 50 percent coinsurance on restorative dental services.
228.29 	(e) Co-payments shall be limited to one per day per
228.30 	provider for nonpreventive visits, eyeglasses, and nonemergency
228.31 	visits to a hospital-based emergency room.  Recipients of
228.32 	general assistance medical care are responsible for all
228.33 	co-payments in this subdivision.  The general assistance medical
228.34 	care reimbursement to the provider shall be reduced by the
228.35 	amount of the co-payment, except that reimbursement for
228.36 	prescription drugs shall not be reduced once a recipient has
229.1 	reached the $20 per month maximum for prescription drug
229.2 	co-payments.  The provider collects the co-payment from the
229.3 	recipient.  Providers may not deny services to recipients who
229.4 	are unable to pay the co-payment, except as provided in
229.5 	paragraph (f).
229.6 	(f) If it is the routine business practice of a provider to
229.7 	refuse service to an individual with uncollected debt, the
229.8 	provider may include uncollected co-payments under this
229.9 	section.  A provider must give advance notice to a recipient
229.10 	with uncollected debt before services can be denied.
229.11 	(g) Any county may, from its own resources, provide medical
229.12 	payments for which state payments are not made.
229.13 	(h) Chemical dependency services that are reimbursed under
229.14 	chapter 254B must not be reimbursed under general assistance
229.15 	medical care.
229.16 	(i) The maximum payment for new vendors enrolled in the
229.17 	general assistance medical care program after the base year
229.18 	shall be determined from the average usual and customary charge
229.19 	of the same vendor type enrolled in the base year.
229.20 	(j) The conditions of payment for services under this
229.21 	subdivision are the same as the conditions specified in rules
229.22 	adopted under chapter 256B governing the medical assistance
229.23 	program, unless otherwise provided by statute or rule.
229.24 	(k) Inpatient and outpatient payments shall be reduced by
229.25 	five percent, effective July 1, 2003.  This reduction is in
229.26 	addition to the five percent reduction effective July 1, 2003,
229.27 	and incorporated by reference in paragraph (i).
229.28 	(l) Payments for all other health services except
229.29 	inpatient, outpatient, and pharmacy services shall be reduced by
229.30 	five percent, effective July 1, 2003.
229.31 	(m) Payments to managed care plans shall be reduced by five
229.32 	percent for services provided on or after October 1, 2003.
229.33 	(n) A hospital receiving a reduced payment as a result of
229.34 	this section may apply the unpaid balance toward satisfaction of
229.35 	the hospital's bad debts.
229.36 	
EFFECTIVE DATE. This section is effective January 1, 2006.

230.1 	Sec. 12. Minnesota Statutes 2004, section 256L.03,
230.2 	subdivision 1, is amended to read:
230.3 		Subdivision 1.Covered health services.  For individuals
230.4 	under section 256L.04, subdivision 7, with income no greater
230.5 	than 75 percent of the federal poverty guidelines or for
230.6 	families with children under section 256L.04, subdivision 1, all
230.7 	subdivisions of this section apply.  "Covered health services"
230.8 	means the health services reimbursed under chapter 256B, with
230.9 	the exception of inpatient hospital services, special education
230.10 	services, private duty nursing services, adult dental care
230.11 	services other than services covered under section 256B.0625,
230.12 	subdivision 9, paragraph (b), orthodontic services, nonemergency
230.13 	medical transportation services, personal care assistant and
230.14 	case management services, nursing home or intermediate care
230.15 	facilities services, inpatient mental health services, and
230.16 	chemical dependency services.  Outpatient mental health services
230.17 	covered under the MinnesotaCare program are limited to
230.18 	diagnostic assessments, psychological testing, explanation of
230.19 	findings, mental health telemedicine, psychiatric consultation,
230.20 	medication management by a physician, day treatment, partial
230.21 	hospitalization, and individual, family, and group psychotherapy.
230.22 	No public funds shall be used for coverage of abortion
230.23 	under MinnesotaCare except where the life of the female would be
230.24 	endangered or substantial and irreversible impairment of a major
230.25 	bodily function would result if the fetus were carried to term;
230.26 	or where the pregnancy is the result of rape or incest.
230.27 	Covered health services shall be expanded as provided in
230.28 	this section.
230.29 	
EFFECTIVE DATE. This section is effective January 1, 2006.

230.30 	ARTICLE 8
230.31 	HEALTH POLICY

230.32 	Section 1. Minnesota Statutes 2004, section 13.3806, is
230.33 	amended by adding a subdivision to read:
230.34 		Subd. 21.Abortion notification data. Classification of
230.35 	data in abortion notification reports is governed by section
230.36 	144.3431.

231.1 	Sec. 2. [62J.495] HEALTH INFORMATION TECHNOLOGY AND
231.2 	INFRASTRUCTURE ADVISORY COMMITTEE.
231.3 		Subdivision 1.Legislative findings and purpose. There
231.4 	is a need for coordination and collaboration among health care
231.5 	payers, providers, consumers, and government in designing and
231.6 	implementing a statewide interoperable health information
231.7 	infrastructure that includes standards for administrative data
231.8 	exchange, clinical support programs, patient consent
231.9 	requirements, quality performance measures, and maintenance of
231.10 	the security and confidentiality of individual patient data.
231.11 		Subd. 2.Establishment; members; duties. (a) The
231.12 	commissioner shall establish a Health Information Technology and
231.13 	Infrastructure Advisory Committee governed by section 15.059 to
231.14 	advise the commissioner on the following matters:
231.15 	(1) assessment of the use of health information technology
231.16 	by the state, licensed health care providers and facilities, and
231.17 	local public health agencies;
231.18 	(2) recommendations for implementing a statewide
231.19 	interoperable health information infrastructure, to include
231.20 	estimates of necessary resources, and for determining standards
231.21 	for administrative data exchange, clinical support programs,
231.22 	patient consent requirements, and maintenance of the security
231.23 	and confidentiality of individual patient data; and 
231.24 	(3) other related issues as requested by the commissioner.
231.25 	(b) The members of the Health Information Technology and
231.26 	Infrastructure Advisory Committee shall include the
231.27 	commissioners, or commissioners' designees, of health, human
231.28 	services, administration, and commerce and additional members to
231.29 	be appointed by the commissioner to include persons representing
231.30 	Minnesota's local public health agencies, licensed hospitals and
231.31 	other licensed facilities and providers, private purchasers, the
231.32 	medical and nursing professions, health insurers and health
231.33 	plans, the state quality improvement organization, academic and
231.34 	research institutions, consumer advisory organizations with an
231.35 	interest and expertise in health information technology,
231.36 	free-market health care policy organizations with an interest in
232.1 	medical privacy and other stakeholders as identified by the
232.2 	Health Information Technology and Infrastructure Advisory
232.3 	Committee.
232.4 		Subd. 3.Annual report. The commissioner shall prepare
232.5 	and issue an annual report not later than January 30 of each
232.6 	year outlining progress to date in implementing a statewide
232.7 	health information infrastructure and recommending future
232.8 	projects.
232.9 		Subd. 4.Expiration. Notwithstanding section 15.059,
232.10 	this section expires June 30, 2009.

232.11 	Sec. 3. Minnesota Statutes 2004, section 103I.101,
232.12 	subdivision 6, is amended to read:
232.13 		Subd. 6.Fees for variances.  The commissioner shall
232.14 	charge a nonrefundable application fee of $150 $175 to cover the
232.15 	administrative cost of processing a request for a variance or
232.16 	modification of rules adopted by the commissioner under this
232.17 	chapter.
232.18 	
EFFECTIVE DATE. This section is effective July 1, 2006.

232.19 	Sec. 4. Minnesota Statutes 2004, section 103I.208,
232.20 	subdivision 1, is amended to read:
232.21 		Subdivision 1.Well notification fee.  The well
232.22 	notification fee to be paid by a property owner is:
232.23 	(1) for a new well, $150 $175, which includes the state
232.24 	core function fee;
232.25 	(2) for a well sealing, $30 $35 for each well, which
232.26 	includes the state core function fee, except that for monitoring
232.27 	wells constructed on a single property, having depths within a
232.28 	25 foot range, and sealed within 48 hours of start of
232.29 	construction, a single fee of $30 $35; and
232.30 	(3) for construction of a dewatering well, $150 $175, which
232.31 	includes the state core function fee, for each well except a
232.32 	dewatering project comprising five or more wells shall be
232.33 	assessed a single fee of $750 $875 for the wells recorded on the
232.34 	notification.
232.35 	
EFFECTIVE DATE. This section is effective July 1, 2006.

232.36 	Sec. 5. Minnesota Statutes 2004, section 103I.208,
233.1 	subdivision 2, is amended to read:
233.2 		Subd. 2.Permit fee.  The permit fee to be paid by a
233.3 	property owner is:
233.4 	(1) for a well that is not in use under a maintenance
233.5 	permit, $125 $150 annually;
233.6 	(2) for construction of a monitoring well, $150 $175, which
233.7 	includes the state core function fee;
233.8 	(3) for a monitoring well that is unsealed under a
233.9 	maintenance permit, $125 $150 annually;
233.10 	(4) for monitoring wells used as a leak detection device at
233.11 	a single motor fuel retail outlet, a single petroleum bulk
233.12 	storage site excluding tank farms, or a single agricultural
233.13 	chemical facility site, the construction permit fee
233.14 	is $150 $175, which includes the state core function fee, per
233.15 	site regardless of the number of wells constructed on the site,
233.16 	and the annual fee for a maintenance permit for unsealed
233.17 	monitoring wells is $125 $150 per site regardless of the number
233.18 	of monitoring wells located on site;
233.19 	(5) for a groundwater thermal exchange device, in addition
233.20 	to the notification fee for wells, $150 $175, which includes the
233.21 	state core function fee;
233.22 	(6) for a vertical heat exchanger, $150 $175;
233.23 	(7) for a dewatering well that is unsealed under a
233.24 	maintenance permit, $125 $150 annually for each well, except a
233.25 	dewatering project comprising more than five wells shall be
233.26 	issued a single permit for $625 $750 annually for wells recorded
233.27 	on the permit; and
233.28 	(8) for excavating holes for the purpose of installing
233.29 	elevator shafts, $150 $175 for each hole.
233.30 	
EFFECTIVE DATE. This section is effective July 1, 2006.

233.31 	Sec. 6. Minnesota Statutes 2004, section 103I.235,
233.32 	subdivision 1, is amended to read:
233.33 		Subdivision 1.Disclosure of wells to buyer.  (a) Before
233.34 	signing an agreement to sell or transfer real property, the
233.35 	seller must disclose in writing to the buyer information about
233.36 	the status and location of all known wells on the property, by
234.1 	delivering to the buyer either a statement by the seller that
234.2 	the seller does not know of any wells on the property, or a
234.3 	disclosure statement indicating the legal description and
234.4 	county, and a map drawn from available information showing the
234.5 	location of each well to the extent practicable.  In the
234.6 	disclosure statement, the seller must indicate, for each well,
234.7 	whether the well is in use, not in use, or sealed.
234.8 	(b) At the time of closing of the sale, the disclosure
234.9 	statement information, name and mailing address of the buyer,
234.10 	and the quartile, section, township, and range in which each
234.11 	well is located must be provided on a well disclosure
234.12 	certificate signed by the seller or a person authorized to act
234.13 	on behalf of the seller.
234.14 	(c) A well disclosure certificate need not be provided if
234.15 	the seller does not know of any wells on the property and the
234.16 	deed or other instrument of conveyance contains the statement:
234.17 	"The Seller certifies that the Seller does not know of any wells
234.18 	on the described real property."
234.19 	(d) If a deed is given pursuant to a contract for deed, the
234.20 	well disclosure certificate required by this subdivision shall
234.21 	be signed by the buyer or a person authorized to act on behalf
234.22 	of the buyer.  If the buyer knows of no wells on the property, a
234.23 	well disclosure certificate is not required if the following
234.24 	statement appears on the deed followed by the signature of the
234.25 	grantee or, if there is more than one grantee, the signature of
234.26 	at least one of the grantees:  "The Grantee certifies that the
234.27 	Grantee does not know of any wells on the described real
234.28 	property."  The statement and signature of the grantee may be on
234.29 	the front or back of the deed or on an attached sheet and an
234.30 	acknowledgment of the statement by the grantee is not required
234.31 	for the deed to be recordable.
234.32 	(e) This subdivision does not apply to the sale, exchange,
234.33 	or transfer of real property:
234.34 	(1) that consists solely of a sale or transfer of severed
234.35 	mineral interests; or
234.36 	(2) that consists of an individual condominium unit as
235.1 	described in chapters 515 and 515B.
235.2 	(f) For an area owned in common under chapter 515 or 515B
235.3 	the association or other responsible person must report to the
235.4 	commissioner by July 1, 1992, the location and status of all
235.5 	wells in the common area.  The association or other responsible
235.6 	person must notify the commissioner within 30 days of any change
235.7 	in the reported status of wells.
235.8 	(g) For real property sold by the state under section
235.9 	92.67, the lessee at the time of the sale is responsible for
235.10 	compliance with this subdivision.
235.11 	(h) If the seller fails to provide a required well
235.12 	disclosure certificate, the buyer, or a person authorized to act
235.13 	on behalf of the buyer, may sign a well disclosure certificate
235.14 	based on the information provided on the disclosure statement
235.15 	required by this section or based on other available information.
235.16 	(i) A county recorder or registrar of titles may not record
235.17 	a deed or other instrument of conveyance dated after October 31,
235.18 	1990, for which a certificate of value is required under section
235.19 	272.115, or any deed or other instrument of conveyance dated
235.20 	after October 31, 1990, from a governmental body exempt from the
235.21 	payment of state deed tax, unless the deed or other instrument
235.22 	of conveyance contains the statement made in accordance with
235.23 	paragraph (c) or (d) or is accompanied by the well disclosure
235.24 	certificate containing all the information required by paragraph
235.25 	(b) or (d).  The county recorder or registrar of titles must not
235.26 	accept a certificate unless it contains all the required
235.27 	information.  The county recorder or registrar of titles shall
235.28 	note on each deed or other instrument of conveyance accompanied
235.29 	by a well disclosure certificate that the well disclosure
235.30 	certificate was received.  The notation must include the
235.31 	statement "No wells on property" if the disclosure certificate
235.32 	states there are no wells on the property.  The well disclosure
235.33 	certificate shall not be filed or recorded in the records
235.34 	maintained by the county recorder or registrar of titles.  After
235.35 	noting "No wells on property" on the deed or other instrument of
235.36 	conveyance, the county recorder or registrar of titles shall
236.1 	destroy or return to the buyer the well disclosure certificate.
236.2 	The county recorder or registrar of titles shall collect from
236.3 	the buyer or the person seeking to record a deed or other
236.4 	instrument of conveyance, a fee of $30 $40 for receipt of a
236.5 	completed well disclosure certificate.  By the tenth day of each
236.6 	month, the county recorder or registrar of titles shall transmit
236.7 	the well disclosure certificates to the commissioner of health.
236.8 	By the tenth day after the end of each calendar quarter, the
236.9 	county recorder or registrar of titles shall transmit to the
236.10 	commissioner of health $27.50 $32.50 of the fee for each well
236.11 	disclosure certificate received during the quarter.  The
236.12 	commissioner shall maintain the well disclosure certificate for
236.13 	at least six years.  The commissioner may store the certificate
236.14 	as an electronic image.  A copy of that image shall be as valid
236.15 	as the original.
236.16 	(j) No new well disclosure certificate is required under
236.17 	this subdivision if the buyer or seller, or a person authorized
236.18 	to act on behalf of the buyer or seller, certifies on the deed
236.19 	or other instrument of conveyance that the status and number of
236.20 	wells on the property have not changed since the last previously
236.21 	filed well disclosure certificate.  The following statement, if
236.22 	followed by the signature of the person making the statement, is
236.23 	sufficient to comply with the certification requirement of this
236.24 	paragraph:  "I am familiar with the property described in this
236.25 	instrument and I certify that the status and number of wells on
236.26 	the described real property have not changed since the last
236.27 	previously filed well disclosure certificate."  The
236.28 	certification and signature may be on the front or back of the
236.29 	deed or on an attached sheet and an acknowledgment of the
236.30 	statement is not required for the deed or other instrument of
236.31 	conveyance to be recordable.
236.32 	(k) The commissioner in consultation with county recorders
236.33 	shall prescribe the form for a well disclosure certificate and
236.34 	provide well disclosure certificate forms to county recorders
236.35 	and registrars of titles and other interested persons.
236.36 	(l) Failure to comply with a requirement of this
237.1 	subdivision does not impair:
237.2 	(1) the validity of a deed or other instrument of
237.3 	conveyance as between the parties to the deed or instrument or
237.4 	as to any other person who otherwise would be bound by the deed
237.5 	or instrument; or
237.6 	(2) the record, as notice, of any deed or other instrument
237.7 	of conveyance accepted for filing or recording contrary to the
237.8 	provisions of this subdivision.
237.9 	
EFFECTIVE DATE. This section is effective July 1, 2006.

237.10 	Sec. 7. Minnesota Statutes 2004, section 103I.601,
237.11 	subdivision 2, is amended to read:
237.12 		Subd. 2.License required to make borings.  (a) Except as
237.13 	provided in paragraph (b) (d), a person may must not make an
237.14 	exploratory boring without an exploratory borer's explorer's 
237.15 	license. The fee for an explorer's license is $75.  The
237.16 	explorer's license is valid until the date prescribed in the
237.17 	license by the commissioner.
237.18 	(b) A person must file an application and renewal
237.19 	application fee to renew the explorer's license by the date
237.20 	stated in the license.  The renewal application fee is $75.
237.21 	(c) If the licensee submits an application fee after the
237.22 	required renewal date, the licensee:
237.23 	(1) must include a late fee of $75; and 
237.24 	(2) may not conduct activities authorized by an explorer's
237.25 	license until the renewal application, renewal application fee,
237.26 	late fee, and sealing reports required in subdivision 9 are
237.27 	submitted.
237.28 	(d) An explorer may must designate a responsible individual
237.29 	to supervise and oversee the making of exploratory borings.
237.30 	Before an individual supervises or oversees an exploratory
237.31 	boring, the individual must file an application and application
237.32 	fee of $75 to qualify as a responsible individual.  The
237.33 	individual must take and pass an examination relating to
237.34 	construction, location, and sealing of exploratory borings.  A
237.35 	professional engineer registered or geoscientist licensed under
237.36 	sections 326.02 to 326.15 or a certified professional geologist
238.1 	certified by the American Institute of Professional Geologists 
238.2 	is not required to take the examination required in this
238.3 	subdivision,but must be licensed certified as a responsible
238.4 	individual to make supervise an exploratory boring.

238.5 	Sec. 8. Minnesota Statutes 2004, section 144.122, is
238.6 	amended to read:
238.7 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
238.8 	(a) The state commissioner of health, by rule, may
238.9 	prescribe reasonable procedures and fees for filing with the
238.10 	commissioner as prescribed by statute and for the issuance of
238.11 	original and renewal permits, licenses, registrations, and
238.12 	certifications issued under authority of the commissioner.  The
238.13 	expiration dates of the various licenses, permits,
238.14 	registrations, and certifications as prescribed by the rules
238.15 	shall be plainly marked thereon.  Fees may include application
238.16 	and examination fees and a penalty fee for renewal applications
238.17 	submitted after the expiration date of the previously issued
238.18 	permit, license, registration, and certification.  The
238.19 	commissioner may also prescribe, by rule, reduced fees for
238.20 	permits, licenses, registrations, and certifications when the
238.21 	application therefor is submitted during the last three months
238.22 	of the permit, license, registration, or certification period.
238.23 	Fees proposed to be prescribed in the rules shall be first
238.24 	approved by the Department of Finance.  All fees proposed to be
238.25 	prescribed in rules shall be reasonable.  The fees shall be in
238.26 	an amount so that the total fees collected by the commissioner
238.27 	will, where practical, approximate the cost to the commissioner
238.28 	in administering the program.  All fees collected shall be
238.29 	deposited in the state treasury and credited to the state
238.30 	government special revenue fund unless otherwise specifically
238.31 	appropriated by law for specific purposes.
238.32 	(b) The commissioner may charge a fee for voluntary
238.33 	certification of medical laboratories and environmental
238.34 	laboratories, and for environmental and medical laboratory
238.35 	services provided by the department, without complying with
238.36 	paragraph (a) or chapter 14.  Fees charged for environment and
239.1 	medical laboratory services provided by the department must be
239.2 	approximately equal to the costs of providing the services.
239.3 	(c) The commissioner may develop a schedule of fees for
239.4 	diagnostic evaluations conducted at clinics held by the services
239.5 	for children with handicaps program.  All receipts generated by
239.6 	the program are annually appropriated to the commissioner for
239.7 	use in the maternal and child health program.
239.8 	(d) The commissioner shall set license fees for hospitals
239.9 	and nursing homes that are not boarding care homes at the
239.10 	following levels:
239.11 	Joint Commission on Accreditation of Healthcare
239.12 	Organizations (JCAHO hospitals) $7,055 $7,555 plus $13 per bed 
239.13 	Non-JCAHO hospitals $4,680 $5,180 plus $234 
239.14 	$247 per bed
239.15 	Nursing home                     $183 plus $91 per bed
239.16 	The commissioner shall set license fees for outpatient
239.17 	surgical centers, boarding care homes, and supervised living
239.18 	facilities at the following levels:
239.19 	Outpatient surgical centers $1,512 $3,349 
239.20 	Boarding care homes              $183 plus $91 per bed
239.21 	Supervised living facilities     $183 plus $91 per bed.
239.22 	(e) Unless prohibited by federal law, the commissioner of
239.23 	health shall charge applicants the following fees to cover the
239.24 	cost of any initial certification surveys required to determine
239.25 	a provider's eligibility to participate in the Medicare or
239.26 	Medicaid program:
239.27 	Prospective payment surveys for          $  900
239.28 	hospitals
239.30 	Swing bed surveys for nursing homes      $1,200
239.32 	Psychiatric hospitals                    $1,400
239.34 	Rural health facilities                  $1,100
239.36 	Portable x-ray providers                 $  500
239.38 	Home health agencies                     $1,800
239.40 	Outpatient therapy agencies              $  800
239.42 	End stage renal dialysis providers       $2,100
239.44 	Independent therapists                   $  800
240.1 	Comprehensive rehabilitation             $1,200
240.2 	outpatient facilities
240.4 	Hospice providers                        $1,700
240.6 	Ambulatory surgical providers            $1,800
240.8 	Hospitals                                $4,200
240.10 	Other provider categories or             Actual surveyor costs:
240.11 	additional resurveys required            average surveyor cost x
240.12 	to complete initial certification        number of hours for the
240.13 	                                         survey process.
240.14 	These fees shall be submitted at the time of the
240.15 	application for federal certification and shall not be
240.16 	refunded.  All fees collected after the date that the imposition
240.17 	of fees is not prohibited by federal law shall be deposited in
240.18 	the state treasury and credited to the state government special
240.19 	revenue fund.

240.20 	Sec. 9. Minnesota Statutes 2004, section 144.147,
240.21 	subdivision 1, is amended to read:
240.22 		Subdivision 1.Definition.  "Eligible rural hospital"
240.23 	means any nonfederal, general acute care hospital that:
240.24 	(1) is either located in a rural area, as defined in the
240.25 	federal Medicare regulations, Code of Federal Regulations, title
240.26 	42, section 405.1041, or located in a community with a
240.27 	population of less than 10,000 15,000, according to United
240.28 	States Census Bureau statistics, outside the seven-county
240.29 	metropolitan area;
240.30 	(2) has 50 or fewer beds; and
240.31 	(3) is not for profit.

240.32 	Sec. 10. Minnesota Statutes 2004, section 144.147,
240.33 	subdivision 2, is amended to read:
240.34 		Subd. 2.Grants authorized.  The commissioner shall
240.35 	establish a program of grants to assist eligible rural
240.36 	hospitals.  The commissioner shall award grants to hospitals and
240.37 	communities for the purposes set forth in paragraphs (a) and (b).
240.38 	(a) Grants may be used by hospitals and their communities
240.39 	to develop strategic plans for preserving or enhancing access to
240.40 	health services.  At a minimum, a strategic plan must consist of:
240.41 	(1) a needs assessment to determine what health services
240.42 	are needed and desired by the community.  The assessment must
241.1 	include interviews with or surveys of area health professionals,
241.2 	local community leaders, and public hearings;
241.3 	(2) an assessment of the feasibility of providing needed
241.4 	health services that identifies priorities and timeliness for
241.5 	potential changes; and
241.6 	(3) an implementation plan.
241.7 	The strategic plan must be developed by a committee that
241.8 	includes representatives from the hospital, local public health
241.9 	agencies, other health providers, and consumers from the
241.10 	community.
241.11 	(b) The grants may also be used by eligible rural hospitals
241.12 	that have developed strategic plans to implement transition
241.13 	projects to modify the type and extent of services provided, in
241.14 	order to reflect the needs of that plan.  Grants may be used by
241.15 	hospitals under this paragraph to develop hospital-based
241.16 	physician practices that integrate hospital and existing medical
241.17 	practice facilities that agree to transfer their practices,
241.18 	equipment, staffing, and administration to the hospital.  The
241.19 	grants may also be used by the hospital to establish a health
241.20 	provider cooperative, a telemedicine system, an electronic
241.21 	health records system,or a rural health care system or to cover
241.22 	expenses associated with being designated as a critical access
241.23 	hospital for the Medicare rural hospital flexibility program.
241.24 	Not more than one-third of any grant shall be used to offset
241.25 	losses incurred by physicians agreeing to transfer their
241.26 	practices to hospitals.

241.27 	Sec. 11. [144.1476] RURAL PHARMACY PLANNING AND
241.28 	TRANSITION GRANT PROGRAM.
241.29 		Subdivision 1.Definitions. (a) For the purposes of this
241.30 	section, the following definitions apply.
241.31 	(b) "Eligible rural community" means:
241.32 	(1) a Minnesota community that is located in a rural area,
241.33 	as defined in the federal Medicare regulations, Code of Federal
241.34 	Regulations, title 42, section 405.1041; or 
241.35 	(2) a Minnesota community that has a population of less
241.36 	than 10,000, according to the United States Bureau of
242.1 	Statistics, and that is outside the seven-county metropolitan
242.2 	area, excluding the cities of Duluth, Mankato, Moorhead,
242.3 	Rochester, and St. Cloud.
242.4 	(c) "Health care provider" means a hospital, clinic,
242.5 	pharmacy, long-term care institution, or other health care
242.6 	facility that is licensed, certified, or otherwise authorized by
242.7 	the laws of this state to provide health care.
242.8 	(d) "Pharmacist" means an individual with a valid license
242.9 	issued under chapter 151 to practice pharmacy.
242.10 	(e) "Pharmacy" has the meaning given under section 151.01,
242.11 	subdivision 2.
242.12 		Subd. 2.Grants authorized; eligibility. (a) The
242.13 	commissioner of health shall establish a program to award grants
242.14 	to eligible rural communities or health care providers in
242.15 	eligible rural communities for planning, establishing, keeping
242.16 	in operation, or providing health care services that preserve
242.17 	access to prescription medications and the skills of a
242.18 	pharmacist according to sections 151.01 to 151.40.
242.19 	(b) To be eligible for a grant, an applicant must develop a
242.20 	strategic plan for preserving or enhancing access to
242.21 	prescription medications and the skills of a pharmacist.  At a
242.22 	minimum, a strategic plan must consist of:
242.23 	(1) a needs assessment to determine what pharmacy services
242.24 	are needed and desired by the community.  The assessment must
242.25 	include interviews with or surveys of area and local health
242.26 	professionals, local community leaders, and public officials;
242.27 	(2) an assessment of the feasibility of providing needed
242.28 	pharmacy services that identifies priorities and timelines for
242.29 	potential changes; and 
242.30 	(3) an implementation plan.
242.31 	(c) A grant may be used by a recipient that has developed a
242.32 	strategic plan to implement transition projects to modify the
242.33 	type and extent of pharmacy services provided, in order to
242.34 	reflect the needs of the community.  Grants may also be used by
242.35 	recipients:
242.36 	(1) to develop pharmacy practices that integrate pharmacy
243.1 	and existing health care provider facilities; or 
243.2 	(2) to establish a pharmacy provider cooperative or
243.3 	initiatives that maintain local access to prescription
243.4 	medications and the skills of a pharmacist.
243.5 		Subd. 3.Funding. In accordance with section 214.06, fee
243.6 	revenues collected by the Board of Pharmacy shall pay for:
243.7 	(1) anticipated operating expenditures during the fiscal
243.8 	biennium; and 
243.9 	(2) appropriations for the rural pharmacy grant program
243.10 	administered by the Department of Health.
243.11 	The commissioner of finance shall make available money in the
243.12 	state government special revenue fund for the operation and
243.13 	administration of the rural pharmacy grant program.  No more
243.14 	than ten percent of the money appropriated for the rural
243.15 	pharmacy grant program may be used for administrative expenses.
243.16 		Subd. 4.Consideration of grants. In determining which
243.17 	applicants shall receive grants under this section, the
243.18 	commissioner of health shall appoint a committee comprised of
243.19 	members with experience and knowledge about rural pharmacy
243.20 	issues including but not limited to two rural pharmacists with a
243.21 	community pharmacy background, two health care providers from
243.22 	rural communities, one representative from a statewide
243.23 	pharmacist organization, and one representative of the Board of
243.24 	Pharmacy.  A representative of the commissioner may serve on the
243.25 	committee in an ex officio status.  In determining who shall
243.26 	receive a grant, the committee shall take into account:
243.27 	(1) improving or maintaining access to prescription
243.28 	medications and the skills of a pharmacist;
243.29 	(2) changes in service populations;
243.30 	(3) the extent community pharmacy needs are not currently
243.31 	met by other providers in the area;
243.32 	(4) the financial condition of the applicant;
243.33 	(5) the integration of pharmacy services into existing
243.34 	health care services; and 
243.35 	(6) community support.
243.36 	The commissioner may also take into account other relevant
244.1 	factors.
244.2 		Subd. 5.Allocation of grants. (a) The commissioner
244.3 	shall establish a deadline for receiving applications and must
244.4 	make a final decision on the funding of each application within
244.5 	60 days of the deadline.  An applicant must apply no later than
244.6 	March 1 of each fiscal year for grants awarded for that fiscal
244.7 	year.
244.8 	(b) Any grant awarded must not exceed $50,000 a year and
244.9 	may not exceed a one-year term.
244.10 	(c) Applicants may apply to the program each year they are
244.11 	eligible.
244.12 	(d) Project grants may not be used to retire debt incurred
244.13 	with respect to any capital expenditure made prior to the date
244.14 	on which the project is initiated.
244.15 		Subd. 6.Evaluation. The commissioner shall evaluate the
244.16 	overall effectiveness of the grant program and may collect
244.17 	progress reports and other information from grantees needed for
244.18 	program evaluation.  An academic institution that has the
244.19 	expertise in evaluating rural pharmacy outcomes may participate
244.20 	in the program evaluation if asked by a grantee or the
244.21 	commissioner.  The commissioner shall compile summaries of
244.22 	successful grant projects and other model community efforts to
244.23 	preserve access to prescription medications and the skills of a
244.24 	pharmacist, and make this information available to Minnesota
244.25 	communities seeking to address local pharmacy issues.

244.26 	Sec. 12. Minnesota Statutes 2004, section 144.148,
244.27 	subdivision 1, is amended to read:
244.28 		Subdivision 1.Definition.  (a) For purposes of this
244.29 	section, the following definitions apply.
244.30 	(b) "Eligible rural hospital" means any nonfederal, general
244.31 	acute care hospital that:
244.32 	(1) is either located in a rural area, as defined in the
244.33 	federal Medicare regulations, Code of Federal Regulations, title
244.34 	42, section 405.1041, or located in a community with a
244.35 	population of less than 10,000 15,000, according to United
244.36 	States Census Bureau statistics, outside the seven-county
245.1 	metropolitan area;
245.2 	(2) has 50 or fewer beds; and
245.3 	(3) is not for profit.
245.4 	(c) "Eligible project" means a modernization project to
245.5 	update, remodel, or replace aging hospital facilities and
245.6 	equipment necessary to maintain the operations of a hospital,
245.7 	including establishing an electronic health records system.

245.8 	Sec. 13. Minnesota Statutes 2004, section 144.1483, is
245.9 	amended to read:
245.10 	144.1483 RURAL HEALTH INITIATIVES.
245.11 	The commissioner of health, through the Office of Rural
245.12 	Health, and consulting as necessary with the commissioner of
245.13 	human services, the commissioner of commerce, the Higher
245.14 	Education Services Office, and other state agencies, shall:
245.15 	(1) develop a detailed plan regarding the feasibility of
245.16 	coordinating rural health care services by organizing individual
245.17 	medical providers and smaller hospitals and clinics into
245.18 	referral networks with larger rural hospitals and clinics that
245.19 	provide a broader array of services;
245.20 	(2) develop and implement a program to assist rural
245.21 	communities in establishing community health centers, as
245.22 	required by section 144.1486;
245.23 	(3) develop recommendations regarding health education and
245.24 	training programs in rural areas, including but not limited to a
245.25 	physician assistants' training program, continuing education
245.26 	programs for rural health care providers, and rural outreach
245.27 	programs for nurse practitioners within existing training
245.28 	programs;
245.29 	(4) (3) develop a statewide, coordinated recruitment
245.30 	strategy for health care personnel and maintain a database on
245.31 	health care personnel as required under section 144.1485;
245.32 	(5) (4) develop and administer technical assistance
245.33 	programs to assist rural communities in:  (i) planning and
245.34 	coordinating the delivery of local health care services; and
245.35 	(ii) hiring physicians, nurse practitioners, public health
245.36 	nurses, physician assistants, and other health personnel;
246.1 	(6) (5) study and recommend changes in the regulation of
246.2 	health care personnel, such as nurse practitioners and physician
246.3 	assistants, related to scope of practice, the amount of on-site
246.4 	physician supervision, and dispensing of medication, to address
246.5 	rural health personnel shortages;
246.6 	(7) (6) support efforts to ensure continued funding for
246.7 	medical and nursing education programs that will increase the
246.8 	number of health professionals serving in rural areas;
246.9 	(8) (7) support efforts to secure higher reimbursement for
246.10 	rural health care providers from the Medicare and medical
246.11 	assistance programs;
246.12 	(9) (8) coordinate the development of a statewide plan for
246.13 	emergency medical services, in cooperation with the Emergency
246.14 	Medical Services Advisory Council;
246.15 	(10) (9) establish a Medicare rural hospital flexibility
246.16 	program pursuant to section 1820 of the federal Social Security
246.17 	Act, United States Code, title 42, section 1395i-4, by
246.18 	developing a state rural health plan and designating, consistent
246.19 	with the rural health plan, rural nonprofit or public hospitals
246.20 	in the state as critical access hospitals.  Critical access
246.21 	hospitals shall include facilities that are certified by the
246.22 	state as necessary providers of health care services to
246.23 	residents in the area.  Necessary providers of health care
246.24 	services are designated as critical access hospitals on the
246.25 	basis of being more than 20 miles, defined as official mileage
246.26 	as reported by the Minnesota Department of Transportation, from
246.27 	the next nearest hospital, being the sole hospital in the
246.28 	county, being a hospital located in a county with a designated
246.29 	medically underserved area or health professional shortage area,
246.30 	or being a hospital located in a county contiguous to a county
246.31 	with a medically underserved area or health professional
246.32 	shortage area.  A critical access hospital located in a county
246.33 	with a designated medically underserved area or a health
246.34 	professional shortage area or in a county contiguous to a county
246.35 	with a medically underserved area or health professional
246.36 	shortage area shall continue to be recognized as a critical
247.1 	access hospital in the event the medically underserved area or
247.2 	health professional shortage area designation is subsequently
247.3 	withdrawn; and
247.4 	(11) (10) carry out other activities necessary to address
247.5 	rural health problems.

247.6 	Sec. 14. Minnesota Statutes 2004, section 144.1501,
247.7 	subdivision 1, is amended to read:
247.8 		Subdivision 1.Definitions.  (a) For purposes of this
247.9 	section, the following definitions apply.
247.10 	(b) "Dentist" means an individual who is licensed to
247.11 	practice dentistry.
247.12 	(c) "Designated rural area" means:
247.13 	(1) an area in Minnesota outside the counties of Anoka,
247.14 	Carver, Dakota, Hennepin, Ramsey, Scott, and Washington,
247.15 	excluding the cities of Duluth, Mankato, Moorhead, Rochester,
247.16 	and St. Cloud; or
247.17 	(2) a municipal corporation, as defined under section
247.18 	471.634, that is physically located, in whole or in part, in an
247.19 	area defined as a designated rural area under clause (1).
247.20 	(c) (d) "Emergency circumstances" means those conditions
247.21 	that make it impossible for the participant to fulfill the
247.22 	service commitment, including death, total and permanent
247.23 	disability, or temporary disability lasting more than two years.
247.24 	(d) (e) "Medical resident" means an individual
247.25 	participating in a medical residency in family practice,
247.26 	internal medicine, obstetrics and gynecology, pediatrics, or
247.27 	psychiatry.
247.28 	(e) (f) "Midlevel practitioner" means a nurse practitioner,
247.29 	nurse-midwife, nurse anesthetist, advanced clinical nurse
247.30 	specialist, or physician assistant.
247.31 	(f) (g) "Nurse" means an individual who has completed
247.32 	training and received all licensing or certification necessary
247.33 	to perform duties as a licensed practical nurse or registered
247.34 	nurse.
247.35 	(g) (h) "Nurse-midwife" means a registered nurse who has
247.36 	graduated from a program of study designed to prepare registered
248.1 	nurses for advanced practice as nurse-midwives.
248.2 	(h) (i) "Nurse practitioner" means a registered nurse who
248.3 	has graduated from a program of study designed to prepare
248.4 	registered nurses for advanced practice as nurse practitioners.
248.5 	(i) (j) "Pharmacist" means an individual with a valid
248.6 	license to practice pharmacy issued under chapter 151.
248.7 	(k) "Physician" means an individual who is licensed to
248.8 	practice medicine in the areas of family practice, internal
248.9 	medicine, obstetrics and gynecology, pediatrics, or psychiatry.
248.10 	(j) (l) "Physician assistant" means a person registered
248.11 	under chapter 147A.
248.12 	(k) (m) "Qualified educational loan" means a government,
248.13 	commercial, or foundation loan for actual costs paid for
248.14 	tuition, reasonable education expenses, and reasonable living
248.15 	expenses related to the graduate or undergraduate education of a
248.16 	health care professional.
248.17 	(l) (n) "Underserved urban community" means a Minnesota
248.18 	urban area or population included in the list of designated
248.19 	primary medical care health professional shortage areas (HPSAs),
248.20 	medically underserved areas (MUAs), or medically underserved
248.21 	populations (MUPs) maintained and updated by the United States
248.22 	Department of Health and Human Services.

248.23 	Sec. 15. Minnesota Statutes 2004, section 144.1501,
248.24 	subdivision 2, is amended to read:
248.25 		Subd. 2.Creation of account.  A health professional
248.26 	education loan forgiveness program account is established.  The
248.27 	commissioner of health shall use money from the account to
248.28 	establish a loan forgiveness program for medical residents
248.29 	agreeing to practice in designated rural areas or underserved
248.30 	urban communities,; for dentists agreeing to deliver at least 25
248.31 	percent of the dentist's yearly patient encounters to state
248.32 	public program enrollees or patients receiving sliding fee
248.33 	schedule discounts through a formal sliding fee schedule meeting
248.34 	the standards established by the United States Department of
248.35 	Health and Human Services under Code of Federal Regulations,
248.36 	title 42, section 51, chapter 303;for midlevel practitioners
249.1 	agreeing to practice in designated rural areas, and for nurses
249.2 	who agree to practice in a Minnesota nursing home or
249.3 	intermediate care facility for persons with mental retardation
249.4 	or related conditions, and for pharmacists who agree to practice
249.5 	in designated rural areas.  Appropriations made to the account
249.6 	do not cancel and are available until expended, except that at
249.7 	the end of each biennium, any remaining balance in the account
249.8 	that is not committed by contract and not needed to fulfill
249.9 	existing commitments shall cancel to the fund.

249.10 	Sec. 16. Minnesota Statutes 2004, section 144.1501,
249.11 	subdivision 3, is amended to read:
249.12 		Subd. 3.Eligibility.  (a) To be eligible to participate
249.13 	in the loan forgiveness program, an individual must:
249.14 	(1) be a medical or dental resident or a licensed
249.15 	pharmacist or be enrolled in a dentist,midlevel practitioner,
249.16 	registered nurse, or a licensed practical nurse training
249.17 	program; and
249.18 	(2) submit an application to the commissioner of
249.19 	health. If fewer applications are submitted by dental students
249.20 	or residents than there are dentist participant slots available,
249.21 	the commissioner may consider applications submitted by dental
249.22 	program graduates who are licensed dentists.
249.23 	(b) An applicant selected to participate must sign a
249.24 	contract to agree to serve a minimum three-year full-time
249.25 	service obligation according to subdivision 2, which shall begin
249.26 	no later than March 31 following completion of required training.

249.27 	Sec. 17. Minnesota Statutes 2004, section 144.1501,
249.28 	subdivision 4, is amended to read:
249.29 		Subd. 4.Loan forgiveness.  The commissioner of health
249.30 	may select applicants each year for participation in the loan
249.31 	forgiveness program, within the limits of available funding. The
249.32 	commissioner shall distribute available funds for loan
249.33 	forgiveness proportionally among the eligible professions
249.34 	according to the vacancy rate for each profession in the
249.35 	required geographic area, patient group,or facility type
249.36 	specified in subdivision 2.  The commissioner shall allocate
250.1 	funds for physician loan forgiveness so that 75 percent of the
250.2 	funds available are used for rural physician loan forgiveness
250.3 	and 25 percent of the funds available are used for underserved
250.4 	urban communities loan forgiveness.  If the commissioner does
250.5 	not receive enough qualified applicants each year to use the
250.6 	entire allocation of funds for urban underserved communities any
250.7 	eligible profession, the remaining funds may be allocated for
250.8 	rural physician loan forgiveness proportionally among the other
250.9 	eligible professions according to the vacancy rate for each
250.10 	profession in the required geographic area, patient group, or
250.11 	facility type specified in subdivision 2.  Applicants are
250.12 	responsible for securing their own qualified educational loans.
250.13 	The commissioner shall select participants based on their
250.14 	suitability for practice serving the required geographic area or
250.15 	facility type specified in subdivision 2, as indicated by
250.16 	experience or training.  The commissioner shall give preference
250.17 	to applicants closest to completing their training.  For each
250.18 	year that a participant meets the service obligation required
250.19 	under subdivision 3, up to a maximum of four years, the
250.20 	commissioner shall make annual disbursements directly to the
250.21 	participant equivalent to 15 percent of the average educational
250.22 	debt for indebted graduates in their profession in the year
250.23 	closest to the applicant's selection for which information is
250.24 	available, not to exceed the balance of the participant's
250.25 	qualifying educational loans.  Before receiving loan repayment
250.26 	disbursements and as requested, the participant must complete
250.27 	and return to the commissioner an affidavit of practice form
250.28 	provided by the commissioner verifying that the participant is
250.29 	practicing as required under subdivisions 2 and 3.  The
250.30 	participant must provide the commissioner with verification that
250.31 	the full amount of loan repayment disbursement received by the
250.32 	participant has been applied toward the designated loans.  After
250.33 	each disbursement, verification must be received by the
250.34 	commissioner and approved before the next loan repayment
250.35 	disbursement is made.  Participants who move their practice
250.36 	remain eligible for loan repayment as long as they practice as
251.1 	required under subdivision 2.

251.2 	Sec. 18. Minnesota Statutes 2004, section 144.226,
251.3 	subdivision 1, is amended to read:
251.4 		Subdivision 1.Which services are for fee.  The fees for
251.5 	the following services shall be the following or an amount
251.6 	prescribed by rule of the commissioner:
251.7 	(a) The fee for the issuance of a certified vital record or
251.8 	a certification that the vital record cannot be found is $8 $9.
251.9 	No fee shall be charged for a certified birth or death record
251.10 	that is reissued within one year of the original issue, if an
251.11 	amendment is made to the vital record and if the previously
251.12 	issued vital record is surrendered. The fee is nonrefundable.
251.13 	(b) The fee for processing a request for the replacement of
251.14 	a birth record for all events, except when filing a recognition
251.15 	of parentage pursuant to section 257.73, subdivision 1,
251.16 	is $20 $40. The fee is payable at the time of application and
251.17 	is nonrefundable.
251.18 	(c) The fee for processing a request for the filing of a
251.19 	delayed registration of birth or death is $20 $40. The fee is
251.20 	payable at the time of application and is nonrefundable.  This
251.21 	fee includes one subsequent review of the request if the request
251.22 	is not acceptable upon the initial receipt.
251.23 	(d) The fee for processing a request for the amendment of
251.24 	any vital record when requested more than 45 days after the
251.25 	filing of the vital record is $20 $40.  No fee shall be charged
251.26 	for an amendment requested within 45 days after the filing of
251.27 	the vital record. The fee is payable at the time of application
251.28 	and is nonrefundable.  This fee includes one subsequent review
251.29 	of the request if the request is not acceptable upon the initial
251.30 	receipt.
251.31 	(e) The fee for processing a request for the verification
251.32 	of information from vital records is $8 $9 when the applicant
251.33 	furnishes the specific information to locate the vital record.
251.34 	When the applicant does not furnish specific information, the
251.35 	fee is $20 per hour for staff time expended.  Specific
251.36 	information includes the correct date of the event and the
252.1 	correct name of the registrant.  Fees charged shall approximate
252.2 	the costs incurred in searching and copying the vital records.
252.3 	The fee shall be is payable at the time of application and is
252.4 	nonrefundable.
252.5 	(f) The fee for processing a request for the issuance of a
252.6 	copy of any document on file pertaining to a vital record or
252.7 	statement that a related document cannot be found is $8 $9. The
252.8 	fee is payable at the time of application and is nonrefundable.

252.9 	Sec. 19. Minnesota Statutes 2004, section 144.226,
252.10 	subdivision 4, is amended to read:
252.11 		Subd. 4.Vital records surcharge.  In addition to any fee
252.12 	prescribed under subdivision 1, there is a nonrefundable
252.13 	surcharge of $2 $4 for each certified and noncertified birth or
252.14 	death record, and for a certification that the record cannot be
252.15 	found.  The local or state registrar shall forward this amount
252.16 	to the commissioner of finance to be deposited into the state
252.17 	government special revenue fund.  This surcharge shall not be
252.18 	charged under those circumstances in which no fee for a birth or
252.19 	death record is permitted under subdivision 1, paragraph (a).

252.20 	Sec. 20. Minnesota Statutes 2004, section 144.226, is
252.21 	amended by adding a subdivision to read:
252.22 		Subd. 5.Electronic verification. A fee for the
252.23 	electronic verification of a vital event, when the information
252.24 	being verified is obtained from a certified birth or death
252.25 	record, shall be established through contractual or interagency
252.26 	agreements with interested local, state, or federal government
252.27 	agencies.

252.28 	Sec. 21. Minnesota Statutes 2004, section 144.226, is
252.29 	amended by adding a subdivision to read:
252.30 		Subd. 6.Alternative payment methods. Notwithstanding
252.31 	subdivision 1, alternative payment methods may be approved and
252.32 	implemented by the state registrar or a local registrar.

252.33 	Sec. 22. [144.3431] ABORTION NOTIFICATION DATA.
252.34 		Subdivision 1.Reporting form. (a) Within 90 days of the
252.35 	effective date of this section, the commissioner of health shall
252.36 	prepare a reporting form for use by physicians and facilities
253.1 	performing abortions.
253.2 	(b) The form shall require the following information:
253.3 	(1) the number of minors or women for whom a guardian has
253.4 	been appointed under sections 524.5-301 to 524.5-317 because of
253.5 	a finding of incompetency for whom the physician or an agent of
253.6 	the physician provided the notice described in section 144.343,
253.7 	subdivision 2; of that number, the number of notices provided
253.8 	personally as described in section 144.343, subdivision 2,
253.9 	paragraph (a), and the number of notices provided by mail as
253.10 	described in section 144.343, subdivision 2, paragraph (b); and
253.11 	of each of those numbers, the number who, to the best of the
253.12 	reporting physician's or reporting facility's information and
253.13 	belief, went on to obtain the abortion from the reporting
253.14 	physician or reporting physician's facility, or from the
253.15 	reporting facility;
253.16 	(2) the number of minors or women for whom a guardian has
253.17 	been appointed under sections 524.5-301 to 524.5-317 because of
253.18 	a finding of incompetency upon whom the physician performed an
253.19 	abortion without providing the notice described in section
253.20 	144.343, subdivision 2; and of that number, the number who were
253.21 	emancipated minors, and the number for whom section 144.343,
253.22 	subdivision 4, was applicable, itemized by each of the
253.23 	limitations identified in paragraphs (a), (b), and (c) of that
253.24 	subdivision;
253.25 	(3) the number of abortions performed by the physician for
253.26 	which judicial authorization was received and for which the
253.27 	notification described in section 144.343, subdivision 2, was
253.28 	not provided;
253.29 	(4) the county the female resides in; the county where the
253.30 	abortion was performed, if different from the female's
253.31 	residence; and, if a judicial bypass was obtained, the county it
253.32 	was obtained in, if different from the female's residence;
253.33 	(5) the age of the female;
253.34 	(6) the race of the female;
253.35 	(7) the process the physician or the physician's agent used
253.36 	to inform the female of the judicial bypass; whether court forms
254.1 	were provided to her; and whether the physician or the
254.2 	physician's agent made the court arrangement for the female; and 
254.3 	(8) how soon after visiting the abortion facility the
254.4 	female went to court to obtain a judicial bypass.
254.5 		Subd. 2.Forms to physicians and facilities. Physicians
254.6 	and facilities required to report under subdivision 3 shall
254.7 	obtain reporting forms from the commissioner.
254.8 		Subd. 3.Submission. (a) The following physicians or
254.9 	facilities must submit the forms to the commissioner no later
254.10 	than April 1 for abortions performed in the previous calendar
254.11 	year:
254.12 	(1) a physician who provides, or whose agent provides, the
254.13 	notice described in section 144.343, subdivision 2, or the
254.14 	facility at which such notice is provided; and 
254.15 	(2) a physician who knowingly performs an abortion upon a
254.16 	minor or a woman for whom a guardian has been appointed
254.17 	according to sections 524.5-301 to 524.5-317 because of a
254.18 	finding of incompetency, or a facility at which such an abortion
254.19 	is performed.
254.20 	(b) The commissioner shall maintain as confidential data
254.21 	which alone or in combination may constitute information that
254.22 	would reasonably lead, using epidemiologic principles, to the
254.23 	identification of:
254.24 	(1) an individual who has had an abortion, who has received
254.25 	judicial authorization for an abortion, or to whom the notice
254.26 	described in section 144.343, subdivision 2, has been provided;
254.27 	or 
254.28 	(2) a physician or facility required to report under
254.29 	paragraph (a).
254.30 		Subd. 4.Failure to report as required. (a) Reports that
254.31 	are not submitted more than 30 days following the due date shall
254.32 	be subject to a late fee of $500 for each additional 30-day
254.33 	period or portion of a 30-day period overdue.  If a physician or
254.34 	facility required to report under this section has not submitted
254.35 	a report, or has submitted only an incomplete report, more than
254.36 	one year following the due date, the commissioner of health
255.1 	shall bring an action in a court of competent jurisdiction for
255.2 	an order directing the physician or facility to submit a
255.3 	complete report within a period stated by court order or be
255.4 	subject to sanctions.  If the commissioner brings such an action
255.5 	for an order directing a physician or facility to submit a
255.6 	complete report, the court may assess reasonable attorney fees
255.7 	and costs against the noncomplying party.
255.8 	(b) Notwithstanding section 13.39, data related to actions
255.9 	taken by the commissioner to enforce any provision of this
255.10 	section is private data if the data, alone or in combination,
255.11 	may constitute information that would reasonably lead, using
255.12 	epidemiologic principles, to the identification of:
255.13 	(1) an individual who has had an abortion, who has received
255.14 	judicial authorization for an abortion, or to whom the notice
255.15 	described in section 144.343, subdivision 2, has been provided;
255.16 	or 
255.17 	(2) a physician or facility required to report under
255.18 	subdivision 3.
255.19 		Subd. 5.Public records. (a) By September 30 of each
255.20 	year, the commissioner of health shall issue a public report
255.21 	providing statistics for each item listed in subdivision 1 for
255.22 	the previous calendar year compiled from reports submitted
255.23 	according to this section.  The report shall also include
255.24 	statistics, which shall be obtained from court administrators,
255.25 	that include:
255.26 	(1) the total number of petitions or motions filed under
255.27 	section 144.343, subdivision 6, paragraph (c), clause (i);
255.28 	(2) the number of cases in which the court appointed a
255.29 	guardian ad litem;
255.30 	(3) the number of cases in which the court appointed
255.31 	counsel;
255.32 	(4) the number of cases in which the judge issued an order
255.33 	authorizing an abortion without notification, including:
255.34 	(i) the number of petitions or motions granted by the court
255.35 	because of a finding of maturity and the basis for that finding;
255.36 	and 
256.1 	(ii) the number of petitions or motions granted because of
256.2 	a finding that the abortion would be in the best interest of the
256.3 	minor and the basis for that finding;
256.4 	(5) the number of denials from which an appeal was filed;
256.5 	(6) the number of appeals that resulted in a denial being
256.6 	affirmed; and 
256.7 	(7) the number of appeals that resulted in reversal of a
256.8 	denial.
256.9 	(b) The report shall provide the statistics for all
256.10 	previous calendar years for which a public report was required
256.11 	to be issued, adjusted to reflect any additional information
256.12 	from late or corrected reports.
256.13 	(c) The commissioner shall ensure that all statistical
256.14 	information included in the public reports are presented so that
256.15 	the data cannot reasonably lead, using epidemiologic principles,
256.16 	to the identification of:
256.17 	(1) an individual who has had an abortion, who has received
256.18 	judicial authorization for an abortion, or to whom the notice
256.19 	described in section 144.343, subdivision 2, has been provided;
256.20 	or 
256.21 	(2) a physician or facility who has submitted a form to the
256.22 	commissioner under subdivision 3.
256.23 		Subd. 6.Modification of requirements. The commissioner
256.24 	of health may, by administrative rule, alter the dates
256.25 	established in subdivisions 3 and 5, consolidate the forms
256.26 	created according to subdivision 1 with the reporting form
256.27 	created according to section 145.4131, or consolidate reports to
256.28 	achieve administrative convenience or fiscal savings, to allow
256.29 	physicians and facilities to submit all information collected by
256.30 	the commissioner regarding abortions at one time, or to reduce
256.31 	the burden of the data collection, so long as the report
256.32 	described in subdivision 5 is issued at least once a year.
256.33 		Subd. 7.Suit to compel statistical report. If the
256.34 	commissioner of health fails to issue the public report required
256.35 	under subdivision 5, any group of ten or more citizens of the
256.36 	state may seek an injunction in a court of competent
257.1 	jurisdiction against the commissioner, requiring that a complete
257.2 	report be issued within a period stated by court order.  Failure
257.3 	to abide by the injunction shall subject the commissioner to
257.4 	sanctions for civil contempt.
257.5 		Subd. 8.Attorney fees. If judgment is rendered in favor
257.6 	of the plaintiff in any action described in this section, the
257.7 	court shall also render judgment for a reasonable attorney fee
257.8 	in favor of the plaintiff against the defendant.  If the
257.9 	judgment is rendered in favor of the defendant and the court
257.10 	finds that plaintiff's suit was frivolous and brought in bad
257.11 	faith, the court shall render judgment for a reasonable attorney
257.12 	fee in favor of the defendant against the plaintiff.
257.13 		Subd. 9.Severability. If any one or more provision,
257.14 	section, subdivision, sentence, clause, phrase, or word of this
257.15 	section or the application thereof to any person or circumstance
257.16 	is found to be unconstitutional, the same is hereby declared to
257.17 	be severable and the balance of this section shall remain
257.18 	effective notwithstanding such unconstitutionality.  The
257.19 	legislature hereby declares that it would have passed this
257.20 	section, and each provision, section, subdivision, sentence,
257.21 	clause, phrase, or word thereof irrespective of the fact that
257.22 	any one provision, section, subdivision, sentence, clause,
257.23 	phrase, or word be declared unconstitutional.

257.24 	Sec. 23. Minnesota Statutes 2004, section 144.3831,
257.25 	subdivision 1, is amended to read:
257.26 		Subdivision 1.Fee setting.  The commissioner of health
257.27 	may assess an annual fee of $5.21 $6.36 for every service
257.28 	connection to a public water supply that is owned or operated by
257.29 	a home rule charter city, a statutory city, a city of the first
257.30 	class, or a town.  The commissioner of health may also assess an
257.31 	annual fee for every service connection served by a water user
257.32 	district defined in section 110A.02.
257.33 	
EFFECTIVE DATE. This section is effective July 1, 2006.

257.34 	Sec. 24. Minnesota Statutes 2004, section 144.551,
257.35 	subdivision 1, is amended to read:
257.36 		Subdivision 1.Restricted construction or modification.
 258.1 	(a) The following construction or modification may not be
258.2 	commenced:
258.3 	(1) any erection, building, alteration, reconstruction,
258.4 	modernization, improvement, extension, lease, or other
258.5 	acquisition by or on behalf of a hospital that increases the bed
258.6 	capacity of a hospital, relocates hospital beds from one
258.7 	physical facility, complex, or site to another, or otherwise
258.8 	results in an increase or redistribution of hospital beds within
258.9 	the state; and
258.10 	(2) the establishment of a new hospital.
258.11 	(b) This section does not apply to:
258.12 	(1) construction or relocation within a county by a
258.13 	hospital, clinic, or other health care facility that is a
258.14 	national referral center engaged in substantial programs of
258.15 	patient care, medical research, and medical education meeting
258.16 	state and national needs that receives more than 40 percent of
258.17 	its patients from outside the state of Minnesota;
258.18 	(2) a project for construction or modification for which a
258.19 	health care facility held an approved certificate of need on May
258.20 	1, 1984, regardless of the date of expiration of the
258.21 	certificate;
258.22 	(3) a project for which a certificate of need was denied
258.23 	before July 1, 1990, if a timely appeal results in an order
258.24 	reversing the denial;
258.25 	(4) a project exempted from certificate of need
258.26 	requirements by Laws 1981, chapter 200, section 2;
258.27 	(5) a project involving consolidation of pediatric
258.28 	specialty hospital services within the Minneapolis-St. Paul
258.29 	metropolitan area that would not result in a net increase in the
258.30 	number of pediatric specialty hospital beds among the hospitals
258.31 	being consolidated;
258.32 	(6) a project involving the temporary relocation of
258.33 	pediatric-orthopedic hospital beds to an existing licensed
258.34 	hospital that will allow for the reconstruction of a new
258.35 	philanthropic, pediatric-orthopedic hospital on an existing site
258.36 	and that will not result in a net increase in the number of
259.1 	hospital beds.  Upon completion of the reconstruction, the
259.2 	licenses of both hospitals must be reinstated at the capacity
259.3 	that existed on each site before the relocation;
259.4 	(7) the relocation or redistribution of hospital beds
259.5 	within a hospital building or identifiable complex of buildings
259.6 	provided the relocation or redistribution does not result in:
259.7 	(i) an increase in the overall bed capacity at that site; (ii)
259.8 	relocation of hospital beds from one physical site or complex to
259.9 	another; or (iii) redistribution of hospital beds within the
259.10 	state or a region of the state;
259.11 	(8) relocation or redistribution of hospital beds within a
259.12 	hospital corporate system that involves the transfer of beds
259.13 	from a closed facility site or complex to an existing site or
259.14 	complex provided that:  (i) no more than 50 percent of the
259.15 	capacity of the closed facility is transferred; (ii) the
259.16 	capacity of the site or complex to which the beds are
259.17 	transferred does not increase by more than 50 percent; (iii) the
259.18 	beds are not transferred outside of a federal health systems
259.19 	agency boundary in place on July 1, 1983; and (iv) the
259.20 	relocation or redistribution does not involve the construction
259.21 	of a new hospital building;
259.22 	(9) a construction project involving up to 35 new beds in a
259.23 	psychiatric hospital in Rice County that primarily serves
259.24 	adolescents and that receives more than 70 percent of its
259.25 	patients from outside the state of Minnesota;
259.26 	(10) a project to replace a hospital or hospitals with a
259.27 	combined licensed capacity of 130 beds or less if:  (i) the new
259.28 	hospital site is located within five miles of the current site;
259.29 	and (ii) the total licensed capacity of the replacement
259.30 	hospital, either at the time of construction of the initial
259.31 	building or as the result of future expansion, will not exceed
259.32 	70 licensed hospital beds, or the combined licensed capacity of
259.33 	the hospitals, whichever is less;
259.34 	(11) the relocation of licensed hospital beds from an
259.35 	existing state facility operated by the commissioner of human
259.36 	services to a new or existing facility, building, or complex
260.1 	operated by the commissioner of human services; from one
260.2 	regional treatment center site to another; or from one building
260.3 	or site to a new or existing building or site on the same
260.4 	campus;
260.5 	(12) the construction or relocation of hospital beds
260.6 	operated by a hospital having a statutory obligation to provide
260.7 	hospital and medical services for the indigent that does not
260.8 	result in a net increase in the number of hospital beds;
260.9 	(13) a construction project involving the addition of up to
260.10 	31 new beds in an existing nonfederal hospital in Beltrami
260.11 	County;
260.12 	(14) a construction project involving the addition of up to
260.13 	eight new beds in an existing nonfederal hospital in Otter Tail
260.14 	County with 100 licensed acute care beds;
260.15 	(15) a construction project involving the addition of 20
260.16 	new hospital beds used for rehabilitation services in an
260.17 	existing hospital in Carver County serving the southwest
260.18 	suburban metropolitan area.  Beds constructed under this clause
260.19 	shall not be eligible for reimbursement under medical
260.20 	assistance, general assistance medical care, or MinnesotaCare;
260.21 	(16) a project for the construction or relocation of up to
260.22 	20 hospital beds for the operation of up to two psychiatric
260.23 	facilities or units for children provided that the operation of
260.24 	the facilities or units have received the approval of the
260.25 	commissioner of human services;
260.26 	(17) a project involving the addition of 14 new hospital
260.27 	beds to be used for rehabilitation services in an existing
260.28 	hospital in Itasca County; or 
260.29 	(18) a project to add 20 licensed beds in existing space at
260.30 	a hospital in Hennepin County that closed 20 rehabilitation beds
260.31 	in 2002, provided that the beds are used only for rehabilitation
260.32 	in the hospital's current rehabilitation building.  If the beds
260.33 	are used for another purpose or moved to another location, the
260.34 	hospital's licensed capacity is reduced by 20 beds; or 
260.35 	(19) a critical access hospital established under section
260.36 	144.1483, clause (10), and section 1820 of the federal Social
261.1 	Security Act, United States Code, title 42, section 1395i-4,
261.2 	that delicensed beds since enactment of the Balanced Budget Act
261.3 	of 1997, Public Law 105-33, to the extent that the critical
261.4 	access hospital does not seek to exceed the maximum number of
261.5 	beds permitted such hospital under federal law.

261.6 	Sec. 25. Minnesota Statutes 2004, section 144.562,
261.7 	subdivision 2, is amended to read:
261.8 		Subd. 2.Eligibility for license condition. (a) A
261.9 	hospital is not eligible to receive a license condition for
261.10 	swing beds unless (1) it either has a licensed bed capacity of
261.11 	less than 50 beds defined in the federal Medicare regulations,
261.12 	Code of Federal Regulations, title 42, section 482.66, or it has
261.13 	a licensed bed capacity of 50 beds or more and has swing beds
261.14 	that were approved for Medicare reimbursement before May 1,
261.15 	1985, or it has a licensed bed capacity of less than 65 beds and
261.16 	the available nursing homes within 50 miles have had, in the
261.17 	aggregate, an average occupancy rate of 96 percent or higher in
261.18 	the most recent two years as documented on the statistical
261.19 	reports to the Department of Health; and (2) it is located in a
261.20 	rural area as defined in the federal Medicare regulations, Code
261.21 	of Federal Regulations, title 42, section 482.66.
261.22 	(b) Except for those critical access hospitals established
261.23 	under section 144.1483, clause (10), and section 1820 of the
261.24 	federal Social Security Act, United States Code, title 42,
261.25 	section 1395i-4, that have an attached nursing home,eligible
261.26 	hospitals are allowed a total of 1,460 2,000 days of swing bed
261.27 	use per year, provided that no more than ten hospital beds are
261.28 	used as swing beds at any one time. Critical access hospitals
261.29 	that have an attached nursing home are allowed swing bed use as
261.30 	provided in federal law.
261.31 	(c) Except for critical access hospitals that have an
261.32 	attached nursing home,the commissioner of health must may 
261.33 	approve swing bed use beyond 1,460 2,000 days as long as there
261.34 	are no Medicare certified skilled nursing facility beds
261.35 	available within 25 miles of that hospital that are willing to
261.36 	admit the patient.  Critical access hospitals exceeding 2,000
262.1 	swing bed days must maintain documentation that they have
262.2 	contacted skilled nursing facilities within 25 miles to
262.3 	determine if any skilled nursing facility beds are available
262.4 	that are willing to admit the patient.
262.5 	(d) After reaching 2,000 days of swing bed use in a year,
262.6 	an eligible hospital to which this limit applies may admit six
262.7 	additional patients to swing beds each year without seeking
262.8 	approval from the commissioner or being in violation of this
262.9 	subdivision.  These six swing bed admissions are exempt from the
262.10 	limit of 2,000 annual swing bed days for hospitals subject to
262.11 	this limit.
262.12 	(e) A health care system that is in full compliance with
262.13 	this subdivision may allocate its total limit of swing bed days
262.14 	among the hospitals within the system, provided that no hospital
262.15 	in the system without an attached nursing home may exceed 2,000
262.16 	swing bed days per year.

262.17 	Sec. 26. [144.574] EDUCATION ABOUT THE DANGERS OF SHAKING
262.18 	INFANTS AND YOUNG CHILDREN.
262.19 		Subdivision 1.Education by hospitals. (a) A hospital
262.20 	licensed under sections 144.50 to 144.56 shall make available
262.21 	for viewing by the parents of each newborn baby delivered in the
262.22 	hospital a video presentation on the dangers associated with
262.23 	shaking infants and young children.
262.24 	(b) A hospital shall use a video obtained from the
262.25 	commissioner or approved by the commissioner.  The commissioner
262.26 	shall provide to a hospital at cost copies of an approved
262.27 	video.  The commissioner shall review other video presentations
262.28 	for possible approval upon the request of a hospital.  The
262.29 	commissioner shall not require a hospital to use videos that
262.30 	would require the hospital to pay royalties for use of the
262.31 	video, restrict viewing in order to comply with public viewing
262.32 	or other restrictions, or be subject to other costs or
262.33 	restrictions associated with copyrights.
262.34 	(c) A hospital shall, whenever possible, request both
262.35 	parents to view the video.
262.36 	(d) The showing or distribution of the video shall not
263.1 	subject any person or facility to any action for damages or
263.2 	other relief provided the person or facility acted in good faith.
263.3 		Subd. 2.Education by health care providers. The
263.4 	commissioner shall establish a protocol for health care
263.5 	providers to educate parents and primary caregivers about the
263.6 	dangers associated with shaking infants and young children.  The
263.7 	commissioner shall request family practice physicians,
263.8 	pediatricians, and other pediatric health care providers to
263.9 	review these dangers with the parents and primary caregivers of
263.10 	infants and young children up to the age of three at each
263.11 	well-baby visit.

263.12 	Sec. 27. [144.601] ESTABLISHING A VOLUNTARY TRAUMA
263.13 	SYSTEM.
263.14 	The legislature finds that death and disability from major
263.15 	trauma among Minnesotans can be reduced by implementing a
263.16 	statewide trauma system designed to provide that each severely
263.17 	injured person is promptly transported and treated at facilities
263.18 	appropriate to the severity of injury.  The legislature further
263.19 	finds that the most effective way to ensure this outcome is
263.20 	through a system of voluntary participation, based on criteria
263.21 	issued by the commissioner of health.

263.22 	Sec. 28. [144.602] DEFINITIONS.
263.23 		Subdivision 1.Applicability. For purposes of sections
263.24 	144.601 to 144.608, the terms defined in this section have the
263.25 	meanings given them.
263.26 		Subd. 2.Commissioner. "Commissioner" means the
263.27 	commissioner of health.
263.28 		Subd. 3.Major trauma. "Major trauma" means a sudden
263.29 	severe injury or damage to the body caused by an external force
263.30 	that results in potentially life-threatening injuries or that
263.31 	could result in the following disabilities:
263.32 	(1) impairment of cognitive or mental abilities;
263.33 	(2) impairment of physical functioning; or 
263.34 	(3) disturbance of behavioral or emotional functioning.
263.35 		Subd. 4.Trauma hospital. "Trauma hospital" means a
263.36 	hospital that voluntarily meets the commissioner's criteria
264.1 	under section 144.603 and that has been designated as a trauma
264.2 	hospital under section 144.605.

264.3 	Sec. 29. [144.603] STATEWIDE TRAUMA SYSTEM CRITERIA.
264.4 		Subdivision 1.Criteria established. The commissioner
264.5 	shall adopt criteria to ensure that severely injured people are
264.6 	promptly transported and treated at trauma hospitals appropriate
264.7 	to the severity of injury.  Minimum criteria shall address
264.8 	emergency medical service trauma triage and transportation
264.9 	guidelines as approved under section 144E.102, subdivision 14,
264.10 	designation of hospitals as trauma hospitals, interhospital
264.11 	transfers, a trauma registry, and a trauma system governance
264.12 	structure.
264.13 		Subd. 2.Basis; verification. The commissioner shall
264.14 	base the establishment, implementation, and modifications to the
264.15 	criteria under subdivision 1 on the department-published
264.16 	Minnesota comprehensive statewide trauma system plan.  The
264.17 	commissioner shall seek the advice of the Trauma Advisory
264.18 	Council in implementing and updating the criteria, using
264.19 	accepted and prevailing trauma transport, treatment, and
264.20 	referral standards of the American College of Surgeons, the
264.21 	American College of Emergency Physicians, the Minnesota
264.22 	Emergency Medical Services Regulatory Board, the national Trauma
264.23 	Resources Network, and other widely recognized trauma experts.
264.24 	The commissioner shall adapt and modify the standards as
264.25 	appropriate to accommodate Minnesota's unique geography and the
264.26 	state's hospital and health professional distribution and shall
264.27 	verify that the criteria are met by each hospital voluntarily
264.28 	participating in the statewide trauma system.
264.29 		Subd. 3.Rule exemption and report to the
264.30 	legislature. In developing and adopting the criteria under this
264.31 	section, the commissioner of health is exempt from chapter 14,
264.32 	including section 14.386.  By September 1, 2009, the
264.33 	commissioner must report to the legislature on implementation of
264.34 	the voluntary trauma system, including recommendations on the
264.35 	need for including the trauma system criteria in rule.

264.36 	Sec. 30. [144.604] TRAUMA TRIAGE AND TRANSPORTATION.
265.1 		Subdivision 1.Transport requirement. Unless the
265.2 	Emergency Medical Services Regulatory Board has approved a
265.3 	licensed ambulance service's deviation from the guidelines under
265.4 	section 144E.101, subdivision 14, the ambulance service must
265.5 	transport major trauma patients from the scene to the highest
265.6 	state-designated trauma hospital within 30 minutes' transport
265.7 	time.
265.8 		Subd. 2.Ground ambulance exceptions. Notwithstanding
265.9 	subdivision 1, ground ambulances must comply with the following:
265.10 	(1) patients with compromised airways must be transported
265.11 	immediately to the nearest designated trauma hospital; and 
265.12 	(2) level II trauma hospitals capable of providing
265.13 	definitive trauma care must not be bypassed to reach a level I
265.14 	trauma hospital.
265.15 		Subd. 3.Undesignated hospitals. No major trauma patient
265.16 	shall be transported to a hospital not participating in the
265.17 	statewide trauma system unless no trauma hospital is available
265.18 	within 30 minutes' transport time.
265.19 	
EFFECTIVE DATE. This section is effective July 1, 2009.

265.20 	Sec. 31. [144.605] DESIGNATING TRAUMA HOSPITALS.
265.21 		Subdivision 1.Naming privileges. Unless it has been
265.22 	designated a trauma hospital by the commissioner, no hospital
265.23 	shall use the term trauma center or trauma hospital in its name
265.24 	or its advertising or shall otherwise indicate it has trauma
265.25 	treatment capabilities.
265.26 		Subd. 2.Designation; reverification. The commissioner
265.27 	shall designate four levels of trauma hospitals.  A hospital
265.28 	that voluntarily meets the criteria for a particular level of
265.29 	trauma hospital shall apply to the commissioner for designation
265.30 	and, upon the commissioner's verifying the hospital meets the
265.31 	criteria, be designated a trauma hospital at the appropriate
265.32 	level for a three-year period.  Prior to the expiration of the
265.33 	three-year designation, a hospital seeking to remain part of the
265.34 	voluntary system must apply for and successfully complete a
265.35 	reverification process, be awaiting the site visit for the
265.36 	reverification, or be awaiting the results of the site visit.
266.1 	The commissioner may extend a hospital's existing designation
266.2 	for up to 18 months on a provisional basis if the hospital has
266.3 	applied for reverification in a timely manner but has not yet
266.4 	completed the reverification process within the expiration of
266.5 	the three-year designation and the extension is in the best
266.6 	interest of trauma system patient safety.  To be granted a
266.7 	provisional extension, the hospital must be:
266.8 	(1) scheduled and awaiting the site visit for
266.9 	reverification;
266.10 	(2) awaiting the results of the site visit; or 
266.11 	(3) responding to and correcting identified deficiencies
266.12 	identified in the site visit.
266.13 		Subd. 3.Acs verification. The commissioner shall grant
266.14 	the appropriate level I, II, or III trauma hospital designation
266.15 	to a hospital that successfully completes and passes the
266.16 	American College of Surgeons (ACS) verification standards at the
266.17 	hospital's cost, submits verification documentation to the
266.18 	Trauma Advisory Council, and formally notifies the Trauma
266.19 	Advisory Council of ACS verification.
266.20 		Subd. 4.Level iii designation; not acs verified. (a)
266.21 	The commissioner shall grant the appropriate level III trauma
266.22 	hospital designation to a hospital that is not ACS verified but
266.23 	that successfully completes the designation process under
266.24 	paragraph (b).
266.25 	(b) The hospital must complete and submit a self-reported
266.26 	survey and application to the Trauma Advisory Council for
266.27 	review, verifying that the hospital meets the criteria as a
266.28 	level III trauma hospital.  When the Trauma Advisory Council is
266.29 	satisfied the application is complete, the commissioner shall
266.30 	arrange a site review visit.  Upon successful completion of the
266.31 	site review, the review team shall make written recommendations
266.32 	to the Trauma Advisory Council.  If approved by the Trauma
266.33 	Advisory Council, a letter of recommendation shall be sent to
266.34 	the commissioner for final approval and designation.
266.35 		Subd. 5.Level iv designation. (a) The commissioner
266.36 	shall grant the appropriate level IV trauma hospital designation
267.1 	to a hospital that successfully completes the designation
267.2 	process under paragraph (b).
267.3 	(b) The hospital must complete and submit a self-reported
267.4 	survey and application to the Trauma Advisory Council for
267.5 	review, verifying that the hospital meets the criteria as a
267.6 	level IV trauma hospital.  When the Trauma Advisory Council is
267.7 	satisfied the application is complete, the council shall review
267.8 	the application and, if the council approves the application,
267.9 	send a letter of recommendation to the commissioner for final
267.10 	approval and designation.  The commissioner shall grant a level
267.11 	IV designation and shall arrange a site review visit within
267.12 	three years of the designation and every three years thereafter,
267.13 	to coincide with the three-year reverification process.
267.14 		Subd. 6.Changes in designation. Changes in a trauma
267.15 	hospital's ability to meet the criteria for the hospital's level
267.16 	of designation must be self-reported to the Trauma Advisory
267.17 	Council and to other regional hospitals and local emergency
267.18 	medical services providers and authorities.  If the hospital
267.19 	cannot correct its ability to meet the criteria for its level
267.20 	within six months, the hospital may apply for redesignation at a
267.21 	different level.
267.22 		Subd. 7.Higher designation. A trauma hospital may apply
267.23 	for a higher trauma hospital designation one time during the
267.24 	hospital's three-year designation by completing the designation
267.25 	process for that level of trauma hospital.
267.26 		Subd. 8.Loss of designation. The commissioner may
267.27 	refuse to designate or redesignate or may revoke a previously
267.28 	issued trauma hospital designation if a hospital does not meet
267.29 	the criteria of the statewide trauma plan, in the interests of
267.30 	patient safety, or if a hospital denies or refuses a reasonable
267.31 	request by the commissioner or the commissioner's designee to
267.32 	verify information by correspondence or an on-site visit.

267.33 	Sec. 32. [144.606] INTERHOSPITAL TRANSFERS.
267.34 		Subdivision 1.Written procedures required. A level III
267.35 	or IV trauma hospital must have predetermined, written
267.36 	procedures that direct the internal process for rapidly and
268.1 	efficiently transferring a major trauma patient to definitive
268.2 	care, including:
268.3 	(1) clearly identified anatomic and physiologic criteria
268.4 	that, if met, will immediately initiate transfer to definitive
268.5 	care;
268.6 	(2) a listing of appropriate ground and air transport
268.7 	services, including primary and secondary telephone contact
268.8 	numbers; and 
268.9 	(3) immediately available supplies, records, or other
268.10 	necessary resources that will accompany a patient.
268.11 		Subd. 2.Transfer agreements. (a) A level III or IV
268.12 	trauma hospital may transfer patients to a hospital with which
268.13 	the trauma hospital has a written transfer agreement.
268.14 	(b) Each agreement must be current and with a trauma
268.15 	hospital or trauma hospitals capable of caring for major trauma
268.16 	injuries.
268.17 	(c) A level III or IV trauma hospital must have a current
268.18 	transfer agreement with a hospital that has special capabilities
268.19 	in the treatment of burn injuries and a transfer agreement with
268.20 	a second hospital that has special capabilities in the treatment
268.21 	of burn injuries, should the primary transfer hospital be unable
268.22 	to accept a burn patient.

268.23 	Sec. 33. [144.607] TRAUMA REGISTRY.
268.24 		Subdivision 1.Registry participation required. A trauma
268.25 	hospital must participate in the statewide trauma registry.
268.26 		Subd. 2.Trauma reporting. A trauma hospital must report
268.27 	major trauma injuries as part of the reporting for the traumatic
268.28 	brain injury and spinal cord injury registry required in
268.29 	sections 144.661 to 144.665.
268.30 		Subd. 3.Application of other law. Sections 144.661 to
268.31 	144.665 apply to a major trauma reported to the statewide trauma
268.32 	registry, with the exception of sections 144.662, clause (2),
268.33 	and 144.664, subdivision 3.

268.34 	Sec. 34. [144.608] TRAUMA ADVISORY COUNCIL.
268.35 		Subdivision 1.Trauma advisory council established. (a)
268.36 	A Trauma Advisory Council is established to advise, consult
269.1 	with, and make recommendations to the commissioner on the
269.2 	development, maintenance, and improvement of a statewide trauma
269.3 	system.
269.4 	(b) The council shall consist of the following members:
269.5 	(1) a trauma surgeon certified by the American College of
269.6 	Surgeons who practices in a level I or II trauma hospital;
269.7 	(2) a general surgeon certified by the American College of
269.8 	Surgeons whose practice includes trauma and who practices in a
269.9 	designated rural area as defined under section 144.1501,
269.10 	subdivision 1, paragraph (b);
269.11 	(3) a neurosurgeon certified by the American Board of
269.12 	Neurological Surgery who practices in a level I or II trauma
269.13 	hospital;
269.14 	(4) a trauma program nurse manager or coordinator
269.15 	practicing in a level I or II trauma hospital;
269.16 	(5) an emergency physician certified by the American
269.17 	College of Emergency Physicians whose practice includes
269.18 	emergency room care in a level I, II, III, or IV trauma
269.19 	hospital;
269.20 	(6) an emergency room nurse manager who practices in a
269.21 	level III or IV trauma hospital;
269.22 	(7) a family practice physician whose practice includes
269.23 	emergency room care in a level III or IV trauma hospital located
269.24 	in a designated rural area as defined under section 144.1501,
269.25 	subdivision 1, paragraph (b);
269.26 	(8) a nurse practitioner, as defined under section
269.27 	144.1501, subdivision 1, paragraph (h), or a physician
269.28 	assistant, as defined under section 144.1501, subdivision 1,
269.29 	paragraph (j), whose practice includes emergency room care in a
269.30 	level IV trauma hospital located in a designated rural area as
269.31 	defined under section 144.1501, subdivision 1, paragraph (b);
269.32 	(9) a pediatrician certified by the American Academy of
269.33 	Pediatrics whose practice includes emergency room care in a
269.34 	level I, II, III, or IV trauma hospital;
269.35 	(10) an orthopedic surgeon certified by the American Board
269.36 	of Orthopaedic Surgery whose practice includes trauma and who
270.1 	practices in a level I, II, or III trauma hospital;
270.2 	(11) the state emergency medical services medical director
270.3 	appointed by the Emergency Medical Services Regulatory Board;
270.4 	(12) a hospital administrator of a level III or IV trauma
270.5 	hospital located in a designated rural area as defined under
270.6 	section 144.1501, subdivision 1, paragraph (b);
270.7 	(13) a rehabilitation specialist whose practice includes
270.8 	rehabilitation of patients with major trauma injuries or
270.9 	traumatic brain injuries and spinal cord injuries as defined
270.10 	under section 144.661;
270.11 	(14) an attendant or ambulance director who is an EMT,
270.12 	EMT-I, or EMT-P within the meaning of section 144E.001 and who
270.13 	actively practices with a licensed ambulance service in a
270.14 	primary service area located in a designated rural area as
270.15 	defined under section 144.1501, subdivision 1, paragraph (b);
270.16 	and 
270.17 	(15) the commissioner of public safety or the
270.18 	commissioner's designee.
270.19 	(c) Council members whose appointment is dependent on
270.20 	practice in a level III or IV trauma hospital may be appointed
270.21 	to an initial term based upon their statements that the hospital
270.22 	intends to become a level III or IV facility by July 1, 2009.
270.23 		Subd. 2.Council administration. (a) The council must
270.24 	meet at least twice a year but may meet more frequently at the
270.25 	call of the chair, a majority of the council members, or the
270.26 	commissioner.
270.27 	(b) The terms, compensation, and removal of members of the
270.28 	council are governed by section 15.059, except that the council
270.29 	expires June 30, 2015.
270.30 	(c) The council may appoint subcommittees and workgroups.
270.31 	Subcommittees shall consist of council members.  Workgroups may
270.32 	include noncouncil members.  Noncouncil members shall be
270.33 	compensated for workgroup activities under section 15.059,
270.34 	subdivision 3, but shall receive expenses only.
270.35 		Subd. 3.Regional trauma advisory councils. (a) Up to
270.36 	eight regional trauma advisory councils may be formed as needed.
271.1 	(b) Regional trauma advisory councils shall advise, consult
271.2 	with, and make recommendation to the state Trauma Advisory
271.3 	Council on suggested regional modifications to the statewide
271.4 	trauma criteria that will improve patient care and accommodate
271.5 	specific regional needs.
271.6 	(c) Each regional advisory council must have no more than
271.7 	15 members.  The commissioner, in consultation with the
271.8 	Emergency Medical Services Regulatory Board, shall name the
271.9 	council members.
271.10 	(d) Regional council members may receive expenses in the
271.11 	same manner and amount as authorized by the plan adopted under
271.12 	section 43A.18, subdivision 2.

271.13 	Sec. 35. [144.707] CANCER DRUG REPOSITORY PROGRAM.
271.14 		Subdivision 1.Definitions. (a) For the purposes of this
271.15 	section, the terms defined in this subdivision have the meanings
271.16 	given.
271.17 	(b) "Cancer drug" means a prescription drug that is used to
271.18 	treat:
271.19 	(1) cancer or the side effects of cancer; or 
271.20 	(2) the side effects of any prescription drug that is used
271.21 	to treat cancer or the side effects of cancer.
271.22 	(c) "Cancer drug repository" means a medical facility or
271.23 	pharmacy that has notified the Board of Pharmacy of its election
271.24 	to participate in the cancer drug repository program.
271.25 	(d) "Cancer supply" or "cancer supplies" means prescription
271.26 	and nonprescription cancer supplies needed to administer a
271.27 	cancer drug.
271.28 	(e) "Board of Pharmacy" means the Minnesota State Board of
271.29 	Pharmacy.
271.30 	(f) "Dispense" has the meaning given in section 151.01,
271.31 	subdivision 30.
271.32 	(g) "Distribute" means to deliver, other than by
271.33 	administering or dispensing.
271.34 	(h) "Donor" means an individual and not a manufacturer or
271.35 	wholesale drug distributor.
271.36 	(i) "Medical facility" means an institution defined in
272.1 	section 144.50, subdivision 2.
272.2 	(j) "Medical supplies" means any prescription and
272.3 	nonprescription medical supply needed to administer a cancer
272.4 	drug.
272.5 	(k) "Pharmacist" has the meaning given in section 151.01,
272.6 	subdivision 3.
272.7 	(l) "Pharmacy" means any pharmacy registered with the Board
272.8 	of Pharmacy according to section 151.19, subdivision 1.
272.9 	(m) "Practitioner" has the meaning given in section 151.01,
272.10 	subdivision 23.
272.11 	(n) "Prescription drug" means a legend drug as defined in
272.12 	section 151.01, subdivision 17.
272.13 	(o) "Side effects of cancer" means symptoms of cancer.
272.14 	(p) "Single-unit-dose packaging" means a single-unit
272.15 	container for articles intended for administration as a single
272.16 	dose, direct from the container.
272.17 	(q) "Tamper-evident unit dose packaging" means a container
272.18 	within which a drug is sealed so that the contents cannot be
272.19 	opened without obvious destruction of the seal.
272.20 		Subd. 2.Establishment. The Board of Pharmacy shall
272.21 	establish and maintain a cancer drug repository program under
272.22 	which any person may donate a cancer drug or supply for use by
272.23 	an individual who meets the eligibility criteria specified under
272.24 	subdivision 4.  Under the program, donations may be made on the
272.25 	premises of a medical facility or pharmacy that elects to
272.26 	participate in the program and meets the requirements specified
272.27 	under subdivision 3.
272.28 		Subd. 3.Requirements for participation by pharmacies and
272.29 	medical facilities. (a) To be eligible for participation in the
272.30 	cancer drug repository program, a pharmacy or medical facility
272.31 	must be licensed and in compliance with all applicable federal
272.32 	and state laws and administrative rules.
272.33 	(b) Participation in the cancer drug repository program is
272.34 	voluntary.  A pharmacy or medical facility may elect to
272.35 	participate in the cancer drug repository program by submitting
272.36 	the following information to the Board of Pharmacy, in a form
273.1 	provided by the Board of Pharmacy:
273.2 	(1) the name, street address, and telephone number of the
273.3 	pharmacy or medical facility;
273.4 	(2) the name and telephone number of a pharmacist who is
273.5 	employed by or under contract with the pharmacy or medical
273.6 	facility, or other contact person who is familiar with the
273.7 	pharmacy's or medical facility's participation in the cancer
273.8 	drug repository program; and 
273.9 	(3) a statement indicating that the pharmacy or medical
273.10 	facility meets the eligibility requirements under paragraph (a)
273.11 	and the chosen level of participation under paragraph (c).
273.12 	(c) A pharmacy or medical facility may fully participate in
273.13 	the cancer drug repository program by accepting, storing, and
273.14 	dispensing donated drugs and supplies, or may limit its
273.15 	participation to only accepting and storing donated drugs and
273.16 	supplies.  If a pharmacy or facility chooses to limit its
273.17 	participation, the pharmacy or facility shall distribute any
273.18 	donated drugs to a fully participating cancer drug repository
273.19 	according to subdivision 8.
273.20 	(d) A pharmacy or medical facility may withdraw from
273.21 	participation in the cancer drug repository program at any time
273.22 	upon notification to the Board of Pharmacy.  A notice to
273.23 	withdraw from participation may be given by telephone or U.S.
273.24 	mail.
273.25 		Subd. 4.Individual eligibility requirements. Any
273.26 	Minnesota resident who is diagnosed with cancer is eligible to
273.27 	receive drugs or supplies under the cancer drug repository
273.28 	program.  Drugs and supplies shall be dispensed according to the
273.29 	priority given under subdivision 6.
273.30 		Subd. 5.Donations of cancer drugs and supplies. (a) Any
273.31 	one of the following persons may donate legally obtained cancer
273.32 	drugs or supplies to a cancer drug repository if the drugs or
273.33 	supplies meet the requirements under paragraph (b) or (c) as
273.34 	determined by a pharmacist who is employed by or under contract
273.35 	with a cancer drug repository:
273.36 	(1) an individual who is 18 years of age or older; or 
274.1 	(2) a pharmacy, medical facility, drug manufacturer, or
274.2 	wholesale drug distributor, if the donated drugs have not been
274.3 	previously dispensed.
274.4 	(b) A cancer drug is eligible for donation under the cancer
274.5 	drug repository program only if the following requirements are
274.6 	met:
274.7 	(1) the donation is accompanied by a cancer drug repository
274.8 	donor form described under paragraph (d) that is signed by the
274.9 	person making the donation or that person's authorized
274.10 	representative;
274.11 	(2) the drug's expiration date is at least six months later
274.12 	than the date that the drug was donated;
274.13 	(3) the drug is in its original, unopened, tamper-evident
274.14 	unit dose packaging that includes the drug's lot number and
274.15 	expiration date.  Single-unit dose drugs may be accepted if the
274.16 	single-unit-dose packaging is unopened; and 
274.17 	(4) the drug is not adulterated or misbranded.
274.18 	(c) Cancer supplies are eligible for donation under the
274.19 	cancer drug repository program only if the following
274.20 	requirements are met:
274.21 	(1) the supplies are not adulterated or misbranded;
274.22 	(2) the supplies are in their original, unopened, sealed
274.23 	packaging; and 
274.24 	(3) the donation is accompanied by a cancer drug repository
274.25 	donor form described under paragraph (d) that is signed by the
274.26 	person making the donation or that person's authorized
274.27 	representative.
274.28 	(d) The cancer drug repository donor form must be provided
274.29 	by the Board of Pharmacy and shall state that to the best of the
274.30 	donor's knowledge the donated drug or supply has been properly
274.31 	stored and that the drug or supply has never been opened, used,
274.32 	tampered with, adulterated, or misbranded.  The Board of
274.33 	Pharmacy shall make the cancer drug repository donor form
274.34 	available on the Board of Pharmacy's Web site.
274.35 	(e) Controlled substances and drugs and supplies that do
274.36 	not meet the criteria under this subdivision are not eligible
275.1 	for donation or acceptance under the cancer drug repository
275.2 	program.
275.3 	(f) Drugs and supplies may be donated on the premises of a
275.4 	cancer drug repository to a pharmacist designated by the
275.5 	repository.  A drop box may not be used to deliver or accept
275.6 	donations.
275.7 	(g) Cancer drugs and supplies donated under the cancer drug
275.8 	repository program must be stored in a secure storage area under
275.9 	environmental conditions appropriate for the drugs or supplies
275.10 	being stored.  Donated drugs and supplies may not be stored with
275.11 	nondonated inventory.
275.12 		Subd. 6.Dispensing requirements. (a) Drugs and supplies
275.13 	must be dispensed by a licensed pharmacist pursuant to a
275.14 	prescription by a practitioner and according to the requirements
275.15 	of chapter 151.
275.16 	(b) Before being dispensed, cancer drugs and supplies shall
275.17 	be visually inspected by the pharmacist for adulteration,
275.18 	misbranding, and date of expiration.  Drugs or supplies that
275.19 	have expired or appear upon visual inspection to be adulterated,
275.20 	misbranded, or tampered with in any way may not be dispensed.
275.21 	(c) Before a cancer drug or supply may be dispensed to an
275.22 	individual, the individual must sign a cancer drug repository
275.23 	recipient form provided by the Board of Pharmacy acknowledging
275.24 	that the individual understands the information stated on the
275.25 	form.  The form shall include the following information:
275.26 	(1) that the drug or supply being dispensed has been
275.27 	donated and may have been previously dispensed;
275.28 	(2) that a visual inspection has been conducted by the
275.29 	pharmacist to ensure that the drug has not expired, has not been
275.30 	adulterated or misbranded, and is in its original, unopened
275.31 	packaging; and 
275.32 	(3) that the dispensing pharmacist, the cancer drug
275.33 	repository, the Board of Pharmacy, and any other participant in
275.34 	the cancer drug repository program cannot guarantee the safety
275.35 	of the drug or supply being dispensed and that the pharmacist
275.36 	has determined that the drug or supply is safe to dispense based
276.1 	on the accuracy of the donor's form submitted with the donated
276.2 	drug or supply and the visual inspection required to be
276.3 	performed by the pharmacist before dispensing.
276.4 	The Board of Pharmacy shall make the cancer drug repository form
276.5 	available on the Board of Pharmacy's Web site.
276.6 	(d) Drugs and supplies shall only be dispensed to
276.7 	individuals who meet the eligibility requirements in subdivision
276.8 	4 and in the following order of priority:
276.9 	(1) individuals who are uninsured;
276.10 	(2) individuals who are enrolled in medical assistance,
276.11 	general assistance medical care, MinnesotaCare, Medicare, or
276.12 	other public assistance health care; and 
276.13 	(3) all other individuals who are otherwise eligible under
276.14 	subdivision 4 to receive drugs or supplies from a cancer drug
276.15 	repository.
276.16 		Subd. 7.Handling fees. A cancer drug repository may
276.17 	charge the individual receiving a drug or supply a handling fee
276.18 	of no more than 250 percent of the medical assistance program
276.19 	dispensing fee for each cancer drug or supply dispensed.
276.20 		Subd. 8.Distribution of donated cancer drugs and
276.21 	supplies. (a) Cancer drug repositories may distribute drugs and
276.22 	supplies donated under the cancer drug repository program to
276.23 	other repositories if requested by a participating repository.
276.24 	(b) A cancer drug repository that has elected not to
276.25 	dispense donated drugs or supplies shall distribute any donated
276.26 	drugs and supplies to a participating repository upon request of
276.27 	the repository.
276.28 	(c) If a cancer drug repository distributes drugs or
276.29 	supplies under paragraph (a) or (b), the repository shall
276.30 	complete a cancer drug repository donor form provided by the
276.31 	Board of Pharmacy.  The completed form and a copy of the donor
276.32 	form that was completed by the original donor under subdivision
276.33 	5 shall be provided to the fully participating cancer drug
276.34 	repository at the time of distribution.
276.35 		Subd. 9.Resale of donated drugs and supplies. Donated
276.36 	drugs and supplies may not be resold.
277.1 		Subd. 10.Record keeping requirements. (a) Cancer drug
277.2 	repository donor and recipient forms shall be maintained for at
277.3 	least five years.
277.4 	(b) A record of destruction of donated drugs and supplies
277.5 	that are not dispensed under subdivision 6 shall be maintained
277.6 	by the dispensing repository for at least five years.  For each
277.7 	drug or supply destroyed, the record shall include the following
277.8 	information:
277.9 	(1) the date of destruction;
277.10 	(2) the name, strength, and quantity of the cancer drug
277.11 	destroyed;
277.12 	(3) the name of the person or firm that destroyed the drug;
277.13 	and 
277.14 	(4) the source of the drugs or supplies destroyed.
277.15 		Subd. 11.Liability. (a) The manufacturer of a drug or
277.16 	supply is not subject to criminal or civil liability for injury,
277.17 	death, or loss to a person or to property due to participation
277.18 	in the cancer drug repository program.  Manufacturers are not
277.19 	liable for:
277.20 	(1) the intentional or unintentional alteration of the drug
277.21 	or supply by a party not under the control of the manufacturer;
277.22 	or 
277.23 	(2) failure of a party not under the control of the
277.24 	manufacturer to transfer or communicate product or consumer
277.25 	information or the expiration date of the donated drug or supply.
277.26 	(b) A medical facility or pharmacy participating in the
277.27 	program, a pharmacist dispensing a drug or supply pursuant to
277.28 	the program, a practitioner administering a drug or supply
277.29 	pursuant to the program, or the donor of a cancer drug or supply
277.30 	is immune from civil liability for an act or omission that
277.31 	causes injury to or the death of an individual to whom the
277.32 	cancer drug or supply is dispensed and no disciplinary action
277.33 	shall be taken against a pharmacist or practitioner so long as
277.34 	the drug or supply is donated, accepted, distributed, and
277.35 	dispensed according to the requirements of this section.  This
277.36 	immunity does not apply if the act or omission involves
278.1 	reckless, wanton, or intentional misconduct, or malpractice
278.2 	unrelated to the quality of the cancer drug or supply.

278.3 	Sec. 36. Minnesota Statutes 2004, section 144.9504,
278.4 	subdivision 2, is amended to read:
278.5 		Subd. 2.Lead risk assessment.  (a) An assessing agency
278.6 	shall conduct a lead risk assessment of a residence according to
278.7 	the venous blood lead level and time frame set forth in clauses
278.8 	(1) to (5) (4) for purposes of secondary prevention:
278.9 	(1) within 48 hours of a child or pregnant female in the
278.10 	residence being identified to the agency as having a venous
278.11 	blood lead level equal to or greater than 70 60 micrograms of
278.12 	lead per deciliter of whole blood;
278.13 	(2) within five working days of a child or pregnant female
278.14 	in the residence being identified to the agency as having a
278.15 	venous blood lead level equal to or greater than 45 micrograms
278.16 	of lead per deciliter of whole blood;
278.17 	(3) within ten working days of a child in the residence
278.18 	being identified to the agency as having a venous blood lead
278.19 	level equal to or greater than 20 15 micrograms of lead per
278.20 	deciliter of whole blood;
278.21 	(4) within ten working days of a child in the residence
278.22 	being identified to the agency as having a venous blood lead
278.23 	level that persists in the range of 15 to 19 micrograms of lead
278.24 	per deciliter of whole blood for 90 days after initial
278.25 	identification; or 
278.26 	(5) within ten working days of a pregnant female in the
278.27 	residence being identified to the agency as having a venous
278.28 	blood lead level equal to or greater than ten micrograms of lead
278.29 	per deciliter of whole blood.
278.30 	(b) Within the limits of available local, state, and
278.31 	federal appropriations, an assessing agency may also conduct a
278.32 	lead risk assessment for children with any elevated blood lead
278.33 	level.
278.34 	(c) In a building with two or more dwelling units, an
278.35 	assessing agency shall assess the individual unit in which the
278.36 	conditions of this section are met and shall inspect all common
279.1 	areas accessible to a child.  If a child visits one or more
279.2 	other sites such as another residence, or a residential or
279.3 	commercial child care facility, playground, or school, the
279.4 	assessing agency shall also inspect the other sites.  The
279.5 	assessing agency shall have one additional day added to the time
279.6 	frame set forth in this subdivision to complete the lead risk
279.7 	assessment for each additional site.
279.8 	(d) Within the limits of appropriations, the assessing
279.9 	agency shall identify the known addresses for the previous 12
279.10 	months of the child or pregnant female with venous blood lead
279.11 	levels of at least 20 15 micrograms per deciliter for the child
279.12 	or at least ten micrograms per deciliter for the pregnant
279.13 	female; notify the property owners, landlords, and tenants at
279.14 	those addresses that an elevated blood lead level was found in a
279.15 	person who resided at the property; and give them primary
279.16 	prevention information.  Within the limits of appropriations,
279.17 	the assessing agency may perform a risk assessment and issue
279.18 	corrective orders in the properties, if it is likely that the
279.19 	previous address contributed to the child's or pregnant female's
279.20 	blood lead level.  The assessing agency shall provide the notice
279.21 	required by this subdivision without identifying the child or
279.22 	pregnant female with the elevated blood lead level.  The
279.23 	assessing agency is not required to obtain the consent of the
279.24 	child's parent or guardian or the consent of the pregnant female
279.25 	for purposes of this subdivision.  This information shall be
279.26 	classified as private data on individuals as defined under
279.27 	section 13.02, subdivision 12.
279.28 	(e) The assessing agency shall conduct the lead risk
279.29 	assessment according to rules adopted by the commissioner under
279.30 	section 144.9508.  An assessing agency shall have lead risk
279.31 	assessments performed by lead risk assessors licensed by the
279.32 	commissioner according to rules adopted under section 144.9508.
279.33 	If a property owner refuses to allow a lead risk assessment, the
279.34 	assessing agency shall begin legal proceedings to gain entry to
279.35 	the property and the time frame for conducting a lead risk
279.36 	assessment set forth in this subdivision no longer applies.  A
280.1 	lead risk assessor or assessing agency may observe the
280.2 	performance of lead hazard reduction in progress and shall
280.3 	enforce the provisions of this section under section 144.9509.
280.4 	Deteriorated painted surfaces, bare soil, and dust must be
280.5 	tested with appropriate analytical equipment to determine the
280.6 	lead content, except that deteriorated painted surfaces or bare
280.7 	soil need not be tested if the property owner agrees to engage
280.8 	in lead hazard reduction on those surfaces.  The lead content of
280.9 	drinking water must be measured if another probable source of
280.10 	lead exposure is not identified.  Within a standard metropolitan
280.11 	statistical area, an assessing agency may order lead hazard
280.12 	reduction of bare soil without measuring the lead content of the
280.13 	bare soil if the property is in a census tract in which soil
280.14 	sampling has been performed according to rules established by
280.15 	the commissioner and at least 25 percent of the soil samples
280.16 	contain lead concentrations above the standard in section
280.17 	144.9508.
280.18 	(f) Each assessing agency shall establish an administrative
280.19 	appeal procedure which allows a property owner to contest the
280.20 	nature and conditions of any lead order issued by the assessing
280.21 	agency.  Assessing agencies must consider appeals that propose
280.22 	lower cost methods that make the residence lead safe.  The
280.23 	commissioner shall use the authority and appeal procedure
280.24 	granted under sections 144.989 to 144.993.
280.25 	(g) Sections 144.9501 to 144.9509 neither authorize nor
280.26 	prohibit an assessing agency from charging a property owner for
280.27 	the cost of a lead risk assessment.

280.28 	Sec. 37. Minnesota Statutes 2004, section 144.98,
280.29 	subdivision 3, is amended to read:
280.30 		Subd. 3.Fees.  (a) An application for certification
280.31 	under subdivision 1 must be accompanied by the biennial fee
280.32 	specified in this subdivision.  The fees are for:
280.33 	(1) nonrefundable base certification fee, $1,200 
280.34 	$1,600; and 
280.35 	(2) sample preparation techniques fees, $100 per technique;
280.36 	and 
281.1 	(3) test category certification fees:
281.2 	Test Category                                   Certification Fee
281.3 	Clean water program bacteriology $600 $800 
281.4 	Safe drinking water program bacteriology $600 $800 
281.5 	Clean water program inorganic chemistry $600 $800 
281.6 	Safe drinking water program inorganic chemistry $600 $800 
281.7 	Clean water program chemistry metals $800 $1,200 
281.8 	Safe drinking water program chemistry metals $800 $1,200 
281.9 	Resource conservation and recovery program
281.10 	  chemistry metals $800 $1,200 
281.11 	Clean water program volatile organic compounds $1,200 $1,500 
281.12 	Safe drinking water program
281.13 	  volatile organic compounds $1,200 $1,500 
281.14 	Resource conservation and recovery program
281.15 	  volatile organic compounds $1,200 $1,500 
281.16 	Underground storage tank program
281.17 	  volatile organic compounds $1,200 $1,500 
281.18 	Clean water program other organic compounds $1,200 $1,500 
281.19 	Safe drinking water program other organic compounds $1,200 $1,500 
281.20 	Resource conservation and recovery program
281.21 	  other organic compounds $1,200 $1,500
281.22 	Clean water program radiochemistry $2,500
281.23 	Safe drinking water program radiochemistry $2,500
281.24 	Resource conservation and recovery program
281.25 	  agricultural contaminants $2,500
281.26 	Resource conservation and recovery program
281.27 	  emerging contaminants $2,500 
281.28 	(b) The total biennial certification fee is the base fee
281.29 	plus the applicable test category fees.
281.30 	(c) Laboratories located outside of this state that require
281.31 	an on-site survey will inspection shall be assessed an
281.32 	additional $2,500 $3,750 fee.
281.33 	(c) The total biennial certification fee includes the base
281.34 	fee, the sample preparation techniques fees, the test category
281.35 	fees, and, when applicable, the on-site inspection fee.
281.36 	(d) Fees must be set so that the total fees support the
282.1 	laboratory certification program.  Direct costs of the
282.2 	certification service include program administration,
282.3 	inspections, the agency's general support costs, and attorney
282.4 	general costs attributable to the fee function.
282.5 	(e) A change fee shall be assessed if a laboratory requests
282.6 	additional analytes or methods at any time other than when
282.7 	applying for or renewing its certification.  The change fee is
282.8 	equal to the test category certification fee for the analyte.
282.9 	(f) A variance fee shall be assessed if a laboratory
282.10 	requests and is granted a variance from a rule adopted under
282.11 	this section.  The variance fee is $500 per variance.
282.12 	(g) Refunds or credits shall not be made for analytes or
282.13 	methods requested but not approved.
282.14 	(h) Certification of a laboratory shall not be awarded
282.15 	until all fees are paid.

282.16 	Sec. 38. Minnesota Statutes 2004, section 144E.101, is
282.17 	amended by adding a subdivision to read:
282.18 		Subd. 14.Trauma triage and transport guidelines. By
282.19 	July 1, 2009, a licensee shall have written age appropriate
282.20 	trauma triage and transport guidelines consistent with the
282.21 	criteria issued by the Trauma Advisory Council and approved by
282.22 	the board.  The board may approve a licensee's requested
282.23 	deviations to the guidelines due to the availability of local or
282.24 	regional trauma resources if the changes are in the best
282.25 	interest of the patient's health.

282.26 	Sec. 39. [145.417] FAMILY PLANNING GRANT FUNDS NOT USED
282.27 	TO SUBSIDIZE ABORTION SERVICES.
282.28 		Subdivision 1.Definitions. (a) For purposes of this
282.29 	section, the following definitions apply.
282.30 	(b) "Abortion" means the use or prescription of any
282.31 	instrument, medicine, drug, or any other substance or device to
282.32 	intentionally terminate the pregnancy of a female known to be
282.33 	pregnant, with an intention other than to prevent the death of
282.34 	the female, increase the probability of a live birth, preserve
282.35 	the life or health of the child after live birth, or remove a
282.36 	dead fetus.
283.1 	(c) "Family planning grant funds" means funds distributed
283.2 	through the family planning special projects grant program under
283.3 	section 145.925, or any other state grant program whose funds
283.4 	are or may be used to fund family planning services.  Family
283.5 	planning grant funds shall not mean medical education funds
283.6 	awarded under section 62J.692 to the University of Minnesota,
283.7 	Mayo Clinic, or any other clinical medical education program in
283.8 	the state.
283.9 	(d) "Family planning services" means preconception services
283.10 	that limit or enhance fertility, including methods of
283.11 	contraception, the management of infertility, preconception
283.12 	counseling, education, and general reproductive health care.
283.13 	(e) "Nondirective counseling" means providing patients with:
283.14 	(1) a list of health care providers and social service
283.15 	providers that provide prenatal care, childbirth care, infant
283.16 	care, foster care, adoption services, alternatives to abortion,
283.17 	or abortion services; and 
283.18 	(2) nondirective, nonmarketing information regarding such
283.19 	providers.
283.20 	(f) "Public advocacy" means engaging in one or more of the
283.21 	following:
283.22 	(1) regularly engaging in efforts to encourage the passage
283.23 	or defeat of legislation pertaining to the continued or expanded
283.24 	availability of abortion;
283.25 	(2) publicly endorsing or recommending the election or
283.26 	defeat of a candidate for public office based on the candidate's
283.27 	position on the legality of abortion; or 
283.28 	(3) engaging in civil litigation against a unit of
283.29 	government as a plaintiff seeking to enjoin or otherwise
283.30 	prohibit enforcement of a statute, ordinance, rule, or
283.31 	regulation pertaining to abortion.
283.32 		Subd. 2.Uses of family planning grant funds. No family
283.33 	planning grant funds may be:
283.34 	(1) expended to directly or indirectly subsidize abortion
283.35 	services or administrative expenses;
283.36 	(2) paid or granted to an organization or an affiliate of
284.1 	an organization that provides abortion services, unless the
284.2 	affiliate is independent as provided in subdivision 4; or 
284.3 	(3) paid or granted to an organization that has adopted or
284.4 	maintains a policy in writing or through oral public statements
284.5 	that abortion is considered part of a continuum of family
284.6 	planning services, reproductive health services, or both.
284.7 		Subd. 3.Organizations receiving family planning grant
284.8 	funds. An organization that receives family planning grant
284.9 	funds:
284.10 	(1) may provide nondirective counseling relating to
284.11 	pregnancy but may not directly refer patients who seek abortion
284.12 	services to any organization that provides abortion services,
284.13 	including an independent affiliate of the organization receiving
284.14 	family planning grant funds.  For purposes of this clause, an
284.15 	affiliate is independent if it satisfies the criteria in
284.16 	subdivision 4, paragraph (a);
284.17 	(2) may not display or distribute marketing materials about
284.18 	abortion services to patients;
284.19 	(3) may not engage in public advocacy promoting the
284.20 	legality or accessibility of abortion; and 
284.21 	(4) must be separately incorporated from any affiliated
284.22 	organization that provides abortion services.
284.23 		Subd. 4.Independent affiliates that provide abortion
284.24 	services. (a) To ensure that the state does not lend its
284.25 	imprimatur to abortion services and to ensure that an
284.26 	organization that provides abortion services does not receive a
284.27 	direct or indirect economic or marketing benefit from family
284.28 	planning grant funds, an organization that receives family
284.29 	planning grant funds may not be affiliated with an organization
284.30 	that provides abortion services unless the organizations are
284.31 	independent from each other.  To be independent, the
284.32 	organizations may not share any of the following:
284.33 	(1) the same or a similar name;
284.34 	(2) medical facilities or nonmedical facilities, including
284.35 	but not limited to, business offices, treatment rooms,
284.36 	consultation rooms, examination rooms, and waiting rooms;
285.1 	(3) expenses;
285.2 	(4) employee wages or salaries; or 
285.3 	(5) equipment or supplies, including but not limited to,
285.4 	computers, telephone systems, telecommunications equipment, and
285.5 	office supplies.
285.6 	(b) An organization that receives family planning grant
285.7 	funds and that is affiliated with an organization that provides
285.8 	abortion services must maintain financial records that
285.9 	demonstrate strict compliance with this subdivision and that
285.10 	demonstrate that its independent affiliate that provides
285.11 	abortion services receives no direct or indirect economic or
285.12 	marketing benefit from the family planning grant funds.
285.13 		Subd. 5.Independent audit. When an organization applies
285.14 	for family planning grant funds, the organization must submit
285.15 	with the grant application a copy of the organization's most
285.16 	recent independent audit to ensure the organization is in
285.17 	compliance with this section.  The independent audit must have
285.18 	been conducted no more than two years before the organization
285.19 	submits its grant application.
285.20 		Subd. 6.Organizations receiving title x funds. Nothing
285.21 	in this section requires an organization that receives federal
285.22 	funds under title X of the Public Health Service Act to refrain
285.23 	from performing any service that is required to be provided as a
285.24 	condition of receiving title X funds, as specified by the
285.25 	provisions of title X or the title X program guidelines for
285.26 	project grants for family planning services published by the
285.27 	United States Department of Health and Human Services.
285.28 		Subd. 7.Severability. If any one or more provision,
285.29 	word, phrase, clause, sentence, or subdivision of this section,
285.30 	or the application to any person or circumstance, is found to be
285.31 	unconstitutional, it is declared to be severable and the balance
285.32 	of this section shall remain effective notwithstanding such
285.33 	unconstitutionality.  The legislature hereby declares that it
285.34 	would have passed this section, and each provision, word,
285.35 	phrase, clause, sentence, or subdivision of it, regardless of
285.36 	the fact that any one or more provision, word, phrase, clause,
286.1 	sentence, or subdivision be declared unconstitutional.

286.2 	Sec. 40. [145.4231] POSITIVE ABORTION ALTERNATIVES.
286.3 		Subdivision 1.Definitions. For purposes of this
286.4 	section, the following terms have the meanings given:
286.5 	(1) "abortion" means the use of any means to terminate the
286.6 	pregnancy of a woman known to be pregnant with knowledge that
286.7 	the termination with those means will, with reasonable
286.8 	likelihood, cause the death of the unborn child.  For purposes
286.9 	of this section, abortion does not include an abortion necessary
286.10 	to prevent the death of the mother; and 
286.11 	(2) "unborn child" means an individual organism of the
286.12 	species Homo sapiens from fertilization until birth.
286.13 		Subd. 2.Eligibility for grants. (a) The commissioner of
286.14 	health shall award grants to eligible applicants under paragraph
286.15 	(c) for the reasonable expenses of programs to support,
286.16 	encourage, and assist women in carrying their pregnancies to
286.17 	term by providing information on, referral to, and assistance
286.18 	with securing necessary services that enable women to carry
286.19 	their pregnancies to term.  Necessary services include, but are
286.20 	not limited to:
286.21 	(1) medical care;
286.22 	(2) nutritional services;
286.23 	(3) housing assistance;
286.24 	(4) adoption services;
286.25 	(5) education and employment assistance;
286.26 	(6) parenting education and support services; and 
286.27 	(7) child care assistance.
286.28 	(b) In addition to providing information and referral under
286.29 	paragraph (a), an eligible program may provide one or more of
286.30 	the necessary services under paragraph (a) that assists women in
286.31 	carrying their pregnancies to term.  To avoid duplication of
286.32 	efforts, grantees may refer to other public or private programs,
286.33 	rather than provide the care directly, if a woman meets
286.34 	eligibility criteria for the other programs.
286.35 	(c) To be eligible for a grant, an agency or organization
286.36 	must:
287.1 	(1) be a private, nonprofit organization;
287.2 	(2) demonstrate that the program is conducted under
287.3 	appropriate supervision;
287.4 	(3) not charge women for services provided under the
287.5 	program;
287.6 	(4) provide each pregnant woman counseled with accurate
287.7 	information on the developmental characteristics of unborn
287.8 	children, including offering the printed information described
287.9 	in section 145.4243;
287.10 	(5) ensure that the alternatives to abortion program's sole
287.11 	purposes are to assist and encourage women in carrying their
287.12 	pregnancies to term and to maximize their potentials thereafter;
287.13 	(6) ensure that none of the funds provided are used to
287.14 	encourage or counsel a woman to have an abortion not necessary
287.15 	to prevent her death, to provide her such an abortion, or to
287.16 	refer her for such an abortion; and 
287.17 	(7) have had the alternatives to abortion program in
287.18 	existence for at least one year as of July 1, 2005.
287.19 	(d) The provisions, words, phrases, and clauses of
287.20 	paragraph (c) are inseverable from this subdivision, and if any
287.21 	provision, word, phrase, or clause of paragraph (c) or the
287.22 	application thereof to any person or circumstance is held
287.23 	invalid, such invalidity shall apply to all of this subdivision.
287.24 	(e) An organization that provides abortions, promotes
287.25 	abortions, or directly refers for abortions is ineligible to
287.26 	receive a grant under this program.  An affiliate of an
287.27 	organization that provides abortions, promotes abortions, or
287.28 	directly refers for abortions is ineligible to receive a grant
287.29 	under this section unless the organizations are separately
287.30 	incorporated and independent from each other.  To be
287.31 	independent, the organizations may not share any of the
287.32 	following:
287.33 	(1) the same or a similar name;
287.34 	(2) medical facilities or nonmedical facilities, including,
287.35 	but not limited to, business offices, treatment rooms,
287.36 	consultation rooms, examination rooms, and waiting rooms;
288.1 	(3) expenses;
288.2 	(4) employee wages or salaries; or 
288.3 	(5) equipment or supplies, including, but not limited to,
288.4 	computers, telephone systems, telecommunications equipment, and
288.5 	office supplies.
288.6 	(f) An organization that receives a grant under this
288.7 	section and that is affiliated with an organization that
288.8 	provides abortion services must maintain financial records that
288.9 	demonstrate strict compliance with this subdivision and that
288.10 	demonstrate that its independent affiliate that provides
288.11 	abortion services receives no direct or indirect economic or
288.12 	marketing benefit from the grant under this section.
288.13 	(g) The following data on participants is private data on
288.14 	individuals under section 13.02, subdivision 12:  all data
288.15 	collected, received, maintained, or disseminated by the grantee
288.16 	using grant funds awarded by the commissioner under this section.
288.17 		Subd. 3.Duties of commissioner. The commissioner of
288.18 	health shall make grants under subdivision 2 beginning no later
288.19 	than July 1, 2006.  The commissioner shall monitor and review
288.20 	the programs of each grantee to ensure that the grantee
288.21 	carefully adheres to the purposes and requirements of
288.22 	subdivision 2 and shall cease funding a grantee that fails to do
288.23 	so.
288.24 		Subd. 4.Severability. Except as provided in subdivision
288.25 	2, paragraph (d), if any provision, word, phrase, or clause of
288.26 	this section or the application thereof to any person or
288.27 	circumstance is held invalid, such invalidity shall not affect
288.28 	the provisions, words, phrases, clauses, or applications of this
288.29 	section that can be given effect without the invalid provision,
288.30 	word, phrase, clause, or application and to this end, the
288.31 	provisions, words, phrases, and clauses of this section are
288.32 	declared to be severable.
288.33 		Subd. 5.Supreme court jurisdiction. The Minnesota
288.34 	Supreme Court has original jurisdiction over an action
288.35 	challenging the constitutionality of this section and shall
288.36 	expedite the resolution of the action.

289.1 	Sec. 41. [145.4232] UNBORN CHILD PAIN PREVENTION.
289.2 		Subdivision 1.Short title. This act shall be known and
289.3 	may be cited as the "Unborn Child Pain Prevention Act." 
289.4 		Subd. 2.Definitions. For purposes of this section, the
289.5 	terms used have the meanings given:
289.6 	(1) "abortion" means the use of any means to terminate the
289.7 	pregnancy of a female known to be pregnant with knowledge that
289.8 	the termination with those means will, with reasonable
289.9 	likelihood, cause the death of the unborn child;
289.10 	(2) "attempt to perform an abortion" means an act, or an
289.11 	omission of a statutorily required act, that, under the
289.12 	circumstances as the actor believes them to be, constitutes a
289.13 	substantial step in a course of conduct planned to culminate in
289.14 	the performance of an abortion in violation of this section;
289.15 	(3) "unborn child" means a member of the species Homo
289.16 	sapiens from fertilization until birth;
289.17 	(4) "medical emergency" means any condition that, on the
289.18 	basis of the physician's good faith clinical judgment, so
289.19 	complicates the medical condition of a pregnant female as to
289.20 	necessitate the immediate abortion of her pregnancy to avert her
289.21 	death or for which a delay will create serious risk of
289.22 	substantial and irreversible impairment of a major bodily
289.23 	function; and 
289.24 	(5) "physician" means a person licensed as a physician or
289.25 	osteopath under chapter 147.
289.26 		Subd. 3.Unborn child pain prevention. Except in the
289.27 	case of a medical emergency, before an abortion is performed on
289.28 	an unborn child who is 20 weeks gestational age or more, the
289.29 	physician performing the abortion or the physician's agent shall
289.30 	inform the female if an anesthetic or analgesic would eliminate
289.31 	or alleviate organic pain to the unborn child caused by the
289.32 	particular method of abortion to be employed and inform her of
289.33 	the particular medical risks associated with the particular
289.34 	anesthetic or analgesic.  With her consent, the physician shall
289.35 	administer such anesthetic or analgesic.
289.36 		Subd. 4.Criminal penalties. Any person who knowingly or
290.1 	recklessly performs or attempts to perform an abortion in
290.2 	violation of this section is guilty of a felony.  No penalty may
290.3 	be assessed against the female upon whom the abortion is
290.4 	performed or attempted to be performed.
290.5 		Subd. 5.Civil remedies. (a) Any person upon whom an
290.6 	abortion has been performed in violation of this section or the
290.7 	father or a grandparent of the unborn child who was the subject
290.8 	of such an abortion may maintain an action against the person
290.9 	who performed the abortion in knowing or reckless violation of
290.10 	this section for actual and punitive damages.  Any person upon
290.11 	whom an abortion has been attempted in violation of this section
290.12 	may maintain an action against the person who attempted to
290.13 	perform the abortion in knowing or reckless violation of this
290.14 	section for actual and punitive damages.
290.15 	(b) If judgment is rendered in favor of the plaintiff in
290.16 	any action described in this subdivision, the court shall render
290.17 	judgment for a reasonable attorney's fee in favor of the
290.18 	plaintiff against the defendant.  If judgment is rendered in
290.19 	favor of the defendant and the court finds that the plaintiff's
290.20 	suit was frivolous and brought in bad faith, the court shall
290.21 	render judgment for a reasonable attorney's fee in favor of the
290.22 	defendant against the plaintiff.
290.23 		Subd. 6.Protection of privacy. In every civil or
290.24 	criminal proceeding or action brought under this section, the
290.25 	court shall rule whether the anonymity of any female upon whom
290.26 	an abortion has been performed or attempted shall be preserved
290.27 	from public disclosure if she does not give her consent to such
290.28 	disclosure.  The court, upon motion or sua sponte, shall make
290.29 	such a ruling and, upon determining that her anonymity should be
290.30 	preserved, shall issue orders to the parties, witnesses, and
290.31 	counsel and shall direct the sealing of the record and exclusion
290.32 	of individuals from courtrooms or hearing rooms to the extent
290.33 	necessary to safeguard her identity from public disclosure.  The
290.34 	order shall be accompanied by specific written findings
290.35 	explaining why the anonymity of the female should be preserved
290.36 	from public disclosure, why the order is essential to that end,
291.1 	how the order is narrowly tailored to serve that interest, and
291.2 	why no reasonable, less restrictive alternative exists.  In the
291.3 	absence of written consent of the female upon whom an abortion
291.4 	has been performed or attempted, anyone, other than a public
291.5 	official, who brings an action under subdivision 4, paragraph
291.6 	(a), shall do so under a pseudonym.  This subdivision may not be
291.7 	construed to conceal the identity of the plaintiff or of
291.8 	witnesses from the defendant.
291.9 		Subd. 7.Severability. If any one or more provision,
291.10 	section, subsection, sentence, clause, phrase, or word of this
291.11 	section or the application thereof to any person or circumstance
291.12 	is found to be unconstitutional, the same is hereby declared to
291.13 	be severable and the balance of this section shall remain
291.14 	effective notwithstanding such unconstitutionality.  The
291.15 	legislature hereby declares that it would have passed this
291.16 	section, and each provision, section, subsection, sentence,
291.17 	clause, phrase, or word thereof, irrespective of the fact that
291.18 	any one or more provision, section, subsection, sentence,
291.19 	clause, phrase, or word be declared unconstitutional.

291.20 	Sec. 42. Minnesota Statutes 2004, section 145.56,
291.21 	subdivision 2, is amended to read:
291.22 		Subd. 2.Community-based programs.  (a) To the extent
291.23 	funds are appropriated for the purposes of this subdivision,the
291.24 	commissioner shall establish a grant program to fund:
291.25 	(1) community-based programs to provide education,
291.26 	outreach, and advocacy services to populations who may be at
291.27 	risk for suicide;
291.28 	(2) community-based programs that educate community helpers
291.29 	and gatekeepers, such as family members, spiritual leaders,
291.30 	coaches, and business owners, employers, and coworkers on how to
291.31 	prevent suicide by encouraging help-seeking behaviors;
291.32 	(3) community-based programs that educate populations at
291.33 	risk for suicide and community helpers and gatekeepers that must
291.34 	include information on the symptoms of depression and other
291.35 	psychiatric illnesses, the warning signs of suicide, skills for
291.36 	preventing suicides, and making or seeking effective referrals
292.1 	to intervention and community resources; and
292.2 	(4) community-based programs to provide evidence-based
292.3 	suicide prevention and intervention education to school staff,
292.4 	parents, and students in grades kindergarten through 12.

292.5 	Sec. 43. Minnesota Statutes 2004, section 145.56,
292.6 	subdivision 5, is amended to read:
292.7 		Subd. 5.Periodic evaluations; biennial reports. To the
292.8 	extent funds are appropriated for the purposes of this
292.9 	subdivision,the commissioner shall conduct periodic evaluations
292.10 	of the impact of and outcomes from implementation of the state's
292.11 	suicide prevention plan and each of the activities specified in
292.12 	this section.  By July 1, 2002, and July 1 of each even-numbered
292.13 	year thereafter, the commissioner shall report the results of
292.14 	these evaluations to the chairs of the policy and finance
292.15 	committees in the house and senate with jurisdiction over health
292.16 	and human services issues.

292.17 	Sec. 44. [145.906] POSTPARTUM DEPRESSION EDUCATION AND
292.18 	INFORMATION.
292.19 	(a) The commissioner of health shall work with health care
292.20 	facilities, licensed health and mental health care
292.21 	professionals, mental health advocates, consumers, and families
292.22 	in the state to develop materials and information about
292.23 	postpartum depression including treatment resources and develop
292.24 	policies and procedures to comply with this section.
292.25 	(b) Physicians, traditional midwives, and other licensed
292.26 	health care professionals providing prenatal care to women must
292.27 	make available to women and their families information about
292.28 	postpartum depression.
292.29 	(c) Hospitals and other health care facilities in the state
292.30 	must provide departing new mothers and fathers and other family
292.31 	members, as appropriate, with written information about
292.32 	postpartum depression, including its symptoms, methods of coping
292.33 	with the illness, and treatment resources.

292.34 	Sec. 45. Minnesota Statutes 2004, section 145.924, is
292.35 	amended to read:
292.36 	145.924 AIDS PREVENTION GRANTS.
293.1 	(a) The commissioner may award grants to boards of health
293.2 	as defined in section 145A.02, subdivision 2, state agencies,
293.3 	state councils, or nonprofit corporations to provide evaluation
293.4 	and counseling services to populations at risk for acquiring
293.5 	human immunodeficiency virus infection, including, but not
293.6 	limited to, minorities, adolescents, intravenous drug users, and
293.7 	homosexual men.
293.8 	(b) The commissioner may award grants to agencies
293.9 	experienced in providing services to communities of color, for
293.10 	the design of innovative outreach and education programs for
293.11 	targeted groups within the community who may be at risk of
293.12 	acquiring the human immunodeficiency virus infection, including
293.13 	intravenous drug users and their partners, adolescents, gay and
293.14 	bisexual individuals and women.  Grants shall be awarded on a
293.15 	request for proposal basis and shall include funds for
293.16 	administrative costs.  Priority for grants shall be given to
293.17 	agencies or organizations that have experience in providing
293.18 	service to the particular community which the grantee proposes
293.19 	to serve; that have policy makers representative of the targeted
293.20 	population; that have experience in dealing with issues relating
293.21 	to HIV/AIDS; and that have the capacity to deal effectively with
293.22 	persons of differing sexual orientations.  For purposes of this
293.23 	paragraph, the "communities of color" are:  the American-Indian
293.24 	community; the Hispanic community; the African-American
293.25 	community; and the Asian-Pacific community.
293.26 	(c) All state grants awarded under this section for
293.27 	programs targeted to adolescents shall include the promotion of
293.28 	abstinence from sexual activity and drug use.
293.29 	(d) No state grant monies awarded under this section shall
293.30 	be used for web sites, pamphlets, or other communications that
293.31 	contain sexually explicit images or language.

293.32 	Sec. 46. Minnesota Statutes 2004, section 145.9268, is
293.33 	amended to read:
293.34 	145.9268 COMMUNITY CLINIC GRANTS.
293.35 		Subdivision 1.Definition. For purposes of this section,
293.36 	"eligible community clinic" means:
294.1 	(1) a nonprofit clinic that provides is established to
294.2 	provide health services under conditions as defined in Minnesota
294.3 	Rules, part 9505.0255,to low income or rural population groups;
294.4 	provides medical, preventive, dental, or mental health primary
294.5 	care services;and utilizes a sliding fee scale or other
294.6 	procedure to determine eligibility for charity care or to ensure
294.7 	that no person will be denied services because of inability to
294.8 	pay;
294.9 	(2) a governmental entity or an Indian tribal government or
294.10 	Indian health service unit that provides services and utilizes a
294.11 	sliding fee scale or other procedure as described under clause
294.12 	(1); or 
294.13 	(3) a consortium of clinics comprised of entities under
294.14 	clause (1) or (2); or 
294.15 	(4) a nonprofit, tribal, or governmental entity proposing
294.16 	the establishment of a clinic that will provide services and
294.17 	utilize a sliding fee scale or other procedure as described
294.18 	under clause (1).
294.19 		Subd. 2.Grants authorized. The commissioner of health
294.20 	shall award grants to eligible community clinics to plan,
294.21 	establish, or operate services to improve the ongoing viability
294.22 	of Minnesota's clinic-based safety net providers.  Grants shall
294.23 	be awarded to support the capacity of eligible community clinics
294.24 	to serve low-income populations, reduce current or future
294.25 	uncompensated care burdens, or provide for improved care
294.26 	delivery infrastructure.  The commissioner shall award grants to
294.27 	community clinics in metropolitan and rural areas of the state,
294.28 	and shall ensure geographic representation in grant awards among
294.29 	all regions of the state.
294.30 		Subd. 3.Allocation of grants. (a) To receive a grant
294.31 	under this section, an eligible community clinic must submit an
294.32 	application to the commissioner of health by the deadline
294.33 	established by the commissioner.  A grant may be awarded upon
294.34 	the signing of a grant contract.  Community clinics may apply
294.35 	for and the commissioner may award grants for one-year or
294.36 	two-year periods.
295.1 	(b) An application must be on a form and contain
295.2 	information as specified by the commissioner but at a minimum
295.3 	must contain:
295.4 	(1) a description of the purpose or project for which grant
295.5 	funds will be used;
295.6 	(2) a description of the problem or problems the grant
295.7 	funds will be used to address; and 
295.8 	(3) a description of achievable objectives, a workplan, and
295.9 	a timeline for implementation and completion of processes or
295.10 	projects enabled by the grant; and 
295.11 	(4) a process for documenting and evaluating results of the
295.12 	grant.
295.13 	(c) The commissioner shall review each application to
295.14 	determine whether the application is complete and whether the
295.15 	applicant and the project are eligible for a grant.  In
295.16 	evaluating applications according to paragraph (d), the
295.17 	commissioner shall establish criteria including, but not limited
295.18 	to:  the priority level eligibility of the project; the
295.19 	applicant's thoroughness and clarity in describing the problem
295.20 	grant funds are intended to address; a description of the
295.21 	applicant's proposed project; a description of the population
295.22 	demographics and service area of the proposed project;the
295.23 	manner in which the applicant will demonstrate the effectiveness
295.24 	of any projects undertaken; and evidence of efficiencies and
295.25 	effectiveness gained through collaborative efforts.  The
295.26 	commissioner may also take into account other relevant factors,
295.27 	including, but not limited to, the percentage for which
295.28 	uninsured patients represent the applicant's patient base and
295.29 	the degree to which grant funds will be used to support services
295.30 	increasing or maintaining access to health care services.
295.31 	During application review, the commissioner may request
295.32 	additional information about a proposed project, including
295.33 	information on project cost.  Failure to provide the information
295.34 	requested disqualifies an applicant.  The commissioner has
295.35 	discretion over the number of grants awarded.
295.36 	(d) In determining which eligible community clinics will
296.1 	receive grants under this section, the commissioner shall give
296.2 	preference to those grant applications that show evidence of
296.3 	collaboration with other eligible community clinics, hospitals,
296.4 	health care providers, or community organizations. In addition,
296.5 	the commissioner shall give priority, in declining order, to
296.6 	grant applications for projects that:
296.7 		Subd. 3a.Awarding grants. (a) The commissioner may
296.8 	award grants for activities to:
296.9 	(1) provide a direct offset to expenses incurred for
296.10 	services provided to the clinic's target population;
296.11 	(2) establish, update, or improve information, data
296.12 	collection, or billing systems, including electronic health
296.13 	records systems;
296.14 	(3) procure, modernize, remodel, or replace equipment used
296.15 	in the delivery of direct patient care at a clinic;
296.16 	(4) provide improvements for care delivery, such as
296.17 	increased translation and interpretation services; or 
296.18 	(5) build a new clinic or expand an existing facility; or 
296.19 	(6) other projects determined by the commissioner to
296.20 	improve the ability of applicants to provide care to the
296.21 	vulnerable populations they serve.
296.22 	(e) (b) A grant awarded to an eligible community clinic may
296.23 	not exceed $300,000 per eligible community clinic.  For an
296.24 	applicant applying as a consortium of clinics, a grant may not
296.25 	exceed $300,000 per clinic included in the consortium.  The
296.26 	commissioner has discretion over the number of grants awarded.
296.27 		Subd. 4.Evaluation and report. The commissioner of
296.28 	health shall evaluate the overall effectiveness of the grant
296.29 	program.  The commissioner shall collect progress reports to
296.30 	evaluate the grant program from the eligible community clinics
296.31 	receiving grants.  Every two years, as part of this evaluation,
296.32 	the commissioner shall report to the legislature on priority
296.33 	areas for grants set under subdivision 3 the needs of community
296.34 	clinics and provide any recommendations for adding or
296.35 	changing priority areas eligible activities.

296.36 	Sec. 47. Minnesota Statutes 2004, section 146A.11,
297.1 	subdivision 1, is amended to read:
297.2 		Subdivision 1.Scope.  All unlicensed complementary and
297.3 	alternative health care practitioners shall provide to each
297.4 	complementary and alternative health care client prior to
297.5 	providing treatment a written copy of the complementary and
297.6 	alternative health care client bill of rights.  A copy must also
297.7 	be posted in a prominent location in the office of the
297.8 	unlicensed complementary and alternative health care
297.9 	practitioner.  Reasonable accommodations shall be made for those
297.10 	clients who cannot read or who have communication impairments
297.11 	and those who do not read or speak English.  The complementary
297.12 	and alternative health care client bill of rights shall include
297.13 	the following:
297.14 	(1) the name, complementary and alternative health care
297.15 	title, business address, and telephone number of the unlicensed
297.16 	complementary and alternative health care practitioner;
297.17 	(2) the degrees, training, experience, or other
297.18 	qualifications of the practitioner regarding the complimentary
297.19 	and alternative health care being provided, followed by the
297.20 	following statement in bold print:
297.21 	"THE STATE OF MINNESOTA HAS NOT ADOPTED ANY EDUCATIONAL AND
297.22 	TRAINING STANDARDS FOR UNLICENSED COMPLEMENTARY AND ALTERNATIVE
297.23 	HEALTH CARE PRACTITIONERS.  THIS STATEMENT OF CREDENTIALS IS FOR
297.24 	INFORMATION PURPOSES ONLY.
297.25 	Under Minnesota law, an unlicensed complementary and
297.26 	alternative health care practitioner may not provide a medical
297.27 	diagnosis or recommend discontinuance of medically prescribed
297.28 	treatments.  If a client desires a diagnosis from a licensed
297.29 	physician, chiropractor, or acupuncture practitioner, or
297.30 	services from a physician, chiropractor, nurse, osteopath,
297.31 	physical therapist, dietitian, nutritionist, acupuncture
297.32 	practitioner, athletic trainer, or any other type of health care
297.33 	provider, the client may seek such services at any time.";
297.34 	(3) the name, business address, and telephone number of the
297.35 	practitioner's supervisor, if any;
297.36 	(4) notice that a complementary and alternative health care
298.1 	client has the right to file a complaint with the practitioner's
298.2 	supervisor, if any, and the procedure for filing complaints;
298.3 	(5) the name, address, and telephone number of the office
298.4 	of unlicensed complementary and alternative health care practice 
298.5 	the attorney general and notice that a the office of the
298.6 	attorney general is the point of contact for purposes of
298.7 	referring client may file complaints with the office to the
298.8 	proper health care board, agency, or law enforcement;
298.9 	(6) the practitioner's fees per unit of service, the
298.10 	practitioner's method of billing for such fees, the names of any
298.11 	insurance companies that have agreed to reimburse the
298.12 	practitioner, or health maintenance organizations with whom the
298.13 	practitioner contracts to provide service, whether the
298.14 	practitioner accepts Medicare, medical assistance, or general
298.15 	assistance medical care, and whether the practitioner is willing
298.16 	to accept partial payment, or to waive payment, and in what
298.17 	circumstances;
298.18 	(7) a statement that the client has a right to reasonable
298.19 	notice of changes in services or charges;
298.20 	(8) a brief summary, in plain language, of the theoretical
298.21 	approach used by the practitioner in providing services to
298.22 	clients;
298.23 	(9) notice that the client has a right to complete and
298.24 	current information concerning the practitioner's assessment and
298.25 	recommended service that is to be provided, including the
298.26 	expected duration of the service to be provided;
298.27 	(10) a statement that clients may expect courteous
298.28 	treatment and to be free from verbal, physical, or sexual abuse
298.29 	by the practitioner;
298.30 	(11) a statement that client records and transactions with
298.31 	the practitioner are confidential, unless release of these
298.32 	records is authorized in writing by the client, or otherwise
298.33 	provided by law;
298.34 	(12) a statement of the client's right to be allowed access
298.35 	to records and written information from records in accordance
298.36 	with section 144.335;
299.1 	(13) a statement that other services may be available in
299.2 	the community, including where information concerning services
299.3 	is available;
299.4 	(14) a statement that the client has the right to choose
299.5 	freely among available practitioners and to change practitioners
299.6 	after services have begun, within the limits of health
299.7 	insurance, medical assistance, or other health programs;
299.8 	(15) a statement that the client has a right to coordinated
299.9 	transfer when there will be a change in the provider of
299.10 	services;
299.11 	(16) a statement that the client may refuse services or
299.12 	treatment, unless otherwise provided by law; and
299.13 	(17) a statement that the client may assert the client's
299.14 	rights without retaliation.

299.15 	Sec. 48. Minnesota Statutes 2004, section 147A.08, is
299.16 	amended to read:
299.17 	147A.08 EXEMPTIONS.
299.18 	(a) This chapter does not apply to, control, prevent, or
299.19 	restrict the practice, service, or activities of persons listed
299.20 	in section 147.09, clauses (1) to (6) and (8) to (13), persons
299.21 	regulated under section 214.01, subdivision 2, or persons
299.22 	defined in section 144.1501, subdivision 1, paragraphs
299.23 	(e) (f), (g) (h), and (h) (i).
299.24 	(b) Nothing in this chapter shall be construed to require
299.25 	registration of:
299.26 	(1) a physician assistant student enrolled in a physician
299.27 	assistant or surgeon assistant educational program accredited by
299.28 	the Committee on Allied Health Education and Accreditation or by
299.29 	its successor agency approved by the board;
299.30 	(2) a physician assistant employed in the service of the
299.31 	federal government while performing duties incident to that
299.32 	employment; or
299.33 	(3) technicians, other assistants, or employees of
299.34 	physicians who perform delegated tasks in the office of a
299.35 	physician but who do not identify themselves as a physician
299.36 	assistant.

300.1 	Sec. 49. Minnesota Statutes 2004, section 150A.22, is
300.2 	amended to read:
300.3 	150A.22 DONATED DENTAL SERVICES.
300.4 	(a) The Board of Dentistry commissioner of health shall
300.5 	contract with the Minnesota Dental Association, or another
300.6 	appropriate and qualified organization to develop and operate a
300.7 	donated dental services program to provide dental care to public
300.8 	program recipients and the uninsured through dentists who
300.9 	volunteer their services without compensation.  As part of the
300.10 	contract, the board commissioner shall include specific
300.11 	performance and outcome measures that the contracting
300.12 	organization must meet.  The donated dental services program
300.13 	shall:
300.14 	(1) establish a network of volunteer dentists, including
300.15 	dental specialties, to donate dental services to eligible
300.16 	individuals;
300.17 	(2) establish a system to refer eligible individuals to the
300.18 	appropriate volunteer dentists; and
300.19 	(3) develop and implement a public awareness campaign to
300.20 	educate eligible individuals about the availability of the
300.21 	program.
300.22 	(b) Funding for the program may be used for administrative
300.23 	or technical support.  The organization contracting with the
300.24 	board commissioner shall provide an annual report that accounts
300.25 	for funding appropriated to the program by the state, documents
300.26 	the number of individuals served by the program and the number
300.27 	of dentists participating as program providers, and provides
300.28 	data on meeting the specific performance and outcome measures
300.29 	identified by the board commissioner.

300.30 	Sec. 50. Minnesota Statutes 2004, section 157.011, is
300.31 	amended by adding a subdivision to read:
300.32 		Subd. 3.Rule exemption. Notwithstanding any rule to the
300.33 	contrary, no food establishment shall be required to acquire
300.34 	equipment or change construction solely because ownership of the
300.35 	food establishment has been transferred.

300.36 	Sec. 51. Minnesota Statutes 2004, section 157.15, is
301.1 	amended by adding a subdivision to read:
301.2 		Subd. 19.Statewide hospitality fee. "Statewide
301.3 	hospitality fee" means a fee to fund statewide food, beverage,
301.4 	and lodging program development activities, including training
301.5 	for inspection staff, technical assistance, maintenance of a
301.6 	statewide integrated food safety and security information
301.7 	system, and other related statewide activities that support the
301.8 	food, beverage, and lodging program activities.

301.9 	Sec. 52. Minnesota Statutes 2004, section 157.16,
301.10 	subdivision 2, is amended to read:
301.11 		Subd. 2.License renewal.  Initial and renewal licenses
301.12 	for all food and beverage service establishments, hotels,
301.13 	motels, lodging establishments, and resorts shall be issued for
301.14 	the calendar year for which application is made and shall expire
301.15 	on December 31 of such year.  Any person who operates a place of
301.16 	business after the expiration date of a license or without
301.17 	having submitted an application and paid the fee shall be deemed
301.18 	to have violated the provisions of this chapter and shall be
301.19 	subject to enforcement action, as provided in the Health
301.20 	Enforcement Consolidation Act, sections 144.989 to 144.993.  In
301.21 	addition, a penalty of $25 $50 shall be added to the total of
301.22 	the license fee for any food and beverage service establishment
301.23 	operating without a license as a mobile food unit, a seasonal
301.24 	temporary or seasonal permanent food stand, or a special event
301.25 	food stand, and a penalty of $50 $100 shall be added to the
301.26 	total of the license fee for all restaurants, food carts,
301.27 	hotels, motels, lodging establishments, and resorts operating
301.28 	without a license for a period of up to 30 days.  A late fee of
301.29 	$300 shall be added to the license fee for establishments
301.30 	operating more than 30 days without a license.

301.31 	Sec. 53. Minnesota Statutes 2004, section 157.16, is
301.32 	amended by adding a subdivision to read:
301.33 		Subd. 2a.Food manager certification. An applicant for
301.34 	certification or certification renewal as a food manager must
301.35 	submit to the commissioner a $28 nonrefundable certification fee
301.36 	payable to the Department of Health.

302.1 	Sec. 54. Minnesota Statutes 2004, section 157.16,
302.2 	subdivision 3, is amended to read:
302.3 		Subd. 3.Establishment fees; definitions.  (a) The
302.4 	following fees are required for food and beverage service
302.5 	establishments, hotels, motels, lodging establishments, and
302.6 	resorts licensed under this chapter.  Food and beverage service
302.7 	establishments must pay the highest applicable fee under
302.8 	paragraph (e) (d), clause (1), (2), (3), or (4), and
302.9 	establishments serving alcohol must pay the highest applicable
302.10 	fee under paragraph (e) (d), clause (6) or (7).  The license fee
302.11 	for new operators previously licensed under this chapter for the
302.12 	same calendar year is one-half of the appropriate annual license
302.13 	fee, plus any penalty that may be required.  The license fee for
302.14 	operators opening on or after October 1 is one-half of the
302.15 	appropriate annual license fee, plus any penalty that may be
302.16 	required.
302.17 	(b) All food and beverage service establishments, except
302.18 	special event food stands, and all hotels, motels, lodging
302.19 	establishments, and resorts shall pay an annual base fee of
302.20 	$145 $150.
302.21 	(c) A special event food stand shall pay a flat fee
302.22 	of $35 $40 annually.  "Special event food stand" means a fee
302.23 	category where food is prepared or served in conjunction with
302.24 	celebrations, county fairs, or special events from a special
302.25 	event food stand as defined in section 157.15.
302.26 	(d) In addition to the base fee in paragraph (b), each food
302.27 	and beverage service establishment, other than a special event
302.28 	food stand, and each hotel, motel, lodging establishment, and
302.29 	resort shall pay an additional annual fee for each fee category
302.30 	as , additional food service, or required additional inspection 
302.31 	specified in this paragraph:
302.32 	(1) Limited food menu selection, $40 $50.  "Limited food
302.33 	menu selection" means a fee category that provides one or more
302.34 	of the following:
302.35 	(i) prepackaged food that receives heat treatment and is
302.36 	served in the package;
303.1 	(ii) frozen pizza that is heated and served;
303.2 	(iii) a continental breakfast such as rolls, coffee, juice,
303.3 	milk, and cold cereal;
303.4 	(iv) soft drinks, coffee, or nonalcoholic beverages; or
303.5 	(v) cleaning for eating, drinking, or cooking utensils,
303.6 	when the only food served is prepared off site.
303.7 	(2) Small establishment, including boarding establishments,
303.8 	$75 $100.  "Small establishment" means a fee category that has
303.9 	no salad bar and meets one or more of the following:
303.10 	(i) possesses food service equipment that consists of no
303.11 	more than a deep fat fryer, a grill, two hot holding containers,
303.12 	and one or more microwave ovens;
303.13 	(ii) serves dipped ice cream or soft serve frozen desserts;
303.14 	(iii) serves breakfast in an owner-occupied bed and
303.15 	breakfast establishment;
303.16 	(iv) is a boarding establishment; or
303.17 	(v) meets the equipment criteria in clause (3), item (i) or
303.18 	(ii), and has a maximum patron seating capacity of not more than
303.19 	50.
303.20 	(3) Medium establishment, $210 $260.  "Medium establishment"
303.21 	means a fee category that meets one or more of the following:
303.22 	(i) possesses food service equipment that includes a range,
303.23 	oven, steam table, salad bar, or salad preparation area;
303.24 	(ii) possesses food service equipment that includes more
303.25 	than one deep fat fryer, one grill, or two hot holding
303.26 	containers; or
303.27 	(iii) is an establishment where food is prepared at one
303.28 	location and served at one or more separate locations.
303.29 	Establishments meeting criteria in clause (2), item (v),
303.30 	are not included in this fee category.
303.31 	(4) Large establishment, $350 $460.  "Large establishment"
303.32 	means either:
303.33 	(i) a fee category that (A) meets the criteria in clause
303.34 	(3), items (i) or (ii), for a medium establishment, (B) seats
303.35 	more than 175 people, and (C) offers the full menu selection an
303.36 	average of five or more days a week during the weeks of
304.1 	operation; or
304.2 	(ii) a fee category that (A) meets the criteria in clause
304.3 	(3), item (iii), for a medium establishment, and (B) prepares
304.4 	and serves 500 or more meals per day.
304.5 	(5) Other food and beverage service, including food carts,
304.6 	mobile food units, seasonal temporary food stands, and seasonal
304.7 	permanent food stands, $40 $50.
304.8 	(6) Beer or wine table service, $40 $50.  "Beer or wine
304.9 	table service" means a fee category where the only alcoholic
304.10 	beverage service is beer or wine, served to customers seated at
304.11 	tables.
304.12 	(7) Alcoholic beverage service, other than beer or wine
304.13 	table service, $105 $135.
304.14 	"Alcohol beverage service, other than beer or wine table
304.15 	service" means a fee category where alcoholic mixed drinks are
304.16 	served or where beer or wine are served from a bar.
304.17 	(8) Lodging per sleeping accommodation unit, $6 $8,
304.18 	including hotels, motels, lodging establishments, and resorts,
304.19 	up to a maximum of $600 $800.  "Lodging per sleeping
304.20 	accommodation unit" means a fee category including the number of
304.21 	guest rooms, cottages, or other rental units of a hotel, motel,
304.22 	lodging establishment, or resort; or the number of beds in a
304.23 	dormitory.
304.24 	(9) First public swimming pool, $140 $180; each additional
304.25 	public swimming pool, $80 $100.  "Public swimming pool" means a
304.26 	fee category that has the meaning given in Minnesota Rules, part
304.27 	4717.0250, subpart 8.
304.28 	(10) First spa, $80 $110; each additional spa, $40 $50.
304.29 	"Spa pool" means a fee category that has the meaning given in
304.30 	Minnesota Rules, part 4717.0250, subpart 9.
304.31 	(11) Private sewer or water, $40 $50.  "Individual private
304.32 	water" means a fee category with a water supply other than a
304.33 	community public water supply as defined in Minnesota Rules,
304.34 	chapter 4720.  "Individual private sewer" means a fee category
304.35 	with an individual sewage treatment system which uses subsurface
304.36 	treatment and disposal.
305.1 	(12) Additional food service, $130.  "Additional food
305.2 	service" means a location at a food service establishment, other
305.3 	than the primary food preparation and service area, used to
305.4 	prepare or serve food to the public.
305.5 	(13) Additional inspection fee, $300.  "Additional
305.6 	inspection fee" means a fee to conduct the second inspection
305.7 	each year for elementary and secondary education facility school
305.8 	lunch programs when required by the Richard B. Russell National
305.9 	School Lunch Act.
305.10 	(e) A fee of $150 $350 for review of the construction plans
305.11 	must accompany the initial license application for food and
305.12 	beverage service establishments restaurants, hotels, motels,
305.13 	lodging establishments, or resorts with five or more sleeping
305.14 	units.
305.15 	(f) When existing food and beverage service establishments,
305.16 	hotels, motels, lodging establishments, or resorts are
305.17 	extensively remodeled, a fee of $150 $250 must be submitted with
305.18 	the remodeling plans. A fee of $250 must be submitted for new
305.19 	construction or remodeling for a restaurant with a limited food
305.20 	menu selection, a seasonal permanent food stand, a mobile food
305.21 	unit, or a food cart, or for a hotel, motel, resort, or lodging
305.22 	establishment addition of less than five sleeping units.
305.23 	(g) Seasonal temporary food stands and special event food
305.24 	stands are not required to submit construction or remodeling
305.25 	plans for review.

305.26 	Sec. 55. Minnesota Statutes 2004, section 157.16, is
305.27 	amended by adding a subdivision to read:
305.28 		Subd. 3a.Statewide hospitality fee. Every person, firm,
305.29 	or corporation that operates a licensed boarding establishment,
305.30 	food and beverage service establishment, seasonal temporary or
305.31 	permanent food stand, special event food stand, mobile food
305.32 	unit, food cart, resort, hotel, motel, or lodging establishment
305.33 	in Minnesota must submit to the commissioner a $35 annual
305.34 	statewide hospitality fee for each licensed activity.  The fee
305.35 	for establishments licensed by the Department of Health is
305.36 	required at the same time the licensure fee is due.  For
306.1 	establishments licensed by local governments, the fee is due by
306.2 	July 1 of each year.

306.3 	Sec. 56. Minnesota Statutes 2004, section 157.20,
306.4 	subdivision 2, is amended to read:
306.5 		Subd. 2.Inspection frequency.  The frequency of
306.6 	inspections of the establishments shall be based on the degree
306.7 	of health risk.
306.8 	(a) High-risk establishments must be inspected at least
306.9 	once a year every 12 months.
306.10 	(b) Medium-risk establishments must be inspected at least
306.11 	once every 18 months.
306.12 	(c) Low-risk establishments must be inspected at least once
306.13 	every two years 24 months.

306.14 	Sec. 57. Minnesota Statutes 2004, section 157.20,
306.15 	subdivision 2a, is amended to read:
306.16 		Subd. 2a.Risk categories.  (a)  [HIGH-RISK
306.17 	ESTABLISHMENT.] "High-risk establishment" means any food and
306.18 	beverage service establishment, hotel, motel, lodging
306.19 	establishment, or resort that:
306.20 	(1) serves potentially hazardous foods that require
306.21 	extensive processing on the premises, including manual handling,
306.22 	cooling, reheating, or holding for service;
306.23 	(2) prepares foods several hours or days before service;
306.24 	(3) serves menu items that epidemiologic experience has
306.25 	demonstrated to be common vehicles of food-borne illness;
306.26 	(4) has a public swimming pool; or
306.27 	(5) draws its drinking water from a surface water supply.
306.28 	(b)  [MEDIUM-RISK ESTABLISHMENT.] "Medium-risk
306.29 	establishment" means a food and beverage service establishment,
306.30 	hotel, motel, lodging establishment, or resort that:
306.31 	(1) serves potentially hazardous foods but with minimal
306.32 	holding between preparation and service; or
306.33 	(2) serves foods, such as pizza, that require extensive
306.34 	handling followed by heat treatment.
306.35 	(c)  [LOW-RISK ESTABLISHMENT.] "Low-risk establishment"
306.36 	means a food and beverage service establishment, hotel, motel,
307.1 	lodging establishment, or resort that is not a high-risk or
307.2 	medium-risk establishment.
307.3 	(d)  [RISK EXCEPTIONS.] Mobile food units, seasonal
307.4 	permanent and seasonal temporary food stands, food carts, and
307.5 	special event food stands are not inspected on an established
307.6 	schedule and therefore are not defined as high-risk,
307.7 	medium-risk, or low-risk establishments.
307.8 	(e) [SCHOOL INSPECTION FREQUENCY.] Elementary and
307.9 	secondary school food service establishments must be inspected
307.10 	according to the assigned risk category or by the frequency
307.11 	required in the Richard B. Russell National School Lunch Act,
307.12 	whichever frequency is more restrictive.

307.13 	Sec. 58. Minnesota Statutes 2004, section 214.01,
307.14 	subdivision 2, is amended to read:
307.15 		Subd. 2.Health-related licensing board.  "Health-related
307.16 	licensing board" means the Board of Examiners of Nursing Home
307.17 	Administrators established pursuant to section 144A.19, the
307.18 	Office of Unlicensed Complementary and Alternative Health Care
307.19 	Practice established pursuant to section 146A.02,the Board of
307.20 	Medical Practice created pursuant to section 147.01, the Board
307.21 	of Nursing created pursuant to section 148.181, the Board of
307.22 	Chiropractic Examiners established pursuant to section 148.02,
307.23 	the Board of Optometry established pursuant to section 148.52,
307.24 	the Board of Physical Therapy established pursuant to section
307.25 	148.67, the Board of Psychology established pursuant to section
307.26 	148.90, the Board of Social Work pursuant to section 148B.19,
307.27 	the Board of Marriage and Family Therapy pursuant to section
307.28 	148B.30, the Office of Mental Health Practice established
307.29 	pursuant to section 148B.61, the Board of Behavioral Health and
307.30 	Therapy established by section 148B.51, the Alcohol and Drug
307.31 	Counselors Licensing Advisory Council established pursuant to
307.32 	section 148C.02, the Board of Dietetics and Nutrition Practice
307.33 	established under section 148.622, the Board of Dentistry
307.34 	established pursuant to section 150A.02, the Board of Pharmacy
307.35 	established pursuant to section 151.02, the Board of Podiatric
307.36 	Medicine established pursuant to section 153.02, and the Board
308.1 	of Veterinary Medicine, established pursuant to section 156.01.

308.2 	Sec. 59. Minnesota Statutes 2004, section 214.06,
308.3 	subdivision 1, is amended to read:
308.4 		Subdivision 1.Fee adjustment.  Notwithstanding any law
308.5 	to the contrary, the commissioner of health as authorized by
308.6 	section 214.13, all health-related licensing boards and all
308.7 	non-health-related licensing boards shall by rule, with the
308.8 	approval of the commissioner of finance, adjust, as needed, any
308.9 	fee which the commissioner of health or the board is empowered
308.10 	to assess.  As provided in section 16A.1285, the adjustment
308.11 	shall be an amount sufficient so that the total fees collected
308.12 	by each board will as closely as possible equal be based on 
308.13 	anticipated expenditures during the fiscal biennium, including
308.14 	expenditures for the programs authorized by sections 214.17 to
308.15 	214.25 and 214.31 to 214.37.144.1476, 214.10, 214.103, 214.11,
308.16 	214.17 to 214.24, 214.28 to 214.37, and 214.40, except that a
308.17 	health-related licensing board may have anticipated expenditures
308.18 	in excess of anticipated revenues in a biennium by using
308.19 	accumulated surplus revenues from fees collected by that board
308.20 	in previous bienniums.  A health-related licensing board shall
308.21 	not spend more money than the amount appropriated by the
308.22 	legislature for a biennium.For members of an occupation
308.23 	registered after July 1, 1984, by the commissioner of health
308.24 	under the provisions of section 214.13, the fee established must
308.25 	include an amount necessary to recover, over a five-year period,
308.26 	the commissioner's direct expenditures for adoption of the rules
308.27 	providing for registration of members of the occupation.  All
308.28 	fees received shall be deposited in the state treasury. Fees
308.29 	received by the commissioner of health or health-related
308.30 	licensing boards must be credited to the health occupations
308.31 	licensing account in the state government special revenue fund.

308.32 	Sec. 60. Minnesota Statutes 2004, section 214.06, is
308.33 	amended by adding a subdivision to read:
308.34 		Subd. 1a.Health occupations licensing account. Fees
308.35 	received by the commissioner of health or health-related
308.36 	licensing boards must be credited to the health occupations
309.1 	licensing account in the state government special revenue fund.
309.2 	The commissioner of finance shall ensure that the revenues and
309.3 	expenditures of each health-related licensing board are tracked
309.4 	separately in the health occupations licensing account.

309.5 	Sec. 61. [245A.034] CHILD CARE PROVIDER TRAINING; DANGERS
309.6 	OF SHAKING INFANTS AND YOUNG CHILDREN.
309.7 	The commissioner shall make available for viewing by all
309.8 	licensed and legal nonlicensed child care providers a video
309.9 	presentation on the dangers associated with shaking infants and
309.10 	young children.  The video presentation shall be part of the
309.11 	initial and ongoing training of licensed child care providers.
309.12 	Legal nonlicensed child care providers may participate at their
309.13 	option in a video presentation session offered under this
309.14 	section.  The commissioner shall provide to child care providers
309.15 	at cost copies of a video approved by the commissioner of health
309.16 	under section 144.574 on the dangers associated with shaking
309.17 	infants and young children.

309.18 	Sec. 62. Minnesota Statutes 2004, section 326.42,
309.19 	subdivision 2, is amended to read:
309.20 		Subd. 2.Fees.  Plumbing system plans and specifications
309.21 	that are submitted to the commissioner for review shall be
309.22 	accompanied by the appropriate plan examination fees.  If the
309.23 	commissioner determines, upon review of the plans, that
309.24 	inadequate fees were paid, the necessary additional fees shall
309.25 	be paid prior to plan approval.  The commissioner shall charge
309.26 	the following fees for plan reviews and audits of plumbing
309.27 	installations for public, commercial, and industrial buildings:
309.28 	(1) systems with both water distribution and drain, waste,
309.29 	and vent systems and having:
309.30 	(i) 25 or fewer drainage fixture units, $150;
309.31 	(ii) 26 to 50 drainage fixture units, $250;
309.32 	(iii) 51 to 150 drainage fixture units, $350;
309.33 	(iv) 151 to 249 drainage fixture units, $500;
309.34 	(v) 250 or more drainage fixture units, $3 per drainage
309.35 	fixture unit to a maximum of $4,000; and
309.36 	(vi) interceptors, separators, or catch basins, $70 per
310.1 	interceptor, separator, or catch basin design;
310.2 	(2) building sewer service only, $150;
310.3 	(3) building water service only, $150;
310.4 	(4) building water distribution system only, no drainage
310.5 	system, $5 per supply fixture unit or $150, whichever is
310.6 	greater;
310.7 	(5) storm drainage system, a minimum fee of $150 or:
310.8 	(i) $50 per drain opening, up to a maximum of $500; and
310.9 	(ii) $70 per interceptor, separator, or catch basin design;
310.10 	(6) manufactured home park or campground, one to 25 sites,
310.11 	$300;
310.12 	(7) manufactured home park or campground, 26 to 50 sites,
310.13 	$350;
310.14 	(8) manufactured home park or campground, 51 to 125 sites,
310.15 	$400;
310.16 	(9) manufactured home park or campground, more than 125
310.17 	sites, $500;
310.18 	(10) accelerated review, double the regular fee, one-half
310.19 	to be refunded if no response from the commissioner within 15
310.20 	business days; and
310.21 	(11) revision to previously reviewed or incomplete plans:
310.22 	(i) review of plans for which commissioner has issued two
310.23 	or more requests for additional information, per review, $100 or
310.24 	ten percent of the original fee, whichever is greater;
310.25 	(ii) proposer-requested revision with no increase in
310.26 	project scope, $50 or ten percent of original fee, whichever is
310.27 	greater; and
310.28 	(iii) proposer-requested revision with an increase in
310.29 	project scope, $50 plus the difference between the original
310.30 	project fee and the revised project fee.

310.31 	Sec. 63. Minnesota Statutes 2004, section 471.61, is
310.32 	amended by adding a subdivision to read:
310.33 		Subd. 5.Provision of long-term care insurance. Any
310.34 	political subdivision, or any two or more political subdivisions
310.35 	acting jointly, may contract with an insurance company licensed
310.36 	to do business in this state for the voluntary purchase of
311.1 	long-term care insurance by the employees and their dependents
311.2 	of the political subdivision or subdivisions.  The coverage may
311.3 	be through a group policy or through individual coverage.

311.4 	Sec. 64. RULE AMENDMENT.
 311.5 	The commissioner of health shall amend Minnesota Rules,
311.6 	part 4626.2015, subparts 3, item C; and 6, item B, to conform
311.7 	with section 53.  The commissioner may use the good cause
311.8 	exemption under Minnesota Statutes, section 14.388, subdivision
311.9 	1, clause (3).  Minnesota Statutes, section 14.386, does not
311.10 	apply, except to the extent provided under Minnesota Statutes,
311.11 	section 14.388.

311.12 	Sec. 65. DIRECTION TO COMMISSIONER; DENTAL REVIEW.
 311.13 	The commissioner of health, in consultation with the
311.14 	relevant dental associations, licensed dental and public health
311.15 	professionals, and others, shall review the leadership and
311.16 	advisory role of the Department of Health relative to dental
311.17 	health including the usefulness of utilizing a dental director.
311.18 	The review shall include prevention, health disparities, and
311.19 	critical access issues and shall be reported to the legislative
311.20 	committees with jurisdiction over health policy by January 15,
311.21 	2006.

311.22 	Sec. 66. CERVICAL CANCER ELIMINATION STUDY.
 311.23 	(a) The commissioner of health shall develop a statewide
311.24 	integrated and comprehensive cervical cancer prevention plan,
311.25 	including strategies for promoting and implementing the plan.
311.26 	The plan must include activities that identify and implement
311.27 	methods to improve the cervical cancer screening rates in
311.28 	Minnesota, including, but not limited to:
311.29 	(1) identifying and disseminating appropriate
311.30 	evidence-based cervical cancer screening guidelines to be used
311.31 	in Minnesota;
311.32 	(2) increasing the use of appropriate screening based on
311.33 	these guidelines for patients seen by medical groups in
311.34 	Minnesota and monitoring results of these medical groups; and 
311.35 	(3) reducing the number of women who should but have not
311.36 	been screened.
312.1 	(b) In developing the plan, the commissioner shall also
312.2 	identify and examine limitations and barriers in providing
312.3 	cervical cancer screening, diagnosis tools, and treatment,
312.4 	including, but not limited to, medical care reimbursement,
312.5 	treatment costs, and the availability of insurance coverage.
312.6 	(c) The commissioner may work with a nonprofit quality
312.7 	improvement organization in Minnesota to identify evidence-based
312.8 	guidelines for cervical cancer screening and to identify methods
312.9 	to improve the cervical cancer screening rates among medical
312.10 	groups; and may work with a nonprofit health care result
312.11 	reporting organization to monitor results by medical groups in
312.12 	Minnesota.
312.13 	(d) The commissioner may convene an advisory committee that
312.14 	includes representatives of health care providers, the American
312.15 	Cancer Society, health plan companies, the University of
312.16 	Minnesota Academic Health Center, community health boards, and
312.17 	the general public.
312.18 	(e) The commissioner shall submit a report to the
312.19 	legislature by January 15, 2006, on:
312.20 	(1) the statewide cervical cancer prevention plan,
312.21 	including a description of the plan activities and strategies
312.22 	developed for promoting and implementing the plan;
312.23 	(2) methods for monitoring the results by medical groups
312.24 	and by the entire state of cervical cancer screening improvement
312.25 	activities; and 
312.26 	(3) recommended changes to existing laws, programs, or
312.27 	services in terms of reducing the occurrence of cervical cancer
312.28 	by improving insurance coverage for the prevention, diagnosis,
312.29 	and treatment for cervical cancer.

312.30 	Sec. 67. REPEALER.
 312.31 	(a) Minnesota Statutes 2004, sections 13.383, subdivision
312.32 	3; 13.411, subdivision 3; 144.1486; 144.1502; 146A.01,
312.33 	subdivisions 2 and 5; 146A.02; 146A.03; 146A.04; 146A.05;
312.34 	146A.06; 146A.07; 146A.08; 146A.09; 146A.10; and 157.215, are
312.35 	repealed.
312.36 	(b) Minnesota Statutes 2004, section 145.925, and Minnesota
313.1 	Rules, parts 4700.1900, 4700.2000, 4700.2100, 4700.2200,
313.2 	4700.2210, 4700.2300, 4700.2400, 4700.2410, 4700.2420, and
313.3 	4700.2500, are repealed.

313.4 	EFFECTIVE DATE. Paragraph (b) of this section is
313.5 	effective July 1, 2006, or upon implementation of the Family
313.6 	Planning Project section 1115 waiver, whichever is later.

313.7 	ARTICLE 9
313.8 	DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT

313.9 	Section 1. ADJUSTMENT.
 313.10 	The dollar amounts shown are added to or, if shown in
313.11 	parentheses, are subtracted from the appropriations in Laws
313.12 	2003, First Special Session chapter 14, as amended by Laws 2004,
313.13 	chapter 272, or other law, and are appropriated from the general
313.14 	fund, or any other fund named, to the Department of Human
313.15 	Services for the purposes specified in this article, to be
313.16 	available for the fiscal year indicated for each purpose.  The
313.17 	figure "2005" used in this article means that the appropriation
313.18 	or appropriations listed are available for the fiscal year
313.19 	ending June 30, 2005.
313.20 	SUMMARY BY FUND
313.21 	2005
313.22 	General Fund                                          25,517,000
313.23 	Health Care Access                                   (33,947,000)
313.24 	TANF                                                    (814,000)
313.25 	TOTAL                                                 (9,244,000)

313.26 	Sec. 2. COMMISSIONER OF HUMAN SERVICES
 313.27 		Subdivision 1.Total
313.28 	Appropriation                                         (9,244,000)
313.29 	Summary by Fund
313.30 	General                                25,517,000
313.31 	Health Care Access                    (33,947,000)
313.32 	TANF                                     (814,000)
313.33 	Subd. 2.  Revenue and Pass-Through
313.34 	TANF                                                    (814,000)
313.35 	Subd. 3.  Basic Health Care Grants
313.36 	General                                               44,502,000
314.1 	Health Care Access                                   (33,947,000)
314.2 	The amount that may be spent from this
314.3 	appropriation for each purpose is as
314.4 	follows:
314.5 	(a) MinnesotaCare
314.6 	Health Care Access                                   (33,947,000)
314.7 	(b) MA Basic Health Care - Families and Children
314.8 	General                                               39,343,000
314.9 	(c) MA Basic Health Care - Elderly and Disabled
314.10 	General                                              (20,641,000)
314.11 	(d) General Assistance Medical Care
314.12 	General                                               25,800,000
314.13 	Subd. 4.  Continuing Care Grants
314.14 	General                                              (18,985,000)
314.15 	The amount that may be spent from this
314.16 	appropriation for each purpose is as
314.17 	follows:
314.18 	(a) MA Long-Term Care Waivers
314.19 	General                                               (6,218,000)
314.20 	(b) MA Long-Term Care Facilities
314.21 	General                                              (15,645,000)
314.22 	(c) Chemical Dependency Entitlement Grants
314.23 	General                                               (2,878,000)

314.24 	ARTICLE 10
314.25 	APPROPRIATIONS

314.26 	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 314.27 	The sums shown in the columns marked "APPROPRIATIONS" are
314.28 	appropriated from the general fund, or any other fund named, to
314.29 	the agencies and for the purposes specified in the sections of
314.30 	this article, to be available for the fiscal years indicated for
314.31 	each purpose.  The figures "2006" and "2007" where used in this
314.32 	article, mean that the appropriation or appropriations listed
314.33 	under them are available for the fiscal year ending June 30,
314.34 	2006, or June 30, 2007, respectively.
314.35 	SUMMARY BY FUND
314.36 	BIENNIAL
314.37 	                           2006          2007           TOTAL
314.38 	General            $3,494,261,000 $3,635,190,000 $7,129,451,000
315.1 	State Government
315.2 	Special Revenue        49,893,000     50,297,000    100,190,000
315.3 	Health Care
315.4 	Access                464,068,000    552,640,000  1,016,708,000
315.5 	Federal TANF           66,989,000     64,446,000    131,435,000
315.6 	Lottery Prize
315.7 	Fund                    1,456,000      1,456,000      2,912,000
315.8 	TOTAL              $4,076,667,000 $4,304,038,000 $8,380,705,000
315.9 	APPROPRIATIONS
315.10 	                                       Available for the Year
315.11 	                                           Ending June 30
315.12 	                                          2006         2007

315.13 	Sec. 2. COMMISSIONER OF
315.14 	HUMAN SERVICES
 315.15 		Subdivision 1.Total
315.16 	Appropriation                     $3,915,840,000 $4,142,334,000
315.17 	Summary by Fund
315.18 	General           3,395,066,000 3,535,538,000
315.19 	State Government
315.20 	Special Revenue         534,000       534,000
315.21 	Health Care
315.22 	Access              457,795,000   546,361,000
315.23 	Federal TANF         60,989,000    58,446,000
315.24 	Lottery Cash
315.25 	Flow                  1,456,000     1,456,000
315.26 	[RECEIPTS FOR SYSTEMS PROJECTS.]
315.27 	Appropriations and federal receipts for
315.28 	information system projects for MAXIS,
315.29 	PRISM, MMIS, AND SSIS must be deposited
315.30 	in the state system account authorized
315.31 	in Minnesota Statutes, section
315.32 	256.014.  Money appropriated for
315.33 	computer projects approved by the
315.34 	Minnesota Office of Technology, funded
315.35 	by the legislature, and approved by the
315.36 	commissioner of finance, may be
315.37 	transferred from one project to another
315.38 	and from development to operations as
315.39 	the commissioner of human services
315.40 	considers necessary.  Any unexpended
315.41 	balance in the appropriation for these
315.42 	projects does not cancel but is
315.43 	available for ongoing development and
315.44 	operations.
315.45 	[SYSTEMS CONTINUITY.] In the event of
315.46 	disruption of technical systems or
315.47 	computer operations, the commissioner
315.48 	may use available grant appropriations
315.49 	to ensure continuity of payments for
315.50 	maintaining the health, safety, and
315.51 	well-being of clients served by
315.52 	programs administered by the Department
315.53 	of Human Services.  Grant funds must be
315.54 	used in a manner consistent with the
315.55 	original intent of the appropriation.
316.1 	[NONFEDERAL SHARE TRANSFERS.] The
316.2 	nonfederal share of activities for
316.3 	which federal administrative
316.4 	reimbursement is appropriated to the
316.5 	commissioner may be transferred to the
316.6 	special revenue fund.
316.7 	[GIFTS.] Notwithstanding Minnesota
316.8 	Statutes, chapter 7, the commissioner
316.9 	may accept, on behalf of the state,
316.10 	additional funding from sources other
316.11 	than state funds for the purpose of
316.12 	financing the cost of assistance
316.13 	program grants or nongrant
316.14 	administration.  All additional funding
316.15 	is appropriated to the commissioner for
316.16 	use as designated by the grantor of
316.17 	funding.
316.18 	[TANF FUNDS APPROPRIATED TO OTHER
316.19 	ENTITIES.] Any expenditures from the
316.20 	TANF block grant shall be expended in
316.21 	accordance with the requirements and
316.22 	limitations of part A of title IV of
316.23 	the Social Security Act, as amended,
316.24 	and any other applicable federal
316.25 	requirement or limitation.  Prior to
316.26 	any expenditure of these funds, the
316.27 	commissioner shall assure that funds
316.28 	are expended in compliance with the
316.29 	requirements and limitations of federal
316.30 	law and that any reporting requirements
316.31 	of federal law are met.  It shall be
316.32 	the responsibility of any entity to
316.33 	which these funds are appropriated to
316.34 	implement a memorandum of understanding
316.35 	with the commissioner that provides the
316.36 	necessary assurance of compliance prior
316.37 	to any expenditure of funds.  The
316.38 	commissioner shall receipt TANF funds
316.39 	appropriated to other state agencies
316.40 	and coordinate all related interagency
316.41 	accounting transactions necessary to
316.42 	implement these appropriations.
316.43 	Unexpended TANF funds appropriated to
316.44 	any state, local, or nonprofit entity
316.45 	cancel at the end of the state fiscal
316.46 	year unless appropriating language
316.47 	permits otherwise.
316.48 	[CAPITATION RATE INCREASE.] Of the
316.49 	health care access fund appropriations
316.50 	to the University of Minnesota in the
316.51 	higher education omnibus appropriation
316.52 	bill, $2,157,000 in fiscal year 2006
316.53 	and $2,157,000 in fiscal year 2007 are
316.54 	to be used to increase the capitation
316.55 	payments under Minnesota Statutes,
316.56 	section 256B.69.  Notwithstanding
316.57 	section 12, this provision shall not
316.58 	expire.
316.59 		Subd. 2.Agency Management
316.60 	Summary by Fund
316.61 	General              46,899,000    46,782,000
316.62 	State Government
316.63 	Special Revenue         415,000       415,000
317.1 	Health Care Access    5,565,000     5,200,000
317.2 	Federal TANF            222,000       222,000
317.3 	The amounts that may be spent from the
317.4 	appropriation for each purpose are as
317.5 	follows:
317.6 	(a) Financial Operations
317.7 	General              10,473,000    10,473,000
317.8 	Health Care Access      813,000       837,000
317.9 	Federal TANF            122,000       122,000
317.10 	[ADMINISTRATIVE BASE ADJUSTMENT - WEB
317.11 	PAYMENT.] The health care access fund
317.12 	base is increased by $28,000 in fiscal
317.13 	year 2008 and $61,000 in fiscal year
317.14 	2009 for fees associated with web-based
317.15 	payment collections.
317.16 	(b) Legal and
317.17 	Regulation Operations
317.18 	General               9,983,000     9,636,000
317.19 	State Government
317.20 	Special Revenue         415,000       415,000
317.21 	Health Care Access      755,000       319,000
317.22 	Federal TANF            100,000       100,000
317.23 	(c) Management Operations
317.24 	General               3,281,000     3,281,000
317.25 	Health Care Access       68,000        68,000
317.26 	(d) Information Technology
317.27 	Operations
317.28 	General              23,162,000    23,392,000
317.29 	Health Care Access    3,929,000     3,976,000
317.30 		Subd. 3.Revenue and Pass-Through Expenditures
317.31 	Summary by Fund
317.32 	Federal TANF         60,767,000    58,224,000
317.33 		Subd. 4.Children and Economic
317.34 	Assistance Grants
317.35 	Summary by Fund
317.36 	General                  37,000       177,000
317.37 	(a) Children's Services Grants
317.38 	General                  34,000       166,000
317.39 	[CHILDREN'S MENTAL HEALTH GRANTS BASE
317.40 	ADJUSTMENT.] The general fund base is
317.41 	increased by $41,000 in fiscal year
317.42 	2008 and fiscal year 2009 for costs
317.43 	associated with the long-term care
317.44 	provider cost-of-living adjustment.
318.1 	(b) Children and Community
318.2 	Services Grants
318.3 	General                   3,000        11,000
318.4 	[CHILDREN'S COMMUNITY SERVICE GRANTS
318.5 	BASE ADJUSTMENT.] The general fund base
318.6 	is increased by $2,000 in fiscal year
318.7 	2008 and fiscal year 2009 for costs
318.8 	associated with the long-term care
318.9 	provider cost-of-living adjustment.
318.10 		Subd. 5.Basic Health Care Grants
318.11 	Summary by Fund
318.12 	General           1,525,139,000 1,602,701,000
318.13 	Health Care Access  429,897,000   523,265,000
318.14 	[UPDATING FEDERAL POVERTY GUIDELINES.]
318.15 	Annual updates to the federal poverty
318.16 	guidelines are effective each July 1,
318.17 	following publication by the United
318.18 	States Department of Health and Human
318.19 	Services for health care programs under
318.20 	Minnesota Statutes, chapters 256, 256B,
318.21 	256D, and 256L.
318.22 	[HEALTH CARE ACCESS FUND SPENDING
318.23 	AUTHORITY.] The commissioner of human
318.24 	services, with the approval of the
318.25 	commissioner of finance, and after
318.26 	notification of the chairs of the
318.27 	relevant house finance committee and
318.28 	senate budget division, may expend
318.29 	money appropriated from the health care
318.30 	access fund for MinnesotaCare and
318.31 	general assistance medical care in
318.32 	either fiscal year of the biennium and
318.33 	transfer unencumbered appropriation
318.34 	balances between these two programs
318.35 	within or between fiscal years for the
318.36 	biennium ending June 30, 2007.
318.37 	[FULL FUNDING FOR DIAGNOSIS RELATED
318.38 	GROUPS PAYMENT ADJUSTMENT.] In order to
318.39 	provide full funding for the
318.40 	diagnosis-related groups for hospitals
318.41 	located in Greater Minnesota under
318.42 	Minnesota Statutes, section 256.969,
318.43 	subdivision 26, the following increases
318.44 	are hereby appropriated:
318.45 	$722,000 in fiscal year 2006 and
318.46 	$1,076,000 in fiscal year 2007 for MA
318.47 	Basic Care-Families and Children;
318.48 	$903,000 in fiscal year 2006 and
318.49 	$1,345,000 in fiscal year 2007 for MA
318.50 	Basic Care-Elderly and Disabled; and
318.51 	$361,000 in fiscal year 2006 and
318.52 	$538,000 in fiscal year 2007 for
318.53 	General Assistance Medical Care.
318.54 	The amounts that may be spent from the
318.55 	appropriation for each purpose are as
318.56 	follows:
318.57 	(a) MinnesotaCare Grants
319.1 	Health Care Access  196,222,000   124,046,000
319.2 	[MINNESOTACARE FEDERAL RECEIPTS.]
319.3 	Receipts received as a result of
319.4 	federal participation pertaining to
319.5 	administrative costs of the Minnesota
319.6 	health care reform waiver shall be
319.7 	deposited as nondedicated revenue in
319.8 	the health care access fund.  Receipts
319.9 	received as a result of federal
319.10 	participation pertaining to grants
319.11 	shall be deposited in the federal fund
319.12 	and shall offset health care access
319.13 	funds for payments to providers.
319.14 	(b) MA Basic Health Care -
319.15 	Families and Children
319.16 	General             619,076,000   735,721,000
319.17 	(c) MA Basic Health Care -
319.18 	Elderly and Disabled
319.19 	General             808,501,000   863,921,000
319.20 	(d) General Assistance Medical Care
319.21 	Grants
319.22 	General              87,777,000       -0-
319.23 	Health Care Access  235,585,000   399,465,000
319.24 	[GAMC DRUG REBATE REVENUES.]
319.25 	Notwithstanding Minnesota Statutes,
319.26 	section 256.01, subdivision 2, drug
319.27 	rebate revenues collected for general
319.28 	assistance medical care claims with a
319.29 	warrant date prior to June 30, 2007,
319.30 	shall be deposited in the general fund
319.31 	and the pharmaceutical discount program
319.32 	implementation is delayed until July 1,
319.33 	2007.  Notwithstanding section 12, this
319.34 	provision will not expire.
319.35 	Health Care Access  235,585,000   398,610,000
319.36 	(e) Prescription Drug Program Grants
319.37 	General               4,318,000       -0-
319.38 	[PDP TO MEDICARE PART D TRANSITION.]
319.39 	The commissioner of human services,
319.40 	with the approval of the commissioner
319.41 	of finance, and after notification of
319.42 	the chair of the senate Health and
319.43 	Human Services Budget Division and the
319.44 	chair of the house Health Policy and
319.45 	Finance Committee, may transfer fiscal
319.46 	year 2006 appropriations between the
319.47 	medical assistance program and the
319.48 	prescription drug program.
319.49 	(f) Health Care Grants -
319.50 	Other Assistance
319.51 	General               5,467,000     3,059,000
319.52 		Subd. 6.Health Care Management
319.53 	Summary by Fund
320.1 	General              25,613,000    26,371,000
320.2 	Health Care Access   20,423,000    17,650,000
320.3 	The amounts that may be spent from the
320.4 	appropriation for each purpose are as
320.5 	follows:
320.6 	(a) Health Care Policy Administration
320.7 	General               8,976,000     9,176,000
320.8 	Health Care Access    3,482,000     2,630,000
320.9 	[HEALTH CARE ACCESS FUND TRANSFERS
320.10 	EXPIRATION.] Notwithstanding Laws 2003,
320.11 	First Special Session chapter 14,
320.12 	article 13C, section 2, subdivision 6,
320.13 	paragraph (b), designating funds
320.14 	available for transfer to the general
320.15 	fund, the commissioner of finance's
320.16 	authorization to transfer those
320.17 	designated funds from the health care
320.18 	access fund shall expire July 1, 2005.
320.19 	[HEALTH CARE ACCESS FUND TRANSFERS.]
320.20 	Transfers of funds between the health
320.21 	care access fund and the general fund
320.22 	authorized under Minnesota Statutes,
320.23 	section 16A.724, supersede the
320.24 	transfers authorized in Laws 2003,
320.25 	First Special Session chapter 14,
320.26 	article 13C, section 2, subdivision 7,
320.27 	paragraph (a).  This provision is
320.28 	effective the day following final
320.29 	enactment.
320.30 	[ADMINISTRATIVE BASE ADJUSTMENT.] The
320.31 	health care access fund base is
320.32 	increased by $1,868,000 in fiscal year
320.33 	2008 and $1,874,000 in fiscal year
320.34 	2009, for implementation of business
320.35 	process redesign in health care.
320.36 	[MINNESOTA SENIOR HEALTH OPTIONS
320.37 	REIMBURSEMENT.] Federal administrative
320.38 	reimbursement resulting from the
320.39 	Minnesota senior health options project
320.40 	is appropriated to the commissioner for
320.41 	this activity.
320.42 	[UTILIZATION REVIEW.] Federal
320.43 	administrative reimbursement resulting
320.44 	from prior authorization and inpatient
320.45 	admission certification by a
320.46 	professional review organization shall
320.47 	be dedicated to the commissioner for
320.48 	these purposes.  A portion of these
320.49 	funds must be used for activities to
320.50 	decrease unnecessary pharmaceutical
320.51 	costs in medical assistance.
320.52 	(b) Health Care Operations
320.53 	General              16,637,000    17,195,000
320.54 	Health Care Access   16,941,000    15,020,000
320.55 		Subd. 7.Continuing Care Grants
320.56 	Summary by Fund
321.1 	General           1,558,757,000 1,643,957,000
321.2 	Lottery Prize         1,308,000     1,308,000
321.3 	The amounts that may be spent from the
321.4 	appropriation for each purpose are as
321.5 	follows:
321.6 	(a) Aging and Adult Services Grant
321.7 	General              15,375,000    14,323,000
321.8 	[MEDICARE PART D.] Of the general fund
321.9 	appropriation for the biennium,
321.10 	$4,697,000 shall be used for grants to
321.11 	the Board on Aging for information and
321.12 	assistance for Medicare Part D
321.13 	implementation.  This money can be used
321.14 	in either year of the biennium.
321.15 	Beginning in fiscal 2008, base level
321.16 	funding is $3,417,000 per year.
321.17 	(b) Alternative Care Grants
321.18 	General              58,073,000    49,706,000
321.19 	[ALTERNATIVE CARE TRANSFER.] Any money
321.20 	allocated to the alternative care
321.21 	program that is not spent for the
321.22 	purposes indicated does not cancel but
321.23 	shall be transferred to the medical
321.24 	assistance account.
321.25 	[ALTERNATIVE CARE BASE.] Base level
321.26 	funding for alternative care grants is
321.27 	increased by $563,000 in fiscal year
321.28 	2008 and by $575,000 in fiscal year
321.29 	2009.
321.30 	[ALTERNATIVE CARE IMPLEMENTATION OF
321.31 	CHANGES TO ELIGIBILITY.] Changes to
321.32 	Minnesota Statutes, section 256B.0913,
321.33 	subdivisions 2 and 4, paragraph (a),
321.34 	are effective July 1, 2005, for all
321.35 	persons found eligible for the
321.36 	alternative care program on and after
321.37 	July 1, 2005.  All persons who are
321.38 	alternative care clients as of June 30,
321.39 	2005, must be subject to Minnesota
321.40 	Statutes, section 256B.0913,
321.41 	subdivisions 2 and 4, paragraph (a), on
321.42 	the annual redetermination of program
321.43 	eligibility due after June 30, 2005,
321.44 	but no later than January 1, 2006.
321.45 	(c) Medical Assistance Grants -
321.46 	Long-term Care Facilities
321.47 	General             522,953,000   524,765,000
321.48 	(d) Medical Assistance Grants -
321.49 	Long-Term Care Waivers and
321.50 	Home Care Grants
321.51 	General             835,332,000   921,347,000
321.52 	[LONG-TERM CARE PROVIDER RATE
321.53 	INCREASE.] The long-term care provider
321.54 	rate increase percentages in Minnesota
321.55 	Statutes, sections 256B.431,
322.1 	subdivision 41; 256B.5012, subdivision
322.2 	6; and 256B.765, subdivision 3, shall
322.3 	be adjusted to reflect a 2.2553 percent
322.4 	increase effective October 1, 2006, and
322.5 	a 2.2553 percent increase effective
322.6 	October 1, 2007.  These percentage
322.7 	increases replace, and are not in
322.8 	addition to, the percentage increases
322.9 	provided in the specified sections of
322.10 	Minnesota Statutes.  This new
322.11 	percentage rate shall become part of
322.12 	base-level funding for fiscal years
322.13 	2008 and 2009.
322.14 	[LIMITING GROWTH IN COMMUNITY
322.15 	ALTERNATIVES FOR DISABLED INDIVIDUALS
322.16 	WAIVER.] For each year of the biennium
322.17 	ending June 30, 2007, the commissioner
322.18 	shall make available additional
322.19 	allocations for home and
322.20 	community-based services covered under
322.21 	Minnesota Statutes, section 256B.49, at
322.22 	a rate of 95 per month or 1,140 per
322.23 	year, plus any additional legislatively
322.24 	authorized growth.  Priorities for the
322.25 	allocation of funds shall be for
322.26 	individuals anticipated to be
322.27 	discharged from institutional settings
322.28 	or who are at imminent risk of a
322.29 	placement in an institutional setting.
322.30 	[LIMITING GROWTH IN TBI WAIVER.] For
322.31 	each year of the biennium ending June
322.32 	30, 2007, the commissioner shall make
322.33 	available additional allocations for
322.34 	home and community-based services
322.35 	covered under Minnesota Statutes,
322.36 	section 256B.49, at a rate of 150 per
322.37 	year.  Priorities for the allocation of
322.38 	funds shall be for individuals
322.39 	anticipated to be discharged from
322.40 	institutional settings or who are at
322.41 	imminent risk of a placement in an
322.42 	institutional setting.
322.43 	[LIMITING GROWTH IN MR/RC WAIVER.] For
322.44 	each year of the biennium ending June
322.45 	30, 2007, the commissioner shall limit
322.46 	the new diversion caseload growth in
322.47 	the MR/RC waiver to 50 additional
322.48 	allocations.  Notwithstanding Minnesota
322.49 	Statutes, section 256B.0916,
322.50 	subdivision 5, paragraph (b), the
322.51 	available diversion allocations shall
322.52 	be awarded to support individuals whose
322.53 	health and safety needs result in an
322.54 	imminent risk of an institutional
322.55 	placement at any time during the fiscal
322.56 	year.
322.57 	[QUALITY ASSURANCE COMMISSION.] Of the
322.58 	general fund appropriation, $299,000 in
322.59 	fiscal year 2006 and $450,000 in fiscal
322.60 	year 2007 is for the Quality Assurance
322.61 	Commission under Minnesota Statutes,
322.62 	section 256B.0951.
322.63 	(e) Mental Health Grants
322.64 	General              46,731,000    47,516,000
323.1 	Lottery Prize         1,308,000     1,308,000
323.2 	[MENTAL HEALTH GRANT BASE.] Base level
323.3 	funding for mental health grants is
323.4 	increased by $388,000 in fiscal year
323.5 	2008 and by $395,000 in fiscal year
323.6 	2009.
323.7 	[RESTRUCTURING OF ADULT MENTAL HEALTH
323.8 	SERVICES.] The commissioner may make
323.9 	transfers that do not increase the
323.10 	state share of costs to effectively
323.11 	implement the restructuring of adult
323.12 	mental health services.
323.13 	[COMPULSIVE GAMBLING PREVENTION AND
323.14 	EDUCATION.] $150,000 is appropriated
323.15 	from the lottery prize fund for the
323.16 	fiscal year ending June 30, 2006, and
323.17 	$150,000 is appropriated from the
323.18 	lottery prize fund for the fiscal year
323.19 	ending June 30, 2007, to the
323.20 	commissioner of human services for a
323.21 	grant to the Northstar Problem Gambling
323.22 	Alliance in Arlington, Minnesota.  Of
323.23 	this appropriation, $75,000 in the
323.24 	fiscal year ending June 30, 2006, and
323.25 	$75,000 in the fiscal year ending June
323.26 	30, 2007, is contingent on
323.27 	demonstration of nonstate matching
323.28 	funds.  The commissioner of finance may
323.29 	disburse the state portion of the
323.30 	matching funds in increments of $37,500
323.31 	upon receipt of a commitment for an
323.32 	equal amount of matching nonstate
323.33 	funds.  These funds shall be used to
323.34 	increase public awareness of problem
323.35 	gambling, education, training, and
323.36 	research.
323.37 	(f) Deaf and Hard-of-Hearing
323.38 	Grants
323.39 	General               1,454,000     1,475,000
323.40 	[DEAF AND HARD-OF-HEARING BASE
323.41 	FUNDING.] Base level funding for the
323.42 	deaf and hard-of-hearing grants is
323.43 	increased by $4,000 in fiscal year 2008
323.44 	and $4,000 in fiscal year 2009.
323.45 	(g) Chemical Dependency
323.46 	Entitlement Grants
323.47 	General              63,183,000    68,744,000
323.48 	(h) Chemical Dependency Nonentitlement
323.49 	Grants
323.50 	General               1,055,000     1,055,000
323.51 	(i) Other Continuing Care Grants
323.52 	General              14,601,000    15,027,000
323.53 	[OTHER CONTINUING CARE GRANTS BASE
323.54 	FUNDING.] Base level funding for other
323.55 	continuing care grants is increased by
323.56 	$45,000 in fiscal year 2008 and $94,000
323.57 	in fiscal year 2009.
324.1 		Subd. 8.Continuing Care Management
324.2 	Summary by Fund
324.3 	General              15,034,000    15,122,000
324.4 	State Government
324.5 	Special Revenue         119,000       119,000
324.6 	Lottery Prize           148,000       148,000
324.7 	[QUALITY ASSURANCE COMMISSION.]
324.8 	$151,000 in fiscal year 2007 is
324.9 	appropriated from the general fund to
324.10 	the commissioner of human services for
324.11 	the Quality Assurance Commission under
324.12 	Minnesota Statutes, section 256B.0951.
324.13 	This funding is added to the base
324.14 	appropriation for the quality assurance
324.15 	commission program for the fiscal year
324.16 	beginning July 1, 2006.
324.17 		Subd. 9.State-Operated Services
324.18 	Summary by Fund
324.19 	General             223,581,000   200,448,000
324.20 	[EVIDENCE-BASED PRACTICE FOR
324.21 	METHAMPHETAMINE TREATMENT.] $300,000 is
324.22 	appropriated from the general fund for
324.23 	the fiscal year ending June 30, 2006,
324.24 	and $300,000 is appropriated from the
324.25 	general fund for the fiscal year ending
324.26 	June 30, 2007, to the commissioner of
324.27 	human services to support development
324.28 	of evidence-based practices for the
324.29 	treatment of methamphetamine abuse at
324.30 	the state-operated services chemical
324.31 	dependency program in Willmar.  These
324.32 	funds shall be used to support research
324.33 	on evidence-based practices for the
324.34 	treatment of methamphetamine abuse, to
324.35 	disseminate the results of the
324.36 	evidence-based practice research
324.37 	statewide, and to create training for
324.38 	addiction counselors specializing in
324.39 	the treatment of methamphetamine abuse.
324.40 	[TRANSFER AUTHORITY RELATED TO
324.41 	STATE-OPERATED SERVICES.] Money
324.42 	appropriated to finance state-operated
324.43 	services programs and administrative
324.44 	services may be transferred between
324.45 	fiscal years of the biennium with the
324.46 	approval of the commissioner of finance.
324.47 	[BASE ADJUSTMENT FOR STATE-OPERATED
324.48 	SERVICES UTILIZATION.] The general fund
324.49 	base is increased by $3,174,000 in
324.50 	fiscal year 2008 and $6,472,000 in
324.51 	fiscal year 2009 for state-operated
324.52 	services forensic operations, with
324.53 	corresponding adjustments to
324.54 	nondedicated revenue estimates.

324.55 	Sec. 3. COMMISSIONER OF HEALTH
 324.56 		Subdivision 1.Total
324.57 	Appropriation                        113,245,000    114,094,000
325.1 	Summary by Fund
325.2 	General              64,452,000    64,909,000
325.3 	State Government
325.4 	Special Revenue      36,520,000    36,906,000
325.5 	Health Care Access    6,273,000     6,279,000
325.6 	Federal TANF          6,000,000     6,000,000
325.7 	[TANF APPROPRIATIONS.] (a) $4,000,000
325.8 	of TANF funds is appropriated each year
325.9 	to the commissioner for home visiting
325.10 	and nutritional services listed under
325.11 	Minnesota Statutes, section 145.882,
325.12 	subdivision 7, clauses (6) and (7).
325.13 	Funding shall be distributed to
325.14 	community health boards based on
325.15 	Minnesota Statutes, section 145A.131,
325.16 	subdivision 1, and tribal governments
325.17 	based on Minnesota Statutes, section
325.18 	145A.14, subdivision 2, paragraph (b).
325.19 	(b) $2,000,000 of TANF funds is
325.20 	appropriated each year to the
325.21 	commissioner for decreasing racial and
325.22 	ethnic disparities in infant mortality
325.23 	rates under Minnesota Statutes, section
325.24 	145.928, subdivision 7.
325.25 	[TANF CARRYFORWARD.] Any unexpended
325.26 	balance of the TANF appropriation in
325.27 	the first year of the biennium does not
325.28 	cancel but is available for the second
325.29 	year.
325.30 	[MN AIDS PROJECT.] Notwithstanding any
325.31 	law to the contrary, the Minnesota AIDS
325.32 	Project is not eligible for any grants
325.33 	from the commissioner of health or
325.34 	Department of Health.
325.35 		Subd. 2.Community and Family
325.36 	Health Promotion
325.37 	Summary by Fund
325.38 	General              40,074,000    38,670,000
325.39 	State Government
325.40 	Special Revenue         341,000       328,000
325.41 	Health Care Access    3,510,000     3,516,000
325.42 	Federal TANF          3,580,000     3,580,000
325.43 	[HEALTH OCCUPATIONS LICENSING.]
325.44 	$200,000 of the appropriation in fiscal
325.45 	year 2006 and $200,000 of the
325.46 	appropriation in fiscal year 2007 from
325.47 	the health occupations licensing
325.48 	account in the state government special
325.49 	revenue fund are for the rural pharmacy
325.50 	planning and transition grant program.
325.51 	[SHAKEN BABY VIDEO.] Of the state
325.52 	government special revenue fund
325.53 	appropriation, $13,000 in 2006 is
325.54 	appropriated to the commissioner of
325.55 	health to provide a video to hospitals
326.1 	on shaken baby syndrome.  The
326.2 	commissioner of health shall assess a
326.3 	fee to hospitals to cover the cost of
326.4 	the approved shaken baby video and the
326.5 	revenue received is to be deposited in
326.6 	the state government special revenue
326.7 	fund.
326.8 	[POSITIVE ABORTION ALTERNATIVES.]
326.9 	$50,000 in fiscal year 2006 is for
326.10 	administrative costs of the positive
326.11 	abortion alternatives program
326.12 	implementation.
326.13 	$2,500,000 in fiscal year 2007 is for
326.14 	positive abortion alternatives under
326.15 	Minnesota Statutes, section 145.4231.
326.16 	Of this amount, $100,000 may be used
326.17 	for administrative costs of
326.18 	implementing the grant program.
326.19 		Subd. 3.Policy Quality and
326.20 	Compliance
326.21 	Summary by Fund
326.22 	General               3,668,000     3,668,000
326.23 	State Government
326.24 	Special Revenue      11,528,000    11,428,000
326.25 	Health Care Access    2,763,000     2,763,000
326.26 	[OCCUPATIONAL THERAPY FEE HOLIDAY.] The
326.27 	commissioner's authority to collect the
326.28 	license renewal fee from occupational
326.29 	therapy practitioners under Minnesota
326.30 	Statutes, section 148.6445, subdivision
326.31 	2, is suspended for fiscal years 2006
326.32 	and 2007.
326.33 		Subd. 4.Health Protection
326.34 	Summary by Fund
326.35 	General               9,118,000     9,118,000
326.36 	State Government
326.37 	Special Revenue      24,316,000    24,815,000
326.38 		Subd. 5.Minority and
326.39 	Multicultural Health
326.40 	Summary by Fund
326.41 	General               6,190,000     8,051,000
326.42 	Federal TANF          2,420,000     2,420,000
326.43 		Subd. 6.Administrative
326.44 	Support Services
326.45 	Summary by Fund
326.46 	General               5,402,000     5,402,000
326.47 	State Government
326.48 	Special Revenue         335,000       335,000

326.49 	Sec. 4. VETERANS NURSING HOMES BOARD
 327.1 	General              30,030,000    30,030,000
327.2 	[VETERANS HOMES SPECIAL REVENUE
327.3 	ACCOUNT.] The general fund
327.4 	appropriations made to the board may be
327.5 	transferred to a veterans homes special
327.6 	revenue account in the special revenue
327.7 	fund in the same manner as other
327.8 	receipts are deposited according to
327.9 	Minnesota Statutes, section 198.34, and
327.10 	are appropriated to the board for the
327.11 	operation of board facilities and
327.12 	programs.

327.13 	Sec. 5. HEALTH-RELATED BOARDS
 327.14 		Subdivision 1.Total
327.15 	Appropriation        12,268,000    12,286,000
327.16 	Summary by Fund
327.17 	General                  25,000        25,000
327.18 	State Government
327.19 	Special Revenue      12,243,000    12,261,000
327.20 	[STATE GOVERNMENT SPECIAL REVENUE
327.21 	FUND.] The appropriations in this
327.22 	section are from the state government
327.23 	special revenue fund, except where
327.24 	noted.
327.25 	[NO SPENDING IN EXCESS OF REVENUES.]
327.26 	The commissioner of finance shall not
327.27 	permit the allotment, encumbrance, or
327.28 	expenditure of money appropriated in
327.29 	this section in excess of the
327.30 	anticipated biennial revenues or
327.31 	accumulated surplus revenues from fees
327.32 	collected by the boards.  Neither this
327.33 	provision nor Minnesota Statutes,
327.34 	section 214.06, applies to transfers
327.35 	from the general contingent account.
327.36 		Subd. 2.Board of Behavioral
327.37 	Health and Therapy                       673,000        673,000
327.38 		Subd. 3.Board of Chiropractic
327.39 	Examiners                                414,000        414,000
327.40 		Subd. 4.Board of Dentistry             888,000        888,000
327.41 		Subd. 5.Board of Dietetic and
327.42 	Nutrition Practice                       101,000        101,000
327.43 	The Board of Dietetic and Nutrition
327.44 	Practice may lower its fees by an
327.45 	amount not to exceed $36,000 in fiscal
327.46 	years 2006, 2007, 2008, and 2009.
327.47 		Subd. 6.Board of Marriage and
327.48 	Family Therapy                           127,000        131,000
327.49 		Subd. 7.Board of Medical
327.50 	Practice                               3,529,000      3,569,000
327.51 		Subd. 8.Board of Nursing             2,561,000      2,567,000
327.52 	The Board of Nursing may lower its fees
327.53 	by an amount not to exceed $467,000 in
327.54 	fiscal year 2006 and $442,000 in fiscal
328.1 	years 2007, 2008, and 2009.
328.2 		Subd. 9.Board of Nursing
328.3 	Home Administrators                      616,000        619,000
328.4 	[ADMINISTRATIVE SERVICES UNIT.] Of this
328.5 	appropriation, $418,000 the first year
328.6 	and $421,000 the second year are for
328.7 	the health boards administrative
328.8 	services unit.  The administrative
328.9 	services unit may receive and expend
328.10 	reimbursements for services performed
328.11 	for other agencies.
328.12 		Subd. 10.Board of Optometry             96,000         96,000
328.13 		Subd. 11.Board of Pharmacy           1,289,000      1,244,000
328.14 	General Fund             25,000        25,000
328.15 	State Government
328.16 	Special Revenue       1,264,000     1,219,000
328.17 	[CANCER DRUG REPOSITORY.] $25,000 each
328.18 	year from the general fund is for the
328.19 	Board of Pharmacy to operate the cancer
328.20 	drug repository program in Minnesota
328.21 	Statutes, section 144.707.
328.22 		Subd. 12.Board of Physical
328.23 	Therapy                                  201,000        207,000
328.24 		Subd. 13.Board of Podiatry              49,000         53,000
328.25 		Subd. 14.Board of Psychology           680,000        680,000
328.26 		Subd. 15.Board of Social
328.27 	Work                                     873,000        873,000
328.28 	[TEMPORARY FEE REDUCTION.] Beginning
328.29 	January 1, 2006, for fiscal year 2006
328.30 	and for fiscal years 2007, 2008, and
328.31 	2009, the following fee changes for
328.32 	fees specified in Minnesota Statutes,
328.33 	section 148D.175, are effective:
328.34 	(1) in subdivision 1, the application
328.35 	fee for a licensed independent social
328.36 	worker is reduced to $45;
328.37 	(2) in subdivision 1, the application
328.38 	fee for a licensed independent clinical
328.39 	social worker is reduced to $45;
328.40 	(3) in subdivision 1, the application
328.41 	fee for a licensure by endorsement is
328.42 	reduced to $85;
328.43 	(4) in subdivision 2, the license fee
328.44 	for a licensed social worker is reduced
328.45 	to $90;
328.46 	(5) in subdivision 2, the license fee
328.47 	for a licensed graduate social worker
328.48 	is reduced to $160;
328.49 	(6) in subdivision 2, the license fee
328.50 	for a licensed independent social
328.51 	worker is reduced to $240;
328.52 	(7) in subdivision 2, the license fee
329.1 	for a licensed independent clinical
329.2 	social worker is reduced to $265;
329.3 	(8) in subdivision 3, the renewal fee
329.4 	for a licensed social worker is reduced
329.5 	to $90;
329.6 	(9) in subdivision 3, the renewal fee
329.7 	for a licensed graduate social worker
329.8 	is reduced to $160;
329.9 	(10) in subdivision 3, the renewal fee
329.10 	for a licensed independent social
329.11 	worker is reduced to $240;
329.12 	(11) in subdivision 3, the renewal fee
329.13 	for a licensed independent clinical
329.14 	social worker is reduced to $265; and
329.15 	(12) in subdivision 5, the renewal late
329.16 	fee is reduced to one-third of the
329.17 	renewal fee specified in subdivision 3.
329.18 	These fee reductions expire on June 30,
329.19 	2009.
329.20 		Subd. 16.Board of Veterinary
329.21 	Medicine                                 171,000        171,000

329.22 	Sec. 6. EMERGENCY MEDICAL SERVICES BOARD
 329.23 		Subdivision 1.Total
329.24 	Appropriation                          3,077,000      3,077,000
329.25 	Summary by Fund
329.26 	General               2,481,000     2,481,000
329.27 	State Government
329.28 	Special Revenue         596,000       596,000
329.29 	[HEALTH PROFESSIONAL SERVICES
329.30 	ACTIVITY.] $596,000 each year from the
329.31 	state government special revenue fund
329.32 	is for the health professional services
329.33 	activity.

329.34 	Sec. 7. COUNCIL ON DISABILITY
 329.35 	General                                  500,000        500,000

329.36 	Sec. 8. OMBUDSMAN FOR MENTAL HEALTH
329.37 	AND MENTAL RETARDATION
 329.38 	General                                1,462,000      1,462,000

329.39 	Sec. 9. OMBUDSMAN FOR FAMILIES
 329.40 	General                                  245,000        245,000

329.41 	Sec. 10. TRANSFERS.
 329.42 		Subdivision 1.Grants. The commissioner of human
329.43 	services, with the approval of the commissioner of finance, and
329.44 	after notification of the chairs of the relevant senate budget
329.45 	division and house finance committee, may transfer unencumbered
329.46 	appropriation balances for the biennium ending June 30, 2007,
330.1 	within fiscal years among the MFIP, general assistance, medical
330.2 	assistance, MFIP child care assistance under Minnesota Statutes,
330.3 	section 119B.05, Minnesota supplemental aid, and group
330.4 	residential housing programs, and the entitlement portion of the
330.5 	chemical dependency consolidated treatment fund, and between
330.6 	fiscal years of the biennium.
330.7 		Subd. 2.Administration. Positions, salary money, and
330.8 	nonsalary administrative money may be transferred within the
330.9 	departments of human services and health and within the programs
330.10 	operated by the veterans nursing homes board as the
330.11 	commissioners and the board consider necessary, with the advance
330.12 	approval of the commissioner of finance.  The commissioner or
330.13 	the board shall inform the chairs of the relevant house and
330.14 	senate health committees quarterly about transfers made under
330.15 	this provision.
330.16 		Subd. 3.Prohibited transfers. Grant money shall not be
330.17 	transferred to operations within the departments of human
330.18 	services and health and within the programs operated by the
330.19 	veterans nursing homes board without the approval of the
330.20 	legislature.

330.21 	Sec. 11. INDIRECT COSTS NOT TO FUND PROGRAMS.
 330.22 	The commissioners of health and of human services shall not
330.23 	use indirect cost allocations to pay for the operational costs
330.24 	of any program for which they are responsible.

330.25 	Sec. 12. SUNSET OF UNCODIFIED LANGUAGE.
 330.26 	All uncodified language contained in this article expires
330.27 	on June 30, 2007, unless a different expiration date is explicit.

330.28 	Sec. 13. EFFECTIVE DATE.
 330.29 	The provisions in this article are effective July 1, 2005,
330.30 	unless a different effective date is specified.

330.31 	ARTICLE 11
330.32 	OPTION B SPENDING

330.33 	Section 1. CONDITIONAL EFFECTIVE DATE.
 330.34 	The policies and the appropriations in this article are
330.35 	effective only if H.F. 1664 is passed by the house of
330.36 	representatives.  The amounts indicated in this article are
331.1 	appropriated to the commissioner of human services for the
331.2 	purposes indicated in the fiscal years indicated.

331.3 	Sec. 2. Minnesota Statutes 2004, section 256D.03,
331.4 	subdivision 3, is amended to read:
331.5 		Subd. 3.General assistance medical care; eligibility.
 331.6 	(a) General assistance medical care may be paid for any person
331.7 	who is not eligible for medical assistance under chapter 256B,
331.8 	including eligibility for medical assistance based on a
331.9 	spenddown of excess income according to section 256B.056,
331.10 	subdivision 5, or MinnesotaCare as defined in paragraph (b),
331.11 	except as provided in paragraph (c), and:
331.12 	(1) who is receiving assistance under section 256D.05,
331.13 	except for families with children who are eligible under
331.14 	Minnesota family investment program (MFIP), or who is having a
331.15 	payment made on the person's behalf under sections 256I.01 to
331.16 	256I.06, or who resides in group residential housing as defined
331.17 	in chapter 256I and can meet a spenddown using the cost of
331.18 	remedial services received through group residential housing; or
331.19 	(2) (i) who is a resident of Minnesota;and
331.20 	(i) who has gross countable income not in excess of 75
331.21 	percent of the federal poverty guidelines for the family size,
331.22 	using a six-month budget period and whose equity in assets is
331.23 	not in excess of $1,000 per assistance unit.  Exempt assets, the
331.24 	reduction of excess assets, and the waiver of excess assets must
331.25 	conform to the medical assistance program in section 256B.056,
331.26 	subdivision 3, with the following exception:  the maximum amount
331.27 	of undistributed funds in a trust that could be distributed to
331.28 	or on behalf of the beneficiary by the trustee, assuming the
331.29 	full exercise of the trustee's discretion under the terms of the
331.30 	trust, must be applied toward the asset maximum; or and 
331.31 	(ii) who has gross countable income above 75 percent not in
331.32 	excess of 75 percent of the federal poverty guidelines but not
331.33 	in excess of 175 percent of the federal poverty guidelines for
331.34 	the family size, using a six-month budget period, or whose
331.35 	equity in assets is not in excess of the limits in section
331.36 	256B.056, subdivision 3c, and who applies during an inpatient
332.1 	hospitalization excess income is spent down to 75 percent of the
332.2 	federal poverty guidelines using a six-month budget period.
332.3 	(b) General assistance medical care may not be paid for
332.4 	applicants or recipients who meet all eligibility requirements
332.5 	of MinnesotaCare as defined in sections 256L.01 to 256L.16, and
332.6 	are adults with dependent children under 21 whose gross family
332.7 	income is equal to or less than 275 190 percent of the federal
332.8 	poverty guidelines.
332.9 	(c) For applications received on or after October 1, 2003,
332.10 	Eligibility may begin no earlier than the date of application.
332.11 	For individuals eligible under paragraph (a), clause (2), item
332.12 	(i),a redetermination of eligibility must occur every 12
332.13 	months. Individuals are eligible under paragraph (a), clause
332.14 	(2), item (ii), only during inpatient hospitalization but may
332.15 	reapply if there is a subsequent period of inpatient
332.16 	hospitalization.Beginning January 1, 2000, Minnesota health
332.17 	care program applications completed by recipients and applicants
332.18 	who are persons described in paragraph (b), may be returned to
332.19 	the county agency to be forwarded to the Department of Human
332.20 	Services or sent directly to the Department of Human Services
332.21 	for enrollment in MinnesotaCare.  If all other eligibility
332.22 	requirements of this subdivision are met, eligibility for
332.23 	general assistance medical care shall be available in any month
332.24 	during which a MinnesotaCare eligibility determination and
332.25 	enrollment are pending.  Upon notification of eligibility for
332.26 	MinnesotaCare, notice of termination for eligibility for general
332.27 	assistance medical care shall be sent to an applicant or
332.28 	recipient.  If all other eligibility requirements of this
332.29 	subdivision are met, eligibility for general assistance medical
332.30 	care shall be available until enrollment in MinnesotaCare
332.31 	subject to the provisions of paragraph (e).
332.32 	(d) The date of an initial Minnesota health care program
332.33 	application necessary to begin a determination of eligibility
332.34 	shall be the date the applicant has provided a name, address,
332.35 	and Social Security number, signed and dated, to the county
332.36 	agency or the Department of Human Services.  If the applicant is
333.1 	unable to provide a name, address, Social Security number, and
333.2 	signature when health care is delivered due to a medical
333.3 	condition or disability, a health care provider may act on an
333.4 	applicant's behalf to establish the date of an initial Minnesota
333.5 	health care program application by providing the county agency
333.6 	or Department of Human Services with provider identification and
333.7 	a temporary unique identifier for the applicant.  The applicant
333.8 	must complete the remainder of the application and provide
333.9 	necessary verification before eligibility can be determined.
333.10 	The county agency must assist the applicant in obtaining
333.11 	verification if necessary.
333.12 	(e) County agencies are authorized to use all automated
333.13 	databases containing information regarding recipients' or
333.14 	applicants' income in order to determine eligibility for general
333.15 	assistance medical care or MinnesotaCare.  Such use shall be
333.16 	considered sufficient in order to determine eligibility and
333.17 	premium payments by the county agency.
333.18 	(f) General assistance medical care is not available for a
333.19 	person in a correctional facility unless the person is detained
333.20 	by law for less than one year in a county correctional or
333.21 	detention facility as a person accused or convicted of a crime,
333.22 	or admitted as an inpatient to a hospital on a criminal hold
333.23 	order, and the person is a recipient of general assistance
333.24 	medical care at the time the person is detained by law or
333.25 	admitted on a criminal hold order and as long as the person
333.26 	continues to meet other eligibility requirements of this
333.27 	subdivision.
333.28 	(g) General assistance medical care is not available for
333.29 	applicants or recipients who do not cooperate with the county
333.30 	agency to meet the requirements of medical assistance.
333.31 	(h) In determining the amount of assets of an individual
333.32 	eligible under paragraph (a), clause (2), item (i),there shall
333.33 	be included any asset or interest in an asset, including an
333.34 	asset excluded under paragraph (a), that was given away, sold,
333.35 	or disposed of for less than fair market value within the 60
333.36 	months preceding application for general assistance medical care
334.1 	or during the period of eligibility.  Any transfer described in
334.2 	this paragraph shall be presumed to have been for the purpose of
334.3 	establishing eligibility for general assistance medical care,
334.4 	unless the individual furnishes convincing evidence to establish
334.5 	that the transaction was exclusively for another purpose.  For
334.6 	purposes of this paragraph, the value of the asset or interest
334.7 	shall be the fair market value at the time it was given away,
334.8 	sold, or disposed of, less the amount of compensation received.
334.9 	For any uncompensated transfer, the number of months of
334.10 	ineligibility, including partial months, shall be calculated by
334.11 	dividing the uncompensated transfer amount by the average
334.12 	monthly per person payment made by the medical assistance
334.13 	program to skilled nursing facilities for the previous calendar
334.14 	year.  The individual shall remain ineligible until this fixed
334.15 	period has expired.  The period of ineligibility may exceed 30
334.16 	months, and a reapplication for benefits after 30 months from
334.17 	the date of the transfer shall not result in eligibility unless
334.18 	and until the period of ineligibility has expired.  The period
334.19 	of ineligibility begins in the month the transfer was reported
334.20 	to the county agency, or if the transfer was not reported, the
334.21 	month in which the county agency discovered the transfer,
334.22 	whichever comes first.  For applicants, the period of
334.23 	ineligibility begins on the date of the first approved
334.24 	application.
334.25 	(i) When determining eligibility for any state benefits
334.26 	under this subdivision, the income and resources of all
334.27 	noncitizens shall be deemed to include their sponsor's income
334.28 	and resources as defined in the Personal Responsibility and Work
334.29 	Opportunity Reconciliation Act of 1996, title IV, Public Law
334.30 	104-193, sections 421 and 422, and subsequently set out in
334.31 	federal rules.
334.32 	(j) Undocumented noncitizens and nonimmigrants are
334.33 	ineligible for general assistance medical care.  For purposes of
334.34 	this subdivision, a nonimmigrant is an individual in one or more
334.35 	of the classes listed in United States Code, title 8, section
334.36 	1101(a)(15), and an undocumented noncitizen is an individual who
335.1 	resides in the United States without the approval or
335.2 	acquiescence of the Immigration and Naturalization Service.
335.3 	(k) Notwithstanding any other provision of law, a
335.4 	noncitizen who is ineligible for medical assistance due to the
335.5 	deeming of a sponsor's income and resources, is ineligible for
335.6 	general assistance medical care.
335.7 	(l) Effective July 1, 2003, general assistance medical care
335.8 	emergency services end.
335.9 	
EFFECTIVE DATE. This section is effective October 1, 2005.

335.10 	Sec. 3. Minnesota Statutes 2004, section 256L.03,
335.11 	subdivision 3, is amended to read:
335.12 		Subd. 3.Inpatient hospital services.  (a) Covered health
335.13 	services shall include inpatient hospital services, including
335.14 	inpatient hospital mental health services and inpatient hospital
335.15 	and residential chemical dependency treatment, subject to those
335.16 	limitations necessary to coordinate the provision of these
335.17 	services with eligibility under the medical assistance
335.18 	spenddown.  Prior to July 1, 1997, the inpatient hospital
335.19 	benefit for adult enrollees is subject to an annual benefit
335.20 	limit of $10,000.  The inpatient hospital benefit for adult
335.21 	enrollees who qualify under section 256L.04, subdivision 7, or 
335.22 	who qualify under section 256L.04, subdivisions 1 and 2, with
335.23 	family gross income that exceeds 175 percent of the federal
335.24 	poverty guidelines and who are not pregnant, is subject to an
335.25 	annual limit of $10,000.
335.26 	(b) Admissions for inpatient hospital services paid for
335.27 	under section 256L.11, subdivision 3, must be certified as
335.28 	medically necessary in accordance with Minnesota Rules, parts
335.29 	9505.0500 to 9505.0540, except as provided in clauses (1) and
335.30 	(2):
335.31 	(1) all admissions must be certified, except those
335.32 	authorized under rules established under section 254A.03,
335.33 	subdivision 3, or approved under Medicare; and
335.34 	(2) payment under section 256L.11, subdivision 3, shall be
335.35 	reduced by five percent for admissions for which certification
335.36 	is requested more than 30 days after the day of admission.  The
336.1 	hospital may not seek payment from the enrollee for the amount
336.2 	of the payment reduction under this clause.
336.3 	
EFFECTIVE DATE. This section is effective October 1, 2005.

336.4 	Sec. 4. Minnesota Statutes 2004, section 256L.03,
336.5 	subdivision 5, is amended to read:
336.6 		Subd. 5.Co-payments and coinsurance.  (a) Except as
336.7 	provided in paragraphs (b) and (c), the MinnesotaCare benefit
336.8 	plan shall include the following co-payments and coinsurance
336.9 	requirements for all enrollees:
336.10 	(1) ten percent of the paid charges for inpatient hospital
336.11 	services for adult enrollees, subject to an annual inpatient
336.12 	out-of-pocket maximum of $1,000 per individual and $3,000 per
336.13 	family;
336.14 	(2) $3 per prescription for adult enrollees;
336.15 	(3) $25 for eyeglasses for adult enrollees; and 
336.16 	(4) $3 per nonpreventive visit.  For purposes of this
336.17 	subdivision, a visit means an episode of service which is
336.18 	required because of an enrollee's symptoms, diagnosis, or
336.19 	established illness, and which is delivered in an ambulatory
336.20 	setting by a physician or physician ancillary, chiropractor,
336.21 	podiatrist, advanced practice nurse, audiologist, optician, or
336.22 	optometrist;
336.23 	(5) $6 for nonemergency visits to a hospital-based
336.24 	emergency room; and 
336.25 	(6) 50 percent of the fee-for-service rate for adult dental
336.26 	care services other than preventive care services for persons
336.27 	eligible under section 256L.04, subdivisions 1 to 7, with income
336.28 	equal to or less than 175 percent of the federal poverty
336.29 	guidelines.
336.30 	(b) Paragraph (a), clause (1), does not apply to parents
336.31 	and relative caretakers of children under the age of 21 in
336.32 	households with family income equal to or less than 175 percent
336.33 	of the federal poverty guidelines.  Paragraph (a), clause (1),
336.34 	does not apply to parents and relative caretakers of children
336.35 	under the age of 21 in households with family income greater
336.36 	than 175 percent of the federal poverty guidelines for inpatient
337.1 	hospital admissions occurring on or after January 1, 2001.
337.2 	(c) Paragraph (a), clauses (1) to (4) (6), do not apply to
337.3 	pregnant women and children under the age of 21.
337.4 	(d) Adult enrollees with family gross income that exceeds
337.5 	175 percent of the federal poverty guidelines and who are not
337.6 	pregnant shall be financially responsible for the coinsurance
337.7 	amount, if applicable, and amounts which exceed the $10,000
337.8 	inpatient hospital benefit limit.
337.9 	(e) When a MinnesotaCare enrollee becomes a member of a
337.10 	prepaid health plan, or changes from one prepaid health plan to
337.11 	another during a calendar year, any charges submitted towards
337.12 	the $10,000 annual inpatient benefit limit, and any
337.13 	out-of-pocket expenses incurred by the enrollee for inpatient
337.14 	services, that were submitted or incurred prior to enrollment,
337.15 	or prior to the change in health plans, shall be disregarded.
337.16 	(f) Paragraph (a), clauses (4) and (5), are limited to one
337.17 	co-payment per day per provider.
337.18 	
EFFECTIVE DATE. This section is effective January 1, 2006.

337.19 	Sec. 5. Minnesota Statutes 2004, section 256L.04,
337.20 	subdivision 1, is amended to read:
337.21 		Subdivision 1.Families with children.  (a) Through
337.22 	September 30, 2005,families with children with family income
337.23 	equal to or less than 275 percent of the federal poverty
337.24 	guidelines for the applicable family size shall be eligible for
337.25 	MinnesotaCare according to this section. Beginning October 1,
337.26 	2005, children and pregnant women with family income equal to or
337.27 	less than 275 percent of the federal poverty guidelines for the
337.28 	applicable family size shall be eligible for MinnesotaCare
337.29 	according to this section.  Beginning October 1, 2005, parents,
337.30 	grandparents, foster parents, relative caretakers, and legal
337.31 	guardians ages 21 and over are not eligible for MinnesotaCare if
337.32 	their gross income exceeds 190 percent of the federal poverty
337.33 	guidelines for the applicable family size.All other provisions
337.34 	of sections 256L.01 to 256L.18, including the insurance-related
337.35 	barriers to enrollment under section 256L.07, shall apply unless
337.36 	otherwise specified.
338.1 	(b) Parents who enroll in the MinnesotaCare program must
338.2 	also enroll their children, if the children are eligible.
338.3 	Children may be enrolled separately without enrollment by
338.4 	parents.  However, if one parent in the household enrolls, both
338.5 	parents must enroll, unless other insurance is available.  If
338.6 	one child from a family is enrolled, all children must be
338.7 	enrolled, unless other insurance is available.  If one spouse in
338.8 	a household enrolls, the other spouse in the household must also
338.9 	enroll, unless other insurance is available.  Families cannot
338.10 	choose to enroll only certain uninsured members.
338.11 	(c) Beginning October 1, 2003, the dependent sibling
338.12 	definition no longer applies to the MinnesotaCare program.
338.13 	These persons are no longer counted in the parental household
338.14 	and may apply as a separate household.
338.15 	(d) Beginning July 1, 2003, or upon federal approval,
338.16 	whichever is later, parents are not eligible for MinnesotaCare
338.17 	if their gross income exceeds $50,000.

338.18 	Sec. 6. Minnesota Statutes 2004, section 256L.11,
338.19 	subdivision 6, is amended to read:
338.20 		Subd. 6.Enrollees 18 or older.  Payment by the
338.21 	MinnesotaCare program for inpatient hospital services provided
338.22 	to MinnesotaCare enrollees eligible under section 256L.04,
338.23 	subdivision 7, or who qualify under section 256L.04,
338.24 	subdivisions 1 and 2, with family gross income that exceeds 175
338.25 	percent of the federal poverty guidelines and who are not
338.26 	pregnant, who are 18 years old or older on the date of admission
338.27 	to the inpatient hospital must be in accordance with paragraphs
338.28 	(a) and (b).  Payment for adults who are not pregnant and are
338.29 	eligible under section 256L.04, subdivisions 1 and 2, and whose
338.30 	incomes are equal to or less than 175 percent of the federal
338.31 	poverty guidelines, shall be as provided for under paragraph (c).
338.32 	(a) If the medical assistance rate minus any co-payment
338.33 	required under section 256L.03, subdivision 4 5, is less than or
338.34 	equal to the amount remaining in the enrollee's benefit limit
338.35 	under section 256L.03, subdivision 3, payment must be the
338.36 	medical assistance rate minus any co-payment required under
339.1 	section 256L.03, subdivision 4 5.  The hospital must not seek
339.2 	payment from the enrollee in addition to the co-payment.  The
339.3 	MinnesotaCare payment plus the co-payment must be treated as
339.4 	payment in full.
339.5 	(b) If the medical assistance rate minus any co-payment
339.6 	required under section 256L.03, subdivision 4 5, is greater than
339.7 	the amount remaining in the enrollee's benefit limit under
339.8 	section 256L.03, subdivision 3, payment must be the lesser of:
339.9 	(1) the amount remaining in the enrollee's benefit limit;
339.10 	or
339.11 	(2) charges submitted for the inpatient hospital services
339.12 	less any co-payment established under section 256L.03,
339.13 	subdivision 4 5.
339.14 	The hospital may seek payment from the enrollee for the
339.15 	amount by which usual and customary charges exceed the payment
339.16 	under this paragraph.  If payment is reduced under section
339.17 	256L.03, subdivision 3, paragraph (b), the hospital may not seek
339.18 	payment from the enrollee for the amount of the reduction.
339.19 	(c) For admissions occurring during the period of July 1,
339.20 	1997, through June 30, 1998, for adults who are not pregnant and
339.21 	are eligible under section 256L.04, subdivisions 1 and 2, and
339.22 	whose incomes are equal to or less than 175 percent of the
339.23 	federal poverty guidelines, the commissioner shall pay hospitals
339.24 	directly, up to the medical assistance payment rate, for
339.25 	inpatient hospital benefits in excess of the $10,000 annual
339.26 	inpatient benefit limit.
339.27 	
EFFECTIVE DATE. This section is effective October 1, 2005.

339.28 	Sec. 7. INCREASE IN GAMC FUNDING RELATED TO SPENDDOWN
339.29 	STANDARD.
 339.30 	$3,062,000 in fiscal year 2006 and $3,964,000 in fiscal
339.31 	year 2007 are added to the appropriations in article 10, section
339.32 	2, subdivision 5, paragraph (d), to increase the general
339.33 	assistance medical care spenddown standard from 50 percent to 75
339.34 	percent of the federal poverty guidelines as provided in section
339.35 	2.

339.36 	Sec. 8. INCREASE IN MINNESOTACARE FUNDING RELATED TO
340.1 	INCOME STANDARD FOR PARENTS.
 340.2 	$2,191,000 in fiscal year 2006 and $6,048,000 in fiscal
340.3 	year 2007 are added to the appropriations in article 10, section
340.4 	2, subdivision 5, paragraph (a), for the purpose of sections 3
340.5 	to 6.

340.6 	Sec. 9. MINNESOTACARE OUTREACH GRANTS.
 340.7 	The repeal in article 3 of Minnesota Statutes 2004, section
340.8 	256L.04, subdivision 11, shall not take effect.

340.9 	Sec. 10. FUNDING FOR MINNESOTACARE OUTREACH GRANTS.
 340.10 	$750,000 in fiscal year 2006 and $750,000 in fiscal year
340.11 	2007 are added to the appropriations in article 10, section 2,
340.12 	subdivision 5, paragraph (f), to fund MinnesotaCare outreach
340.13 	grants under Minnesota Statutes, section 256L.04, subdivision
340.14 	11.  Federal administrative reimbursement resulting from
340.15 	MinnesotaCare outreach is appropriated to the commissioner for
340.16 	this purpose.

340.17 	Sec. 11. HOME CARE SERVICES REIMBURSEMENT RATES.
 340.18 	$1,261,000 in fiscal year 2006 and $1,973,000 in fiscal
340.19 	year 2007 are added to the appropriations in article 10, section
340.20 	2, subdivision 7, paragraph (d), to provide additional increases
340.21 	in reimbursement rates for home health services under Minnesota
340.22 	Statutes, section 256B.763.  The commissioner must recalculate
340.23 	the rates in Minnesota Statutes, section 256B.763, to reflect
340.24 	these additional appropriations.

340.25 	Sec. 12. OTHER PROVISIONS.
 340.26 	The amendments in this article to sections of law supersede
340.27 	and shall be implemented in place of the amendments or repealers
340.28 	to those sections in article 3.