1.1 	A bill for an act
1.2 	relating to state government; modifying licensing
1.3 	fees; expanding health care program eligibility;
1.4 	enacting health care cost containment measures;
1.5 	modifying mental and chemical health programs;
1.6 	adjusting family support programs; reducing certain
1.7 	parental fees; providing a cost-of-living adjustment
1.8 	for certain human services program employees;
1.9 	modifying long-term care programs; modifying
1.10 	continuing care programs; allowing penalties;
1.11 	appropriating money; amending Minnesota Statutes 2004,
1.12 	sections 62A.65, subdivision 3; 62D.12, subdivision
1.13 	19; 62J.04, subdivision 3, by adding a subdivision;
1.14 	62J.041; 62J.301, subdivision 3; 62J.38; 62J.43;
1.15 	62J.692, subdivision 3; 62L.08, subdivision 8; 62M.06,
1.16 	subdivisions 2, 3; 62Q.37, subdivision 7; 103I.101,
1.17 	subdivision 6; 103I.208, subdivisions 1, 2; 103I.235,
1.18 	subdivision 1; 103I.601, subdivision 2; 119B.011, by
1.19 	adding a subdivision; 119B.05, subdivision 1; 144.122;
1.20 	144.147, subdivisions 1, 2; 144.148, subdivision 1;
1.21 	144.1483; 144.1501, subdivisions 1, 2, 3, 4; 144.226,
1.22 	subdivision 1, by adding subdivisions; 144.3831,
1.23 	subdivision 1; 144.551, subdivision 1; 144.562,
1.24 	subdivision 2; 144.9504, subdivision 2; 144.98,
1.25 	subdivision 3; 144A.073, subdivision 10, by adding a
1.26 	subdivision; 144E.101, by adding a subdivision;
1.27 	145.9268; 157.15, by adding a subdivision; 157.16,
1.28 	subdivisions 2, 3, by adding subdivisions; 157.20,
1.29 	subdivisions 2, 2a; 241.01, by adding a subdivision;
1.30 	244.054; 245.4661, by adding subdivisions; 245.4874;
1.31 	245.4885, subdivisions 1, 2, by adding a subdivision;
1.32 	252.27, subdivision 2a; 252.291, by adding a
1.33 	subdivision; 254B.03, subdivision 4; 256.01,
1.34 	subdivision 2, by adding a subdivision; 256.045,
1.35 	subdivisions 3, 3a; 256.741, subdivision 4; 256.9365;
1.36 	256.969, by adding a subdivision; 256B.02, subdivision
1.37 	12; 256B.04, by adding a subdivision; 256B.055, by
1.38 	adding a subdivision; 256B.056, subdivisions 5, 5a,
1.39 	5b, 7, by adding subdivisions; 256B.057, subdivision
1.40 	1; 256B.0621, subdivisions 2, 3, 4, 5, 6, 7;
1.41 	256B.0622, subdivision 2; 256B.0625, subdivisions 2,
1.42 	9, 13e, as amended, 13f, 17, 19c, by adding
1.43 	subdivisions; 256B.0627, subdivisions 1, 4, 5, 9, by
1.44 	adding a subdivision; 256B.0916, by adding a
1.45 	subdivision; 256B.15, subdivisions 1, 1a, 2; 256B.19,
1.46 	subdivision 1; 256B.431, by adding subdivisions;
2.1 	256B.434, subdivision 4, by adding a subdivision;
2.2 	256B.440, by adding a subdivision; 256B.5012, by
2.3 	adding a subdivision; 256B.69, subdivisions 4, 23;
2.4 	256D.03, subdivision 4; 256D.045; 256D.44, subdivision
2.5 	5; 256J.021; 256J.08, subdivision 65; 256J.21,
2.6 	subdivision 2; 256J.39, by adding a subdivision;
2.7 	256J.521, subdivision 1; 256J.53, subdivision 2;
2.8 	256J.626, subdivisions 1, 2, 3, 4, 7; 256J.95,
2.9 	subdivisions 3, 9; 256L.01, subdivisions 4, 5;
2.10 	256L.03, subdivisions 1, 1b, 5; 256L.04, subdivisions
2.11 	2, 7, by adding subdivisions; 256L.05, subdivisions 3,
2.12 	3a; 256L.07, subdivisions 1, 3, by adding a
2.13 	subdivision; 256L.12, subdivision 6; 256L.15,
2.14 	subdivisions 2, 3; 295.582; 326.01, by adding a
2.15 	subdivision; 326.37, subdivision 1, by adding a
2.16 	subdivision; 326.38; 326.40, subdivision 1; 326.42,
2.17 	subdivision 2; 514.981, subdivision 6; 524.3-805;
2.18 	549.02, by adding a subdivision; 549.04; 641.15,
2.19 	subdivision 2; Laws 2003, First Special Session
2.20 	chapter 14, article 12, section 93; article 13C,
2.21 	section 2, subdivision 6; proposing coding for new law
2.22 	in Minnesota Statutes, chapters 62J; 144; 145; 151;
2.23 	256; 256B; 256J; 256L; 326; 501B; 641; repealing
2.24 	Minnesota Statutes 2004, sections 119B.074; 144.1486;
2.25 	157.215; 256B.0631; 256J.37, subdivisions 3a, 3b;
2.26 	256L.035; 326.45; 514.991; 514.992; 514.993; 514.994;
2.27 	514.995.
2.28 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.29 	ARTICLE 1
2.30 	HEALTH DEPARTMENT

2.31 	Section 1. [62J.495] HEALTH INFORMATION TECHNOLOGY AND
2.32 	INFRASTRUCTURE ADVISORY COMMITTEE.
2.33 		Subdivision 1.Establishment; members; duties. (a) The
2.34 	commissioner shall establish a Health Information Technology and
2.35 	Infrastructure Advisory Committee governed by section 15.059 to
2.36 	advise the commissioner on the following matters:
2.37 	(1) assessment of the use of health information technology
2.38 	by the state, licensed health care providers and facilities, and
2.39 	local public health agencies;
2.40 	(2) recommendations for implementing a statewide
2.41 	interoperable health information infrastructure, to include
2.42 	estimates of necessary resources, and for determining standards
2.43 	for administrative data exchange, clinical support programs, and
2.44 	maintenance of the security and confidentiality of individual
2.45 	patient data; and 
2.46 	(3) other related issues as requested by the commissioner.
2.47 	(b) The members of the Health Information Technology and
2.48 	Infrastructure Advisory Committee shall include the
2.49 	commissioners, or commissioners' designees, of health, human
3.1 	services, and commerce and additional members to be appointed by
3.2 	the commissioner to include persons representing Minnesota's
3.3 	local public health agencies, licensed hospitals and other
3.4 	licensed facilities and providers, the medical and nursing
3.5 	professions, health insurers and health plans, the state quality
3.6 	improvement organization, academic and research institutions,
3.7 	consumer advisory organizations with an interest and expertise
3.8 	in health information technology, and other stakeholders as
3.9 	identified by the Health Information Technology and
3.10 	Infrastructure Advisory Committee.
3.11 		Subd. 2.Annual report. The commissioner shall prepare
3.12 	and issue an annual report not later than January 30 of each
3.13 	year outlining progress to date in implementing a statewide
3.14 	health information infrastructure and recommending future
3.15 	projects.
3.16 		Subd. 3.Expiration. Notwithstanding section 15.059,
3.17 	this section expires June 30, 2009.

3.18 	Sec. 2. Minnesota Statutes 2004, section 103I.101,
3.19 	subdivision 6, is amended to read:
3.20 		Subd. 6.Fees for variances.  The commissioner shall
3.21 	charge a nonrefundable application fee of $150 $175 to cover the
3.22 	administrative cost of processing a request for a variance or
3.23 	modification of rules adopted by the commissioner under this
3.24 	chapter.
3.25 	
EFFECTIVE DATE. This section is effective July 1, 2006.

3.26 	Sec. 3. Minnesota Statutes 2004, section 103I.208,
3.27 	subdivision 1, is amended to read:
3.28 		Subdivision 1.Well notification fee.  The well
3.29 	notification fee to be paid by a property owner is:
3.30 	(1) for a new well, $150 $175, which includes the state
3.31 	core function fee;
3.32 	(2) for a well sealing, $30 $35 for each well, which
3.33 	includes the state core function fee, except that for monitoring
3.34 	wells constructed on a single property, having depths within a
3.35 	25 foot range, and sealed within 48 hours of start of
3.36 	construction, a single fee of $30 $35; and
4.1 	(3) for construction of a dewatering well, $150 $175, which
4.2 	includes the state core function fee, for each well except a
4.3 	dewatering project comprising five or more wells shall be
4.4 	assessed a single fee of $750 $875 for the wells recorded on the
4.5 	notification.
4.6 	
EFFECTIVE DATE. This section is effective July 1, 2006.

4.7 	Sec. 4. Minnesota Statutes 2004, section 103I.208,
4.8 	subdivision 2, is amended to read:
4.9 		Subd. 2.Permit fee.  The permit fee to be paid by a
4.10 	property owner is:
4.11 	(1) for a well that is not in use under a maintenance
4.12 	permit, $125 $150 annually;
4.13 	(2) for construction of a monitoring well, $150 $175, which
4.14 	includes the state core function fee;
4.15 	(3) for a monitoring well that is unsealed under a
4.16 	maintenance permit, $125 $150 annually;
4.17 	(4) for monitoring wells used as a leak detection device at
4.18 	a single motor fuel retail outlet, a single petroleum bulk
4.19 	storage site excluding tank farms, or a single agricultural
4.20 	chemical facility site, the construction permit fee
4.21 	is $150 $175, which includes the state core function fee, per
4.22 	site regardless of the number of wells constructed on the site,
4.23 	and the annual fee for a maintenance permit for unsealed
4.24 	monitoring wells is $125 $150 per site regardless of the number
4.25 	of monitoring wells located on site;
4.26 	(5) for a groundwater thermal exchange device, in addition
4.27 	to the notification fee for wells, $150 $175, which includes the
4.28 	state core function fee;
4.29 	(6) for a vertical heat exchanger, $150 $175;
4.30 	(7) for a dewatering well that is unsealed under a
4.31 	maintenance permit, $125 $150 annually for each well, except a
4.32 	dewatering project comprising more than five wells shall be
4.33 	issued a single permit for $625 $750 annually for wells recorded
4.34 	on the permit; and
4.35 	(8) for excavating holes for the purpose of installing
4.36 	elevator shafts, $150 $175 for each hole.
5.1 	
EFFECTIVE DATE. This section is effective July 1, 2006.

5.2 	Sec. 5. Minnesota Statutes 2004, section 103I.235,
5.3 	subdivision 1, is amended to read:
5.4 		Subdivision 1.Disclosure of wells to buyer.  (a) Before
5.5 	signing an agreement to sell or transfer real property, the
5.6 	seller must disclose in writing to the buyer information about
5.7 	the status and location of all known wells on the property, by
5.8 	delivering to the buyer either a statement by the seller that
5.9 	the seller does not know of any wells on the property, or a
5.10 	disclosure statement indicating the legal description and
5.11 	county, and a map drawn from available information showing the
5.12 	location of each well to the extent practicable.  In the
5.13 	disclosure statement, the seller must indicate, for each well,
5.14 	whether the well is in use, not in use, or sealed.
5.15 	(b) At the time of closing of the sale, the disclosure
5.16 	statement information, name and mailing address of the buyer,
5.17 	and the quartile, section, township, and range in which each
5.18 	well is located must be provided on a well disclosure
5.19 	certificate signed by the seller or a person authorized to act
5.20 	on behalf of the seller.
5.21 	(c) A well disclosure certificate need not be provided if
5.22 	the seller does not know of any wells on the property and the
5.23 	deed or other instrument of conveyance contains the statement:
5.24 	"The Seller certifies that the Seller does not know of any wells
5.25 	on the described real property."
5.26 	(d) If a deed is given pursuant to a contract for deed, the
5.27 	well disclosure certificate required by this subdivision shall
5.28 	be signed by the buyer or a person authorized to act on behalf
5.29 	of the buyer.  If the buyer knows of no wells on the property, a
5.30 	well disclosure certificate is not required if the following
5.31 	statement appears on the deed followed by the signature of the
5.32 	grantee or, if there is more than one grantee, the signature of
5.33 	at least one of the grantees:  "The Grantee certifies that the
5.34 	Grantee does not know of any wells on the described real
5.35 	property."  The statement and signature of the grantee may be on
5.36 	the front or back of the deed or on an attached sheet and an
6.1 	acknowledgment of the statement by the grantee is not required
6.2 	for the deed to be recordable.
6.3 	(e) This subdivision does not apply to the sale, exchange,
6.4 	or transfer of real property:
6.5 	(1) that consists solely of a sale or transfer of severed
6.6 	mineral interests; or
6.7 	(2) that consists of an individual condominium unit as
6.8 	described in chapters 515 and 515B.
6.9 	(f) For an area owned in common under chapter 515 or 515B
6.10 	the association or other responsible person must report to the
6.11 	commissioner by July 1, 1992, the location and status of all
6.12 	wells in the common area.  The association or other responsible
6.13 	person must notify the commissioner within 30 days of any change
6.14 	in the reported status of wells.
6.15 	(g) For real property sold by the state under section
6.16 	92.67, the lessee at the time of the sale is responsible for
6.17 	compliance with this subdivision.
6.18 	(h) If the seller fails to provide a required well
6.19 	disclosure certificate, the buyer, or a person authorized to act
6.20 	on behalf of the buyer, may sign a well disclosure certificate
6.21 	based on the information provided on the disclosure statement
6.22 	required by this section or based on other available information.
6.23 	(i) A county recorder or registrar of titles may not record
6.24 	a deed or other instrument of conveyance dated after October 31,
6.25 	1990, for which a certificate of value is required under section
6.26 	272.115, or any deed or other instrument of conveyance dated
6.27 	after October 31, 1990, from a governmental body exempt from the
6.28 	payment of state deed tax, unless the deed or other instrument
6.29 	of conveyance contains the statement made in accordance with
6.30 	paragraph (c) or (d) or is accompanied by the well disclosure
6.31 	certificate containing all the information required by paragraph
6.32 	(b) or (d).  The county recorder or registrar of titles must not
6.33 	accept a certificate unless it contains all the required
6.34 	information.  The county recorder or registrar of titles shall
6.35 	note on each deed or other instrument of conveyance accompanied
6.36 	by a well disclosure certificate that the well disclosure
7.1 	certificate was received.  The notation must include the
7.2 	statement "No wells on property" if the disclosure certificate
7.3 	states there are no wells on the property.  The well disclosure
7.4 	certificate shall not be filed or recorded in the records
7.5 	maintained by the county recorder or registrar of titles.  After
7.6 	noting "No wells on property" on the deed or other instrument of
7.7 	conveyance, the county recorder or registrar of titles shall
7.8 	destroy or return to the buyer the well disclosure certificate.
7.9 	The county recorder or registrar of titles shall collect from
7.10 	the buyer or the person seeking to record a deed or other
7.11 	instrument of conveyance, a fee of $30 $40 for receipt of a
7.12 	completed well disclosure certificate.  By the tenth day of each
7.13 	month, the county recorder or registrar of titles shall transmit
7.14 	the well disclosure certificates to the commissioner of health.
7.15 	By the tenth day after the end of each calendar quarter, the
7.16 	county recorder or registrar of titles shall transmit to the
7.17 	commissioner of health $27.50 $32.50 of the fee for each well
7.18 	disclosure certificate received during the quarter.  The
7.19 	commissioner shall maintain the well disclosure certificate for
7.20 	at least six years.  The commissioner may store the certificate
7.21 	as an electronic image.  A copy of that image shall be as valid
7.22 	as the original.
7.23 	(j) No new well disclosure certificate is required under
7.24 	this subdivision if the buyer or seller, or a person authorized
7.25 	to act on behalf of the buyer or seller, certifies on the deed
7.26 	or other instrument of conveyance that the status and number of
7.27 	wells on the property have not changed since the last previously
7.28 	filed well disclosure certificate.  The following statement, if
7.29 	followed by the signature of the person making the statement, is
7.30 	sufficient to comply with the certification requirement of this
7.31 	paragraph:  "I am familiar with the property described in this
7.32 	instrument and I certify that the status and number of wells on
7.33 	the described real property have not changed since the last
7.34 	previously filed well disclosure certificate."  The
7.35 	certification and signature may be on the front or back of the
7.36 	deed or on an attached sheet and an acknowledgment of the
8.1 	statement is not required for the deed or other instrument of
8.2 	conveyance to be recordable.
8.3 	(k) The commissioner in consultation with county recorders
8.4 	shall prescribe the form for a well disclosure certificate and
8.5 	provide well disclosure certificate forms to county recorders
8.6 	and registrars of titles and other interested persons.
8.7 	(l) Failure to comply with a requirement of this
8.8 	subdivision does not impair:
8.9 	(1) the validity of a deed or other instrument of
8.10 	conveyance as between the parties to the deed or instrument or
8.11 	as to any other person who otherwise would be bound by the deed
8.12 	or instrument; or
8.13 	(2) the record, as notice, of any deed or other instrument
8.14 	of conveyance accepted for filing or recording contrary to the
8.15 	provisions of this subdivision.
8.16 	
EFFECTIVE DATE. This section is effective July 1, 2006.

8.17 	Sec. 6. Minnesota Statutes 2004, section 103I.601,
8.18 	subdivision 2, is amended to read:
8.19 		Subd. 2.License required to make borings.  (a) Except as
8.20 	provided in paragraph (b) (d), a person may must not make an
8.21 	exploratory boring without an exploratory borer's explorer's 
8.22 	license. The fee for an explorer's license is $75.  The
8.23 	explorer's license is valid until the date prescribed in the
8.24 	license by the commissioner.
8.25 	(b) A person must file an application and renewal
8.26 	application fee to renew the explorer's license by the date
8.27 	stated in the license.  The renewal application fee is $75.
8.28 	(c) If the licensee submits an application fee after the
8.29 	required renewal date, the licensee:
8.30 	(1) must include a late fee of $75; and 
8.31 	(2) may not conduct activities authorized by an explorer's
8.32 	license until the renewal application, renewal application fee,
8.33 	late fee, and sealing reports required in subdivision 9 are
8.34 	submitted.
8.35 	(d) An explorer may must designate a responsible individual
8.36 	to supervise and oversee the making of exploratory borings.
9.1 	Before an individual supervises or oversees an exploratory
9.2 	boring, the individual must file an application and application
9.3 	fee of $75 to qualify as a responsible individual.  The
9.4 	individual must take and pass an examination relating to
9.5 	construction, location, and sealing of exploratory borings.  A
9.6 	professional engineer registered or geoscientist licensed under
9.7 	sections 326.02 to 326.15 or a certified professional geologist
9.8 	certified by the American Institute of Professional Geologists 
9.9 	is not required to take the examination required in this
9.10 	subdivision,but must be licensed certified as a responsible
9.11 	individual to make supervise an exploratory boring.

9.12 	Sec. 7. Minnesota Statutes 2004, section 144.122, is
9.13 	amended to read:
9.14 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
9.15 	(a) The state commissioner of health, by rule, may
9.16 	prescribe reasonable procedures and fees for filing with the
9.17 	commissioner as prescribed by statute and for the issuance of
9.18 	original and renewal permits, licenses, registrations, and
9.19 	certifications issued under authority of the commissioner.  The
9.20 	expiration dates of the various licenses, permits,
9.21 	registrations, and certifications as prescribed by the rules
9.22 	shall be plainly marked thereon.  Fees may include application
9.23 	and examination fees and a penalty fee for renewal applications
9.24 	submitted after the expiration date of the previously issued
9.25 	permit, license, registration, and certification.  The
9.26 	commissioner may also prescribe, by rule, reduced fees for
9.27 	permits, licenses, registrations, and certifications when the
9.28 	application therefor is submitted during the last three months
9.29 	of the permit, license, registration, or certification period.
9.30 	Fees proposed to be prescribed in the rules shall be first
9.31 	approved by the Department of Finance.  All fees proposed to be
9.32 	prescribed in rules shall be reasonable.  The fees shall be in
9.33 	an amount so that the total fees collected by the commissioner
9.34 	will, where practical, approximate the cost to the commissioner
9.35 	in administering the program.  All fees collected shall be
9.36 	deposited in the state treasury and credited to the state
10.1 	government special revenue fund unless otherwise specifically
10.2 	appropriated by law for specific purposes.
10.3 	(b) The commissioner shall adopt rules establishing
10.4 	criteria and procedures for refusal to grant or renew licenses
10.5 	and registrations, and for suspension and revocation of licenses
10.6 	and registrations.
10.7 	(c) The commissioner may refuse to grant or renew licenses
10.8 	and registrations, or suspend or revoke licenses and
10.9 	registrations, according to the commissioner's criteria and
10.10 	procedures as adopted by rule.
10.11 	(d) The commissioner may charge a fee for voluntary
10.12 	certification of medical laboratories and environmental
10.13 	laboratories, and for environmental and medical laboratory
10.14 	services provided by the department, without complying with
10.15 	paragraph (a) or chapter 14.  Fees charged for environment and
10.16 	medical laboratory services provided by the department must be
10.17 	approximately equal to the costs of providing the services.
10.18 	(c) (e) The commissioner may develop a schedule of fees for
10.19 	diagnostic evaluations conducted at clinics held by the services
10.20 	for children with handicaps program.  All receipts generated by
10.21 	the program are annually appropriated to the commissioner for
10.22 	use in the maternal and child health program.
10.23 	(d) (f) The commissioner shall set license fees for
10.24 	hospitals and nursing homes that are not boarding care homes at
10.25 	the following levels:
10.26 	Joint Commission on Accreditation of Healthcare
10.27 	Organizations (JCAHO hospitals) $7,055 $7,555 plus $13 per bed 
10.28 	Non-JCAHO hospitals $4,680 $5,180 plus $234 
10.29 	$247 per bed
10.30 	Nursing home                     $183 plus $91 per bed
10.31 	The commissioner shall set license fees for outpatient
10.32 	surgical centers, boarding care homes, and supervised living
10.33 	facilities at the following levels:
10.34 	Outpatient surgical centers $1,512 $3,349 
10.35 	Boarding care homes              $183 plus $91 per bed
10.36 	Supervised living facilities     $183 plus $91 per bed.
11.1 	(e) (g) Unless prohibited by federal law, the commissioner
11.2 	of health shall charge applicants the following fees to cover
11.3 	the cost of any initial certification surveys required to
11.4 	determine a provider's eligibility to participate in the
11.5 	Medicare or Medicaid program:
11.6 	Prospective payment surveys for          $  900
11.7 	hospitals
11.9 	Swing bed surveys for nursing homes      $1,200
11.11 	Psychiatric hospitals                    $1,400
11.13 	Rural health facilities                  $1,100
11.15 	Portable x-ray providers                 $  500
11.17 	Home health agencies                     $1,800
11.19 	Outpatient therapy agencies              $  800
11.21 	End stage renal dialysis providers       $2,100
11.23 	Independent therapists                   $  800
11.25 	Comprehensive rehabilitation             $1,200
11.26 	outpatient facilities
11.28 	Hospice providers                        $1,700
11.30 	Ambulatory surgical providers            $1,800
11.32 	Hospitals                                $4,200
11.34 	Other provider categories or             Actual surveyor costs:
11.35 	additional resurveys required            average surveyor cost x
11.36 	to complete initial certification        number of hours for the
11.37 	                                         survey process.
11.38 	These fees shall be submitted at the time of the
11.39 	application for federal certification and shall not be
11.40 	refunded.  All fees collected after the date that the imposition
11.41 	of fees is not prohibited by federal law shall be deposited in
11.42 	the state treasury and credited to the state government special
11.43 	revenue fund.
11.44 	(h) The commissioner shall charge the following fees for
11.45 	examinations, registrations, licenses, and inspections:
11.46 	Plumbing examination $ 50
11.47 	Water conditioning examination $ 50
11.48 	Plumbing bond registration fee $ 40
11.49 	Water conditioning bond registration fee $ 40
11.50 	Master plumber's license $120
11.51 	Restricted plumbing contractor license $ 90
12.1 	Journeyman plumber's license $ 55
12.2 	Apprentice registration $ 25
12.3 	Water conditioning contractor license $ 70
12.4 	Water conditioning installer license $ 35
12.5 	Residential inspection fee (each visit) $ 50 
12.6 	Public, commercial, and Inspection fee
12.7 	industrial inspections
12.8 	   25 or fewer drainage
12.9 	   fixture units $ 300
12.10 	   26 to 50 drainage
12.11 	   fixture units $ 900
12.12 	   51 to 150 drainage
12.13 	   fixture units $1,200
12.14 	   151 to 249 drainage
12.15 	   fixture units $1,500
12.16 	   250 or more drainage
12.17 	   fixture units $1,800
12.18 	   Callback fee (each visit) $ 100 

12.19 	Sec. 8. Minnesota Statutes 2004, section 144.147,
12.20 	subdivision 1, is amended to read:
12.21 		Subdivision 1.Definition.  "Eligible rural hospital"
12.22 	means any nonfederal, general acute care hospital that:
12.23 	(1) is either located in a rural area, as defined in the
12.24 	federal Medicare regulations, Code of Federal Regulations, title
12.25 	42, section 405.1041, or located in a community with a
12.26 	population of less than 10,000 15,000, according to United
12.27 	States Census Bureau statistics, outside the seven-county
12.28 	metropolitan area;
12.29 	(2) has 50 or fewer beds; and
12.30 	(3) is not for profit.

12.31 	Sec. 9. Minnesota Statutes 2004, section 144.147,
12.32 	subdivision 2, is amended to read:
12.33 		Subd. 2.Grants authorized.  The commissioner shall
12.34 	establish a program of grants to assist eligible rural
12.35 	hospitals.  The commissioner shall award grants to hospitals and
12.36 	communities for the purposes set forth in paragraphs (a) and (b).
13.1 	(a) Grants may be used by hospitals and their communities
13.2 	to develop strategic plans for preserving or enhancing access to
13.3 	health services.  At a minimum, a strategic plan must consist of:
13.4 	(1) a needs assessment to determine what health services
13.5 	are needed and desired by the community.  The assessment must
13.6 	include interviews with or surveys of area health professionals,
13.7 	local community leaders, and public hearings;
13.8 	(2) an assessment of the feasibility of providing needed
13.9 	health services that identifies priorities and timeliness for
13.10 	potential changes; and
13.11 	(3) an implementation plan.
13.12 	The strategic plan must be developed by a committee that
13.13 	includes representatives from the hospital, local public health
13.14 	agencies, other health providers, and consumers from the
13.15 	community.
13.16 	(b) The grants may also be used by eligible rural hospitals
13.17 	that have developed strategic plans to implement transition
13.18 	projects to modify the type and extent of services provided, in
13.19 	order to reflect the needs of that plan.  Grants may be used by
13.20 	hospitals under this paragraph to develop hospital-based
13.21 	physician practices that integrate hospital and existing medical
13.22 	practice facilities that agree to transfer their practices,
13.23 	equipment, staffing, and administration to the hospital.  The
13.24 	grants may also be used by the hospital to establish a health
13.25 	provider cooperative, a telemedicine system, an electronic
13.26 	health records system,or a rural health care system or to cover
13.27 	expenses associated with being designated as a critical access
13.28 	hospital for the Medicare rural hospital flexibility program.
13.29 	Not more than one-third of any grant shall be used to offset
13.30 	losses incurred by physicians agreeing to transfer their
13.31 	practices to hospitals. The commissioner shall give priority to
13.32 	grant applications for projects involving electronic health
13.33 	records systems.

13.34 	Sec. 10. [144.1476] RURAL PHARMACY PLANNING AND
13.35 	TRANSITION GRANT PROGRAM.
13.36 		Subdivision 1.Definitions. (a) For the purposes of this
14.1 	section, the following definitions apply.
14.2 	(b) "Eligible rural community" means:
14.3 	(1) a Minnesota community that is located in a rural area,
14.4 	as defined in the federal Medicare regulations, Code of Federal
14.5 	Regulations, title 42, section 405.1041; or 
14.6 	(2) a Minnesota community that has a population of less
14.7 	than 10,000, according to the United States Bureau of
14.8 	Statistics, and that is outside the seven-county metropolitan
14.9 	area, excluding the cities of Duluth, Mankato, Moorhead,
14.10 	Rochester, and St. Cloud.
14.11 	(c) "Health care provider" means a hospital, clinic,
14.12 	pharmacy, long-term care institution, or other health care
14.13 	facility that is licensed, certified, or otherwise authorized by
14.14 	the laws of this state to provide health care.
14.15 	(d) "Pharmacist" means an individual with a valid license
14.16 	issued under chapter 151 to practice pharmacy.
14.17 	(e) "Pharmacy" has the meaning given under section 151.01,
14.18 	subdivision 2.
14.19 		Subd. 2.Grants authorized; eligibility. (a) The
14.20 	commissioner of health shall establish a program to award grants
14.21 	to eligible rural communities or health care providers in
14.22 	eligible rural communities for planning, establishing, keeping
14.23 	in operation, or providing health care services that preserve
14.24 	access to prescription medications and the skills of a
14.25 	pharmacist according to sections 151.01 to 151.40.
14.26 	(b) To be eligible for a grant, an applicant must develop a
14.27 	strategic plan for preserving or enhancing access to
14.28 	prescription medications and the skills of a pharmacist.  At a
14.29 	minimum, a strategic plan must consist of:
14.30 	(1) a needs assessment to determine what pharmacy services
14.31 	are needed and desired by the community.  The assessment must
14.32 	include interviews with or surveys of area and local health
14.33 	professionals, local community leaders, and public officials;
14.34 	(2) an assessment of the feasibility of providing needed
14.35 	pharmacy services that identifies priorities and timelines for
14.36 	potential changes; and 
15.1 	(3) an implementation plan.
15.2 	(c) A grant may be used by a recipient that has developed a
15.3 	strategic plan to implement transition projects to modify the
15.4 	type and extent of pharmacy services provided, in order to
15.5 	reflect the needs of the community.  Grants may also be used by
15.6 	recipients:
15.7 	(1) to develop pharmacy practices that integrate pharmacy
15.8 	and existing health care provider facilities; or 
15.9 	(2) to establish a pharmacy provider cooperative or
15.10 	initiatives that maintain local access to prescription
15.11 	medications and the skills of a pharmacist.
15.12 		Subd. 3.Consideration of grants. In determining which
15.13 	applicants shall receive grants under this section, the
15.14 	commissioner of health shall appoint a committee comprised of
15.15 	members with experience and knowledge about rural pharmacy
15.16 	issues, including, but not limited to, two rural pharmacists
15.17 	with a community pharmacy background, two health care providers
15.18 	from rural communities, one representative from a statewide
15.19 	pharmacist organization, and one representative of the Board of
15.20 	Pharmacy.  A representative of the commissioner may serve on the
15.21 	committee in an ex officio status.  In determining who shall
15.22 	receive a grant, the committee shall take into account:
15.23 	(1) improving or maintaining access to prescription
15.24 	medications and the skills of a pharmacist;
15.25 	(2) changes in service populations;
15.26 	(3) the extent community pharmacy needs are not currently
15.27 	met by other providers in the area;
15.28 	(4) the financial condition of the applicant;
15.29 	(5) the integration of pharmacy services into existing
15.30 	health care services; and 
15.31 	(6) community support.
15.32 	The commissioner may also take into account other relevant
15.33 	factors.
15.34 		Subd. 4.Allocation of grants. (a) The commissioner
15.35 	shall establish a deadline for receiving applications and must
15.36 	make a final decision on the funding of each application within
16.1 	60 days of the deadline.  An applicant must apply no later than
16.2 	March 1 of each fiscal year for grants awarded for that fiscal
16.3 	year.
16.4 	(b) Any grant awarded must not exceed $50,000 a year and
16.5 	may not exceed a one-year term.
16.6 	(c) Applicants may apply to the program each year they are
16.7 	eligible.
16.8 	(d) Project grants may not be used to retire debt incurred
16.9 	with respect to any capitol expenditure made prior to the date
16.10 	on which the project is initiated.
16.11 		Subd. 5.Evaluation. The commissioner shall evaluate the
16.12 	overall effectiveness of the grant program and may collect
16.13 	progress reports and other information from grantees needed for
16.14 	program evaluation.  An academic institution that has the
16.15 	expertise in evaluating rural pharmacy outcomes may participate
16.16 	in the program evaluation if asked by a grantee or the
16.17 	commissioner.  The commissioner shall compile summaries of
16.18 	successful grant projects and other model community efforts to
16.19 	preserve access to prescription medications and the skills of a
16.20 	pharmacist, and make this information available to Minnesota
16.21 	communities seeking to address local pharmacy issues.

16.22 	Sec. 11. Minnesota Statutes 2004, section 144.148,
16.23 	subdivision 1, is amended to read:
16.24 		Subdivision 1.Definition.  (a) For purposes of this
16.25 	section, the following definitions apply.
16.26 	(b) "Eligible rural hospital" means any nonfederal, general
16.27 	acute care hospital that:
16.28 	(1) is either located in a rural area, as defined in the
16.29 	federal Medicare regulations, Code of Federal Regulations, title
16.30 	42, section 405.1041, or located in a community with a
16.31 	population of less than 10,000 15,000, according to United
16.32 	States Census Bureau statistics, outside the seven-county
16.33 	metropolitan area;
16.34 	(2) has 50 or fewer beds; and
16.35 	(3) is not for profit.
16.36 	(c) "Eligible project" means a modernization project to
17.1 	update, remodel, or replace aging hospital facilities and
17.2 	equipment necessary to maintain the operations of a hospital,
17.3 	including establishing an electronic health records system.  The
17.4 	commissioner shall give priority to grant applications for
17.5 	projects involving electronic health records systems.

17.6 	Sec. 12. Minnesota Statutes 2004, section 144.1483, is
17.7 	amended to read:
17.8 	144.1483 RURAL HEALTH INITIATIVES.
17.9 	The commissioner of health, through the Office of Rural
17.10 	Health, and consulting as necessary with the commissioner of
17.11 	human services, the commissioner of commerce, the Higher
17.12 	Education Services Office, and other state agencies, shall:
17.13 	(1) develop a detailed plan regarding the feasibility of
17.14 	coordinating rural health care services by organizing individual
17.15 	medical providers and smaller hospitals and clinics into
17.16 	referral networks with larger rural hospitals and clinics that
17.17 	provide a broader array of services;
17.18 	(2) develop and implement a program to assist rural
17.19 	communities in establishing community health centers, as
17.20 	required by section 144.1486;
17.21 	(3) develop recommendations regarding health education and
17.22 	training programs in rural areas, including but not limited to a
17.23 	physician assistants' training program, continuing education
17.24 	programs for rural health care providers, and rural outreach
17.25 	programs for nurse practitioners within existing training
17.26 	programs;
17.27 	(4) (3) develop a statewide, coordinated recruitment
17.28 	strategy for health care personnel and maintain a database on
17.29 	health care personnel as required under section 144.1485;
17.30 	(5) (4) develop and administer technical assistance
17.31 	programs to assist rural communities in:  (i) planning and
17.32 	coordinating the delivery of local health care services; and
17.33 	(ii) hiring physicians, nurse practitioners, public health
17.34 	nurses, physician assistants, and other health personnel;
17.35 	(6) (5) study and recommend changes in the regulation of
17.36 	health care personnel, such as nurse practitioners and physician
18.1 	assistants, related to scope of practice, the amount of on-site
18.2 	physician supervision, and dispensing of medication, to address
18.3 	rural health personnel shortages;
18.4 	(7) (6) support efforts to ensure continued funding for
18.5 	medical and nursing education programs that will increase the
18.6 	number of health professionals serving in rural areas;
18.7 	(8) (7) support efforts to secure higher reimbursement for
18.8 	rural health care providers from the Medicare and medical
18.9 	assistance programs;
18.10 	(9) (8) coordinate the development of a statewide plan for
18.11 	emergency medical services, in cooperation with the Emergency
18.12 	Medical Services Advisory Council;
18.13 	(10) (9) establish a Medicare rural hospital flexibility
18.14 	program pursuant to section 1820 of the federal Social Security
18.15 	Act, United States Code, title 42, section 1395i-4, by
18.16 	developing a state rural health plan and designating, consistent
18.17 	with the rural health plan, rural nonprofit or public hospitals
18.18 	in the state as critical access hospitals.  Critical access
18.19 	hospitals shall include facilities that are certified by the
18.20 	state as necessary providers of health care services to
18.21 	residents in the area.  Necessary providers of health care
18.22 	services are designated as critical access hospitals on the
18.23 	basis of being more than 20 miles, defined as official mileage
18.24 	as reported by the Minnesota Department of Transportation, from
18.25 	the next nearest hospital, being the sole hospital in the
18.26 	county, being a hospital located in a county with a designated
18.27 	medically underserved area or health professional shortage area,
18.28 	or being a hospital located in a county contiguous to a county
18.29 	with a medically underserved area or health professional
18.30 	shortage area.  A critical access hospital located in a county
18.31 	with a designated medically underserved area or a health
18.32 	professional shortage area or in a county contiguous to a county
18.33 	with a medically underserved area or health professional
18.34 	shortage area shall continue to be recognized as a critical
18.35 	access hospital in the event the medically underserved area or
18.36 	health professional shortage area designation is subsequently
19.1 	withdrawn; and
19.2 	(11) (10) carry out other activities necessary to address
19.3 	rural health problems.

19.4 	Sec. 13. Minnesota Statutes 2004, section 144.1501,
19.5 	subdivision 1, is amended to read:
19.6 		Subdivision 1.Definitions.  (a) For purposes of this
19.7 	section, the following definitions apply.
19.8 	(b) "Designated rural area" means:
19.9 	(1) an area in Minnesota outside the counties of Anoka,
19.10 	Carver, Dakota, Hennepin, Ramsey, Scott, and Washington,
19.11 	excluding the cities of Duluth, Mankato, Moorhead, Rochester,
19.12 	and St. Cloud; or
19.13 	(2) a municipal corporation, as defined under section
19.14 	471.634, that is physically located, in whole or in part, in an
19.15 	area defined as a designated rural area under clause (1).
19.16 	(c) "Emergency circumstances" means those conditions that
19.17 	make it impossible for the participant to fulfill the service
19.18 	commitment, including death, total and permanent disability, or
19.19 	temporary disability lasting more than two years.
19.20 	(d) "Medical resident" means an individual participating in
19.21 	a medical residency in family practice, internal medicine,
19.22 	obstetrics and gynecology, pediatrics, or psychiatry.
19.23 	(e) "Midlevel practitioner" means a nurse practitioner,
19.24 	nurse-midwife, nurse anesthetist, advanced clinical nurse
19.25 	specialist, or physician assistant.
19.26 	(f) "Nurse" means an individual who has completed training
19.27 	and received all licensing or certification necessary to perform
19.28 	duties as a licensed practical nurse or registered nurse.
19.29 	(g) "Nurse-midwife" means a registered nurse who has
19.30 	graduated from a program of study designed to prepare registered
19.31 	nurses for advanced practice as nurse-midwives.
19.32 	(h) "Nurse practitioner" means a registered nurse who has
19.33 	graduated from a program of study designed to prepare registered
19.34 	nurses for advanced practice as nurse practitioners.
19.35 	(i) "Pharmacist" means an individual with a valid license
19.36 	issued under chapter 151 to practice pharmacy.
20.1 	(j) "Physician" means an individual who is licensed to
20.2 	practice medicine in the areas of family practice, internal
20.3 	medicine, obstetrics and gynecology, pediatrics, or psychiatry.
20.4 	(j) (k) "Physician assistant" means a person registered
20.5 	under chapter 147A.
20.6 	(k) (l) "Qualified educational loan" means a government,
20.7 	commercial, or foundation loan for actual costs paid for
20.8 	tuition, reasonable education expenses, and reasonable living
20.9 	expenses related to the graduate or undergraduate education of a
20.10 	health care professional.
20.11 	(l) (m) "Underserved urban community" means a Minnesota
20.12 	urban area or population included in the list of designated
20.13 	primary medical care health professional shortage areas (HPSAs),
20.14 	medically underserved areas (MUAs), or medically underserved
20.15 	populations (MUPs) maintained and updated by the United States
20.16 	Department of Health and Human Services.

20.17 	Sec. 14. Minnesota Statutes 2004, section 144.1501,
20.18 	subdivision 2, is amended to read:
20.19 		Subd. 2.Creation of account. (a) A health professional
20.20 	education loan forgiveness program account is established.  The
20.21 	commissioner of health shall use money from the account to
20.22 	establish a loan forgiveness program:
20.23 	(1) for medical residents agreeing to practice in
20.24 	designated rural areas or underserved urban communities,or
20.25 	specializing in the area of pediatric psychiatry;
20.26 	(2) for midlevel practitioners agreeing to practice in
20.27 	designated rural areas, and or to teach for at least 20 hours
20.28 	per week in the nursing field in a postsecondary program;
20.29 	(3) for nurses who agree to practice in a Minnesota nursing
20.30 	home or intermediate care facility for persons with mental
20.31 	retardation or related conditions or to teach for at least 20
20.32 	hours per week in the nursing field in a postsecondary program;
20.33 	(4) for other health care technicians agreeing to teach for
20.34 	at least 20 hours per week in their designated field in a
20.35 	postsecondary program.  The commissioner, in consultation with
20.36 	the Healthcare Education-Industry Partnership, shall determine
21.1 	the health care fields where the need is the greatest,
21.2 	including, but not limited to, respiratory therapy, clinical
21.3 	laboratory technology, radiologic technology, and surgical
21.4 	technology; and 
21.5 	(5) for pharmacists who agree to practice in designated
21.6 	rural areas.
21.7 	(b) Appropriations made to the account do not cancel and
21.8 	are available until expended, except that at the end of each
21.9 	biennium, any remaining balance in the account that is not
21.10 	committed by contract and not needed to fulfill existing
21.11 	commitments shall cancel to the fund.

21.12 	Sec. 15. Minnesota Statutes 2004, section 144.1501,
21.13 	subdivision 3, is amended to read:
21.14 		Subd. 3.Eligibility.  (a) To be eligible to participate
21.15 	in the loan forgiveness program, an individual must:
21.16 	(1) be a medical resident or a licensed pharmacist or be
21.17 	enrolled in a midlevel practitioner, registered nurse, or a 
21.18 	licensed practical nurse training program; and
21.19 	(2) submit an application to the commissioner of health.
21.20 	(b) An applicant selected to participate must sign a
21.21 	contract to agree to serve a minimum three-year full-time
21.22 	service obligation according to subdivision 2, which shall begin
21.23 	no later than March 31 following completion of required training.

21.24 	Sec. 16. Minnesota Statutes 2004, section 144.1501,
21.25 	subdivision 4, is amended to read:
21.26 		Subd. 4.Loan forgiveness.  The commissioner of health
21.27 	may select applicants each year for participation in the loan
21.28 	forgiveness program, within the limits of available funding. The
21.29 	commissioner shall distribute available funds for loan
21.30 	forgiveness proportionally among the eligible professions
21.31 	according to the vacancy rate for each profession in the
21.32 	required geographic area or ,facility type, teaching area, or
21.33 	specialty type specified in subdivision 2.  The commissioner
21.34 	shall allocate funds for physician loan forgiveness so that 75
21.35 	percent of the funds available are used for rural physician loan
21.36 	forgiveness and 25 percent of the funds available are used for
22.1 	underserved urban communities and pediatric psychiatry loan
22.2 	forgiveness.  If the commissioner does not receive enough
22.3 	qualified applicants each year to use the entire allocation of
22.4 	funds for urban underserved communities or pediatric psychiatry,
22.5 	the remaining funds may be allocated for rural physician loan
22.6 	forgiveness.  Applicants are responsible for securing their own
22.7 	qualified educational loans.  The commissioner shall select
22.8 	participants based on their suitability for practice serving the
22.9 	required geographic area or facility type specified in
22.10 	subdivision 2, as indicated by experience or training.  The
22.11 	commissioner shall give preference to applicants closest to
22.12 	completing their training.  For each year that a participant
22.13 	meets the service obligation required under subdivision 3, up to
22.14 	a maximum of four years, the commissioner shall make annual
22.15 	disbursements directly to the participant equivalent to 15
22.16 	percent of the average educational debt for indebted graduates
22.17 	in their profession in the year closest to the applicant's
22.18 	selection for which information is available, not to exceed the
22.19 	balance of the participant's qualifying educational loans.
22.20 	Before receiving loan repayment disbursements and as requested,
22.21 	the participant must complete and return to the commissioner an
22.22 	affidavit of practice form provided by the commissioner
22.23 	verifying that the participant is practicing as required under
22.24 	subdivisions 2 and 3.  The participant must provide the
22.25 	commissioner with verification that the full amount of loan
22.26 	repayment disbursement received by the participant has been
22.27 	applied toward the designated loans.  After each disbursement,
22.28 	verification must be received by the commissioner and approved
22.29 	before the next loan repayment disbursement is made.
22.30 	Participants who move their practice remain eligible for loan
22.31 	repayment as long as they practice as required under subdivision
22.32 	2.

22.33 	Sec. 17. Minnesota Statutes 2004, section 144.226,
22.34 	subdivision 1, is amended to read:
22.35 		Subdivision 1.Which services are for fee.  The fees for
22.36 	the following services shall be the following or an amount
23.1 	prescribed by rule of the commissioner:
23.2 	(a) The fee for the issuance of a certified vital record or
23.3 	a certification that the vital record cannot be found is $8 $9.
23.4 	No fee shall be charged for a certified birth or death record
23.5 	that is reissued within one year of the original issue, if an
23.6 	amendment is made to the vital record and if the previously
23.7 	issued vital record is surrendered. The fee is nonrefundable.
23.8 	(b) The fee for processing a request for the replacement of
23.9 	a birth record for all events, except when filing a recognition
23.10 	of parentage pursuant to section 257.73, subdivision 1,
23.11 	is $20 $40. The fee is payable at the time of application and
23.12 	is nonrefundable.
23.13 	(c) The fee for processing a request for the filing of a
23.14 	delayed registration of birth or death is $20 $40. The fee is
23.15 	payable at the time of application and is nonrefundable.  This
23.16 	fee includes one subsequent review of the request if the request
23.17 	is not acceptable upon the initial receipt.
23.18 	(d) The fee for processing a request for the amendment of
23.19 	any vital record when requested more than 45 days after the
23.20 	filing of the vital record is $20 $40.  No fee shall be charged
23.21 	for an amendment requested within 45 days after the filing of
23.22 	the vital record. The fee is payable at the time of application
23.23 	and is nonrefundable.  This fee includes one subsequent review
23.24 	of the request if the request is not acceptable upon the initial
23.25 	receipt.
23.26 	(e) The fee for processing a request for the verification
23.27 	of information from vital records is $8 $9 when the applicant
23.28 	furnishes the specific information to locate the vital record.
23.29 	When the applicant does not furnish specific information, the
23.30 	fee is $20 per hour for staff time expended.  Specific
23.31 	information includes the correct date of the event and the
23.32 	correct name of the registrant.  Fees charged shall approximate
23.33 	the costs incurred in searching and copying the vital records.
23.34 	The fee shall be is payable at the time of application and is
23.35 	nonrefundable.
23.36 	(f) The fee for processing a request for the issuance of a
24.1 	copy of any document on file pertaining to a vital record or
24.2 	statement that a related document cannot be found is $8 $9. The
24.3 	fee is payable at the time of application and is nonrefundable.

24.4 	Sec. 18. Minnesota Statutes 2004, section 144.226, is
24.5 	amended by adding a subdivision to read:
24.6 		Subd. 5.Electronic verification. A fee for the
24.7 	electronic verification of a vital event, when the information
24.8 	being verified is obtained from a certified birth or death
24.9 	record, shall be established through contractual or interagency
24.10 	agreements with interested local, state, or federal government
24.11 	agencies.

24.12 	Sec. 19. Minnesota Statutes 2004, section 144.226, is
24.13 	amended by adding a subdivision to read:
24.14 		Subd. 6.Alternative payment methods. Notwithstanding
24.15 	subdivision 1, alternative payment methods may be approved and
24.16 	implemented by the state registrar or a local registrar.

24.17 	Sec. 20. Minnesota Statutes 2004, section 144.3831,
24.18 	subdivision 1, is amended to read:
24.19 		Subdivision 1.Fee setting.  The commissioner of health
24.20 	may assess an annual fee of $5.21 $6.36 for every service
24.21 	connection to a public water supply that is owned or operated by
24.22 	a home rule charter city, a statutory city, a city of the first
24.23 	class, or a town.  The commissioner of health may also assess an
24.24 	annual fee for every service connection served by a water user
24.25 	district defined in section 110A.02.
24.26 	
EFFECTIVE DATE. This section is effective July 1, 2006.

24.27 	Sec. 21. Minnesota Statutes 2004, section 144.551,
24.28 	subdivision 1, is amended to read:
24.29 		Subdivision 1.Restricted construction or modification.
 24.30 	(a) The following construction or modification may not be
24.31 	commenced:
24.32 	(1) any erection, building, alteration, reconstruction,
24.33 	modernization, improvement, extension, lease, or other
24.34 	acquisition by or on behalf of a hospital that increases the bed
24.35 	capacity of a hospital, relocates hospital beds from one
24.36 	physical facility, complex, or site to another, or otherwise
25.1 	results in an increase or redistribution of hospital beds within
25.2 	the state; and
25.3 	(2) the establishment of a new hospital.
25.4 	(b) This section does not apply to:
25.5 	(1) construction or relocation within a county by a
25.6 	hospital, clinic, or other health care facility that is a
25.7 	national referral center engaged in substantial programs of
25.8 	patient care, medical research, and medical education meeting
25.9 	state and national needs that receives more than 40 percent of
25.10 	its patients from outside the state of Minnesota;
25.11 	(2) a project for construction or modification for which a
25.12 	health care facility held an approved certificate of need on May
25.13 	1, 1984, regardless of the date of expiration of the
25.14 	certificate;
25.15 	(3) a project for which a certificate of need was denied
25.16 	before July 1, 1990, if a timely appeal results in an order
25.17 	reversing the denial;
25.18 	(4) a project exempted from certificate of need
25.19 	requirements by Laws 1981, chapter 200, section 2;
25.20 	(5) a project involving consolidation of pediatric
25.21 	specialty hospital services within the Minneapolis-St. Paul
25.22 	metropolitan area that would not result in a net increase in the
25.23 	number of pediatric specialty hospital beds among the hospitals
25.24 	being consolidated;
25.25 	(6) a project involving the temporary relocation of
25.26 	pediatric-orthopedic hospital beds to an existing licensed
25.27 	hospital that will allow for the reconstruction of a new
25.28 	philanthropic, pediatric-orthopedic hospital on an existing site
25.29 	and that will not result in a net increase in the number of
25.30 	hospital beds.  Upon completion of the reconstruction, the
25.31 	licenses of both hospitals must be reinstated at the capacity
25.32 	that existed on each site before the relocation;
25.33 	(7) the relocation or redistribution of hospital beds
25.34 	within a hospital building or identifiable complex of buildings
25.35 	provided the relocation or redistribution does not result in:
25.36 	(i) an increase in the overall bed capacity at that site; (ii)
26.1 	relocation of hospital beds from one physical site or complex to
26.2 	another; or (iii) redistribution of hospital beds within the
26.3 	state or a region of the state;
26.4 	(8) relocation or redistribution of hospital beds within a
26.5 	hospital corporate system that involves the transfer of beds
26.6 	from a closed facility site or complex to an existing site or
26.7 	complex provided that:  (i) no more than 50 percent of the
26.8 	capacity of the closed facility is transferred; (ii) the
26.9 	capacity of the site or complex to which the beds are
26.10 	transferred does not increase by more than 50 percent; (iii) the
26.11 	beds are not transferred outside of a federal health systems
26.12 	agency boundary in place on July 1, 1983; and (iv) the
26.13 	relocation or redistribution does not involve the construction
26.14 	of a new hospital building;
26.15 	(9) a construction project involving up to 35 new beds in a
26.16 	psychiatric hospital in Rice County that primarily serves
26.17 	adolescents and that receives more than 70 percent of its
26.18 	patients from outside the state of Minnesota;
26.19 	(10) a project to replace a hospital or hospitals with a
26.20 	combined licensed capacity of 130 beds or less if:  (i) the new
26.21 	hospital site is located within five miles of the current site;
26.22 	and (ii) the total licensed capacity of the replacement
26.23 	hospital, either at the time of construction of the initial
26.24 	building or as the result of future expansion, will not exceed
26.25 	70 licensed hospital beds, or the combined licensed capacity of
26.26 	the hospitals, whichever is less;
26.27 	(11) the relocation of licensed hospital beds from an
26.28 	existing state facility operated by the commissioner of human
26.29 	services to a new or existing facility, building, or complex
26.30 	operated by the commissioner of human services; from one
26.31 	regional treatment center site to another; or from one building
26.32 	or site to a new or existing building or site on the same
26.33 	campus;
26.34 	(12) the construction or relocation of hospital beds
26.35 	operated by a hospital within or among hospitals having a
26.36 	statutory obligation to provide hospital and medical services
27.1 	for the indigent that does not result in a net increase in the
27.2 	number of hospital beds;
27.3 	(13) a construction project involving the addition of up to
27.4 	31 new beds in an existing nonfederal hospital in Beltrami
27.5 	County;
27.6 	(14) a construction project involving the addition of up to
27.7 	eight new beds in an existing nonfederal hospital in Otter Tail
27.8 	County with 100 licensed acute care beds;
27.9 	(15) a construction project involving the addition of 20
27.10 	new hospital beds used for rehabilitation services in an
27.11 	existing hospital in Carver County serving the southwest
27.12 	suburban metropolitan area.  Beds constructed under this clause
27.13 	shall not be eligible for reimbursement under medical
27.14 	assistance, general assistance medical care, or MinnesotaCare;
27.15 	(16) a project for the construction or relocation of up to
27.16 	20 hospital beds for the operation of up to two psychiatric
27.17 	facilities or units for children provided that the operation of
27.18 	the facilities or units have received the approval of the
27.19 	commissioner of human services;
27.20 	(17) a project involving the addition of 14 new hospital
27.21 	beds to be used for rehabilitation services in an existing
27.22 	hospital in Itasca County; or 
27.23 	(18) a project to add 20 licensed beds in existing space at
27.24 	a hospital in Hennepin County that closed 20 rehabilitation beds
27.25 	in 2002, provided that the beds are used only for rehabilitation
27.26 	in the hospital's current rehabilitation building.  If the beds
27.27 	are used for another purpose or moved to another location, the
27.28 	hospital's licensed capacity is reduced by 20 beds; or 
27.29 	(19) a critical access hospital established under section
27.30 	144.1483, clause (9), and section 1820 of the federal Social
27.31 	Security Act, United States Code, title 42, section 1395i-4,
27.32 	that delicensed beds since enactment of the Balanced Budget Act
27.33 	of 1997, Public Law 105-33, to the extent that the critical
27.34 	access hospital does not seek to exceed the maximum number of
27.35 	beds permitted such hospital under federal law.

27.36 	Sec. 22. Minnesota Statutes 2004, section 144.562,
28.1 	subdivision 2, is amended to read:
28.2 		Subd. 2.Eligibility for license condition. (a) A
28.3 	hospital is not eligible to receive a license condition for
28.4 	swing beds unless (1) it either has a licensed bed capacity of
28.5 	less than 50 beds defined in the federal Medicare regulations,
28.6 	Code of Federal Regulations, title 42, section 482.66, or it has
28.7 	a licensed bed capacity of 50 beds or more and has swing beds
28.8 	that were approved for Medicare reimbursement before May 1,
28.9 	1985, or it has a licensed bed capacity of less than 65 beds and
28.10 	the available nursing homes within 50 miles have had, in the
28.11 	aggregate, an average occupancy rate of 96 percent or higher in
28.12 	the most recent two years as documented on the statistical
28.13 	reports to the Department of Health; and (2) it is located in a
28.14 	rural area as defined in the federal Medicare regulations, Code
28.15 	of Federal Regulations, title 42, section 482.66.
28.16 	(b) Except for those critical access hospitals established
28.17 	under section 144.1483, clause (9), and section 1820 of the
28.18 	federal Social Security Act, United States Code, title 42,
28.19 	section 1395i-4, that have an attached nursing home or that
28.20 	owned a nursing home located in the same municipality as of May
28.21 	1, 2005,eligible hospitals are allowed a total of 1,460 2,000 
28.22 	days of swing bed use per year, provided that no more than ten
28.23 	hospital beds are used as swing beds at any one time. Critical
28.24 	access hospitals that have an attached nursing home or that
28.25 	owned a nursing home located in the same municipality as of May
28.26 	1, 2005, are allowed swing bed use as provided in federal law.
28.27 	(c) Except for critical access hospitals that have an
28.28 	attached nursing home or that owned a nursing home located in
28.29 	the same municipality as of May 1, 2005,the commissioner of
28.30 	health must may approve swing bed use beyond 1,460 2,000 days as
28.31 	long as there are no Medicare certified skilled nursing facility
28.32 	beds available within 25 miles of that hospital that are willing
28.33 	to admit the patient.  Critical access hospitals exceeding 2,000
28.34 	swing bed days must maintain documentation that they have
28.35 	contacted skilled nursing facilities within 25 miles to
28.36 	determine if any skilled nursing facility beds are available
29.1 	that are willing to admit the patient.
29.2 	(d) After reaching 2,000 days of swing bed use in a year,
29.3 	an eligible hospital to which this limit applies may admit six
29.4 	additional patients to swing beds each year without seeking
29.5 	approval from the commissioner or being in violation of this
29.6 	subdivision.  These six swing bed admissions are exempt from the
29.7 	limit of 2,000 annual swing bed days for hospitals subject to
29.8 	this limit.
29.9 	(e) A health care system that is in full compliance with
29.10 	this subdivision may allocate its total limit of swing bed days
29.11 	among the hospitals within the system, provided that no hospital
29.12 	in the system without an attached nursing home may exceed 2,000
29.13 	swing bed days per year.

29.14 	Sec. 23. [144.602] DEFINITIONS.
29.15 		Subdivision 1.Applicability. For purposes of sections
29.16 	144.601 to 144.608, the terms defined in this section have the
29.17 	meanings given them.
29.18 		Subd. 2.Commissioner. "Commissioner" means the
29.19 	commissioner of health.
29.20 		Subd. 3.Major trauma. "Major trauma" means a sudden
29.21 	severe injury or damage to the body caused by an external force
29.22 	that results in potentially life-threatening injuries or that
29.23 	could result in the following disabilities:
29.24 	(1) impairment of cognitive or mental abilities;
29.25 	(2) impairment of physical functioning; or 
29.26 	(3) disturbance of behavioral or emotional functioning.
29.27 		Subd. 4.Trauma hospital. "Trauma hospital" means a
29.28 	hospital that voluntarily meets the commissioner's criteria
29.29 	under section 144.603 and that has been designated as a trauma
29.30 	hospital under section 144.605.

29.31 	Sec. 24. [144.603] STATEWIDE TRAUMA SYSTEM CRITERIA.
29.32 		Subdivision 1.Criteria established. The commissioner
29.33 	shall adopt criteria to ensure that severely injured people are
29.34 	promptly transported and treated at trauma hospitals appropriate
29.35 	to the severity of injury.  Minimum criteria shall govern
29.36 	emergency medical service trauma triage and transportation
30.1 	guidelines, designation of hospitals as trauma hospitals,
30.2 	interhospital transfers, a trauma registry, and a trauma system
30.3 	governance structure.
30.4 		Subd. 2.Basis; verification. The commissioner shall
30.5 	base the establishment, implementation, and modifications to the
30.6 	criteria under subdivision 1 on the department-published
30.7 	Minnesota comprehensive statewide trauma system plan.  The
30.8 	commissioner shall seek the advice of the Trauma Advisory
30.9 	Council in implementing and updating the criteria, using
30.10 	accepted and prevailing trauma transport, treatment, and
30.11 	referral standards of the American College of Surgeons, the
30.12 	American College of Emergency Physicians, the Minnesota
30.13 	Emergency Medical Services Regulatory Board, the national Trauma
30.14 	Resources Network, and other widely recognized trauma experts.
30.15 	The commissioner shall adapt and modify the standards as
30.16 	appropriate to accommodate Minnesota's unique geography and the
30.17 	state's hospital and health professional distribution and shall
30.18 	verify that the criteria are met by each hospital voluntarily
30.19 	participating in the statewide trauma system.
30.20 		Subd. 3.Rule exemption and report to legislature. In
30.21 	developing and adopting the criteria under this section, the
30.22 	commissioner of health is exempt from chapter 14, including
30.23 	section 14.386.  By September 1, 2009, the commissioner must
30.24 	report to the legislature on implementation of the voluntary
30.25 	trauma system, including recommendations on the need for
30.26 	including the trauma system criteria in rule.

30.27 	Sec. 25. [144.604] TRAUMA TRIAGE AND TRANSPORTATION.
30.28 		Subdivision 1.Transport requirement. Unless the
30.29 	Emergency Medical Services Regulatory Board has approved a
30.30 	licensed ambulance service's deviation from the guidelines under
30.31 	section 144E.101, subdivision 14, the ambulance service must
30.32 	transport major trauma patients from the scene to the highest
30.33 	state-designated trauma hospital within 30 minutes' transport
30.34 	time.
30.35 		Subd. 2.Exceptions. Notwithstanding subdivision 1:
30.36 	(1) patients with compromised airways must be transported
31.1 	immediately to the nearest designated trauma hospital; and 
31.2 	(2) level II trauma hospitals capable of providing
31.3 	definitive trauma care must not be bypassed to reach a level I
31.4 	trauma hospital.
31.5 		Subd. 3.Undesignated hospitals. No major trauma patient
31.6 	shall be transported to a hospital not participating in the
31.7 	statewide trauma system unless no trauma hospital is available
31.8 	within 30 minutes' transport time.
31.9 	
EFFECTIVE DATE. This section is effective July 1, 2009.

31.10 	Sec. 26. [144.605] DESIGNATING TRAUMA HOSPITALS.
31.11 		Subdivision 1.Naming privileges. Unless it has been
31.12 	designated a trauma hospital by the commissioner, no hospital
31.13 	shall use the term trauma center or trauma hospital in its name
31.14 	or its advertising or shall otherwise indicate it has trauma
31.15 	treatment capabilities.
31.16 		Subd. 2.Designation; reverification. The commissioner
31.17 	shall designate four levels of trauma hospitals.  A hospital
31.18 	that voluntarily meets the criteria for a particular level of
31.19 	trauma hospital shall apply to the commissioner for designation
31.20 	and, upon the commissioner's verifying the hospital meets the
31.21 	criteria, be designated a trauma hospital at the appropriate
31.22 	level for a three-year period.  Prior to the expiration of the
31.23 	three-year designation, a hospital seeking to remain part of the
31.24 	voluntary system must apply for and successfully complete a
31.25 	reverification process, be awaiting the site visit for the
31.26 	reverification, or be awaiting the results of the site visit.
31.27 	The commissioner may extend a hospital's existing designation
31.28 	for up to 18 months on a provisional basis if the hospital has
31.29 	applied for reverification in a timely manner but has not yet
31.30 	completed the reverification process within the expiration of
31.31 	the three-year designation and the extension is in the best
31.32 	interest of trauma system patient safety.  To be granted a
31.33 	provisional extension, the hospital must be:
31.34 	(1) scheduled and awaiting the site visit for
31.35 	reverification;
31.36 	(2) awaiting the results of the site visit; or 
32.1 	(3) responding to and correcting identified deficiencies
32.2 	identified in the site visit.
32.3 		Subd. 3.Acs verification. The commissioner shall grant
32.4 	the appropriate level I, II, or III trauma hospital designation
32.5 	to a hospital that successfully completes and passes the
32.6 	American College of Surgeons (ACS) verification standards at the
32.7 	hospital's cost, submits verification documentation to the
32.8 	Trauma Advisory Council, and formally notifies the Trauma
32.9 	Advisory Council of ACS verification.
32.10 		Subd. 4.Level iii designation; not acs verified. (a)
32.11 	The commissioner shall grant the appropriate level III trauma
32.12 	hospital designation to a hospital that is not ACS verified but
32.13 	that successfully completes the designation process under
32.14 	paragraph (b).
32.15 	(b) The hospital must complete and submit a self-reported
32.16 	survey and application to the Trauma Advisory Council for
32.17 	review, verifying that the hospital meets the criteria as a
32.18 	level III trauma hospital.  When the Trauma Advisory Council is
32.19 	satisfied the application is complete, the commissioner shall
32.20 	arrange a site review visit.  Upon successful completion of the
32.21 	site review, the review team shall make written recommendations
32.22 	to the Trauma Advisory Council.  If approved by the Trauma
32.23 	Advisory Council, a letter of recommendation shall be sent to
32.24 	the commissioner for final approval and designation.
32.25 		Subd. 5.Level iv designation. (a) The commissioner
32.26 	shall grant the appropriate level IV trauma hospital designation
32.27 	to a hospital that successfully completes the designation
32.28 	process under paragraph (b).
32.29 	(b) The hospital must complete and submit a self-reported
32.30 	survey and application to the Trauma Advisory Council for
32.31 	review, verifying that the hospital meets the criteria as a
32.32 	level IV trauma hospital.  When the Trauma Advisory Council is
32.33 	satisfied the application is complete, the council shall review
32.34 	the application and, if the council approves the application,
32.35 	send a letter of recommendation to the commissioner for final
32.36 	approval and designation.  The commissioner shall grant a level
33.1 	IV designation and shall arrange a site review visit within
33.2 	three years of the designation and every three years thereafter,
33.3 	to coincide with the three-year reverification process.
33.4 		Subd. 6.Changes in designation. Changes in a trauma
33.5 	hospital's ability to meet the criteria for the hospital's level
33.6 	of designation must be self-reported to the Trauma Advisory
33.7 	Council and to other regional hospitals and local emergency
33.8 	medical services providers and authorities.  If the hospital
33.9 	cannot correct its ability to meet the criteria for its level
33.10 	within six months, the hospital may apply for redesignation at a
33.11 	different level.
33.12 		Subd. 7.Higher designation. A trauma hospital may apply
33.13 	for a higher trauma hospital designation one time during the
33.14 	hospital's three-year designation by completing the designation
33.15 	process for that level of trauma hospital.
33.16 		Subd. 8.Loss of designation. The commissioner may
33.17 	refuse to designate or redesignate or may revoke a previously
33.18 	issued trauma hospital designation if a hospital does not meet
33.19 	the criteria of the statewide trauma plan, in the interests of
33.20 	patient safety, or if a hospital denies or refuses a reasonable
33.21 	request by the commissioner or the commissioner's designee to
33.22 	verify information by correspondence or an on-site visit.

33.23 	Sec. 27. [144.606] INTERHOSPITAL TRANSFERS.
33.24 		Subdivision 1.Written procedures required. A level III
33.25 	or IV trauma hospital must have predetermined, written
33.26 	procedures that direct the internal process for rapidly and
33.27 	efficiently transferring a major trauma patient to definitive
33.28 	care, including:
33.29 	(1) clearly identified anatomic and physiologic criteria
33.30 	that, if met, will immediately initiate transfer to definitive
33.31 	care;
33.32 	(2) a listing of appropriate ground and air transport
33.33 	services, including primary and secondary telephone contact
33.34 	numbers; and 
33.35 	(3) immediately available supplies, records, or other
33.36 	necessary resources that will accompany a patient.
34.1 		Subd. 2.Transfer agreements. (a) A level III or IV
34.2 	trauma hospital may transfer patients to a hospital with which
34.3 	the trauma hospital has a written transfer agreement.
34.4 	(b) Each agreement must be current and with a trauma
34.5 	hospital or trauma hospitals capable of caring for major trauma
34.6 	injuries.
34.7 	(c) A level III or IV trauma hospital must have a current
34.8 	transfer agreement with a hospital that has special capabilities
34.9 	in the treatment of burn injuries and a transfer agreement with
34.10 	a second hospital that has special capabilities in the treatment
34.11 	of burn injuries, should the primary transfer hospital be unable
34.12 	to accept a burn patient.

34.13 	Sec. 28. [144.607] TRAUMA REGISTRY.
34.14 		Subdivision 1.Registry participation required. A trauma
34.15 	hospital must participate in the statewide trauma registry.
34.16 		Subd. 2.Trauma reporting. A trauma hospital must report
34.17 	major trauma injuries as part of the reporting for the traumatic
34.18 	brain injury and spinal cord injury registry required in
34.19 	sections 144.661 to 144.665.
34.20 		Subd. 3.Application of other law. Sections 144.661 to
34.21 	144.665 apply to a major trauma reported to the statewide trauma
34.22 	registry, with the exception of sections 144.662, clause (2),
34.23 	and 144.664, subdivision 3.

34.24 	Sec. 29. [144.608] TRAUMA ADVISORY COUNCIL.
34.25 		Subdivision 1.Trauma advisory council established. (a)
34.26 	A Trauma Advisory Council is established to advise, consult
34.27 	with, and make recommendations to the commissioner on the
34.28 	development, maintenance, and improvement of a statewide trauma
34.29 	system.
34.30 	(b) The council shall consist of the following members:
34.31 	(1) a trauma surgeon certified by the American College of
34.32 	Surgeons who practices in a level I or II trauma hospital;
34.33 	(2) a general surgeon certified by the American College of
34.34 	Surgeons whose practice includes trauma and who practices in a
34.35 	designated rural area as defined under section 144.1501,
34.36 	subdivision 1, paragraph (b);
35.1 	(3) a neurosurgeon certified by the American Board of
35.2 	Neurological Surgery who practices in a level I or II trauma
35.3 	hospital;
35.4 	(4) a trauma program nurse manager or coordinator
35.5 	practicing in a level I or II trauma hospital;
35.6 	(5) an emergency physician certified by the American
35.7 	College of Emergency Physicians whose practice includes
35.8 	emergency room care in a level I, II, III, or IV trauma
35.9 	hospital;
35.10 	(6) an emergency room nurse manager who practices in a
35.11 	level III or IV trauma hospital;
35.12 	(7) a family practice physician whose practice includes
35.13 	emergency room care in a level III or IV trauma hospital located
35.14 	in a designated rural area as defined under section 144.1501,
35.15 	subdivision 1, paragraph (b);
35.16 	(8) a nurse practitioner, as defined under section
35.17 	144.1501, subdivision 1, paragraph (h), or a physician
35.18 	assistant, as defined under section 144.1501, subdivision 1,
35.19 	paragraph (j), whose practice includes emergency room care in a
35.20 	level IV trauma hospital located in a designated rural area as
35.21 	defined under section 144.1501, subdivision 1, paragraph (b);
35.22 	(9) a pediatrician certified by the American Academy of
35.23 	Pediatrics whose practice includes emergency room care in a
35.24 	level I, II, III, or IV trauma hospital;
35.25 	(10) an orthopedic surgeon certified by the American Board
35.26 	of Orthopedic Surgery whose practice includes trauma and who
35.27 	practices in a level I, II, or III trauma hospital;
35.28 	(11) the state emergency medical services medical director
35.29 	appointed by the Emergency Medical Services Regulatory Board;
35.30 	(12) a hospital administrator of a level III or IV trauma
35.31 	hospital located in a designated rural area as defined under
35.32 	section 144.1501, subdivision 1, paragraph (b);
35.33 	(13) a rehabilitation specialist whose practice includes
35.34 	rehabilitation of patients with major trauma injuries or
35.35 	traumatic brain injuries and spinal cord injuries as defined
35.36 	under section 144.661;
36.1 	(14) an attendant or ambulance director who is an EMT,
36.2 	EMT-I, or EMT-P within the meaning of section 144E.001 and who
36.3 	actively practices with a licensed ambulance service in a
36.4 	primary service area located in a designated rural area as
36.5 	defined under section 144.1501, subdivision 1, paragraph (b);
36.6 	and 
36.7 	(15) the commissioner of public safety or the
36.8 	commissioner's designee.
36.9 	(c) Council members whose appointment is dependent on
36.10 	practice in a level III or IV trauma hospital may be appointed
36.11 	to an initial term based upon their statements that the hospital
36.12 	intends to become a level III or IV facility by July 1, 2009.
36.13 		Subd. 2.Council administration. (a) The council must
36.14 	meet at least twice a year but may meet more frequently at the
36.15 	call of the chair, a majority of the council members, or the
36.16 	commissioner.
36.17 	(b) The terms, compensation, and removal of members of the
36.18 	council are governed by section 15.059, except that the council
36.19 	expires June 30, 2015.
36.20 	(c) The council may appoint subcommittees and workgroups.
36.21 	Subcommittees shall consist of council members.  Workgroups may
36.22 	include noncouncil members.  Noncouncil members shall be
36.23 	compensated for workgroup activities under section 15.059,
36.24 	subdivision 3, but shall receive expenses only.
36.25 		Subd. 3.Regional trauma advisory councils. (a) Up to
36.26 	eight regional trauma advisory councils may be formed as needed.
36.27 	(b) Regional trauma advisory councils shall advise, consult
36.28 	with, and make recommendation to the state Trauma Advisory
36.29 	Council on suggested regional modifications to the statewide
36.30 	trauma criteria that will improve patient care and accommodate
36.31 	specific regional needs.
36.32 	(c) Each regional advisory council must have no more than
36.33 	15 members.  The commissioner, in consultation with the
36.34 	Emergency Medical Services Regulatory Board and the commissioner
36.35 	of public safety, shall name the council members.
36.36 	(d) Regional council members may receive expenses in the
37.1 	same manner and amount as authorized by the plan adopted under
37.2 	section 43A.18, subdivision 2.

37.3 	Sec. 30. Minnesota Statutes 2004, section 144.9504,
37.4 	subdivision 2, is amended to read:
37.5 		Subd. 2.Lead risk assessment.  (a) An assessing agency
37.6 	shall conduct a lead risk assessment of a residence according to
37.7 	the venous blood lead level and time frame set forth in clauses
37.8 	(1) to (5) (4) for purposes of secondary prevention:
37.9 	(1) within 48 hours of a child or pregnant female in the
37.10 	residence being identified to the agency as having a venous
37.11 	blood lead level equal to or greater than 70 60 micrograms of
37.12 	lead per deciliter of whole blood;
37.13 	(2) within five working days of a child or pregnant female
37.14 	in the residence being identified to the agency as having a
37.15 	venous blood lead level equal to or greater than 45 micrograms
37.16 	of lead per deciliter of whole blood;
37.17 	(3) within ten working days of a child in the residence
37.18 	being identified to the agency as having a venous blood lead
37.19 	level equal to or greater than 20 15 micrograms of lead per
37.20 	deciliter of whole blood; or 
37.21 	(4) within ten working days of a child in the residence
37.22 	being identified to the agency as having a venous blood lead
37.23 	level that persists in the range of 15 to 19 micrograms of lead
37.24 	per deciliter of whole blood for 90 days after initial
37.25 	identification; or 
37.26 	(5) within ten working days of a pregnant female in the
37.27 	residence being identified to the agency as having a venous
37.28 	blood lead level equal to or greater than ten micrograms of lead
37.29 	per deciliter of whole blood.
37.30 	(b) Within the limits of available local, state, and
37.31 	federal appropriations, an assessing agency may also conduct a
37.32 	lead risk assessment for children with any elevated blood lead
37.33 	level.
37.34 	(c) In a building with two or more dwelling units, an
37.35 	assessing agency shall assess the individual unit in which the
37.36 	conditions of this section are met and shall inspect all common
38.1 	areas accessible to a child.  If a child visits one or more
38.2 	other sites such as another residence, or a residential or
38.3 	commercial child care facility, playground, or school, the
38.4 	assessing agency shall also inspect the other sites.  The
38.5 	assessing agency shall have one additional day added to the time
38.6 	frame set forth in this subdivision to complete the lead risk
38.7 	assessment for each additional site.
38.8 	(d) Within the limits of appropriations, the assessing
38.9 	agency shall identify the known addresses for the previous 12
38.10 	months of the child or pregnant female with venous blood lead
38.11 	levels of at least 20 15 micrograms per deciliter for the child
38.12 	or at least ten micrograms per deciliter for the pregnant
38.13 	female; notify the property owners, landlords, and tenants at
38.14 	those addresses that an elevated blood lead level was found in a
38.15 	person who resided at the property; and give them primary
38.16 	prevention information.  Within the limits of appropriations,
38.17 	the assessing agency may perform a risk assessment and issue
38.18 	corrective orders in the properties, if it is likely that the
38.19 	previous address contributed to the child's or pregnant female's
38.20 	blood lead level.  The assessing agency shall provide the notice
38.21 	required by this subdivision without identifying the child or
38.22 	pregnant female with the elevated blood lead level.  The
38.23 	assessing agency is not required to obtain the consent of the
38.24 	child's parent or guardian or the consent of the pregnant female
38.25 	for purposes of this subdivision.  This information shall be
38.26 	classified as private data on individuals as defined under
38.27 	section 13.02, subdivision 12.
38.28 	(e) The assessing agency shall conduct the lead risk
38.29 	assessment according to rules adopted by the commissioner under
38.30 	section 144.9508.  An assessing agency shall have lead risk
38.31 	assessments performed by lead risk assessors licensed by the
38.32 	commissioner according to rules adopted under section 144.9508.
38.33 	If a property owner refuses to allow a lead risk assessment, the
38.34 	assessing agency shall begin legal proceedings to gain entry to
38.35 	the property and the time frame for conducting a lead risk
38.36 	assessment set forth in this subdivision no longer applies.  A
39.1 	lead risk assessor or assessing agency may observe the
39.2 	performance of lead hazard reduction in progress and shall
39.3 	enforce the provisions of this section under section 144.9509.
39.4 	Deteriorated painted surfaces, bare soil, and dust must be
39.5 	tested with appropriate analytical equipment to determine the
39.6 	lead content, except that deteriorated painted surfaces or bare
39.7 	soil need not be tested if the property owner agrees to engage
39.8 	in lead hazard reduction on those surfaces.  The lead content of
39.9 	drinking water must be measured if another probable source of
39.10 	lead exposure is not identified.  Within a standard metropolitan
39.11 	statistical area, an assessing agency may order lead hazard
39.12 	reduction of bare soil without measuring the lead content of the
39.13 	bare soil if the property is in a census tract in which soil
39.14 	sampling has been performed according to rules established by
39.15 	the commissioner and at least 25 percent of the soil samples
39.16 	contain lead concentrations above the standard in section
39.17 	144.9508.
39.18 	(f) Each assessing agency shall establish an administrative
39.19 	appeal procedure which allows a property owner to contest the
39.20 	nature and conditions of any lead order issued by the assessing
39.21 	agency.  Assessing agencies must consider appeals that propose
39.22 	lower cost methods that make the residence lead safe.  The
39.23 	commissioner shall use the authority and appeal procedure
39.24 	granted under sections 144.989 to 144.993.
39.25 	(g) Sections 144.9501 to 144.9509 neither authorize nor
39.26 	prohibit an assessing agency from charging a property owner for
39.27 	the cost of a lead risk assessment.

39.28 	Sec. 31. Minnesota Statutes 2004, section 144.98,
39.29 	subdivision 3, is amended to read:
39.30 		Subd. 3.Fees.  (a) An application for certification
39.31 	under subdivision 1 must be accompanied by the biennial fee
39.32 	specified in this subdivision.  The fees are for:
39.33 	(1) nonrefundable base certification fee, $1,200 
39.34 	$1,600; and 
39.35 	(2) sample preparation techniques fees, $100 per technique;
39.36 	and 
40.1 	(3) test category certification fees:
40.2 	Test Category                                   Certification Fee
40.3 	Clean water program bacteriology $600 $800 
40.4 	Safe drinking water program bacteriology $600 $800 
40.5 	Clean water program inorganic chemistry $600 $800 
40.6 	Safe drinking water program inorganic chemistry $600 $800 
40.7 	Clean water program chemistry metals $800 $1,200 
40.8 	Safe drinking water program chemistry metals $800 $1,200 
40.9 	Resource conservation and recovery program
40.10 	  chemistry metals $800 $1,200 
40.11 	Clean water program volatile organic compounds $1,200 $1,500 
40.12 	Safe drinking water program
40.13 	  volatile organic compounds $1,200 $1,500 
40.14 	Resource conservation and recovery program
40.15 	  volatile organic compounds $1,200 $1,500 
40.16 	Underground storage tank program
40.17 	  volatile organic compounds $1,200 $1,500 
40.18 	Clean water program other organic compounds $1,200 $1,500 
40.19 	Safe drinking water program other organic compounds $1,200 $1,500 
40.20 	Resource conservation and recovery program
40.21 	  other organic compounds $1,200 $1,500
40.22 	Clean water program radiochemistry $2,500
40.23 	Safe drinking water program radiochemistry $2,500
40.24 	Resource conservation and recovery program
40.25 	  agricultural contaminants $2,500
40.26 	Resource conservation and recovery program
40.27 	  emerging contaminants $2,500 
40.28 	(b) The total biennial certification fee is the base fee
40.29 	plus the applicable test category fees.
40.30 	(c) Laboratories located outside of this state that require
40.31 	an on-site survey will inspection shall be assessed an
40.32 	additional $2,500 $3,750 fee.
40.33 	(c) The total biennial certification fee includes the base
40.34 	fee, the sample preparation techniques fees, the test category
40.35 	fees, and, when applicable, the on-site inspection fee.
40.36 	(d) Fees must be set so that the total fees support the
41.1 	laboratory certification program.  Direct costs of the
41.2 	certification service include program administration,
41.3 	inspections, the agency's general support costs, and attorney
41.4 	general costs attributable to the fee function.
41.5 	(e) A change fee shall be assessed if a laboratory requests
41.6 	additional analytes or methods at any time other than when
41.7 	applying for or renewing its certification.  The change fee is
41.8 	equal to the test category certification fee for the analyte.
41.9 	(f) A variance fee shall be assessed if a laboratory
41.10 	requests and is granted a variance from a rule adopted under
41.11 	this section.  The variance fee is $500 per variance.
41.12 	(g) Refunds or credits shall not be made for analytes or
41.13 	methods requested but not approved.
41.14 	(h) Certification of a laboratory shall not be awarded
41.15 	until all fees are paid.

41.16 	Sec. 32. Minnesota Statutes 2004, section 144E.101, is
41.17 	amended by adding a subdivision to read:
41.18 		Subd. 14.Trauma triage and transport guidelines. A
41.19 	licensee shall have written age appropriate trauma triage and
41.20 	transport guidelines consistent with the criteria established by
41.21 	the Trauma Advisory Council established under section 144.608,
41.22 	and approved by the board.  The board may approve a licensee's
41.23 	requested deviations to the guidelines due to the availability
41.24 	of local or regional trauma resources if the changes are in the
41.25 	best interest of the patient's health.

41.26 	Sec. 33. [145.906] POSTPARTUM DEPRESSION EDUCATION AND
41.27 	INFORMATION.
41.28 	(a) The commissioner of health shall work with health care
41.29 	facilities, licensed health and mental health care
41.30 	professionals, mental health advocates, consumers, and families
41.31 	in the state to develop materials and information about
41.32 	postpartum depression, including treatment resources, and
41.33 	develop policies and procedures to comply with this section.
41.34 	(b) Physicians, traditional midwives, and other licensed
41.35 	health care professionals providing prenatal care to women must
41.36 	have available to women and their families information about
42.1 	postpartum depression.
42.2 	(c) Hospitals and other health care facilities in the state
42.3 	must provide departing new mothers and fathers and other family
42.4 	members, as appropriate, with written information about
42.5 	postpartum depression, including its symptoms, methods of coping
42.6 	with the illness, and treatment resources.

42.7 	Sec. 34. Minnesota Statutes 2004, section 145.9268, is
42.8 	amended to read:
42.9 	145.9268 COMMUNITY CLINIC GRANTS.
42.10 		Subdivision 1.Definition. For purposes of this section,
42.11 	"eligible community clinic" means:
42.12 	(1) a nonprofit clinic that provides is established to
42.13 	provide health services under conditions as defined in Minnesota
42.14 	Rules, part 9505.0255,to low income or rural population groups;
42.15 	provides medical, preventive, dental, or mental health primary
42.16 	care services;and utilizes a sliding fee scale or other
42.17 	procedure to determine eligibility for charity care or to ensure
42.18 	that no person will be denied services because of inability to
42.19 	pay;
42.20 	(2) a governmental entity or an Indian tribal government or
42.21 	Indian health service unit that provides services and utilizes a
42.22 	sliding fee scale or other procedure as described under clause
42.23 	(1); or 
42.24 	(3) a consortium of clinics comprised of entities under
42.25 	clause (1) or (2); or 
42.26 	(4) a nonprofit, tribal, or governmental entity proposing
42.27 	the establishment of a clinic that will provide services and
42.28 	utilize a sliding fee scale or other procedure as described
42.29 	under clause (1).
42.30 		Subd. 2.Grants authorized. The commissioner of health
42.31 	shall award grants to eligible community clinics to plan,
42.32 	establish, or operate services to improve the ongoing viability
42.33 	of Minnesota's clinic-based safety net providers.  Grants shall
42.34 	be awarded to support the capacity of eligible community clinics
42.35 	to serve low-income populations, reduce current or future
42.36 	uncompensated care burdens, or provide for improved care
43.1 	delivery infrastructure.  The commissioner shall award grants to
43.2 	community clinics in metropolitan and rural areas of the state,
43.3 	and shall ensure geographic representation in grant awards among
43.4 	all regions of the state.
43.5 		Subd. 3.Allocation of grants. (a) To receive a grant
43.6 	under this section, an eligible community clinic must submit an
43.7 	application to the commissioner of health by the deadline
43.8 	established by the commissioner.  A grant may be awarded upon
43.9 	the signing of a grant contract.  Community clinics may apply
43.10 	for and the commissioner may award grants for one-year or
43.11 	two-year periods.
43.12 	(b) An application must be on a form and contain
43.13 	information as specified by the commissioner but at a minimum
43.14 	must contain:
43.15 	(1) a description of the purpose or project for which grant
43.16 	funds will be used;
43.17 	(2) a description of the problem or problems the grant
43.18 	funds will be used to address; and 
43.19 	(3) a description of achievable objectives, a workplan, and
43.20 	a timeline for implementation and completion of processes or
43.21 	projects enabled by the grant; and 
43.22 	(4) a process for documenting and evaluating results of the
43.23 	grant.
43.24 	(c) The commissioner shall review each application to
43.25 	determine whether the application is complete and whether the
43.26 	applicant and the project are eligible for a grant.  In
43.27 	evaluating applications according to paragraph (d), the
43.28 	commissioner shall establish criteria including, but not limited
43.29 	to:  the priority level eligibility of the project; the
43.30 	applicant's thoroughness and clarity in describing the problem
43.31 	grant funds are intended to address; a description of the
43.32 	applicant's proposed project; a description of the population
43.33 	demographics and service area of the proposed project;the
43.34 	manner in which the applicant will demonstrate the effectiveness
43.35 	of any projects undertaken; and evidence of efficiencies and
43.36 	effectiveness gained through collaborative efforts.  The
44.1 	commissioner may also take into account other relevant factors,
44.2 	including, but not limited to, the percentage for which
44.3 	uninsured patients represent the applicant's patient base and
44.4 	the degree to which grant funds will be used to support services
44.5 	increasing or maintaining access to health care services.
44.6 	During application review, the commissioner may request
44.7 	additional information about a proposed project, including
44.8 	information on project cost.  Failure to provide the information
44.9 	requested disqualifies an applicant.  The commissioner has
44.10 	discretion over the number of grants awarded.
44.11 	(d) In determining which eligible community clinics will
44.12 	receive grants under this section, the commissioner shall give
44.13 	preference to those grant applications that show evidence of
44.14 	collaboration with other eligible community clinics, hospitals,
44.15 	health care providers, or community organizations. In addition,
44.16 	the commissioner shall give priority, in declining order, to
44.17 	grant applications for projects that:In addition, the
44.18 	commissioner shall give priority to grant applications for
44.19 	projects involving electronic health records systems.
44.20 		Subd. 3a.Awarding grants. (a) The commissioner may
44.21 	award grants for activities to:
44.22 	(1) provide a direct offset to expenses incurred for
44.23 	services provided to the clinic's target population;
44.24 	(2) establish, update, or improve information, data
44.25 	collection, or billing systems, including electronic health
44.26 	records systems;
44.27 	(3) procure, modernize, remodel, or replace equipment used
44.28 	in the delivery of direct patient care at a clinic;
44.29 	(4) provide improvements for care delivery, such as
44.30 	increased translation and interpretation services; or 
44.31 	(5) build a new clinic or expand an existing facility; or 
44.32 	(6) other projects determined by the commissioner to
44.33 	improve the ability of applicants to provide care to the
44.34 	vulnerable populations they serve.
44.35 	(e) (b) A grant awarded to an eligible community clinic may
44.36 	not exceed $300,000 per eligible community clinic.  For an
45.1 	applicant applying as a consortium of clinics, a grant may not
45.2 	exceed $300,000 per clinic included in the consortium.  The
45.3 	commissioner has discretion over the number of grants awarded.
45.4 		Subd. 4.Evaluation and report. The commissioner of
45.5 	health shall evaluate the overall effectiveness of the grant
45.6 	program.  The commissioner shall collect progress reports to
45.7 	evaluate the grant program from the eligible community clinics
45.8 	receiving grants.  Every two years, as part of this evaluation,
45.9 	the commissioner shall report to the legislature on priority
45.10 	areas for grants set under subdivision 3 the needs of community
45.11 	clinics and provide any recommendations for adding or
45.12 	changing priority areas eligible activities.

45.13 	Sec. 35. Minnesota Statutes 2004, section 157.15, is
45.14 	amended by adding a subdivision to read:
45.15 		Subd. 19.Statewide hospitality fee. "Statewide
45.16 	hospitality fee" means a fee to fund statewide food, beverage,
45.17 	and lodging program development activities, including training
45.18 	for inspection staff, technical assistance, maintenance of a
45.19 	statewide integrated food safety and security information
45.20 	system, and other related statewide activities that support the
45.21 	food, beverage, and lodging program activities.

45.22 	Sec. 36. Minnesota Statutes 2004, section 157.16,
45.23 	subdivision 2, is amended to read:
45.24 		Subd. 2.License renewal.  Initial and renewal licenses
45.25 	for all food and beverage service establishments, hotels,
45.26 	motels, lodging establishments, and resorts shall be issued for
45.27 	the calendar year for which application is made and shall expire
45.28 	on December 31 of such year.  Any person who operates a place of
45.29 	business after the expiration date of a license or without
45.30 	having submitted an application and paid the fee shall be deemed
45.31 	to have violated the provisions of this chapter and shall be
45.32 	subject to enforcement action, as provided in the Health
45.33 	Enforcement Consolidation Act, sections 144.989 to 144.993.  In
45.34 	addition, a penalty of $25 $50 shall be added to the total of
45.35 	the license fee for any food and beverage service establishment
45.36 	operating without a license as a mobile food unit, a seasonal
46.1 	temporary or seasonal permanent food stand, or a special event
46.2 	food stand, and a penalty of $50 $100 shall be added to the
46.3 	total of the license fee for all restaurants, food carts,
46.4 	hotels, motels, lodging establishments, and resorts operating
46.5 	without a license for a period of up to 30 days.  A late fee of
46.6 	$300 shall be added to the license fee for establishments
46.7 	operating more than 30 days without a license.

46.8 	Sec. 37. Minnesota Statutes 2004, section 157.16, is
46.9 	amended by adding a subdivision to read:
46.10 		Subd. 2a.Food manager certification. An applicant for
46.11 	certification or certification renewal as a food manager must
46.12 	submit to the commissioner a $28 nonrefundable certification fee
46.13 	payable to the Department of Health.

46.14 	Sec. 38. Minnesota Statutes 2004, section 157.16,
46.15 	subdivision 3, is amended to read:
46.16 		Subd. 3.Establishment fees; definitions.  (a) The
46.17 	following fees are required for food and beverage service
46.18 	establishments, hotels, motels, lodging establishments, and
46.19 	resorts licensed under this chapter.  Food and beverage service
46.20 	establishments must pay the highest applicable fee under
46.21 	paragraph (e) (d), clause (1), (2), (3), or (4), and
46.22 	establishments serving alcohol must pay the highest applicable
46.23 	fee under paragraph (e) (d), clause (6) or (7).  The license fee
46.24 	for new operators previously licensed under this chapter for the
46.25 	same calendar year is one-half of the appropriate annual license
46.26 	fee, plus any penalty that may be required.  The license fee for
46.27 	operators opening on or after October 1 is one-half of the
46.28 	appropriate annual license fee, plus any penalty that may be
46.29 	required.
46.30 	(b) All food and beverage service establishments, except
46.31 	special event food stands, and all hotels, motels, lodging
46.32 	establishments, and resorts shall pay an annual base fee of
46.33 	$145 $150.
46.34 	(c) A special event food stand shall pay a flat fee
46.35 	of $35 $40 annually.  "Special event food stand" means a fee
46.36 	category where food is prepared or served in conjunction with
47.1 	celebrations, county fairs, or special events from a special
47.2 	event food stand as defined in section 157.15.
47.3 	(d) In addition to the base fee in paragraph (b), each food
47.4 	and beverage service establishment, other than a special event
47.5 	food stand, and each hotel, motel, lodging establishment, and
47.6 	resort shall pay an additional annual fee for each fee category
47.7 	as , additional food service, or required additional inspection 
47.8 	specified in this paragraph:
47.9 	(1) Limited food menu selection, $40 $50.  "Limited food
47.10 	menu selection" means a fee category that provides one or more
47.11 	of the following:
47.12 	(i) prepackaged food that receives heat treatment and is
47.13 	served in the package;
47.14 	(ii) frozen pizza that is heated and served;
47.15 	(iii) a continental breakfast such as rolls, coffee, juice,
47.16 	milk, and cold cereal;
47.17 	(iv) soft drinks, coffee, or nonalcoholic beverages; or
47.18 	(v) cleaning for eating, drinking, or cooking utensils,
47.19 	when the only food served is prepared off site.
47.20 	(2) Small establishment, including boarding establishments,
47.21 	$75 $100.  "Small establishment" means a fee category that has
47.22 	no salad bar and meets one or more of the following:
47.23 	(i) possesses food service equipment that consists of no
47.24 	more than a deep fat fryer, a grill, two hot holding containers,
47.25 	and one or more microwave ovens;
47.26 	(ii) serves dipped ice cream or soft serve frozen desserts;
47.27 	(iii) serves breakfast in an owner-occupied bed and
47.28 	breakfast establishment;
47.29 	(iv) is a boarding establishment; or
47.30 	(v) meets the equipment criteria in clause (3), item (i) or
47.31 	(ii), and has a maximum patron seating capacity of not more than
47.32 	50.
47.33 	(3) Medium establishment, $210 $260.  "Medium establishment"
47.34 	means a fee category that meets one or more of the following:
47.35 	(i) possesses food service equipment that includes a range,
47.36 	oven, steam table, salad bar, or salad preparation area;
48.1 	(ii) possesses food service equipment that includes more
48.2 	than one deep fat fryer, one grill, or two hot holding
48.3 	containers; or
48.4 	(iii) is an establishment where food is prepared at one
48.5 	location and served at one or more separate locations.
48.6 	Establishments meeting criteria in clause (2), item (v),
48.7 	are not included in this fee category.
48.8 	(4) Large establishment, $350 $460.  "Large establishment"
48.9 	means either:
48.10 	(i) a fee category that (A) meets the criteria in clause
48.11 	(3), items (i) or (ii), for a medium establishment, (B) seats
48.12 	more than 175 people, and (C) offers the full menu selection an
48.13 	average of five or more days a week during the weeks of
48.14 	operation; or
48.15 	(ii) a fee category that (A) meets the criteria in clause
48.16 	(3), item (iii), for a medium establishment, and (B) prepares
48.17 	and serves 500 or more meals per day.
48.18 	(5) Other food and beverage service, including food carts,
48.19 	mobile food units, seasonal temporary food stands, and seasonal
48.20 	permanent food stands, $40 $50.
48.21 	(6) Beer or wine table service, $40 $50.  "Beer or wine
48.22 	table service" means a fee category where the only alcoholic
48.23 	beverage service is beer or wine, served to customers seated at
48.24 	tables.
48.25 	(7) Alcoholic beverage service, other than beer or wine
48.26 	table service, $105 $135.
48.27 	"Alcohol beverage service, other than beer or wine table
48.28 	service" means a fee category where alcoholic mixed drinks are
48.29 	served or where beer or wine are served from a bar.
48.30 	(8) Lodging per sleeping accommodation unit, $6 $8,
48.31 	including hotels, motels, lodging establishments, and resorts,
48.32 	up to a maximum of $600 $800.  "Lodging per sleeping
48.33 	accommodation unit" means a fee category including the number of
48.34 	guest rooms, cottages, or other rental units of a hotel, motel,
48.35 	lodging establishment, or resort; or the number of beds in a
48.36 	dormitory.
49.1 	(9) First public swimming pool, $140 $180; each additional
49.2 	public swimming pool, $80 $100.  "Public swimming pool" means a
49.3 	fee category that has the meaning given in Minnesota Rules, part
49.4 	4717.0250, subpart 8.
49.5 	(10) First spa, $80 $110; each additional spa, $40 $50.
49.6 	"Spa pool" means a fee category that has the meaning given in
49.7 	Minnesota Rules, part 4717.0250, subpart 9.
49.8 	(11) Private sewer or water, $40 $50.  "Individual private
49.9 	water" means a fee category with a water supply other than a
49.10 	community public water supply as defined in Minnesota Rules,
49.11 	chapter 4720.  "Individual private sewer" means a fee category
49.12 	with an individual sewage treatment system which uses subsurface
49.13 	treatment and disposal.
49.14 	(12) Additional food service, $130.  "Additional food
49.15 	service" means a location at a food service establishment, other
49.16 	than the primary food preparation and service area, used to
49.17 	prepare or serve food to the public.
49.18 	(13) Additional inspection fee, $300.  "Additional
49.19 	inspection fee" means a fee to conduct the second inspection
49.20 	each year for elementary and secondary education facility school
49.21 	lunch programs when required by the Richard B. Russell National
49.22 	School Lunch Act.
49.23 	(e) A fee of $150 $350 for review of the construction plans
49.24 	must accompany the initial license application for food and
49.25 	beverage service establishments restaurants, hotels, motels,
49.26 	lodging establishments, or resorts with five or more sleeping
49.27 	units.
49.28 	(f) When existing food and beverage service establishments,
49.29 	hotels, motels, lodging establishments, or resorts are
49.30 	extensively remodeled, a fee of $150 $250 must be submitted with
49.31 	the remodeling plans. A fee of $250 must be submitted for new
49.32 	construction or remodeling for a restaurant with a limited food
49.33 	menu selection, a seasonal permanent food stand, a mobile food
49.34 	unit, or a food cart, or for a hotel, motel, resort, or lodging
49.35 	establishment addition of less than five sleeping units.
49.36 	(g) Seasonal temporary food stands and special event food
50.1 	stands are not required to submit construction or remodeling
50.2 	plans for review.

50.3 	Sec. 39. Minnesota Statutes 2004, section 157.16, is
50.4 	amended by adding a subdivision to read:
50.5 		Subd. 3a.Statewide hospitality fee. Every person, firm,
50.6 	or corporation that operates a licensed boarding establishment,
50.7 	food and beverage service establishment, seasonal temporary or
50.8 	permanent food stand, special event food stand, mobile food
50.9 	unit, food cart, resort, hotel, motel, or lodging establishment
50.10 	in Minnesota must submit to the commissioner a $35 annual
50.11 	statewide hospitality fee for each licensed activity.  The fee
50.12 	for establishments licensed by the Department of Health is
50.13 	required at the same time the licensure fee is due.  For
50.14 	establishments licensed by local governments, the fee is due by
50.15 	July 1 of each year.

50.16 	Sec. 40. Minnesota Statutes 2004, section 157.20,
50.17 	subdivision 2, is amended to read:
50.18 		Subd. 2.Inspection frequency.  The frequency of
50.19 	inspections of the establishments shall be based on the degree
50.20 	of health risk.
50.21 	(a) High-risk establishments must be inspected at least
50.22 	once a year every 12 months.
50.23 	(b) Medium-risk establishments must be inspected at least
50.24 	once every 18 months.
50.25 	(c) Low-risk establishments must be inspected at least once
50.26 	every two years 24 months.

50.27 	Sec. 41. Minnesota Statutes 2004, section 157.20,
50.28 	subdivision 2a, is amended to read:
50.29 		Subd. 2a.Risk categories.  (a)  [HIGH-RISK
50.30 	ESTABLISHMENT.] "High-risk establishment" means any food and
50.31 	beverage service establishment, hotel, motel, lodging
50.32 	establishment, or resort that:
50.33 	(1) serves potentially hazardous foods that require
50.34 	extensive processing on the premises, including manual handling,
50.35 	cooling, reheating, or holding for service;
50.36 	(2) prepares foods several hours or days before service;
51.1 	(3) serves menu items that epidemiologic experience has
51.2 	demonstrated to be common vehicles of food-borne illness;
51.3 	(4) has a public swimming pool; or
51.4 	(5) draws its drinking water from a surface water supply.
51.5 	(b)  [MEDIUM-RISK ESTABLISHMENT.] "Medium-risk
51.6 	establishment" means a food and beverage service establishment,
51.7 	hotel, motel, lodging establishment, or resort that:
51.8 	(1) serves potentially hazardous foods but with minimal
51.9 	holding between preparation and service; or
51.10 	(2) serves foods, such as pizza, that require extensive
51.11 	handling followed by heat treatment.
51.12 	(c)  [LOW-RISK ESTABLISHMENT.] "Low-risk establishment"
51.13 	means a food and beverage service establishment, hotel, motel,
51.14 	lodging establishment, or resort that is not a high-risk or
51.15 	medium-risk establishment.
51.16 	(d)  [RISK EXCEPTIONS.] Mobile food units, seasonal
51.17 	permanent and seasonal temporary food stands, food carts, and
51.18 	special event food stands are not inspected on an established
51.19 	schedule and therefore are not defined as high-risk,
51.20 	medium-risk, or low-risk establishments.
51.21 	(e) [SCHOOL INSPECTION FREQUENCY.] Elementary and
51.22 	secondary school food service establishments must be inspected
51.23 	according to the assigned risk category or by the frequency
51.24 	required in the Richard B. Russell National School Lunch Act,
51.25 	whichever frequency is more restrictive.

51.26 	Sec. 42. Minnesota Statutes 2004, section 326.01, is
51.27 	amended by adding a subdivision to read:
51.28 		Subd. 9a.Restricted plumbing contractor. A "restricted
51.29 	plumbing contractor" is any person skilled in the planning,
51.30 	superintending, and practical installation of plumbing who is
51.31 	otherwise lawfully qualified to contract for plumbing and
51.32 	installations and to conduct the business of plumbing, who is
51.33 	familiar with the laws and rules governing the business of
51.34 	plumbing, and who performs the plumbing trade in cities and
51.35 	towns with a population of fewer than 5,000 according to federal
51.36 	census.

52.1 	Sec. 43. Minnesota Statutes 2004, section 326.37,
52.2 	subdivision 1, is amended to read:
52.3 		Subdivision 1.Rules.  The state commissioner of
52.4 	health may shall, by rule, prescribe minimum uniform standards
52.5 	which shall be uniform, and which standards shall thereafter be 
52.6 	effective for all new plumbing installations, including
52.7 	additions, extensions, alterations, and replacements connected
52.8 	with any water or sewage disposal system owned or operated by or
52.9 	for any municipality, institution, factory, office building,
52.10 	hotel, apartment building, or any other place of business
52.11 	regardless of location or the population of the city or town in
52.12 	which located.  Notwithstanding the provisions of Minnesota
52.13 	Rules, part 4715.3130, as they apply to review of plans and
52.14 	specifications, the commissioner may allow plumbing
52.15 	construction, alteration, or extension to proceed without
52.16 	approval of the plans or specifications by the commissioner.
52.17 	The commissioner shall administer the provisions of
52.18 	sections 326.37 to 326.45 326.451 and for such purposes may
52.19 	employ plumbing inspectors and other assistants.

52.20 	Sec. 44. Minnesota Statutes 2004, section 326.37, is
52.21 	amended by adding a subdivision to read:
52.22 		Subd. 1a.Inspection. All new plumbing installations,
52.23 	including additions, extensions, alterations, and replacements,
52.24 	shall be inspected by the commissioner for compliance with
52.25 	accepted standards of construction for health, safety to life
52.26 	and property, and compliance with applicable codes.  The
52.27 	Department of Health must have full implementation of its
52.28 	inspections plan in place and operational July 1, 2007.  This
52.29 	subdivision does not apply where a political subdivision
52.30 	requires, by ordinance, plumbing inspections similar to the
52.31 	requirements of this subdivision.

52.32 	Sec. 45. Minnesota Statutes 2004, section 326.38, is
52.33 	amended to read:
52.34 	326.38 LOCAL REGULATIONS.
52.35 	Any city having a system of waterworks or sewerage, or any
52.36 	town in which reside over 5,000 people exclusive of any
53.1 	statutory cities located therein, or the metropolitan airports
53.2 	commission, may, by ordinance, adopt local regulations providing
53.3 	for plumbing permits, bonds, approval of plans, and inspections
53.4 	of plumbing, which regulations are not in conflict with the
53.5 	plumbing standards on the same subject prescribed by the state
53.6 	commissioner of health.  No city or such town shall prohibit
53.7 	plumbers licensed by the state commissioner of health from
53.8 	engaging in or working at the business, except cities and
53.9 	statutory cities which, prior to April 21, 1933, by ordinance
53.10 	required the licensing of plumbers. No city or such town may
53.11 	require a license for persons performing building sewer or water
53.12 	service installation who have completed pipe laying training as
53.13 	prescribed by the commissioner of health.Any city by ordinance
53.14 	may prescribe regulations, reasonable standards, and inspections
53.15 	and grant permits to any person, firm, or corporation engaged in
53.16 	the business of installing water softeners, who is not licensed
53.17 	as a master plumber or journeyman plumber by the state
53.18 	commissioner of health, to connect water softening and water
53.19 	filtering equipment to private residence water distribution
53.20 	systems, where provision has been previously made therefor and
53.21 	openings left for that purpose or by use of cold water
53.22 	connections to a domestic water heater; where it is not
53.23 	necessary to rearrange, make any extension or alteration of, or
53.24 	addition to any pipe, fixture or plumbing connected with the
53.25 	water system except to connect the water softener, and provided
53.26 	the connections so made comply with minimum standards prescribed
53.27 	by the state commissioner of health.

53.28 	Sec. 46. Minnesota Statutes 2004, section 326.40,
53.29 	subdivision 1, is amended to read:
53.30 		Subdivision 1.plumbers must be licensed in certain
53.31 	cities; master and journeyman plumbers master, journeyman, and
53.32 	restricted plumbing contractors; plumbing on one's own premises;
53.33 	rules for examination. In any city now or hereafter having
53.34 	5,000 or more population, according to the last federal census,
53.35 	and having a system of waterworks or sewerage, no person, firm,
53.36 	or corporation shall engage in or work at the business of a
54.1 	master plumber or journeyman plumber unless licensed to do so by
54.2 	the state commissioner of health.No person, firm, or
54.3 	corporation may engage in or work at the business of a master
54.4 	plumber, restricted plumbing contractor, or journeyman plumber
54.5 	unless licensed to do so by the commissioner of health under
54.6 	sections 326.37 to 326.451.  A license is not required for:
54.7 	(1) persons performing building sewer or water service
54.8 	installation who have completed pipe laying training as
54.9 	prescribed by the commissioner of health; or 
54.10 	(2) persons selling an appliance plumbing installation
54.11 	service at point of sale if the installation work is performed
54.12 	by a plumber licensed under sections 326.37 to 326.451.
54.13 	A master plumber may also work as a journeyman plumber.
54.14 	Anyone not so licensed may do plumbing work which complies with
54.15 	the provisions of the minimum standard prescribed by the state
54.16 	commissioner of health on premises or that part of premises
54.17 	owned and actually occupied by the worker as a residence, unless
54.18 	otherwise forbidden to do so by a local ordinance.
54.19 	In any such city No person, firm, or corporation shall
54.20 	engage in the business of installing plumbing nor install
54.21 	plumbing in connection with the dealing in and selling of
54.22 	plumbing material and supplies unless at all times a licensed
54.23 	master plumber or restricted plumbing contractor, who shall be
54.24 	responsible for proper installation, is in charge of the
54.25 	plumbing work of the person, firm, or corporation.
54.26 	The Department of Health shall prescribe rules, not
54.27 	inconsistent herewith, for the examination and licensing of
54.28 	plumbers.

54.29 	Sec. 47. [326.402] RESTRICTED PLUMBING CONTRACTOR
54.30 	LICENSE.
54.31 		Subdivision 1.Licensure. The commissioner shall grant a
54.32 	restricted plumbing contractor license to any person who applies
54.33 	to the commissioner and provides evidence of having at least two
54.34 	years of practical plumbing experience in the plumbing trade
54.35 	preceding application for licensure.
54.36 		Subd. 2.Use of license. A restricted plumbing
55.1 	contractor may engage in the plumbing trade only in cities and
55.2 	towns with a population of fewer than 5,000 according to federal
55.3 	census.
55.4 		Subd. 3.Application period. Applications for restricted
55.5 	plumbing contractor licenses must be submitted to the
55.6 	commissioner prior to January 1, 2006.
55.7 		Subd. 4.Use period for restricted plumbing contractor
55.8 	license. A restricted plumbing contractor license does not
55.9 	expire and remains in effect for as long as that person engages
55.10 	in the plumbing trade.
55.11 		Subd. 5.Prohibition of transference. A restricted
55.12 	plumbing contractor license must not be transferred or sold to
55.13 	any other person.
55.14 		Subd. 6.Restricted plumbing contractor license renewal.
 55.15 	The commissioner shall adopt rules for renewal of the restricted
55.16 	plumbing contractor license.

55.17 	Sec. 48. Minnesota Statutes 2004, section 326.42,
55.18 	subdivision 2, is amended to read:
55.19 		Subd. 2.Fees.  Plumbing system plans and specifications
55.20 	that are submitted to the commissioner for review shall be
55.21 	accompanied by the appropriate plan examination fees.  If the
55.22 	commissioner determines, upon review of the plans, that
55.23 	inadequate fees were paid, the necessary additional fees shall
55.24 	be paid prior to plan approval.  The commissioner shall charge
55.25 	the following fees for plan reviews and audits of plumbing
55.26 	installations for public, commercial, and industrial buildings:
55.27 	(1) systems with both water distribution and drain, waste,
55.28 	and vent systems and having:
55.29 	(i) 25 or fewer drainage fixture units, $150;
55.30 	(ii) 26 to 50 drainage fixture units, $250;
55.31 	(iii) 51 to 150 drainage fixture units, $350;
55.32 	(iv) 151 to 249 drainage fixture units, $500;
55.33 	(v) 250 or more drainage fixture units, $3 per drainage
55.34 	fixture unit to a maximum of $4,000; and
55.35 	(vi) interceptors, separators, or catch basins, $70 per
55.36 	interceptor, separator, or catch basin design;
56.1 	(2) building sewer service only, $150;
56.2 	(3) building water service only, $150;
56.3 	(4) building water distribution system only, no drainage
56.4 	system, $5 per supply fixture unit or $150, whichever is
56.5 	greater;
56.6 	(5) storm drainage system, a minimum fee of $150 or:
56.7 	(i) $50 per drain opening, up to a maximum of $500; and
56.8 	(ii) $70 per interceptor, separator, or catch basin design;
56.9 	(6) manufactured home park or campground, one to 25 sites,
56.10 	$300;
56.11 	(7) manufactured home park or campground, 26 to 50 sites,
56.12 	$350;
56.13 	(8) manufactured home park or campground, 51 to 125 sites,
56.14 	$400;
56.15 	(9) manufactured home park or campground, more than 125
56.16 	sites, $500;
56.17 	(10) accelerated review, double the regular fee, one-half
56.18 	to be refunded if no response from the commissioner within 15
56.19 	business days; and
56.20 	(11) revision to previously reviewed or incomplete plans:
56.21 	(i) review of plans for which commissioner has issued two
56.22 	or more requests for additional information, per review, $100 or
56.23 	ten percent of the original fee, whichever is greater;
56.24 	(ii) proposer-requested revision with no increase in
56.25 	project scope, $50 or ten percent of original fee, whichever is
56.26 	greater; and
56.27 	(iii) proposer-requested revision with an increase in
56.28 	project scope, $50 plus the difference between the original
56.29 	project fee and the revised project fee.

56.30 	Sec. 49. [326.451] INSPECTORS.
56.31 	(a) The commissioner shall set all reasonable criteria and
56.32 	procedures by rule for inspector certification, certification
56.33 	period, examinations, examination fees, certification fees, and
56.34 	renewal of certifications.
56.35 	(b) The commissioner shall adopt reasonable rules
56.36 	establishing criteria and procedures for refusal to grant or
57.1 	renew inspector certifications, and for suspension and
57.2 	revocation of inspector certifications.
57.3 	(c) The commissioner shall refuse to renew or grant
57.4 	inspector certifications, or suspend or revoke inspector
57.5 	certifications, in accordance with the commissioner's criteria
57.6 	and procedures as adopted by rule.

57.7 	Sec. 50. CERVICAL CANCER ELIMINATION STUDY.
 57.8 	(a) The commissioner of health shall develop a statewide
57.9 	integrated and comprehensive cervical cancer prevention plan,
57.10 	including strategies for promoting and implementing the plan.
57.11 	The plan must include activities that identify and implement
57.12 	methods to improve the cervical cancer screening rates in
57.13 	Minnesota, including, but not limited to:
57.14 	(1) identifying and disseminating appropriate
57.15 	evidence-based cervical cancer screening guidelines to be used
57.16 	in Minnesota;
57.17 	(2) increasing the use of appropriate screening based on
57.18 	these guidelines for patients seen by medical groups in
57.19 	Minnesota and monitoring results of these medical groups; and 
57.20 	(3) reducing the number of women who should but have not
57.21 	been screened.
57.22 	(b) In developing the plan, the commissioner shall also
57.23 	identify and examine limitations and barriers in providing
57.24 	cervical cancer screening, diagnosis tools, and treatment,
57.25 	including, but not limited to, medical care reimbursement,
57.26 	treatment costs, and the availability of insurance coverage.
57.27 	(c) The commissioner may work with a nonprofit quality
57.28 	improvement organization in Minnesota to identify evidence-based
57.29 	guidelines for cervical cancer screening and to identify methods
57.30 	to improve the cervical cancer screening rates among medical
57.31 	groups; and may work with a nonprofit health care result
57.32 	reporting organization to monitor results by medical groups in
57.33 	Minnesota.
57.34 	(d) The commissioner may convene an advisory committee that
57.35 	includes representatives of health care providers, the American
57.36 	Cancer Society, health plan companies, the University of
58.1 	Minnesota Academic Health Center, community health boards, and
58.2 	the general public.
58.3 	(e) The commissioner shall submit a report to the
58.4 	legislature by January 15, 2006, on:
58.5 	(1) the statewide cervical cancer prevention plan,
58.6 	including a description of the plan activities and strategies
58.7 	developed for promoting and implementing the plan;
58.8 	(2) methods for monitoring the results by medical groups
58.9 	and by the entire state of cervical cancer screening improvement
58.10 	activities; and 
58.11 	(3) recommended changes to existing laws, programs, or
58.12 	services in terms of reducing the occurrence of cervical cancer
58.13 	by improving insurance coverage for the prevention, diagnosis,
58.14 	and treatment for cervical cancer.

58.15 	Sec. 51. CLINICAL TRIAL WORK GROUP; REPORT.
 58.16 	The commissioners of health and commerce shall, in
58.17 	consultation with the commissioner of employee relations,
58.18 	convene a work group regarding health plan coverage of routine
58.19 	care associated with clinical trials.  The work group must
58.20 	explore what high-quality clinical trials beyond cancer-only
58.21 	clinical trials should be covered by health plans.  All other
58.22 	types of clinical trials, disease-based or technology-based such
58.23 	as drug trials or device trials should be considered.  The work
58.24 	group shall use the current, cancer-only model voluntary
58.25 	agreement that includes definitions of high-quality clinical
58.26 	trials, protocol induced costs, and routine care costs as a
58.27 	starting point for discussions.  As determined appropriate, the
58.28 	work group shall establish model voluntary agreement guidelines
58.29 	for health plan coverage of routine patient care costs incurred
58.30 	by patients participating in high quality clinical trials.  The
58.31 	work group shall be made up of representatives of consumers,
58.32 	patient advocates, health plan companies, fully insured and
58.33 	self-insured purchasers, providers, and other health care
58.34 	professionals involved in the care and treatment of patients.
58.35 	The commissioners shall submit the findings and recommendations
58.36 	of the work group to the chairs of the senate and house
59.1 	committees having jurisdiction over health policy and finance by
59.2 	January 15, 2006.

59.3 	Sec. 52. PUBLIC HEALTH INFORMATION NETWORK.
 59.4 	(a) The commissioner of health shall work with local public
59.5 	health departments to develop a public health information
59.6 	network.  The development of the network must be consistent with
59.7 	the recommendations, goals, and strategies of the Minnesota
59.8 	public health information network report to the 2005 legislature
59.9 	and the e-health initiative.
59.10 	(b) The commissioner of health shall work with the
59.11 	commissioner of human services to determine how data from care
59.12 	systems can be utilized to assist with population health needs
59.13 	assessments and targeted prevention efforts.  The commissioner
59.14 	of health shall incorporate these findings into the development
59.15 	of a Minnesota public health information network and the
59.16 	e-health initiative.

59.17 	Sec. 53. REPORT TO LEGISLATURE ON SWING BED USAGE.
 59.18 	The commissioner of health shall review swing bed and
59.19 	related data reported under Minnesota Statutes, sections
59.20 	144.562, subdivision 3, paragraph (f); 144.564; and 144.698.
59.21 	The commissioner shall report and make any appropriate
59.22 	recommendations to the legislature by January 31, 2007, on:
59.23 	(1) the use of swing bed days by all hospitals and by
59.24 	critical access hospitals;
59.25 	(2) occupancy rates in skilled nursing facilities within 25
59.26 	miles of hospitals with swing beds; and 
59.27 	(3) information provided by rural providers on the use of
59.28 	swing beds and the adequacy of rural services across the
59.29 	continuum of care.

59.30 	Sec. 54. IMPLEMENTATION OF AN ELECTRONIC HEALTH RECORDS
59.31 	SYSTEM.
 59.32 	The commissioner of health, in consultation with the
59.33 	electronic health record planning work group established in Laws
59.34 	2004, chapter 288, article 7, section 7, shall develop a
59.35 	statewide plan for all hospitals and physician group practices
59.36 	to have in place an interoperable electronic health records
60.1 	system by January 1, 2015.  In developing the plan, the
60.2 	commissioner shall consider:
60.3 	(1) creating financial assistance to hospitals and
60.4 	providers for implementing or updating an electronic health
60.5 	records system, including, but not limited to, the establishment
60.6 	of grants, financial incentives, or low-interest loans;
60.7 	(2) addressing specific needs and concerns of safety-net
60.8 	hospitals, community health clinics, and other health care
60.9 	providers who serve low-income patients in implementing an
60.10 	electronic records system within the hospital or practice; and 
60.11 	(3) providing assistance in the development of possible
60.12 	alliances or collaborations among providers.
60.13 	The commissioner shall provide preliminary reports to the
60.14 	chairs of the senate and house committees with jurisdiction over
60.15 	health care policy and finance biennially beginning January 15,
60.16 	2007, on the status of reaching the goal for all hospitals and
60.17 	physician group practices to have an interoperable electronic
60.18 	health records system in place by January 1, 2015.  The reports
60.19 	shall include recommendations on statutory language necessary to
60.20 	implement the plan, including possible financing options.

60.21 	Sec. 55. RULE AMENDMENT.
 60.22 	The commissioner of health shall amend Minnesota Rules,
60.23 	part 4626.2015, subparts 3, item C; and 6, item B, to conform
60.24 	with Minnesota Statutes, section 157.16, subdivision 2a.  The
60.25 	commissioner may use the good cause exemption under Minnesota
60.26 	Statutes, section 14.388, subdivision 1, clause (3).  Minnesota
60.27 	Statutes, section 14.386, does not apply, except to the extent
60.28 	provided under Minnesota Statutes, section 14.388.

60.29 	Sec. 56. REVISOR'S INSTRUCTION.
 60.30 	The revisor of statutes shall change all references to
60.31 	Minnesota Statutes, section 326.45, to Minnesota Statutes,
60.32 	section 326.451, in Minnesota Statutes, sections 144.99, 326.44,
60.33 	326.61, and 326.65.

60.34 	Sec. 57. REPEALER.
 60.35 	Minnesota Statutes 2004, sections 144.1486; 157.215; and
60.36 	326.45, are repealed.

61.1 	ARTICLE 2
61.2 	HEALTH CARE - DEPARTMENT OF HUMAN SERVICES

61.3 	Section 1. Minnesota Statutes 2004, section 62D.12,
61.4 	subdivision 19, is amended to read:
61.5 		Subd. 19.Coverage of service.  A health maintenance
61.6 	organization may not deny or limit coverage of a service which
61.7 	the enrollee has already received solely on the basis of lack of
61.8 	prior authorization or second opinion, to the extent that the
61.9 	service would otherwise have been covered under the member's
61.10 	contract by the health maintenance organization had prior
61.11 	authorization or second opinion been obtained. This subdivision
61.12 	does not apply to health maintenance organizations for services
61.13 	provided in the prepaid health programs administered under
61.14 	chapter 256B, 256D, or 256L.

61.15 	Sec. 2. Minnesota Statutes 2004, section 62J.43, is
61.16 	amended to read:
61.17 	62J.43  BEST PRACTICES EVIDENCE-BASED HEALTH CARE
61.18 	GUIDELINES AND QUALITY IMPROVEMENT.
61.19 	(a) Subdivision 1.[ADOPTION OF BEST
61.20 	PRACTICES EVIDENCE-BASED HEALTH CARE GUIDELINES.] To improve
61.21 	quality and reduce health care costs, state agencies shall
61.22 	encourage the adoption use of best practice evidence-based
61.23 	health care guidelines and participation in best practices 
61.24 	quality of care measurement activities by physicians medical
61.25 	groups, hospitals, other health care providers, and health plan
61.26 	companies.  The commissioner of health shall facilitate access
61.27 	to best practice evidence-based health care guidelines and
61.28 	quality of care measurement information to for providers,
61.29 	purchasers, and consumers by:
61.30 	(1) identifying and promoting local community-based,
61.31 	physician-designed best practices care evidence-based health
61.32 	care guidelines across the Minnesota health care system using
61.33 	local community-based, physician-designed guidelines whenever
61.34 	they are available and meet the criteria set forth in
61.35 	subdivision 2;
61.36 	(2) disseminating information available to the commissioner
62.1 	on adherence to best practices care by physicians the
62.2 	performance of Minnesota medical groups, hospitals,and other
62.3 	health care providers in Minnesota in providing care in
62.4 	accordance with evidence-based health care guidelines;
62.5 	(3) educating consumers and purchasers on how to
62.6 	effectively use this information effectively in choosing their
62.7 	providers and in making purchasing decisions; and
62.8 	(4) making best practices evidence-based health care
62.9 	guidelines and quality of care measurement information available
62.10 	to enrollees and program participants through the Department of
62.11 	Health's Web site.  The commissioner may convene an advisory
62.12 	committee to ensure that the Web site is designed to provide
62.13 	user friendly and easy accessibility.
62.14 	(b)  The commissioner of health shall collaborate with a
62.15 	nonprofit Minnesota quality improvement organization
62.16 	specializing in best practices and quality of care measurements
62.17 	to provide best practices criteria and assist in the collection
62.18 	of the data.
62.19 	(c) Subd. 2.[CRITERIA FOR EVIDENCE-BASED HEALTH CARE
62.20 	GUIDELINES.] Guidelines identified under this section must meet
62.21 	the following criteria:
62.22 	(1) the scope and intended use of the guideline are clearly
62.23 	stated;
62.24 	(2) the authors are listed and any conflicts of interest
62.25 	are disclosed;
62.26 	(3) the authors represent all pertinent clinical fields or
62.27 	other means of input have been used for pertinent clinical
62.28 	fields not represented among the authors;
62.29 	(4) the development process is explicitly stated;
62.30 	(5) the guideline is grounded in evidence;
62.31 	(6) the evidence is cited and graded with respect to its
62.32 	strength;
62.33 	(7) the document itself is clear and practical;
62.34 	(8) the document is flexible in use, with exceptions noted
62.35 	or provided for with general statements;
62.36 	(9) measures are included for use in systems improvement
63.1 	pursued to improve the likelihood that health care will be
63.2 	provided in accordance with the guideline; and 
63.3 	(10) the document provides for scheduled reviews and
63.4 	updating.
63.5 		Subd. 3.Identification of evidence-based health care
63.6 	guidelines. In order to identify evidence-based guidelines for
63.7 	promotion under this section, the commissioner of health shall
63.8 	collaborate with a nonprofit Minnesota quality improvement
63.9 	organization that specializes in producing guidelines and using
63.10 	them to improve health care.  The guidelines identified may be
63.11 	ones produced by that organization or ones produced by other
63.12 	nonprofit Minnesota or national organizations, provided that the
63.13 	guidelines fulfill the criteria set forth in subdivision 2.
63.14 		Subd. 4.Initial evidence-based health care guidelines.
 63.15 	The initial best practices and quality of care measurement
63.16 	criteria developed topics of the evidence-based health care
63.17 	guidelines initially identified and promoted shall include
63.18 	asthma, diabetes, and at least two other preventive health
63.19 	measures.  Hypertension and coronary artery disease shall be
63.20 	included within one year following availability hypertension,
63.21 	coronary artery disease, depression, preventive services, acute
63.22 	myocardial infarction, heart failure, pneumonia, and surgical
63.23 	infections.  The guidelines on these topics shall be identified
63.24 	and promotion begun by December 15, 2005.
63.25 	(d) The commissioners of human services and employee
63.26 	relations may use the data to make decisions about contracts
63.27 	they enter into with health plan companies.
63.28 	(e) Subd. 5.[LIMITATIONS.] This section does not apply if
63.29 	the best practices evidence-based health care guidelines
63.30 	authorize or recommend denial of treatment, food, or fluids
63.31 	necessary to sustain life on the basis of the patient's age or
63.32 	expected length of life or the patient's present or predicted
63.33 	disability, degree of medical dependency, or quality of life.
63.34 	(f) The commissioner of health, human services, and
63.35 	employee relations shall report to the legislature by January
63.36 	15, 2005, on the status of best practices and quality of care
64.1 	initiatives, and shall present recommendations to the
64.2 	legislature on any statutory changes needed to increase the
64.3 	effectiveness of these initiatives.
64.4 	(g) This section expires June 30, 2006.

64.5 	Sec. 3. Minnesota Statutes 2004, section 62M.06,
64.6 	subdivision 2, is amended to read:
64.7 		Subd. 2.Expedited appeal.  (a) When an initial
64.8 	determination not to certify a health care service is made prior
64.9 	to or during an ongoing service requiring review and the
64.10 	attending health care professional believes that the
64.11 	determination warrants an expedited appeal, the utilization
64.12 	review organization must ensure that the enrollee and the
64.13 	attending health care professional have an opportunity to appeal
64.14 	the determination over the telephone on an expedited basis.  In
64.15 	such an appeal, the utilization review organization must ensure
64.16 	reasonable access to its consulting physician or health care
64.17 	provider. For review of initial determinations not to certify a
64.18 	service for prepaid health care programs under chapter 256B,
64.19 	256D, or 256L, the health care provider conducting the review
64.20 	must follow coverage policies adopted by the health plan company
64.21 	that are based upon published evidence-based health care
64.22 	guidelines as established by a nonprofit Minnesota quality
64.23 	improvement organization, a nationally recognized guideline
64.24 	development organization, or by the professional association of
64.25 	the specialty that typically provides the service provided that
64.26 	the guidelines meet the criteria set forth in section 62J.43,
64.27 	subdivision 2.
64.28 	(b) The utilization review organization shall notify the
64.29 	enrollee and attending health care professional by telephone of
64.30 	its determination on the expedited appeal as expeditiously as
64.31 	the enrollee's medical condition requires, but no later than 72
64.32 	hours after receiving the expedited appeal.
64.33 	(c) If the determination not to certify is not reversed
64.34 	through the expedited appeal, the utilization review
64.35 	organization must include in its notification the right to
64.36 	submit the appeal to the external appeal process described in
65.1 	section 62Q.73 and the procedure for initiating the process.
65.2 	This information must be provided in writing to the enrollee and
65.3 	the attending health care professional as soon as practical.

65.4 	Sec. 4. Minnesota Statutes 2004, section 62M.06,
65.5 	subdivision 3, is amended to read:
65.6 		Subd. 3.Standard appeal.  The utilization review
65.7 	organization must establish procedures for appeals to be made
65.8 	either in writing or by telephone.
65.9 	(a) A utilization review organization shall notify in
65.10 	writing the enrollee, attending health care professional, and
65.11 	claims administrator of its determination on the appeal within
65.12 	30 days upon receipt of the notice of appeal.  If the
65.13 	utilization review organization cannot make a determination
65.14 	within 30 days due to circumstances outside the control of the
65.15 	utilization review organization, the utilization review
65.16 	organization may take up to 14 additional days to notify the
65.17 	enrollee, attending health care professional, and claims
65.18 	administrator of its determination.  If the utilization review
65.19 	organization takes any additional days beyond the initial 30-day
65.20 	period to make its determination, it must inform the enrollee,
65.21 	attending health care professional, and claims administrator, in
65.22 	advance, of the extension and the reasons for the extension.
65.23 	(b) The documentation required by the utilization review
65.24 	organization may include copies of part or all of the medical
65.25 	record and a written statement from the attending health care
65.26 	professional.
65.27 	(c) Prior to upholding the initial determination not to
65.28 	certify for clinical reasons, the utilization review
65.29 	organization shall conduct a review of the documentation by a
65.30 	physician who did not make the initial determination not to
65.31 	certify. For review of initial determinations not to certify a
65.32 	service for prepaid health care programs under chapter 256B,
65.33 	256D, or 256L, the physician conducting the review must follow
65.34 	coverage policies adopted by the health plan company that are
65.35 	based upon publicly available evidence-based health care
65.36 	guidelines as established by a nonprofit Minnesota quality
66.1 	improvement organization, a nationally recognized guideline
66.2 	development organization, or by the professional association of
66.3 	the specialty that typically provides the service provided that
66.4 	the guidelines meet the criteria set forth in section 62J.43,
66.5 	subdivision 2.
66.6 	(d) The process established by a utilization review
66.7 	organization may include defining a period within which an
66.8 	appeal must be filed to be considered.  The time period must be
66.9 	communicated to the enrollee and attending health care
66.10 	professional when the initial determination is made.
66.11 	(e) An attending health care professional or enrollee who
66.12 	has been unsuccessful in an attempt to reverse a determination
66.13 	not to certify shall, consistent with section 72A.285, be
66.14 	provided the following:
66.15 	(1) a complete summary of the review findings;
66.16 	(2) qualifications of the reviewers, including any license,
66.17 	certification, or specialty designation; and
66.18 	(3) the relationship between the enrollee's diagnosis and
66.19 	the review criteria used as the basis for the decision,
66.20 	including the specific rationale for the reviewer's decision.
66.21 	(f) In cases of appeal to reverse a determination not to
66.22 	certify for clinical reasons, the utilization review
66.23 	organization must ensure that a physician of the utilization
66.24 	review organization's choice in the same or a similar specialty
66.25 	as typically manages the medical condition, procedure, or
66.26 	treatment under discussion is reasonably available to review the
66.27 	case.
66.28 	(g) If the initial determination is not reversed on appeal,
66.29 	the utilization review organization must include in its
66.30 	notification the right to submit the appeal to the external
66.31 	review process described in section 62Q.73 and the procedure for
66.32 	initiating the external process.

66.33 	Sec. 5. Minnesota Statutes 2004, section 256.045,
66.34 	subdivision 3, is amended to read:
66.35 		Subd. 3.State agency hearings.  (a) State agency
66.36 	hearings are available for the following:  (1) any person
67.1 	applying for, receiving or having received public assistance,
67.2 	medical care, or a program of social services granted by the
67.3 	state agency or a county agency or the federal Food Stamp Act
67.4 	whose application for assistance is denied, not acted upon with
67.5 	reasonable promptness, or whose assistance is suspended,
67.6 	reduced, terminated, or claimed to have been incorrectly paid;
67.7 	(2) any patient or relative aggrieved by an order of the
67.8 	commissioner under section 252.27; (3) a party aggrieved by a
67.9 	ruling of a prepaid health plan; (4) except as provided under
67.10 	chapter 245C, any individual or facility determined by a lead
67.11 	agency to have maltreated a vulnerable adult under section
67.12 	626.557 after they have exercised their right to administrative
67.13 	reconsideration under section 626.557; (5) any person whose
67.14 	claim for foster care payment according to a placement of the
67.15 	child resulting from a child protection assessment under section
67.16 	626.556 is denied or not acted upon with reasonable promptness,
67.17 	regardless of funding source; (6) any person to whom a right of
67.18 	appeal according to this section is given by other provision of
67.19 	law; (7) an applicant aggrieved by an adverse decision to an
67.20 	application for a hardship waiver under section 256B.15; (8) an
67.21 	applicant aggrieved by an adverse decision to an application or
67.22 	redetermination for a Medicare Part D prescription drug subsidy
67.23 	under section 256B.04, subdivision 4a; (9) except as provided
67.24 	under chapter 245A, an individual or facility determined to have
67.25 	maltreated a minor under section 626.556, after the individual
67.26 	or facility has exercised the right to administrative
67.27 	reconsideration under section 626.556; or (9) (10) except as
67.28 	provided under chapter 245C, an individual disqualified under
67.29 	sections 245C.14 and 245C.15, on the basis of serious or
67.30 	recurring maltreatment; a preponderance of the evidence that the
67.31 	individual has committed an act or acts that meet the definition
67.32 	of any of the crimes listed in section 245C.15, subdivisions 1
67.33 	to 4; or for failing to make reports required under section
67.34 	626.556, subdivision 3, or 626.557, subdivision 3.  Hearings
67.35 	regarding a maltreatment determination under clause (4)
67.36 	or (8) (9) and a disqualification under this clause in which the
68.1 	basis for a disqualification is serious or recurring
68.2 	maltreatment, which has not been set aside under sections
68.3 	245C.22 and 245C.23, shall be consolidated into a single fair
68.4 	hearing.  In such cases, the scope of review by the human
68.5 	services referee shall include both the maltreatment
68.6 	determination and the disqualification.  The failure to exercise
68.7 	the right to an administrative reconsideration shall not be a
68.8 	bar to a hearing under this section if federal law provides an
68.9 	individual the right to a hearing to dispute a finding of
68.10 	maltreatment.  Individuals and organizations specified in this
68.11 	section may contest the specified action, decision, or final
68.12 	disposition before the state agency by submitting a written
68.13 	request for a hearing to the state agency within 30 days after
68.14 	receiving written notice of the action, decision, or final
68.15 	disposition, or within 90 days of such written notice if the
68.16 	applicant, recipient, patient, or relative shows good cause why
68.17 	the request was not submitted within the 30-day time limit.
68.18 	The hearing for an individual or facility under clause (4),
68.19 	(8) (9), or (9) (10) is the only administrative appeal to the
68.20 	final agency determination specifically, including a challenge
68.21 	to the accuracy and completeness of data under section 13.04.
68.22 	Hearings requested under clause (4) apply only to incidents of
68.23 	maltreatment that occur on or after October 1, 1995.  Hearings
68.24 	requested by nursing assistants in nursing homes alleged to have
68.25 	maltreated a resident prior to October 1, 1995, shall be held as
68.26 	a contested case proceeding under the provisions of chapter 14.
68.27 	Hearings requested under clause (8) (9) apply only to incidents
68.28 	of maltreatment that occur on or after July 1, 1997.  A hearing
68.29 	for an individual or facility under clause (8) (9) is only
68.30 	available when there is no juvenile court or adult criminal
68.31 	action pending.  If such action is filed in either court while
68.32 	an administrative review is pending, the administrative review
68.33 	must be suspended until the judicial actions are completed.  If
68.34 	the juvenile court action or criminal charge is dismissed or the
68.35 	criminal action overturned, the matter may be considered in an
68.36 	administrative hearing.
69.1 	For purposes of this section, bargaining unit grievance
69.2 	procedures are not an administrative appeal.
69.3 	The scope of hearings involving claims to foster care
69.4 	payments under clause (5) shall be limited to the issue of
69.5 	whether the county is legally responsible for a child's
69.6 	placement under court order or voluntary placement agreement
69.7 	and, if so, the correct amount of foster care payment to be made
69.8 	on the child's behalf and shall not include review of the
69.9 	propriety of the county's child protection determination or
69.10 	child placement decision.
69.11 	(b) A vendor of medical care as defined in section 256B.02,
69.12 	subdivision 7, or a vendor under contract with a county agency
69.13 	to provide social services is not a party and may not request a
69.14 	hearing under this section, except if assisting a recipient as
69.15 	provided in subdivision 4.
69.16 	(c) An applicant or recipient is not entitled to receive
69.17 	social services beyond the services included in the amended
69.18 	community social services plan.
69.19 	(d) The commissioner may summarily affirm the county or
69.20 	state agency's proposed action without a hearing when the sole
69.21 	issue is an automatic change due to a change in state or federal
69.22 	law.

69.23 	Sec. 6. Minnesota Statutes 2004, section 256.045,
69.24 	subdivision 3a, is amended to read:
69.25 		Subd. 3a.Prepaid health plan appeals.  (a) All prepaid
69.26 	health plans under contract to the commissioner under chapter
69.27 	256B or 256D must provide for a complaint system according to
69.28 	section 62D.11.  When a prepaid health plan denies, reduces, or
69.29 	terminates a health service or denies a request to authorize a
69.30 	previously authorized health service, the prepaid health plan
69.31 	must notify the recipient of the right to file a complaint or an
69.32 	appeal.  The notice must include the name and telephone number
69.33 	of the ombudsman and notice of the recipient's right to request
69.34 	a hearing under paragraph (b). When a complaint is filed, the
69.35 	prepaid health plan must notify the ombudsman within three
69.36 	working days.Recipients may request the assistance of the
70.1 	ombudsman in the complaint system process.  The prepaid health
70.2 	plan must issue a written resolution of the complaint to the
70.3 	recipient within 30 days after the complaint is filed with the
70.4 	prepaid health plan.  A recipient is not required to exhaust the
70.5 	complaint system procedures in order to request a hearing under
70.6 	paragraph (b).
70.7 	(b) Recipients enrolled in a prepaid health plan under
70.8 	chapter 256B or 256D may contest a prepaid health plan's denial,
70.9 	reduction, or termination of health services, a prepaid health
70.10 	plan's denial of a request to authorize a previously authorized
70.11 	health service, or the prepaid health plan's written resolution
70.12 	of a complaint by submitting a written request for a hearing
70.13 	according to subdivision 3.  A state human services referee
70.14 	shall conduct a hearing on the matter and shall recommend an
70.15 	order to the commissioner of human services. The referee may
70.16 	not overturn a decision by a prepaid health plan to deny or
70.17 	limit coverage for services if the prepaid health plan has used
70.18 	coverage policies adopted by the health plan company that are
70.19 	based upon published evidence-based health care guidelines that
70.20 	meet the criteria set forth in section 62J.43, subdivision 2, in
70.21 	making the determination unless the recipient can show by clear
70.22 	and convincing evidence that the determination should be
70.23 	overturned.The commissioner need not grant a hearing if the
70.24 	sole issue raised by a recipient is the commissioner's authority
70.25 	to require mandatory enrollment in a prepaid health plan in a
70.26 	county where prepaid health plans are under contract with the
70.27 	commissioner.  The state human services referee may order a
70.28 	second medical opinion from the prepaid health plan or may order
70.29 	a second medical opinion from a nonprepaid health plan provider
70.30 	at the expense of the prepaid health plan.  Recipients may
70.31 	request the assistance of the ombudsman in the appeal process.
70.32 	(c) In the written request for a hearing to appeal from a
70.33 	prepaid health plan's denial, reduction, or termination of a
70.34 	health service, a prepaid health plan's denial of a request to
70.35 	authorize a previously authorized service, or the prepaid health
70.36 	plan's written resolution to a complaint, a recipient may
71.1 	request an expedited hearing.  If an expedited appeal is
71.2 	warranted, the state human services referee shall hear the
71.3 	appeal and render a decision within a time commensurate with the
71.4 	level of urgency involved, based on the individual circumstances
71.5 	of the case.

71.6 	Sec. 7. Minnesota Statutes 2004, section 256.9365, is
71.7 	amended to read:
71.8 	256.9365  PURCHASE OF CONTINUATION COVERAGE FOR AIDS
71.9 	PATIENTS HIV HEALTH CARE ACCESS PROGRAMS.
71.10 		Subdivision 1.insurance assistance program established.
 71.11 	The commissioner of human services shall establish a program to
71.12 	pay private health plan premiums for persons who have contracted
71.13 	human immunodeficiency virus (HIV) to enable them to continue
71.14 	coverage under a group or individual health plan.  If a person
71.15 	is determined to be eligible under subdivision 2, the
71.16 	commissioner shall pay the portion of the group plan premium for
71.17 	which the individual is responsible, if the individual is
71.18 	responsible for at least 50 percent of the cost of the premium,
71.19 	or pay the individual plan premium.  The commissioner shall not
71.20 	pay for that portion of a premium that is attributable to other
71.21 	family members or dependents health care access program for
71.22 	low-income Minnesotans living with HIV that provides access to
71.23 	HIV treatment consistent with the guidelines of the United
71.24 	States Public Health Service.  The program shall provide
71.25 	assistance with medical insurance premiums to secure or maintain
71.26 	necessary health care insurance coverage.
71.27 		Subd. 2.Eligibility requirements. To be eligible for
71.28 	the HIV health care access program, an applicant must satisfy
71.29 	the following requirements:
71.30 	(1) the applicant must provide a physician's statement
71.31 	verifying that the applicant is infected with HIV and is, or
71.32 	within three months is likely to become, too ill to work in the
71.33 	applicant's current employment because of HIV-related disease;
71.34 	(2) the applicant's have a monthly gross family income must 
71.35 	that does not exceed 300 percent of the federal poverty
71.36 	guidelines, after deducting medical expenses and insurance
72.1 	premiums;
72.2 	(3) the applicant must not own assets with a combined value
72.3 	of more than $25,000, excluding:
72.4 	(i) all assets excluded under section 256B.056;
72.5 	(ii) retirement accounts, Keogh plans, and pension plans;
72.6 	and 
72.7 	(iii) medical expense accounts set up through the
72.8 	individual's employer; and 
72.9 	(4) if applying for payment of group plan premiums, the
72.10 	applicant must be covered by an employer's or former employer's
72.11 	group insurance plan have no health insurance coverage; have no
72.12 	health insurance coverage because of ineligibility due to a
72.13 	preexisting condition; or face loss of health insurance coverage
72.14 	due to a change in employment status;
72.15 	(5) reside in Minnesota;
72.16 	(6) have been determined ineligible for Medicare, Medicaid,
72.17 	MinnesotaCare, and general assistance medical care; and 
72.18 	(7) meet monthly cost-sharing obligations as provided for
72.19 	in subdivision 4.
72.20 		Subd. 3.cost-effective coverage benefits. (a) For
72.21 	individuals who are uninsured or insured with 50 percent or less
72.22 	of the premium by an employer, the commissioner shall pay that
72.23 	portion of the group plan premium for which the individual is
72.24 	responsible or shall pay the individual plan premium.  The
72.25 	commissioner shall not pay for that portion of a premium that is
72.26 	attributable to other family members or dependents.
72.27 	(b) Requirements for the payment of individual plan
72.28 	premiums under subdivision 2, clause (5),1 must be designed to
72.29 	ensure that the state cost of paying an individual plan premium
72.30 	does not exceed the estimated state cost that would otherwise be
72.31 	incurred in the medical assistance or general assistance medical
72.32 	care program.  The commissioner shall purchase the most
72.33 	cost-effective coverage available for eligible
72.34 	individuals. Efforts shall be made to obtain coverage that is
72.35 	consistent with the guidelines of the United States Public
72.36 	Health Service for HIV treatment, and to the extent possible,
73.1 	provides comprehensive coverage that includes medical, mental
73.2 	health, and substance abuse treatment.
73.3 		Subd. 4.Cost-sharing responsibilities. The commissioner
73.4 	may establish cost-sharing responsibilities for individuals
73.5 	determined to be eligible for the HIV health care access program
73.6 	that are consistent with guidelines established in the federal
73.7 	Ryan White Care Act.  These obligations, when appropriate for
73.8 	efficient program administration, should be consistent with
73.9 	cost-sharing requirements for other Minnesota health care
73.10 	programs.
73.11 		Subd. 5.Fiscal integrity. (a) The commissioner shall
73.12 	manage the HIV health care access program to assure that the
73.13 	program spending does not exceed the resources made available by
73.14 	the federal government and the legislature.
73.15 	(b) The commissioner shall make necessary program changes
73.16 	to assure the fiscal integrity of the program.
73.17 	(c) Each year following the release of the November revenue
73.18 	forecast, the commissioner shall report to the chairs of the
73.19 	appropriate health and human services finance committees the
73.20 	forecasted need for the HIV health care access programs included
73.21 	in this section.  The report shall include information about the
73.22 	anticipated enrollment, service utilization, service costs,
73.23 	state, federal, and special revenue resources available to fund
73.24 	the program needs, and any anticipated funding shortfall.
73.25 	(d) When a shortfall of funding is projected,
73.26 	recommendations should be included to assure that the program
73.27 	expenditures are maintained within the anticipated available
73.28 	funding.
73.29 		Subd. 6.Continuation of care. (a) The commissioner
73.30 	shall establish policies and procedures to ensure that initial
73.31 	and continued access to HIV treatment is provided to recipients
73.32 	who meet the eligibility requirements in subdivision 2.
73.33 	(b) The policies and procedures shall consider the impacts
73.34 	of continued HIV treatment on:
73.35 	(1) reducing the risk for HIV transmission;
73.36 	(2) preventing program recipients from becoming drug
74.1 	resistant; and 
74.2 	(3) the prevention of the development of drug-resistant
74.3 	strains of HIV.
74.4 		Subd. 7.Coordination with federally funded hiv health
74.5 	care access programs. (a) The commissioner shall administer the
74.6 	HIV health care access program in coordination with funding
74.7 	received from the Ryan White Care Act.
74.8 	(b) Within the limits of the federal funding available for
74.9 	these purposes, the commissioner may provide access to drugs
74.10 	that treat HIV and manage the side effects of HIV treatment to
74.11 	persons who meet the eligibility requirements in subdivision 2.
74.12 	(c) The commissioner may establish co-payment obligations
74.13 	for drugs purchased under this section.
74.14 		Subd. 8.Community advisory process. The commissioner
74.15 	shall establish a community advisory process for assessing the
74.16 	effectiveness of the policies and procedures established for the
74.17 	HIV health care access program.  As appropriate to minimize
74.18 	duplicative efforts, the process shall include consultation
74.19 	with, coordination with, and reporting to the Minnesota HIV
74.20 	Services Planning Council.  Public notification shall be made of
74.21 	the committee's members and meetings.

74.22 	Sec. 8. [256.9545] PRESCRIPTION DRUG DISCOUNT PROGRAM.
74.23 		Subdivision 1.Establishment; administration. The
74.24 	commissioner shall establish and administer the prescription
74.25 	drug discount program.
74.26 	Subd. 2.[COMMISSIONER'S AUTHORITY.] The commissioner
74.27 	shall administer a drug rebate program for drugs purchased
74.28 	according to the prescription drug discount program.  The
74.29 	commissioner shall execute a rebate agreement from all
74.30 	manufacturers that choose to participate in the program for
74.31 	those drugs covered under the medical assistance program.  For
74.32 	each drug, the amount of the rebate shall be equal to the rebate
74.33 	as defined for purposes of the federal rebate program in United
74.34 	States Code, title 42, section 1396r-8.  The rebate program
74.35 	shall utilize the terms and conditions used for the federal
74.36 	rebate program established according to section 1927 of title
75.1 	XIX of the federal Social Security Act.
75.2 		Subd. 3.Definitions. For the purpose of this section,
75.3 	the following terms have the meanings given them.
75.4 	(a) "Commissioner" means the commissioner of human services.
75.5 	(b) "Participating manufacturer" means a manufacturer as
75.6 	defined in section 151.44, paragraph (c), that agrees to
75.7 	participate in the prescription drug discount program.
75.8 	(c) "Covered prescription drug" means a prescription drug
75.9 	as defined in section 151.44, paragraph (d), that is covered
75.10 	under medical assistance as described in section 256B.0625,
75.11 	subdivision 13, and that is provided by a participating
75.12 	manufacturer that has a fully executed rebate agreement with the
75.13 	commissioner under this section and complies with that agreement.
75.14 	(d) "Health carrier" means an insurance company licensed
75.15 	under chapter 60A to offer, sell, or issue an individual or
75.16 	group policy of accident and sickness insurance as defined in
75.17 	section 62A.01; a nonprofit health service plan corporation
75.18 	operating under chapter 62C; a health maintenance organization
75.19 	operating under chapter 62D; a joint self-insurance employee
75.20 	health plan operating under chapter 62H; a community integrated
75.21 	service network licensed under chapter 62N; a fraternal benefit
75.22 	society operating under chapter 64B; a city, county, school
75.23 	district, or other political subdivision providing self-insured
75.24 	health coverage under section 471.617 or sections 471.98 to
75.25 	471.982; and a self-funded health plan under the Employee
75.26 	Retirement Income Security Act of 1974, as amended.
75.27 	(e) "Participating pharmacy" means a pharmacy as defined in
75.28 	section 151.01, subdivision 2, that agrees to participate in the
75.29 	prescription drug discount program.
75.30 	(f) "Enrolled individual" means a person who is eligible
75.31 	for the program under subdivision 4 and has enrolled in the
75.32 	program according to subdivision 5.
75.33 		Subd. 4.Eligibility. To be eligible for the program, an
75.34 	applicant must:
75.35 	(1) be a permanent resident of Minnesota as defined in
75.36 	section 256L.09, subdivision 4;
76.1 	(2) not be enrolled in Medicare, medical assistance,
76.2 	general assistance medical care, or MinnesotaCare;
76.3 	(3) not be enrolled in and have currently available
76.4 	prescription drug coverage under a health plan offered by a
76.5 	health carrier or employer or under a pharmacy benefit program
76.6 	offered by a pharmaceutical manufacturer; and 
76.7 	(4) not be enrolled in and have currently available
76.8 	prescription drug coverage under a Medicare supplement plan, as
76.9 	defined in sections 62A.31 to 62A.44, or policies, contracts, or
76.10 	certificates that supplement Medicare issued by health
76.11 	maintenance organizations or those policies, contracts, or
76.12 	certificates governed by section 1833 or 1876 of the federal
76.13 	Social Security Act, United States Code, title 42, section 1395,
76.14 	et seq., as amended.
76.15 		Subd. 5.Application procedure. (a) Applications and
76.16 	information on the program must be made available at county
76.17 	social services agencies, health care provider offices, and
76.18 	agencies and organizations serving senior citizens.  Individuals
76.19 	shall submit applications and any information specified by the
76.20 	commissioner as being necessary to verify eligibility directly
76.21 	to the commissioner.  The commissioner shall determine an
76.22 	applicant's eligibility for the program within 30 days from the
76.23 	date the application is received.  Upon notice of approval, the
76.24 	applicant must submit to the commissioner the enrollment fee
76.25 	specified in subdivision 10.  Eligibility begins the month after
76.26 	the enrollment fee is received by the commissioner.
76.27 	(b) An enrollee's eligibility must be renewed every 12
76.28 	months with the 12-month period beginning in the month after the
76.29 	application is approved.
76.30 	(c) The commissioner shall develop an application form that
76.31 	does not exceed one page in length and requires information
76.32 	necessary to determine eligibility for the program.
76.33 		Subd. 6.Participating pharmacy. (a) Upon implementation
76.34 	of the prescription drug discount program, until January 1,
76.35 	2008, a participating pharmacy, in accordance with a valid
76.36 	prescription, must sell a covered prescription drug to an
77.1 	enrolled individual at the medical assistance rate.
77.2 	(b) After January 1, 2008, a participating pharmacy, in
77.3 	accordance with a valid prescription, must sell a covered
77.4 	prescription drug to an enrolled individual at the medical
77.5 	assistance rate, minus an amount that is equal to the rebate
77.6 	amount described in subdivision 8, plus the amount of any switch
77.7 	fee established by the commissioner under subdivision 10,
77.8 	paragraph (b).
77.9 	(c) Each participating pharmacy shall provide the
77.10 	commissioner with all information necessary to administer the
77.11 	program, including, but not limited to, information on
77.12 	prescription drug sales to enrolled individuals and usual and
77.13 	customary retail prices.
77.14 		Subd. 7.Notification of rebate amount. The commissioner
77.15 	shall notify each participating manufacturer, each calendar
77.16 	quarter or according to a schedule to be established by the
77.17 	commissioner, of the amount of the rebate owed on the
77.18 	prescription drugs sold by participating pharmacies to enrolled
77.19 	individuals.
77.20 		Subd. 8.Provision of rebate. To the extent that a
77.21 	participating manufacturer's prescription drugs are prescribed
77.22 	to a resident of this state, the manufacturer must provide a
77.23 	rebate equal to the rebate provided under the medical assistance
77.24 	program for any prescription drug distributed by the
77.25 	manufacturer that is purchased by an enrolled individual at a
77.26 	participating pharmacy.  The participating manufacturer must
77.27 	provide full payment within 38 days of receipt of the state
77.28 	invoice for the rebate, or according to a schedule to be
77.29 	established by the commissioner.  The commissioner shall deposit
77.30 	all rebates received into the Minnesota prescription drug
77.31 	dedicated fund established under subdivision 11.  The
77.32 	manufacturer must provide the commissioner with any information
77.33 	necessary to verify the rebate determined per drug.
77.34 		Subd. 9.Payment to pharmacies. Beginning January 1,
77.35 	2008, the commissioner shall distribute on a biweekly basis an
77.36 	amount that is equal to an amount collected under subdivision 8
78.1 	to each participating pharmacy based on the prescription drugs
78.2 	sold by that pharmacy to enrolled individuals on or after
78.3 	January 1, 2008.
78.4 		Subd. 10.Enrollment fee; switch fee. (a) The
78.5 	commissioner shall establish an annual enrollment fee that
78.6 	covers the commissioner's expenses for enrollment, processing
78.7 	claims, and distributing rebates under this program.
78.8 	(b) The commissioner shall establish a reasonable switch
78.9 	fee that covers expenses incurred by participating pharmacies in
78.10 	formatting for electronic submission claims for prescription
78.11 	drugs sold to enrolled individuals.
78.12 		Subd. 11.Dedicated fund; creation; use of fund. (a) The
78.13 	Minnesota prescription drug dedicated fund is established as an
78.14 	account in the state treasury.  The commissioner of finance
78.15 	shall credit to the dedicated fund all rebates paid under
78.16 	subdivision 8, any federal funds received for the program, all
78.17 	enrollment fees paid by the enrollees, and any appropriations or
78.18 	allocations designated for the fund.  The commissioner of
78.19 	finance shall ensure that fund money is invested under section
78.20 	11A.25.  All money earned by the fund must be credited to the
78.21 	fund.  The fund shall earn a proportionate share of the total
78.22 	state annual investment income.
78.23 	(b) Money in the fund is appropriated to the commissioner
78.24 	to reimburse participating pharmacies for prescription drugs the
78.25 	rebate discount provided to enrolled individuals under
78.26 	subdivision 6, paragraph (b); to reimburse the commissioner for
78.27 	costs related to enrollment, processing claims, and distributing
78.28 	rebates and for other reasonable administrative costs related to
78.29 	administration of the prescription drug discount program; and to
78.30 	repay the appropriation provided for this section.  The
78.31 	commissioner must administer the program so that the costs total
78.32 	no more than funds appropriated plus the drug rebate proceeds.
78.33 	
EFFECTIVE DATE. This section is effective August 1, 2006,
78.34 	or upon HealthMatch implementation, whichever is later.

78.35 	Sec. 9. Minnesota Statutes 2004, section 256.969, is
78.36 	amended by adding a subdivision to read:
79.1 		Subd. 27.Annual nonmedical assistance payment. (a) In
79.2 	addition to any other payment under this section, the
79.3 	commissioner shall make the following payments:
79.4 	(1) for a hospital located in Minnesota and not eligible
79.5 	for payments under subdivision 20, with a medical assistance
79.6 	inpatient utilization rate greater than 19 percent of total
79.7 	patient days during the base year, a payment equal to 13 percent
79.8 	of the total of the operating and payment rates;
79.9 	(2) for a hospital located in Minnesota in a specified
79.10 	urban area outside of the seven-county metropolitan area and not
79.11 	eligible for payments under subdivision 20, with a medical
79.12 	assistance inpatient utilization rate less than or equal to 19
79.13 	percent of total patient days during the base year, a payment
79.14 	equal to ten percent of the total of the operating and property
79.15 	payment rates.  For purposes of this clause, the following
79.16 	cities are specified urban areas:  Detroit Lakes, Rochester,
79.17 	Willmar, Hutchinson, Alexandria, Austin, Cambridge, Brainerd,
79.18 	Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids, Wyoming,
79.19 	Fergus Falls, Albert Lea, Winona, Virginia, Thief River Falls,
79.20 	and Wadena; and 
79.21 	(3) for a hospital located in Minnesota but not located in
79.22 	a specified urban area under clause (2) and not eligible for
79.23 	payments under subdivision 20, with a medical assistance
79.24 	inpatient utilization rate less than or equal to 19 percent of
79.25 	total patient days during the base year, a payment equal to five
79.26 	percent of the total of the operating and property payment rates.
79.27 	(b) The payments under paragraph (a) shall be 100 percent
79.28 	state dollars derived from federal reimbursements to the
79.29 	commissioner to reimburse nonstate expenditures reported under
79.30 	section 256B.199.
79.31 	(c) The payments under paragraph (a) shall be paid annually
79.32 	on July 1, beginning July 1, 2005, or upon the receipt of
79.33 	federal reimbursements under section 256B.199, whichever occurs
79.34 	last, for services to be rendered in the fiscal year beginning
79.35 	on July 1, based on services rendered in the previous calendar
79.36 	year.
80.1 	(d) The commissioner shall not adjust rates paid to a
80.2 	prepaid health plan under contract with the commissioner to
80.3 	reflect payments provided in paragraph (a).
80.4 	(e) If federal reimbursements are not available under
80.5 	section 256B.199 for all payments under paragraph (a), the
80.6 	commissioner shall reduce payments under paragraph (a) on a pro
80.7 	rata basis so that payments under paragraph (a) do not exceed
80.8 	the federal reimbursements.
80.9 	(f) For purposes of this subdivision, medical assistance
80.10 	does not include general assistance medical care.
80.11 	(g) The commissioner may ratably reduce or increase the
80.12 	payments under this subdivision in order to ensure that these
80.13 	total payments equal the amount of reimbursement received by the
80.14 	commissioner under section 256B.199.
80.15 	(h) The commissioner may, in consultation with the nonstate
80.16 	entities identified in section 256B.199, adjust the amounts
80.17 	reported by nonstate entities under section 256B.199 when
80.18 	application for reimbursement is made to the federal government,
80.19 	and otherwise adjust the provisions of this subdivision in order
80.20 	to maximize payments to qualifying hospitals.
80.21 	
EFFECTIVE DATE. This section is effective the day
80.22 	following final enactment.  The commissioner of human services
80.23 	shall submit necessary medical assistance plan amendments to
80.24 	implement this section within 30 days of enactment.

80.25 	Sec. 10. Minnesota Statutes 2004, section 256B.02,
80.26 	subdivision 12, is amended to read:
80.27 		Subd. 12.Third-party payer.  "Third-party payer" means a
80.28 	person, entity, or agency or government program that has a
80.29 	probable obligation to pay all or part of the costs of a medical
80.30 	assistance recipient's health services. Third-party payer
80.31 	includes an entity under contract with the recipient to cover
80.32 	all or part of the recipient's medical costs.

80.33 	Sec. 11. Minnesota Statutes 2004, section 256B.04, is
80.34 	amended by adding a subdivision to read:
80.35 		Subd. 4a.Medicare prescription drug subsidy. The
80.36 	commissioner shall perform all duties necessary to administer
81.1 	eligibility determinations for the Medicare Part D prescription
81.2 	drug subsidy and facilitate the enrollment of eligible medical
81.3 	assistance recipients into Medicare prescription drug plans as
81.4 	required by the Medicare Prescription Drug, Improvement, and
81.5 	Modernization Act of 2003 (MMA), Public Law 108-173, and Code of
81.6 	Federal Regulations, title 42, sections 423.30 to 423.56 and
81.7 	423.771 to 423.800.

81.8 	Sec. 12. Minnesota Statutes 2004, section 256B.055, is
81.9 	amended by adding a subdivision to read:
81.10 		Subd. 14.Persons detained by law. (a) An inmate of a
81.11 	correctional facility who is conditionally released as
81.12 	authorized under section 241.26, 244.065, or 631.425 may be
81.13 	eligible for medical assistance if the individual does not
81.14 	require the security of a public detention facility and is
81.15 	housed in a halfway house or community correction center, or
81.16 	under house arrest and monitored by electronic surveillance in a
81.17 	residence approved by the commissioner of corrections.
81.18 	(b) An individual, regardless of age, who is considered an
81.19 	inmate of a public institution as defined in Code of Federal
81.20 	Regulations, title 42, section 435.1009, is not eligible for
81.21 	medical assistance.

81.22 	Sec. 13. Minnesota Statutes 2004, section 256B.056, is
81.23 	amended by adding a subdivision to read:
81.24 		Subd. 3d.Reduction of excess assets. Assets in excess
81.25 	of the limits in subdivisions 3 to 3c may be reduced to
81.26 	allowable limits as follows:
81.27 	(a) Assets may be reduced in any of the three calendar
81.28 	months before the month of application in which the applicant
81.29 	seeks coverage by:
81.30 	(1) designating burial funds up to $1,500 for each
81.31 	applicant, spouse, and MA-eligible dependent child; and 
81.32 	(2) paying health service bills incurred in the retroactive
81.33 	period for which the applicant seeks eligibility, starting with
81.34 	the oldest bill.  After assets are reduced to allowable limits,
81.35 	eligibility begins with the next dollar of MA-covered health
81.36 	services incurred in the retroactive period.  Applicants
82.1 	reducing assets under this subdivision who also have excess
82.2 	income shall first spend excess assets to pay health service
82.3 	bills and may meet the income spenddown on remaining bills.
82.4 	(b) Assets may be reduced beginning the month of
82.5 	application by:
82.6 	(1) paying bills for health services that would otherwise
82.7 	be paid by medical assistance; and 
82.8 	(2) using any means other than a transfer of assets for
82.9 	less than fair market value as defined in section 256B.0595,
82.10 	subdivision 1, paragraph (b).

82.11 	Sec. 14. Minnesota Statutes 2004, section 256B.056,
82.12 	subdivision 5, is amended to read:
82.13 		Subd. 5.Excess income.  A person who has excess income
82.14 	is eligible for medical assistance if the person has expenses
82.15 	for medical care that are more than the amount of the person's
82.16 	excess income, computed by deducting incurred medical expenses
82.17 	from the excess income to reduce the excess to the income
82.18 	standard specified in subdivision 5c.  The person shall elect to
82.19 	have the medical expenses deducted at the beginning of a
82.20 	one-month budget period or at the beginning of a six-month
82.21 	budget period.  The commissioner shall allow persons eligible
82.22 	for assistance on a one-month spenddown basis under this
82.23 	subdivision to elect to pay the monthly spenddown amount in
82.24 	advance of the month of eligibility to the state agency in order
82.25 	to maintain eligibility on a continuous basis.  If the recipient
82.26 	does not pay the spenddown amount on or before the 20th last
82.27 	business day of the month, the recipient is ineligible for this
82.28 	option for the following month.  The local agency shall code the
82.29 	Medicaid Management Information System (MMIS) to indicate that
82.30 	the recipient has elected this option.  The state agency shall
82.31 	convey recipient eligibility information relative to the
82.32 	collection of the spenddown to providers through the Electronic
82.33 	Verification System (EVS).  A recipient electing advance payment
82.34 	must pay the state agency the monthly spenddown amount on or
82.35 	before noon on the 20th last business day of the month in order
82.36 	to be eligible for this option in the following month.
83.1 	
EFFECTIVE DATE. This section is effective August 1, 2006,
83.2 	or upon HealthMatch implementation, whichever is later.

83.3 	Sec. 15. Minnesota Statutes 2004, section 256B.056,
83.4 	subdivision 5a, is amended to read:
83.5 		Subd. 5a.Individuals on fixed or excluded income.
 83.6 	Recipients of medical assistance who receive only fixed unearned
83.7 	or excluded income, when that income is excluded from
83.8 	consideration as income or unvarying in amount and timing of
83.9 	receipt throughout the year, shall report and verify their
83.10 	income annually every 12 months.  The 12-month period begins
83.11 	with the month of application.
83.12 	
EFFECTIVE DATE. This section is effective August 1, 2006,
83.13 	or upon HealthMatch implementation, whichever is later.

83.14 	Sec. 16. Minnesota Statutes 2004, section 256B.056,
83.15 	subdivision 5b, is amended to read:
83.16 		Subd. 5b.Individuals with low income.  Recipients of
83.17 	medical assistance not residing in a long-term care facility who
83.18 	have slightly fluctuating income which is below the medical
83.19 	assistance income limit shall report and verify their income on
83.20 	a semiannual basis every six months.  The six-month period
83.21 	begins the month of application.
83.22 	
EFFECTIVE DATE. This section is effective August 1, 2006,
83.23 	or upon HealthMatch implementation, whichever is later.

83.24 	Sec. 17. Minnesota Statutes 2004, section 256B.056,
83.25 	subdivision 7, is amended to read:
83.26 		Subd. 7.Period of eligibility.  Eligibility is available
83.27 	for the month of application and for three months prior to
83.28 	application if the person was eligible in those prior
83.29 	months. Eligibility for months prior to application is
83.30 	determined independently from eligibility for the month of
83.31 	application and future months.A redetermination of eligibility
83.32 	must occur every 12 months. The 12-month period begins with the
83.33 	month of application.
83.34 	
EFFECTIVE DATE. This section is effective August 1, 2006,
83.35 	or upon HealthMatch implementation, whichever is later.

83.36 	Sec. 18. Minnesota Statutes 2004, section 256B.056, is
84.1 	amended by adding a subdivision to read:
84.2 		Subd. 9.Notice. The state agency must be given notice
84.3 	of monetary claims against a person, entity, or corporation that
84.4 	may be liable to pay all or part of the cost of medical care
84.5 	when the state agency has paid or becomes liable for the cost of
84.6 	that care.  Notice must be given according to paragraphs (a) to
84.7 	(d).
84.8 	(a) An applicant for medical assistance shall notify the
84.9 	state or local agency of any possible claims when the applicant
84.10 	submits the application.  A recipient of medical assistance
84.11 	shall notify the state or local agency of any possible claims
84.12 	when those claims arise.
84.13 	(b) A person providing medical care services to a recipient
84.14 	of medical assistance shall notify the state agency when the
84.15 	person has reason to believe that a third party may be liable
84.16 	for payment of the cost of medical care.
84.17 	(c) A party to a claim that may be assigned to the state
84.18 	agency under this section shall notify the state agency of its
84.19 	potential assignment claim in writing at each of the following
84.20 	stages of a claim:
84.21 	(1) when a claim is filed;
84.22 	(2) when an action is commenced; and 
84.23 	(3) when a claim is concluded by payment, award, judgment,
84.24 	settlement, or otherwise.
84.25 	(d) Every party involved in any stage of a claim under this
84.26 	subdivision is required to provide notice to the state agency at
84.27 	that stage of the claim.  However, when one of the parties to
84.28 	the claim provides notice at that stage, every other party to
84.29 	the claim is deemed to have provided the required notice for
84.30 	that stage of the claim.  If the required notice under this
84.31 	paragraph is not provided to the state agency, all parties to
84.32 	the claim are deemed to have failed to provide the required
84.33 	notice.  A party to the claim includes the injured person or the
84.34 	person's legal representative, the plaintiff, the defendants, or
84.35 	persons alleged to be responsible for compensating the injured
84.36 	person or plaintiff, and any other party to the cause of action
85.1 	or claim, regardless of whether the party knows the state agency
85.2 	has a potential or actual assignment claim.

85.3 	Sec. 19. Minnesota Statutes 2004, section 256B.057,
85.4 	subdivision 1, is amended to read:
85.5 		Subdivision 1.Infants and pregnant women.  (a) (1) An
85.6 	infant less than one year of age is eligible for medical
85.7 	assistance if countable family income is equal to or less than
85.8 	275 percent of the federal poverty guideline for the same family
85.9 	size.  A pregnant woman who has written verification of a
85.10 	positive pregnancy test from a physician or licensed registered
85.11 	nurse is eligible for medical assistance if countable family
85.12 	income is equal to or less than 200 275 percent of the federal
85.13 	poverty guideline for the same family size.  For purposes of
85.14 	this subdivision, "countable family income" means the amount of
85.15 	income considered available using the methodology of the AFDC
85.16 	program under the state's AFDC plan as of July 16, 1996, as
85.17 	required by the Personal Responsibility and Work Opportunity
85.18 	Reconciliation Act of 1996 (PRWORA), Public Law 104-193, except
85.19 	for the earned income disregard and employment deductions.
85.20 	(2) For applications processed within one calendar month
85.21 	prior to the effective date, eligibility shall be determined by
85.22 	applying the income standards and methodologies in effect prior
85.23 	to the effective date for any months in the six-month budget
85.24 	period before that date and the income standards and
85.25 	methodologies in effect on the effective date for any months in
85.26 	the six-month budget period on or after that date.  The income
85.27 	standards for each month shall be added together and compared to
85.28 	the applicant's total countable income for the six-month budget
85.29 	period to determine eligibility.
85.30 	(b)(1)  (Expired, 1Sp2003 c 14 art 12 s 19)
85.31 	(2) For applications processed within one calendar month
85.32 	prior to July 1, 2003, eligibility shall be determined by
85.33 	applying the income standards and methodologies in effect prior
85.34 	to July 1, 2003, for any months in the six-month budget period
85.35 	before July 1, 2003, and the income standards and methodologies
85.36 	in effect on the expiration date for any months in the six-month
86.1 	budget period on or after July 1, 2003.  The income standards
86.2 	for each month shall be added together and compared to the
86.3 	applicant's total countable income for the six-month budget
86.4 	period to determine eligibility.
86.5 	(c) Dependent care and child support paid under court order
86.6 	shall be deducted from the countable income of pregnant
86.7 	women.An amount equal to the amount of earned income exceeding
86.8 	275 percent of the federal poverty guideline plus the earned
86.9 	income disregards and deductions of the AFDC program under the
86.10 	state's AFDC plan as of July 16, 1996, as required by the
86.11 	Personal Responsibility and Work Opportunity Reconciliation Act
86.12 	of 1996 (PRWORA), Public Law 104-193, that exceeds 275 percent
86.13 	of the federal poverty guideline will be deducted for pregnant
86.14 	women and infants less than one year of age.
86.15 	(d) An infant born on or after January 1, 1991, to a woman
86.16 	who was eligible for and receiving medical assistance on the
86.17 	date of the child's birth shall continue to be eligible for
86.18 	medical assistance without redetermination until the child's
86.19 	first birthday, as long as the child remains in the woman's
86.20 	household.
86.21 	
EFFECTIVE DATE. The amendments to paragraphs (a) and (b)
86.22 	are effective retroactively from July 1, 2004, and the amendment
86.23 	to paragraph (c) is effective retroactively from October 1, 2003.

86.24 	Sec. 20. Minnesota Statutes 2004, section 256B.0625,
86.25 	subdivision 9, is amended to read:
86.26 		Subd. 9.Dental services. (a) Medical assistance covers
86.27 	dental services.  Dental services include, with prior
86.28 	authorization, fixed bridges that are cost-effective for persons
86.29 	who cannot use removable dentures because of their medical
86.30 	condition.
86.31 	(b) Coverage of dental services for adults age 21 and over
86.32 	who are not pregnant is subject to a $500 annual benefit limit
86.33 	and covered services are limited to:
86.34 	(1) diagnostic and preventative services;
86.35 	(2) restorative services; and 
86.36 	(3) emergency services.
87.1 	Emergency services, dentures, and extractions related to
87.2 	dentures are not included in the $500 annual benefit limit.

87.3 	Sec. 21. Minnesota Statutes 2004, section 256B.0625,
87.4 	subdivision 13e, as amended by 2005 S.F. No. 1879, article 13,
87.5 	section 7, subdivision 13e, if enacted, is amended to read:
87.6 		Subd. 13e.Payment rates.  (a) The basis for determining
87.7 	the amount of payment shall be the lower of the actual
87.8 	acquisition costs of the drugs plus a fixed dispensing fee; the
87.9 	maximum allowable cost set by the federal government or by the
87.10 	commissioner plus the fixed dispensing fee; or the usual and
87.11 	customary price charged to the public.  The amount of payment
87.12 	basis must be reduced to reflect all discount amounts applied to
87.13 	the charge by any provider/insurer agreement or contract for
87.14 	submitted charges to medical assistance programs.  The net
87.15 	submitted charge may not be greater than the patient liability
87.16 	for the service.  The pharmacy dispensing fee shall be $3.65,
87.17 	except that the dispensing fee for intravenous solutions which
87.18 	must be compounded by the pharmacist shall be $8 per bag, $14
87.19 	per bag for cancer chemotherapy products, and $30 per bag for
87.20 	total parenteral nutritional products dispensed in one liter
87.21 	quantities, or $44 per bag for total parenteral nutritional
87.22 	products dispensed in quantities greater than one liter.  Actual
87.23 	acquisition cost includes quantity and other special discounts
87.24 	except time and cash discounts.  The actual acquisition cost of
87.25 	a drug shall be estimated by the commissioner, at average
87.26 	wholesale price minus 11.5 percent, except that where a drug has
87.27 	had its wholesale price reduced as a result of the actions of
87.28 	the National Association of Medicaid Fraud Control Units, the
87.29 	estimated actual acquisition cost shall be the reduced average
87.30 	wholesale price, without the 11.5 percent deduction.  The actual
87.31 	acquisition cost of antihemophilic factor drugs shall be
87.32 	estimated at the average wholesale price minus 30 percent.  The
87.33 	maximum allowable cost of a multisource drug may be set by the
87.34 	commissioner and it shall be comparable to, but no higher than,
87.35 	the maximum amount paid by other third-party payors in this
87.36 	state who have maximum allowable cost programs.  Establishment
88.1 	of the amount of payment for drugs shall not be subject to the
88.2 	requirements of the Administrative Procedure Act.
88.3 	(b) An additional dispensing fee of $.30 may be added to
88.4 	the dispensing fee paid to pharmacists for legend drug
88.5 	prescriptions dispensed to residents of long-term care
88.6 	facilities when a unit dose blister card system, approved by the
88.7 	department, is used.  Under this type of dispensing system, the
88.8 	pharmacist must dispense a 30-day supply of drug.  The National
88.9 	Drug Code (NDC) from the drug container used to fill the blister
88.10 	card must be identified on the claim to the department.  The
88.11 	unit dose blister card containing the drug must meet the
88.12 	packaging standards set forth in Minnesota Rules, part
88.13 	6800.2700, that govern the return of unused drugs to the
88.14 	pharmacy for reuse.  The pharmacy provider will be required to
88.15 	credit the department for the actual acquisition cost of all
88.16 	unused drugs that are eligible for reuse.  Over-the-counter
88.17 	medications must be dispensed in the manufacturer's unopened
88.18 	package.  The commissioner may permit the drug clozapine to be
88.19 	dispensed in a quantity that is less than a 30-day supply.
88.20 	(c) Whenever a generically equivalent product is available,
88.21 	payment shall be on the basis of the actual acquisition cost of
88.22 	the generic drug, or on the maximum allowable cost established
88.23 	by the commissioner.
88.24 	(d) The basis for determining the amount of payment for
88.25 	drugs administered in an outpatient setting shall be the lower
88.26 	of the usual and customary cost submitted by the provider or the
88.27 	amount established for Medicare by the United States Department
88.28 	of Health and Human Services pursuant to title XVIII, section
88.29 	1847a of the federal Social Security Act.
88.30 	(e) The commissioner may negotiate lower reimbursement
88.31 	rates for specialty pharmacy products than the rates specified
88.32 	in paragraph (a).  The commissioner may require individuals
88.33 	enrolled in the health care programs administered by the
88.34 	department to obtain specialty pharmacy products from providers
88.35 	with whom the commissioner has negotiated lower reimbursement
88.36 	rates.  Specialty pharmacy products are defined as those used by
89.1 	a small number of recipients or recipients with complex and
89.2 	chronic diseases that require expensive and challenging drug
89.3 	regimens.  Examples of these conditions include, but are not
89.4 	limited to:  multiple sclerosis, HIV/AIDS, transplantation,
89.5 	hepatitis C, growth hormone deficiency, Crohn's Disease,
89.6 	rheumatoid arthritis, and certain forms of cancer.  Specialty
89.7 	pharmaceutical products include injectable and infusion
89.8 	therapies, biotechnology drugs, high-cost therapies, and
89.9 	therapies that require complex care.  The commissioner shall
89.10 	consult with the formulary committee to develop a list of
89.11 	specialty pharmacy products subject to this paragraph. In
89.12 	consulting with the formulary committee in developing this list,
89.13 	the commissioner shall take into consideration the population
89.14 	served by special pharmacy products, the current delivery system
89.15 	and standard of care in the state, and any access to care issues
89.16 	that lower reimbursement rates may create.  The commissioner
89.17 	shall have the discretion to adjust the reimbursement rate to
89.18 	prevent access to care issues.

89.19 	Sec. 22. Minnesota Statutes 2004, section 256B.0625,
89.20 	subdivision 13f, is amended to read:
89.21 		Subd. 13f.Prior authorization.  (a) The Formulary
89.22 	Committee shall review and recommend drugs which require prior
89.23 	authorization.  The Formulary Committee shall establish general
89.24 	criteria to be used for the prior authorization of brand-name
89.25 	drugs for which generically equivalent drugs are available, but
89.26 	the committee is not required to review each brand-name drug for
89.27 	which a generically equivalent drug is available.
89.28 	(b) Prior authorization may be required by the commissioner
89.29 	before certain formulary drugs are eligible for payment.  The
89.30 	Formulary Committee may recommend drugs for prior authorization
89.31 	directly to the commissioner.  The commissioner may also request
89.32 	that the Formulary Committee review a drug for prior
89.33 	authorization.  Before the commissioner may require prior
89.34 	authorization for a drug:
89.35 	(1) the commissioner must provide information to the
89.36 	Formulary Committee on the impact that placing the drug on prior
90.1 	authorization may have on the quality of patient care and on
90.2 	program costs, information regarding whether the drug is subject
90.3 	to clinical abuse or misuse, and relevant data from the state
90.4 	Medicaid program if such data is available;
90.5 	(2) the Formulary Committee must review the drug, taking
90.6 	into account medical and clinical data and the information
90.7 	provided by the commissioner; and
90.8 	(3) the Formulary Committee must hold a public forum and
90.9 	receive public comment for an additional 15 days.
90.10 	The commissioner must provide a 15-day notice period before
90.11 	implementing the prior authorization.
90.12 	(c) Prior authorization shall not be required or utilized
90.13 	for any atypical antipsychotic drug prescribed for the treatment
90.14 	of mental illness if:
90.15 	(1) there is no generically equivalent drug available; and
90.16 	(2) the drug was initially prescribed for the recipient
90.17 	prior to July 1, 2003; or
90.18 	(3) the drug is part of the recipient's current course of
90.19 	treatment.
90.20 	This paragraph applies to any multistate preferred drug list or
90.21 	supplemental drug rebate program established or administered by
90.22 	the commissioner.
90.23 	(d) Prior authorization shall not be required or utilized
90.24 	for any antihemophilic factor drug prescribed for the treatment
90.25 	of hemophilia and blood disorders where there is no generically
90.26 	equivalent drug available if the prior authorization is used in
90.27 	conjunction with any supplemental drug rebate program or
90.28 	multistate preferred drug list established or administered by
90.29 	the commissioner. This paragraph expires July 1, 2005.
90.30 	(e) The commissioner may require prior authorization for
90.31 	brand name drugs whenever a generically equivalent product is
90.32 	available, even if the prescriber specifically indicates
90.33 	"dispense as written-brand necessary" on the prescription as
90.34 	required by section 151.21, subdivision 2.
90.35 	
EFFECTIVE DATE. This section is effective June 30, 2005.

90.36 	Sec. 23. Minnesota Statutes 2004, section 256B.0625, is
91.1 	amended by adding a subdivision to read:
91.2 		Subd. 13h.Medication therapy management care. (a)
91.3 	Medical assistance covers medication therapy management services
91.4 	for a recipient taking four or more prescriptions to treat or
91.5 	prevent two or more chronic medical conditions, or a recipient
91.6 	with a drug therapy problem that is identified or prior
91.7 	authorized by the commissioner that has resulted or is likely to
91.8 	result in significant nondrug program costs.  For purposes of
91.9 	this subdivision, "medication therapy management" means the
91.10 	provision of the following pharmaceutical care services by a
91.11 	licensed pharmacist to optimize the therapeutic outcomes of the
91.12 	patient's medications:
91.13 	(1) performing or obtaining necessary assessments of the
91.14 	patient's health status;
91.15 	(2) formulating a medication treatment plan;
91.16 	(3) monitoring and evaluating the patient's response to
91.17 	therapy, including safety and effectiveness;
91.18 	(4) performing a comprehensive medication review to
91.19 	identify, resolve, and prevent medication-related problems,
91.20 	including adverse drug events;
91.21 	(5) documenting the care delivered and communicating
91.22 	essential information to the patient's other primary care
91.23 	providers;
91.24 	(6) providing verbal education and training designed to
91.25 	enhance patient understanding and appropriate use of the
91.26 	patient's medications;
91.27 	(7) providing information, support services, and resources
91.28 	designed to enhance patient adherence with the patient's
91.29 	therapeutic regimens; and 
91.30 	(8) coordinating and integrating medication therapy
91.31 	management services within the broader health care management
91.32 	services being provided to the patient.
91.33 	Nothing in this subdivision shall be construed to expand or
91.34 	modify the scope of practice of the pharmacist as defined in
91.35 	section 151.01, subdivision 27.
91.36 	(b) To be eligible for reimbursement for services under
92.1 	this subdivision, a pharmacist must meet the following
92.2 	requirements:
92.3 	(1) have a valid license issued under chapter 151;
92.4 	(2) have graduated from an accredited college of pharmacy
92.5 	on or after May 1996 or completed a structured and comprehensive
92.6 	education program approved by the Board of Pharmacy and the
92.7 	American Council of Pharmaceutical Education for the provision
92.8 	and documentation of pharmaceutical care management services
92.9 	that has both clinical and didactic elements;
92.10 	(3) be practicing in an ambulatory care setting as part of
92.11 	a multidisciplinary team or have developed a structured patient
92.12 	care process that is offered in a private or semiprivate patient
92.13 	care area that is separate from the commercial business that
92.14 	also occurs in the setting; and 
92.15 	(4) make use of an electronic patient record system that
92.16 	meets state standards.
92.17 	(c) For the purposes of reimbursement for medication
92.18 	therapy management services, the commissioner may enroll
92.19 	individual pharmacists as medical assistance providers.  The
92.20 	commissioner may also establish contact requirements between the
92.21 	pharmacist and recipient, including limiting the number of
92.22 	reimbursable consultations per recipient.
92.23 	(d) The commissioner, after receiving recommendations from
92.24 	professional medical associations, professional pharmacy
92.25 	associations, and consumer groups shall convene an 11-member
92.26 	Medication Therapy Management Advisory Committee, to advise the
92.27 	commissioner on the implementation and administration of
92.28 	medication therapy management services.  The committee shall be
92.29 	comprised of two licensed physicians; two licensed pharmacists;
92.30 	two consumer representatives; two health plan representatives;
92.31 	and three members with expertise in the area of medication
92.32 	therapy management, who may be licensed physicians or licensed
92.33 	pharmacists.  The committee is governed by section 15.059,
92.34 	except that committee members do not receive compensation or
92.35 	reimbursement for expenses.  The advisory committee shall expire
92.36 	on June 30, 2007.
93.1 	(e) The commissioner shall evaluate the effect of
93.2 	medication therapy management on quality of care, patient
93.3 	outcomes, and program costs, and shall include a description of
93.4 	any savings generated in the medical assistance program that can
93.5 	be attributable to this coverage.  The evaluation shall be
93.6 	submitted to the legislature by December 15, 2007.  The
93.7 	commissioner may contract with a vendor or an academic
93.8 	institution that has expertise in evaluating health care
93.9 	outcomes for the purpose of completing the evaluation.

93.10 	Sec. 24. Minnesota Statutes 2004, section 256B.0625,
93.11 	subdivision 17, is amended to read:
93.12 		Subd. 17.Transportation costs.  (a) Medical assistance
93.13 	covers transportation costs incurred solely for obtaining
93.14 	emergency medical care or transportation costs incurred by
93.15 	eligible persons in obtaining emergency or nonemergency medical
93.16 	care when paid directly to an ambulance company, common carrier,
93.17 	or other recognized providers of transportation services.
93.18 	(b) Medical assistance covers special transportation, as
93.19 	defined in Minnesota Rules, part 9505.0315, subpart 1, item F,
93.20 	if the recipient has a physical or mental impairment that would
93.21 	prohibit the recipient from safely accessing and using a bus,
93.22 	taxi, other commercial transportation, or private automobile.
93.23 	The commissioner may use an order by the recipient's attending
93.24 	physician to certify that the recipient requires special
93.25 	transportation services.  Special transportation includes
93.26 	driver-assisted service to eligible individuals.
93.27 	Driver-assisted service includes passenger pickup at and return
93.28 	to the individual's residence or place of business, assistance
93.29 	with admittance of the individual to the medical facility, and
93.30 	assistance in passenger securement or in securing of wheelchairs
93.31 	or stretchers in the vehicle.  Special transportation providers
93.32 	must obtain written documentation from the health care service
93.33 	provider who is serving the recipient being transported,
93.34 	identifying the time that the recipient arrived.  Special
93.35 	transportation providers may not bill for separate base rates
93.36 	for the continuation of a trip beyond the original destination.
94.1 	Special transportation providers must take recipients to the
94.2 	nearest appropriate health care provider, using the most direct
94.3 	route available.  The maximum medical assistance reimbursement
94.4 	rates for special transportation services are:
94.5 	(1) $18 $16.50 for the base rate and $1.40 $1.35 per mile
94.6 	for services to eligible persons who need a
94.7 	wheelchair-accessible van;
94.8 	(2) $12 $11.50 for the base rate and $1.35 $1.30 per mile
94.9 	for services to eligible persons who do not need a
94.10 	wheelchair-accessible van; and
94.11 	(3) $36 $60 for the base rate and $1.40 $2.40 per mile, and
94.12 	an attendant rate of $9 per trip, for services to eligible
94.13 	persons who need a stretcher-accessible vehicle.

94.14 	Sec. 25. [256B.072] PERFORMANCE REPORTING AND QUALITY
94.15 	IMPROVEMENT PAYMENT SYSTEM.
94.16 	(a) The commissioner of human services shall establish a
94.17 	performance reporting and propose a payment system for health
94.18 	care providers who provide health care services to public
94.19 	program recipients covered under chapters 256B, 256D, and 256L,
94.20 	reporting separately for managed care and fee-for-service
94.21 	recipients.
94.22 	(b) The measures used for the performance reporting and
94.23 	payment system for medical groups shall include, but are not
94.24 	limited to, measures of care for asthma, diabetes, hypertension,
94.25 	and coronary artery disease and measures of preventive care
94.26 	services.  The measures used for the performance reporting and
94.27 	payment system for inpatient hospitals shall include, but are
94.28 	not limited to, measures of care for acute myocardial
94.29 	infarction, heart failure, and pneumonia, and measures of care
94.30 	and prevention of surgical infections.  In the case of a medical
94.31 	group, the measures used shall be consistent with measures
94.32 	published by nonprofit Minnesota or national organizations that
94.33 	produce and disseminate health care quality measures or
94.34 	evidence-based health care guidelines and that meet the criteria
94.35 	set forth in section 62J.43, subdivision 2.  In the case of
94.36 	inpatient hospital measures, the commissioner shall appoint the
95.1 	Minnesota Hospital Association and Stratis Health to advise on
95.2 	the development of the performance measures to be used for
95.3 	hospital reporting.  To enable a consistent measurement process
95.4 	across the community, the commissioner may use measures of care
95.5 	provided for patients in addition to those identified in
95.6 	paragraph (a).  The commissioner shall ensure collaboration with
95.7 	other health care reporting organizations so that the measures
95.8 	described in this section are consistent with those reported by
95.9 	those organizations and used by other purchasers in Minnesota.
95.10 	(c) For recipients seen on or after January 1, 2007, the
95.11 	commissioner shall propose a performance bonus payment to
95.12 	providers who have achieved certain levels of performance
95.13 	established by the commissioner with respect to the measures or
95.14 	who have achieved certain rates of improvement established by
95.15 	the commissioner with respect to the measures or whose rates of
95.16 	achievement have increased over a previous period, as
95.17 	established by the commissioner.  The performance bonus payment
95.18 	may be a fixed dollar amount per patient, paid quarterly or
95.19 	annually, or alternatively payment may be made as a percentage
95.20 	increase over payments allowed elsewhere in statute for the
95.21 	recipients identified in paragraph (a).  In order for providers
95.22 	to be eligible for a performance bonus payment under this
95.23 	section, the commissioner may require the providers to submit
95.24 	information in a required format to a health care reporting
95.25 	organization or to cooperate with the information collection
95.26 	procedures of that organization.  The commissioner may contract
95.27 	with a reporting organization to assist with the collection of
95.28 	reporting information and to prevent duplication of reporting.
95.29 	The commissioner may limit application of the performance bonus
95.30 	payment system to providers that provide a sufficiently large
95.31 	volume of care to permit adequate statistical precision in the
95.32 	measurement of that care, as established by the commissioner,
95.33 	after consulting with other health care quality reporting
95.34 	organizations.
95.35 	(d) The commissioner shall publish a description of the
95.36 	proposed performance reporting and proposed payment system for
96.1 	the calendar year beginning January 1, 2007, and each subsequent
96.2 	calendar year, at least three months prior to the beginning of
96.3 	that calendar year.
96.4 	(e) By October 1, 2007, and annually thereafter, the
96.5 	commissioner shall report through a public Web site the results
96.6 	by medical group and hospitals where possible of the measures
96.7 	and when feasible the performance payments under this section,
96.8 	and shall compare the results by medical group and hospital for
96.9 	patients enrolled in public programs to patients enrolled in
96.10 	private health plans.  To achieve this reporting, the
96.11 	commissioner may contract with a health care reporting
96.12 	organization that operates a Web site suitable for this purpose.

96.13 	Sec. 26. Minnesota Statutes 2004, section 256B.0916, is
96.14 	amended by adding a subdivision to read:
96.15 		Subd. 10.Transitional supports allowance. A
96.16 	transitional supports allowance shall be available to all
96.17 	persons under a home and community-based waiver who are moving
96.18 	from a licensed setting to a community setting.  "Transitional
96.19 	supports allowance" means a onetime payment of up to $3,000, to
96.20 	cover the costs, not covered by other sources, associated with
96.21 	moving from a licensed setting to a community setting.  Covered
96.22 	costs include:
96.23 	(1) lease or rent deposits;
96.24 	(2) security deposits;
96.25 	(3) utilities set-up costs, including telephone;
96.26 	(4) essential furnishings and supplies; and 
96.27 	(5) personal supports and transports needed to locate and
96.28 	transition to community settings.
96.29 	
EFFECTIVE DATE. This section is effective upon federal
96.30 	approval and to the extent approved as a federal waiver
96.31 	amendment.

96.32 	Sec. 27. [256B.0918] EMPLOYEE SCHOLARSHIP COSTS AND
96.33 	TRAINING IN ENGLISH AS A SECOND LANGUAGE.
96.34 	(a) For the fiscal year beginning July 1, 2005, the
96.35 	commissioner shall provide to each provider listed in paragraph
96.36 	(c) a scholarship reimbursement increase of two-tenths percent
97.1 	of the reimbursement rate for that provider to be used:
97.2 	(1) for employee scholarships that satisfy the following
97.3 	requirements:
97.4 	(i) scholarships are available to all employees who work an
97.5 	average of at least 20 hours per week for the provider, except
97.6 	administrators, department supervisors, and registered nurses;
97.7 	and 
97.8 	(ii) the course of study is expected to lead to career
97.9 	advancement with the provider or in long-term care, including
97.10 	home care or care of persons with disabilities, including
97.11 	medical care interpreter services and social work; and 
97.12 	(2) to provide job-related training in English as a second
97.13 	language.
97.14 	(b) A provider receiving a rate adjustment under this
97.15 	subdivision with an annualized value of at least $1,000 shall
97.16 	maintain documentation to be submitted to the commissioner on a
97.17 	schedule determined by the commissioner and on a form supplied
97.18 	by the commissioner of the scholarship rate increase received,
97.19 	including:
97.20 	(1) the amount received from this reimbursement increase;
97.21 	(2) the amount used for training in English as a second
97.22 	language;
97.23 	(3) the number of persons receiving the training;
97.24 	(4) the name of the person or entity providing the
97.25 	training; and 
97.26 	(5) for each scholarship recipient, the name of the
97.27 	recipient, the amount awarded, the educational institution
97.28 	attended, the nature of the educational program, the program
97.29 	completion date, and a determination of the amount spent as a
97.30 	percentage of the provider's reimbursement.
97.31 	The commissioner shall report to the legislature annually,
97.32 	beginning January 15, 2006, with information on the use of these
97.33 	funds.
97.34 	(c) The rate increases described in this section shall be
97.35 	provided to home and community-based waivered services for
97.36 	persons with mental retardation or related conditions under
98.1 	section 256B.501; home and community-based waivered services for
98.2 	the elderly under section 256B.0915; waivered services under
98.3 	community alternatives for disabled individuals under section
98.4 	256B.49; community alternative care waivered services under
98.5 	section 256B.49; traumatic brain injury waivered services under
98.6 	section 256B.49; nursing services and home health services under
98.7 	section 256B.0625, subdivision 6a; personal care services and
98.8 	nursing supervision of personal care services under section
98.9 	256B.0625, subdivision 19a; private duty nursing services under
98.10 	section 256B.0625, subdivision 7; day training and habilitation
98.11 	services for adults with mental retardation or related
98.12 	conditions under sections 252.40 to 252.46; alternative care
98.13 	services under section 256B.0913; adult residential program
98.14 	grants under Minnesota Rules, parts 9535.2000 to 9535.3000;
98.15 	semi-independent living services (SILS) under section 252.275,
98.16 	including SILS funding under county social services grants
98.17 	formerly funded under chapter 256I; community support services
98.18 	for deaf and hard-of-hearing adults with mental illness who use
98.19 	or wish to use sign language as their primary means of
98.20 	communication; the group residential housing supplementary
98.21 	service rate under section 256I.05, subdivision 1a; chemical
98.22 	dependency residential and nonresidential service providers
98.23 	under section 254B.03; and intermediate care facilities for
98.24 	persons with mental retardation under section 256B.5012.
98.25 	(d) These increases shall be included in the provider's
98.26 	reimbursement rate for the purpose of determining future rates
98.27 	for the provider.

98.28 	Sec. 28. [256B.199] PAYMENTS REPORTED BY GOVERNMENTAL
98.29 	ENTITIES.
98.30 	(a) Hennepin County, Hennepin County Medical Center, Ramsey
98.31 	County, Regions Hospital, the University of Minnesota, and
98.32 	Fairview-University Medical Center shall annually report to the
98.33 	commissioner by June 1, beginning June 1, 2005, payments made
98.34 	during the previous calendar year that may qualify for
98.35 	reimbursement under federal law.  Subject to the reports due
98.36 	June 1, 2005, the amounts for calendar year 2004 are expected to
99.1 	be as follows:
99.2 	(1) Hennepin County and Hennepin County Medical Center,
99.3 	$31,980,000;
99.4 	(2) Ramsey County and Regions Hospital, $20,980,000; and 
99.5 	(3) University of Minnesota and Fairview-University Medical
99.6 	Center, $11,050,000.
99.7 	(b) Based on these reports, the commissioner shall apply
99.8 	for federal matching funds.  These funds are appropriated to the
99.9 	commissioner for the annual payments under section 256.969,
99.10 	subdivision 27.

99.11 	EFFECTIVE DATE. This section is effective the day
99.12 	following final enactment.  The commissioner of human services
99.13 	shall submit necessary medical assistance plan amendments to
99.14 	implement this section within 30 days of enactment.

99.15 	Sec. 29. Minnesota Statutes 2004, section 256B.69,
99.16 	subdivision 4, is amended to read:
99.17 		Subd. 4.Limitation of choice.  (a) The commissioner
99.18 	shall develop criteria to determine when limitation of choice
99.19 	may be implemented in the experimental counties.  The criteria
99.20 	shall ensure that all eligible individuals in the county have
99.21 	continuing access to the full range of medical assistance
99.22 	services as specified in subdivision 6.
99.23 	(b) The commissioner shall exempt the following persons
99.24 	from participation in the project, in addition to those who do
99.25 	not meet the criteria for limitation of choice:
99.26 	(1) persons eligible for medical assistance according to
99.27 	section 256B.055, subdivision 1;
99.28 	(2) persons eligible for medical assistance due to
99.29 	blindness or disability as determined by the Social Security
99.30 	Administration or the state medical review team, unless:
99.31 	(i) they are 65 years of age or older; or
99.32 	(ii) they reside in Itasca County or they reside in a
99.33 	county in which the commissioner conducts a pilot project under
99.34 	a waiver granted pursuant to section 1115 of the Social Security
99.35 	Act;
99.36 	(3) recipients who currently have private coverage through
100.1 	a health maintenance organization;
100.2 	(4) recipients who are eligible for medical assistance by
100.3 	spending down excess income for medical expenses other than the
100.4 	nursing facility per diem expense;
100.5 	(5) recipients who receive benefits under the Refugee
100.6 	Assistance Program, established under United States Code, title
100.7 	8, section 1522(e);
100.8 	(6) children who are both determined to be severely
100.9 	emotionally disturbed and receiving case management services
100.10 	according to section 256B.0625, subdivision 20;
100.11 	(7) adults who are both determined to be seriously and
100.12 	persistently mentally ill and received case management services
100.13 	according to section 256B.0625, subdivision 20;
100.14 	(8) persons eligible for medical assistance according to
100.15 	section 256B.057, subdivision 10; and
100.16 	(9) persons with access to cost-effective
100.17 	employer-sponsored private health insurance or persons enrolled
100.18 	in an non-Medicare individual health plan determined to be
100.19 	cost-effective according to section 256B.0625, subdivision 15.
100.20 	Children under age 21 who are in foster placement may enroll in
100.21 	the project on an elective basis.  Individuals excluded under
100.22 	clauses (1), (6), and (7) may choose to enroll on an elective
100.23 	basis.  The commissioner may enroll recipients in the prepaid
100.24 	medical assistance program for seniors who are (1) age 65 and
100.25 	over, and (2) eligible for medical assistance by spending down
100.26 	excess income.
100.27 	(c) The commissioner may allow persons with a one-month
100.28 	spenddown who are otherwise eligible to enroll to voluntarily
100.29 	enroll or remain enrolled, if they elect to prepay their monthly
100.30 	spenddown to the state.
100.31 	(d) The commissioner may require those individuals to
100.32 	enroll in the prepaid medical assistance program who otherwise
100.33 	would have been excluded under paragraph (b), clauses (1), (3),
100.34 	and (8), and under Minnesota Rules, part 9500.1452, subpart 2,
100.35 	items H, K, and L.
100.36 	(e) Before limitation of choice is implemented, eligible
101.1 	individuals shall be notified and after notification, shall be
101.2 	allowed to choose only among demonstration providers.  The
101.3 	commissioner may assign an individual with private coverage
101.4 	through a health maintenance organization, to the same health
101.5 	maintenance organization for medical assistance coverage, if the
101.6 	health maintenance organization is under contract for medical
101.7 	assistance in the individual's county of residence.  After
101.8 	initially choosing a provider, the recipient is allowed to
101.9 	change that choice only at specified times as allowed by the
101.10 	commissioner.  If a demonstration provider ends participation in
101.11 	the project for any reason, a recipient enrolled with that
101.12 	provider must select a new provider but may change providers
101.13 	without cause once more within the first 60 days after
101.14 	enrollment with the second provider.
101.15 	(f) An infant born to a woman who is eligible for and
101.16 	receiving medical assistance and who is enrolled in the prepaid
101.17 	medical assistance program shall be retroactively enrolled to
101.18 	the month of birth in the same managed care plan as the mother
101.19 	once the child is enrolled in medical assistance unless the
101.20 	child is determined to be excluded from enrollment in a prepaid
101.21 	plan under this section.

101.22 	Sec. 30. Minnesota Statutes 2004, section 256D.03,
101.23 	subdivision 4, is amended to read:
101.24 		Subd. 4.General assistance medical care; services.
 101.25 	(a)(i) For a person who is eligible under subdivision 3,
101.26 	paragraph (a), clause (2), item (i), general assistance medical
101.27 	care covers, except as provided in paragraph (c):
101.28 	(1) inpatient hospital services;
101.29 	(2) outpatient hospital services;
101.30 	(3) services provided by Medicare certified rehabilitation
101.31 	agencies;
101.32 	(4) prescription drugs and other products recommended
101.33 	through the process established in section 256B.0625,
101.34 	subdivision 13;
101.35 	(5) equipment necessary to administer insulin and
101.36 	diagnostic supplies and equipment for diabetics to monitor blood
102.1 	sugar level;
102.2 	(6) eyeglasses and eye examinations provided by a physician
102.3 	or optometrist;
102.4 	(7) hearing aids;
102.5 	(8) prosthetic devices;
102.6 	(9) laboratory and X-ray services;
102.7 	(10) physician's services;
102.8 	(11) medical transportation except special transportation;
102.9 	(12) chiropractic services as covered under the medical
102.10 	assistance program;
102.11 	(13) podiatric services;
102.12 	(14) dental services and dentures, subject to the
102.13 	limitations specified in section 256B.0625, subdivision 9as
102.14 	covered under the medical assistance program;
102.15 	(15) outpatient services provided by a mental health center
102.16 	or clinic that is under contract with the county board and is
102.17 	established under section 245.62;
102.18 	(16) day treatment services for mental illness provided
102.19 	under contract with the county board;
102.20 	(17) prescribed medications for persons who have been
102.21 	diagnosed as mentally ill as necessary to prevent more
102.22 	restrictive institutionalization;
102.23 	(18) psychological services, medical supplies and
102.24 	equipment, and Medicare premiums, coinsurance and deductible
102.25 	payments;
102.26 	(19) medical equipment not specifically listed in this
102.27 	paragraph when the use of the equipment will prevent the need
102.28 	for costlier services that are reimbursable under this
102.29 	subdivision;
102.30 	(20) services performed by a certified pediatric nurse
102.31 	practitioner, a certified family nurse practitioner, a certified
102.32 	adult nurse practitioner, a certified obstetric/gynecological
102.33 	nurse practitioner, a certified neonatal nurse practitioner, or
102.34 	a certified geriatric nurse practitioner in independent
102.35 	practice, if (1) the service is otherwise covered under this
102.36 	chapter as a physician service, (2) the service provided on an
103.1 	inpatient basis is not included as part of the cost for
103.2 	inpatient services included in the operating payment rate, and
103.3 	(3) the service is within the scope of practice of the nurse
103.4 	practitioner's license as a registered nurse, as defined in
103.5 	section 148.171;
103.6 	(21) services of a certified public health nurse or a
103.7 	registered nurse practicing in a public health nursing clinic
103.8 	that is a department of, or that operates under the direct
103.9 	authority of, a unit of government, if the service is within the
103.10 	scope of practice of the public health nurse's license as a
103.11 	registered nurse, as defined in section 148.171; and
103.12 	(22) telemedicine consultations, to the extent they are
103.13 	covered under section 256B.0625, subdivision 3b.
103.14 	(ii) Effective October 1, 2003, for a person who is
103.15 	eligible under subdivision 3, paragraph (a), clause (2), item
103.16 	(ii), general assistance medical care coverage is limited to
103.17 	inpatient hospital services, including physician services
103.18 	provided during the inpatient hospital stay.  A $1,000
103.19 	deductible is required for each inpatient hospitalization.
103.20 	(b) Gender reassignment surgery and related services are
103.21 	not covered services under this subdivision unless the
103.22 	individual began receiving gender reassignment services prior to
103.23 	July 1, 1995.
103.24 	(c) In order to contain costs, the commissioner of human
103.25 	services shall select vendors of medical care who can provide
103.26 	the most economical care consistent with high medical standards
103.27 	and shall where possible contract with organizations on a
103.28 	prepaid capitation basis to provide these services.  The
103.29 	commissioner shall consider proposals by counties and vendors
103.30 	for prepaid health plans, competitive bidding programs, block
103.31 	grants, or other vendor payment mechanisms designed to provide
103.32 	services in an economical manner or to control utilization, with
103.33 	safeguards to ensure that necessary services are provided.
103.34 	Before implementing prepaid programs in counties with a county
103.35 	operated or affiliated public teaching hospital or a hospital or
103.36 	clinic operated by the University of Minnesota, the commissioner
104.1 	shall consider the risks the prepaid program creates for the
104.2 	hospital and allow the county or hospital the opportunity to
104.3 	participate in the program in a manner that reflects the risk of
104.4 	adverse selection and the nature of the patients served by the
104.5 	hospital, provided the terms of participation in the program are
104.6 	competitive with the terms of other participants considering the
104.7 	nature of the population served.  Payment for services provided
104.8 	pursuant to this subdivision shall be as provided to medical
104.9 	assistance vendors of these services under sections 256B.02,
104.10 	subdivision 8, and 256B.0625.  For payments made during fiscal
104.11 	year 1990 and later years, the commissioner shall consult with
104.12 	an independent actuary in establishing prepayment rates, but
104.13 	shall retain final control over the rate methodology.
104.14 	(d) Recipients eligible under subdivision 3, paragraph (a),
104.15 	clause (2), item (i), shall pay the following co-payments for
104.16 	services provided on or after October 1, 2003:
104.17 	(1) $3 per nonpreventive visit.  For purposes of this
104.18 	subdivision, a visit means an episode of service which is
104.19 	required because of a recipient's symptoms, diagnosis, or
104.20 	established illness, and which is delivered in an ambulatory
104.21 	setting by a physician or physician ancillary, chiropractor,
104.22 	podiatrist, nurse midwife, advanced practice nurse, audiologist,
104.23 	optician, or optometrist;
104.24 	(2) $25 for eyeglasses;
104.25 	(3) $25 for nonemergency visits to a hospital-based
104.26 	emergency room;
104.27 	(4) $3 per brand-name drug prescription and $1 per generic
104.28 	drug prescription, subject to a $20 per month maximum for
104.29 	prescription drug co-payments.  No co-payments shall apply to
104.30 	antipsychotic drugs when used for the treatment of mental
104.31 	illness; and 
104.32 	(5) 50 percent coinsurance on restorative dental services.
104.33 	(e) Co-payments shall be limited to one per day per
104.34 	provider for nonpreventive visits, eyeglasses, and nonemergency
104.35 	visits to a hospital-based emergency room.  Recipients of
104.36 	general assistance medical care are responsible for all
105.1 	co-payments in this subdivision.  The general assistance medical
105.2 	care reimbursement to the provider shall be reduced by the
105.3 	amount of the co-payment, except that reimbursement for
105.4 	prescription drugs shall not be reduced once a recipient has
105.5 	reached the $20 per month maximum for prescription drug
105.6 	co-payments.  The provider collects the co-payment from the
105.7 	recipient.  Providers may not deny services to recipients who
105.8 	are unable to pay the co-payment, except as provided in
105.9 	paragraph (f).
105.10 	(f) If it is the routine business practice of a provider to
105.11 	refuse service to an individual with uncollected debt, the
105.12 	provider may include uncollected co-payments under this
105.13 	section.  A provider must give advance notice to a recipient
105.14 	with uncollected debt before services can be denied.
105.15 	(g) (d) Any county may, from its own resources, provide
105.16 	medical payments for which state payments are not made.
105.17 	(h) (e) Chemical dependency services that are reimbursed
105.18 	under chapter 254B must not be reimbursed under general
105.19 	assistance medical care.
105.20 	(i) (f) The maximum payment for new vendors enrolled in the
105.21 	general assistance medical care program after the base year
105.22 	shall be determined from the average usual and customary charge
105.23 	of the same vendor type enrolled in the base year.
105.24 	(j) (g) The conditions of payment for services under this
105.25 	subdivision are the same as the conditions specified in rules
105.26 	adopted under chapter 256B governing the medical assistance
105.27 	program, unless otherwise provided by statute or rule.
105.28 	(k) (h) Inpatient and outpatient payments shall be reduced
105.29 	by five percent, effective July 1, 2003.  This reduction is in
105.30 	addition to the five percent reduction effective July 1, 2003,
105.31 	and incorporated by reference in paragraph (i) (f).
105.32 	(l) (i) Payments for all other health services except
105.33 	inpatient, outpatient, and pharmacy services shall be reduced by
105.34 	five percent, effective July 1, 2003.
105.35 	(m) (j) Payments to managed care plans shall be reduced by
105.36 	five percent for services provided on or after October 1, 2003.
106.1 	(n) (k) A hospital receiving a reduced payment as a result
106.2 	of this section may apply the unpaid balance toward satisfaction
106.3 	of the hospital's bad debts.
106.4 	
EFFECTIVE DATE. This section is effective January 1, 2006.

106.5 	Sec. 31. Minnesota Statutes 2004, section 256D.045, is
106.6 	amended to read:
106.7 	256D.045 SOCIAL SECURITY NUMBER REQUIRED.
106.8 	To be eligible for general assistance under sections
106.9 	256D.01 to 256D.21, an individual must provide the individual's
106.10 	Social Security number to the county agency or submit proof that
106.11 	an application has been made. An individual who refuses to
106.12 	provide a Social Security number because of a well-established
106.13 	religious objection as described in Code of Federal Regulations,
106.14 	title 42, section 435.910, may be eligible for general
106.15 	assistance medical care under section 256D.03.The provisions
106.16 	of this section do not apply to the determination of eligibility
106.17 	for emergency general assistance under section 256D.06,
106.18 	subdivision 2.  This provision applies to eligible children
106.19 	under the age of 18 effective July 1, 1997.

106.20 	EFFECTIVE DATE. This section is effective August 1, 2006,
106.21 	or upon HealthMatch implementation, whichever is later.

106.22 	Sec. 32. Minnesota Statutes 2004, section 256L.01,
106.23 	subdivision 4, is amended to read:
106.24 		Subd. 4.Gross individual or gross family income.  (a)
106.25 	"Gross individual or gross family income" for nonfarm
106.26 	self-employed means income calculated for the six-month period
106.27 	of eligibility using as the baseline the adjusted gross income
106.28 	reported on the applicant's federal income tax form for the
106.29 	previous year and adding back in reported depreciation,
106.30 	carryover loss, and net operating loss amounts that apply to the
106.31 	business in which the family is currently engaged.
106.32 	(b) "Gross individual or gross family income" for farm
106.33 	self-employed means income calculated for the six-month period
106.34 	of eligibility using as the baseline the adjusted gross income
106.35 	reported on the applicant's federal income tax form for the
106.36 	previous year and adding back in reported depreciation amounts
107.1 	that apply to the business in which the family is currently
107.2 	engaged.
107.3 	(c) Applicants shall report the most recent financial
107.4 	situation of the family if it has changed from the period of
107.5 	time covered by the federal income tax form.  The report may be
107.6 	in the form of percentage increase or decrease "Gross individual
107.7 	or gross family income" means the total income for all family
107.8 	members, calculated for the six-month period of eligibility.
107.9 	
EFFECTIVE DATE. This section is effective August 1, 2006,
107.10 	or upon HealthMatch implementation, whichever is later.

107.11 	Sec. 33. Minnesota Statutes 2004, section 256L.01,
107.12 	subdivision 5, is amended to read:
107.13 		Subd. 5.Income. (a) "Income" has the meaning given for
107.14 	earned and unearned income for families and children in the
107.15 	medical assistance program, according to the state's aid to
107.16 	families with dependent children plan in effect as of July 16,
107.17 	1996.  The definition does not include medical assistance income
107.18 	methodologies and deeming requirements.  The earned income of
107.19 	full-time and part-time students under age 19 is not counted as
107.20 	income.  Public assistance payments and supplemental security
107.21 	income are not excluded income.
107.22 	(b) For purposes of this subdivision, and unless otherwise
107.23 	specified in this section, the commissioner shall use reasonable
107.24 	methods to calculate gross earned and unearned income including,
107.25 	but not limited to, projecting income based on income received
107.26 	within the past 30 days, the last 90 days, or the last 12 months.
107.27 	
EFFECTIVE DATE. This section is effective July 1, 2005.

107.28 	Sec. 34. Minnesota Statutes 2004, section 256L.03,
107.29 	subdivision 1, is amended to read:
107.30 		Subdivision 1.Covered health services. For individuals
107.31 	under section 256L.04, subdivision 7, with income no greater
107.32 	than 75 percent of the federal poverty guidelines or for
107.33 	families with children under section 256L.04, subdivision 1, all
107.34 	subdivisions of this section apply."Covered health services"
107.35 	means the health services reimbursed under chapter 256B, with
107.36 	the exception of inpatient hospital services, special education
108.1 	services, private duty nursing services, adult dental care
108.2 	services other than services covered under section 256B.0625,
108.3 	subdivision 9, paragraph (b),orthodontic services, nonemergency
108.4 	medical transportation services, personal care assistant and
108.5 	case management services, nursing home or intermediate care
108.6 	facilities services, inpatient mental health services, and
108.7 	chemical dependency services.  Outpatient mental health services
108.8 	covered under the MinnesotaCare program are limited to
108.9 	diagnostic assessments, psychological testing, explanation of
108.10 	findings, medication management by a physician, day treatment,
108.11 	partial hospitalization, and individual, family, and group
108.12 	psychotherapy.
108.13 	No public funds shall be used for coverage of abortion
108.14 	under MinnesotaCare except where the life of the female would be
108.15 	endangered or substantial and irreversible impairment of a major
108.16 	bodily function would result if the fetus were carried to term;
108.17 	or where the pregnancy is the result of rape or incest.
108.18 	Covered health services shall be expanded as provided in
108.19 	this section.
108.20 	
EFFECTIVE DATE. Notwithstanding section 256B.69,
108.21 	subdivision 5a, paragraph (b), this section is effective July 1,
108.22 	2005.

108.23 	Sec. 35. Minnesota Statutes 2004, section 256L.03,
108.24 	subdivision 1b, is amended to read:
108.25 		Subd. 1b.Pregnant women; eligibility for full medical
108.26 	assistance services. Beginning January 1, 1999,A pregnant 
108.27 	woman who is enrolled in MinnesotaCare when her pregnancy is
108.28 	diagnosed is eligible for coverage of all services provided
108.29 	under the medical assistance program according to chapter 256B
108.30 	retroactive to the date the pregnancy is medically diagnosed of
108.31 	conception.  Co-payments totaling $30 or more, paid after the
108.32 	date the pregnancy is diagnosed of conception, shall be refunded.

108.33 	Sec. 36. Minnesota Statutes 2004, section 256L.03,
108.34 	subdivision 5, is amended to read:
108.35 		Subd. 5.Co-payments and coinsurance.  (a) Except as
108.36 	provided in paragraphs (b) and (c), the MinnesotaCare benefit
109.1 	plan shall include the following co-payments and coinsurance
109.2 	requirements for all enrollees:
109.3 	(1) ten percent of the paid charges for inpatient hospital
109.4 	services for adult enrollees, subject to an annual inpatient
109.5 	out-of-pocket maximum of $1,000 per individual and $3,000 per
109.6 	family;
109.7 	(2) $3 per prescription for adult enrollees;
109.8 	(3) $25 for eyeglasses for adult enrollees; and
109.9 	(4) 50 percent of the fee-for-service rate for adult dental
109.10 	care services other than preventive care services for persons
109.11 	eligible under section 256L.04, subdivisions 1 to 7, with income
109.12 	equal to or less greater than 175 190 percent of the federal
109.13 	poverty guidelines.
109.14 	(b) Paragraph (a), clause (1), does not apply to parents
109.15 	and relative caretakers of children under the age of 21 in
109.16 	households with family income equal to or less than 175 percent
109.17 	of the federal poverty guidelines.  Paragraph (a), clause (1),
109.18 	does not apply to parents and relative caretakers of children
109.19 	under the age of 21 in households with family income greater
109.20 	than 175 percent of the federal poverty guidelines for inpatient
109.21 	hospital admissions occurring on or after January 1, 2001.
109.22 	(c) Paragraph (a), clauses (1) to (4), do not apply to
109.23 	pregnant women and children under the age of 21.
109.24 	(d) Adult enrollees with family gross income that exceeds
109.25 	175 percent of the federal poverty guidelines and who are not
109.26 	pregnant shall be financially responsible for the coinsurance
109.27 	amount, if applicable, and amounts which exceed the $10,000
109.28 	inpatient hospital benefit limit.
109.29 	(e) When a MinnesotaCare enrollee becomes a member of a
109.30 	prepaid health plan, or changes from one prepaid health plan to
109.31 	another during a calendar year, any charges submitted towards
109.32 	the $10,000 annual inpatient benefit limit, and any
109.33 	out-of-pocket expenses incurred by the enrollee for inpatient
109.34 	services, that were submitted or incurred prior to enrollment,
109.35 	or prior to the change in health plans, shall be disregarded.
109.36 	
EFFECTIVE DATE. This section is effective August 1, 2006,
110.1 	or upon HealthMatch implementation, whichever is later.

110.2 	Sec. 37. Minnesota Statutes 2004, section 256L.04, is
110.3 	amended by adding a subdivision to read:
110.4 		Subd. 1a.Social security number required. (a)
110.5 	Individuals and families applying for MinnesotaCare coverage
110.6 	must provide a Social Security number.
110.7 	(b) The commissioner shall not deny eligibility to an
110.8 	otherwise eligible applicant who has applied for a Social
110.9 	Security number and is awaiting issuance of that Social Security
110.10 	number.
110.11 	(c) Newborns enrolled under section 256L.05, subdivision 3,
110.12 	are exempt from the requirements of this subdivision.
110.13 	(d) Individuals who refuse to provide a Social Security
110.14 	number because of well-established religious objections are
110.15 	exempt from the requirements of this subdivision.  The term
110.16 	"well-established religious objections" has the meaning given in
110.17 	Code of Federal Regulations, title 42, section 435.910.
110.18 	
EFFECTIVE DATE. This section is effective August 1, 2006,
110.19 	or upon HealthMatch implementation, whichever is later.

110.20 	Sec. 38. Minnesota Statutes 2004, section 256L.04,
110.21 	subdivision 2, is amended to read:
110.22 		Subd. 2.Cooperation in establishing third-party
110.23 	liability, paternity, and other medical support.  (a) To be
110.24 	eligible for MinnesotaCare, individuals and families must
110.25 	cooperate with the state agency to identify potentially liable
110.26 	third-party payers and assist the state in obtaining third-party
110.27 	payments.  "Cooperation" includes, but is not limited
110.28 	to, complying with the notice requirements in section 256B.056,
110.29 	subdivision 9,identifying any third party who may be liable for
110.30 	care and services provided under MinnesotaCare to the enrollee,
110.31 	providing relevant information to assist the state in pursuing a
110.32 	potentially liable third party, and completing forms necessary
110.33 	to recover third-party payments.
110.34 	(b) A parent, guardian, relative caretaker, or child
110.35 	enrolled in the MinnesotaCare program must cooperate with the
110.36 	Department of Human Services and the local agency in
111.1 	establishing the paternity of an enrolled child and in obtaining
111.2 	medical care support and payments for the child and any other
111.3 	person for whom the person can legally assign rights, in
111.4 	accordance with applicable laws and rules governing the medical
111.5 	assistance program.  A child shall not be ineligible for or
111.6 	disenrolled from the MinnesotaCare program solely because the
111.7 	child's parent, relative caretaker, or guardian fails to
111.8 	cooperate in establishing paternity or obtaining medical support.

111.9 	Sec. 39. Minnesota Statutes 2004, section 256L.04, is
111.10 	amended by adding a subdivision to read:
111.11 		Subd. 2a.Applications for other benefits. To be
111.12 	eligible for MinnesotaCare, individuals and families must take
111.13 	all necessary steps to obtain other benefits as described in
111.14 	Code of Federal Regulations, title 42, section 435.608.
111.15 	Applicants and enrollees must apply for other benefits within 30
111.16 	days.
111.17 	
EFFECTIVE DATE. This section is effective August 1, 2006,
111.18 	or upon HealthMatch implementation, whichever is later.

111.19 	Sec. 40. Minnesota Statutes 2004, section 256L.04,
111.20 	subdivision 7, is amended to read:
111.21 		Subd. 7.Single adults and households with no children.
 111.22 	The definition of eligible persons includes all individuals and
111.23 	households with no children who have gross family incomes that
111.24 	are equal to or less than 175 190 percent of the federal poverty
111.25 	guidelines.
111.26 	
EFFECTIVE DATE. This section is effective August 1, 2006,
111.27 	or upon HealthMatch implementation, whichever is later.

111.28 	Sec. 41. Minnesota Statutes 2004, section 256L.05,
111.29 	subdivision 3, is amended to read:
111.30 		Subd. 3.Effective date of coverage.  (a) The effective
111.31 	date of coverage is the first day of the month following the
111.32 	month in which eligibility is approved and the first premium
111.33 	payment has been received.  As provided in section 256B.057,
111.34 	coverage for newborns is automatic from the date of birth and
111.35 	must be coordinated with other health coverage.  The effective
111.36 	date of coverage for eligible newly adoptive children added to a
112.1 	family receiving covered health services is the date of entry
112.2 	into the family month of placement.  The effective date of
112.3 	coverage for other new recipients members added to the family
112.4 	receiving covered health services is the first day of the month
112.5 	following the month in which eligibility is approved or at
112.6 	renewal, whichever the family receiving covered health services
112.7 	prefers the change is reported.  All eligibility criteria must
112.8 	be met by the family at the time the new family member is
112.9 	added.  The income of the new family member is included with the
112.10 	family's gross income and the adjusted premium begins in the
112.11 	month the new family member is added.
112.12 	(b) The initial premium must be received by the last
112.13 	working day of the month for coverage to begin the first day of
112.14 	the following month.
112.15 	(c) Benefits are not available until the day following
112.16 	discharge if an enrollee is hospitalized on the first day of
112.17 	coverage.
112.18 	(d) Notwithstanding any other law to the contrary, benefits
112.19 	under sections 256L.01 to 256L.18 are secondary to a plan of
112.20 	insurance or benefit program under which an eligible person may
112.21 	have coverage and the commissioner shall use cost avoidance
112.22 	techniques to ensure coordination of any other health coverage
112.23 	for eligible persons.  The commissioner shall identify eligible
112.24 	persons who may have coverage or benefits under other plans of
112.25 	insurance or who become eligible for medical assistance.
112.26 	
EFFECTIVE DATE. This section is effective August 1, 2006,
112.27 	or upon HealthMatch implementation, whichever is later.

112.28 	Sec. 42. Minnesota Statutes 2004, section 256L.05,
112.29 	subdivision 3a, is amended to read:
112.30 		Subd. 3a.Renewal of eligibility.  (a) Beginning January
112.31 	1, 1999, an enrollee's eligibility must be renewed every 12
112.32 	months.  The 12-month period begins in the month after the month
112.33 	the application is approved.
112.34 	(b) Beginning October 1, 2004, an enrollee's eligibility
112.35 	must be renewed every six months.  The first six-month period of
112.36 	eligibility begins in the month after the month the application
113.1 	is approved received by the commissioner. The effective date of
113.2 	coverage within the first six-month period of eligibility is as
113.3 	provided in subdivision 3.Each new period of eligibility must
113.4 	take into account any changes in circumstances that impact
113.5 	eligibility and premium amount.  An enrollee must provide all
113.6 	the information needed to redetermine eligibility by the first
113.7 	day of the month that ends the eligibility period.  The premium
113.8 	for the new period of eligibility must be received as provided
113.9 	in section 256L.06 in order for eligibility to continue.
113.10 	
EFFECTIVE DATE. This section is effective August 1, 2006,
113.11 	or upon HealthMatch implementation, whichever is later.

113.12 	Sec. 43. Minnesota Statutes 2004, section 256L.07,
113.13 	subdivision 1, is amended to read:
113.14 		Subdivision 1.General requirements.  (a) Children
113.15 	enrolled in the original children's health plan as of September
113.16 	30, 1992, children who enrolled in the MinnesotaCare program
113.17 	after September 30, 1992, pursuant to Laws 1992, chapter 549,
113.18 	article 4, section 17, and children who have family gross
113.19 	incomes that are equal to or less than 150 percent of the
113.20 	federal poverty guidelines are eligible without meeting the
113.21 	requirements of subdivision 2 and the four-month requirement in
113.22 	subdivision 3, as long as they maintain continuous coverage in
113.23 	the MinnesotaCare program or medical assistance.  Children who
113.24 	apply for MinnesotaCare on or after the implementation date of
113.25 	the employer-subsidized health coverage program as described in
113.26 	Laws 1998, chapter 407, article 5, section 45, who have family
113.27 	gross incomes that are equal to or less than 150 percent of the
113.28 	federal poverty guidelines, must meet the requirements of
113.29 	subdivision 2 to be eligible for MinnesotaCare.
113.30 	(b) Families enrolled in MinnesotaCare under section
113.31 	256L.04, subdivision 1, whose income increases above 275 percent
113.32 	of the federal poverty guidelines, are no longer eligible for
113.33 	the program and shall be disenrolled by the commissioner.
113.34 	Individuals enrolled in MinnesotaCare under section 256L.04,
113.35 	subdivision 7, whose income increases above 175 percent of the
113.36 	federal poverty guidelines are no longer eligible for the
114.1 	program and shall be disenrolled by the commissioner.  For
114.2 	persons disenrolled under this subdivision, MinnesotaCare
114.3 	coverage terminates the last day of the calendar month following
114.4 	the month in which the commissioner determines that the income
114.5 	of a family or individual exceeds program income limits.
114.6 	(c)(1) Notwithstanding paragraph (b), families enrolled in
114.7 	MinnesotaCare under section 256L.04, subdivision 1, may remain
114.8 	enrolled in MinnesotaCare if ten percent of their annual income
114.9 	is less than the annual premium for a policy with a $500
114.10 	deductible available through the Minnesota Comprehensive Health
114.11 	Association.  Families who are no longer eligible for
114.12 	MinnesotaCare under this subdivision shall be given an 18-month
114.13 	notice period from the date that ineligibility is determined
114.14 	before disenrollment.  This clause expires February 1, 2004.
114.15 	(2) Effective February 1, 2004, notwithstanding paragraph
114.16 	(b), children may remain enrolled in MinnesotaCare if ten
114.17 	percent of their annual gross individual or gross family income
114.18 	as defined in section 256L.01, subdivision 4,is less than the
114.19 	annual premium for a six-month policy with a $500 deductible
114.20 	available through the Minnesota Comprehensive Health
114.21 	Association.  Children who are no longer eligible for
114.22 	MinnesotaCare under this clause shall be given a 12-month notice
114.23 	period from the date that ineligibility is determined before
114.24 	disenrollment.  The premium for children remaining eligible
114.25 	under this clause shall be the maximum premium determined under
114.26 	section 256L.15, subdivision 2, paragraph (b).
114.27 	(d) Effective July 1, 2003, notwithstanding paragraphs (b)
114.28 	and (c), parents are no longer eligible for MinnesotaCare if
114.29 	gross household income exceeds $50,000 $25,000 for the six-month
114.30 	period of eligibility.
114.31 	
EFFECTIVE DATE. This section is effective August 1, 2006,
114.32 	or upon HealthMatch implementation, whichever is later.

114.33 	Sec. 44. Minnesota Statutes 2004, section 256L.07,
114.34 	subdivision 3, is amended to read:
114.35 		Subd. 3.Other health coverage.  (a) Families and
114.36 	individuals enrolled in the MinnesotaCare program must have no
115.1 	health coverage while enrolled or for at least four months prior
115.2 	to application and renewal.  Children enrolled in the original
115.3 	children's health plan and children in families with income
115.4 	equal to or less than 150 percent of the federal poverty
115.5 	guidelines, who have other health insurance, are eligible if the
115.6 	coverage:
115.7 	(1) lacks two or more of the following:
115.8 	(i) basic hospital insurance;
115.9 	(ii) medical-surgical insurance;
115.10 	(iii) prescription drug coverage;
115.11 	(iv) dental coverage; or
115.12 	(v) vision coverage;
115.13 	(2) requires a deductible of $100 or more per person per
115.14 	year; or
115.15 	(3) lacks coverage because the child has exceeded the
115.16 	maximum coverage for a particular diagnosis or the policy
115.17 	excludes a particular diagnosis.
115.18 	The commissioner may change this eligibility criterion for
115.19 	sliding scale premiums in order to remain within the limits of
115.20 	available appropriations.  The requirement of no health coverage
115.21 	does not apply to newborns.
115.22 	(b) Medical assistance, general assistance medical care,
115.23 	and the Civilian Health and Medical Program of the Uniformed
115.24 	Service, CHAMPUS, or other coverage provided under United States
115.25 	Code, title 10, subtitle A, part II, chapter 55, are not
115.26 	considered insurance or health coverage for purposes of the
115.27 	four-month requirement described in this subdivision.
115.28 	(c) For purposes of this subdivision, an applicant or
115.29 	enrollee who is entitled to Medicare Part A or enrolled in
115.30 	Medicare Part B coverage under title XVIII of the Social
115.31 	Security Act, United States Code, title 42, sections 1395c
115.32 	to 1395w-4 1395w-152, is considered to have health coverage.  An
115.33 	applicant or enrollee who is entitled to premium-free Medicare
115.34 	Part A may not refuse to apply for or enroll in Medicare
115.35 	coverage to establish eligibility for MinnesotaCare.
115.36 	(d) Applicants who were recipients of medical assistance or
116.1 	general assistance medical care within one month of application
116.2 	must meet the provisions of this subdivision and subdivision 2.
116.3 	(e) Effective October 1, 2003, applicants who were
116.4 	recipients of medical assistance and had Cost-effective health
116.5 	insurance which that was paid for by medical assistance are
116.6 	exempt from is not considered health coverage for purposes of 
116.7 	the four-month requirement under this section, except if the
116.8 	insurance continued after medical assistance no longer
116.9 	considered it cost-effective or after medical assistance closed.

116.10 	Sec. 45. Minnesota Statutes 2004, section 256L.07, is
116.11 	amended by adding a subdivision to read:
116.12 		Subd. 5.Voluntary disenrollment for members of
116.13 	military. Notwithstanding section 256L.05, subdivision 3b,
116.14 	MinnesotaCare enrollees who are members of the military and
116.15 	their families, who choose to voluntarily disenroll from the
116.16 	program when one or more family members are called to active
116.17 	duty, may reenroll during or following that member's tour of
116.18 	active duty.  Those individuals and families shall be considered
116.19 	to have good cause for voluntary termination under section
116.20 	256L.06, subdivision 3, paragraph (d).  Income and asset
116.21 	increases reported at the time of reenrollment shall be
116.22 	disregarded.  All provisions of sections 256L.01 to 256L.18,
116.23 	shall apply to individuals and families enrolled under this
116.24 	subdivision upon six-month renewal.

116.25 	Sec. 46. Minnesota Statutes 2004, section 256L.12,
116.26 	subdivision 6, is amended to read:
116.27 		Subd. 6.Co-payments and benefit limits.  Enrollees are
116.28 	responsible for all co-payments in sections section 256L.03,
116.29 	subdivision 5, and 256L.035,and shall pay co-payments to the
116.30 	managed care plan or to its participating providers.  The
116.31 	enrollee is also responsible for payment of inpatient hospital
116.32 	charges which exceed the MinnesotaCare benefit limit.

116.33 	Sec. 47. Minnesota Statutes 2004, section 256L.15,
116.34 	subdivision 2, is amended to read:
116.35 		Subd. 2.Sliding fee scale to determine percentage of
116.36 	monthly gross individual or family income.  (a) The commissioner
117.1 	shall establish a sliding fee scale to determine the percentage
117.2 	of monthly gross individual or family income that households at
117.3 	different income levels must pay to obtain coverage through the
117.4 	MinnesotaCare program.  The sliding fee scale must be based on
117.5 	the enrollee's monthly gross individual or family income.  The
117.6 	sliding fee scale must contain separate tables based on
117.7 	enrollment of one, two, or three or more persons.  The sliding
117.8 	fee scale begins with a premium of 1.5 percent of monthly gross
117.9 	individual or family income for individuals or families with
117.10 	incomes below the limits for the medical assistance program for
117.11 	families and children in effect on January 1, 1999, and proceeds
117.12 	through the following evenly spaced steps:  1.8, 2.3, 3.1, 3.8,
117.13 	4.8, 5.9, 7.4, and 8.8 percent.  These percentages are matched
117.14 	to evenly spaced income steps ranging from the medical
117.15 	assistance income limit for families and children in effect on
117.16 	January 1, 1999, to 275 percent of the federal poverty
117.17 	guidelines for the applicable family size, up to a family size
117.18 	of five.  The sliding fee scale for a family of five must be
117.19 	used for families of more than five.  Effective October 1, 2003,
117.20 	the commissioner shall increase each percentage by 0.5
117.21 	percentage points for enrollees with income greater than 100
117.22 	percent but not exceeding 200 percent of the federal poverty
117.23 	guidelines and shall increase each percentage by 1.0 percentage
117.24 	points for families and children with incomes greater than 200
117.25 	percent of the federal poverty guidelines.  The sliding fee
117.26 	scale and percentages are not subject to the provisions of
117.27 	chapter 14.  If a family or individual reports increased income
117.28 	after enrollment, premiums shall not be adjusted until
117.29 	eligibility renewal.
117.30 	(b)(1) Enrolled families whose gross annual income
117.31 	increases above 275 percent of the federal poverty guideline
117.32 	shall pay the maximum premium.  This clause expires effective
117.33 	February 1, 2004.
117.34 	(2) Effective February 1, 2004, children in families whose
117.35 	gross income is above 275 percent of the federal poverty
117.36 	guidelines shall pay the maximum premium.
118.1 	(3) The maximum premium is defined as a base charge for
118.2 	one, two, or three or more enrollees so that if all
118.3 	MinnesotaCare cases paid the maximum premium, the total revenue
118.4 	would equal the total cost of MinnesotaCare medical coverage and
118.5 	administration.  In this calculation, administrative costs shall
118.6 	be assumed to equal ten percent of the total.  The costs of
118.7 	medical coverage for pregnant women and children under age two
118.8 	and the enrollees in these groups shall be excluded from the
118.9 	total.  The maximum premium for two enrollees shall be twice the
118.10 	maximum premium for one, and the maximum premium for three or
118.11 	more enrollees shall be three times the maximum premium for one.
118.12 	
EFFECTIVE DATE. This section is effective August 1, 2006,
118.13 	or upon HealthMatch implementation, whichever is later.

118.14 	Sec. 48. Minnesota Statutes 2004, section 256L.15,
118.15 	subdivision 3, is amended to read:
118.16 		Subd. 3.Exceptions to sliding scale. An annual premium
118.17 	of $48 is required for all Children in families with income at
118.18 	or less than below 150 percent of the federal poverty guidelines
118.19 	pay a monthly premium of $4.
118.20 	
EFFECTIVE DATE. This section is effective August 1, 2006,
118.21 	or upon HealthMatch implementation, whichever is later.

118.22 	Sec. 49. [256L.20] MINNESOTACARE OPTION FOR SMALL
118.23 	EMPLOYERS.
118.24 		Subdivision 1.Definitions. (a) For the purpose of this
118.25 	section, the terms used have the meanings given them.
118.26 	(b) "Dependent" means an unmarried child under 21 years of
118.27 	age.
118.28 	(c) "Eligible employer" means a business that employs at
118.29 	least two, but not more than 50, eligible employees, the
118.30 	majority of whom are employed in the state, and includes a
118.31 	municipality that has 50 or fewer employees.
118.32 	(d) "Eligible employee" means an employee who works at
118.33 	least 20 hours per week for an eligible employer.  Eligible
118.34 	employee does not include an employee who works on a temporary
118.35 	or substitute basis or who does not work more than 26 weeks
118.36 	annually.
119.1 	(e) "Maximum premium" has the meaning given under section
119.2 	256L.15, subdivision 2, paragraph (b), clause (3).
119.3 	(f) "Participating employer" means an eligible employer who
119.4 	meets the requirements in subdivision 3 and applies to the
119.5 	commissioner to enroll its eligible employees and their
119.6 	dependents in the MinnesotaCare program.
119.7 	(g) "Program" means the MinnesotaCare program.
119.8 		Subd. 2.Option. Eligible employees and their dependents
119.9 	may enroll in MinnesotaCare if the eligible employer meets the
119.10 	requirements of subdivision 3.  The effective date of coverage
119.11 	is according to section 256L.05, subdivision 3.
119.12 		Subd. 3.Employer requirements. The commissioner shall
119.13 	establish procedures for an eligible employer to apply for
119.14 	coverage through the program.  In order to participate, an
119.15 	eligible employer must meet the following requirements:
119.16 	(1) agrees to contribute toward the cost of the premium for
119.17 	the employee and the employee's dependents according to
119.18 	subdivision 4;
119.19 	(2) certifies that at least 75 percent of its eligible
119.20 	employees who do not have other creditable health coverage are
119.21 	enrolled in the program;
119.22 	(3) offers coverage to all eligible employees and the
119.23 	dependents of eligible employees; and 
119.24 	(4) has not provided employer-subsidized health coverage as
119.25 	an employee benefit during the previous 12 months, as defined in
119.26 	section 256L.07, subdivision 2, paragraph (c).
119.27 		Subd. 4.Premiums. (a) The premium for MinnesotaCare
119.28 	coverage provided under this section is equal to the maximum
119.29 	premium regardless of the income of the eligible employee.
119.30 	(b) For eligible employees without dependents with income
119.31 	equal to or less than 175 percent of the federal poverty
119.32 	guidelines and for eligible employees with dependents with
119.33 	income equal to or less than 275 percent of the federal poverty
119.34 	guidelines, the participating employer shall pay 50 percent of
119.35 	the maximum premium for the eligible employee and any
119.36 	dependents, if applicable.
120.1 	(c) For eligible employees without dependents with income
120.2 	over 175 percent of the federal poverty guidelines and for
120.3 	eligible employees with dependents with income over 275 percent
120.4 	of the federal poverty guidelines, the participating employer
120.5 	shall pay the full cost of the maximum premium for the eligible
120.6 	employee and any dependents, if applicable.  The participating
120.7 	employer may require the employee to pay a portion of the cost
120.8 	of the premium so long as the employer pays 50 percent of the
120.9 	cost.  If the employer requires the employee to pay a portion of
120.10 	the premium, the employee shall pay the portion of the cost to
120.11 	the employer.
120.12 	(d) The commissioner shall collect premium payments from
120.13 	participating employers for eligible employees and their
120.14 	dependents who are covered by the program as provided under this
120.15 	section.  All premiums collected shall be deposited in the
120.16 	health care access fund.
120.17 		Subd. 5.Coverage. The coverage offered to those
120.18 	enrolled in the program under this section must include all
120.19 	health services described under section 256L.03 and all
120.20 	co-payments and coinsurance requirements under section 256L.03,
120.21 	subdivision 5, apply.
120.22 		Subd. 6.Enrollment. Upon payment of the premium, in
120.23 	accordance with this section and section 256L.06, eligible
120.24 	employees and their dependents shall be enrolled in
120.25 	MinnesotaCare.  For purposes of enrollment under this section,
120.26 	income eligibility limits established under sections 256L.04 and
120.27 	256L.07, subdivision 1, and asset limits established under
120.28 	section 256L.17 do not apply.  The barriers established under
120.29 	section 256L.07, subdivision 2 or 3, do not apply to enrollees
120.30 	eligible under this section.  The commissioner may require
120.31 	eligible employees to provide income verification to determine
120.32 	premiums.
120.33 	
EFFECTIVE DATE. This section is effective August 1, 2006,
120.34 	or upon HealthMatch implementation, whichever is later.

120.35 	Sec. 50. Minnesota Statutes 2004, section 549.02, is
120.36 	amended by adding a subdivision to read:
121.1 		Subd. 3.Limitation. Notwithstanding subdivisions 1 and
121.2 	2, where the state agency is named or intervenes as a party to
121.3 	enforce the agency's rights under section 256B.056, the agency
121.4 	shall not be liable for costs to any prevailing defendant.

121.5 	Sec. 51. Minnesota Statutes 2004, section 549.04, is
121.6 	amended to read:
121.7 	549.04 DISBURSEMENTS; TAXATION AND ALLOWANCE.
121.8 		Subdivision 1.Generally. In every action in a district
121.9 	court, the prevailing party, including any public employee who
121.10 	prevails in an action for wrongfully denied or withheld
121.11 	employment benefits or rights, shall be allowed reasonable
121.12 	disbursements paid or incurred, including fees and mileage paid
121.13 	for service of process by the sheriff or by a private person.
121.14 		Subd. 2.Limitation. Notwithstanding subdivision 1,
121.15 	where the state agency is named or intervenes as a party to
121.16 	enforce the agency's rights under section 256B.056, the agency
121.17 	shall not be liable for disbursements to any prevailing
121.18 	defendant.

121.19 	Sec. 52. Laws 2003, First Special Session chapter 14,
121.20 	article 12, section 93, is amended to read:
121.21 	Sec. 93REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY
121.22 	CRITERIA AND POTENTIAL COST SAVINGS.
 121.23 	The commissioner of human services, in consultation with
121.24 	the commissioner of transportation and special transportation
121.25 	service providers, shall review eligibility criteria for medical
121.26 	assistance special transportation services and shall evaluate
121.27 	whether the level of special transportation services provided
121.28 	should be based on the degree of impairment of the client, as
121.29 	well as the medical diagnosis.  The commissioner shall also
121.30 	evaluate methods for reducing the cost of special transportation
121.31 	services, including, but not limited to:
121.32 	(1) requiring providers to maintain a daily log book
121.33 	confirming delivery of clients to medical facilities;
121.34 	(2) requiring providers to implement commercially available
121.35 	computer mapping programs to calculate mileage for purposes of
121.36 	reimbursement;
122.1 	(3) restricting special transportation service from being
122.2 	provided solely for trips to pharmacies;
122.3 	(4) modifying eligibility for special transportation;
122.4 	(5) expanding alternatives to the use of special
122.5 	transportation services;
122.6 	(6) improving the process of certifying persons as eligible
122.7 	for special transportation services; and
122.8 	(7) examining the feasibility and benefits of licensing
122.9 	special transportation providers.
122.10 	The commissioner shall present recommendations for changes
122.11 	in the eligibility criteria and potential cost-savings for
122.12 	special transportation services to the chairs and ranking
122.13 	minority members of the house and senate committees having
122.14 	jurisdiction over health and human services spending by January
122.15 	15, 2004.  The commissioner is prohibited from using a broker or
122.16 	coordinator to manage special transportation services until July
122.17 	1, 2005 2006, except for the purposes of checking for recipient
122.18 	eligibility, authorizing recipients for appropriate level of
122.19 	transportation, and monitoring provider compliance with
122.20 	Minnesota Statutes, section 256B.0625, subdivision 17.  This
122.21 	prohibition does not apply to the purchase or management of
122.22 	common carrier transportation.

122.23 	Sec. 53. ADVISORY COMMITTEE ON NONEMERGENCY
122.24 	TRANSPORTATION SERVICES.
 122.25 	The commissioner of human services may establish a
122.26 	seven-member advisory committee on medical assistance
122.27 	nonemergency transportation services.  The committee may consist
122.28 	of:  a representative of the commissioner of human services, who
122.29 	may serve as chair; two special transportation service
122.30 	providers, appointed by the trade associations representing
122.31 	special transportation service providers; two representatives of
122.32 	nursing facilities, one appointed by the Minnesota Health and
122.33 	Housing Alliance and the other appointed by Care Providers of
122.34 	Minnesota; and one house of representatives and one senate
122.35 	member, appointed respectively by the chairs of the house of
122.36 	representatives and senate committees with jurisdiction over
123.1 	medical assistance funding.  The advisory committee may monitor
123.2 	and evaluate the provision of medical assistance nonemergency
123.3 	medical transportation services, and present recommendations for
123.4 	any necessary changes to the commissioner.

123.5 	Sec. 54. EMPLOYER DISCLOSURE FOR MINNESOTA HEALTH CARE
123.6 	PROGRAM.
 123.7 		Subdivision 1.Definitions. (a) For purposes of this
123.8 	section, the following definitions apply.
123.9 	(b) "Commissioner" means the commissioner of human services.
123.10 	(c) "Minnesota health care program" means the prescription
123.11 	drug program under section 256.955, medical assistance under
123.12 	chapter 256B, general assistance medical care under section
123.13 	256D.03, subdivision 3, and MinnesotaCare under chapter 256L.
123.14 		Subd. 2.Report. (a) By January 15, 2007, for the
123.15 	previous fiscal year, the commissioner shall submit to the
123.16 	legislature a report identifying all employers that employ 50 or
123.17 	more employees who are Minnesota health care program
123.18 	recipients.  In determining whether the 50-employee threshold is
123.19 	met, the commissioner shall include all employees employed by an
123.20 	employer and its subsidiaries at all locations within the
123.21 	state.  The report shall include the following information:
123.22 	(1) the name of the employer and, as appropriate, the names
123.23 	of its subsidiaries that employ Minnesota health care program
123.24 	recipients;
123.25 	(2) the number of Minnesota health care program recipients
123.26 	who are employees of the employer;
123.27 	(3) the number of Minnesota health care program recipients
123.28 	who are spouses or dependents of employees of the employer; and 
123.29 	(4) the cost to the state of providing health care benefits
123.30 	for these employers' employees and enrolled dependents.
123.31 	(b) In preparing and publishing the report, the
123.32 	commissioner shall take reasonable precautions to protect the
123.33 	identity of Minnesota health care program recipients:
123.34 	(1) the report shall include only nonindividually
123.35 	identifiable summary data as defined in section 13.02,
123.36 	subdivision 19;
124.1 	(2) the commissioner shall employ generally accepted
124.2 	statistical and scientific principles and methods for rendering
124.3 	information as not individually identifiable.  The commissioner
124.4 	must determine that there is an insignificant risk that
124.5 	information in the report could be used, alone or in combination
124.6 	with other reasonably available information, to identify any
124.7 	Minnesota health care program recipient; and 
124.8 	(3) the commissioner shall comply with all other applicable
124.9 	privacy and security provisions of the Health Insurance
124.10 	Portability and Accountability Act of 1996, Public Law 104-191,
124.11 	and its corresponding regulations, Code of Federal Regulations,
124.12 	title 45, sections 160, 162, and 164; Minnesota Statutes,
124.13 	chapter 13; section 144.335; and any other applicable state and
124.14 	federal law.
124.15 	(c) The commissioner shall make the report available to the
124.16 	public on the Department of Human Services' Web site, and shall
124.17 	provide a copy of the report to any member of the public upon
124.18 	request.

124.19 	Sec. 55. LIMITING COVERAGE OF HEALTH CARE SERVICES FOR
124.20 	MEDICAL ASSISTANCE, GENERAL ASSISTANCE MEDICAL CARE, AND
124.21 	MINNESOTACARE PROGRAMS.
 124.22 		Subdivision 1.Prior authorization of services. (a)
124.23 	Effective July 1, 2005, prior authorization is required for the
124.24 	services described in subdivision 2 for reimbursement under
124.25 	chapters 256B, 256D, and 256L.
124.26 	(b) Prior authorization shall be conducted under the
124.27 	direction of the medical director of the Department of Human
124.28 	Services in conjunction with a medical policy advisory council.
124.29 	To the extent available, the medical director shall use publicly
124.30 	available evidence-based guidelines developed by an independent,
124.31 	nonprofit organization or by the professional association of the
124.32 	specialty that typically provides the service or by a multistate
124.33 	Medicaid evidence-based practice center.  If the commissioner
124.34 	does not have a medical director and medical policy director in
124.35 	place, the commissioner shall contract prior authorization to a
124.36 	Minnesota-licensed utilization review organization or to another
125.1 	entity such as a peer review organization eligible to operate in
125.2 	Minnesota.
125.3 	(c) A prepaid health plan shall use prior authorization for
125.4 	the services described in subdivision 2 unless the prepaid
125.5 	health plan is otherwise using evidence-based practices to
125.6 	address these services.
125.7 		Subd. 2.Services requiring prior authorization. The
125.8 	following services require prior authorization:
125.9 	(1) elective outpatient high-technology imaging to include
125.10 	positive emission tomography (PET) scans, magnetic resonance
125.11 	imaging (MRI), computed tomography (CT), and nuclear cardiology;
125.12 	(2) spinal fusion, unless in an emergency situation related
125.13 	to trauma;
125.14 	(3) bariatric surgery;
125.15 	(4) chiropractic visits beyond ten visits;
125.16 	(5) circumcision; and 
125.17 	(6) orthodontia.
125.18 		Subd. 3.Rate reduction. Effective for the services
125.19 	identified in subdivision 2, rendered on or after July 1, 2005,
125.20 	the payment rate shall be reduced by ten percent from the rate
125.21 	in effect on June 30, 2005.
125.22 		Subd. 4.Expiration. This section shall expire July 1,
125.23 	2006, or upon the completion of the prior authorization system
125.24 	required under subdivision 1, whichever is earlier.

125.25 	Sec. 56. ORAL HEALTH CARE PILOT PROJECT.
 125.26 	The commissioner shall implement a two-year pilot project
125.27 	to provide services for state program recipients through a new
125.28 	oral health care delivery system.  The commissioner shall
125.29 	contract with a qualified entity or entities to administer the
125.30 	pilot project.

125.31 	Sec. 57. SOLE-SOURCE MANAGED CARE CONTRACT.
 125.32 	Notwithstanding Minnesota Statutes, section 256B.692,
125.33 	subdivision 6, the commissioner of human services shall not
125.34 	reject a county-based purchasing health plan proposal that
125.35 	requires county-based purchasing on a sole-source basis if the
125.36 	implementation of the sole-source purchasing proposal does not
126.1 	limit an enrollee's provider choice or access to services.  The
126.2 	commissioner shall request federal approval, if necessary, to
126.3 	permit or maintain a sole-source purchasing option even if
126.4 	choice is available in the area.

126.5 	Sec. 58. PLANNING PROCESS FOR MANAGED CARE.
 126.6 	The commissioner of human services shall develop a planning
126.7 	process for the purposes of implementing at least one additional
126.8 	managed care arrangement to provide medical assistance services,
126.9 	excluding continuing care services, to recipients enrolled in
126.10 	the medical assistance fee-for-service program, effective
126.11 	January 1, 2007.  This planning process shall include an
126.12 	advisory committee composed of current fee-for-service
126.13 	consumers, consumer advocates, and providers, as well as
126.14 	representatives of health plans and other provider organizations
126.15 	qualified to provide basic health care services to persons with
126.16 	disabilities.  The commissioner shall seek any additional
126.17 	federal authority necessary to provide basic health care
126.18 	services through contracted managed care arrangements.

126.19 	Sec. 59. REPEALER.
 126.20 	(a) Notwithstanding Minnesota Statutes, section 256B.69,
126.21 	subdivision 5a, paragraph (b), Minnesota Statutes 2004, section
126.22 	256L.035, is repealed effective July 1, 2005.
126.23 	(b) Minnesota Statutes 2004, section 256B.0631, is repealed
126.24 	effective January 1, 2006.

126.25 	ARTICLE 3
126.26 	HEALTH CARE COST CONTAINMENT

126.27 	Section 1. Minnesota Statutes 2004, section 62A.65,
126.28 	subdivision 3, is amended to read:
126.29 		Subd. 3.Premium rate restrictions.  No individual health
126.30 	plan may be offered, sold, issued, or renewed to a Minnesota
126.31 	resident unless the premium rate charged is determined in
126.32 	accordance with the following requirements:
126.33 	(a) Premium rates must be no more than 25 percent above and
126.34 	no more than 25 percent below the index rate charged to
126.35 	individuals for the same or similar coverage, adjusted pro rata
126.36 	for rating periods of less than one year.  The premium
127.1 	variations permitted by this paragraph must be based only upon
127.2 	health status, claims experience, and occupation.  For purposes
127.3 	of this paragraph, health status includes refraining from
127.4 	tobacco use or other actuarially valid lifestyle factors
127.5 	associated with good health, provided that the lifestyle factor
127.6 	and its effect upon premium rates have been determined by the
127.7 	commissioner to be actuarially valid and have been approved by
127.8 	the commissioner.  Variations permitted under this paragraph
127.9 	must not be based upon age or applied differently at different
127.10 	ages.  This paragraph does not prohibit use of a constant
127.11 	percentage adjustment for factors permitted to be used under
127.12 	this paragraph.
127.13 	(b) Premium rates may vary based upon the ages of covered
127.14 	persons only as provided in this paragraph.  In addition to the
127.15 	variation permitted under paragraph (a), each health carrier may
127.16 	use an additional premium variation based upon age of up to plus
127.17 	or minus 50 percent of the index rate.
127.18 	(c) A health carrier may request approval by the
127.19 	commissioner to establish no more than three geographic regions
127.20 	and to establish separate index rates for each region, provided
127.21 	that the index rates do not vary between any two regions by more
127.22 	than 20 percent.  Health carriers that do not do business in the
127.23 	Minneapolis/St. Paul metropolitan area may request approval for
127.24 	no more than two geographic regions, and clauses (2) and (3) do
127.25 	not apply to approval of requests made by those health
127.26 	carriers.  The commissioner may grant approval if the following
127.27 	conditions are met:
127.28 	(1) the geographic regions must be applied uniformly by the
127.29 	health carrier;
127.30 	(2) one geographic region must be based on the
127.31 	Minneapolis/St. Paul metropolitan area;
127.32 	(3) for each geographic region that is rural, the index
127.33 	rate for that region must not exceed the index rate for the
127.34 	Minneapolis/St. Paul metropolitan area; and
127.35 	(4) the health carrier provides actuarial justification
127.36 	acceptable to the commissioner for the proposed geographic
128.1 	variations in index rates, establishing that the variations are
128.2 	based upon differences in the cost to the health carrier of
128.3 	providing coverage.
128.4 	(d) Health carriers may use rate cells and must file with
128.5 	the commissioner the rate cells they use.  Rate cells must be
128.6 	based upon the number of adults or children covered under the
128.7 	policy and may reflect the availability of Medicare coverage.
128.8 	The rates for different rate cells must not in any way reflect
128.9 	generalized differences in expected costs between principal
128.10 	insureds and their spouses.
128.11 	(e) In developing its index rates and premiums for a health
128.12 	plan, a health carrier shall take into account only the
128.13 	following factors:
128.14 	(1) actuarially valid differences in rating factors
128.15 	permitted under paragraphs (a) and (b); and
128.16 	(2) actuarially valid geographic variations if approved by
128.17 	the commissioner as provided in paragraph (c).
128.18 	(f) All premium variations must be justified in initial
128.19 	rate filings and upon request of the commissioner in rate
128.20 	revision filings.  All rate variations are subject to approval
128.21 	by the commissioner.
128.22 	(g) The loss ratio must comply with the section 62A.021
128.23 	requirements for individual health plans.
128.24 	(h) Notwithstanding paragraphs (a) to (g),the rates must
128.25 	not be approved,unless the commissioner has determined that the
128.26 	rates are reasonable.  In determining reasonableness, the
128.27 	commissioner shall consider the growth rates applied under
128.28 	section 62J.04, subdivision 1, paragraph (b) apply the premium
128.29 	growth limits established under section 62J.04, subdivision 1b,
128.30 	to the calendar year or years that the proposed premium rate
128.31 	would be in effect, and shall consider actuarially valid changes
128.32 	in risks associated with the enrollee populations,and
128.33 	actuarially valid changes as a result of statutory changes in
128.34 	Laws 1992, chapter 549.

128.35 	Sec. 2. Minnesota Statutes 2004, section 62J.04, is
128.36 	amended by adding a subdivision to read:
129.1 		Subd. 1b.Premium growth limits. (a) For calendar year
129.2 	2005 and each year thereafter, the commissioner shall set annual
129.3 	premium growth limits for health plan companies.  The premium
129.4 	limits set by the commissioner for calendar years 2005 to 2010
129.5 	shall not exceed the regional Consumer Price Index for urban
129.6 	consumers for the preceding calendar year plus two percentage
129.7 	points and an additional one percentage point to be used to
129.8 	finance the implementation of the electronic medical record
129.9 	system.  The commissioner shall ensure that the additional
129.10 	percentage point is being used to provide financial assistance
129.11 	to health care providers to implement electronic medical record
129.12 	systems either directly or through an increase in reimbursement.
129.13 	(b) For the calendar years beyond 2010, the rate of premium
129.14 	growth shall be limited to the change in the Consumer Price
129.15 	Index for urban consumers for the previous calendar year plus
129.16 	two percentage points.  The commissioners of health and commerce
129.17 	shall make a recommendation to the legislature by January 15,
129.18 	2009, regarding the continuation of the additional percentage
129.19 	point to the growth limit described in paragraph (a).  The
129.20 	recommendation shall be based on the progress made by health
129.21 	care providers in instituting an electronic medical record
129.22 	system and in creating a statewide interactive electronic health
129.23 	record system.
129.24 	(c) The commissioner may add additional percentage points
129.25 	as needed to the premium limit for a calendar year if a major
129.26 	disaster, bioterrorism, or a public health emergency occurs that
129.27 	results in higher health care costs.  Any additional percentage
129.28 	points must reflect the additional cost to the health care
129.29 	system directly attributed to the disaster or emergency.
129.30 	(d) The commissioner shall publish the annual premium
129.31 	growth limits in the State Register by January 31 of the year
129.32 	that the limits are to be in effect.
129.33 	(e) For the purpose of this subdivision, premium growth is
129.34 	measured as the percentage change in per member, per month
129.35 	premium revenue from the current year to the previous year.
129.36 	Premium growth rates shall be calculated for the following lines
130.1 	of business:  individual, small group, and large group.  Data
130.2 	used for premium growth rate calculations shall be submitted as
130.3 	part of the cost containment filing under section 62J.38.
130.4 	(f) For purposes of this subdivision, "health plan company"
130.5 	has the meaning given in section 62J.041.
130.6 	(g) A health plan company may reduce reimbursement to
130.7 	providers in order to meet the premium growth limitations
130.8 	required by this section.

130.9 	Sec. 3. Minnesota Statutes 2004, section 62J.04,
130.10 	subdivision 3, is amended to read:
130.11 		Subd. 3.Cost containment duties.  The commissioner shall:
130.12 	(1) establish statewide and regional cost containment goals
130.13 	for total health care spending under this section and collect
130.14 	data as described in sections 62J.38 to 62J.41 to monitor
130.15 	statewide achievement of the cost containment goals and premium
130.16 	growth limits;
130.17 	(2) divide the state into no fewer than four regions, with
130.18 	one of those regions being the Minneapolis/St. Paul metropolitan
130.19 	statistical area but excluding Chisago, Isanti, Wright, and
130.20 	Sherburne Counties, for purposes of fostering the development of
130.21 	regional health planning and coordination of health care
130.22 	delivery among regional health care systems and working to
130.23 	achieve the cost containment goals;
130.24 	(3) monitor the quality of health care throughout the state
130.25 	and take action as necessary to ensure an appropriate level of
130.26 	quality;
130.27 	(4) issue recommendations regarding uniform billing forms,
130.28 	uniform electronic billing procedures and data interchanges,
130.29 	patient identification cards, and other uniform claims and
130.30 	administrative procedures for health care providers and private
130.31 	and public sector payers.  In developing the recommendations,
130.32 	the commissioner shall review the work of the work group on
130.33 	electronic data interchange (WEDI) and the American National
130.34 	Standards Institute (ANSI) at the national level, and the work
130.35 	being done at the state and local level.  The commissioner may
130.36 	adopt rules requiring the use of the Uniform Bill 82/92 form,
131.1 	the National Council of Prescription Drug Providers (NCPDP) 3.2
131.2 	electronic version, the Centers for Medicare and Medicaid
131.3 	Services 1500 form, or other standardized forms or procedures;
131.4 	(5) undertake health planning responsibilities;
131.5 	(6) authorize, fund, or promote research and
131.6 	experimentation on new technologies and health care procedures;
131.7 	(7) within the limits of appropriations for these purposes,
131.8 	administer or contract for statewide consumer education and
131.9 	wellness programs that will improve the health of Minnesotans
131.10 	and increase individual responsibility relating to personal
131.11 	health and the delivery of health care services, undertake
131.12 	prevention programs including initiatives to improve birth
131.13 	outcomes, expand childhood immunization efforts, and provide
131.14 	start-up grants for worksite wellness programs;
131.15 	(8) undertake other activities to monitor and oversee the
131.16 	delivery of health care services in Minnesota with the goal of
131.17 	improving affordability, quality, and accessibility of health
131.18 	care for all Minnesotans; and
131.19 	(9) make the cost containment goal and premium growth limit 
131.20 	data available to the public in a consumer-oriented manner.

131.21 	Sec. 4. Minnesota Statutes 2004, section 62J.041, is
131.22 	amended to read:
131.23 	62J.041  INTERIM HEALTH PLAN COMPANY COST CONTAINMENT GOALS 
131.24 	HEALTH CARE EXPENDITURE LIMITS.
131.25 		Subdivision 1.Definitions. (a) For purposes of this
131.26 	section, the following definitions apply.
131.27 	(b) "Health plan company" has the definition provided in
131.28 	section 62Q.01. This definition does not include the state
131.29 	employee health plan offered under chapter 43A.
131.30 	(c) " Total Health care expenditures" means incurred claims
131.31 	or expenditures on health care services, administrative
131.32 	expenses, charitable contributions, and all other payments made
131.33 	by health plan companies out of premium revenues.
131.34 	(d) "Net expenditures" means total expenditures minus
131.35 	exempted taxes and assessments and payments or allocations made
131.36 	to establish or maintain reserves.
132.1 	(e) "Exempted taxes and assessments" means direct payments
132.2 	for taxes to government agencies, contributions to the Minnesota
132.3 	Comprehensive Health Association, the medical assistance
132.4 	provider's surcharge under section 256.9657, the MinnesotaCare
132.5 	provider tax under section 295.52, assessments by the Health
132.6 	Coverage Reinsurance Association, assessments by the Minnesota
132.7 	Life and Health Insurance Guaranty Association, assessments by
132.8 	the Minnesota Risk Adjustment Association, and any new
132.9 	assessments imposed by federal or state law.
132.10 	(f) "Consumer cost-sharing or subscriber liability" means
132.11 	enrollee coinsurance, co-payment, deductible payments, and
132.12 	amounts in excess of benefit plan maximums.
132.13 		Subd. 2.Establishment. The commissioner of health shall
132.14 	establish cost containment goals health care expenditure limits 
132.15 	for the increase in net calendar year 2006, and each year
132.16 	thereafter, for health care expenditures by each health plan
132.17 	company for calendar years 1994, 1995, 1996, and 1997.  The cost
132.18 	containment goals must be the same as the annual cost
132.19 	containment goals for health care spending established under
132.20 	section 62J.04, subdivision 1, paragraph (b).  Health plan
132.21 	companies that are affiliates may elect to meet one
132.22 	combined cost containment goal health care expenditure limit.
132.23 	The limits set by the commissioner shall not exceed the premium
132.24 	limits established in section 62J.04, subdivision 1b.
132.25 		Subd. 3.Determination of expenditures. Health plan
132.26 	companies shall submit to the commissioner of health, by April
132.27 	1, 1994, for calendar year 1993; April 1, 1995, for calendar
132.28 	year 1994; April 1, 1996, for calendar year 1995; April 1, 1997,
132.29 	for calendar year 1996; and April 1, 1998, for calendar year
132.30 	1997 of each year beginning 2006,all information the
132.31 	commissioner determines to be necessary to implement this
132.32 	section.  The information must be submitted in the form
132.33 	specified by the commissioner.  The information must include,
132.34 	but is not limited to, health care expenditures per member per
132.35 	month or cost per employee per month, and detailed information
132.36 	on revenues and reserves.  The commissioner, to the extent
133.1 	possible, shall coordinate the submittal of the information
133.2 	required under this section with the submittal of the financial
133.3 	data required under chapter 62J, to minimize the administrative
133.4 	burden on health plan companies.  The commissioner may adjust
133.5 	final expenditure figures for demographic changes, risk
133.6 	selection, changes in basic benefits, and legislative
133.7 	initiatives that materially change health care costs, as long as
133.8 	these adjustments are consistent with the methodology submitted
133.9 	by the health plan company to the commissioner, and approved by
133.10 	the commissioner as actuarially justified. The methodology to
133.11 	be used for adjustments and the election to meet one cost
133.12 	containment goal for affiliated health plan companies must be
133.13 	submitted to the commissioner by September 1, 1994.  Community
133.14 	integrated service networks may submit the information with
133.15 	their application for licensure.  The commissioner shall also
133.16 	accept changes to methodologies already submitted.  The
133.17 	adjustment methodology submitted and approved by the
133.18 	commissioner must apply to the data submitted for calendar years
133.19 	1994 and 1995.  The commissioner may allow changes to accepted
133.20 	adjustment methodologies for data submitted for calendar years
133.21 	1996 and 1997.  Changes to the adjustment methodology must be
133.22 	received by September 1, 1996, and must be approved by the
133.23 	commissioner.
133.24 		Subd. 4.Monitoring of reserves. (a) The commissioners
133.25 	of health and commerce shall monitor health plan company
133.26 	reserves and net worth as established under chapters 60A, 62C,
133.27 	62D, 62H, and 64B, with respect to the health plan companies
133.28 	that each commissioner respectively regulates to assess the
133.29 	degree to which savings resulting from the establishment of cost
133.30 	containment goals are passed on to consumers in the form of
133.31 	lower premium rates.
133.32 	(b) Health plan companies shall fully reflect in the
133.33 	premium rates the savings generated by the cost containment
133.34 	goals.  No premium rate, currently reviewed by the Department of
133.35 	Health or Commerce, may be approved for those health plan
133.36 	companies unless the health plan company establishes to the
134.1 	satisfaction of the commissioner of commerce or the commissioner
134.2 	of health, as appropriate, that the proposed new rate would
134.3 	comply with this paragraph.
134.4 	(c) Health plan companies, except those licensed under
134.5 	chapter 60A to sell accident and sickness insurance under
134.6 	chapter 62A, shall annually before the end of the fourth fiscal
134.7 	quarter provide to the commissioner of health or commerce, as
134.8 	applicable, a projection of the level of reserves the company
134.9 	expects to attain during each quarter of the following fiscal
134.10 	year.  These health plan companies shall submit with required
134.11 	quarterly financial statements a calculation of the actual
134.12 	reserve level attained by the company at the end of each quarter
134.13 	including identification of the sources of any significant
134.14 	changes in the reserve level and an updated projection of the
134.15 	level of reserves the health plan company expects to attain by
134.16 	the end of the fiscal year.  In cases where the health plan
134.17 	company has been given a certificate to operate a new health
134.18 	maintenance organization under chapter 62D, or been licensed as
134.19 	a community integrated service network under chapter 62N, or
134.20 	formed an affiliation with one of these organizations, the
134.21 	health plan company shall also submit with its quarterly
134.22 	financial statement, total enrollment at the beginning and end
134.23 	of the quarter and enrollment changes within each service area
134.24 	of the new organization.  The reserve calculations shall be
134.25 	maintained by the commissioners as trade secret information,
134.26 	except to the extent that such information is also required to
134.27 	be filed by another provision of state law and is not treated as
134.28 	trade secret information under such other provisions.
134.29 	(d) Health plan companies in paragraph (c) whose reserves
134.30 	are less than the required minimum or more than the required
134.31 	maximum at the end of the fiscal year shall submit a plan of
134.32 	corrective action to the commissioner of health or commerce
134.33 	under subdivision 7.
134.34 	(e) The commissioner of commerce, in consultation with the
134.35 	commissioner of health, shall report to the legislature no later
134.36 	than January 15, 1995, as to whether the concept of a reserve
135.1 	corridor or other mechanism for purposes of monitoring reserves
135.2 	is adaptable for use with indemnity health insurers that do
135.3 	business in multiple states and that must comply with their
135.4 	domiciliary state's reserves requirements.
135.5 		Subd. 5.Notice. The commissioner of health shall
135.6 	publish in the State Register and make available to the public
135.7 	by July 1, 1995 2007, and each year thereafter,a list of all
135.8 	health plan companies that exceeded their cost containment goal 
135.9 	health care expenditure limit for the 1994 previous calendar
135.10 	year. The commissioner shall publish in the State Register and
135.11 	make available to the public by July 1, 1996, a list of all
135.12 	health plan companies that exceeded their combined cost
135.13 	containment goal for calendar years 1994 and 1995.The
135.14 	commissioner shall notify each health plan company that the
135.15 	commissioner has determined that the health plan company
135.16 	exceeded its cost containment goal,health care expenditure
135.17 	limit at least 30 days before publishing the list, and shall
135.18 	provide each health plan company with ten days to provide an
135.19 	explanation for exceeding the cost containment goal health care
135.20 	expenditure limit.  The commissioner shall review the
135.21 	explanation and may change a determination if the commissioner
135.22 	determines the explanation to be valid.
135.23 		Subd. 6.Assistance by the commissioner of commerce. The
135.24 	commissioner of commerce shall provide assistance to the
135.25 	commissioner of health in monitoring health plan companies
135.26 	regulated by the commissioner of commerce.

135.27 	Sec. 5. [62J.255] HEALTH RISK INFORMATION SHEET.
135.28 	(a) A health plan company shall provide to each enrollee on
135.29 	an annual basis information on the increased personal health
135.30 	risks and the additional costs to the health care system due to
135.31 	obesity and to the use of tobacco.
135.32 	(b) The commissioner, in consultation with the Minnesota
135.33 	Medical Association, shall develop an information sheet on the
135.34 	personal health risks of obesity and smoking and on the
135.35 	additional costs to the health care system due to obesity and
135.36 	due to smoking.  The information sheet shall be posted on the
136.1 	Minnesota Department of Health's Web site.
136.2 	(c) When providing the information required in paragraph
136.3 	(a), the health plan company must also provide each enrollee
136.4 	with information on the best practices care guidelines and
136.5 	quality of care measurement criteria identified in section
136.6 	62J.43 as well as the availability of this information on the
136.7 	department's Web site.
136.8 	(d) This section does not apply to health plan companies
136.9 	offering only limited dental or vision plans.

136.10 	Sec. 6. Minnesota Statutes 2004, section 62J.301,
136.11 	subdivision 3, is amended to read:
136.12 		Subd. 3.General duties.  The commissioner shall:
136.13 	(1) collect and maintain data which enable population-based
136.14 	monitoring and trending of the access, utilization, quality, and
136.15 	cost of health care services within Minnesota;
136.16 	(2) collect and maintain data for the purpose of estimating
136.17 	total Minnesota health care expenditures and trends;
136.18 	(3) collect and maintain data for the purposes of setting
136.19 	cost containment goals and premium growth limits under section
136.20 	62J.04, and measuring cost containment goal and premium growth
136.21 	limit compliance;
136.22 	(4) conduct applied research using existing and new data
136.23 	and promote applications based on existing research;
136.24 	(5) develop and implement data collection procedures to
136.25 	ensure a high level of cooperation from health care providers
136.26 	and health plan companies, as defined in section 62Q.01,
136.27 	subdivision 4;
136.28 	(6) work closely with health plan companies and health care
136.29 	providers to promote improvements in health care efficiency and
136.30 	effectiveness; and
136.31 	(7) participate as a partner or sponsor of private sector
136.32 	initiatives that promote publicly disseminated applied research
136.33 	on health care delivery, outcomes, costs, quality, and
136.34 	management.

136.35 	Sec. 7. Minnesota Statutes 2004, section 62J.38, is
136.36 	amended to read:
137.1 	62J.38 COST CONTAINMENT DATA FROM GROUP PURCHASERS.
137.2 	(a) The commissioner shall require group purchasers to
137.3 	submit detailed data on total health care spending for each
137.4 	calendar year.  Group purchasers shall submit data for the 1993
137.5 	calendar year by April 1, 1994, and each April 1 thereafter
137.6 	shall submit data for the preceding calendar year.
137.7 	(b) The commissioner shall require each group purchaser to
137.8 	submit data on revenue, expenses, and member months, as
137.9 	applicable.  Revenue data must distinguish between premium
137.10 	revenue and revenue from other sources and must also include
137.11 	information on the amount of revenue in reserves and changes in
137.12 	reserves. Premium revenue data, information on aggregate
137.13 	enrollment, and data on member months must be broken down to
137.14 	distinguish between individual market, small group market, and
137.15 	large group market.  Filings under this section for calendar
137.16 	year 2005 must also include information broken down by
137.17 	individual market, small group market, and large group market
137.18 	for calendar year 2004.Expenditure data must distinguish
137.19 	between costs incurred for patient care and administrative
137.20 	costs.  Patient care and administrative costs must include only
137.21 	expenses incurred on behalf of health plan members and must not
137.22 	include the cost of providing health care services for
137.23 	nonmembers at facilities owned by the group purchaser or
137.24 	affiliate.  Expenditure data must be provided separately for the
137.25 	following categories and for other categories required by the
137.26 	commissioner:  physician services, dental services, other
137.27 	professional services, inpatient hospital services, outpatient
137.28 	hospital services, emergency, pharmacy services and other
137.29 	nondurable medical goods, mental health, and chemical dependency
137.30 	services, other expenditures, subscriber liability, and
137.31 	administrative costs.  Administrative costs must include costs
137.32 	for marketing; advertising; overhead; salaries and benefits of
137.33 	central office staff who do not provide direct patient care;
137.34 	underwriting; lobbying; claims processing; provider contracting
137.35 	and credentialing; detection and prevention of payment for
137.36 	fraudulent or unjustified requests for reimbursement or
138.1 	services; clinical quality assurance and other types of medical
138.2 	care quality improvement efforts; concurrent or prospective
138.3 	utilization review as defined in section 62M.02; costs incurred
138.4 	to acquire a hospital, clinic, or health care facility, or the
138.5 	assets thereof; capital costs incurred on behalf of a hospital
138.6 	or clinic; lease payments; or any other costs incurred pursuant
138.7 	to a partnership, joint venture, integration, or affiliation
138.8 	agreement with a hospital, clinic, or other health care
138.9 	provider.  Capital costs and costs incurred must be recorded
138.10 	according to standard accounting principles.  The reports of
138.11 	this data must also separately identify expenses for local,
138.12 	state, and federal taxes, fees, and assessments.  The
138.13 	commissioner may require each group purchaser to submit any
138.14 	other data, including data in unaggregated form, for the
138.15 	purposes of developing spending estimates, setting spending
138.16 	limits, and monitoring actual spending and costs.  In addition
138.17 	to reporting administrative costs incurred to acquire a
138.18 	hospital, clinic, or health care facility, or the assets
138.19 	thereof; or any other costs incurred pursuant to a partnership,
138.20 	joint venture, integration, or affiliation agreement with a
138.21 	hospital, clinic, or other health care provider; reports
138.22 	submitted under this section also must include the payments made
138.23 	during the calendar year for these purposes.  The commissioner
138.24 	shall make public, by group purchaser data collected under this
138.25 	paragraph in accordance with section 62J.321, subdivision 5.
138.26 	Workers' compensation insurance plans and automobile insurance
138.27 	plans are exempt from complying with this paragraph as it
138.28 	relates to the submission of administrative costs.
138.29 	(c) The commissioner may collect information on:
138.30 	(1) premiums, benefit levels, managed care procedures, and
138.31 	other features of health plan companies;
138.32 	(2) prices, provider experience, and other information for
138.33 	services less commonly covered by insurance or for which
138.34 	patients commonly face significant out-of-pocket expenses; and
138.35 	(3) information on health care services not provided
138.36 	through health plan companies, including information on prices,
139.1 	costs, expenditures, and utilization.
139.2 	(d) All group purchasers shall provide the required data
139.3 	using a uniform format and uniform definitions, as prescribed by
139.4 	the commissioner.

139.5 	Sec. 8. [62J.82] CHARGES TO UNINSURED; PROVIDER
139.6 	RECOURSE.
139.7 		Subdivision 1.Definitions. (a) For purposes of this
139.8 	section, the terms defined in this subdivision have the meanings
139.9 	given them.
139.10 	(b) "Covered individual" means an individual who has health
139.11 	plan company or public health care program coverage for health
139.12 	care services.
139.13 	(c) "CPT code" means a code contained in the most current
139.14 	edition of the Physician's Current Procedural Terminology (CPT)
139.15 	manual published by the American Medical Association.
139.16 	(d) "Dependent" has the meaning given under section 62L.02,
139.17 	subdivision 11.
139.18 	(e) "Health care service" has the meaning given under
139.19 	section 62J.17, subdivision 2.
139.20 	(f) "Health plan company" has the meaning given under
139.21 	section 62Q.01, subdivision 4.
139.22 	(g) "Person" means an individual, corporation, firm,
139.23 	partnership, incorporated or unincorporated association, or any
139.24 	other legal or commercial entity.
139.25 	(h) "Provider" means a hospital or outpatient surgical
139.26 	center licensed under chapter 144.
139.27 	(i) "Third-party payer" means a health plan company or a
139.28 	public health care plan or program.
139.29 	(j) "Uninsured individual" means a person or dependent who
139.30 	does not have health plan company coverage or who is not
139.31 	otherwise covered by a third-party payer.
139.32 		Subd. 2.Notice to uninsured. (a) A provider may attempt
139.33 	to obtain from a person or the person's representative
139.34 	information about whether any third-party payer may fully or
139.35 	partially cover the charges for health care services rendered by
139.36 	the provider to the person.
140.1 	(b) A provider shall inform each person, both orally and in
140.2 	writing, immediately upon first meeting with that person, or as
140.3 	soon as practicable thereafter, that uninsured individuals will
140.4 	be charged or billed for health care services in amounts that do
140.5 	not exceed the amounts described in subdivision 3.
140.6 	(c) If, at the time health care services are provided, a
140.7 	person has not provided proof of coverage by a third-party payer
140.8 	or a provider otherwise determines that the person is an
140.9 	uninsured individual, the provider, as part of any billing to
140.10 	the person, shall provide the person with a clear and
140.11 	conspicuous notice that includes:
140.12 	(1) a statement of charges for health care services
140.13 	rendered by the provider; and 
140.14 	(2) a statement that uninsured individuals will be charged
140.15 	or billed for health care services in amounts that do not exceed
140.16 	the amounts described in subdivision 3.
140.17 	(d) For purposes of the notice required under paragraph
140.18 	(c), a provider may incorporate the items into the provider's
140.19 	existing billing statements and is not required to develop a
140.20 	separate notice.  All communications to a person required by
140.21 	this subdivision must be language appropriate.
140.22 		Subd. 3.Provider charges to uninsured. In billing or
140.23 	charging an uninsured individual or the individual's
140.24 	representative for medically necessary health care services, a
140.25 	provider must bill by CPT code, or other billing identifier as
140.26 	may be routinely used for billing that health care service.  A
140.27 	provider shall not bill or charge an uninsured individual or the
140.28 	individual's representative more than the amount the provider is
140.29 	paid for that service by the nongovernmental third-party payer
140.30 	that provided the most revenue to the provider during the
140.31 	previous calendar year, plus any applicable cost sharing
140.32 	payments payable by an individual covered by that provider's
140.33 	highest volume plan.  After a bill or charge is issued under
140.34 	this subdivision, a provider may not increase the bill or charge.
140.35 		Subd. 4.Limitations. Notwithstanding any other
140.36 	provision of law, the amounts paid by uninsured individuals for
141.1 	health care services according to subdivision 3 does not
141.2 	constitute a provider's uniform, published, prevailing, or
141.3 	customary charges, or its usual fees to the general public, for
141.4 	purposes of any payment limit under the Medicare or medical
141.5 	assistance programs or any other federal or state financed
141.6 	health care program.
141.7 		Subd. 5.Recourse limited. (a) Providers under agreement
141.8 	with a health plan company or public health care plan or program
141.9 	to provide health care services shall not have recourse against
141.10 	covered individuals, or persons acting on their behalf, for
141.11 	amounts above those specified in the evidence of coverage or
141.12 	other plan or program document as co-payments or coinsurance for
141.13 	health care services.  This subdivision applies only to health
141.14 	plans that provide coverage equivalent to or greater than a
141.15 	number two qualified plan described under section 62E.08, and is
141.16 	not limited to the following events:
141.17 	(1) nonpayment by the health plan company;
141.18 	(2) insolvency of the health plan company; and 
141.19 	(3) breach of the agreement between the health plan company
141.20 	and the provider.
141.21 	(b) This subdivision does not limit a provider's ability to
141.22 	seek payment from any person other than the covered individual,
141.23 	the covered individual's guardian or conservator, the covered
141.24 	individual's immediate family members, or the covered
141.25 	individual's legal representative in the event of nonpayment by
141.26 	a health plan company.
141.27 		Subd. 6.Remedies. A person may file an action in
141.28 	district court seeking injunctive relief and damages for
141.29 	violations of this section.  In any such action, a person may
141.30 	also recover costs and disbursements and reasonable attorney
141.31 	fees.
141.32 		Subd. 7.Grounds for disciplinary action. Violations of
141.33 	this section may be grounds for disciplinary or regulatory
141.34 	action against a provider by the appropriate licensing board or
141.35 	agency.
141.36 		Subd. 8.Authority of attorney general. The attorney
142.1 	general may investigate violations of this section under section
142.2 	8.31.  The attorney general may file an action for violations of
142.3 	this section according to section 8.31 or may pursue other
142.4 	remedies available to the attorney general.
142.5 		Subd. 9.Income and asset limitations. The provisions of
142.6 	this section shall not apply to uninsured individuals with an
142.7 	annual family income above $125,000.

142.8 	Sec. 9. [62J.84] HOSPITAL CHARGE DISCLOSURE.
142.9 	The Minnesota Hospital Association shall develop a
142.10 	Web-based system, available to the public free of charge, for
142.11 	reporting charge information, including, but not limited to,
142.12 	number of discharges, average length of stay, average charge,
142.13 	average charge per day, and median charge, for each of the 50
142.14 	most common inpatient diagnosis-related groups and the 25 most
142.15 	common outpatient surgical procedures as specified by the
142.16 	Minnesota Hospital Association.  The Web site must provide
142.17 	information that compares hospital-specific data to hospital
142.18 	statewide data.  The Web site must be established by October 1,
142.19 	2006, and must be updated annually.  If a hospital does not
142.20 	provide this information to the Minnesota Hospital Association,
142.21 	the commissioner may require the hospital to do so.  The
142.22 	commissioner shall provide a link to this information on the
142.23 	department's Web site.

142.24 	Sec. 10. Minnesota Statutes 2004, section 62L.08,
142.25 	subdivision 8, is amended to read:
142.26 		Subd. 8.Filing requirement. (a) No later than July 1,
142.27 	1993, and each year thereafter, a health carrier that offers,
142.28 	sells, issues, or renews a health benefit plan for small
142.29 	employers shall file with the commissioner the index rates and
142.30 	must demonstrate that all rates shall be within the rating
142.31 	restrictions defined in this chapter.  Such demonstration must
142.32 	include the allowable range of rates from the index rates and a
142.33 	description of how the health carrier intends to use demographic
142.34 	factors including case characteristics in calculating the
142.35 	premium rates.
142.36 	(b) Notwithstanding paragraph (a),the rates shall not be
143.1 	approved,unless the commissioner has determined that the rates
143.2 	are reasonable.  In determining reasonableness, the commissioner
143.3 	shall consider the growth rates applied under section 62J.04,
143.4 	subdivision 1, paragraph (b) apply the premium growth limits
143.5 	established under section 62J.04, subdivision 1b, to the
143.6 	calendar year or years that the proposed premium rate would be
143.7 	in effect, and shall consider actuarially valid changes in risk
143.8 	associated with the enrollee population, and actuarially valid
143.9 	changes as a result of statutory changes in Laws 1992, chapter
143.10 	549. For premium rates proposed to go into effect between July
143.11 	1, 1993 and December 31, 1993, the pertinent growth rate is the
143.12 	growth rate applied under section 62J.04, subdivision 1,
143.13 	paragraph (b), to calendar year 1994.

143.14 	Sec. 11. Minnesota Statutes 2004, section 62Q.37,
143.15 	subdivision 7, is amended to read:
143.16 		Subd. 7.Human services. (a) The commissioner of human
143.17 	services shall implement this section in a manner that is
143.18 	consistent with applicable federal laws and regulations and that
143.19 	avoids the duplication of review activities performed by a
143.20 	nationally recognized independent organization.
143.21 	(b) By December 31 of each year, the commissioner shall
143.22 	submit to the legislature a written report identifying the
143.23 	number of audits performed by a nationally recognized
143.24 	independent organization that were accepted, partially accepted,
143.25 	or rejected by the commissioner under this section.  The
143.26 	commissioner shall provide the rationale for partial acceptance
143.27 	or rejection.  If the rationale for the partial acceptance or
143.28 	rejection was based on the commissioner's determination that the
143.29 	standards used in the audit were not equivalent to state law,
143.30 	regulation, or contract requirement, the report must document
143.31 	the variances between the audit standards and the applicable
143.32 	state requirements.

143.33 	ARTICLE 4
143.34 	LONG-TERM CARE AND CONTINUING CARE

143.35 	Section 1. Minnesota Statutes 2004, section 144A.073, is
143.36 	amended by adding a subdivision to read:
144.1 		Subd. 3d.Project amendment authorized. Notwithstanding
144.2 	the provisions of subdivision 3b:
144.3 	(1) a nursing facility located in the city of Duluth with
144.4 	42 licensed beds as of January 1, 2005, that received approval
144.5 	under this section in 2002 for a moratorium exception project
144.6 	may reduce the number of resident rooms in the new addition from
144.7 	13 to nine and may reduce the common space by more than five
144.8 	percent; and 
144.9 	(2) a nursing facility located in the city of Duluth with
144.10 	127 licensed beds as of January 1, 2005, that received approval
144.11 	under this section in 2002 for a moratorium exception project
144.12 	may reduce the number of single rooms from 46 to 42 and may
144.13 	reduce the common space by more than five percent.

144.14 	Sec. 2. Minnesota Statutes 2004, section 144A.073,
144.15 	subdivision 10, is amended to read:
144.16 		Subd. 10.Extension of approval of moratorium exception.
 144.17 	Notwithstanding subdivision 3, the commissioner of health shall
144.18 	extend project approval for an additional 18 36 months for any
144.19 	proposed exception to the nursing home licensure and
144.20 	certification moratorium if the proposal was approved under this
144.21 	section between July 1, 2001, and June 30, 2003.

144.22 	Sec. 3. Minnesota Statutes 2004, section 252.291, is
144.23 	amended by adding a subdivision to read:
144.24 		Subd. 2b.Exception for brown county facility. (a) The
144.25 	commissioner shall authorize and grant a new license under
144.26 	chapter 245A to a new intermediate care facility for persons
144.27 	with mental retardation under the following circumstances:
144.28 	(1) the new facility replaces an existing six-bed
144.29 	intermediate care facility for the mentally retarded located in
144.30 	Brown County that has been operating since June 1982;
144.31 	(2) the new facility is located on an already purchased
144.32 	parcel of land; and 
144.33 	(3) the new facility is handicapped accessible.
144.34 	(b) The medical assistance payment rate for the new
144.35 	facility shall be the higher of the rate specified in paragraph
144.36 	(c) or as otherwise provided by law.
145.1 	(c) The new facility shall be considered a newly
145.2 	established facility for rate-setting purposes and shall be
145.3 	eligible for the investment per bed limit specified in section
145.4 	256B.501, subdivision 11, paragraph (c), and the interest
145.5 	expense limitation specified in section 256B.501, subdivision
145.6 	11, paragraph (d).  Notwithstanding section 256B.5011, the newly
145.7 	established facility's initial payment rate shall be set
145.8 	according to Minnesota Rules, part 9553.0075, and shall not be
145.9 	subject to the provisions of section 256B.501, subdivision 5b.
145.10 	(d) During the construction of the new facility, Brown
145.11 	County shall work with residents, families, and service
145.12 	providers to explore all service options open to current
145.13 	residents of the facility.

145.14 	Sec. 4. Minnesota Statutes 2004, section 256B.0621,
145.15 	subdivision 2, is amended to read:
145.16 		Subd. 2.Targeted case management; definitions.  For
145.17 	purposes of subdivisions 3 to 10, the following terms have the
145.18 	meanings given them:
145.19 	(1) "home care service recipients" means those individuals
145.20 	receiving the following services under section 256B.0627:
145.21 	skilled nursing visits, home health aide visits, private duty
145.22 	nursing, personal care assistants, or therapies provided through
145.23 	a home health agency;
145.24 	(2) "home care targeted case management" means the
145.25 	provision of targeted case management services for the purpose
145.26 	of assisting home care service recipients to gain access to
145.27 	needed services and supports so that they may remain in the
145.28 	community;
145.29 	(3) "institutions" means hospitals, consistent with Code of
145.30 	Federal Regulations, title 42, section 440.10; regional
145.31 	treatment center inpatient services, consistent with section
145.32 	245.474; nursing facilities; and intermediate care facilities
145.33 	for persons with mental retardation;
145.34 	(4) "relocation targeted case management" means includes 
145.35 	the provision of both county targeted case management and public
145.36 	or private vendor service coordination services for the purpose
146.1 	of assisting recipients to gain access to needed services and
146.2 	supports if they choose to move from an institution to the
146.3 	community.  Relocation targeted case management may be provided
146.4 	during the last 180 consecutive days of an eligible recipient's
146.5 	institutional stay; and
146.6 	(5) "targeted case management" means case management
146.7 	services provided to help recipients gain access to needed
146.8 	medical, social, educational, and other services and supports.

146.9 	Sec. 5. Minnesota Statutes 2004, section 256B.0621,
146.10 	subdivision 3, is amended to read:
146.11 		Subd. 3.Eligibility.  The following persons are eligible
146.12 	for relocation targeted case management or home care-targeted 
146.13 	care targeted case management:
146.14 	(1) medical assistance eligible persons residing in
146.15 	institutions who choose to move into the community are eligible
146.16 	for relocation targeted case management services; and
146.17 	(2) medical assistance eligible persons receiving home care
146.18 	services, who are not eligible for any other medical assistance
146.19 	reimbursable case management service, are eligible for home
146.20 	care-targeted care targeted case management services beginning
146.21 	January 1, 2003 July 1, 2005.

146.22 	Sec. 6. Minnesota Statutes 2004, section 256B.0621,
146.23 	subdivision 4, is amended to read:
146.24 		Subd. 4.Relocation targeted county case management
146.25 	provider qualifications.  (a) A relocation targeted county case
146.26 	management provider is an enrolled medical assistance provider
146.27 	who is determined by the commissioner to have all of the
146.28 	following characteristics:
146.29 	(1) the legal authority to provide public welfare under
146.30 	sections 393.01, subdivision 7; and 393.07; or a federally
146.31 	recognized Indian tribe;
146.32 	(2) the demonstrated capacity and experience to provide the
146.33 	components of case management to coordinate and link community
146.34 	resources needed by the eligible population;
146.35 	(3) the administrative capacity and experience to serve the
146.36 	target population for whom it will provide services and ensure
147.1 	quality of services under state and federal requirements;
147.2 	(4) the legal authority to provide complete investigative
147.3 	and protective services under section 626.556, subdivision 10;
147.4 	and child welfare and foster care services under section 393.07,
147.5 	subdivisions 1 and 2; or a federally recognized Indian tribe;
147.6 	(5) a financial management system that provides accurate
147.7 	documentation of services and costs under state and federal
147.8 	requirements; and
147.9 	(6) the capacity to document and maintain individual case
147.10 	records under state and federal requirements.
147.11 	(b) A provider of targeted case management under section
147.12 	256B.0625, subdivision 20, may be deemed a certified provider of
147.13 	relocation targeted case management.
147.14 	(c) A relocation targeted county case management provider
147.15 	may subcontract with another provider to deliver relocation
147.16 	targeted case management services.  Subcontracted providers must
147.17 	demonstrate the ability to provide the services outlined in
147.18 	subdivision 6, and have a procedure in place that notifies the
147.19 	recipient and the recipient's legal representative of any
147.20 	conflict of interest if the contracted targeted case management
147.21 	provider also provides, or will provide, the recipient's
147.22 	services and supports. Counties must require that contracted
147.23 	providers must provide information on all conflicts of interest
147.24 	and obtain the recipient's informed consent or provide the
147.25 	recipient with alternatives.

147.26 	Sec. 7. Minnesota Statutes 2004, section 256B.0621,
147.27 	subdivision 5, is amended to read:
147.28 		Subd. 5.Home care targeted case management and
147.29 	relocation service coordination provider qualifications. The
147.30 	following qualifications and certification standards must be met
147.31 	by Providers of home care targeted case management and
147.32 	relocation service coordination must meet the qualifications
147.33 	under subdivision 4 for county vendors or the following
147.34 	qualifications and certification standards for private vendors.
147.35 	(a) The commissioner must certify each provider of home
147.36 	care targeted case management and relocation service
148.1 	coordination before enrollment.  The certification process shall
148.2 	examine the provider's ability to meet the requirements in this
148.3 	subdivision and other state and federal requirements of this
148.4 	service.
148.5 	(b) A Both home care targeted case management provider is
148.6 	an providers and relocation service coordination providers are 
148.7 	enrolled medical assistance provider providers who has have a
148.8 	minimum of a bachelor's degree or a license in a health or human
148.9 	services field, or comparable training and two years of
148.10 	experience in human services, and is have been determined by the
148.11 	commissioner to have all of the following characteristics:
148.12 	(1) the demonstrated capacity and experience to provide the
148.13 	components of case management to coordinate and link community
148.14 	resources needed by the eligible population;
148.15 	(2) the administrative capacity and experience to serve the
148.16 	target population for whom it will provide services and ensure
148.17 	quality of services under state and federal requirements;
148.18 	(3) a financial management system that provides accurate
148.19 	documentation of services and costs under state and federal
148.20 	requirements;
148.21 	(4) the capacity to document and maintain individual case
148.22 	records under state and federal requirements; and 
148.23 	(5) the capacity to coordinate with county administrative
148.24 	functions;
148.25 	(6) have no financial interest in the provision of
148.26 	out-of-home residential services to persons for whom targeted
148.27 	case management or relocation service coordination is provided;
148.28 	and 
148.29 	(7) if a provider has a financial interest in services
148.30 	other than out-of-home residential services provided to persons
148.31 	for whom targeted case management or relocation service
148.32 	coordination is also provided, the county must determine each
148.33 	year that:
148.34 	(i) any possible conflict of interest is explained annually
148.35 	at a face-to-face meeting and in writing and the person provides
148.36 	written informed consent consistent with section 256B.77,
149.1 	subdivision 2, paragraph (p); and 
149.2 	(ii) information on a range of other feasible service
149.3 	provider options has been provided.
149.4 	(c) The State of Minnesota, a county board, or agency
149.5 	acting on behalf of a county board shall not be liable for
149.6 	damages, injuries, or liabilities sustained because of services
149.7 	provided to a client by a private service coordination vendor.

149.8 	Sec. 8. Minnesota Statutes 2004, section 256B.0621,
149.9 	subdivision 6, is amended to read:
149.10 		Subd. 6.Eligible services. (a) Services eligible for
149.11 	medical assistance reimbursement as targeted case management
149.12 	include:
149.13 	(1) assessment of the recipient's need for targeted case
149.14 	management services and for persons choosing to relocate, the
149.15 	county must provide service coordination provider options at the
149.16 	first contact and upon request;
149.17 	(2) development, completion, and regular review of a
149.18 	written individual service plan, which is based upon the
149.19 	assessment of the recipient's needs and choices, and which will
149.20 	ensure access to medical, social, educational, and other related
149.21 	services and supports;
149.22 	(3) routine contact or communication with the recipient,
149.23 	recipient's family, primary caregiver, legal representative,
149.24 	substitute care provider, service providers, or other relevant
149.25 	persons identified as necessary to the development or
149.26 	implementation of the goals of the individual service plan;
149.27 	(4) coordinating referrals for, and the provision of, case
149.28 	management services for the recipient with appropriate service
149.29 	providers, consistent with section 1902(a)(23) of the Social
149.30 	Security Act;
149.31 	(5) coordinating and monitoring the overall service
149.32 	delivery and engaging in advocacy as needed to ensure quality of
149.33 	services, appropriateness, and continued need;
149.34 	(6) completing and maintaining necessary documentation that
149.35 	supports and verifies the activities in this subdivision;
149.36 	(7) traveling assisting individuals in order to access
150.1 	needed services, including travel to conduct a visit with the
150.2 	recipient or other relevant person necessary to develop or
150.3 	implement the goals of the individual service plan; and
150.4 	(8) coordinating with the institution discharge planner in
150.5 	the 180-day period before the recipient's discharge.
150.6 	(b) Relocation targeted county case management includes
150.7 	services under paragraph (a), clauses (1), (2), and (4).
150.8 	Relocation service coordination includes services under
150.9 	paragraph (a), clauses (3) and (5) to (8).  Home care targeted
150.10 	case management includes services under paragraph (a), clauses
150.11 	(1) to (8).

150.12 	Sec. 9. Minnesota Statutes 2004, section 256B.0621,
150.13 	subdivision 7, is amended to read:
150.14 		Subd. 7.Time lines.  The following time lines must be
150.15 	met for assigning a case manager:
150.16 	(a) For relocation targeted case management, an eligible
150.17 	recipient must be assigned a county case manager who visits the
150.18 	person within 20 working days of requesting a case manager from
150.19 	their county of financial responsibility as determined under
150.20 	chapter 256G.
150.21 	(1) If a county agency, its contractor, or federally
150.22 	recognized tribe does not provide case management services as
150.23 	required, the recipient may obtain targeted relocation case
150.24 	management services relocation service coordination from an
150.25 	alternative a provider of targeted case management services
150.26 	enrolled by the commissioner qualified under subdivision 5.
150.27 	(2) The commissioner may waive the provider requirements in
150.28 	subdivision 4, paragraph (a), clauses (1) and (4), to ensure
150.29 	recipient access to the assistance necessary to move from an
150.30 	institution to the community.  The recipient or the recipient's
150.31 	legal guardian shall provide written notice to the county or
150.32 	tribe of the decision to obtain services from an alternative
150.33 	provider.
150.34 	(3) Providers of relocation targeted case management
150.35 	enrolled under this subdivision shall:
150.36 	(i) meet the provider requirements under subdivision 4 that
151.1 	are not waived by the commissioner;
151.2 	(ii) be qualified to provide the services specified in
151.3 	subdivision 6;
151.4 	(iii) coordinate efforts with local social service agencies
151.5 	and tribes; and
151.6 	(iv) comply with the conflict of interest provisions
151.7 	established under subdivision 4, paragraph (c).
151.8 	(4) Local social service agencies and federally recognized
151.9 	tribes shall cooperate with providers certified by the
151.10 	commissioner under this subdivision to facilitate the
151.11 	recipient's successful relocation from an institution to the
151.12 	community.
151.13 	(b) For home care targeted case management, an eligible
151.14 	recipient must be assigned a case manager within 20 working days
151.15 	of requesting a case manager from a home care targeted case
151.16 	management provider, as defined in subdivision 5.

151.17 	Sec. 10. Minnesota Statutes 2004, section 256B.0625,
151.18 	subdivision 2, is amended to read:
151.19 		Subd. 2.Skilled and intermediate nursing care.  Medical
151.20 	assistance covers skilled nursing home services and services of
151.21 	intermediate care facilities, including training and
151.22 	habilitation services, as defined in section 252.41, subdivision
151.23 	3, for persons with mental retardation or related conditions who
151.24 	are residing in intermediate care facilities for persons with
151.25 	mental retardation or related conditions.  Medical assistance
151.26 	must not be used to pay the costs of nursing care provided to a
151.27 	patient in a swing bed as defined in section 144.562, unless (a)
151.28 	the facility in which the swing bed is located is eligible as a
151.29 	sole community provider, as defined in Code of Federal
151.30 	Regulations, title 42, section 412.92, or the facility is a
151.31 	public hospital owned by a governmental entity with 15 or fewer
151.32 	licensed acute care beds; (b) the Centers for Medicare and
151.33 	Medicaid Services approves the necessary state plan amendments;
151.34 	(c) the patient was screened as provided by law; (d) the patient
151.35 	no longer requires acute care services; and (e) no nursing home
151.36 	beds are available within 25 miles of the facility. The
152.1 	commissioner shall exempt a facility from compliance with the
152.2 	sole community provider requirement in clause (a) if, as of
152.3 	January 1, 2004, the facility had an agreement with the
152.4 	commissioner to provide medical assistance swing bed services.
152.5 	Medical assistance also covers up to ten days of nursing care
152.6 	provided to a patient in a swing bed if:  (1) the patient's
152.7 	physician certifies that the patient has a terminal illness or
152.8 	condition that is likely to result in death within 30 days and
152.9 	that moving the patient would not be in the best interests of
152.10 	the patient and patient's family; (2) no open nursing home beds
152.11 	are available within 25 miles of the facility; and (3) no open
152.12 	beds are available in any Medicare hospice program within 50
152.13 	miles of the facility.  The daily medical assistance payment for
152.14 	nursing care for the patient in the swing bed is the statewide
152.15 	average medical assistance skilled nursing care per diem as
152.16 	computed annually by the commissioner on July 1 of each year.
152.17 	
EFFECTIVE DATE. This section is effective the day
152.18 	following final enactment and applies to medical assistance
152.19 	payments for swing bed services provided on or after March 5,
152.20 	2005.

152.21 	Sec. 11. Minnesota Statutes 2004, section 256B.0625,
152.22 	subdivision 19c, is amended to read:
152.23 		Subd. 19c.Personal care.  Medical assistance covers
152.24 	personal care assistant services provided by an individual who
152.25 	is qualified to provide the services according to subdivision
152.26 	19a and section 256B.0627, where the services are prescribed 
152.27 	determined to be medically necessary by a physician, provided in
152.28 	accordance with a service plan of treatment ,and are supervised
152.29 	by the recipient or a qualified professional. The physician's
152.30 	determination of medical necessity for personal care assistant
152.31 	services shall be documented on a form approved by the
152.32 	commissioner and include the diagnosis or condition of the
152.33 	person that results in a need for personal care assistant
152.34 	services and be updated either when the person's medical
152.35 	condition requires a change or at least annually if the medical
152.36 	need for personal care services is ongoing.
153.1 	"Qualified professional" means a mental health professional as
153.2 	defined in section 245.462, subdivision 18, or 245.4871,
153.3 	subdivision 27; or a registered nurse as defined in sections
153.4 	148.171 to 148.285, or a licensed social worker as defined in
153.5 	section 148B.21.  As part of the assessment, the county public
153.6 	health nurse will assist the recipient or responsible party to
153.7 	identify the most appropriate person to provide supervision of
153.8 	the personal care assistant.  The qualified professional shall
153.9 	perform the duties described in Minnesota Rules, part 9505.0335,
153.10 	subpart 4.

153.11 	Sec. 12. Minnesota Statutes 2004, section 256B.0627,
153.12 	subdivision 1, is amended to read:
153.13 		Subdivision 1.Definition.  (a) "Activities of daily
153.14 	living" includes eating, toileting, grooming, dressing, bathing,
153.15 	transferring, mobility, and positioning.
153.16 	(b) "Assessment" means a review and evaluation of a
153.17 	recipient's need for home care services conducted in person.
153.18 	Assessments for private duty nursing shall be conducted by a
153.19 	registered private duty nurse.  Assessments for home health
153.20 	agency services shall be conducted by a home health agency
153.21 	nurse.  Assessments for personal care assistant services shall
153.22 	be conducted by the county public health nurse or a certified
153.23 	public health nurse under contract with the county.  A
153.24 	face-to-face assessment must include:  documentation of health
153.25 	status, determination of need, evaluation of service
153.26 	effectiveness, identification of appropriate services, service
153.27 	plan development or modification, coordination of services,
153.28 	referrals and follow-up to appropriate payers and community
153.29 	resources, completion of required reports, recommendation of
153.30 	service authorization, and consumer education.  Once the need
153.31 	for personal care assistant services is determined under this
153.32 	section, the county public health nurse or certified public
153.33 	health nurse under contract with the county is responsible for
153.34 	communicating this recommendation to the commissioner and the
153.35 	recipient.  A face-to-face assessment for personal care
153.36 	assistant services is conducted on those recipients who have
154.1 	never had a county public health nurse assessment.  A
154.2 	face-to-face assessment must occur at least annually or when
154.3 	there is a significant change in the recipient's condition or
154.4 	when there is a change in the need for personal care assistant
154.5 	services.  A service update may substitute for the annual
154.6 	face-to-face assessment when there is not a significant change
154.7 	in recipient condition or a change in the need for personal care
154.8 	assistant service.  A service update or review for temporary
154.9 	increase includes a review of initial baseline data, evaluation
154.10 	of service effectiveness, redetermination of service need,
154.11 	modification of service plan and appropriate referrals, update
154.12 	of initial forms, obtaining service authorization, and on going
154.13 	consumer education.  Assessments for medical assistance home
154.14 	care services for mental retardation or related conditions and
154.15 	alternative care services for developmentally disabled home and
154.16 	community-based waivered recipients may be conducted by the
154.17 	county public health nurse to ensure coordination and avoid
154.18 	duplication.  Assessments must be completed on forms provided by
154.19 	the commissioner within 30 days of a request for home care
154.20 	services by a recipient or responsible party.
154.21 	(c) "Care plan" means a written description of personal
154.22 	care assistant services developed by the qualified professional
154.23 	or the recipient's physician with the recipient or responsible
154.24 	party to be used by the personal care assistant with a copy
154.25 	provided to the recipient or responsible party.
154.26 	(d) "Complex and regular private duty nursing care" means:
154.27 	(1) complex care is private duty nursing provided to
154.28 	recipients who are ventilator dependent or for whom a physician
154.29 	has certified that were it not for private duty nursing the
154.30 	recipient would meet the criteria for inpatient hospital
154.31 	intensive care unit (ICU) level of care; and
154.32 	(2) regular care is private duty nursing provided to all
154.33 	other recipients.
154.34 	(e) "Health-related functions" means functions that can be
154.35 	delegated or assigned by a licensed health care professional
154.36 	under state law to be performed by a personal care attendant.
155.1 	(f) "Home care services" means a health service, determined
155.2 	by the commissioner as medically necessary, that is ordered by a
155.3 	physician and documented in a service plan that is reviewed by
155.4 	the physician at least once every 60 days for the provision of
155.5 	home health services, or private duty nursing, or at least once
155.6 	every 365 days for personal care.  Home care services are
155.7 	provided to the recipient at the recipient's residence that is a
155.8 	place other than a hospital or long-term care facility or as
155.9 	specified in section 256B.0625.
155.10 	(g) "Instrumental activities of daily living" includes meal
155.11 	planning and preparation, managing finances, shopping for food,
155.12 	clothing, and other essential items, performing essential
155.13 	household chores, communication by telephone and other media,
155.14 	and getting around and participating in the community.
155.15 	(h) "Medically necessary" has the meaning given in
155.16 	Minnesota Rules, parts 9505.0170 to 9505.0475.
155.17 	(i) "Personal care assistant" means a person who:
155.18 	(1) is at least 18 years old, except for persons 16 to 18
155.19 	years of age who participated in a related school-based job
155.20 	training program or have completed a certified home health aide
155.21 	competency evaluation;
155.22 	(2) is able to effectively communicate with the recipient
155.23 	and personal care provider organization;
155.24 	(3) effective July 1, 1996, has completed one of the
155.25 	training requirements as specified in Minnesota Rules, part
155.26 	9505.0335, subpart 3, items A to D;
155.27 	(4) has the ability to, and provides covered personal care
155.28 	assistant services according to the recipient's care plan,
155.29 	responds appropriately to recipient needs, and reports changes
155.30 	in the recipient's condition to the supervising qualified
155.31 	professional or physician;
155.32 	(5) is not a consumer of personal care assistant services;
155.33 	and 
155.34 	(6) maintains daily written records detailing:
155.35 	(i) the actual services provided to the recipient; and 
155.36 	(ii) the amount of time spent providing the services; and 
156.1 	(7) is subject to criminal background checks and procedures
156.2 	specified in chapter 245C.
156.3 	(j) "Personal care provider organization" means an
156.4 	organization enrolled to provide personal care assistant
156.5 	services under the medical assistance program that complies with
156.6 	the following:
156.7 	(1) owners who have a five percent interest or more, and
156.8 	managerial officials are subject to a background study as
156.9 	provided in chapter 245C.  This applies to currently enrolled
156.10 	personal care provider organizations and those agencies seeking
156.11 	enrollment as a personal care provider organization.  An
156.12 	organization will be barred from enrollment if an owner or
156.13 	managerial official of the organization has been convicted of a
156.14 	crime specified in chapter 245C, or a comparable crime in
156.15 	another jurisdiction, unless the owner or managerial official
156.16 	meets the reconsideration criteria specified in chapter 245C;
156.17 	(2) the organization must maintain a surety bond and
156.18 	liability insurance throughout the duration of enrollment and
156.19 	provides proof thereof.  The insurer must notify the Department
156.20 	of Human Services of the cancellation or lapse of policy;and
156.21 	(3) the organization must maintain documentation of services as
156.22 	specified in Minnesota Rules, part 9505.2175, subpart 7, as well
156.23 	as evidence of compliance with personal care assistant training
156.24 	requirements;
156.25 	(3) the organization must maintain documentation and a
156.26 	recipient file and satisfy communication requirements in
156.27 	subdivision 4, paragraph (f); and 
156.28 	(4) the organization must comply with all laws and rules
156.29 	governing the provision of personal care services.
156.30 	(k) "Responsible party" means an individual who is capable
156.31 	of providing the support necessary to assist the recipient to
156.32 	live in the community, is at least 18 years old, actively
156.33 	participates in planning and directing of personal care
156.34 	assistant services, and is not the personal care assistant.  The
156.35 	responsible party must be accessible to the recipient and the
156.36 	personal care assistant when personal care services are being
157.1 	provided and monitor the services at least weekly according to
157.2 	the plan of care.  The responsible party must be identified at
157.3 	the time of assessment and listed on the recipient's service
157.4 	agreement and care plan.  Responsible parties who are parents of
157.5 	minors or guardians of minors or incapacitated persons may
157.6 	delegate the responsibility to another adult who is not the
157.7 	personal care assistant during a temporary absence of at least
157.8 	24 hours but not more than six months.  The person delegated as
157.9 	a responsible party must be able to meet the definition of
157.10 	responsible party, except that the delegated responsible party
157.11 	is required to reside with the recipient only while serving as
157.12 	the responsible party.  The delegated responsible party is not
157.13 	required to reside with the recipient while serving as the
157.14 	responsible party if adequate supervision and monitoring are
157.15 	provided for as part of the person's individual service plan
157.16 	under a home and community-based waiver program or in
157.17 	conjunction with a home care targeted case management service
157.18 	provider or other case manager.  The responsible party must
157.19 	assure that the delegate performs the functions of the
157.20 	responsible party, is identified at the time of the assessment,
157.21 	and is listed on the service agreement and the care plan.
157.22 	Foster care license holders may be designated the responsible
157.23 	party for residents of the foster care home if case management
157.24 	is provided as required in section 256B.0625, subdivision 19a.
157.25 	For persons who, as of April 1, 1992, are sharing personal care
157.26 	assistant services in order to obtain the availability of
157.27 	24-hour coverage, an employee of the personal care provider
157.28 	organization may be designated as the responsible party if case
157.29 	management is provided as required in section 256B.0625,
157.30 	subdivision 19a.
157.31 	(l) "Service plan" means a written description of the
157.32 	services needed based on the assessment developed by the nurse
157.33 	who conducts the assessment together with the recipient or
157.34 	responsible party.  The service plan shall include a description
157.35 	of the covered home care services, frequency and duration of
157.36 	services, and expected outcomes and goals.  The recipient and
158.1 	the provider chosen by the recipient or responsible party must
158.2 	be given a copy of the completed service plan within 30 calendar
158.3 	days of the request for home care services by the recipient or
158.4 	responsible party.
158.5 	(m) "Skilled nurse visits" are provided in a recipient's
158.6 	residence under a plan of care or service plan that specifies a
158.7 	level of care which the nurse is qualified to provide.  These
158.8 	services are:
158.9 	(1) nursing services according to the written plan of care
158.10 	or service plan and accepted standards of medical and nursing
158.11 	practice in accordance with chapter 148;
158.12 	(2) services which due to the recipient's medical condition
158.13 	may only be safely and effectively provided by a registered
158.14 	nurse or a licensed practical nurse;
158.15 	(3) assessments performed only by a registered nurse; and
158.16 	(4) teaching and training the recipient, the recipient's
158.17 	family, or other caregivers requiring the skills of a registered
158.18 	nurse or licensed practical nurse.
158.19 	(n) "Telehomecare" means the use of telecommunications
158.20 	technology by a home health care professional to deliver home
158.21 	health care services, within the professional's scope of
158.22 	practice, to a patient located at a site other than the site
158.23 	where the practitioner is located.

158.24 	Sec. 13. Minnesota Statutes 2004, section 256B.0627,
158.25 	subdivision 4, is amended to read:
158.26 		Subd. 4.Personal care assistant services.  (a) The
158.27 	personal care assistant services that are eligible for payment
158.28 	are services and supports furnished to an individual, as needed,
158.29 	to assist in accomplishing activities of daily living;
158.30 	instrumental activities of daily living; health-related
158.31 	functions through hands-on assistance, supervision, and cuing;
158.32 	and redirection and intervention for behavior including
158.33 	observation and monitoring.
158.34 	(b) Payment for services will be made within the limits
158.35 	approved using the prior authorized process established in
158.36 	subdivision 5.
159.1 	(c) The amount and type of services authorized shall be
159.2 	based on an assessment of the recipient's needs in these areas:
159.3 	(1) bowel and bladder care;
159.4 	(2) skin care to maintain the health of the skin;
159.5 	(3) repetitive maintenance range of motion, muscle
159.6 	strengthening exercises, and other tasks specific to maintaining
159.7 	a recipient's optimal level of function;
159.8 	(4) respiratory assistance;
159.9 	(5) transfers and ambulation;
159.10 	(6) bathing, grooming, and hairwashing necessary for
159.11 	personal hygiene;
159.12 	(7) turning and positioning;
159.13 	(8) assistance with furnishing medication that is
159.14 	self-administered;
159.15 	(9) application and maintenance of prosthetics and
159.16 	orthotics;
159.17 	(10) cleaning medical equipment;
159.18 	(11) dressing or undressing;
159.19 	(12) assistance with eating and meal preparation and
159.20 	necessary grocery shopping;
159.21 	(13) accompanying a recipient to obtain medical diagnosis
159.22 	or treatment;
159.23 	(14) assisting, monitoring, or prompting the recipient to
159.24 	complete the services in clauses (1) to (13);
159.25 	(15) redirection, monitoring, and observation that are
159.26 	medically necessary and an integral part of completing the
159.27 	personal care assistant services described in clauses (1) to
159.28 	(14);
159.29 	(16) redirection and intervention for behavior, including
159.30 	observation and monitoring;
159.31 	(17) interventions for seizure disorders, including
159.32 	monitoring and observation if the recipient has had a seizure
159.33 	that requires intervention within the past three months;
159.34 	(18) tracheostomy suctioning using a clean procedure if the
159.35 	procedure is properly delegated by a registered nurse.  Before
159.36 	this procedure can be delegated to a personal care assistant, a
160.1 	registered nurse must determine that the tracheostomy suctioning
160.2 	can be accomplished utilizing a clean rather than a sterile
160.3 	procedure and must ensure that the personal care assistant has
160.4 	been taught the proper procedure; and
160.5 	(19) incidental household services that are an integral
160.6 	part of a personal care service described in clauses (1) to (18).
160.7 	For purposes of this subdivision, monitoring and observation
160.8 	means watching for outward visible signs that are likely to
160.9 	occur and for which there is a covered personal care service or
160.10 	an appropriate personal care intervention.  For purposes of this
160.11 	subdivision, a clean procedure refers to a procedure that
160.12 	reduces the numbers of microorganisms or prevents or reduces the
160.13 	transmission of microorganisms from one person or place to
160.14 	another.  A clean procedure may be used beginning 14 days after
160.15 	insertion.
160.16 	(d) The personal care assistant services that are not
160.17 	eligible for payment are the following:
160.18 	(1) services not ordered by the physician provided without
160.19 	a physician's determination of medical necessity as required by
160.20 	section 256B.0625, subdivision 19c.  The determination must be
160.21 	in the recipient's file at the time claims are submitted for
160.22 	payment;
160.23 	(2) assessments by personal care assistant provider
160.24 	organizations or by independently enrolled registered nurses;
160.25 	(3) services that are not in the service plan;
160.26 	(4) services provided by the recipient's spouse, legal
160.27 	guardian for an adult or child recipient, or parent of a
160.28 	recipient under age 18;
160.29 	(5) services provided by a foster care provider of a
160.30 	recipient who cannot direct the recipient's own care, unless
160.31 	monitored by a county or state case manager under section
160.32 	256B.0625, subdivision 19a;
160.33 	(6) services provided by the residential or program license
160.34 	holder in a residence for more than four persons;
160.35 	(7) services that are the responsibility of a residential
160.36 	or program license holder under the terms of a service agreement
161.1 	and administrative rules;
161.2 	(8) sterile procedures;
161.3 	(9) injections of fluids into veins, muscles, or skin;
161.4 	(10) homemaker services that are not an integral part of a
161.5 	personal care assistant services;
161.6 	(11) home maintenance or chore services;
161.7 	(12) services not specified under paragraph (a); and
161.8 	(13) services not authorized by the commissioner or the
161.9 	commissioner's designee.
161.10 	(e) The recipient or responsible party may choose to
161.11 	supervise the personal care assistant or to have a qualified
161.12 	professional, as defined in section 256B.0625, subdivision 19c,
161.13 	provide the supervision.  As required under section 256B.0625,
161.14 	subdivision 19c, the county public health nurse, as a part of
161.15 	the assessment, will assist the recipient or responsible party
161.16 	to identify the most appropriate person to provide supervision
161.17 	of the personal care assistant.  Health-related delegated tasks
161.18 	performed by the personal care assistant will be under the
161.19 	supervision of a qualified professional or the direction of the
161.20 	recipient's physician.  If the recipient has a qualified
161.21 	professional, Minnesota Rules, part 9505.0335, subpart 4,
161.22 	applies.
161.23 	(f) In order to be paid for personal care services,
161.24 	personal care provider organizations, and personal care choice
161.25 	providers are required:
161.26 	(1) to maintain a recipient file for each recipient for
161.27 	whom services are being billed that contains:
161.28 	(i) the current physician's determination of medical
161.29 	necessity as required by section 256B.0625, subdivision 19c;
161.30 	(ii) the service plan, including the monthly authorized
161.31 	hours, or flexible use plan;
161.32 	(iii) the care plan, signed by the recipient and the
161.33 	qualified professional, if required or designated, detailing the
161.34 	personal care services to be provided;
161.35 	(iv) documentation, on a form approved by the commissioner
161.36 	and signed by the personal care assistant, specifying the day,
162.1 	month, year, arrival, and departure times, with AM and PM
162.2 	notation, for all services provided to the recipient.  The form
162.3 	must include a notice that it is a federal crime to provide
162.4 	false information on personal care service billings for medical
162.5 	assistance payment; and 
162.6 	(v) all notices to the recipient regarding personal care
162.7 	service use exceeding authorized hours; and 
162.8 	(2) to communicate, by telephone if available, and in
162.9 	writing, with the recipient or the responsible party about the
162.10 	schedule for use of authorized hours and to notify the recipient
162.11 	and the county public health nurse in advance and as soon as
162.12 	possible, on a form approved by the commissioner, if the monthly
162.13 	number of hours authorized is likely to be exceeded for the
162.14 	month.
162.15 	(g) The commissioner shall establish an ongoing audit
162.16 	process for potential fraud and abuse for personal care
162.17 	assistant services.  The audit process must include, at a
162.18 	minimum, a requirement that the documentation of hours of care
162.19 	provided be on a form approved by the commissioner and include
162.20 	the personal care assistant's signature attesting that the hours
162.21 	shown on each bill were provided by the personal care assistant
162.22 	on the dates and the times specified.

162.23 	Sec. 14. Minnesota Statutes 2004, section 256B.0627,
162.24 	subdivision 5, is amended to read:
162.25 		Subd. 5.Limitation on payments.  Medical assistance
162.26 	payments for home care services shall be limited according to
162.27 	this subdivision.
162.28 	(a)  [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A
162.29 	recipient may receive the following home care services during a
162.30 	calendar year:
162.31 	(1) up to two face-to-face assessments to determine a
162.32 	recipient's need for personal care assistant services;
162.33 	(2) one service update done to determine a recipient's need
162.34 	for personal care assistant services; and
162.35 	(3) up to nine skilled nurse visits.
162.36 	(b)  [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care
163.1 	services above the limits in paragraph (a) must receive the
163.2 	commissioner's prior authorization, except when:
163.3 	(1) the home care services were required to treat an
163.4 	emergency medical condition that if not immediately treated
163.5 	could cause a recipient serious physical or mental disability,
163.6 	continuation of severe pain, or death.  The provider must
163.7 	request retroactive authorization no later than five working
163.8 	days after giving the initial service.  The provider must be
163.9 	able to substantiate the emergency by documentation such as
163.10 	reports, notes, and admission or discharge histories;
163.11 	(2) the home care services were provided on or after the
163.12 	date on which the recipient's eligibility began, but before the
163.13 	date on which the recipient was notified that the case was
163.14 	opened.  Authorization will be considered if the request is
163.15 	submitted by the provider within 20 working days of the date the
163.16 	recipient was notified that the case was opened;
163.17 	(3) a third-party payor for home care services has denied
163.18 	or adjusted a payment.  Authorization requests must be submitted
163.19 	by the provider within 20 working days of the notice of denial
163.20 	or adjustment.  A copy of the notice must be included with the
163.21 	request;
163.22 	(4) the commissioner has determined that a county or state
163.23 	human services agency has made an error; or
163.24 	(5) the professional nurse determines an immediate need for
163.25 	up to 40 skilled nursing or home health aide visits per calendar
163.26 	year and submits a request for authorization within 20 working
163.27 	days of the initial service date, and medical assistance is
163.28 	determined to be the appropriate payer.
163.29 	(c)  [RETROACTIVE AUTHORIZATION.] A request for retroactive
163.30 	authorization will be evaluated according to the same criteria
163.31 	applied to prior authorization requests.
163.32 	(d)  [ASSESSMENT AND SERVICE PLAN.] Assessments under
163.33 	section 256B.0627, subdivision 1, paragraph (a), shall be
163.34 	conducted initially, and at least annually thereafter, in person
163.35 	with the recipient and result in a completed service plan using
163.36 	forms specified by the commissioner.  Within 30 days of
164.1 	recipient or responsible party request for home care services,
164.2 	the assessment, the service plan, and other information
164.3 	necessary to determine medical necessity such as diagnostic or
164.4 	testing information, social or medical histories, and hospital
164.5 	or facility discharge summaries shall be submitted to the
164.6 	commissioner.  Notwithstanding the provisions of section
164.7 	256B.0627, subdivision 12, the commissioner shall maximize
164.8 	federal financial participation to pay for public health nurse
164.9 	assessments for personal care services.  For personal care
164.10 	assistant services:
164.11 	(1) The amount and type of service authorized based upon
164.12 	the assessment and service plan will follow the recipient if the
164.13 	recipient chooses to change providers.
164.14 	(2) If the recipient's medical need changes, the
164.15 	recipient's provider may assess the need for a change in service
164.16 	authorization and request the change from the county public
164.17 	health nurse.  Within 30 days of the request, the public health
164.18 	nurse will determine whether to request the change in services
164.19 	based upon the provider assessment, or conduct a home visit to
164.20 	assess the need and determine whether the change is
164.21 	appropriate. If the change in service need is due to a change
164.22 	in medical condition, a new physician's determination of medical
164.23 	necessity, required by section 256B.0625, subdivision 19c, must
164.24 	be obtained.
164.25 	(3) To continue to receive personal care assistant services
164.26 	after the first year, the recipient or the responsible party, in
164.27 	conjunction with the public health nurse, may complete a service
164.28 	update on forms developed by the commissioner according to
164.29 	criteria and procedures in subdivision 1.
164.30 	(e)  [PRIOR AUTHORIZATION.] The commissioner, or the
164.31 	commissioner's designee, shall review the assessment, service
164.32 	update, request for temporary services, request for flexible use
164.33 	option,service plan, and any additional information that is
164.34 	submitted.  The commissioner shall, within 30 days after
164.35 	receiving a complete request, assessment, and service plan,
164.36 	authorize home care services as follows:
165.1 	(1)  [HOME HEALTH SERVICES.] All home health services
165.2 	provided by a home health aide must be prior authorized by the
165.3 	commissioner or the commissioner's designee.  Prior
165.4 	authorization must be based on medical necessity and
165.5 	cost-effectiveness when compared with other care options.  When
165.6 	home health services are used in combination with personal care
165.7 	and private duty nursing, the cost of all home care services
165.8 	shall be considered for cost-effectiveness.  The commissioner
165.9 	shall limit home health aide visits to no more than one visit
165.10 	each per day.  The commissioner, or the commissioner's designee,
165.11 	may authorize up to two skilled nurse visits per day.
165.12 	(2)  [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal
165.13 	care assistant services and supervision by a qualified
165.14 	professional, if requested by the recipient, must be prior
165.15 	authorized by the commissioner or the commissioner's designee
165.16 	except for the assessments established in paragraph (a).  The
165.17 	amount of personal care assistant services authorized must be
165.18 	based on the recipient's home care rating.  A child may not be
165.19 	found to be dependent in an activity of daily living if because
165.20 	of the child's age an adult would either perform the activity
165.21 	for the child or assist the child with the activity and the
165.22 	amount of assistance needed is similar to the assistance
165.23 	appropriate for a typical child of the same age.  Based on
165.24 	medical necessity, the commissioner may authorize:
165.25 	(A) up to two times the average number of direct care hours
165.26 	provided in nursing facilities for the recipient's comparable
165.27 	case mix level; or
165.28 	(B) up to three times the average number of direct care
165.29 	hours provided in nursing facilities for recipients who have
165.30 	complex medical needs or are dependent in at least seven
165.31 	activities of daily living and need physical assistance with
165.32 	eating or have a neurological diagnosis; or
165.33 	(C) up to 60 percent of the average reimbursement rate, as
165.34 	of July 1, 1991, for care provided in a regional treatment
165.35 	center for recipients who have Level I behavior, plus any
165.36 	inflation adjustment as provided by the legislature for personal
166.1 	care service; or
166.2 	(D) up to the amount the commissioner would pay, as of July
166.3 	1, 1991, plus any inflation adjustment provided for home care
166.4 	services, for care provided in a regional treatment center for
166.5 	recipients referred to the commissioner by a regional treatment
166.6 	center preadmission evaluation team.  For purposes of this
166.7 	clause, home care services means all services provided in the
166.8 	home or community that would be included in the payment to a
166.9 	regional treatment center; or
166.10 	(E) up to the amount medical assistance would reimburse for
166.11 	facility care for recipients referred to the commissioner by a
166.12 	preadmission screening team established under section 256B.0911
166.13 	or 256B.092; and
166.14 	(F) a reasonable amount of time for the provision of
166.15 	supervision by a qualified professional of personal care
166.16 	assistant services, if a qualified professional is requested by
166.17 	the recipient or responsible party.
166.18 	(ii) The number of direct care hours shall be determined
166.19 	according to the annual cost report submitted to the department
166.20 	by nursing facilities.  The average number of direct care hours,
166.21 	as established by May 1, 1992, shall be calculated and
166.22 	incorporated into the home care limits on July 1, 1992.  These
166.23 	limits shall be calculated to the nearest quarter hour.
166.24 	(iii) The home care rating shall be determined by the
166.25 	commissioner or the commissioner's designee based on information
166.26 	submitted to the commissioner by the county public health nurse
166.27 	on forms specified by the commissioner.  The home care rating
166.28 	shall be a combination of current assessment tools developed
166.29 	under sections 256B.0911 and 256B.501 with an addition for
166.30 	seizure activity that will assess the frequency and severity of
166.31 	seizure activity and with adjustments, additions, and
166.32 	clarifications that are necessary to reflect the needs and
166.33 	conditions of recipients who need home care including children
166.34 	and adults under 65 years of age.  The commissioner shall
166.35 	establish these forms and protocols under this section and shall
166.36 	use an advisory group, including representatives of recipients,
167.1 	providers, and counties, for consultation in establishing and
167.2 	revising the forms and protocols.
167.3 	(iv) A recipient shall qualify as having complex medical
167.4 	needs if the care required is difficult to perform and because
167.5 	of recipient's medical condition requires more time than
167.6 	community-based standards allow or requires more skill than
167.7 	would ordinarily be required and the recipient needs or has one
167.8 	or more of the following:
167.9 	(A) daily tube feedings;
167.10 	(B) daily parenteral therapy;
167.11 	(C) wound or decubiti care;
167.12 	(D) postural drainage, percussion, nebulizer treatments,
167.13 	suctioning, tracheotomy care, oxygen, mechanical ventilation;
167.14 	(E) catheterization;
167.15 	(F) ostomy care;
167.16 	(G) quadriplegia; or
167.17 	(H) other comparable medical conditions or treatments the
167.18 	commissioner determines would otherwise require institutional
167.19 	care.
167.20 	(v) A recipient shall qualify as having Level I behavior if
167.21 	there is reasonable supporting evidence that the recipient
167.22 	exhibits, or that without supervision, observation, or
167.23 	redirection would exhibit, one or more of the following
167.24 	behaviors that cause, or have the potential to cause:
167.25 	(A) injury to the recipient's own body;
167.26 	(B) physical injury to other people; or
167.27 	(C) destruction of property.
167.28 	(vi) Time authorized for personal care relating to Level I
167.29 	behavior in subclause (v), items (A) to (C), shall be based on
167.30 	the predictability, frequency, and amount of intervention
167.31 	required.
167.32 	(vii) A recipient shall qualify as having Level II behavior
167.33 	if the recipient exhibits on a daily basis one or more of the
167.34 	following behaviors that interfere with the completion of
167.35 	personal care assistant services under subdivision 4, paragraph
167.36 	(a):
168.1 	(A) unusual or repetitive habits;
168.2 	(B) withdrawn behavior; or
168.3 	(C) offensive behavior.
168.4 	(viii) A recipient with a home care rating of Level II
168.5 	behavior in subclause (vii), items (A) to (C), shall be rated as
168.6 	comparable to a recipient with complex medical needs under
168.7 	subclause (iv).  If a recipient has both complex medical needs
168.8 	and Level II behavior, the home care rating shall be the next
168.9 	complex category up to the maximum rating under subclause (i),
168.10 	item (B).
168.11 	(3)  [PRIVATE DUTY NURSING SERVICES.] All private duty
168.12 	nursing services shall be prior authorized by the commissioner
168.13 	or the commissioner's designee.  Prior authorization for private
168.14 	duty nursing services shall be based on medical necessity and
168.15 	cost-effectiveness when compared with alternative care options.
168.16 	The commissioner may authorize medically necessary private duty
168.17 	nursing services in quarter-hour units when:
168.18 	(i) the recipient requires more individual and continuous
168.19 	care than can be provided during a nurse visit; or
168.20 	(ii) the cares are outside of the scope of services that
168.21 	can be provided by a home health aide or personal care assistant.
168.22 	The commissioner may authorize:
168.23 	(A) up to two times the average amount of direct care hours
168.24 	provided in nursing facilities statewide for case mix
168.25 	classification "K" as established by the annual cost report
168.26 	submitted to the department by nursing facilities in May 1992;
168.27 	(B) private duty nursing in combination with other home
168.28 	care services up to the total cost allowed under clause (2);
168.29 	(C) up to 16 hours per day if the recipient requires more
168.30 	nursing than the maximum number of direct care hours as
168.31 	established in item (A) and the recipient meets the hospital
168.32 	admission criteria established under Minnesota Rules, parts
168.33 	9505.0501 to 9505.0540.
168.34 	The commissioner may authorize up to 16 hours per day of
168.35 	medically necessary private duty nursing services or up to 24
168.36 	hours per day of medically necessary private duty nursing
169.1 	services until such time as the commissioner is able to make a
169.2 	determination of eligibility for recipients who are
169.3 	cooperatively applying for home care services under the
169.4 	community alternative care program developed under section
169.5 	256B.49, or until it is determined by the appropriate regulatory
169.6 	agency that a health benefit plan is or is not required to pay
169.7 	for appropriate medically necessary health care services.
169.8 	Recipients or their representatives must cooperatively assist
169.9 	the commissioner in obtaining this determination.  Recipients
169.10 	who are eligible for the community alternative care program may
169.11 	not receive more hours of nursing under this section than would
169.12 	otherwise be authorized under section 256B.49.
169.13 	(4)  [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is
169.14 	ventilator-dependent, the monthly medical assistance
169.15 	authorization for home care services shall not exceed what the
169.16 	commissioner would pay for care at the highest cost hospital
169.17 	designated as a long-term hospital under the Medicare program.
169.18 	For purposes of this clause, home care services means all
169.19 	services provided in the home that would be included in the
169.20 	payment for care at the long-term hospital.
169.21 	"Ventilator-dependent" means an individual who receives
169.22 	mechanical ventilation for life support at least six hours per
169.23 	day and is expected to be or has been dependent for at least 30
169.24 	consecutive days.
169.25 	(f)  [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner
169.26 	or the commissioner's designee shall determine the time period
169.27 	for which a prior authorization shall be effective and, if
169.28 	flexible use has been requested, whether to allow the flexible
169.29 	use option.  If the recipient continues to require home care
169.30 	services beyond the duration of the prior authorization, the
169.31 	home care provider must request a new prior authorization.
169.32 	Under no circumstances, other than the exceptions in paragraph
169.33 	(b), shall a prior authorization be valid prior to the date the
169.34 	commissioner receives the request or for more than 12 months.  A
169.35 	recipient who appeals a reduction in previously authorized home
169.36 	care services may continue previously authorized services, other
170.1 	than temporary services under paragraph (h), pending an appeal
170.2 	under section 256.045.  The commissioner must provide a detailed
170.3 	explanation of why the authorized services are reduced in amount
170.4 	from those requested by the home care provider.
170.5 	(g)  [APPROVAL OF HOME CARE SERVICES.] The commissioner or
170.6 	the commissioner's designee shall determine the medical
170.7 	necessity of home care services, the level of caregiver
170.8 	according to subdivision 2, and the institutional comparison
170.9 	according to this subdivision, the cost-effectiveness of
170.10 	services, and the amount, scope, and duration of home care
170.11 	services reimbursable by medical assistance, based on the
170.12 	assessment, primary payer coverage determination information as
170.13 	required, the service plan, the recipient's age, the cost of
170.14 	services, the recipient's medical condition, and diagnosis or
170.15 	disability.  The commissioner may publish additional criteria
170.16 	for determining medical necessity according to section 256B.04.
170.17 	(h)  [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.]
170.18 	The agency nurse, the independently enrolled private duty nurse,
170.19 	or county public health nurse may request a temporary
170.20 	authorization for home care services by telephone.  The
170.21 	commissioner may approve a temporary level of home care services
170.22 	based on the assessment, and service or care plan information,
170.23 	and primary payer coverage determination information as required.
170.24 	Authorization for a temporary level of home care services
170.25 	including nurse supervision is limited to the time specified by
170.26 	the commissioner, but shall not exceed 45 days, unless extended
170.27 	because the county public health nurse has not completed the
170.28 	required assessment and service plan, or the commissioner's
170.29 	determination has not been made.  The level of services
170.30 	authorized under this provision shall have no bearing on a
170.31 	future prior authorization.
170.32 	(i)  [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.]
170.33 	Home care services provided in an adult or child foster care
170.34 	setting must receive prior authorization by the department
170.35 	according to the limits established in paragraph (a).
170.36 	The commissioner may not authorize:
171.1 	(1) home care services that are the responsibility of the
171.2 	foster care provider under the terms of the foster care
171.3 	placement agreement and administrative rules;
171.4 	(2) personal care assistant services when the foster care
171.5 	license holder is also the personal care provider or personal
171.6 	care assistant unless the recipient can direct the recipient's
171.7 	own care, or case management is provided as required in section
171.8 	256B.0625, subdivision 19a;
171.9 	(3) personal care assistant services when the responsible
171.10 	party is an employee of, or under contract with, or has any
171.11 	direct or indirect financial relationship with the personal care
171.12 	provider or personal care assistant, unless case management is
171.13 	provided as required in section 256B.0625, subdivision 19a; or
171.14 	(4) personal care assistant and private duty nursing
171.15 	services when the number of foster care residents is greater
171.16 	than four unless the county responsible for the recipient's
171.17 	foster placement made the placement prior to April 1, 1992,
171.18 	requests that personal care assistant and private duty nursing
171.19 	services be provided, and case management is provided as
171.20 	required in section 256B.0625, subdivision 19a.

171.21 	Sec. 15. Minnesota Statutes 2004, section 256B.0627,
171.22 	subdivision 9, is amended to read:
171.23 		Subd. 9.option for flexible use of personal care
171.24 	assistant hours.  (a) "Flexible use option " means the scheduled
171.25 	use of authorized hours of personal care assistant services,
171.26 	which vary within the length of the a service authorization
171.27 	period covering no more than six months,in order to more
171.28 	effectively meet the needs and schedule of the
171.29 	recipient. Authorized hours not used within the six-month
171.30 	period may not be carried over to another time period.  The
171.31 	flexible use of personal care assistant hours for a six-month
171.32 	period must be prior authorized by the commissioner, based on a
171.33 	request submitted on a form approved by the commissioner.  The
171.34 	request must include the assessment and the annual service plan
171.35 	prepared by the county public health nurse.
171.36 	(b) The recipient or responsible party, together with the
172.1 	case manager, if the recipient has case management services, and
172.2 	the county public health nurse, shall determine whether flexible
172.3 	use is an appropriate option based on the needs, abilities,
172.4 	preferences, and history of service use of the recipient or
172.5 	responsible party, and if appropriate, must ensure that the
172.6 	allocation of hours covers the ongoing needs of the recipient
172.7 	over an entire year divided into two six-month periods of
172.8 	flexible use.
172.9 	(c) If prior authorized,recipients may use their approved
172.10 	hours flexibly within the service authorization period for
172.11 	medically necessary covered services specified in the assessment
172.12 	required in subdivision 1.  The flexible use of authorized hours
172.13 	does not increase the total amount of authorized hours available
172.14 	to a recipient as determined under subdivision 5.  The
172.15 	commissioner shall not authorize additional personal care
172.16 	assistant services to supplement a service authorization that is
172.17 	exhausted before the end date under a flexible service use plan,
172.18 	unless the county public health nurse determines a change in
172.19 	condition and a need for increased services is established.
172.20 	(b) (d) The personal care provider organization and the 
172.21 	recipient or responsible party, together with the provider,must
172.22 	work to monitor and document the use of authorized hours and
172.23 	ensure that a recipient is able to manage services effectively
172.24 	throughout the authorized period.  Upon request of the recipient
172.25 	or responsible party, the provider must furnish regular updates
172.26 	to the recipient or responsible party on the amount of personal
172.27 	care assistant services used develop a written month-to-month
172.28 	plan of the projected use of personal care assistant services
172.29 	that is part of the care plan and ensures:
172.30 	(1) that the health and safety needs of the recipient will
172.31 	be met;
172.32 	(2) that the total annual authorization will not be used
172.33 	before the end of the authorization period; and 
172.34 	(3) monthly monitoring will be conducted of hours used as a
172.35 	percentage of the authorized amount.
172.36 	(e) The provider shall notify the recipient, the case
173.1 	manager, if the recipient has case management services, and the
173.2 	county public health nurse in advance and as soon as possible,
173.3 	on a form approved by the commissioner, if the monthly amount of
173.4 	hours authorized is likely to be exceeded for the month.
173.5 	(f) The commissioner shall provide written notice to the
173.6 	provider, the recipient or responsible party, the county case
173.7 	manager, if the recipient has case management services, and the
173.8 	county public health nurse, when a flexible use recipient
173.9 	exceeds the personal care service authorization for the month by
173.10 	an amount determined by the commissioner.  If the use of hours
173.11 	exceeds the monthly service authorization by the amount
173.12 	determined by the commissioner for two months during any
173.13 	three-month period, the commissioner shall notify the recipient
173.14 	and the county public health nurse that the flexible use
173.15 	authorization will be revoked beginning the following month.
173.16 	The revocation will not become effective if, within ten working
173.17 	days of the commissioner's notice of flexible use revocation,
173.18 	the county public health nurse requests prior authorization for
173.19 	an increase in the service authorization and continuation of the
173.20 	flexible use option, or the recipient appeals and assistance
173.21 	pending appeal is ordered.  The commissioner shall determine
173.22 	whether to approve the increase and continued flexible use.
173.23 	(g) The recipient or responsible party may stop the
173.24 	flexible use of hours by notifying the provider and county
173.25 	public health nurse in writing.
173.26 	(h)  The recipient or responsible party may appeal the
173.27 	commissioner's action according to section 256.045.  The denial
173.28 	or revocation of the flexible use option shall not affect the
173.29 	recipient's authorized level of personal care assistant services
173.30 	as determined under subdivision 5.

173.31 	Sec. 16. Minnesota Statutes 2004, section 256B.0627, is
173.32 	amended by adding a subdivision to read:
173.33 		Subd. 18.Oversight of enrolled personal care assistant
173.34 	services providers. The commissioner may request from providers
173.35 	documentation of compliance with laws, rules, and policies
173.36 	governing the provision of personal care assistant services.  A
174.1 	personal care assistant service provider must provide the
174.2 	requested documentation to the commissioner within ten business
174.3 	days of the request.  Failure to provide information to
174.4 	demonstrate substantial compliance with laws, rules, or policies
174.5 	may result in suspension, denial, or termination of the provider
174.6 	agreement.

174.7 	Sec. 17. Minnesota Statutes 2004, section 256B.15,
174.8 	subdivision 1, is amended to read:
174.9 		Subdivision 1.Policy, applicability, purpose, and
174.10 	construction; definition.  (a) It is the policy of this state
174.11 	that individuals or couples, either or both of whom participate
174.12 	in the medical assistance program, use their own assets to pay
174.13 	their share of the total cost of their care during or after
174.14 	their enrollment in the program according to applicable federal
174.15 	law and the laws of this state.  The following provisions apply:
174.16 	(1) subdivisions 1c to 1k shall not apply to claims arising
174.17 	under this section which are presented under section 525.313;
174.18 	(2) the provisions of subdivisions 1c to 1k expanding the
174.19 	interests included in an estate for purposes of recovery under
174.20 	this section give effect to the provisions of United States
174.21 	Code, title 42, section 1396p, governing recoveries, but do not
174.22 	give rise to any express or implied liens in favor of any other
174.23 	parties not named in these provisions;
174.24 	(3) the continuation of a recipient's life estate or joint
174.25 	tenancy interest in real property after the recipient's death
174.26 	for the purpose of recovering medical assistance under this
174.27 	section modifies common law principles holding that these
174.28 	interests terminate on the death of the holder;
174.29 	(4) all laws, rules, and regulations governing or involved
174.30 	with a recovery of medical assistance shall be liberally
174.31 	construed to accomplish their intended purposes;
174.32 	(5) a deceased recipient's life estate and joint tenancy
174.33 	interests continued under this section shall be owned by the
174.34 	remaindermen or surviving joint tenants as their interests may
174.35 	appear on the date of the recipient's death.  They shall not be
174.36 	merged into the remainder interest or the interests of the
175.1 	surviving joint tenants by reason of ownership.  They shall be
175.2 	subject to the provisions of this section.  Any conveyance,
175.3 	transfer, sale, assignment, or encumbrance by a remainderman, a
175.4 	surviving joint tenant, or their heirs, successors, and assigns
175.5 	shall be deemed to include all of their interest in the deceased
175.6 	recipient's life estate or joint tenancy interest continued
175.7 	under this section; and 
175.8 	(6) the provisions of subdivisions 1c to 1k continuing a
175.9 	recipient's joint tenancy interests in real property after the
175.10 	recipient's death do not apply to a homestead owned of record,
175.11 	on the date the recipient dies, by the recipient and the
175.12 	recipient's spouse as joint tenants with a right of
175.13 	survivorship.  Homestead means the real property occupied by the
175.14 	surviving joint tenant spouse as their sole residence on the
175.15 	date the recipient dies and classified and taxed to the
175.16 	recipient and surviving joint tenant spouse as homestead
175.17 	property for property tax purposes in the calendar year in which
175.18 	the recipient dies.  For purposes of this exemption, real
175.19 	property the recipient and their surviving joint tenant spouse
175.20 	purchase solely with the proceeds from the sale of their prior
175.21 	homestead, own of record as joint tenants, and qualify as
175.22 	homestead property under section 273.124 in the calendar year in
175.23 	which the recipient dies and prior to the recipient's death
175.24 	shall be deemed to be real property classified and taxed to the
175.25 	recipient and their surviving joint tenant spouse as homestead
175.26 	property in the calendar year in which the recipient dies.  The
175.27 	surviving spouse, or any person with personal knowledge of the
175.28 	facts, may provide an affidavit describing the homestead
175.29 	property affected by this clause and stating facts showing
175.30 	compliance with this clause.  The affidavit shall be prima facie
175.31 	evidence of the facts it states; and 
175.32 	(7) no action shall be taken to enforce or collect any lien
175.33 	arising under this section or under sections 514.980 to 514.985
175.34 	and sections 514.991 to 514.995 with respect to a homestead
175.35 	owned of record, on the date the recipient dies, by the
175.36 	recipient and a joint tenant with a right of survivorship, until
176.1 	the joint tenant sells the homestead, ceases to reside in the
176.2 	homestead, or dies.  Homestead means the real property occupied
176.3 	by the surviving joint tenant as the sole residence on the date
176.4 	the recipient dies and classified and taxed to the recipient and
176.5 	surviving joint tenant as homestead property for property tax
176.6 	purposes in the calendar year in which the recipient dies.  For
176.7 	purposes of this exemption, real property the recipient and the
176.8 	surviving joint tenant purchase solely with the proceeds from
176.9 	the sale of the prior homestead, own of record as joint tenants,
176.10 	and qualify as homestead property under section 273.124 in the
176.11 	calendar year in which the recipient dies and prior to the
176.12 	recipient's death shall be deemed to be real property classified
176.13 	and taxed to the recipient and the surviving joint tenant as
176.14 	homestead property in the calendar year in which the recipient
176.15 	dies.  The surviving joint tenant, or any person with personal
176.16 	knowledge of the facts, may provide an affidavit describing the
176.17 	homestead property affected by this clause and stating facts
176.18 	showing compliance with this clause.  The affidavit shall be
176.19 	prima facie evidence of the facts it states.  The estate, any
176.20 	owner of an interest in the property that is or may be subject
176.21 	to the lien, or any other interested party, may voluntarily pay
176.22 	off, settle, or otherwise satisfy the claim secured or to be
176.23 	secured by the lien at any time before or after the lien is
176.24 	filed or recorded.  Such payoffs, settlements, and satisfactions
176.25 	shall be deemed to be voluntary repayments of past medical
176.26 	assistance payments for the benefit of the deceased recipient,
176.27 	and neither the process of settling the claim, the payment of
176.28 	the claim, or the acceptance of a payment shall constitute an
176.29 	adjustment or recovery that is prohibited under this section.
176.30 	(b) The commissioner shall release liens arising under
176.31 	notices of potential claims under this section and medical
176.32 	assistance liens under sections 514.980 to 514.985, against a
176.33 	deceased recipient's life estates and jointly owned interests in
176.34 	farm and income producing real property they own of record on
176.35 	the date they die if their interest in the property ends at
176.36 	their death, the surviving remainderman or surviving joint
177.1 	tenant owns their interest in the property of record on that
177.2 	date, and all of the following conditions apply with respect to
177.3 	the surviving remainderman or the surviving joint tenant and
177.4 	their interest in the property:
177.5 	(1) the farm property is real property for which all of the
177.6 	following apply continuously for a period beginning at least
177.7 	three years before the calendar year in which the recipient
177.8 	first received long-term care medical assistance through the
177.9 	date of the recipient's death:
177.10 	(i) the remainderman or surviving joint tenant is a farmer,
177.11 	as defined in section 500.24, subdivision 2, paragraph (n), and
177.12 	is engaged in farming, as defined in section 500.24, subdivision
177.13 	2, paragraph (a);
177.14 	(ii) all of the land is a family farm as defined in section
177.15 	500.24, subdivision 2, paragraph (b); and 
177.16 	(iii) all of the land is classified and taxed as class 2a
177.17 	agricultural land under section 273.13, subdivision 23,
177.18 	paragraph (a), for property tax purposes; and 
177.19 	(2) the income-producing property is real property for
177.20 	which all of the following apply continuously for a period
177.21 	beginning at least three years before the calendar year in which
177.22 	the recipient first received long-term care medical assistance
177.23 	through the date of the recipient's death:
177.24 	(i) no part of the property is classified or taxed as
177.25 	homestead property for property tax purposes, provided that if
177.26 	the property is classified and taxed as both homestead and
177.27 	nonhomestead property, the portion of the property classified
177.28 	and taxed as nonhomestead property shall be considered to
177.29 	satisfy this requirement;
177.30 	(ii) all of the property is classified and taxed as class
177.31 	1c property under section 273.13, subdivision 22, paragraph (c),
177.32 	except that part of the class 1c property that is a dwelling
177.33 	occupied as a homestead; class 3a or 3b commercial or industrial
177.34 	property under section 273.13, subdivision 24; or as class 4a or
177.35 	4c property classified under section 273.13, subdivision 25,
177.36 	paragraphs (a) and (d), for property tax purposes; and 
178.1 	(iii) the business, profession, or occupation in which the
178.2 	real property is used is the primary business, profession, or
178.3 	occupation of the remainderman or surviving joint tenant and the
178.4 	real property is used solely for that business, profession, or
178.5 	occupation.  A primary business, profession, or occupation is
178.6 	one the ongoing operation of which provides at least 65 percent
178.7 	of a person's gross income for federal income tax purposes for
178.8 	the calendar year.
178.9 	(c) For purposes of this section, "medical assistance"
178.10 	includes the medical assistance program under this chapter and
178.11 	the general assistance medical care program under chapter 256D
178.12 	and but does not include the alternative care program for
178.13 	nonmedical assistance recipients under section 256B.0913.
178.14 	
EFFECTIVE DATE. The amendments in this section are
178.15 	effective July 1, 2005, and apply to the estates of decedents
178.16 	who die on or after that date.

178.17 	Sec. 18. Minnesota Statutes 2004, section 256B.15,
178.18 	subdivision 1a, is amended to read:
178.19 		Subd. 1a.Estates subject to claims.  If a person
178.20 	receives any medical assistance hereunder, on the person's
178.21 	death, if single, or on the death of the survivor of a married
178.22 	couple, either or both of whom received medical assistance, or
178.23 	as otherwise provided for in this section, the total amount paid
178.24 	for medical assistance rendered for the person and spouse shall
178.25 	be filed as a claim against the estate of the person or the
178.26 	estate of the surviving spouse in the court having jurisdiction
178.27 	to probate the estate or to issue a decree of descent according
178.28 	to sections 525.31 to 525.313.
178.29 	A claim shall be filed if medical assistance was rendered
178.30 	for either or both persons under one of the following
178.31 	circumstances:
178.32 	(a) the person was over 55 years of age, and received
178.33 	services under this chapter, excluding alternative care;
178.34 	(b) the person resided in a medical institution for six
178.35 	months or longer, received services under this chapter,
178.36 	excluding alternative care, and, at the time of
179.1 	institutionalization or application for medical assistance,
179.2 	whichever is later, the person could not have reasonably been
179.3 	expected to be discharged and returned home, as certified in
179.4 	writing by the person's treating physician.  For purposes of
179.5 	this section only, a "medical institution" means a skilled
179.6 	nursing facility, intermediate care facility, intermediate care
179.7 	facility for persons with mental retardation, nursing facility,
179.8 	or inpatient hospital; or
179.9 	(c) the person received general assistance medical care
179.10 	services under chapter 256D.
179.11 	The claim shall be considered an expense of the last
179.12 	illness of the decedent for the purpose of section 524.3-805.
179.13 	Any statute of limitations that purports to limit any county
179.14 	agency or the state agency, or both, to recover for medical
179.15 	assistance granted hereunder shall not apply to any claim made
179.16 	hereunder for reimbursement for any medical assistance granted
179.17 	hereunder.  Notice of the claim shall be given to all heirs and
179.18 	devisees of the decedent whose identity can be ascertained with
179.19 	reasonable diligence.  The notice must include procedures and
179.20 	instructions for making an application for a hardship waiver
179.21 	under subdivision 5; time frames for submitting an application
179.22 	and determination; and information regarding appeal rights and
179.23 	procedures.  Counties are entitled to one-half of the nonfederal
179.24 	share of medical assistance collections from estates that are
179.25 	directly attributable to county effort. Counties are entitled
179.26 	to ten percent of the collections for alternative care directly
179.27 	attributable to county effort.
179.28 	
EFFECTIVE DATE. The amendments in this section are
179.29 	effective July 1, 2005, and apply to the estates of decedents
179.30 	who die on or after that date.

179.31 	Sec. 19. Minnesota Statutes 2004, section 256B.15,
179.32 	subdivision 2, is amended to read:
179.33 		Subd. 2.Limitations on claims.  The claim shall include
179.34 	only the total amount of medical assistance rendered after age
179.35 	55 or during a period of institutionalization described in
179.36 	subdivision 1a, clause (b), and the total amount of general
180.1 	assistance medical care rendered, and shall not include
180.2 	interest.  Claims that have been allowed but not paid shall bear
180.3 	interest according to section 524.3-806, paragraph (d).  A claim
180.4 	against the estate of a surviving spouse who did not receive
180.5 	medical assistance, for medical assistance rendered for the
180.6 	predeceased spouse, is limited to the value of the assets of the
180.7 	estate that were marital property or jointly owned property at
180.8 	any time during the marriage. Claims for alternative care shall
180.9 	be net of all premiums paid under section 256B.0913, subdivision
180.10 	12, on or after July 1, 2003, and shall be limited to services
180.11 	provided on or after July 1, 2003.
180.12 	
EFFECTIVE DATE. This section is effective July 1, 2005,
180.13 	for decedents dying on or after that date.

180.14 	Sec. 20. Minnesota Statutes 2004, section 256B.431, is
180.15 	amended by adding a subdivision to read:
180.16 		Subd. 41.Nursing facility rate increases for october 1,
180.17 	2005, and july 1, 2006. (a) For the rate period beginning
180.18 	October 1, 2005, and the rate year beginning July 1, 2006, the
180.19 	commissioner shall make available to each nursing facility
180.20 	reimbursed under this section or section 256B.434 an adjustment
180.21 	equal to two percent of the total operating payment rate.
180.22 	(b) Money resulting from the rate adjustment under
180.23 	paragraph (a) must be used to increase wages and benefits and
180.24 	pay associated costs for employees, except management fees, the
180.25 	administrator, and central office staff.  Except as provided in
180.26 	paragraph (c), money received by a facility as a result of the
180.27 	rate adjustment provided in paragraph (a) must be used only for
180.28 	wage, benefit, and staff increases implemented on or after the
180.29 	effective date of the rate increase each year, and must not be
180.30 	used for increases implemented prior to that date.
180.31 	(c) With respect only to the October 1, 2005, rate
180.32 	increase, a hospital-attached nursing facility that incurred
180.33 	costs for salary and employee benefit increases first provided
180.34 	after July 1, 2003, may count those costs towards the amount
180.35 	required to be spent on salaries and benefits under paragraph
180.36 	(b).  These costs must be reported to the commissioner in the
181.1 	form and manner specified by the commissioner.
181.2 	(d) Nursing facilities may apply for the rate adjustment
181.3 	under paragraph (a).  The application must be made to the
181.4 	commissioner and contain a plan by which the nursing facility
181.5 	will distribute the funds according to paragraph (b).  For
181.6 	nursing facilities in which the employees are represented by an
181.7 	exclusive bargaining representative, an agreement negotiated and
181.8 	agreed to by the employer and the exclusive bargaining
181.9 	representative constitutes the plan.  A negotiated agreement may
181.10 	constitute the plan only if the agreement is finalized after the
181.11 	date of enactment of all increases for the rate year and signed
181.12 	by both parties prior to submission to the commissioner.  The
181.13 	commissioner shall review the plan to ensure that the rate
181.14 	adjustments are used as provided in paragraph (b).  To be
181.15 	eligible, a facility must submit its distribution plan by March
181.16 	31, 2006, and December 31, 2006, respectively.  If a facility's
181.17 	distribution plan is effective after the first day of the
181.18 	applicable rate period that the funds are available, the rate
181.19 	adjustments are effective the same date as the facility's plan.
181.20 	(e) A copy of the approved distribution plan must be made
181.21 	available to all employees by giving each employee a copy or by
181.22 	posting a copy in an area of the nursing facility to which all
181.23 	employees have access.  If an employee does not receive the wage
181.24 	and benefit adjustment described in the facility's approved plan
181.25 	and is unable to resolve the problem with the facility's
181.26 	management or through the employee's union representative, the
181.27 	employee may contact the commissioner at an address or telephone
181.28 	number provided by the commissioner and included in the approved
181.29 	plan.

181.30 	Sec. 21. Minnesota Statutes 2004, section 256B.431, is
181.31 	amended by adding a subdivision to read:
181.32 		Subd. 42.Single-bed room payment rate. (a) Beginning
181.33 	July 1, 2005, the operating payment rate for nursing facilities
181.34 	reimbursed under this section or section 256B.434 shall be
181.35 	increased by five percent multiplied by the ratio of the number
181.36 	of new single-bed rooms created divided by the number of active
182.1 	beds on July 1, 2005, for each bed closure that results in the
182.2 	creation of a single-bed room after July 1, 2005.
182.3 	(b) A nursing facility is prohibited from discharging
182.4 	residents for purposes of establishing single-bed rooms.  A
182.5 	nursing facility must retain a statement from any resident
182.6 	discharged to another nursing facility between July 1, 2005, and
182.7 	December 31, 2007, signed by the resident or the resident's
182.8 	designated responsible party, certifying the resident requests
182.9 	to move and is under no coercion to be discharged.  This signed
182.10 	statement must be witnessed and signed by the local ombudsman.
182.11 	The commissioner shall assess a monetary penalty of $5,000 per
182.12 	occurrence against any nursing facility determined to have
182.13 	discharged a resident for purposes of establishing single-bed
182.14 	rooms.
182.15 	(c) If after the date of enactment of this section and
182.16 	before December 31, 2007, more than 4,000 nursing home beds are
182.17 	removed from service, a portion of the appropriation for nursing
182.18 	homes shall be transferred to the alternative care program.  The
182.19 	amount of this transfer shall equal the number of beds removed
182.20 	from service less 4,000, multiplied by the average monthly
182.21 	per-person cost for alternative care, multiplied by 12, and
182.22 	further multiplied by 0.3.
182.23 	(d) Savings that result from bed closures on or after July
182.24 	1, 2005, that do not result in the establishment of single-bed
182.25 	rooms and exceed the number of closures included in the February
182.26 	2005 forecast shall not cancel to the general fund but shall be
182.27 	deposited in the health care quality improvement account
182.28 	established under section 256.957.
182.29 	(e) For the rate year beginning July 1, 2005, the amount
182.30 	nursing facilities receive for medically necessary single-bed
182.31 	rooms under Minnesota Rules, part 9549.0070, subpart 3, shall be
182.32 	up to 114.365 percent of the established total payment rate for
182.33 	the resident.  For the rate year beginning July 1, 2006, the
182.34 	amount nursing facilities receive for medically necessary
182.35 	single-bed rooms under Minnesota Rules, part 9549.0070, subpart
182.36 	3, shall be up to 114.75 percent of the established total
183.1 	payment rate for the resident.  For the rate years beginning on
183.2 	or after July 1, 2007, the single-bed payment rate shall be up
183.3 	to 115 percent of the established total payment rate for the
183.4 	resident.

183.5 	Sec. 22. Minnesota Statutes 2004, section 256B.434,
183.6 	subdivision 4, is amended to read:
183.7 		Subd. 4.Alternate rates for nursing facilities.  (a) For
183.8 	nursing facilities which have their payment rates determined
183.9 	under this section rather than section 256B.431, the
183.10 	commissioner shall establish a rate under this subdivision.  The
183.11 	nursing facility must enter into a written contract with the
183.12 	commissioner.
183.13 	(b) A nursing facility's case mix payment rate for the
183.14 	first rate year of a facility's contract under this section is
183.15 	the payment rate the facility would have received under section
183.16 	256B.431.
183.17 	(c) A nursing facility's case mix payment rates for the
183.18 	second and subsequent years of a facility's contract under this
183.19 	section are the previous rate year's contract payment rates plus
183.20 	an inflation adjustment and, for facilities reimbursed under
183.21 	this section or section 256B.431, an adjustment to include the
183.22 	cost of any increase in Health Department licensing fees for the
183.23 	facility taking effect on or after July 1, 2001.  The index for
183.24 	the inflation adjustment must be based on the change in the
183.25 	Consumer Price Index-All Items (United States City average)
183.26 	(CPI-U) forecasted by the commissioner of finance's national
183.27 	economic consultant, as forecasted in the fourth quarter of the
183.28 	calendar year preceding the rate year.  The inflation adjustment
183.29 	must be based on the 12-month period from the midpoint of the
183.30 	previous rate year to the midpoint of the rate year for which
183.31 	the rate is being determined.  For the rate years beginning on
183.32 	July 1, 1999, July 1, 2000, July 1, 2001, July 1, 2002, July 1,
183.33 	2003, and July 1, 2004, July 1, 2005, and July 1, 2006, this
183.34 	paragraph shall apply only to the property-related payment rate,
183.35 	except that adjustments to include the cost of any increase in
183.36 	Health Department licensing fees taking effect on or after July
184.1 	1, 2001, shall be provided.  In determining the amount of the
184.2 	property-related payment rate adjustment under this paragraph,
184.3 	the commissioner shall determine the proportion of the
184.4 	facility's rates that are property-related based on the
184.5 	facility's most recent cost report.
184.6 	(d) The commissioner shall develop additional
184.7 	incentive-based payments of up to five percent above the
184.8 	standard contract rate for achieving outcomes specified in each
184.9 	contract.  The specified facility-specific outcomes must be
184.10 	measurable and approved by the commissioner.  The commissioner
184.11 	may establish, for each contract, various levels of achievement
184.12 	within an outcome.  After the outcomes have been specified the
184.13 	commissioner shall assign various levels of payment associated
184.14 	with achieving the outcome.  Any incentive-based payment cancels
184.15 	if there is a termination of the contract.  In establishing the
184.16 	specified outcomes and related criteria the commissioner shall
184.17 	consider the following state policy objectives:
184.18 	(1) improved cost effectiveness and quality of life as
184.19 	measured by improved clinical outcomes;
184.20 	(2) successful diversion or discharge to community
184.21 	alternatives;
184.22 	(3) decreased acute care costs;
184.23 	(4) improved consumer satisfaction;
184.24 	(5) the achievement of quality; or
184.25 	(6) any additional outcomes proposed by a nursing facility
184.26 	that the commissioner finds desirable.

184.27 	Sec. 23. Minnesota Statutes 2004, section 256B.434, is
184.28 	amended by adding a subdivision to read:
184.29 		Subd. 4f.Rate increase effective july 1, 2005. For the
184.30 	rate year beginning July 1, 2005, a facility in Ramsey County
184.31 	licensed for 180 beds shall have its operating payment rate as
184.32 	determined under this section and in effect on June 30, 2005,
184.33 	increased by $2.49.  The increase under this subdivision shall
184.34 	be included in the facility's total payment rates for the
184.35 	purposes of determining future rates under this section or any
184.36 	other section.

185.1 	Sec. 24. Minnesota Statutes 2004, section 256B.440, is
185.2 	amended by adding a subdivision to read:
185.3 		Subd. 4.Continued system development. (a) The
185.4 	commissioner shall continue developmental work on a new nursing
185.5 	home reimbursement system and present recommendations for a new
185.6 	system to the legislature by January 15, 2006.  The new system
185.7 	shall comply with subdivisions 1 and 2.
185.8 	(b) Nursing facilities shall continue to file, and the
185.9 	commissioner shall continue to collect and audit, annual cost
185.10 	reports under the conditions specified in subdivision 3.
185.11 	(c) Notwithstanding any contrary provisions of chapter 16C,
185.12 	the commissioner may, within the limits of appropriations
185.13 	specifically available for this purpose, extend contracts
185.14 	previously negotiated for consulting work on development of the
185.15 	new reimbursement system.

185.16 	Sec. 25. Minnesota Statutes 2004, section 256B.5012, is
185.17 	amended by adding a subdivision to read:
185.18 		Subd. 6.Icf/mr rate increases beginning october 1, 2005,
185.19 	and july 1, 2006. (a) For the rate periods beginning October 1,
185.20 	2005, and July 1, 2006, the commissioner shall make available to
185.21 	each facility reimbursed under this section an adjustment to the
185.22 	total operating payment rate of two percent.
185.23 	(b) Money resulting from the rate adjustment under
185.24 	paragraph (a) must be used to increase wages and benefits and
185.25 	pay associated costs for employees, except for administrative
185.26 	and central office employees.  Money received by a facility as a
185.27 	result of the rate adjustment provided in paragraph (a) must be
185.28 	used only for wage, benefit, and staff increases implemented on
185.29 	or after the effective date of the rate increase each year, and
185.30 	must not be used for increases implemented prior to that date.
185.31 	(c) For each facility, the commissioner shall make
185.32 	available an adjustment using the percentage specified in
185.33 	paragraph (a) multiplied by the total payment rate, excluding
185.34 	the property-related payment rate, in effect on the preceding
185.35 	day.  The total payment rate shall include the adjustment
185.36 	provided in section 256B.501, subdivision 12.
186.1 	(d) A facility whose payment rates are governed by closure
186.2 	agreements, receivership agreements, or Minnesota Rules, part
186.3 	9553.0075, is not eligible for an adjustment otherwise granted
186.4 	under this subdivision.
186.5 	(e) A facility may apply for the payment rate adjustment
186.6 	provided under paragraph (a).  The application must be made to
186.7 	the commissioner and contain a plan by which the facility will
186.8 	distribute the funds according to paragraph (b).  For facilities
186.9 	in which the employees are represented by an exclusive
186.10 	bargaining representative, an agreement negotiated and agreed to
186.11 	by the employer and the exclusive bargaining representative
186.12 	constitutes the plan.  A negotiated agreement may constitute the
186.13 	plan only if the agreement is finalized after the date of
186.14 	enactment of all rate increases for the rate year.  The
186.15 	commissioner shall review the plan to ensure that the payment
186.16 	rate adjustment per diem is used as provided in this
186.17 	subdivision.  To be eligible, a facility must submit its plan by
186.18 	March 31, 2006, and December 31, 2006, respectively.  If a
186.19 	facility's plan is effective for its employees after the first
186.20 	day of the applicable rate period that the funds are available,
186.21 	the payment rate adjustment per diem is effective the same date
186.22 	as its plan.
186.23 	(f) A copy of the approved distribution plan must be made
186.24 	available to all employees by giving each employee a copy or by
186.25 	posting it in an area of the facility to which all employees
186.26 	have access.  If an employee does not receive the wage and
186.27 	benefit adjustment described in the facility's approved plan and
186.28 	is unable to resolve the problem with the facility's management
186.29 	or through the employee's union representative, the employee may
186.30 	contact the commissioner at an address or telephone number
186.31 	provided by the commissioner and included in the approved plan.

186.32 	Sec. 26. Minnesota Statutes 2004, section 256B.69,
186.33 	subdivision 23, is amended to read:
186.34 		Subd. 23.Alternative integrated long-term care services;
186.35 	elderly and disabled persons.  (a) The commissioner may
186.36 	implement demonstration projects to create alternative
187.1 	integrated delivery systems for acute and long-term care
187.2 	services to elderly persons and persons with disabilities as
187.3 	defined in section 256B.77, subdivision 7a, that provide
187.4 	increased coordination, improve access to quality services, and
187.5 	mitigate future cost increases.  The commissioner may seek
187.6 	federal authority to combine Medicare and Medicaid capitation
187.7 	payments for the purpose of such demonstrations.  Medicare funds
187.8 	and services shall be administered according to the terms and
187.9 	conditions of the federal waiver and demonstration provisions.
187.10 	For the purpose of administering medical assistance funds,
187.11 	demonstrations under this subdivision are subject to
187.12 	subdivisions 1 to 22.  The provisions of Minnesota Rules, parts
187.13 	9500.1450 to 9500.1464, apply to these demonstrations, with the
187.14 	exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457,
187.15 	subpart 1, items B and C, which do not apply to persons
187.16 	enrolling in demonstrations under this section.  An initial open
187.17 	enrollment period may be provided.  Persons who disenroll from
187.18 	demonstrations under this subdivision remain subject to
187.19 	Minnesota Rules, parts 9500.1450 to 9500.1464.  When a person is
187.20 	enrolled in a health plan under these demonstrations and the
187.21 	health plan's participation is subsequently terminated for any
187.22 	reason, the person shall be provided an opportunity to select a
187.23 	new health plan and shall have the right to change health plans
187.24 	within the first 60 days of enrollment in the second health
187.25 	plan.  Persons required to participate in health plans under
187.26 	this section who fail to make a choice of health plan shall not
187.27 	be randomly assigned to health plans under these demonstrations.
187.28 	Notwithstanding section 256L.12, subdivision 5, and Minnesota
187.29 	Rules, part 9505.5220, subpart 1, item A, if adopted, for the
187.30 	purpose of demonstrations under this subdivision, the
187.31 	commissioner may contract with managed care organizations,
187.32 	including counties, to serve only elderly persons eligible for
187.33 	medical assistance, elderly and disabled persons, or disabled
187.34 	persons only.  For persons with primary diagnoses of mental
187.35 	retardation or a related condition, serious and persistent
187.36 	mental illness, or serious emotional disturbance, the
188.1 	commissioner must ensure that the county authority has approved
188.2 	the demonstration and contracting design.  Enrollment in these
188.3 	projects for persons with disabilities shall be voluntary.  The
188.4 	commissioner shall not implement any demonstration project under
188.5 	this subdivision for persons with primary diagnoses of mental
188.6 	retardation or a related condition, serious and persistent
188.7 	mental illness, or serious emotional disturbance, without
188.8 	approval of the county board of the county in which the
188.9 	demonstration is being implemented.
188.10 	(b) Notwithstanding chapter 245B, sections 252.40 to
188.11 	252.46, 256B.092, 256B.501 to 256B.5015, and Minnesota Rules,
188.12 	parts 9525.0004 to 9525.0036, 9525.1200 to 9525.1330, 9525.1580,
188.13 	and 9525.1800 to 9525.1930, the commissioner may implement under
188.14 	this section projects for persons with developmental
188.15 	disabilities.  The commissioner may capitate payments for ICF/MR
188.16 	services, waivered services for mental retardation or related
188.17 	conditions, including case management services, day training and
188.18 	habilitation and alternative active treatment services, and
188.19 	other services as approved by the state and by the federal
188.20 	government.  Case management and active treatment must be
188.21 	individualized and developed in accordance with a
188.22 	person-centered plan.  Costs under these projects may not exceed
188.23 	costs that would have been incurred under fee-for-service.
188.24 	Beginning July 1, 2003, and until two years after the pilot
188.25 	project implementation date, subcontractor participation in the
188.26 	long-term care developmental disability pilot is limited to a
188.27 	nonprofit long-term care system providing ICF/MR services, home
188.28 	and community-based waiver services, and in-home services to no
188.29 	more than 120 consumers with developmental disabilities in
188.30 	Carver, Hennepin, and Scott Counties.  The commissioner shall
188.31 	report to the legislature prior to expansion of the
188.32 	developmental disability pilot project.  This paragraph expires
188.33 	two years after the implementation date of the pilot project.
188.34 	(c) Before implementation of a demonstration project for
188.35 	disabled persons, the commissioner must provide information to
188.36 	appropriate committees of the house of representatives and
189.1 	senate and must involve representatives of affected disability
189.2 	groups in the design of the demonstration projects.
189.3 	(d) A nursing facility reimbursed under the alternative
189.4 	reimbursement methodology in section 256B.434 may, in
189.5 	collaboration with a hospital, clinic, or other health care
189.6 	entity provide services under paragraph (a).  The commissioner
189.7 	shall amend the state plan and seek any federal waivers
189.8 	necessary to implement this paragraph.
189.9 	(e) Notwithstanding section 256B.0621, health plans
189.10 	providing services under this section are responsible for home
189.11 	care targeted case management and relocation targeted case
189.12 	management.  Services must be provided according to the terms of
189.13 	the waivers and contracts approved by the federal government.

189.14 	Sec. 27. [501B.895] PUBLIC HEALTH CARE PROGRAMS AND
189.15 	CERTAIN TRUSTS.
189.16 	(a) It is the public policy of this state that individuals
189.17 	use all available resources to pay for the cost of long-term
189.18 	care services, as defined in section 256B.0595, before turning
189.19 	to Minnesota health care program funds, and that trust
189.20 	instruments should not be permitted to shield available
189.21 	resources of an individual or an individual's spouse from such
189.22 	use.  Any irrevocable inter vivos trust or any legal instrument,
189.23 	device, or arrangement similar to an irrevocable inter vivos
189.24 	trust created on or after July 1, 2005, containing assets or
189.25 	income of an individual or an individual's spouse, including
189.26 	those created by a person, court, or administrative body with
189.27 	legal authority to act in place of, at the direction of, upon
189.28 	the request of, or on behalf of the individual or individual's
189.29 	spouse, becomes revocable by operation of law for the sole
189.30 	purpose of a state or local human services agency determination
189.31 	on an application by the individual or the individual's spouse
189.32 	for payment of long-term care services through a Minnesota
189.33 	public health care program under chapter 256.  For purposes of
189.34 	this section, any inter vivos trust and any legal instrument,
189.35 	device, or arrangement similar to an inter vivos trust:
189.36 	(1) shall be deemed to be located in and subject to the
190.1 	laws of this state; and 
190.2 	(2) is created as of the date it is fully executed by or on
190.3 	behalf of all of the settlors or others.
190.4 	(b) For purposes of this section, a legal instrument,
190.5 	device, or arrangement similar to an irrevocable inter vivos
190.6 	trust means any instrument, device, or arrangement which
190.7 	involves a grantor who transfers or whose property is
190.8 	transferred by another including, but not limited to, any court,
190.9 	administrative body, or anyone else with authority to act on
190.10 	their behalf or at their direction, to an individual or entity
190.11 	with fiduciary, contractual, or legal obligations to the grantor
190.12 	or others to be held, managed, or administered by the individual
190.13 	or entity for the benefit of the grantor or others.  These legal
190.14 	instruments, devices, or other arrangements are irrevocable
190.15 	inter vivos trusts for purposes of this section.
190.16 	(c) In the event of a conflict between this section and the
190.17 	provisions of an irrevocable trust created on or after July 1,
190.18 	2005, this section shall control.
190.19 	(d) This section does not apply to trusts that qualify as
190.20 	supplemental needs trusts under section 501B.89 or to trusts
190.21 	meeting the criteria of United States Code, title 42, section
190.22 	1396p (d)(4)(a) and (c) for purposes of eligibility for medical
190.23 	assistance.
190.24 	(e) This section applies to all trusts first created on or
190.25 	after July 1, 2005, and to all interests in real or personal
190.26 	property regardless of the date on which the interest was
190.27 	created, reserved, or acquired.

190.28 	Sec. 28. Minnesota Statutes 2004, section 514.981,
190.29 	subdivision 6, is amended to read:
190.30 		Subd. 6.Time limits; claim limits; liens on life estates
190.31 	and joint tenancies.  (a) A medical assistance lien is a lien on
190.32 	the real property it describes for a period of ten years from
190.33 	the date it attaches according to section 514.981, subdivision
190.34 	2, paragraph (a), except as otherwise provided for in sections
190.35 	514.980 to 514.985.  The agency may renew a medical assistance
190.36 	lien for an additional ten years from the date it would
191.1 	otherwise expire by recording or filing a certificate of renewal
191.2 	before the lien expires.  The certificate shall be recorded or
191.3 	filed in the office of the county recorder or registrar of
191.4 	titles for the county in which the lien is recorded or filed.
191.5 	The certificate must refer to the recording or filing data for
191.6 	the medical assistance lien it renews.  The certificate need not
191.7 	be attested, certified, or acknowledged as a condition for
191.8 	recording or filing.  The registrar of titles or the recorder
191.9 	shall file, record, index, and return the certificate of renewal
191.10 	in the same manner as provided for medical assistance liens in
191.11 	section 514.982, subdivision 2.
191.12 	(b) A medical assistance lien is not enforceable against
191.13 	the real property of an estate to the extent there is a
191.14 	determination by a court of competent jurisdiction, or by an
191.15 	officer of the court designated for that purpose, that there are
191.16 	insufficient assets in the estate to satisfy the agency's
191.17 	medical assistance lien in whole or in part because of the
191.18 	homestead exemption under section 256B.15, subdivision 4, the
191.19 	rights of the surviving spouse or minor children under section
191.20 	524.2-403, paragraphs (a) and (b), or claims with a priority
191.21 	under section 524.3-805, paragraph (a), clauses (1) to (4).  For
191.22 	purposes of this section, the rights of the decedent's adult
191.23 	children to exempt property under section 524.2-403, paragraph
191.24 	(b), shall not be considered costs of administration under
191.25 	section 524.3-805, paragraph (a), clause (1).
191.26 	(c) Notwithstanding any law or rule to the contrary, the
191.27 	provisions in clauses (1) to (7) apply if a life estate subject
191.28 	to a medical assistance lien ends according to its terms, or if
191.29 	a medical assistance recipient who owns a life estate or any
191.30 	interest in real property as a joint tenant that is subject to a
191.31 	medical assistance lien dies.
191.32 	(1) The medical assistance recipient's life estate or joint
191.33 	tenancy interest in the real property shall not end upon the
191.34 	recipient's death but shall merge into the remainder interest or
191.35 	other interest in real property the medical assistance recipient
191.36 	owned in joint tenancy with others.  The medical assistance lien
192.1 	shall attach to and run with the remainder or other interest in
192.2 	the real property to the extent of the medical assistance
192.3 	recipient's interest in the property at the time of the
192.4 	recipient's death as determined under this section.
192.5 	(2) If the medical assistance recipient's interest was a
192.6 	life estate in real property, the lien shall be a lien against
192.7 	the portion of the remainder equal to the percentage factor for
192.8 	the life estate of a person the medical assistance recipient's
192.9 	age on the date the life estate ended according to its terms or
192.10 	the date of the medical assistance recipient's death as listed
192.11 	in the Life Estate Mortality Table in the health care program's
192.12 	manual.
192.13 	(3) If the medical assistance recipient owned the interest
192.14 	in real property in joint tenancy with others, the lien shall be
192.15 	a lien against the portion of that interest equal to the
192.16 	fractional interest the medical assistance recipient would have
192.17 	owned in the jointly owned interest had the medical assistance
192.18 	recipient and the other owners held title to that interest as
192.19 	tenants in common on the date the medical assistance recipient
192.20 	died.
192.21 	(4) The medical assistance lien shall remain a lien against
192.22 	the remainder or other jointly owned interest for the length of
192.23 	time and be renewable as provided in paragraph (a).
192.24 	(5) Subdivision 5, paragraph (a), clause (4), paragraph
192.25 	(b), clauses (1) and (2); and subdivision 6, paragraph (b), do
192.26 	not apply to medical assistance liens which attach to interests
192.27 	in real property as provided under this subdivision.
192.28 	(6) The continuation of a medical assistance recipient's
192.29 	life estate or joint tenancy interest in real property after the
192.30 	medical assistance recipient's death for the purpose of
192.31 	recovering medical assistance provided for in sections 514.980
192.32 	to 514.985 modifies common law principles holding that these
192.33 	interests terminate on the death of the holder.
192.34 	(7) Notwithstanding any law or rule to the contrary, no
192.35 	release, satisfaction, discharge, or affidavit under section
192.36 	256B.15 shall extinguish or terminate the life estate or joint
193.1 	tenancy interest of a medical assistance recipient subject to a
193.2 	lien under sections 514.980 to 514.985 on the date the recipient
193.3 	dies.
193.4 	(8) No action shall be taken to enforce or collect any lien
193.5 	arising under section 256B.15 or under sections 514.980 to
193.6 	514.985 and sections 514.991 to 514.995 with respect to a
193.7 	homestead owned of record, on the date the recipient dies, by
193.8 	the recipient and a joint tenant with a right of survivorship,
193.9 	until the joint tenant sells the homestead, ceases to reside in
193.10 	the homestead, or dies.  Homestead means the real property
193.11 	occupied by the surviving joint tenant as the sole residence on
193.12 	the date the recipient dies and classified and taxed to the
193.13 	recipient and surviving joint tenant as homestead property for
193.14 	property tax purposes in the calendar year in which the
193.15 	recipient dies.  For purposes of this exemption, real property
193.16 	the recipient and the surviving joint tenant purchase solely
193.17 	with the proceeds from the sale of the prior homestead, own of
193.18 	record as joint tenants, and qualify as homestead property under
193.19 	section 273.124 in the calendar year in which the recipient dies
193.20 	and prior to the recipient's death shall be deemed to be real
193.21 	property classified and taxed to the recipient and the surviving
193.22 	joint tenant as homestead property in the calendar year in which
193.23 	the recipient dies.  The surviving joint tenant, or any person
193.24 	with personal knowledge of the facts, may provide an affidavit
193.25 	describing the homestead property affected by this clause and
193.26 	stating facts showing compliance with this clause.  The
193.27 	affidavit shall be prima facie evidence of the facts it states.
193.28 	The estate, any owner of an interest in the property that is or
193.29 	may be subject to the lien, or any other interested party, may
193.30 	voluntarily pay off, settle, or otherwise satisfy the claim
193.31 	secured or to be secured by the lien at any time before or after
193.32 	the lien is filed or recorded.  Such payoffs, settlements, and
193.33 	satisfactions shall be deemed to be voluntary repayments of past
193.34 	medical assistance payments for the benefit of the deceased
193.35 	recipient, and neither the process of settling the claim, the
193.36 	payment of the claim, or the acceptance of a payment shall
194.1 	constitute an adjustment or recovery that is prohibited under
194.2 	this section.
194.3 	(9) The provisions of clauses (1) to (7) (8) do not apply
194.4 	to a homestead owned of record, on the date the recipient dies,
194.5 	by the recipient and the recipient's spouse as joint tenants
194.6 	with a right of survivorship.  Homestead means the real property
194.7 	occupied by the surviving joint tenant spouse as their sole
194.8 	residence on the date the recipient dies and classified and
194.9 	taxed to the recipient and surviving joint tenant spouse as
194.10 	homestead property for property tax purposes in the calendar
194.11 	year in which the recipient dies.  For purposes of this
194.12 	exemption, real property the recipient and their surviving joint
194.13 	tenant spouse purchase solely with the proceeds from the sale of
194.14 	their prior homestead, own of record as joint tenants, and
194.15 	qualify as homestead property under section 273.124 in the
194.16 	calendar year in which the recipient dies and prior to the
194.17 	recipient's death shall be deemed to be real property classified
194.18 	and taxed to the recipient and their surviving joint tenant
194.19 	spouse as homestead property in the calendar year in which the
194.20 	recipient dies.  The surviving spouse, or any person with
194.21 	personal knowledge of the facts, may provide an affidavit
194.22 	describing the homestead property affected by this clause and
194.23 	stating facts showing compliance with this clause.  The
194.24 	affidavit shall be prima facie evidence of the facts it states.
194.25 	(d) The commissioner shall release liens arising under
194.26 	notices of potential claims under section 256B.15 and medical
194.27 	assistance liens under sections 514.980 to 514.985, against a
194.28 	deceased recipient's life estates and jointly owned interests in
194.29 	farm and income producing real property they own of record on
194.30 	the date they die if their interest in the property ends at
194.31 	their death, the surviving remainderman or surviving joint
194.32 	tenant owns their interest in the property of record on that
194.33 	date, and all of the following conditions apply with respect to
194.34 	the surviving remainderman or surviving joint tenant and their
194.35 	interest in the property:
194.36 	(1) the farm property is real property for which all of the
195.1 	following apply continuously for a period beginning at least
195.2 	three years before the calendar year in which the recipient
195.3 	first received long-term care medical assistance through the
195.4 	date of the recipient's death:
195.5 	(i) the remainderman or surviving joint tenant is a farmer,
195.6 	as defined in section 500.24, subdivision 2, paragraph (n), and
195.7 	is engaged in farming, as defined in section 500.24, subdivision
195.8 	2, paragraph (a);
195.9 	(ii) all of the land is a family farm as defined in section
195.10 	500.24, subdivision 2, paragraph (b); and 
195.11 	(iii) all of the land is classified and taxed as class 2a
195.12 	agricultural land under section 273.13, subdivision 23,
195.13 	paragraph (a), for property tax purposes; and 
195.14 	(2) the income-producing property is real property for
195.15 	which all of the following apply continuously for a period
195.16 	beginning at least three years before the calendar year in which
195.17 	the recipient first received long-term care medical assistance
195.18 	through the date of the recipient's death:
195.19 	(i) no part of the property is classified or taxed as
195.20 	homestead property for property tax purposes, provided that if
195.21 	the property is classified and taxed as both homestead and
195.22 	nonhomestead property, the portion of the property classified
195.23 	and taxed as nonhomestead property shall be considered to
195.24 	satisfy this requirement;
195.25 	(ii) all of the property is classified and taxed as class
195.26 	1c property under section 273.13, subdivision 22, paragraph (c),
195.27 	except that part of the class 1c property that is a dwelling
195.28 	occupied as a homestead; class 3a or 3b commercial or industrial
195.29 	property under section 273.13, subdivision 24; or as class 4a or
195.30 	4c property classified under section 273.13, subdivision 25,
195.31 	paragraphs (a) and (d), for property tax purposes; and 
195.32 	(iii) the business, profession, or occupation in which the
195.33 	real property is used is the primary business, profession, or
195.34 	occupation of the remainderman or surviving joint tenant and the
195.35 	real property is used solely for that business, profession, or
195.36 	occupation.  A primary business, profession, or occupation is
196.1 	one the ongoing operation of which provides at least 65 percent
196.2 	of a person's gross income for federal income tax purposes for
196.3 	the calendar year.
196.4 	
EFFECTIVE DATE. This section is effective July 1, 2005,
196.5 	and applies to the estates of decedents who die on or after that
196.6 	date.

196.7 	Sec. 29. Minnesota Statutes 2004, section 524.3-805, is
196.8 	amended to read:
196.9 	524.3-805 CLASSIFICATION OF CLAIMS.
196.10 	(a) If the applicable assets of the estate are insufficient
196.11 	to pay all claims in full, the personal representative shall
196.12 	make payment in the following order:
196.13 	(1) costs and expenses of administration;
196.14 	(2) reasonable funeral expenses;
196.15 	(3) debts and taxes with preference under federal law;
196.16 	(4) reasonable and necessary medical, hospital, or nursing
196.17 	home expenses of the last illness of the decedent, including
196.18 	compensation of persons attending the decedent, a claim filed
196.19 	under section 256B.15 for recovery of expenditures for
196.20 	alternative care for nonmedical assistance recipients under
196.21 	section 256B.0913,and including a claim filed pursuant to
196.22 	section 256B.15;
196.23 	(5) reasonable and necessary medical, hospital, and nursing
196.24 	home expenses for the care of the decedent during the year
196.25 	immediately preceding death;
196.26 	(6) debts with preference under other laws of this state,
196.27 	and state taxes;
196.28 	(7) all other claims.
196.29 	(b) No preference shall be given in the payment of any
196.30 	claim over any other claim of the same class, and a claim due
196.31 	and payable shall not be entitled to a preference over claims
196.32 	not due, except that if claims for expenses of the last illness
196.33 	involve only claims filed under section 256B.15 for recovery of
196.34 	expenditures for alternative care for nonmedical assistance
196.35 	recipients under section 256B.0913, section 246.53 for costs of
196.36 	state hospital care and claims filed under section 256B.15,
197.1 	claims filed to recover expenditures for alternative care for
197.2 	nonmedical assistance recipients under section 256B.0913 shall
197.3 	have preference over claims filed under both sections 246.53 and
197.4 	other claims filed under section 256B.15, and .Claims filed
197.5 	under section 246.53 have preference over claims filed under
197.6 	section 256B.15for recovery of amounts other than those for
197.7 	expenditures for alternative care for nonmedical assistance
197.8 	recipients under section 256B.0913.

197.9 	EFFECTIVE DATE. This section is effective July 1, 2005,
197.10 	for decedents dying on or after that date.

197.11 	Sec. 30. COMMUNITY SERVICES PROVIDER RATE INCREASES.
 197.12 	(a) The commissioner of human services shall increase
197.13 	reimbursement rates by two percent for the rate period beginning
197.14 	October 1, 2005, and the rate year beginning July 1, 2006,
197.15 	effective for services rendered on or after those dates.
197.16 	(b) The two percent annual rate increase described in this
197.17 	section must be provided to:
197.18 	(1) home and community-based waivered services for persons
197.19 	with mental retardation or related conditions under Minnesota
197.20 	Statutes, section 256B.501;
197.21 	(2) home and community-based waivered services for the
197.22 	elderly under Minnesota Statutes, section 256B.0915;
197.23 	(3) waivered services under community alternatives for
197.24 	disabled individuals under Minnesota Statutes, section 256B.49;
197.25 	(4) community alternative care waivered services under
197.26 	Minnesota Statutes, section 256B.49;
197.27 	(5) traumatic brain injury waivered services under
197.28 	Minnesota Statutes, section 256B.49;
197.29 	(6) nursing services and home health services under
197.30 	Minnesota Statutes, section 256B.0625, subdivision 6a;
197.31 	(7) personal care services and nursing supervision of
197.32 	personal care services under Minnesota Statutes, section
197.33 	256B.0625, subdivision 19a;
197.34 	(8) private duty nursing services under Minnesota Statutes,
197.35 	section 256B.0625, subdivision 7;
197.36 	(9) day training and habilitation services for adults with
198.1 	mental retardation or related conditions under Minnesota
198.2 	Statutes, sections 252.40 to 252.46;
198.3 	(10) alternative care services under Minnesota Statutes,
198.4 	section 256B.0913;
198.5 	(11) adult residential program grants under Minnesota
198.6 	Rules, parts 9535.2000 to 9535.3000;
198.7 	(12) adult and family community support grants under
198.8 	Minnesota Rules, parts 9535.1700 to 9535.1760;
198.9 	(13) the group residential housing supplementary service
198.10 	rate under Minnesota Statutes, section 256I.05, subdivision 1a;
198.11 	(14) adult mental health integrated fund grants under
198.12 	Minnesota Statutes, section 245.4661;
198.13 	(15) semi-independent living services under Minnesota
198.14 	Statutes, section 252.275, including SILS funding under county
198.15 	social services grants formerly funded under Minnesota Statutes,
198.16 	chapter 256I;
198.17 	(16) community support services for deaf and
198.18 	hard-of-hearing adults with mental illness who use or wish to
198.19 	use sign language as their primary means of communication; and 
198.20 	(17) living skills training programs for persons with
198.21 	intractable epilepsy who need assistance in the transition to
198.22 	independent living.
198.23 	(c) Providers that receive a rate increase under this
198.24 	section shall use the additional revenue to increase wages and
198.25 	benefits and pay associated costs for employees, except for
198.26 	management fees, the administrator, and central office staffs.
198.27 	(d) For public employees, the increase for wages and
198.28 	benefits for certain staff is available and pay rates shall be
198.29 	increased only to the extent that they comply with laws
198.30 	governing public employees collective bargaining.  Money
198.31 	received by a provider for pay increases under this section may
198.32 	be used only for increases implemented on or after the first day
198.33 	of the rate period in which the increase is available and must
198.34 	not be used for increases implemented prior to that date.
198.35 	(e) A copy of the provider's plan for complying with
198.36 	paragraph (c) must be made available to all employees by giving
199.1 	each employee a copy or by posting a copy in an area of the
199.2 	provider's operation to which all employees have access.  If an
199.3 	employee does not receive the adjustment, if any, described in
199.4 	the plan and is unable to resolve the problem with the provider,
199.5 	the employee may contact the employee's union representative.
199.6 	If the employee is not covered by a collective bargaining
199.7 	agreement, the employee may contact the commissioner at a
199.8 	telephone number provided by the commissioner and included in
199.9 	the provider's plan.

199.10 	Sec. 31. CONSUMER-DIRECTED COMMUNITY SUPPORTS
199.11 	METHODOLOGY.
 199.12 	For persons using the home and community-based waiver for
199.13 	persons with developmental disabilities whose Consumer-Directed
199.14 	Community Supports budgets were reduced by the October 2004,
199.15 	state-set budget methodology, the commissioner of human services
199.16 	must allow exceptions to exceed the state-set budget formula up
199.17 	to the daily average cost during calendar year 2004 or for
199.18 	persons who graduated from school during 2004, the average daily
199.19 	cost during July through December 2004, less one-half of case
199.20 	management and home modifications over $5,000 when the
199.21 	individual's county of financial responsibility determines that:
199.22 	(1) necessary alternative services will cost the same or
199.23 	more than the person's current budget; and 
199.24 	(2) administrative expenses or provider rates will result
199.25 	in fewer hours of needed staffing for the person than under the
199.26 	Consumer-Directed Community Supports option.  Any exceptions the
199.27 	county grants must be within the county's allowable aggregate
199.28 	amount for the home and community-based waiver for persons with
199.29 	developmental disabilities.

199.30 	EFFECTIVE DATE. This section is effective upon federal
199.31 	approval of the waiver amendment in section 33.

199.32 	Sec. 32. COSTS ASSOCIATED WITH PHYSICAL ACTIVITIES.
 199.33 	The expenses allowed for adults under the Consumer-Directed
199.34 	Community Supports option shall include costs at the lowest rate
199.35 	available, considering daily, monthly, semiannual, annual, or
199.36 	membership rates, including transportation, associated with
200.1 	physical exercise or other physical activities to maintain or
200.2 	improve the person's health and functioning.

200.3 	EFFECTIVE DATE. This section is effective upon federal
200.4 	approval of the waiver amendment in section 33.

200.5 	Sec. 33. WAIVER AMENDMENT.
 200.6 	The commissioner of human services shall submit an
200.7 	amendment to the Centers for Medicare and Medicaid Services
200.8 	consistent with sections 31 and 32 by August 1, 2005.

200.9 	Sec. 34. INDEPENDENT EVALUATION AND REVIEW OF UNALLOWABLE
200.10 	ITEMS.
 200.11 	The commissioner of human services shall include in the
200.12 	independent evaluation of the Consumer-Directed Community
200.13 	Supports option provided through the home and community-based
200.14 	services waivers for persons with disabilities under 65 years of
200.15 	age:
200.16 	(1) provision for ongoing, regular participation by
200.17 	stakeholder representatives through June 30, 2007;
200.18 	(2) recommendations on whether changes to the unallowable
200.19 	items should be made to meet the health, safety, or welfare
200.20 	needs of participants in the Consumer-Directed Community
200.21 	Supports option within the allowed budget amounts.  The
200.22 	recommendations on allowable items shall be provided to the
200.23 	senate and house of representatives committees with jurisdiction
200.24 	over human services policy and finance issues by January 15,
200.25 	2006; and 
200.26 	(3) a review of the statewide caseload changes for the
200.27 	disability waiver programs for persons under 65 years of age
200.28 	that occurred since the state-set budget methodology
200.29 	implementation on October 1, 2004, and recommendations on the
200.30 	fiscal impact of the budget methodology on use of the
200.31 	Consumer-Directed Community Supports option.

200.32 	EFFECTIVE DATE. This section is effective the day
200.33 	following final enactment.

200.34 	Sec. 35. IMMUNITY; REFUNDS BARRED.
 200.35 	(a) The commissioner of human services, county agencies,
200.36 	and elected officials and their employees are immune from all
201.1 	liability for any action taken implementing those portions of
201.2 	Laws 2003, First Special Session chapter 14, that extend medical
201.3 	assistance lien and estate claims recovery policies to include
201.4 	the alternative care program, as those laws existed at the time
201.5 	the action was taken.
201.6 	(b) The legislature expressly intends that none of the
201.7 	recoveries of alternative care payments the state or a local
201.8 	agency made under Minnesota Statutes, sections 256B.15 and
201.9 	514.991 to 514.995, as they existed prior to the effective date
201.10 	of this amendment, shall be refunded or repaid.

201.11 	EFFECTIVE DATE. This section is effective July 1, 2005.

201.12 	Sec. 36. SKILLED NURSING FACILITIES IN FARIBAULT COUNTY.
 201.13 	All skilled nursing facilities in Faribault County shall
201.14 	have the inspection required under Minnesota Statutes, section
201.15 	144A.10, conducted by the Department of Health's Mankato survey
201.16 	team.

201.17 	Sec. 37. EXPIRATION DATE.
 201.18 	Section 31 shall expire on the date the commissioner of
201.19 	human services implements a new consumer-directed community
201.20 	supports budget methodology that is based on reliable and
201.21 	accurate information about the services and supports intensity
201.22 	needs of persons using the option and that adequately accounts
201.23 	for the increased costs of adults who graduate from school and
201.24 	need services funded by the waiver during the day.

201.25 	Sec. 38. REPEALER.
 201.26 	Minnesota Statutes 2004, sections 514.991; 514.992;
201.27 	514.993; 514.994; and 514.995, are repealed effective July 1,
201.28 	2005.  On and after the repeal date all alternative care liens
201.29 	of record shall be of no force and effect, shall not be liens on
201.30 	real property, and examiners of title shall disregard these
201.31 	liens and shall not carry them forward to subsequent
201.32 	certificates of title.

201.33 	ARTICLE 5
201.34 	MENTAL AND CHEMICAL HEALTH

201.35 	Section 1. Minnesota Statutes 2004, section 62J.692,
201.36 	subdivision 3, is amended to read:
202.1 		Subd. 3.Application process.  (a) A clinical medical
202.2 	education program conducted in Minnesota by a teaching
202.3 	institution to train physicians, doctor of pharmacy
202.4 	practitioners, dentists, chiropractors, or physician assistants
202.5 	is eligible for funds under subdivision 4 if the program:
202.6 	(1) is funded, in part, by patient care revenues;
202.7 	(2) occurs in patient care settings that face increased
202.8 	financial pressure as a result of competition with nonteaching
202.9 	patient care entities; and
202.10 	(3) emphasizes primary care or specialties that are in
202.11 	undersupply in Minnesota.
202.12 	A clinical medical education program that trains
202.13 	pediatricians is requested to include in its program curriculum
202.14 	training in case management and medication management for
202.15 	children suffering from mental illness to be eligible for funds
202.16 	under subdivision 4.
202.17 	(b) A clinical medical education program for advanced
202.18 	practice nursing is eligible for funds under subdivision 4 if
202.19 	the program meets the eligibility requirements in paragraph (a),
202.20 	clauses (1) to (3), and is sponsored by the University of
202.21 	Minnesota Academic Health Center, the Mayo Foundation, or
202.22 	institutions that are part of the Minnesota State Colleges and
202.23 	Universities system or members of the Minnesota Private College
202.24 	Council.
202.25 	(c) Applications must be submitted to the commissioner by a
202.26 	sponsoring institution on behalf of an eligible clinical medical
202.27 	education program and must be received by October 31 of each
202.28 	year for distribution in the following year.  An application for
202.29 	funds must contain the following information:
202.30 	(1) the official name and address of the sponsoring
202.31 	institution and the official name and site address of the
202.32 	clinical medical education programs on whose behalf the
202.33 	sponsoring institution is applying;
202.34 	(2) the name, title, and business address of those persons
202.35 	responsible for administering the funds;
202.36 	(3) for each clinical medical education program for which
203.1 	funds are being sought; the type and specialty orientation of
203.2 	trainees in the program; the name, site address, and medical
203.3 	assistance provider number of each training site used in the
203.4 	program; the total number of trainees at each training site; and
203.5 	the total number of eligible trainee FTEs at each site.  Only
203.6 	those training sites that host 0.5 FTE or more eligible trainees
203.7 	for a program may be included in the program's application; and
203.8 	(4) other supporting information the commissioner deems
203.9 	necessary to determine program eligibility based on the criteria
203.10 	in paragraphs (a) and (b) and to ensure the equitable
203.11 	distribution of funds.
203.12 	(d) An application must include the information specified
203.13 	in clauses (1) to (3) for each clinical medical education
203.14 	program on an annual basis for three consecutive years.  After
203.15 	that time, an application must include the information specified
203.16 	in clauses (1) to (3) in the first year of each biennium:
203.17 	(1) audited clinical training costs per trainee for each
203.18 	clinical medical education program when available or estimates
203.19 	of clinical training costs based on audited financial data;
203.20 	(2) a description of current sources of funding for
203.21 	clinical medical education costs, including a description and
203.22 	dollar amount of all state and federal financial support,
203.23 	including Medicare direct and indirect payments; and
203.24 	(3) other revenue received for the purposes of clinical
203.25 	training.
203.26 	(e) An applicant that does not provide information
203.27 	requested by the commissioner shall not be eligible for funds
203.28 	for the current funding cycle.

203.29 	Sec. 2. Minnesota Statutes 2004, section 244.054, is
203.30 	amended to read:
203.31 	244.054 DISCHARGE PLANS; OFFENDERS WITH SERIOUS AND
203.32 	PERSISTENT MENTAL ILLNESS.
203.33 		Subdivision 1.Offer to develop plan. The commissioner
203.34 	of human services, in collaboration with the commissioner of
203.35 	corrections, shall offer to develop a discharge plan for
203.36 	community-based services for every offender with serious and
204.1 	persistent mental illness, as defined in section 245.462,
204.2 	subdivision 20, paragraph (c), and every offender who has had a
204.3 	diagnosis of mental illness and would otherwise be eligible for
204.4 	case management services under section 245.462, subdivision 20,
204.5 	paragraph (c), but for the requirement that the offender be
204.6 	hospitalized or in residential treatment,who is being released
204.7 	from a correctional facility.  If an offender is being released
204.8 	pursuant to section 244.05, the offender may choose to have the
204.9 	discharge plan made one of the conditions of the offender's
204.10 	supervised release and shall follow the conditions to the extent
204.11 	that services are available and offered to the offender.
204.12 		Subd. 2.Content of plan. If an offender chooses to have
204.13 	a discharge plan developed, the commissioner of human services
204.14 	shall develop and implement a discharge plan, which must include
204.15 	at least the following:
204.16 	(1) at least 90 days before the offender is due to be
204.17 	discharged, the commissioner of human services shall designate
204.18 	an agent of the Department of Human Services a discharge planner 
204.19 	with mental health training to serve as the primary person
204.20 	responsible for carrying out discharge planning activities;
204.21 	(2) at least 75 days before the offender is due to be
204.22 	discharged, the offender's designated agent discharge planner 
204.23 	shall:
204.24 	(i) obtain informed consent and releases of information
204.25 	from the offender that are needed for transition services, and
204.26 	forward them to the appropriate local entity;
204.27 	(ii) contact the county human services department in the
204.28 	community where the offender expects to reside following
204.29 	discharge, and inform the department of the offender's impending
204.30 	discharge and the planned date of the offender's return to the
204.31 	community; determine whether the county or a designated
204.32 	contracted provider will provide case management services to the
204.33 	offender; refer the offender to the case management services
204.34 	provider; and confirm that the case management services provider
204.35 	will have opened the offender's case prior to the offender's
204.36 	discharge; and
205.1 	(iii) refer the offender to appropriate staff in the county
205.2 	human services department in the community where the offender
205.3 	expects to reside following discharge, for enrollment of the
205.4 	offender if eligible in medical assistance or general assistance
205.5 	medical care, using special procedures established by process
205.6 	and Department of Human Services bulletin assist the offender in
205.7 	filling out an application for medical assistance, general
205.8 	assistance medical care, or MinnesotaCare and submit the
205.9 	application for eligibility determination to the commissioner.
205.10 	The commissioner shall determine an offender's eligibility no
205.11 	more than 45 days, or no more than 60 days if the offender's
205.12 	disability status must be determined, from the date that the
205.13 	application is received by the department.  The effective date
205.14 	of eligibility for the health care program shall be no earlier
205.15 	than the date of the offender's release.  If eligibility is
205.16 	approved, the commissioner shall mail a Minnesota health care
205.17 	program membership card to the facility in which the offender
205.18 	resides and transfer the offender's case to MinnesotaCare
205.19 	operations within the department or the appropriate county human
205.20 	services agency in the county where the offender expects to
205.21 	reside following release for ongoing case management;
205.22 	(3) at least 2-1/2 months before discharge, the offender's
205.23 	designated agent discharge planner shall secure timely
205.24 	appointments for the offender with a psychiatrist no later than
205.25 	30 days following discharge, and with other program staff at a
205.26 	community mental health provider that is able to serve former
205.27 	offenders with serious and persistent mental illness;
205.28 	(4) at least 30 days before discharge, the offender's
205.29 	designated agent discharge planner shall convene a predischarge
205.30 	assessment and planning meeting of key staff from the programs
205.31 	in which the offender has participated while in the correctional
205.32 	facility, the offender, the supervising agent, and the mental
205.33 	health case management services provider assigned to the
205.34 	offender.  At the meeting, attendees shall provide background
205.35 	information and continuing care recommendations for the
205.36 	offender, including information on the offender's risk for
206.1 	relapse; current medications, including dosage and frequency;
206.2 	therapy and behavioral goals; diagnostic and assessment
206.3 	information, including results of a chemical dependency
206.4 	evaluation; confirmation of appointments with a psychiatrist and
206.5 	other program staff in the community; a relapse prevention plan;
206.6 	continuing care needs; needs for housing, employment, and
206.7 	finance support and assistance; and recommendations for
206.8 	successful community integration, including chemical dependency
206.9 	treatment or support if chemical dependency is a risk factor.
206.10 	Immediately following this meeting, the offender's designated
206.11 	agent discharge planner shall summarize this background
206.12 	information and continuing care recommendations in a written
206.13 	report;
206.14 	(5) immediately following the predischarge assessment and
206.15 	planning meeting, the provider of mental health case management
206.16 	services who will serve the offender following discharge shall
206.17 	offer to make arrangements and referrals for housing, financial
206.18 	support, benefits assistance, employment counseling, and other
206.19 	services required in sections 245.461 to 245.486;
206.20 	(6) at least ten days before the offender's first scheduled
206.21 	postdischarge appointment with a mental health provider, the
206.22 	offender's designated agent discharge planner shall transfer the
206.23 	following records to the offender's case management services
206.24 	provider and psychiatrist:  the predischarge assessment and
206.25 	planning report, medical records, and pharmacy records.  These
206.26 	records may be transferred only if the offender provides
206.27 	informed consent for their release;
206.28 	(7) upon discharge, the offender's designated agent 
206.29 	discharge planner shall ensure that the offender leaves the
206.30 	correctional facility with at least a ten-day supply of all
206.31 	necessary medications; and
206.32 	(8) upon discharge, the prescribing authority at the
206.33 	offender's correctional facility shall telephone in
206.34 	prescriptions for all necessary medications to a pharmacy in the
206.35 	community where the offender plans to reside.  The prescriptions
206.36 	must provide at least a 30-day 60-day supply of all necessary
207.1 	medications, and must be able to be refilled once for one
207.2 	additional 30-day supply.
207.3 	
EFFECTIVE DATE. Subdivision 2, clause (2), item (iii), is
207.4 	effective August 1, 2006, or upon HealthMatch implementation,
207.5 	whichever is later.

207.6 	Sec. 3. Minnesota Statutes 2004, section 245.4661, is
207.7 	amended by adding a subdivision to read:
207.8 		Subd. 8.Supportive housing and other community services
207.9 	for individuals transitioning from anoka-metro regional
207.10 	treatment center. The commissioner, through agreements with
207.11 	counties and in consultation with providers of supportive
207.12 	housing with services and others, shall transition individuals
207.13 	who are currently at Anoka-Metro Regional Treatment Center into
207.14 	the community, who are ready to be discharged or who are at
207.15 	imminent risk of admission.  The commissioner shall expand the
207.16 	adult mental health initiative pilot projects under section
207.17 	245.4661 to provide appropriate, thorough, flexible, and
207.18 	sufficient services that may include supportive housing with
207.19 	services, assertive community treatment, case management, and
207.20 	other community supports for individuals with a mental illness
207.21 	who:
207.22 	(1) are at imminent risk of being admitted to, or are ready
207.23 	to be discharged or have recently been discharged from, a
207.24 	regional treatment center, community hospital, or residential
207.25 	treatment program; and 
207.26 	(2) have no appropriate housing available or lack the
207.27 	resources necessary to access permanent housing.

207.28 	Sec. 4. Minnesota Statutes 2004, section 245.4661, is
207.29 	amended by adding a subdivision to read:
207.30 		Subd. 9.Bed closing. The commissioner shall close 25
207.31 	beds at the Anoka-Metro Regional Treatment Center by July 1,
207.32 	2007, and an additional 25 beds by July 1, 2008, or after
207.33 	sufficient alternative services have been developed.  The
207.34 	commissioner shall transfer state savings resulting from these
207.35 	bed closures into appropriate accounts according to subdivision
207.36 	10 to pay for the ongoing provision of the alternative services
208.1 	in subdivision 8 and for expansion of contract beds under
208.2 	section 256.9693.  No individual will be involuntarily
208.3 	discharged under this subdivision if appropriate community
208.4 	services are not available to support the individual.

208.5 	Sec. 5. Minnesota Statutes 2004, section 245.4661, is
208.6 	amended by adding a subdivision to read:
208.7 		Subd. 10.Budget flexibility. The commissioner may make
208.8 	budget transfers that do not increase the state share of costs
208.9 	to effectively implement the restructuring of adult mental
208.10 	health services.

208.11 	Sec. 6. Minnesota Statutes 2004, section 245.4661, is
208.12 	amended by adding a subdivision to read:
208.13 		Subd. 11.County eligibility. The commissioner may
208.14 	approve funding for services under subdivision 8 according to
208.15 	subdivisions 9 and 10 for a county or group of counties that:
208.16 	(1) agrees to outcome-based performance criteria that
208.17 	includes a reduction in utilization of regional treatment center
208.18 	inpatient services through provision of quality services that
208.19 	meet individual needs;
208.20 	(2) agrees to the collection and submission of data
208.21 	necessary to measure progress towards the criteria in clause (1)
208.22 	and measurement of any resulting state or county savings;
208.23 	(3) agrees to reinvest in the services defined in
208.24 	subdivision 8 an amount equal to the ten percent county share of
208.25 	regional treatment center services for the fiscal year ending
208.26 	June 30, 2004, applied against the bed utilization reduction in
208.27 	clause (1); and 
208.28 	(4) agrees to develop a supportive housing program that
208.29 	insures the delivery of employment services, supportive
208.30 	services, housing and health care for eligible individuals, or
208.31 	agrees to contract with an existing integrated program.

208.32 	Sec. 7. Minnesota Statutes 2004, section 245.4874, is
208.33 	amended to read:
208.34 	245.4874 DUTIES OF COUNTY BOARD.
208.35 	(a) The county board in each county shall use its share of
208.36 	mental health and Community Social Services Act funds allocated
209.1 	by the commissioner according to a biennial children's mental
209.2 	health component of the community social services plan that is
209.3 	approved by the commissioner.  The county board must:
209.4 	(1) develop a system of affordable and locally available
209.5 	children's mental health services according to sections 245.487
209.6 	to 245.4887;
209.7 	(2) establish a mechanism providing for interagency
209.8 	coordination as specified in section 245.4875, subdivision 6;
209.9 	(3) develop a biennial children's mental health component
209.10 	of the community social services plan which considers the
209.11 	assessment of unmet needs in the county as reported by the local
209.12 	children's mental health advisory council under section
209.13 	245.4875, subdivision 5, paragraph (b), clause (3).  The county
209.14 	shall provide, upon request of the local children's mental
209.15 	health advisory council, readily available data to assist in the
209.16 	determination of unmet needs;
209.17 	(4) assure that parents and providers in the county receive
209.18 	information about how to gain access to services provided
209.19 	according to sections 245.487 to 245.4887;
209.20 	(5) coordinate the delivery of children's mental health
209.21 	services with services provided by social services, education,
209.22 	corrections, health, and vocational agencies to improve the
209.23 	availability of mental health services to children and the
209.24 	cost-effectiveness of their delivery;
209.25 	(6) assure that mental health services delivered according
209.26 	to sections 245.487 to 245.4887 are delivered expeditiously and
209.27 	are appropriate to the child's diagnostic assessment and
209.28 	individual treatment plan;
209.29 	(7) provide the community with information about predictors
209.30 	and symptoms of emotional disturbances and how to access
209.31 	children's mental health services according to sections 245.4877
209.32 	and 245.4878;
209.33 	(8) provide for case management services to each child with
209.34 	severe emotional disturbance according to sections 245.486;
209.35 	245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3,
209.36 	and 5;
210.1 	(9) provide for screening of each child under section
210.2 	245.4885 upon admission to a residential treatment facility,
210.3 	acute care hospital inpatient treatment, or informal admission
210.4 	to a regional treatment center;
210.5 	(10) prudently administer grants and purchase-of-service
210.6 	contracts that the county board determines are necessary to
210.7 	fulfill its responsibilities under sections 245.487 to 245.4887;
210.8 	(11) assure that mental health professionals, mental health
210.9 	practitioners, and case managers employed by or under contract
210.10 	to the county to provide mental health services are qualified
210.11 	under section 245.4871;
210.12 	(12) assure that children's mental health services are
210.13 	coordinated with adult mental health services specified in
210.14 	sections 245.461 to 245.486 so that a continuum of mental health
210.15 	services is available to serve persons with mental illness,
210.16 	regardless of the person's age;
210.17 	(13) assure that culturally informed mental health
210.18 	consultants are used as necessary to assist the county board in
210.19 	assessing and providing appropriate treatment for children of
210.20 	cultural or racial minority heritage; and
210.21 	(14) consistent with section 245.486, arrange for or
210.22 	provide a children's mental health screening to a child
210.23 	receiving child protective services or a child in out-of-home
210.24 	placement, a child for whom parental rights have been
210.25 	terminated, a child found to be delinquent, and a child found to
210.26 	have committed a juvenile petty offense for the third or
210.27 	subsequent time, unless a screening has been performed within
210.28 	the previous 180 days, or the child is currently under the care
210.29 	of a mental health professional.  The court or county agency
210.30 	must notify a parent or guardian whose parental rights have not
210.31 	been terminated of the potential mental health screening and the
210.32 	option to prevent the screening by notifying the court or county
210.33 	agency in writing.  The screening shall be conducted with a
210.34 	screening instrument approved by the commissioner of human
210.35 	services according to criteria that are updated and issued
210.36 	annually to ensure that approved screening instruments are valid
211.1 	and useful for child welfare and juvenile justice populations,
211.2 	and shall be conducted by a mental health practitioner as
211.3 	defined in section 245.4871, subdivision 26, or a probation
211.4 	officer or local social services agency staff person who is
211.5 	trained in the use of the screening instrument.  Training in the
211.6 	use of the instrument shall include training in the
211.7 	administration of the instrument, the interpretation of its
211.8 	validity given the child's current circumstances, the state and
211.9 	federal data practices laws and confidentiality standards, the
211.10 	parental consent requirement, and providing respect for families
211.11 	and cultural values.  If the screen indicates a need for
211.12 	assessment, the child's family, or if the family lacks mental
211.13 	health insurance, the local social services agency, in
211.14 	consultation with the child's family, shall have conducted a
211.15 	diagnostic assessment, including a functional assessment, as
211.16 	defined in section 245.4871.  The administration of the
211.17 	screening shall safeguard the privacy of children receiving the
211.18 	screening and their families and shall comply with the Minnesota
211.19 	Government Data Practices Act, chapter 13, and the federal
211.20 	Health Insurance Portability and Accountability Act of 1996,
211.21 	Public Law 104-191.  Screening results shall be considered
211.22 	private data and the commissioner shall not collect individual
211.23 	screening results.
211.24 	(b) When the county board refers clients to providers of
211.25 	children's therapeutic services and supports under section
211.26 	256B.0943, the county board must clearly identify the
211.27 	nonchildren's therapeutic services and supports covered services
211.28 	components and identify the reimbursement source for those
211.29 	requested services, the method of payment, and the payment rate
211.30 	to the provider.

211.31 	Sec. 8. Minnesota Statutes 2004, section 245.4885,
211.32 	subdivision 1, is amended to read:
211.33 		Subdivision 1.screening required admission criteria.
 211.34 	The county board shall, prior to admission, except in the case
211.35 	of emergency admission, screen determine the needed level of
211.36 	care for all children referred for treatment of severe emotional
212.1 	disturbance to in a treatment foster care setting,residential
212.2 	treatment facility,or informally admitted to a regional
212.3 	treatment center if public funds are used to pay for the
212.4 	services.  The county board shall also screen determine the
212.5 	needed level of care for all children admitted to an acute care
212.6 	hospital for treatment of severe emotional disturbance if public
212.7 	funds other than reimbursement under chapters 256B and 256D are
212.8 	used to pay for the services. If a child is admitted to a
212.9 	residential treatment facility or acute care hospital for
212.10 	emergency treatment or held for emergency care by a regional
212.11 	treatment center under section 253B.05, subdivision 1, screening
212.12 	must occur within three working days of admission.
212.13 	Screening The level of care determination shall determine
212.14 	whether the proposed treatment:
212.15 	(1) is necessary;
212.16 	(2) is appropriate to the child's individual treatment
212.17 	needs;
212.18 	(3) cannot be effectively provided in the child's home; and
212.19 	(4) provides a length of stay as short as possible
212.20 	consistent with the individual child's need.
212.21 	When a screening level of care determination is conducted,
212.22 	the county board may not determine that referral or admission to
212.23 	a treatment foster care setting,residential treatment facility,
212.24 	or acute care hospital is not appropriate solely because
212.25 	services were not first provided to the child in a less
212.26 	restrictive setting and the child failed to make progress toward
212.27 	or meet treatment goals in the less restrictive
212.28 	setting. Screening shall include both The level of care
212.29 	determination must be based on a diagnostic assessment and that
212.30 	includes a functional assessment which evaluates family, school,
212.31 	and community living situations; and an assessment of the
212.32 	child's need for care out of the home using a validated tool
212.33 	which assesses a child's functional status and assigns an
212.34 	appropriate level of care.  The validated tool must be approved
212.35 	by the commissioner of human services.  If a diagnostic
212.36 	assessment or including a functional assessment has been
213.1 	completed by a mental health professional within the past 180
213.2 	days, a new diagnostic or functional assessment need not be
213.3 	completed unless in the opinion of the current treating mental
213.4 	health professional the child's mental health status has changed
213.5 	markedly since the assessment was completed.  The child's parent
213.6 	shall be notified if an assessment will not be completed and of
213.7 	the reasons.  A copy of the notice shall be placed in the
213.8 	child's file.  Recommendations developed as part of
213.9 	the screening level of care determination process shall include
213.10 	specific community services needed by the child and, if
213.11 	appropriate, the child's family, and shall indicate whether or
213.12 	not these services are available and accessible to the child and
213.13 	family.
213.14 	During the screening level of care determination process,
213.15 	the child, child's family, or child's legal representative, as
213.16 	appropriate, must be informed of the child's eligibility for
213.17 	case management services and family community support services
213.18 	and that an individual family community support plan is being
213.19 	developed by the case manager, if assigned.
213.20 	Screening The level of care determination shall be in
213.21 	compliance comply with section 260C.212.  Wherever possible, the
213.22 	parent shall be consulted in the screening process, unless
213.23 	clinically inappropriate.
213.24 	The screening process level of care determination, and
213.25 	placement decision, and recommendations for mental health
213.26 	services must be documented in the child's record.
213.27 	An alternate review process may be approved by the
213.28 	commissioner if the county board demonstrates that an alternate
213.29 	review process has been established by the county board and the
213.30 	times of review, persons responsible for the review, and review
213.31 	criteria are comparable to the standards in clauses (1) to (4).
213.32 	
EFFECTIVE DATE. This section is effective July 1, 2006.

213.33 	Sec. 9. Minnesota Statutes 2004, section 245.4885, is
213.34 	amended by adding a subdivision to read:
213.35 		Subd. 1a.Emergency admission. Effective July 1, 2006,
213.36 	if a child is admitted to a treatment foster care setting,
214.1 	residential treatment facility, or acute care hospital for
214.2 	emergency treatment or held for emergency care by a regional
214.3 	treatment center under section 253B.05, subdivision 1, the level
214.4 	of care determination must occur within three working days of
214.5 	admission.

214.6 	Sec. 10. Minnesota Statutes 2004, section 245.4885,
214.7 	subdivision 2, is amended to read:
214.8 		Subd. 2.Qualifications. No later than July 1, 1991,
214.9 	Screening Level of care determination of children for treatment
214.10 	foster care,residential,and inpatient services must be
214.11 	conducted by a mental health professional.  Where appropriate
214.12 	and available, culturally informed mental health consultants
214.13 	must participate in the screening level of care determination.
214.14 	Mental health professionals providing screening level of care
214.15 	determination for treatment foster care,inpatient,and
214.16 	residential services must not be financially affiliated with any
214.17 	acute care inpatient hospital, residential treatment facility,
214.18 	or regional treatment center nongovernment entity which may be
214.19 	providing those services. The commissioner may waive this
214.20 	requirement for mental health professional participation after
214.21 	July 1, 1991, if the county documents that:
214.22 	(1) mental health professionals or mental health
214.23 	practitioners are unavailable to provide this service; and 
214.24 	(2) services are provided by a designated person with
214.25 	training in human services who receives clinical supervision
214.26 	from a mental health professional.
214.27 	
EFFECTIVE DATE. This section is effective July 1, 2006.

214.28 	Sec. 11. Minnesota Statutes 2004, section 254B.03,
214.29 	subdivision 4, is amended to read:
214.30 		Subd. 4.Division of costs.  Except for services provided
214.31 	by a county under section 254B.09, subdivision 1, or services
214.32 	provided under section 256B.69 or 256D.03, subdivision 4,
214.33 	paragraph (b), or when the primary drug problem is amphetamine
214.34 	or methamphetamine abuse or dependence,the county shall, out of
214.35 	local money, pay the state for 15 percent of the cost of
214.36 	chemical dependency services, including those services provided
215.1 	to persons eligible for medical assistance under chapter 256B
215.2 	and general assistance medical care under chapter 256D.
215.3 	Counties may use the indigent hospitalization levy for treatment
215.4 	and hospital payments made under this section.  Fifteen percent
215.5 	of any state collections from private or third-party pay, less
215.6 	15 percent of the cost of payment and collections, must be
215.7 	distributed to the county that paid for a portion of the
215.8 	treatment under this section.  If all funds allocated according
215.9 	to section 254B.02 are exhausted by a county and, except for
215.10 	treatment provided for amphetamine or methamphetamine abuse or
215.11 	dependence,the county has met or exceeded the base level of
215.12 	expenditures under section 254B.02, subdivision 3, the county
215.13 	shall pay the state for 15 percent of the costs paid by the
215.14 	state under this section, unless the payment is for treatment of
215.15 	amphetamine or methamphetamine abuse of dependence.  The
215.16 	commissioner may refuse to pay state funds for services to
215.17 	persons not eligible under section 254B.04, subdivision 1, if
215.18 	the county financially responsible for the persons has exhausted
215.19 	its allocation.
215.20 	
EFFECTIVE DATE. This section is effective January 1, 2006.

215.21 	Sec. 12. Minnesota Statutes 2004, section 256B.0622,
215.22 	subdivision 2, is amended to read:
215.23 		Subd. 2.Definitions.  For purposes of this section, the
215.24 	following terms have the meanings given them.
215.25 	(a) "Intensive nonresidential rehabilitative mental health
215.26 	services" means adult rehabilitative mental health services as
215.27 	defined in section 256B.0623, subdivision 2, paragraph (a),
215.28 	except that these services are provided by a multidisciplinary
215.29 	staff using a total team approach consistent with assertive
215.30 	community treatment, the Fairweather Lodge treatment model, as
215.31 	defined by the standards established by the National Coalition
215.32 	for Community Living,and other evidence-based practices, and
215.33 	directed to recipients with a serious mental illness who require
215.34 	intensive services.
215.35 	(b) "Intensive residential rehabilitative mental health
215.36 	services" means short-term, time-limited services provided in a
216.1 	residential setting to recipients who are in need of more
216.2 	restrictive settings and are at risk of significant functional
216.3 	deterioration if they do not receive these services.  Services
216.4 	are designed to develop and enhance psychiatric stability,
216.5 	personal and emotional adjustment, self-sufficiency, and skills
216.6 	to live in a more independent setting.  Services must be
216.7 	directed toward a targeted discharge date with specified client
216.8 	outcomes and must be consistent with the Fairweather Lodge
216.9 	treatment model as defined in paragraph (a), and other 
216.10 	evidence-based practices.
216.11 	(c) "Evidence-based practices" are nationally recognized
216.12 	mental health services that are proven by substantial research
216.13 	to be effective in helping individuals with serious mental
216.14 	illness obtain specific treatment goals.
216.15 	(d) "Overnight staff" means a member of the intensive
216.16 	residential rehabilitative mental health treatment team who is
216.17 	responsible during hours when recipients are typically asleep.
216.18 	(e) "Treatment team" means all staff who provide services
216.19 	under this section to recipients.  At a minimum, this includes
216.20 	the clinical supervisor, mental health professionals, mental
216.21 	health practitioners, and mental health rehabilitation workers.

216.22 	Sec. 13. Minnesota Statutes 2004, section 256B.0625, is
216.23 	amended by adding a subdivision to read:
216.24 		Subd. 46.Mental health telemedicine. Effective January
216.25 	1, 2006, and subject to federal approval, mental health services
216.26 	that are otherwise covered by medical assistance as direct
216.27 	face-to-face services may be provided via two-way interactive
216.28 	video.  Use of two-way interactive video must be medically
216.29 	appropriate to the condition and needs of the person being
216.30 	served.  Reimbursement is at the same rates and under the same
216.31 	conditions that would otherwise apply to the service.  The
216.32 	interactive video equipment and connection must comply with
216.33 	Medicare standards in effect at the time the service is provided.

216.34 	Sec. 14. Minnesota Statutes 2004, section 256B.0625, is
216.35 	amended by adding a subdivision to read:
216.36 		Subd. 47.Treatment foster care services. Effective July
217.1 	1, 2006, and subject to federal approval, medical assistance
217.2 	covers treatment foster care services according to section
217.3 	256B.0946.

217.4 	Sec. 15. Minnesota Statutes 2004, section 256B.0625, is
217.5 	amended by adding a subdivision to read:
217.6 		Subd. 48.Psychiatric consultation to primary care
217.7 	practitioners. Effective January 1, 2006, medical assistance
217.8 	covers consultation provided by a psychiatrist via telephone,
217.9 	e-mail, facsimile, or other means of communication to primary
217.10 	care practitioners, including pediatricians.  The need for
217.11 	consultation and the receipt of the consultation must be
217.12 	documented in the patient record maintained by the primary care
217.13 	practitioner.  If the patient consents, and subject to federal
217.14 	limitations and data privacy provisions, the consultation may be
217.15 	provided without the patient present.

217.16 	Sec. 16. [256B.0946] TREATMENT FOSTER CARE.
217.17 		Subdivision 1.Covered service. (a) Effective July 1,
217.18 	2006, and subject to federal approval, medical assistance covers
217.19 	medically necessary services described under paragraph (b) that
217.20 	are provided by a provider entity eligible under subdivision 3
217.21 	to a client eligible under subdivision 2 who is placed in a
217.22 	treatment foster home licensed under Minnesota Rules, parts
217.23 	2960.3000 to 2960.3340.
217.24 	(b) Services to children with severe emotional disturbance
217.25 	residing in treatment foster care settings must meet the
217.26 	relevant standards for mental health services under sections
217.27 	245.487 to 245.4887.  In addition, specific service components
217.28 	reimbursed by medical assistance must meet the following
217.29 	standards:
217.30 	(1) case management service component must meet the
217.31 	standards in Minnesota Rules, parts 9520.0900 to 9520.0926 and
217.32 	9505.0322, excluding subparts 6 and 10;
217.33 	(2) psychotherapy and skills training components must meet
217.34 	the standards for children's therapeutic services and supports
217.35 	in section 256B.0943; and 
217.36 	(3) family psychoeducation services under supervision of a
218.1 	mental health professional.
218.2 		Subd. 2.Determination of client eligibility. A client's
218.3 	eligibility to receive treatment foster care under this section
218.4 	shall be determined by a diagnostic assessment, an evaluation of
218.5 	level of care needed, and development of an individual treatment
218.6 	plan, as defined in paragraphs (a) to (c).
218.7 	(a) The diagnostic assessment must:
218.8 	(1) be conducted by a psychiatrist, licensed psychologist,
218.9 	or licensed independent clinical social worker that is performed
218.10 	within 180 days prior to the start of service;
218.11 	(2) include current diagnoses on all five axes of the
218.12 	client's current mental health status;
218.13 	(3) determine whether or not a child meets the criteria for
218.14 	severe emotional disturbance in section 245.4871, subdivision 6,
218.15 	or for serious and persistent mental illness in section 245.462,
218.16 	subdivision 20; and 
218.17 	(4) be completed annually until age 18.  For individuals
218.18 	between age 18 and 21, unless a client's mental health condition
218.19 	has changed markedly since the client's most recent diagnostic
218.20 	assessment, annual updating is necessary.  For the purpose of
218.21 	this section, "updating" means a written summary, including
218.22 	current diagnoses on all five axes, by a mental health
218.23 	professional of the client's current mental status and service
218.24 	needs.
218.25 	(b) The evaluation of level of care must be conducted by
218.26 	the placing county with an instrument approved by the
218.27 	commissioner of human services.  The commissioner shall update
218.28 	the list of approved level of care instruments annually.
218.29 	(c) The individual treatment plan must be:
218.30 	(1) based on the information in the client's diagnostic
218.31 	assessment;
218.32 	(2) developed through a child-centered, family driven
218.33 	planning process that identifies service needs and
218.34 	individualized, planned, and culturally appropriate
218.35 	interventions that contain specific measurable treatment goals
218.36 	and objectives for the client and treatment strategies for the
219.1 	client's family and foster family;
219.2 	(3) reviewed at least once every 90 days and revised; and 
219.3 	(4) signed by the client or, if appropriate, by the
219.4 	client's parent or other person authorized by statute to consent
219.5 	to mental health services for the client.
219.6 		Subd. 3.Eligible providers. For purposes of this
219.7 	section, a provider agency must have an individual placement
219.8 	agreement for each recipient and must be a licensed child
219.9 	placing agency, under Minnesota Rules, parts 9543.0010 to
219.10 	9543.0150, and either:
219.11 	(1) a county;
219.12 	(2) an Indian Health Services facility operated by a tribe
219.13 	or tribal organization under funding authorized by United States
219.14 	Code, title 25, sections 450f to 450n, or title 3 of the Indian
219.15 	Self-Determination Act, Public Law 93-638, section 638
219.16 	(facilities or providers); or 
219.17 	(3) a noncounty entity under contract with a county board.
219.18 		Subd. 4.Eligible provider responsibilities. (a) To be
219.19 	an eligible provider under this section, a provider must develop
219.20 	written policies and procedures for treatment foster care
219.21 	services consistent with subdivision 1, paragraph (b), clauses
219.22 	(1), (2), and (3).
219.23 	(b) In delivering services under this section, a treatment
219.24 	foster care provider must ensure that staff caseload size
219.25 	reasonably enables the provider to play an active role in
219.26 	service planning, monitoring, delivering, and reviewing for
219.27 	discharge planning to meet the needs of the client, the client's
219.28 	foster family, and the birth family, as specified in each
219.29 	client's individual treatment plan.
219.30 		Subd. 5.Service authorization. The commissioner will
219.31 	administer authorizations for services under this section in
219.32 	compliance with section 256B.0625, subdivision 25.
219.33 		Subd. 6.Excluded services. (a) Services in clauses (1)
219.34 	to (4) are not eligible as components of treatment foster care
219.35 	services:
219.36 	(1) treatment foster care services provided in violation of
220.1 	medical assistance policy in Minnesota Rules, part 9505.0220;
220.2 	(2) service components of children's therapeutic services
220.3 	and supports simultaneously provided by more than one treatment
220.4 	foster care provider;
220.5 	(3) home and community-based waiver services; and 
220.6 	(4) treatment foster care services provided to a child
220.7 	without a level of care determination according to section
220.8 	245.4885, subdivision 1.
220.9 	(b) Children receiving treatment foster care services are
220.10 	not eligible for medical assistance reimbursement for the
220.11 	following services while receiving treatment foster care:
220.12 	(1) mental health case management services under section
220.13 	256B.0625, subdivision 20; and 
220.14 	(2) psychotherapy and skill training components of
220.15 	children's therapeutic services and supports under section
220.16 	256B.0625, subdivision 35b.

220.17 	Sec. 17. [256B.0947] TRANSITIONAL YOUTH INTENSIVE
220.18 	REHABILITATIVE MENTAL HEALTH SERVICES.
220.19 		Subdivision 1.Scope. Subject to federal approval,
220.20 	medical assistance covers medically necessary, intensive
220.21 	nonresidential rehabilitative mental health services as defined
220.22 	in subdivision 2, for recipients as defined in subdivision 3,
220.23 	when the services are provided by an entity meeting the
220.24 	standards in this section.
220.25 		Subd. 2.Definitions. For purposes of this section, the
220.26 	following terms have the meanings given them.
220.27 	(a) "Intensive nonresidential rehabilitative mental health
220.28 	services" means child rehabilitative mental health services as
220.29 	defined in section 256B.0943, except that these services are
220.30 	provided by a multidisciplinary staff using a total team
220.31 	approach consistent with assertive community treatment, or other
220.32 	evidence-based practices, and directed to recipients with a
220.33 	serious mental illness who require intensive services.
220.34 	(b) "Evidence-based practices" are nationally recognized
220.35 	mental health services that are proven by substantial research
220.36 	to be effective in helping individuals with serious mental
221.1 	illness obtain specific treatment goals.
221.2 	(c) "Treatment team" means all staff who provide services
221.3 	to recipients under this section.  At a minimum, this includes
221.4 	the clinical supervisor, mental health professionals, mental
221.5 	health practitioners, mental health behavioral aides, and a
221.6 	school representative familiar with the recipient's individual
221.7 	education plan (IEP) if applicable.
221.8 		Subd. 3.Eligibility for transitional youth. An eligible
221.9 	recipient under the age of 18 is an individual who:
221.10 	(1) is age 16 or 17;
221.11 	(2) is diagnosed with a medical condition, such as an
221.12 	emotional disturbance or traumatic brain injury, for which
221.13 	intensive nonresidential rehabilitative mental health services
221.14 	are needed;
221.15 	(3) has substantial disability and functional impairment in
221.16 	three or more of the areas listed in section 245.462,
221.17 	subdivision 11a, so that self-sufficiency upon adulthood or
221.18 	emancipation is unlikely; and 
221.19 	(4) has had a recent diagnostic assessment by a qualified
221.20 	professional that documents that intensive nonresidential
221.21 	rehabilitative mental health services are medically necessary to
221.22 	address identified disability and functional impairments and
221.23 	individual recipient goals.
221.24 		Subd. 4.Provider certification and contract
221.25 	requirements. (a) The intensive nonresidential rehabilitative
221.26 	mental health services provider must:
221.27 	(1) have a contract with the host county to provide
221.28 	intensive transition youth rehabilitative mental health
221.29 	services; and 
221.30 	(2) be certified by the commissioner as being in compliance
221.31 	with this section and section 256B.0943.
221.32 	(b) The commissioner shall develop procedures for counties
221.33 	and providers to submit contracts and other documentation as
221.34 	needed to allow the commissioner to determine whether the
221.35 	standards in this section are met.
221.36 		Subd. 5.Standards applicable to nonresidential
222.1 	providers. (a) Services must be provided by a certified
222.2 	provider entity as defined in section 256B.0943, subdivision 4
222.3 	that meets the requirements in section 245B.0943, subdivisions 5
222.4 	and 6.
222.5 	(b) The clinical supervisor must be an active member of the
222.6 	treatment team.  The treatment team must meet with the clinical
222.7 	supervisor at least weekly to discuss recipients' progress and
222.8 	make rapid adjustments to meet recipients' needs.  The team
222.9 	meeting shall include recipient-specific case reviews and
222.10 	general treatment discussions among team members.
222.11 	Recipient-specific case reviews and planning must be documented
222.12 	in the individual recipient's treatment record.
222.13 	(c) Treatment staff must have prompt access in person or by
222.14 	telephone to a mental health practitioner or mental health
222.15 	professional.  The provider must have the capacity to promptly
222.16 	and appropriately respond to emergent needs and make any
222.17 	necessary staffing adjustments to assure the health and safety
222.18 	of recipients.
222.19 	(d) The initial functional assessment must be completed
222.20 	within ten days of intake and updated at least every three
222.21 	months or prior to discharge from the service, whichever comes
222.22 	first.
222.23 	(e) The initial individual treatment plan must be completed
222.24 	within ten days of intake and reviewed and updated at least
222.25 	monthly with the recipient.
222.26 		Subd. 6.Additional standards for nonresidential
222.27 	services. The standards in this subdivision apply to intensive
222.28 	nonresidential rehabilitative mental health services.
222.29 	(1) The treatment team must use team treatment, not an
222.30 	individual treatment model.
222.31 	(2) The clinical supervisor must function as a practicing
222.32 	clinician at least on a part-time basis.
222.33 	(3) The staffing ratio must not exceed ten recipients to
222.34 	one full-time equivalent treatment team position.
222.35 	(4) Services must be available at times that meet client
222.36 	needs.
223.1 	(5) The treatment team must actively and assertively engage
223.2 	and reach out to the recipient's family members and significant
223.3 	others, after obtaining the recipient's permission.
223.4 	(6) The treatment team must establish ongoing communication
223.5 	and collaboration between the team, family, and significant
223.6 	others and educate the family and significant others about
223.7 	mental illness, symptom management, and the family's role in
223.8 	treatment.
223.9 	(7) The treatment team must provide interventions to
223.10 	promote positive interpersonal relationships.
223.11 		Subd. 7.Medical assistance payment for intensive
223.12 	rehabilitative mental health services. (a) Payment for
223.13 	nonresidential services in this section shall be based on one
223.14 	daily rate per provider inclusive of the following services
223.15 	received by an eligible recipient in a given calendar day: all
223.16 	rehabilitative services under this section, staff travel time to
223.17 	provide rehabilitative services under this section, and
223.18 	nonresidential crisis stabilization services under section
223.19 	256B.0944.
223.20 	(b) Except as indicated in paragraph (c), payment will not
223.21 	be made to more than one entity for each recipient for services
223.22 	provided under this section on a given day.  If services under
223.23 	this section are provided by a team that includes staff from
223.24 	more than one entity, the team must determine how to distribute
223.25 	the payment among the members.
223.26 	(c) The host county shall recommend to the commissioner one
223.27 	rate for each entity that will bill medical assistance for
223.28 	nonresidential intensive rehabilitative mental health services.
223.29 	In developing these rates, the host county shall consider and
223.30 	document:
223.31 	(1) the cost for similar services in the local trade area;
223.32 	(2) actual costs incurred by entities providing the
223.33 	services;
223.34 	(3) the intensity and frequency of services to be provided
223.35 	to each recipient;
223.36 	(4) the degree to which recipients will receive services
224.1 	other than services under this section; and 
224.2 	(5) the costs of other services that will be separately
224.3 	reimbursed.
224.4 	(d) The rate for intensive rehabilitative mental health
224.5 	services must exclude medical assistance room and board rate, as
224.6 	defined in section 256I.03, subdivision 6, and services not
224.7 	covered under this section, such as partial hospitalization and
224.8 	inpatient services.  Physician services are not a component of
224.9 	the treatment team and may be billed separately.  The county's
224.10 	recommendation shall specify the period for which the rate will
224.11 	be applicable, not to exceed two years.
224.12 	(e) When services under this section are provided by an
224.13 	assertive community team, case management functions must be an
224.14 	integral part of the team.
224.15 	(f) The rate for a provider must not exceed the rate
224.16 	charged by that provider for the same service to other payors.
224.17 	(g) The commissioner shall approve or reject the county's
224.18 	rate recommendation, based on the commissioner's own analysis of
224.19 	the criteria in paragraph (c).
224.20 		Subd. 9.Provider enrollment; rate setting for
224.21 	county-operated entities. Counties that employ their own staff
224.22 	to provide services under this section shall apply directly to
224.23 	the commissioner for enrollment and rate setting.  In this case,
224.24 	a county contract is not required and the commissioner shall
224.25 	perform the program review and rate setting duties which would
224.26 	otherwise be required of counties under this section.
224.27 	
EFFECTIVE DATE. This section is effective July 1, 2006.

224.28 	Sec. 18. Minnesota Statutes 2004, section 256B.19,
224.29 	subdivision 1, is amended to read:
224.30 		Subdivision 1.Division of cost.  The state and county
224.31 	share of medical assistance costs not paid by federal funds
224.32 	shall be as follows:
224.33 	(1) beginning January 1, 1992, 50 percent state funds and
224.34 	50 percent county funds for the cost of placement of severely
224.35 	emotionally disturbed children in regional treatment centers;
224.36 	(2) beginning January 1, 2003, 80 percent state funds and
225.1 	20 percent county funds for the costs of nursing facility
225.2 	placements of persons with disabilities under the age of 65 that
225.3 	have exceeded 90 days.  This clause shall be subject to chapter
225.4 	256G and shall not apply to placements in facilities not
225.5 	certified to participate in medical assistance;
225.6 	(3) beginning July 1, 2004, 80 percent state funds and 20
225.7 	percent county funds for the costs of placements that have
225.8 	exceeded 90 days in intermediate care facilities for persons
225.9 	with mental retardation or a related condition that have seven
225.10 	or more beds.  This provision includes pass-through payments
225.11 	made under section 256B.5015; and 
225.12 	(4) beginning July 1, 2004, when state funds are used to
225.13 	pay for a nursing facility placement due to the facility's
225.14 	status as an institution for mental diseases (IMD), the county
225.15 	shall pay 20 percent of the nonfederal share of costs that have
225.16 	exceeded 90 days.  This clause is subject to chapter 256G; and 
225.17 	(5) beginning July 1, 2006, 50 percent state funds and 50
225.18 	percent county funds for the cost of treatment foster care
225.19 	services under section 256B.0946.
225.20 	For counties that participate in a Medicaid demonstration
225.21 	project under sections 256B.69 and 256B.71, the division of the
225.22 	nonfederal share of medical assistance expenses for payments
225.23 	made to prepaid health plans or for payments made to health
225.24 	maintenance organizations in the form of prepaid capitation
225.25 	payments, this division of medical assistance expenses shall be
225.26 	95 percent by the state and five percent by the county of
225.27 	financial responsibility.
225.28 	In counties where prepaid health plans are under contract
225.29 	to the commissioner to provide services to medical assistance
225.30 	recipients, the cost of court ordered treatment ordered without
225.31 	consulting the prepaid health plan that does not include
225.32 	diagnostic evaluation, recommendation, and referral for
225.33 	treatment by the prepaid health plan is the responsibility of
225.34 	the county of financial responsibility.

225.35 	Sec. 19. Minnesota Statutes 2004, section 256D.03,
225.36 	subdivision 4, is amended to read:
226.1 		Subd. 4.General assistance medical care; services.
 226.2 	(a)(i) For a person who is eligible under subdivision 3,
226.3 	paragraph (a), clause (2), item (i), general assistance medical
226.4 	care covers, except as provided in paragraph (c):
226.5 	(1) inpatient hospital services;
226.6 	(2) outpatient hospital services;
226.7 	(3) services provided by Medicare certified rehabilitation
226.8 	agencies;
226.9 	(4) prescription drugs and other products recommended
226.10 	through the process established in section 256B.0625,
226.11 	subdivision 13;
226.12 	(5) equipment necessary to administer insulin and
226.13 	diagnostic supplies and equipment for diabetics to monitor blood
226.14 	sugar level;
226.15 	(6) eyeglasses and eye examinations provided by a physician
226.16 	or optometrist;
226.17 	(7) hearing aids;
226.18 	(8) prosthetic devices;
226.19 	(9) laboratory and X-ray services;
226.20 	(10) physician's services;
226.21 	(11) medical transportation except special transportation;
226.22 	(12) chiropractic services as covered under the medical
226.23 	assistance program;
226.24 	(13) podiatric services;
226.25 	(14) dental services and dentures, subject to the
226.26 	limitations specified in section 256B.0625, subdivision 9;
226.27 	(15) outpatient services provided by a mental health center
226.28 	or clinic that is under contract with the county board and is
226.29 	established under section 245.62;
226.30 	(16) day treatment services for mental illness provided
226.31 	under contract with the county board;
226.32 	(17) prescribed medications for persons who have been
226.33 	diagnosed as mentally ill as necessary to prevent more
226.34 	restrictive institutionalization;
226.35 	(18) psychological services, medical supplies and
226.36 	equipment, and Medicare premiums, coinsurance and deductible
227.1 	payments;
227.2 	(19) medical equipment not specifically listed in this
227.3 	paragraph when the use of the equipment will prevent the need
227.4 	for costlier services that are reimbursable under this
227.5 	subdivision;
227.6 	(20) services performed by a certified pediatric nurse
227.7 	practitioner, a certified family nurse practitioner, a certified
227.8 	adult nurse practitioner, a certified obstetric/gynecological
227.9 	nurse practitioner, a certified neonatal nurse practitioner, or
227.10 	a certified geriatric nurse practitioner in independent
227.11 	practice, if (1) the service is otherwise covered under this
227.12 	chapter as a physician service, (2) the service provided on an
227.13 	inpatient basis is not included as part of the cost for
227.14 	inpatient services included in the operating payment rate, and
227.15 	(3) the service is within the scope of practice of the nurse
227.16 	practitioner's license as a registered nurse, as defined in
227.17 	section 148.171;
227.18 	(21) services of a certified public health nurse or a
227.19 	registered nurse practicing in a public health nursing clinic
227.20 	that is a department of, or that operates under the direct
227.21 	authority of, a unit of government, if the service is within the
227.22 	scope of practice of the public health nurse's license as a
227.23 	registered nurse, as defined in section 148.171; and 
227.24 	(22) telemedicine consultations, to the extent they are
227.25 	covered under section 256B.0625, subdivision 3b; and 
227.26 	(23) mental health telemedicine and psychiatric
227.27 	consultation as covered under section 256B.0625, subdivisions 46
227.28 	and 48.
227.29 	(ii) Effective October 1, 2003, for a person who is
227.30 	eligible under subdivision 3, paragraph (a), clause (2), item
227.31 	(ii), general assistance medical care coverage is limited to
227.32 	inpatient hospital services, including physician services
227.33 	provided during the inpatient hospital stay.  A $1,000
227.34 	deductible is required for each inpatient hospitalization.
227.35 	(b) Gender reassignment surgery and related services are
227.36 	not covered services under this subdivision unless the
228.1 	individual began receiving gender reassignment services prior to
228.2 	July 1, 1995.
228.3 	(c) In order to contain costs, the commissioner of human
228.4 	services shall select vendors of medical care who can provide
228.5 	the most economical care consistent with high medical standards
228.6 	and shall where possible contract with organizations on a
228.7 	prepaid capitation basis to provide these services.  The
228.8 	commissioner shall consider proposals by counties and vendors
228.9 	for prepaid health plans, competitive bidding programs, block
228.10 	grants, or other vendor payment mechanisms designed to provide
228.11 	services in an economical manner or to control utilization, with
228.12 	safeguards to ensure that necessary services are provided.
228.13 	Before implementing prepaid programs in counties with a county
228.14 	operated or affiliated public teaching hospital or a hospital or
228.15 	clinic operated by the University of Minnesota, the commissioner
228.16 	shall consider the risks the prepaid program creates for the
228.17 	hospital and allow the county or hospital the opportunity to
228.18 	participate in the program in a manner that reflects the risk of
228.19 	adverse selection and the nature of the patients served by the
228.20 	hospital, provided the terms of participation in the program are
228.21 	competitive with the terms of other participants considering the
228.22 	nature of the population served.  Payment for services provided
228.23 	pursuant to this subdivision shall be as provided to medical
228.24 	assistance vendors of these services under sections 256B.02,
228.25 	subdivision 8, and 256B.0625.  For payments made during fiscal
228.26 	year 1990 and later years, the commissioner shall consult with
228.27 	an independent actuary in establishing prepayment rates, but
228.28 	shall retain final control over the rate methodology.
228.29 	(d) Recipients eligible under subdivision 3, paragraph (a),
228.30 	clause (2), item (i), shall pay the following co-payments for
228.31 	services provided on or after October 1, 2003:
228.32 	(1) $3 per nonpreventive visit.  For purposes of this
228.33 	subdivision, a visit means an episode of service which is
228.34 	required because of a recipient's symptoms, diagnosis, or
228.35 	established illness, and which is delivered in an ambulatory
228.36 	setting by a physician or physician ancillary, chiropractor,
229.1 	podiatrist, nurse midwife, advanced practice nurse, audiologist,
229.2 	optician, or optometrist;
229.3 	(2) $25 for eyeglasses;
229.4 	(3) $25 for nonemergency visits to a hospital-based
229.5 	emergency room;
229.6 	(4) $3 per brand-name drug prescription and $1 per generic
229.7 	drug prescription, subject to a $20 per month maximum for
229.8 	prescription drug co-payments.  No co-payments shall apply to
229.9 	antipsychotic drugs when used for the treatment of mental
229.10 	illness; and
229.11 	(5) 50 percent coinsurance on restorative dental services.
229.12 	(e) Co-payments shall be limited to one per day per
229.13 	provider for nonpreventive visits, eyeglasses, and nonemergency
229.14 	visits to a hospital-based emergency room.  Recipients of
229.15 	general assistance medical care are responsible for all
229.16 	co-payments in this subdivision.  The general assistance medical
229.17 	care reimbursement to the provider shall be reduced by the
229.18 	amount of the co-payment, except that reimbursement for
229.19 	prescription drugs shall not be reduced once a recipient has
229.20 	reached the $20 per month maximum for prescription drug
229.21 	co-payments.  The provider collects the co-payment from the
229.22 	recipient.  Providers may not deny services to recipients who
229.23 	are unable to pay the co-payment, except as provided in
229.24 	paragraph (f).
229.25 	(f) If it is the routine business practice of a provider to
229.26 	refuse service to an individual with uncollected debt, the
229.27 	provider may include uncollected co-payments under this
229.28 	section.  A provider must give advance notice to a recipient
229.29 	with uncollected debt before services can be denied.
229.30 	(g) Any county may, from its own resources, provide medical
229.31 	payments for which state payments are not made.
229.32 	(h) Chemical dependency services that are reimbursed under
229.33 	chapter 254B must not be reimbursed under general assistance
229.34 	medical care.
229.35 	(i) The maximum payment for new vendors enrolled in the
229.36 	general assistance medical care program after the base year
230.1 	shall be determined from the average usual and customary charge
230.2 	of the same vendor type enrolled in the base year.
230.3 	(j) The conditions of payment for services under this
230.4 	subdivision are the same as the conditions specified in rules
230.5 	adopted under chapter 256B governing the medical assistance
230.6 	program, unless otherwise provided by statute or rule.
230.7 	(k) Inpatient and outpatient payments shall be reduced by
230.8 	five percent, effective July 1, 2003.  This reduction is in
230.9 	addition to the five percent reduction effective July 1, 2003,
230.10 	and incorporated by reference in paragraph (i).
230.11 	(l) Payments for all other health services except
230.12 	inpatient, outpatient, and pharmacy services shall be reduced by
230.13 	five percent, effective July 1, 2003.
230.14 	(m) Payments to managed care plans shall be reduced by five
230.15 	percent for services provided on or after October 1, 2003.
230.16 	(n) A hospital receiving a reduced payment as a result of
230.17 	this section may apply the unpaid balance toward satisfaction of
230.18 	the hospital's bad debts.
230.19 	
EFFECTIVE DATE. This section is effective January 1, 2006.

230.20 	Sec. 20. Minnesota Statutes 2004, section 256D.44,
230.21 	subdivision 5, is amended to read:
230.22 		Subd. 5.Special needs.  In addition to the state
230.23 	standards of assistance established in subdivisions 1 to 4,
230.24 	payments are allowed for the following special needs of
230.25 	recipients of Minnesota supplemental aid who are not residents
230.26 	of a nursing home, a regional treatment center, or a group
230.27 	residential housing facility.
230.28 	(a) The county agency shall pay a monthly allowance for
230.29 	medically prescribed diets if the cost of those additional
230.30 	dietary needs cannot be met through some other maintenance
230.31 	benefit.  The need for special diets or dietary items must be
230.32 	prescribed by a licensed physician.  Costs for special diets
230.33 	shall be determined as percentages of the allotment for a
230.34 	one-person household under the thrifty food plan as defined by
230.35 	the United States Department of Agriculture.  The types of diets
230.36 	and the percentages of the thrifty food plan that are covered
231.1 	are as follows:
231.2 	(1) high protein diet, at least 80 grams daily, 25 percent
231.3 	of thrifty food plan;
231.4 	(2) controlled protein diet, 40 to 60 grams and requires
231.5 	special products, 100 percent of thrifty food plan;
231.6 	(3) controlled protein diet, less than 40 grams and
231.7 	requires special products, 125 percent of thrifty food plan;
231.8 	(4) low cholesterol diet, 25 percent of thrifty food plan;
231.9 	(5) high residue diet, 20 percent of thrifty food plan;
231.10 	(6) pregnancy and lactation diet, 35 percent of thrifty
231.11 	food plan;
231.12 	(7) gluten-free diet, 25 percent of thrifty food plan;
231.13 	(8) lactose-free diet, 25 percent of thrifty food plan;
231.14 	(9) antidumping diet, 15 percent of thrifty food plan;
231.15 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
231.16 	(11) ketogenic diet, 25 percent of thrifty food plan.
231.17 	(b) Payment for nonrecurring special needs must be allowed
231.18 	for necessary home repairs or necessary repairs or replacement
231.19 	of household furniture and appliances using the payment standard
231.20 	of the AFDC program in effect on July 16, 1996, for these
231.21 	expenses, as long as other funding sources are not available.
231.22 	(c) A fee for guardian or conservator service is allowed at
231.23 	a reasonable rate negotiated by the county or approved by the
231.24 	court.  This rate shall not exceed five percent of the
231.25 	assistance unit's gross monthly income up to a maximum of $100
231.26 	per month.  If the guardian or conservator is a member of the
231.27 	county agency staff, no fee is allowed.
231.28 	(d) The county agency shall continue to pay a monthly
231.29 	allowance of $68 for restaurant meals for a person who was
231.30 	receiving a restaurant meal allowance on June 1, 1990, and who
231.31 	eats two or more meals in a restaurant daily.  The allowance
231.32 	must continue until the person has not received Minnesota
231.33 	supplemental aid for one full calendar month or until the
231.34 	person's living arrangement changes and the person no longer
231.35 	meets the criteria for the restaurant meal allowance, whichever
231.36 	occurs first.
232.1 	(e) A fee of ten percent of the recipient's gross income or
232.2 	$25, whichever is less, is allowed for representative payee
232.3 	services provided by an agency that meets the requirements under
232.4 	SSI regulations to charge a fee for representative payee
232.5 	services.  This special need is available to all recipients of
232.6 	Minnesota supplemental aid regardless of their living
232.7 	arrangement.
232.8 	(f) Notwithstanding the language in this subdivision, an
232.9 	amount equal to the maximum allotment authorized by the federal
232.10 	Food Stamp Program for a single individual which is in effect on
232.11 	the first day of January of the previous year will be added to
232.12 	the standards of assistance established in subdivisions 1 to 4
232.13 	for individuals under the age of 65 who are relocating from an
232.14 	institution, or an adult mental health residential treatment
232.15 	program under section 256B.0622,and who are shelter needy.  An
232.16 	eligible individual who receives this benefit prior to age 65
232.17 	may continue to receive the benefit after the age of 65.
232.18 	"Shelter needy" means that the assistance unit incurs
232.19 	monthly shelter costs that exceed 40 percent of the assistance
232.20 	unit's gross income before the application of this special needs
232.21 	standard.  "Gross income" for the purposes of this section is
232.22 	the applicant's or recipient's income as defined in section
232.23 	256D.35, subdivision 10, or the standard specified in
232.24 	subdivision 3, whichever is greater.  A recipient of a federal
232.25 	or state housing subsidy, that limits shelter costs to a
232.26 	percentage of gross income, shall not be considered shelter
232.27 	needy for purposes of this paragraph.

232.28 	Sec. 21. Minnesota Statutes 2004, section 256L.03,
232.29 	subdivision 1, is amended to read:
232.30 		Subdivision 1.Covered health services.  For individuals
232.31 	under section 256L.04, subdivision 7, with income no greater
232.32 	than 75 percent of the federal poverty guidelines or for
232.33 	families with children under section 256L.04, subdivision 1, all
232.34 	subdivisions of this section apply.  "Covered health services"
232.35 	means the health services reimbursed under chapter 256B, with
232.36 	the exception of inpatient hospital services, special education
233.1 	services, private duty nursing services, adult dental care
233.2 	services other than services covered under section 256B.0625,
233.3 	subdivision 9, paragraph (b), orthodontic services, nonemergency
233.4 	medical transportation services, personal care assistant and
233.5 	case management services, nursing home or intermediate care
233.6 	facilities services, inpatient mental health services, and
233.7 	chemical dependency services.  Outpatient mental health services
233.8 	covered under the MinnesotaCare program are limited to
233.9 	diagnostic assessments, psychological testing, explanation of
233.10 	findings, mental health telemedicine, psychiatric consultation,
233.11 	medication management by a physician, day treatment, partial
233.12 	hospitalization, and individual, family, and group psychotherapy.
233.13 	No public funds shall be used for coverage of abortion
233.14 	under MinnesotaCare except where the life of the female would be
233.15 	endangered or substantial and irreversible impairment of a major
233.16 	bodily function would result if the fetus were carried to term;
233.17 	or where the pregnancy is the result of rape or incest.
233.18 	Covered health services shall be expanded as provided in
233.19 	this section.
233.20 	
EFFECTIVE DATE. This section is effective January 1, 2006.

233.21 	Sec. 22. [641.155] DISCHARGE PLANS; OFFENDERS WITH
233.22 	SERIOUS AND PERSISTENT MENTAL ILLNESS.
233.23 	The commissioner of corrections shall develop a model
233.24 	discharge planning process for every offender with a serious and
233.25 	persistent mental illness, as defined in section 245.462,
233.26 	subdivision 20, paragraph (c), who has been convicted and
233.27 	sentenced to serve three or more months and is being released
233.28 	from a county jail or county regional jail.
233.29 	An offender with a serious and persistent mental illness,
233.30 	as defined in section 245.462, subdivision 20, paragraph (c),
233.31 	who has been convicted and sentenced to serve three or more
233.32 	months and is being released from a county jail or county
233.33 	regional jail shall be referred to the appropriate staff in the
233.34 	county human services department at least 60 days before being
233.35 	released.  The county human services department may carry out
233.36 	provisions of the model discharge planning process such as:
234.1 	(1) providing assistance in filling out an application for
234.2 	medical assistance, general assistance medical care, or
234.3 	MinnesotaCare;
234.4 	(2) making a referral for case management as outlined under
234.5 	section 245.467, subdivision 4;
234.6 	(3) providing assistance in obtaining a state photo
234.7 	identification;
234.8 	(4) securing a timely appointment with a psychiatrist or
234.9 	other appropriate community mental health providers; and 
234.10 	(5) providing prescriptions for a 30-day supply of all
234.11 	necessary medications.

234.12 	Sec. 23. PRIORITY IN JANITORIAL CONTRACTS.
 234.13 	When awarding contracts to provide the janitorial services
234.14 	for the new Department of Human Services and Department of
234.15 	Health buildings, the commissioner of administration shall give
234.16 	priority to supported work vendors.

234.17 	ARTICLE 6
234.18 	FAMILY SUPPORT

234.19 	Section 1. Minnesota Statutes 2004, section 119B.011, is
234.20 	amended by adding a subdivision to read:
234.21 		Subd. 23.Work participation rate enhancement
234.22 	program. "Work participation rate enhancement program" means
234.23 	the program established under section 256J.575.

234.24 	Sec. 2. Minnesota Statutes 2004, section 119B.05,
234.25 	subdivision 1, is amended to read:
234.26 		Subdivision 1.Eligible participants.  Families eligible
234.27 	for child care assistance under the MFIP child care program are:
234.28 	(1) MFIP participants who are employed or in job search and
234.29 	meet the requirements of section 119B.10;
234.30 	(2) persons who are members of transition year families
234.31 	under section 119B.011, subdivision 20, and meet the
234.32 	requirements of section 119B.10;
234.33 	(3) families who are participating in employment
234.34 	orientation or job search, or other employment or training
234.35 	activities that are included in an approved employability
234.36 	development plan under section 256J.95;
235.1 	(4) MFIP families who are participating in work job search,
235.2 	job support, employment, or training activities as required in
235.3 	their employment plan, or in appeals, hearings, assessments, or
235.4 	orientations according to chapter 256J;
235.5 	(5) MFIP families who are participating in social services
235.6 	activities under chapter 256J as required in their employment
235.7 	plan approved according to chapter 256J;
235.8 	(6) families who are participating in services or
235.9 	activities that are included in an approved family stabilization
235.10 	plan under section 256J.575;
235.11 	(7) families who are participating in programs as required
235.12 	in tribal contracts under section 119B.02, subdivision 2, or
235.13 	256.01, subdivision 2; and
235.14 	(7) (8) families who are participating in the transition
235.15 	year extension under section 119B.011, subdivision 20a.

235.16 	Sec. 3. Minnesota Statutes 2004, section 252.27,
235.17 	subdivision 2a, is amended to read:
235.18 		Subd. 2a.Contribution amount.  (a) The natural or
235.19 	adoptive parents of a minor child, including a child determined
235.20 	eligible for medical assistance without consideration of
235.21 	parental income, must contribute to the cost of services used by
235.22 	making monthly payments on a sliding scale based on income,
235.23 	unless the child is married or has been married, parental rights
235.24 	have been terminated, or the child's adoption is subsidized
235.25 	according to section 259.67 or through title IV-E of the Social
235.26 	Security Act.
235.27 	(b) For households with adjusted gross income equal to or
235.28 	greater than 100 percent of federal poverty guidelines, the
235.29 	parental contribution shall be computed by applying the
235.30 	following schedule of rates to the adjusted gross income of the
235.31 	natural or adoptive parents:
235.32 	(1) if the adjusted gross income is equal to or greater
235.33 	than 100 percent of federal poverty guidelines and less than 175
235.34 	percent of federal poverty guidelines, the parental contribution
235.35 	is $4 per month;
235.36 	(2) if the adjusted gross income is equal to or greater
236.1 	than 175 percent of the federal poverty guidelines and less than
236.2 	or equal to 200 percent of the federal poverty guidelines, the
236.3 	parental contribution shall be one percent of the adjusted gross
236.4 	income;
236.5 	(3) if the adjusted gross income is equal to or greater
236.6 	than 175 200 percent of federal poverty guidelines and less than
236.7 	or equal to 375 420 percent of federal poverty guidelines, the
236.8 	parental contribution shall be determined using a sliding fee
236.9 	scale established by the commissioner of human services which
236.10 	begins at one percent of adjusted gross income at 175 200 
236.11 	percent of federal poverty guidelines and increases to 7.5
236.12 	percent of adjusted gross income for those with adjusted gross
236.13 	income up to 375 420 percent of federal poverty guidelines;
236.14 	(3) (4) if the adjusted gross income is greater than 375 
236.15 	420 percent of federal poverty guidelines and less than 675
236.16 	percent of federal poverty guidelines, the parental contribution
236.17 	shall be 7.5 percent of adjusted gross income;
236.18 	(4) (5) if the adjusted gross income is equal to or greater
236.19 	than 675 percent of federal poverty guidelines and less than 975
236.20 	percent of federal poverty guidelines, the parental contribution
236.21 	shall be ten percent of adjusted gross income; and
236.22 	(5) (6) if the adjusted gross income is equal to or greater
236.23 	than 975 percent of federal poverty guidelines, the parental
236.24 	contribution shall be 12.5 percent of adjusted gross income.
236.25 	If the child lives with the parent, the annual adjusted
236.26 	gross income is reduced by $2,400 prior to calculating the
236.27 	parental contribution.  If the child resides in an institution
236.28 	specified in section 256B.35, the parent is responsible for the
236.29 	personal needs allowance specified under that section in
236.30 	addition to the parental contribution determined under this
236.31 	section.  The parental contribution is reduced by any amount
236.32 	required to be paid directly to the child pursuant to a court
236.33 	order, but only if actually paid.
236.34 	(c) The household size to be used in determining the amount
236.35 	of contribution under paragraph (b) includes natural and
236.36 	adoptive parents and their dependents, including the child
237.1 	receiving services.  Adjustments in the contribution amount due
237.2 	to annual changes in the federal poverty guidelines shall be
237.3 	implemented on the first day of July following publication of
237.4 	the changes.
237.5 	(d) For purposes of paragraph (b), "income" means the
237.6 	adjusted gross income of the natural or adoptive parents
237.7 	determined according to the previous year's federal tax form,
237.8 	except, effective retroactive to July 1, 2003, taxable capital
237.9 	gains to the extent the funds have been used to purchase a
237.10 	home and funds from early withdrawn qualified retirement
237.11 	accounts under the Internal Revenue Code shall not be counted as
237.12 	income.
237.13 	(e) The contribution shall be explained in writing to the
237.14 	parents at the time eligibility for services is being
237.15 	determined.  The contribution shall be made on a monthly basis
237.16 	effective with the first month in which the child receives
237.17 	services.  Annually upon redetermination or at termination of
237.18 	eligibility, if the contribution exceeded the cost of services
237.19 	provided, the local agency or the state shall reimburse that
237.20 	excess amount to the parents, either by direct reimbursement if
237.21 	the parent is no longer required to pay a contribution, or by a
237.22 	reduction in or waiver of parental fees until the excess amount
237.23 	is exhausted.
237.24 	(f) The monthly contribution amount must be reviewed at
237.25 	least every 12 months; when there is a change in household size;
237.26 	and when there is a loss of or gain in income from one month to
237.27 	another in excess of ten percent.  The local agency shall mail a
237.28 	written notice 30 days in advance of the effective date of a
237.29 	change in the contribution amount.  A decrease in the
237.30 	contribution amount is effective in the month that the parent
237.31 	verifies a reduction in income or change in household size.
237.32 	(g) Parents of a minor child who do not live with each
237.33 	other shall each pay the contribution required under paragraph
237.34 	(a).  An amount equal to the annual , except that a court-ordered
237.35 	child support payment actually paid on behalf of the child
237.36 	receiving services shall be deducted from the adjusted gross
238.1 	income contribution of the parent making the payment prior to
238.2 	calculating the parental contribution under paragraph (b).
238.3 	(h) The contribution under paragraph (b) shall be increased
238.4 	by an additional five percent if the local agency determines
238.5 	that insurance coverage is available but not obtained for the
238.6 	child.  For purposes of this section, "available" means the
238.7 	insurance is a benefit of employment for a family member at an
238.8 	annual cost of no more than five percent of the family's annual
238.9 	income.  For purposes of this section, "insurance" means health
238.10 	and accident insurance coverage, enrollment in a nonprofit
238.11 	health service plan, health maintenance organization,
238.12 	self-insured plan, or preferred provider organization.
238.13 	Parents who have more than one child receiving services
238.14 	shall not be required to pay more than the amount for the child
238.15 	with the highest expenditures.  There shall be no resource
238.16 	contribution from the parents.  The parent shall not be required
238.17 	to pay a contribution in excess of the cost of the services
238.18 	provided to the child, not counting payments made to school
238.19 	districts for education-related services.  Notice of an increase
238.20 	in fee payment must be given at least 30 days before the
238.21 	increased fee is due.
238.22 	(i) The contribution under paragraph (b) shall be reduced
238.23 	by $300 per fiscal year if, in the 12 months prior to July 1:
238.24 	(1) the parent applied for insurance for the child;
238.25 	(2) the insurer denied insurance;
238.26 	(3) the parents submitted a complaint or appeal, in writing
238.27 	to the insurer, submitted a complaint or appeal, in writing, to
238.28 	the commissioner of health or the commissioner of commerce, or
238.29 	litigated the complaint or appeal; and
238.30 	(4) as a result of the dispute, the insurer reversed its
238.31 	decision and granted insurance.
238.32 	For purposes of this section, "insurance" has the meaning
238.33 	given in paragraph (h).
238.34 	A parent who has requested a reduction in the contribution
238.35 	amount under this paragraph shall submit proof in the form and
238.36 	manner prescribed by the commissioner or county agency,
239.1 	including, but not limited to, the insurer's denial of
239.2 	insurance, the written letter or complaint of the parents, court
239.3 	documents, and the written response of the insurer approving
239.4 	insurance.  The determinations of the commissioner or county
239.5 	agency under this paragraph are not rules subject to chapter 14.

239.6 	Sec. 4. Minnesota Statutes 2004, section 256.01, is
239.7 	amended by adding a subdivision to read:
239.8 		Subd. 14b.American indian child welfare projects. (a)
239.9 	The commissioner of human services may authorize projects to
239.10 	test tribal delivery of child welfare services to American
239.11 	Indian children and their parents and custodians living on the
239.12 	reservation.  The commissioner has authority to solicit and
239.13 	determine which tribes may participate in a project.  Grants may
239.14 	be issued to Minnesota Indian tribes to support the projects.
239.15 	The commissioner may waive existing state rules as needed to
239.16 	accomplish the projects.  Notwithstanding section 626.556, the
239.17 	commissioner may authorize projects to use alternative methods
239.18 	of investigating and assessing reports of child maltreatment,
239.19 	provided that the projects comply with the provisions of section
239.20 	626.556 dealing with the rights of individuals who are subjects
239.21 	of reports or investigations, including notice and appeal rights
239.22 	and data practices requirements.  The commissioner may seek any
239.23 	federal approvals necessary to carry out the projects as well as
239.24 	seek and use any funds available to the commissioner, including
239.25 	use of federal funds, foundation funds, existing grant funds,
239.26 	and other funds.  The commissioner is authorized to advance
239.27 	state funds as necessary to operate the projects.  Federal
239.28 	reimbursement applicable to the projects is appropriated to the
239.29 	commissioner for the purposes of the projects.  The projects
239.30 	must be required to address responsibility for safety,
239.31 	permanency, and well-being of children.
239.32 	(b) For the purposes of this section, "American Indian
239.33 	child" means a person from birth to 18 years of age who is a
239.34 	tribal member or eligible for membership in one of the tribes
239.35 	chosen for the project under this subdivision and who is
239.36 	residing on the reservation of that tribe.
240.1 	(c) In order to qualify for an American Indian child
240.2 	welfare project, a tribe must:
240.3 	(1) be one of the existing tribes with reservation land in
240.4 	Minnesota;
240.5 	(2) have a tribal court with jurisdiction over child
240.6 	custody proceedings;
240.7 	(3) have a substantial number of children for whom
240.8 	determinations of maltreatment have occurred;
240.9 	(4) have capacity to respond to reports of abuse and
240.10 	neglect under section 626.556;
240.11 	(5) provide a wide range of services to families in need of
240.12 	child welfare services; and 
240.13 	(6) have a tribal-state title IV-E agreement in effect.
240.14 	(d) Grants awarded under this section may be used for the
240.15 	nonfederal costs of providing child welfare services to American
240.16 	Indian children on the tribe's reservation, including costs
240.17 	associated with:
240.18 	(1) assessment and prevention of child abuse and neglect;
240.19 	(2) family preservation;
240.20 	(3) facilitative, supportive, and reunification services;
240.21 	(4) out-of-home placement for children removed from the
240.22 	home for child protective purposes; and 
240.23 	(5) other activities and services approved by the
240.24 	commissioner that further the goals of providing safety,
240.25 	permanency, and well-being of American Indian children.
240.26 	(e) When a tribe has initiated a project and has been
240.27 	approved by the commissioner to assume child welfare
240.28 	responsibilities for American Indian children of that tribe
240.29 	under this section, the affected county social service agency is
240.30 	relieved of responsibility for responding to reports of abuse
240.31 	and neglect under section 626.556 for those children during the
240.32 	time the tribal project is in effect and receiving funding for
240.33 	the project.  The commissioner shall work with tribes and
240.34 	affected counties to develop procedures for data collection,
240.35 	evaluation, and clarification of the ongoing role and financial
240.36 	responsibilities of the county and tribe for child welfare
241.1 	services prior to initiation of the project.  Children who have
241.2 	not been identified by the tribe as participating in the project
241.3 	shall remain the responsibility of the county.  Nothing in this
241.4 	section changes the responsibilities of the county law
241.5 	enforcement agency or court services.
241.6 	(f) The commissioner shall collect information on outcomes
241.7 	relating to child safety, permanency, and well-being of American
241.8 	Indian children who are served in the projects.  Participating
241.9 	tribes must provide information to the state in a format deemed
241.10 	acceptable by the state to meet state and federal reporting
241.11 	requirements.
241.12 	(g) For counties with tribes participating in the American
241.13 	Indian Child Welfare Project, five percent of the total cost of
241.14 	the nonfederal share is to be paid by the county.

241.15 	Sec. 5. Minnesota Statutes 2004, section 256J.021, is
241.16 	amended to read:
241.17 	256J.021 SEPARATE STATE PROGRAM PROGRAMS FOR USE OF STATE
241.18 	MONEY.
241.19 	(a) Beginning October 1, 2001, and each year thereafter,
241.20 	the commissioner of human services must treat MFIP expenditures
241.21 	made to or on behalf of any minor child under section 256J.02,
241.22 	subdivision 2, clause (1), who is a resident of this state under
241.23 	section 256J.12, and who is part of a two-parent eligible
241.24 	household as expenditures under a separately funded state
241.25 	program and report those expenditures to the federal Department
241.26 	of Health and Human Services as separate state program
241.27 	expenditures under Code of Federal Regulations, title 45,
241.28 	section 263.5.
241.29 	(b) Beginning October 1, 2005, and each year thereafter,
241.30 	the commissioner of human services must treat MFIP expenditures
241.31 	made to or on behalf of any minor child under section 256J.02,
241.32 	subdivision 2, clause (1), who is a resident of this state under
241.33 	section 256J.12, and who is part of a household participating in
241.34 	the work participation rate enhancement program under section
241.35 	256J.575 as expenditures under a separately funded state program
241.36 	and report those expenditures to the federal Department of
242.1 	Health and Human Services as separate state program expenditures
242.2 	under Code of Federal Regulations, title 45, section 263.5.

242.3 	Sec. 6. Minnesota Statutes 2004, section 256J.08,
242.4 	subdivision 65, is amended to read:
242.5 		Subd. 65.Participant.  "Participant" means a person who
242.6 	is currently receiving cash assistance or the food portion
242.7 	available through MFIP.  A person who fails to withdraw or
242.8 	access electronically any portion of the person's cash and food
242.9 	assistance payment by the end of the payment month, who makes a
242.10 	written request for closure before the first of a payment month
242.11 	and repays cash and food assistance electronically issued for
242.12 	that payment month within that payment month, or who returns any
242.13 	uncashed assistance check and food coupons and withdraws from
242.14 	the program is not a participant.  A person who withdraws a cash
242.15 	or food assistance payment by electronic transfer or receives
242.16 	and cashes an MFIP assistance check or food coupons and is
242.17 	subsequently determined to be ineligible for assistance for that
242.18 	period of time is a participant, regardless whether that
242.19 	assistance is repaid.  The term "participant" includes the
242.20 	caregiver relative and the minor child whose needs are included
242.21 	in the assistance payment.  A person in an assistance unit who
242.22 	does not receive a cash and food assistance payment because the
242.23 	case has been suspended from MFIP is a participant.  A person
242.24 	who receives cash payments under the diversionary work program
242.25 	under section 256J.95 is a participant. A person who receives
242.26 	cash payments under the work participation rate enhancement
242.27 	program under section 256J.575 is a participant.

242.28 	Sec. 7. Minnesota Statutes 2004, section 256J.21,
242.29 	subdivision 2, is amended to read:
242.30 		Subd. 2.Income exclusions.  The following must be
242.31 	excluded in determining a family's available income:
242.32 	(1) payments for basic care, difficulty of care, and
242.33 	clothing allowances received for providing family foster care to
242.34 	children or adults under Minnesota Rules, parts 9545.0010 to
242.35 	9545.0260 and 9555.5050 to 9555.6265, and payments received and
242.36 	used for care and maintenance of a third-party beneficiary who
243.1 	is not a household member;
243.2 	(2) reimbursements for employment training received through
243.3 	the Workforce Investment Act of 1998, United States Code, title
243.4 	20, chapter 73, section 9201;
243.5 	(3) reimbursement for out-of-pocket expenses incurred while
243.6 	performing volunteer services, jury duty, employment, or
243.7 	informal carpooling arrangements directly related to employment;
243.8 	(4) all educational assistance, except the county agency
243.9 	must count graduate student teaching assistantships,
243.10 	fellowships, and other similar paid work as earned income and,
243.11 	after allowing deductions for any unmet and necessary
243.12 	educational expenses, shall count scholarships or grants awarded
243.13 	to graduate students that do not require teaching or research as
243.14 	unearned income;
243.15 	(5) loans, regardless of purpose, from public or private
243.16 	lending institutions, governmental lending institutions, or
243.17 	governmental agencies;
243.18 	(6) loans from private individuals, regardless of purpose,
243.19 	provided an applicant or participant documents that the lender
243.20 	expects repayment;
243.21 	(7)(i) state income tax refunds; and
243.22 	(ii) federal income tax refunds;
243.23 	(8)(i) federal earned income credits;
243.24 	(ii) Minnesota working family credits;
243.25 	(iii) state homeowners and renters credits under chapter
243.26 	290A; and
243.27 	(iv) federal or state tax rebates;
243.28 	(9) funds received for reimbursement, replacement, or
243.29 	rebate of personal or real property when these payments are made
243.30 	by public agencies, awarded by a court, solicited through public
243.31 	appeal, or made as a grant by a federal agency, state or local
243.32 	government, or disaster assistance organizations, subsequent to
243.33 	a presidential declaration of disaster;
243.34 	(10) the portion of an insurance settlement that is used to
243.35 	pay medical, funeral, and burial expenses, or to repair or
243.36 	replace insured property;
244.1 	(11) reimbursements for medical expenses that cannot be
244.2 	paid by medical assistance;
244.3 	(12) payments by a vocational rehabilitation program
244.4 	administered by the state under chapter 268A, except those
244.5 	payments that are for current living expenses;
244.6 	(13) in-kind income, including any payments directly made
244.7 	by a third party to a provider of goods and services;
244.8 	(14) assistance payments to correct underpayments, but only
244.9 	for the month in which the payment is received;
244.10 	(15) payments for short-term emergency needs under section
244.11 	256J.626, subdivision 2;
244.12 	(16) funeral and cemetery payments as provided by section
244.13 	256.935;
244.14 	(17) nonrecurring cash gifts of $30 or less, not exceeding
244.15 	$30 per participant in a calendar month;
244.16 	(18) any form of energy assistance payment made through
244.17 	Public Law 97-35, Low-Income Home Energy Assistance Act of 1981,
244.18 	payments made directly to energy providers by other public and
244.19 	private agencies, and any form of credit or rebate payment
244.20 	issued by energy providers;
244.21 	(19) Supplemental Security Income (SSI), including
244.22 	retroactive SSI payments and other income of an SSI recipient,
244.23 	except as described in section 256J.37, subdivision 3b;
244.24 	(20) Minnesota supplemental aid, including retroactive
244.25 	payments;
244.26 	(21) proceeds from the sale of real or personal property;
244.27 	(22) state adoption assistance payments under section
244.28 	259.67, and up to an equal amount of county adoption assistance
244.29 	payments;
244.30 	(23) state-funded family subsidy program payments made
244.31 	under section 252.32 to help families care for children with
244.32 	mental retardation or related conditions, consumer support grant
244.33 	funds under section 256.476, and resources and services for a
244.34 	disabled household member under one of the home and
244.35 	community-based waiver services programs under chapter 256B;
244.36 	(24) interest payments and dividends from property that is
245.1 	not excluded from and that does not exceed the asset limit;
245.2 	(25) rent rebates;
245.3 	(26) income earned by a minor caregiver, minor child
245.4 	through age 6, or a minor child who is at least a half-time
245.5 	student in an approved elementary or secondary education
245.6 	program;
245.7 	(27) income earned by a caregiver under age 20 who is at
245.8 	least a half-time student in an approved elementary or secondary
245.9 	education program;
245.10 	(28) MFIP child care payments under section 119B.05;
245.11 	(29) all other payments made through MFIP to support a
245.12 	caregiver's pursuit of greater economic stability;
245.13 	(30) income a participant receives related to shared living
245.14 	expenses;
245.15 	(31) reverse mortgages;
245.16 	(32) benefits provided by the Child Nutrition Act of 1966,
245.17 	United States Code, title 42, chapter 13A, sections 1771 to
245.18 	1790;
245.19 	(33) benefits provided by the women, infants, and children
245.20 	(WIC) nutrition program, United States Code, title 42, chapter
245.21 	13A, section 1786;
245.22 	(34) benefits from the National School Lunch Act, United
245.23 	States Code, title 42, chapter 13, sections 1751 to 1769e;
245.24 	(35) relocation assistance for displaced persons under the
245.25 	Uniform Relocation Assistance and Real Property Acquisition
245.26 	Policies Act of 1970, United States Code, title 42, chapter 61,
245.27 	subchapter II, section 4636, or the National Housing Act, United
245.28 	States Code, title 12, chapter 13, sections 1701 to 1750jj;
245.29 	(36) benefits from the Trade Act of 1974, United States
245.30 	Code, title 19, chapter 12, part 2, sections 2271 to 2322;
245.31 	(37) war reparations payments to Japanese Americans and
245.32 	Aleuts under United States Code, title 50, sections 1989 to
245.33 	1989d;
245.34 	(38) payments to veterans or their dependents as a result
245.35 	of legal settlements regarding Agent Orange or other chemical
245.36 	exposure under Public Law 101-239, section 10405, paragraph
246.1 	(a)(2)(E);
246.2 	(39) income that is otherwise specifically excluded from
246.3 	MFIP consideration in federal law, state law, or federal
246.4 	regulation;
246.5 	(40) security and utility deposit refunds;
246.6 	(41) American Indian tribal land settlements excluded under
246.7 	Public Laws 98-123, 98-124, and 99-377 to the Mississippi Band
246.8 	Chippewa Indians of White Earth, Leech Lake, and Mille Lacs
246.9 	reservations and payments to members of the White Earth Band,
246.10 	under United States Code, title 25, chapter 9, section 331, and
246.11 	chapter 16, section 1407;
246.12 	(42) all income of the minor parent's parents and
246.13 	stepparents when determining the grant for the minor parent in
246.14 	households that include a minor parent living with parents or
246.15 	stepparents on MFIP with other children;
246.16 	(43) income of the minor parent's parents and stepparents
246.17 	equal to 200 percent of the federal poverty guideline for a
246.18 	family size not including the minor parent and the minor
246.19 	parent's child in households that include a minor parent living
246.20 	with parents or stepparents not on MFIP when determining the
246.21 	grant for the minor parent.  The remainder of income is deemed
246.22 	as specified in section 256J.37, subdivision 1b;
246.23 	(44) payments made to children eligible for relative
246.24 	custody assistance under section 257.85;
246.25 	(45) vendor payments for goods and services made on behalf
246.26 	of a client unless the client has the option of receiving the
246.27 	payment in cash; and
246.28 	(46) the principal portion of a contract for deed payment.

246.29 	Sec. 8. Minnesota Statutes 2004, section 256J.39, is
246.30 	amended by adding a subdivision to read:
246.31 		Subd. 1a.Prohibited purchases. MFIP recipients are
246.32 	prohibited from using MFIP monthly cash assistance payments
246.33 	issued in the form of an electronic benefits transfer to
246.34 	purchase tobacco products or alcohol.

246.35 	Sec. 9. Minnesota Statutes 2004, section 256J.521,
246.36 	subdivision 1, is amended to read:
247.1 		Subdivision 1.Assessments.  (a) For purposes of MFIP
247.2 	employment services, assessment is a continuing process of
247.3 	gathering information related to employability for the purpose
247.4 	of identifying both participant's strengths and strategies for
247.5 	coping with issues that interfere with employment.  The job
247.6 	counselor must use information from the assessment process to
247.7 	develop and update the employment plan under subdivision 2 or 3,
247.8 	as appropriate, and to determine whether the participant
247.9 	qualifies for a family violence waiver including an employment
247.10 	plan under subdivision 3, and to determine whether the
247.11 	participant should be referred to the work participation rate
247.12 	enhancement program under section 256J.575.
247.13 	(b) The scope of assessment must cover at least the
247.14 	following areas:
247.15 	(1) basic information about the participant's ability to
247.16 	obtain and retain employment, including:  a review of the
247.17 	participant's education level; interests, skills, and abilities;
247.18 	prior employment or work experience; transferable work skills;
247.19 	child care and transportation needs;
247.20 	(2) identification of personal and family circumstances
247.21 	that impact the participant's ability to obtain and retain
247.22 	employment, including:  any special needs of the children, the
247.23 	level of English proficiency, family violence issues, and any
247.24 	involvement with social services or the legal system;
247.25 	(3) the results of a mental and chemical health screening
247.26 	tool designed by the commissioner and results of the brief
247.27 	screening tool for special learning needs.  Screening tools for
247.28 	mental and chemical health and special learning needs must be
247.29 	approved by the commissioner and may only be administered by job
247.30 	counselors or county staff trained in using such screening
247.31 	tools.  The commissioner shall work with county agencies to
247.32 	develop protocols for referrals and follow-up actions after
247.33 	screens are administered to participants, including guidance on
247.34 	how employment plans may be modified based upon outcomes of
247.35 	certain screens.  Participants must be told of the purpose of
247.36 	the screens and how the information will be used to assist the
248.1 	participant in identifying and overcoming barriers to
248.2 	employment.  Screening for mental and chemical health and
248.3 	special learning needs must be completed by participants who are
248.4 	unable to find suitable employment after six weeks of job search
248.5 	under subdivision 2, paragraph (b), and participants who are
248.6 	determined to have barriers to employment under subdivision 2,
248.7 	paragraph (d).  Failure to complete the screens will result in
248.8 	sanction under section 256J.46; and
248.9 	(4) a comprehensive review of participation and progress
248.10 	for participants who have received MFIP assistance and have not
248.11 	worked in unsubsidized employment during the past 12 months.
248.12 	The purpose of the review is to determine the need for
248.13 	additional services and supports, including placement in
248.14 	subsidized employment or unpaid work experience under section
248.15 	256J.49, subdivision 13, or referral to the work participation
248.16 	rate enhancement program under section 256J.575.
248.17 	(c) Information gathered during a caregiver's participation
248.18 	in the diversionary work program under section 256J.95 must be
248.19 	incorporated into the assessment process.
248.20 	(d) The job counselor may require the participant to
248.21 	complete a professional chemical use assessment to be performed
248.22 	according to the rules adopted under section 254A.03,
248.23 	subdivision 3, including provisions in the administrative rules
248.24 	which recognize the cultural background of the participant, or a
248.25 	professional psychological assessment as a component of the
248.26 	assessment process, when the job counselor has a reasonable
248.27 	belief, based on objective evidence, that a participant's
248.28 	ability to obtain and retain suitable employment is impaired by
248.29 	a medical condition.  The job counselor may assist the
248.30 	participant with arranging services, including child care
248.31 	assistance and transportation, necessary to meet needs
248.32 	identified by the assessment.  Data gathered as part of a
248.33 	professional assessment must be classified and disclosed
248.34 	according to the provisions in section 13.46.

248.35 	Sec. 10. Minnesota Statutes 2004, section 256J.53,
248.36 	subdivision 2, is amended to read:
249.1 		Subd. 2.Approval of postsecondary education or
249.2 	training.  (a) In order for a postsecondary education or
249.3 	training program to be an approved activity in an employment
249.4 	plan, the participant must be working in unsubsidized employment
249.5 	at least 20 ten hours per week.
249.6 	(b) Participants seeking approval of a postsecondary
249.7 	education or training plan must provide documentation that:
249.8 	(1) the employment goal can only be met with the additional
249.9 	education or training;
249.10 	(2) there are suitable employment opportunities that
249.11 	require the specific education or training in the area in which
249.12 	the participant resides or is willing to reside;
249.13 	(3) the education or training will result in significantly
249.14 	higher wages for the participant than the participant could earn
249.15 	without the education or training;
249.16 	(4) the participant can meet the requirements for admission
249.17 	into the program; and
249.18 	(5) there is a reasonable expectation that the participant
249.19 	will complete the training program based on such factors as the
249.20 	participant's MFIP assessment, previous education, training, and
249.21 	work history; current motivation; and changes in previous
249.22 	circumstances.
249.23 	(c) The hourly unsubsidized employment requirement does not
249.24 	apply for intensive education or training programs lasting 12
249.25 	weeks or less when full-time attendance is required.
249.26 	(d) Participants with an approved employment plan in place
249.27 	on July 1, 2003, which includes more than 12 months of
249.28 	postsecondary education or training shall be allowed to complete
249.29 	that plan provided that hourly requirements in section 256J.55,
249.30 	subdivision 1, and conditions specified in paragraph (b), and
249.31 	subdivisions 3 and 5 are met.  A participant whose case is
249.32 	subsequently closed for three months or less for reasons other
249.33 	than noncompliance with program requirements and who returns to
249.34 	MFIP shall be allowed to complete that plan provided that hourly
249.35 	requirements in section 256J.55, subdivision 1, and conditions
249.36 	specified in paragraph (b) and subdivisions 3 and 5 are met.

250.1 	Sec. 11. [256J.575] WORK PARTICIPATION RATE ENHANCEMENT
250.2 	PROGRAM.
250.3 		Subdivision 1.Purpose. (a) The work participation rate
250.4 	enhancement program (WORK PREP) is Minnesota's TANF program to
250.5 	serve families who are not making significant progress within
250.6 	MFIP due to a variety of barriers to employment.
250.7 	(b) The goal of this program is to stabilize and improve
250.8 	the lives of families at risk of long-term welfare dependency or
250.9 	family instability due to employment barriers such as physical
250.10 	disability, mental disability, age, and caring for a disabled
250.11 	household member.  WORK PREP provides services to promote and
250.12 	support families to achieve the greatest possible degree of
250.13 	self-sufficiency.  Counties may provide supportive and other
250.14 	allowable services funded by the MFIP consolidated fund under
250.15 	section 256J.626 to eligible participants.
250.16 		Subd. 2.Definitions. The terms used in this section
250.17 	have the meanings given them in paragraphs (a) to (d).
250.18 	(a) The "work participation rate enhancement program" means
250.19 	the program established under this section.
250.20 	(b) "Case management" means the services provided by or
250.21 	through the county agency to participating families, including
250.22 	assessment, information, referrals, and assistance in the
250.23 	preparation and implementation of a family stabilization plan
250.24 	under subdivision 5.
250.25 	(c) "Family stabilization plan" means a plan developed by a
250.26 	case manager and the participant, which identifies the
250.27 	participant's most appropriate path to unsubsidized employment,
250.28 	family stability, and barrier reduction, taking into account the
250.29 	family's circumstances.
250.30 	(d) "Family stabilization services" means programs,
250.31 	activities, and services in this section that provide
250.32 	participants and their family members with assistance regarding,
250.33 	but not limited to:
250.34 	(1) obtaining and retaining unsubsidized employment;
250.35 	(2) family stability;
250.36 	(3) economic stability; and 
251.1 	(4) barrier reduction.
251.2 	The goal of the program is to achieve the greatest degree
251.3 	of economic self-sufficiency and family well-being possible for
251.4 	the family under the circumstances.
251.5 		Subd. 3.Eligibility. (a) The following MFIP or DWP
251.6 	participants are eligible for the program under this section:
251.7 	(1) a participant identified under section 256J.561,
251.8 	subdivision 2, paragraph (d), who has or is eligible for an
251.9 	employment plan developed under section 256J.521, subdivision 2,
251.10 	paragraph (c);
251.11 	(2) a participant identified under section 256J.95,
251.12 	subdivision 12, paragraph (b), as unlikely to benefit from the
251.13 	diversionary work program;
251.14 	(3) a participant who meets the requirements for or has
251.15 	been granted a hardship extension under section 256J.425,
251.16 	subdivision 2 or 3; and 
251.17 	(4) a participant who is applying for supplemental security
251.18 	income or Social Security disability insurance.
251.19 	(b) Families must meet all other eligibility requirements
251.20 	for MFIP established in this chapter.  Families are eligible for
251.21 	financial assistance to the same extent as if they were
251.22 	participating in MFIP.
251.23 		Subd. 4.Universal participation. All caregivers must
251.24 	participate in family stabilization services as defined in
251.25 	subdivision 2.
251.26 		Subd. 5.Case management; family stabilization plans;
251.27 	coordinated services. (a) The county agency shall provide
251.28 	family stabilization services to families through a case
251.29 	management model.  A case manager shall be assigned to each
251.30 	participating family within 30 days after the family begins to
251.31 	receive financial assistance as a participant of the work
251.32 	participation rate enhancement program.  The case manager, with
251.33 	the full involvement of the family, shall recommend, and the
251.34 	county agency shall establish and modify as necessary, a family
251.35 	stabilization plan for each participating family.
251.36 	(b) The family stabilization plan shall include:
252.1 	(1) each participant's plan for long-term self-sufficiency,
252.2 	including an employment goal where applicable;
252.3 	(2) an assessment of each participant's strengths and
252.4 	barriers, and any special circumstances of the participant's
252.5 	family that impact, or are likely to impact, the participant's
252.6 	progress towards the goals in the plan; and 
252.7 	(3) an identification of the services, supports, education,
252.8 	training, and accommodations needed to overcome any barriers to
252.9 	enable the family to achieve self-sufficiency and to fulfill
252.10 	each caregiver's personal and family responsibilities.
252.11 	(c) The case manager and the participant must meet within
252.12 	30 days of the family's referral to the case manager.  The
252.13 	initial family stabilization plan shall be completed within 30
252.14 	days of the first meeting with the case manager.  The case
252.15 	manager shall establish a schedule for periodic review of the
252.16 	family stabilization plan that includes personal contact with
252.17 	the participant at least once per month.  In addition, the case
252.18 	manager shall review and modify if necessary the plan under the
252.19 	following circumstances:
252.20 	(1) there is a lack of satisfactory progress in achieving
252.21 	the goals of the plan;
252.22 	(2) the participant has lost unsubsidized or subsidized
252.23 	employment;
252.24 	(3) a family member has failed to comply with a family
252.25 	stabilization plan requirement;
252.26 	(4) services required by the plan are unavailable; or 
252.27 	(5) changes to the plan are needed to promote the
252.28 	well-being of the children.
252.29 	(d) Family stabilization plans under this section shall be
252.30 	written for a period of time not to exceed six months.
252.31 		Subd. 6.Cooperation with program requirements. (a) To
252.32 	be eligible, a participant must comply with paragraphs (b) to
252.33 	(f).
252.34 	(b) Participants shall engage in family stabilization plan
252.35 	activities listed in clause (1) or (2) for the number of hours
252.36 	per week that the activities are scheduled and available, unless
253.1 	good cause exists for not doing so, as defined in section
253.2 	256J.57, subdivision 1:
253.3 	(1) in single-parent families with no children under six
253.4 	years of age, the case manager and the participant must develop
253.5 	a family stabilization plan that includes 30 to 35 hours per
253.6 	week of activities; and 
253.7 	(2) in single-parent families with a child under six years
253.8 	of age, the case manager and the participant must develop a
253.9 	family stabilization plan that includes 20 to 35 hours per week
253.10 	of activities.
253.11 	(c) The case manager shall review the participant's
253.12 	progress toward the goals in the family stabilization plan every
253.13 	six months to determine whether conditions have changed,
253.14 	including whether revisions to the plan are needed.
253.15 	(d) When the participant has increased participation in
253.16 	work-related activities sufficient to meet the federal
253.17 	participation requirements of TANF, the county agency shall
253.18 	refer the participant to the MFIP program and assign the
253.19 	participant to a job counselor.  The participant and the job
253.20 	counselor must meet within 15 days of referral to MFIP to
253.21 	develop an employment plan under section 256J.521.  No
253.22 	reapplication is necessary and financial assistance shall
253.23 	continue without interruption.
253.24 	(e) Participants who have not increased their participation
253.25 	in work activities sufficient to meet the federal participation
253.26 	requirements of TANF may request a referral to the MFIP program
253.27 	and assignment to a job counselor after 12 months in the program.
253.28 	(f) A participant's requirement to comply with any or all
253.29 	family stabilization plan requirements under this subdivision
253.30 	shall be excused when the case management services, training and
253.31 	educational services, and family support services identified in
253.32 	the participant's family stabilization plan are unavailable for
253.33 	reasons beyond the control of the participant, including when
253.34 	money appropriated is not sufficient to provide the services.
253.35 		Subd. 7.Sanctions. (a) The financial assistance grant
253.36 	of a participating family shall be reduced, according to section
254.1 	256J.46, if a participating adult fails without good cause to
254.2 	comply or continue to comply with the family stabilization plan
254.3 	requirements in this subdivision, unless compliance has been
254.4 	excused under subdivision 6, paragraph (f).
254.5 	(b) Given the purpose of the work participation rate
254.6 	enhancement program in this section and the nature of the
254.7 	underlying family circumstances that act as barriers to both
254.8 	employment and full compliance with program requirements,
254.9 	sanctions are appropriate only when it is clear that there is
254.10 	both ability to comply and willful noncompliance on the part of
254.11 	the participant.
254.12 	(c) Prior to the imposition of a sanction, the county
254.13 	agency must review the participant's case to determine if the
254.14 	family stabilization plan is still appropriate and meet with the
254.15 	participants face-to-face.  The participant may bring an
254.16 	advocate to the face-to-face meeting.  If a face-to-face meeting
254.17 	is not conducted, the county agency must send the participant a
254.18 	written notice that includes the information required under
254.19 	clause (1):
254.20 	(1) during the face-to-face meeting, the county agency must:
254.21 	(i) determine whether the continued noncompliance can be
254.22 	explained and mitigated by providing a needed family
254.23 	stabilization service, as defined in subdivision 2, paragraph
254.24 	(d);
254.25 	(ii) determine whether the participant qualifies for a good
254.26 	cause exception under section 256J.57, or if the sanction is for
254.27 	noncooperation with child support requirements, determine if the
254.28 	participant qualifies for a good cause exemption under section
254.29 	256.741, subdivision 10;
254.30 	(iii) determine whether activities in the family
254.31 	stabilization plan are appropriate based on the family's
254.32 	circumstances;
254.33 	(iv) explain the consequences of continuing noncompliance;
254.34 	(v) identify other resources that may be available to the
254.35 	participant to meet the needs of the family; and 
254.36 	(vi) inform the participant of the right to appeal under
255.1 	section 256J.40; and 
255.2 	(2) if the lack of an identified activity or service can
255.3 	explain the noncompliance, the county must work with the
255.4 	participant to provide the identified activity.
255.5 	(d) After the requirements of paragraph (c) are met and
255.6 	prior to imposition of a sanction, the county agency shall
255.7 	provide a notice of intent to sanction under section 256J.57,
255.8 	subdivision 2, and, when applicable, a notice of adverse action
255.9 	as provided in section 256J.31.
255.10 	(e) Section 256J.57 applies to this section except to the
255.11 	extent that it is modified by this subdivision.

255.12 	Sec. 12. [256J.621] WORK PARTICIPATION BONUS.
255.13 	Upon exiting the diversionary work program (DWP) or upon
255.14 	terminating MFIP cash assistance with earnings, a participant
255.15 	who is employed and working 24 hours a week may be eligible for
255.16 	transitional assistance of $50 per month to assist in meeting
255.17 	the family's basic needs as the participant continues to move
255.18 	toward self-sufficiency.
255.19 	To be eligible for a transitional assistance payment, the
255.20 	participant must not receive MFIP cash assistance or
255.21 	diversionary work program assistance during the month and must
255.22 	be employed an average of at least 24 hours a week.
255.23 	Transitional assistance shall be available for a maximum of 12
255.24 	months from the date the participant exited the diversionary
255.25 	work program or terminated MFIP cash assistance.
255.26 	The commissioner shall establish policies and develop forms
255.27 	to verify eligibility for transitional assistance.  The forms
255.28 	must contain all data elements required to meet federal TANF
255.29 	reporting requirements.
255.30 	Expenditures on the transitional assistance program shall
255.31 	be state-funded and treated as segregated funds under the
255.32 	state's TANF maintenance of effort requirement.  Months in which
255.33 	a participant receives transitional assistance under this
255.34 	section shall not count toward the participant's MFIP 60-month
255.35 	time limit.
255.36 	This section shall take effect if federal law changes the
256.1 	TANF work participation rates that states must meet and the
256.2 	commissioner determines that implementation of this program will
256.3 	enhance Minnesota's TANF work participation rates.

256.4 	Sec. 13. Minnesota Statutes 2004, section 256J.626,
256.5 	subdivision 1, is amended to read:
256.6 		Subdivision 1.Consolidated fund.  The consolidated fund
256.7 	is established to support counties and tribes in meeting their
256.8 	duties under this chapter.  Counties and tribes must use funds
256.9 	from the consolidated fund to develop programs and services that
256.10 	are designed to improve participant outcomes as measured in
256.11 	section 256J.751, subdivision 2, and to provide case management
256.12 	services to participants of the work participation rate
256.13 	enhancement program.  Counties may use the funds for any
256.14 	allowable expenditures under subdivision 2.  Tribes may use the
256.15 	funds for any allowable expenditures under subdivision 2, except
256.16 	those in clauses (1) and (6).

256.17 	Sec. 14. Minnesota Statutes 2004, section 256J.626,
256.18 	subdivision 2, is amended to read:
256.19 		Subd. 2.Allowable expenditures.  (a) The commissioner
256.20 	must restrict expenditures under the consolidated fund to
256.21 	benefits and services allowed under title IV-A of the federal
256.22 	Social Security Act.  Allowable expenditures under the
256.23 	consolidated fund may include, but are not limited to:
256.24 	(1) short-term, nonrecurring shelter and utility needs that
256.25 	are excluded from the definition of assistance under Code of
256.26 	Federal Regulations, title 45, section 260.31, for families who
256.27 	meet the residency requirement in section 256J.12, subdivisions
256.28 	1 and 1a.  Payments under this subdivision are not considered
256.29 	TANF cash assistance and are not counted towards the 60-month
256.30 	time limit;
256.31 	(2) transportation needed to obtain or retain employment or
256.32 	to participate in other approved work activities or activities
256.33 	under a family stabilization plan;
256.34 	(3) direct and administrative costs of staff to deliver
256.35 	employment services for MFIP or ,the diversionary work
256.36 	program, or the work participation rate enhancement program;to
257.1 	administer financial assistance,;and to provide specialized
257.2 	services intended to assist hard-to-employ participants to
257.3 	transition to work or transition from the work participation
257.4 	rate enhancement program to MFIP;
257.5 	(4) costs of education and training including functional
257.6 	work literacy and English as a second language;
257.7 	(5) cost of work supports including tools, clothing, boots,
257.8 	and other work-related expenses;
257.9 	(6) county administrative expenses as defined in Code of
257.10 	Federal Regulations, title 45, section 260(b);
257.11 	(7) services to parenting and pregnant teens;
257.12 	(8) supported work;
257.13 	(9) wage subsidies;
257.14 	(10) child care needed for MFIP or , the diversionary work
257.15 	program, or the work participation rate enhancement program 
257.16 	participants to participate in social services;
257.17 	(11) child care to ensure that families leaving MFIP or
257.18 	diversionary work program will continue to receive child care
257.19 	assistance from the time the family no longer qualifies for
257.20 	transition year child care until an opening occurs under the
257.21 	basic sliding fee child care program; and 
257.22 	(12) services to help noncustodial parents who live in
257.23 	Minnesota and have minor children receiving MFIP or DWP
257.24 	assistance, but do not live in the same household as the child,
257.25 	obtain or retain employment; and 
257.26 	(13) services to help families participating in the work
257.27 	participation rate enhancement program achieve the greatest
257.28 	possible degree of self-sufficiency.
257.29 	(b) Administrative costs that are not matched with county
257.30 	funds as provided in subdivision 8 may not exceed 7.5 percent of
257.31 	a county's or 15 percent of a tribe's allocation under this
257.32 	section.  The commissioner shall define administrative costs for
257.33 	purposes of this subdivision.

257.34 	Sec. 15. Minnesota Statutes 2004, section 256J.626,
257.35 	subdivision 3, is amended to read:
257.36 		Subd. 3.Eligibility for services.  Families with a minor
258.1 	child, a pregnant woman, or a noncustodial parent of a minor
258.2 	child receiving assistance, with incomes below 200 percent of
258.3 	the federal poverty guideline for a family of the applicable
258.4 	size, are eligible for services funded under the consolidated
258.5 	fund.  Counties and tribes must give priority to families
258.6 	currently receiving MFIP or , the diversionary work program, or
258.7 	the work participation rate enhancement program,and families at
258.8 	risk of receiving MFIP or diversionary work program.

258.9 	Sec. 16. Minnesota Statutes 2004, section 256J.626,
258.10 	subdivision 4, is amended to read:
258.11 		Subd. 4.County and tribal biennial service agreements.
 258.12 	(a) Effective January 1, 2004, and each two-year period
258.13 	thereafter, each county and tribe must have in place an approved
258.14 	biennial service agreement related to the services and programs
258.15 	in this chapter.  In counties with a city of the first class
258.16 	with a population over 300,000, the county must consider a
258.17 	service agreement that includes a jointly developed plan for the
258.18 	delivery of employment services with the city.  Counties may
258.19 	collaborate to develop multicounty, multitribal, or regional
258.20 	service agreements.
258.21 	(b) The service agreements will be completed in a form
258.22 	prescribed by the commissioner.  The agreement must include:
258.23 	(1) a statement of the needs of the service population and
258.24 	strengths and resources in the community;
258.25 	(2) numerical goals for participant outcomes measures to be
258.26 	accomplished during the biennial period.  The commissioner may
258.27 	identify outcomes from section 256J.751, subdivision 2, as core
258.28 	outcomes for all counties and tribes;
258.29 	(3) strategies the county or tribe will pursue to achieve
258.30 	the outcome targets.  Strategies must include specification of
258.31 	how funds under this section will be used and may include
258.32 	community partnerships that will be established or strengthened;
258.33 	and 
258.34 	(4) strategies the county or tribe will pursue under the
258.35 	work participation rate enhancement program; and 
258.36 	(5) other items prescribed by the commissioner in
259.1 	consultation with counties and tribes.
259.2 	(c) The commissioner shall provide each county and tribe
259.3 	with information needed to complete an agreement, including:
259.4 	(1) information on MFIP cases in the county or tribe; (2)
259.5 	comparisons with the rest of the state; (3) baseline performance
259.6 	on outcome measures; and (4) promising program practices.
259.7 	(d) The service agreement must be submitted to the
259.8 	commissioner by October 15, 2003, and October 15 of each second
259.9 	year thereafter.  The county or tribe must allow a period of not
259.10 	less than 30 days prior to the submission of the agreement to
259.11 	solicit comments from the public on the contents of the
259.12 	agreement.
259.13 	(e) The commissioner must, within 60 days of receiving each
259.14 	county or tribal service agreement, inform the county or tribe
259.15 	if the service agreement is approved.  If the service agreement
259.16 	is not approved, the commissioner must inform the county or
259.17 	tribe of any revisions needed prior to approval.
259.18 	(f) The service agreement in this subdivision supersedes
259.19 	the plan requirements of section 116L.88.

259.20 	Sec. 17. Minnesota Statutes 2004, section 256J.626,
259.21 	subdivision 7, is amended to read:
259.22 		Subd. 7.Performance base funds.  (a) Beginning calendar
259.23 	year 2005, each county and tribe will be allocated 95 100 
259.24 	percent of their initial calendar year allocation.  Counties and
259.25 	tribes will be allocated additional funds from federal TANF
259.26 	bonus funds the state receives based on performance as follows:
259.27 	(1) for calendar year 2005, a county or tribe that achieves
259.28 	a 30 percent rate or higher on the MFIP participation rate under
259.29 	section 256J.751, subdivision 2, clause (8), as averaged across
259.30 	the four quarterly measurements for the most recent year for
259.31 	which the measurements are available, will receive an additional
259.32 	allocation equal to 2.5 percent of its initial allocation to be
259.33 	determined by the commissioner based upon available funds; and
259.34 	(2) for calendar year 2006, a county or tribe that achieves
259.35 	a 40 percent rate or a five percentage point improvement over
259.36 	the previous year's MFIP participation rate under section
260.1 	256J.751, subdivision 2, clause (8), as averaged across the four
260.2 	quarterly measurements for the most recent year for which the
260.3 	measurements are available, will receive an additional
260.4 	allocation equal to 2.5 percent of its initial allocation to be
260.5 	determined by the commissioner based upon available funds; and
260.6 	(3) for calendar year 2007, a county or tribe that achieves
260.7 	a 50 percent rate or a five percentage point improvement over
260.8 	the previous year's MFIP participation rate under section
260.9 	256J.751, subdivision 2, clause (8), as averaged across the four
260.10 	quarterly measurements for the most recent year for which the
260.11 	measurements are available, will receive an additional
260.12 	allocation equal to 2.5 percent of its initial allocation to be
260.13 	determined by the commissioner based upon available funds; and
260.14 	(4) for calendar year 2008 and yearly thereafter, a county
260.15 	or tribe that achieves a 50 percent MFIP participation rate
260.16 	under section 256J.751, subdivision 2, clause (8), as averaged
260.17 	across the four quarterly measurements for the most recent year
260.18 	for which the measurements are available, will receive an
260.19 	additional allocation equal to 2.5 percent of its initial
260.20 	allocation to be determined by the commissioner based upon
260.21 	available funds; and
260.22 	(5) for calendar years 2005 and thereafter, a county or
260.23 	tribe that performs above the top of its range of expected
260.24 	performance on the three-year self-support index under section
260.25 	256J.751, subdivision 2, clause (7), in both measurements in the
260.26 	preceding year will receive an additional allocation equal to
260.27 	five percent of its initial allocation to be determined by the
260.28 	commissioner based upon available funds; or
260.29 	(6) for calendar years 2005 and thereafter, a county or
260.30 	tribe that performs within its range of expected performance on
260.31 	the three-year self-support index under section 256J.751,
260.32 	subdivision 2, clause (7), in both measurements in the preceding
260.33 	year, or above the top of its range of expected performance in
260.34 	one measurement and within its expected range of performance in
260.35 	the other measurement, will receive an additional allocation
260.36 	equal to 2.5 percent of its initial allocation to be determined
261.1 	by the commissioner based upon available funds.
261.2 	(b) Funds remaining unallocated after the performance-based
261.3 	allocations in paragraph (a) are available to the commissioner
261.4 	for innovation projects under subdivision 5.
261.5 	(c)(1) If available funds are insufficient to meet county
261.6 	and tribal allocations under paragraph (a), the commissioner may
261.7 	make available for allocation funds that are unobligated and
261.8 	available from the innovation projects through the end of the
261.9 	current biennium.
261.10 	(2) If after the application of clause (1) funds remain
261.11 	insufficient to meet county and tribal allocations under
261.12 	paragraph (a), the commissioner must proportionally reduce the
261.13 	allocation of each county and tribe with respect to their
261.14 	maximum allocation available under paragraph (a).

261.15 	Sec. 18. Minnesota Statutes 2004, section 256J.95,
261.16 	subdivision 3, is amended to read:
261.17 		Subd. 3.Eligibility for diversionary work program.  (a)
261.18 	Except for the categories of family units listed below, all
261.19 	family units who apply for cash benefits and who meet MFIP
261.20 	eligibility as required in sections 256J.11 to 256J.15 are
261.21 	eligible and must participate in the diversionary work program.
261.22 	Family units that are not eligible for the diversionary work
261.23 	program include:
261.24 	(1) child only cases;
261.25 	(2) a single-parent family unit that includes a child under
261.26 	12 weeks of age.  A parent is eligible for this exception once
261.27 	in a parent's lifetime and is not eligible if the parent has
261.28 	already used the previously allowed child under age one
261.29 	exemption from MFIP employment services;
261.30 	(3) a minor parent without a high school diploma or its
261.31 	equivalent;
261.32 	(4) an 18- or 19-year-old caregiver without a high school
261.33 	diploma or its equivalent who chooses to have an employment plan
261.34 	with an education option;
261.35 	(5) a caregiver age 60 or over;
261.36 	(6) family units with a caregiver who received DWP benefits
262.1 	in the 12 months prior to the month the family applied for DWP,
262.2 	except as provided in paragraph (c);
262.3 	(7) family units with a caregiver who received MFIP within
262.4 	the 12 months prior to the month the family unit applied for
262.5 	DWP;
262.6 	(8) a family unit with a caregiver who received 60 or more
262.7 	months of TANF assistance; and
262.8 	(9) a family unit with a caregiver who is disqualified from
262.9 	DWP or MFIP due to fraud.
262.10 	(b) A two-parent family must participate in DWP unless both
262.11 	caregivers meet the criteria for an exception under paragraph
262.12 	(a), clauses (1) through (5), or the family unit includes a
262.13 	parent who meets the criteria in paragraph (a), clause (6), (7),
262.14 	(8), or (9).
262.15 	(c) Once DWP eligibility is determined, the four months run
262.16 	consecutively.  If a participant leaves the program for any
262.17 	reason and reapplies during the four-month period, the county
262.18 	must redetermine eligibility for DWP.
262.19 	(d) Newly arrived refugees and asylees as defined in Code
262.20 	of Federal Regulations, title 45, chapter IV, section 400.2, who
262.21 	have arrived in the United States within the last two months
262.22 	shall be exempt from mandatory participation in the diversionary
262.23 	work program and may enroll directly into the MFIP program.
262.24 	
EFFECTIVE DATE. This section is effective the day
262.25 	following final enactment.

262.26 	Sec. 19. Minnesota Statutes 2004, section 256J.95,
262.27 	subdivision 9, is amended to read:
262.28 		Subd. 9.Property and income limitations.  The asset
262.29 	limits and exclusions in section 256J.20 apply to applicants and
262.30 	recipients of DWP.  All payments, unless excluded in section
262.31 	256J.21, must be counted as income to determine eligibility for
262.32 	the diversionary work program.  The county shall treat income as
262.33 	outlined in section 256J.37, except for subdivision 3a.  The
262.34 	initial income test and the disregards in section 256J.21,
262.35 	subdivision 3, shall be followed for determining eligibility for
262.36 	the diversionary work program.

263.1 	Sec. 20. REPEALER.
 263.2 	Minnesota Statutes 2004, section 256J.37, subdivisions 3a
263.3 	and 3b, are repealed effective the first day of the second month
263.4 	after the date of approval by the United States Department of
263.5 	Agriculture.

263.6 	ARTICLE 7
263.7 	MISCELLANEOUS

263.8 	Section 1. [151.52] MANUFACTURER PRICE REPORT.
263.9 		Subdivision 1.Report. All drug manufacturers registered
263.10 	or licensed to do business in this state shall, on a quarterly
263.11 	basis, report by National Drug Code the following pharmaceutical
263.12 	pricing criteria to the commissioner of human services for each
263.13 	of their drugs:  average wholesale price, wholesale acquisition
263.14 	cost, average manufacturer price as defined in United States
263.15 	Code, title 42, chapter 7, subchapter XIX, section 1396r-8(k),
263.16 	and best price as defined in United States Code, title 42,
263.17 	chapter 7, subchapter XIX, section 1396r-8(c)(1)(C).  The
263.18 	calculation of average wholesale price and wholesale acquisition
263.19 	cost shall be the net of all volume discounts, prompt payment
263.20 	discounts, chargebacks, short-dated product discounts, cash
263.21 	discounts, free goods, rebates, and all other price concessions
263.22 	or incentives provided to a purchaser that result in a reduction
263.23 	in the ultimate cost to the purchaser.  When reporting average
263.24 	wholesale price, wholesale acquisition cost, average
263.25 	manufacturer price, and best price, manufacturers shall also
263.26 	include a detailed description of the methodology by which the
263.27 	prices were calculated.  When a manufacturer reports average
263.28 	wholesale price, wholesale acquisition cost, average
263.29 	manufacturer price, or best price, the president or chief
263.30 	executive officer of the manufacturer shall certify on a form
263.31 	provided by the commissioner of human services, that the
263.32 	reported prices are accurate.  Any information reported under
263.33 	this section shall be classified as nonpublic data under section
263.34 	13.02, subdivision 9.  Notwithstanding the classification of
263.35 	data in this section and subdivision 2, the Minnesota Attorney
263.36 	General's Office, the federal Centers for Medicare and Medicaid
264.1 	Services or another law enforcement agency may access and obtain
264.2 	copies of the data required under this section and use that data
264.3 	for law enforcement purposes.
264.4 		Subd. 2.Penalties and remedies. The attorney general
264.5 	may pursue the penalties and remedies available to the attorney
264.6 	general under section 8.31 against any manufacturer who violates
264.7 	this section.

264.8 	Sec. 2. [151.55] CANCER DRUG REPOSITORY PROGRAM.
264.9 		Subdivision 1.Definitions. (a) For the purposes of this
264.10 	section, the terms defined in this subdivision have the meanings
264.11 	given.
264.12 	(b) "Board" means the Board of Pharmacy.
264.13 	(c) "Cancer drug" means a prescription drug that is used to
264.14 	treat:
264.15 	(1) cancer or the side effects of cancer; or 
264.16 	(2) the side effects of any prescription drug that is used
264.17 	to treat cancer or the side effects of cancer.
264.18 	(d) "Cancer drug repository" means a medical facility or
264.19 	pharmacy that has notified the board of its election to
264.20 	participate in the cancer drug repository program.
264.21 	(e) "Cancer supply" or "supplies" means prescription and
264.22 	nonprescription cancer supplies needed to administer a cancer
264.23 	drug.
264.24 	(f) "Dispense" has the meaning given in section 151.01,
264.25 	subdivision 30.
264.26 	(g) "Distribute" means to deliver, other than by
264.27 	administering or dispensing.
264.28 	(h) "Medical facility" means an institution defined in
264.29 	section 144.50, subdivision 2.
264.30 	(i) "Medical supplies" means any prescription and
264.31 	nonprescription medical supply needed to administer a cancer
264.32 	drug.
264.33 	(j) "Pharmacist" has the meaning given in section 151.01,
264.34 	subdivision 3.
264.35 	(k) "Pharmacy" means any pharmacy registered with the Board
264.36 	of Pharmacy according to section 151.19, subdivision 1.
265.1 	(l) "Practitioner" has the meaning given in section 151.01,
265.2 	subdivision 23.
265.3 	(m) "Prescription drug" means a legend drug as defined in
265.4 	section 151.01, subdivision 17.
265.5 	(n) "Side effects of cancer" means symptoms of cancer.
265.6 	(o) "Single-unit-dose packaging" means a single-unit
265.7 	container for articles intended for administration as a single
265.8 	dose, direct from the container.
265.9 	(p) "Tamper-evident unit dose packaging" means a container
265.10 	within which a drug is sealed so that the contents cannot be
265.11 	opened without obvious destruction of the seal.
265.12 		Subd. 2.Establishment. The Board of Pharmacy shall
265.13 	establish and maintain a cancer drug repository program, under
265.14 	which any person may donate a cancer drug or supply for use by
265.15 	an individual who meets the eligibility criteria specified under
265.16 	subdivision 4.  Under the program, donations may be made on the
265.17 	premises of a medical facility or pharmacy that elects to
265.18 	participate in the program and meets the requirements specified
265.19 	under subdivision 3.
265.20 		Subd. 3.Requirements for participation by pharmacies and
265.21 	medical facilities. (a) To be eligible for participation in the
265.22 	cancer drug repository program, a pharmacy or medical facility
265.23 	must be licensed and in compliance with all applicable federal
265.24 	and state laws and administrative rules.
265.25 	(b) Participation in the cancer drug repository program is
265.26 	voluntary.  A pharmacy or medical facility may elect to
265.27 	participate in the cancer drug repository program by submitting
265.28 	the following information to the board, in a form provided by
265.29 	the board:
265.30 	(1) the name, street address, and telephone number of the
265.31 	pharmacy or medical facility;
265.32 	(2) the name and telephone number of a pharmacist who is
265.33 	employed by or under contract with the pharmacy or medical
265.34 	facility, or other contact person who is familiar with the
265.35 	pharmacy's or medical facility's participation in the cancer
265.36 	drug repository program; and 
266.1 	(3) a statement indicating that the pharmacy or medical
266.2 	facility meets the eligibility requirements under paragraph (a)
266.3 	and the chosen level of participation under paragraph (c).
266.4 	(c) A pharmacy or medical facility may fully participate in
266.5 	the cancer drug repository program by accepting, storing, and
266.6 	dispensing or administering donated drugs and supplies, or may
266.7 	limit its participation to only accepting and storing donated
266.8 	drugs and supplies.  If a pharmacy or facility chooses to limit
266.9 	its participation, the pharmacy or facility shall distribute any
266.10 	donated drugs to a fully participating cancer drug repository
266.11 	according to subdivision 8.
266.12 	(d) A pharmacy or medical facility may withdraw from
266.13 	participation in the cancer drug repository program at any time
266.14 	upon notification to the board.  A notice to withdraw from
266.15 	participation may be given by telephone or regular mail.
266.16 		Subd. 4.Individual eligibility requirements. Any
266.17 	Minnesota resident who is diagnosed with cancer is eligible to
266.18 	receive drugs or supplies under the cancer drug repository
266.19 	program.  Drugs and supplies shall be dispensed or administered
266.20 	according to the priority given under subdivision 6, paragraph
266.21 	(d).
266.22 		Subd. 5.Donations of cancer drugs and supplies. (a) Any
266.23 	one of the following persons may donate legally obtained cancer
266.24 	drugs or supplies to a cancer drug repository, if the drugs or
266.25 	supplies meet the requirements under paragraph (b) or (c) as
266.26 	determined by a pharmacist who is employed by or under contract
266.27 	with a cancer drug repository:
266.28 	(1) an individual who is 18 years old or older; or 
266.29 	(2) a pharmacy, medical facility, drug manufacturer, or
266.30 	wholesale drug distributor, if the donated drugs have not been
266.31 	previously dispensed.
266.32 	(b) A cancer drug is eligible for donation under the cancer
266.33 	drug repository program only if the following requirements are
266.34 	met:
266.35 	(1) the donation is accompanied by a cancer drug repository
266.36 	donor form described under paragraph (d) that is signed by the
267.1 	person making the donation or that person's authorized
267.2 	representative;
267.3 	(2) the drug's expiration date is at least six months later
267.4 	than the date that the drug was donated;
267.5 	(3) the drug is in its original, unopened, tamper-evident
267.6 	unit dose packaging that includes the drug's lot number and
267.7 	expiration date.  Single-unit dose drugs may be accepted if the
267.8 	single-unit-dose packaging is unopened; and 
267.9 	(4) the drug is not adulterated or misbranded.
267.10 	(c) Cancer supplies are eligible for donation under the
267.11 	cancer drug repository program only if the following
267.12 	requirements are met:
267.13 	(1) the supplies are not adulterated or misbranded;
267.14 	(2) the supplies are in their original, unopened, sealed
267.15 	packaging; and 
267.16 	(3) the donation is accompanied by a cancer drug repository
267.17 	donor form described under paragraph (d) that is signed by the
267.18 	person making the donation or that person's authorized
267.19 	representative.
267.20 	(d) The cancer drug repository donor form must be provided
267.21 	by the board and shall state that to the best of the donor's
267.22 	knowledge the donated drug or supply has been properly stored
267.23 	and that the drug or supply has never been opened, used,
267.24 	tampered with, adulterated, or misbranded.  The board shall make
267.25 	the cancer drug repository donor form available on the
267.26 	Department of Health's Web site.
267.27 	(e) Controlled substances and drugs and supplies that do
267.28 	not meet the criteria under this subdivision are not eligible
267.29 	for donation or acceptance under the cancer drug repository
267.30 	program.
267.31 	(f) Drugs and supplies may be donated on the premises of a
267.32 	cancer drug repository to a pharmacist designated by the
267.33 	repository.  A drop box may not be used to deliver or accept
267.34 	donations.
267.35 	(g) Cancer drugs and supplies donated under the cancer drug
267.36 	repository program must be stored in a secure storage area under
268.1 	environmental conditions appropriate for the drugs or supplies
268.2 	being stored.  Donated drugs and supplies may not be stored with
268.3 	nondonated inventory.
268.4 		Subd. 6.Dispensing requirements. (a) Drugs and supplies
268.5 	must be dispensed by a licensed pharmacist pursuant to a
268.6 	prescription by a practitioner or may be dispensed or
268.7 	administered by a practitioner according to the requirements of
268.8 	chapter 151 and within the practitioner's scope of practice.
268.9 	(b) Cancer drugs and supplies shall be visually inspected
268.10 	by the pharmacist or practitioner before being dispensed or
268.11 	administered for adulteration, misbranding, and date of
268.12 	expiration.  Drugs or supplies that have expired or appear upon
268.13 	visual inspection to be adulterated, misbranded, or tampered
268.14 	with in any way may not be dispensed or administered.
268.15 	(c) Before a cancer drug or supply may be dispensed or
268.16 	administered to an individual, the individual must sign a cancer
268.17 	drug repository recipient form provided by the board
268.18 	acknowledging that the individual understands the information
268.19 	stated on the form.  The form shall include the following
268.20 	information:
268.21 	(1) that the drug or supply being dispensed or administered
268.22 	has been donated and may have been previously dispensed;
268.23 	(2) that a visual inspection has been conducted by the
268.24 	pharmacist or practitioner to ensure that the drug has not
268.25 	expired, has not been adulterated or misbranded, and is in its
268.26 	original, unopened packaging; and 
268.27 	(3) that the dispensing pharmacist, the dispensing or
268.28 	administering practitioner, the cancer drug repository, the
268.29 	state Department of Health, and any other participant of the
268.30 	cancer drug repository program cannot guarantee the safety of
268.31 	the drug or supply being dispensed or administered and that the
268.32 	pharmacist or practitioner has determined that the drug or
268.33 	supply is safe to dispense or administer based on the accuracy
268.34 	of the donor's form submitted with the donated drug or supply
268.35 	and the visual inspection required to be performed by the
268.36 	pharmacist or practitioner before dispensing or administering.
269.1 	The board shall make the cancer drug repository form available
269.2 	on the Department of Health's Web site.
269.3 	(d) Drugs and supplies shall only be dispensed or
269.4 	administered to individuals who meet the eligibility
269.5 	requirements in subdivision 4 and in the following order of
269.6 	priority:
269.7 	(1) individuals who are uninsured;
269.8 	(2) individuals who are enrolled in medical assistance,
269.9 	general assistance medical care, MinnesotaCare, Medicare, or
269.10 	other public assistance health care; and 
269.11 	(3) all other individuals who are otherwise eligible under
269.12 	subdivision 4 to receive drugs or supplies from a cancer drug
269.13 	repository.
269.14 		Subd. 7.Handling fees. A cancer drug repository may
269.15 	charge the individual receiving a drug or supply a handling fee
269.16 	of no more than 250 percent of the medical assistance program
269.17 	dispensing fee for each cancer drug or supply dispensed or
269.18 	administered.
269.19 		Subd. 8.Distribution of donated cancer drugs and
269.20 	supplies. (a) Cancer drug repositories may distribute drugs and
269.21 	supplies donated under the cancer drug repository program to
269.22 	other repositories if requested by a participating repository.
269.23 	(b) A cancer drug repository that has elected not to
269.24 	dispense donated drugs or supplies shall distribute any donated
269.25 	drugs and supplies to a participating repository upon request of
269.26 	the repository.
269.27 	(c) If a cancer drug repository distributes drugs or
269.28 	supplies under paragraph (a) or (b), the repository shall
269.29 	complete a cancer drug repository donor form provided by the
269.30 	board.  The completed form and a copy of the donor form that was
269.31 	completed by the original donor under subdivision 5 shall be
269.32 	provided to the fully participating cancer drug repository at
269.33 	the time of distribution.
269.34 		Subd. 9.Resale of donated drugs or supplies. Donated
269.35 	drugs and supplies may not be resold.
269.36 		Subd. 10.Record-keeping requirements. (a) Cancer drug
270.1 	repository donor and recipient forms shall be maintained for at
270.2 	least five years.
270.3 	(b) A record of destruction of donated drugs and supplies
270.4 	that are not dispensed under subdivision 6 shall be maintained
270.5 	by the dispensing repository for at least five years.  For each
270.6 	drug or supply destroyed, the record shall include the following
270.7 	information:
270.8 	(1) the date of destruction;
270.9 	(2) the name, strength, and quantity of the cancer drug
270.10 	destroyed;
270.11 	(3) the name of the person or firm that destroyed the drug;
270.12 	and 
270.13 	(4) the source of the drugs or supplies destroyed.
270.14 		Subd. 11.Liability. A medical facility or pharmacy
270.15 	participating in the program, a pharmacist dispensing a drug or
270.16 	supply pursuant to the program, a practitioner dispensing or
270.17 	administering a drug or supply pursuant to the program, or the
270.18 	donor of a cancer drug or supply is immune from civil liability
270.19 	for an act or omission relating to the quality of a cancer drug
270.20 	or supply that causes injury to or the death of an individual to
270.21 	whom the cancer drug or supply is dispensed or administered and
270.22 	no disciplinary action shall be taken against a pharmacist or
270.23 	practitioner so long as the drug or supply is donated, accepted,
270.24 	distributed, and dispensed or administered according to the
270.25 	requirements of this section.  This immunity does not apply if
270.26 	the act or omission involves reckless, wanton, or intentional
270.27 	misconduct or malpractice unrelated to the quality of the
270.28 	donated cancer drug or supply.

270.29 	Sec. 3. Minnesota Statutes 2004, section 241.01, is
270.30 	amended by adding a subdivision to read:
270.31 		Subd. 10.Purchasing for prescription drugs. In
270.32 	accordance with section 241.021, subdivision 4, the commissioner
270.33 	may contract with a separate entity to purchase prescription
270.34 	drugs for persons confined in institutions under the control of
270.35 	the commissioner.  Local governments may participate in this
270.36 	purchasing pool in order to purchase prescription drugs for
271.1 	those persons confined in local correctional facilities in which
271.2 	the local government has responsibility for providing health
271.3 	care.  If any county participates, the commissioner shall
271.4 	appoint a county representative to any committee convened by the
271.5 	commissioner for the purpose of establishing a drug formulary to
271.6 	be used for state and local correctional facilities.

271.7 	Sec. 4. Minnesota Statutes 2004, section 256.01,
271.8 	subdivision 2, is amended to read:
271.9 		Subd. 2.Specific powers.  Subject to the provisions of
271.10 	section 241.021, subdivision 2, the commissioner of human
271.11 	services shall carry out the specific duties in paragraphs (a)
271.12 	through (aa) (bb):
271.13 	(a) Administer and supervise all forms of public assistance
271.14 	provided for by state law and other welfare activities or
271.15 	services as are vested in the commissioner.  Administration and
271.16 	supervision of human services activities or services includes,
271.17 	but is not limited to, assuring timely and accurate distribution
271.18 	of benefits, completeness of service, and quality program
271.19 	management.  In addition to administering and supervising human
271.20 	services activities vested by law in the department, the
271.21 	commissioner shall have the authority to:
271.22 	(1) require county agency participation in training and
271.23 	technical assistance programs to promote compliance with
271.24 	statutes, rules, federal laws, regulations, and policies
271.25 	governing human services;
271.26 	(2) monitor, on an ongoing basis, the performance of county
271.27 	agencies in the operation and administration of human services,
271.28 	enforce compliance with statutes, rules, federal laws,
271.29 	regulations, and policies governing welfare services and promote
271.30 	excellence of administration and program operation;
271.31 	(3) develop a quality control program or other monitoring
271.32 	program to review county performance and accuracy of benefit
271.33 	determinations;
271.34 	(4) require county agencies to make an adjustment to the
271.35 	public assistance benefits issued to any individual consistent
271.36 	with federal law and regulation and state law and rule and to
272.1 	issue or recover benefits as appropriate;
272.2 	(5) delay or deny payment of all or part of the state and
272.3 	federal share of benefits and administrative reimbursement
272.4 	according to the procedures set forth in section 256.017;
272.5 	(6) make contracts with and grants to public and private
272.6 	agencies and organizations, both profit and nonprofit, and
272.7 	individuals, using appropriated funds; and
272.8 	(7) enter into contractual agreements with federally
272.9 	recognized Indian tribes with a reservation in Minnesota to the
272.10 	extent necessary for the tribe to operate a federally approved
272.11 	family assistance program or any other program under the
272.12 	supervision of the commissioner.  The commissioner shall consult
272.13 	with the affected county or counties in the contractual
272.14 	agreement negotiations, if the county or counties wish to be
272.15 	included, in order to avoid the duplication of county and tribal
272.16 	assistance program services.  The commissioner may establish
272.17 	necessary accounts for the purposes of receiving and disbursing
272.18 	funds as necessary for the operation of the programs.
272.19 	(b) Inform county agencies, on a timely basis, of changes
272.20 	in statute, rule, federal law, regulation, and policy necessary
272.21 	to county agency administration of the programs.
272.22 	(c) Administer and supervise all child welfare activities;
272.23 	promote the enforcement of laws protecting handicapped,
272.24 	dependent, neglected and delinquent children, and children born
272.25 	to mothers who were not married to the children's fathers at the
272.26 	times of the conception nor at the births of the children;
272.27 	license and supervise child-caring and child-placing agencies
272.28 	and institutions; supervise the care of children in boarding and
272.29 	foster homes or in private institutions; and generally perform
272.30 	all functions relating to the field of child welfare now vested
272.31 	in the State Board of Control.
272.32 	(d) Administer and supervise all noninstitutional service
272.33 	to handicapped persons, including those who are visually
272.34 	impaired, hearing impaired, or physically impaired or otherwise
272.35 	handicapped.  The commissioner may provide and contract for the
272.36 	care and treatment of qualified indigent children in facilities
273.1 	other than those located and available at state hospitals when
273.2 	it is not feasible to provide the service in state hospitals.
273.3 	(e) Assist and actively cooperate with other departments,
273.4 	agencies and institutions, local, state, and federal, by
273.5 	performing services in conformity with the purposes of Laws
273.6 	1939, chapter 431.
273.7 	(f) Act as the agent of and cooperate with the federal
273.8 	government in matters of mutual concern relative to and in
273.9 	conformity with the provisions of Laws 1939, chapter 431,
273.10 	including the administration of any federal funds granted to the
273.11 	state to aid in the performance of any functions of the
273.12 	commissioner as specified in Laws 1939, chapter 431, and
273.13 	including the promulgation of rules making uniformly available
273.14 	medical care benefits to all recipients of public assistance, at
273.15 	such times as the federal government increases its participation
273.16 	in assistance expenditures for medical care to recipients of
273.17 	public assistance, the cost thereof to be borne in the same
273.18 	proportion as are grants of aid to said recipients.
273.19 	(g) Establish and maintain any administrative units
273.20 	reasonably necessary for the performance of administrative
273.21 	functions common to all divisions of the department.
273.22 	(h) Act as designated guardian of both the estate and the
273.23 	person of all the wards of the state of Minnesota, whether by
273.24 	operation of law or by an order of court, without any further
273.25 	act or proceeding whatever, except as to persons committed as
273.26 	mentally retarded.  For children under the guardianship of the
273.27 	commissioner whose interests would be best served by adoptive
273.28 	placement, the commissioner may contract with a licensed
273.29 	child-placing agency or a Minnesota tribal social services
273.30 	agency to provide adoption services.  A contract with a licensed
273.31 	child-placing agency must be designed to supplement existing
273.32 	county efforts and may not replace existing county programs,
273.33 	unless the replacement is agreed to by the county board and the
273.34 	appropriate exclusive bargaining representative or the
273.35 	commissioner has evidence that child placements of the county
273.36 	continue to be substantially below that of other counties.
274.1 	Funds encumbered and obligated under an agreement for a specific
274.2 	child shall remain available until the terms of the agreement
274.3 	are fulfilled or the agreement is terminated.
274.4 	(i) Act as coordinating referral and informational center
274.5 	on requests for service for newly arrived immigrants coming to
274.6 	Minnesota.
274.7 	(j) The specific enumeration of powers and duties as
274.8 	hereinabove set forth shall in no way be construed to be a
274.9 	limitation upon the general transfer of powers herein contained.
274.10 	(k) Establish county, regional, or statewide schedules of
274.11 	maximum fees and charges which may be paid by county agencies
274.12 	for medical, dental, surgical, hospital, nursing and nursing
274.13 	home care and medicine and medical supplies under all programs
274.14 	of medical care provided by the state and for congregate living
274.15 	care under the income maintenance programs.
274.16 	(l) Have the authority to conduct and administer
274.17 	experimental projects to test methods and procedures of
274.18 	administering assistance and services to recipients or potential
274.19 	recipients of public welfare.  To carry out such experimental
274.20 	projects, it is further provided that the commissioner of human
274.21 	services is authorized to waive the enforcement of existing
274.22 	specific statutory program requirements, rules, and standards in
274.23 	one or more counties.  The order establishing the waiver shall
274.24 	provide alternative methods and procedures of administration,
274.25 	shall not be in conflict with the basic purposes, coverage, or
274.26 	benefits provided by law, and in no event shall the duration of
274.27 	a project exceed four years.  It is further provided that no
274.28 	order establishing an experimental project as authorized by the
274.29 	provisions of this section shall become effective until the
274.30 	following conditions have been met:
274.31 	(1) the secretary of health and human services of the
274.32 	United States has agreed, for the same project, to waive state
274.33 	plan requirements relative to statewide uniformity; and
274.34 	(2) a comprehensive plan, including estimated project
274.35 	costs, shall be approved by the Legislative Advisory Commission
274.36 	and filed with the commissioner of administration.
275.1 	(m) According to federal requirements, establish procedures
275.2 	to be followed by local welfare boards in creating citizen
275.3 	advisory committees, including procedures for selection of
275.4 	committee members.
275.5 	(n) Allocate federal fiscal disallowances or sanctions
275.6 	which are based on quality control error rates for the aid to
275.7 	families with dependent children program formerly codified in
275.8 	sections 256.72 to 256.87, medical assistance, or food stamp
275.9 	program in the following manner:
275.10 	(1) one-half of the total amount of the disallowance shall
275.11 	be borne by the county boards responsible for administering the
275.12 	programs.  For the medical assistance and the AFDC program
275.13 	formerly codified in sections 256.72 to 256.87, disallowances
275.14 	shall be shared by each county board in the same proportion as
275.15 	that county's expenditures for the sanctioned program are to the
275.16 	total of all counties' expenditures for the AFDC program
275.17 	formerly codified in sections 256.72 to 256.87, and medical
275.18 	assistance programs.  For the food stamp program, sanctions
275.19 	shall be shared by each county board, with 50 percent of the
275.20 	sanction being distributed to each county in the same proportion
275.21 	as that county's administrative costs for food stamps are to the
275.22 	total of all food stamp administrative costs for all counties,
275.23 	and 50 percent of the sanctions being distributed to each county
275.24 	in the same proportion as that county's value of food stamp
275.25 	benefits issued are to the total of all benefits issued for all
275.26 	counties.  Each county shall pay its share of the disallowance
275.27 	to the state of Minnesota.  When a county fails to pay the
275.28 	amount due hereunder, the commissioner may deduct the amount
275.29 	from reimbursement otherwise due the county, or the attorney
275.30 	general, upon the request of the commissioner, may institute
275.31 	civil action to recover the amount due; and
275.32 	(2) notwithstanding the provisions of clause (1), if the
275.33 	disallowance results from knowing noncompliance by one or more
275.34 	counties with a specific program instruction, and that knowing
275.35 	noncompliance is a matter of official county board record, the
275.36 	commissioner may require payment or recover from the county or
276.1 	counties, in the manner prescribed in clause (1), an amount
276.2 	equal to the portion of the total disallowance which resulted
276.3 	from the noncompliance, and may distribute the balance of the
276.4 	disallowance according to clause (1).
276.5 	(o) Develop and implement special projects that maximize
276.6 	reimbursements and result in the recovery of money to the
276.7 	state.  For the purpose of recovering state money, the
276.8 	commissioner may enter into contracts with third parties.  Any
276.9 	recoveries that result from projects or contracts entered into
276.10 	under this paragraph shall be deposited in the state treasury
276.11 	and credited to a special account until the balance in the
276.12 	account reaches $1,000,000.  When the balance in the account
276.13 	exceeds $1,000,000, the excess shall be transferred and credited
276.14 	to the general fund.  All money in the account is appropriated
276.15 	to the commissioner for the purposes of this paragraph.
276.16 	(p) Have the authority to make direct payments to
276.17 	facilities providing shelter to women and their children
276.18 	according to section 256D.05, subdivision 3.  Upon the written
276.19 	request of a shelter facility that has been denied payments
276.20 	under section 256D.05, subdivision 3, the commissioner shall
276.21 	review all relevant evidence and make a determination within 30
276.22 	days of the request for review regarding issuance of direct
276.23 	payments to the shelter facility.  Failure to act within 30 days
276.24 	shall be considered a determination not to issue direct payments.
276.25 	(q) Have the authority to establish and enforce the
276.26 	following county reporting requirements:
276.27 	(1) the commissioner shall establish fiscal and statistical
276.28 	reporting requirements necessary to account for the expenditure
276.29 	of funds allocated to counties for human services programs.
276.30 	When establishing financial and statistical reporting
276.31 	requirements, the commissioner shall evaluate all reports, in
276.32 	consultation with the counties, to determine if the reports can
276.33 	be simplified or the number of reports can be reduced;
276.34 	(2) the county board shall submit monthly or quarterly
276.35 	reports to the department as required by the commissioner.
276.36 	Monthly reports are due no later than 15 working days after the
277.1 	end of the month.  Quarterly reports are due no later than 30
277.2 	calendar days after the end of the quarter, unless the
277.3 	commissioner determines that the deadline must be shortened to
277.4 	20 calendar days to avoid jeopardizing compliance with federal
277.5 	deadlines or risking a loss of federal funding.  Only reports
277.6 	that are complete, legible, and in the required format shall be
277.7 	accepted by the commissioner;
277.8 	(3) if the required reports are not received by the
277.9 	deadlines established in clause (2), the commissioner may delay
277.10 	payments and withhold funds from the county board until the next
277.11 	reporting period.  When the report is needed to account for the
277.12 	use of federal funds and the late report results in a reduction
277.13 	in federal funding, the commissioner shall withhold from the
277.14 	county boards with late reports an amount equal to the reduction
277.15 	in federal funding until full federal funding is received;
277.16 	(4) a county board that submits reports that are late,
277.17 	illegible, incomplete, or not in the required format for two out
277.18 	of three consecutive reporting periods is considered
277.19 	noncompliant.  When a county board is found to be noncompliant,
277.20 	the commissioner shall notify the county board of the reason the
277.21 	county board is considered noncompliant and request that the
277.22 	county board develop a corrective action plan stating how the
277.23 	county board plans to correct the problem.  The corrective
277.24 	action plan must be submitted to the commissioner within 45 days
277.25 	after the date the county board received notice of
277.26 	noncompliance;
277.27 	(5) the final deadline for fiscal reports or amendments to
277.28 	fiscal reports is one year after the date the report was
277.29 	originally due.  If the commissioner does not receive a report
277.30 	by the final deadline, the county board forfeits the funding
277.31 	associated with the report for that reporting period and the
277.32 	county board must repay any funds associated with the report
277.33 	received for that reporting period;
277.34 	(6) the commissioner may not delay payments, withhold
277.35 	funds, or require repayment under clause (3) or (5) if the
277.36 	county demonstrates that the commissioner failed to provide
278.1 	appropriate forms, guidelines, and technical assistance to
278.2 	enable the county to comply with the requirements.  If the
278.3 	county board disagrees with an action taken by the commissioner
278.4 	under clause (3) or (5), the county board may appeal the action
278.5 	according to sections 14.57 to 14.69; and
278.6 	(7) counties subject to withholding of funds under clause
278.7 	(3) or forfeiture or repayment of funds under clause (5) shall
278.8 	not reduce or withhold benefits or services to clients to cover
278.9 	costs incurred due to actions taken by the commissioner under
278.10 	clause (3) or (5).
278.11 	(r) Allocate federal fiscal disallowances or sanctions for
278.12 	audit exceptions when federal fiscal disallowances or sanctions
278.13 	are based on a statewide random sample for the foster care
278.14 	program under title IV-E of the Social Security Act, United
278.15 	States Code, title 42, in direct proportion to each county's
278.16 	title IV-E foster care maintenance claim for that period.
278.17 	(s) Be responsible for ensuring the detection, prevention,
278.18 	investigation, and resolution of fraudulent activities or
278.19 	behavior by applicants, recipients, and other participants in
278.20 	the human services programs administered by the department.
278.21 	(t) Require county agencies to identify overpayments,
278.22 	establish claims, and utilize all available and cost-beneficial
278.23 	methodologies to collect and recover these overpayments in the
278.24 	human services programs administered by the department.
278.25 	(u) Have the authority to administer a drug rebate program
278.26 	for drugs purchased pursuant to the prescription drug program
278.27 	established under section 256.955 after the beneficiary's
278.28 	satisfaction of any deductible established in the program.  The
278.29 	commissioner shall require a rebate agreement from all
278.30 	manufacturers of covered drugs as defined in section 256B.0625,
278.31 	subdivision 13.  Rebate agreements for prescription drugs
278.32 	delivered on or after July 1, 2002, must include rebates for
278.33 	individuals covered under the prescription drug program who are
278.34 	under 65 years of age.  For each drug, the amount of the rebate
278.35 	shall be equal to the rebate as defined for purposes of the
278.36 	federal rebate program in United States Code, title 42, section
279.1 	1396r-8.  The manufacturers must provide full payment within 30
279.2 	days of receipt of the state invoice for the rebate within the
279.3 	terms and conditions used for the federal rebate program
279.4 	established pursuant to section 1927 of title XIX of the Social
279.5 	Security Act.  The manufacturers must provide the commissioner
279.6 	with any information necessary to verify the rebate determined
279.7 	per drug.  The rebate program shall utilize the terms and
279.8 	conditions used for the federal rebate program established
279.9 	pursuant to section 1927 of title XIX of the Social Security Act.
279.10 	(v) Have the authority to administer the federal drug
279.11 	rebate program for drugs purchased under the medical assistance
279.12 	program as allowed by section 1927 of title XIX of the Social
279.13 	Security Act and according to the terms and conditions of
279.14 	section 1927.  Rebates shall be collected for all drugs that
279.15 	have been dispensed or administered in an outpatient setting and
279.16 	that are from manufacturers who have signed a rebate agreement
279.17 	with the United States Department of Health and Human Services.
279.18 	(w) Have the authority to administer a supplemental drug
279.19 	rebate program for drugs purchased under the medical assistance
279.20 	program.  The commissioner may enter into supplemental rebate
279.21 	contracts with pharmaceutical manufacturers and may require
279.22 	prior authorization for drugs that are from manufacturers that
279.23 	have not signed a supplemental rebate contract.  Prior
279.24 	authorization of drugs shall be subject to the provisions of
279.25 	section 256B.0625, subdivision 13.
279.26 	(x) Operate the department's communication systems account
279.27 	established in Laws 1993, First Special Session chapter 1,
279.28 	article 1, section 2, subdivision 2, to manage shared
279.29 	communication costs necessary for the operation of the programs
279.30 	the commissioner supervises.  A communications account may also
279.31 	be established for each regional treatment center which operates
279.32 	communications systems.  Each account must be used to manage
279.33 	shared communication costs necessary for the operations of the
279.34 	programs the commissioner supervises.  The commissioner may
279.35 	distribute the costs of operating and maintaining communication
279.36 	systems to participants in a manner that reflects actual usage.
280.1 	Costs may include acquisition, licensing, insurance,
280.2 	maintenance, repair, staff time and other costs as determined by
280.3 	the commissioner.  Nonprofit organizations and state, county,
280.4 	and local government agencies involved in the operation of
280.5 	programs the commissioner supervises may participate in the use
280.6 	of the department's communications technology and share in the
280.7 	cost of operation.  The commissioner may accept on behalf of the
280.8 	state any gift, bequest, devise or personal property of any
280.9 	kind, or money tendered to the state for any lawful purpose
280.10 	pertaining to the communication activities of the department.
280.11 	Any money received for this purpose must be deposited in the
280.12 	department's communication systems accounts.  Money collected by
280.13 	the commissioner for the use of communication systems must be
280.14 	deposited in the state communication systems account and is
280.15 	appropriated to the commissioner for purposes of this section.
280.16 	(y) Receive any federal matching money that is made
280.17 	available through the medical assistance program for the
280.18 	consumer satisfaction survey.  Any federal money received for
280.19 	the survey is appropriated to the commissioner for this
280.20 	purpose.  The commissioner may expend the federal money received
280.21 	for the consumer satisfaction survey in either year of the
280.22 	biennium.
280.23 	(z) Designate community information and referral call
280.24 	centers and incorporate cost reimbursement claims from the
280.25 	designated community information and referral call centers into
280.26 	the federal cost reimbursement claiming processes of the
280.27 	department according to federal law, rule, and regulations.
280.28 	Existing information and referral centers provided by Greater
280.29 	Twin Cities United Way or existing call centers for which
280.30 	Greater Twin Cities United Way has legal authority to represent,
280.31 	shall be included in these designations upon review by the
280.32 	commissioner and assurance that these services are accredited
280.33 	and in compliance with national standards.  Any reimbursement is
280.34 	appropriated to the commissioner and all designated information
280.35 	and referral centers shall receive payments according to normal
280.36 	department schedules established by the commissioner upon final
281.1 	approval of allocation methodologies from the United States
281.2 	Department of Health and Human Services Division of Cost
281.3 	Allocation or other appropriate authorities.
281.4 	(aa) Develop recommended standards for foster care homes
281.5 	that address the components of specialized therapeutic services
281.6 	to be provided by foster care homes with those services.
281.7 	(bb) Authorize the method of payment to or from the
281.8 	department as part of the human services programs administered
281.9 	by the department.  This authorization includes the receipt or
281.10 	disbursement of funds held by the department in a fiduciary
281.11 	capacity as part of the human services programs administered by
281.12 	the department.

281.13 	Sec. 5. Minnesota Statutes 2004, section 256.741,
281.14 	subdivision 4, is amended to read:
281.15 		Subd. 4.Effect of assignment.  Assignments in this
281.16 	section take effect upon a determination that the applicant is
281.17 	eligible for public assistance.  The amount of support assigned
281.18 	under this subdivision may not exceed the total amount of public
281.19 	assistance issued or the total support obligation, whichever is
281.20 	less.  Child care support collections made according to an
281.21 	assignment under subdivision 2, paragraph (c), must be
281.22 	deposited, subject to any limitations of federal law, by the
281.23 	commissioner of human services in the child support collection
281.24 	account in the special revenue fund and appropriated to the
281.25 	commissioner of education for child care assistance under
281.26 	section 119B.03.  These collections are in addition to state and
281.27 	federal funds appropriated to the child care in the general fund.

281.28 	Sec. 6. [256.957] HEALTH CARE QUALITY IMPROVEMENT
281.29 	ACCOUNT.
281.30 	A health care quality improvement account is established in
281.31 	the general fund.

281.32 	Sec. 7. Minnesota Statutes 2004, section 256B.0625,
281.33 	subdivision 13e, is amended to read:
281.34 		Subd. 13e.Payment rates.  (a) The basis for determining
281.35 	the amount of payment shall be the lower of the actual
281.36 	acquisition costs of the drugs plus a fixed dispensing fee; the
282.1 	maximum allowable cost set by the federal government or by the
282.2 	commissioner plus the fixed dispensing fee; or the usual and
282.3 	customary price charged to the public.  The amount of payment
282.4 	basis must be reduced to reflect all discount amounts applied to
282.5 	the charge by any provider/insurer agreement or contract for
282.6 	submitted charges to medical assistance programs.  The net
282.7 	submitted charge may not be greater than the patient liability
282.8 	for the service.  The pharmacy dispensing fee shall be $3.65,
282.9 	except that the dispensing fee for intravenous solutions which
282.10 	must be compounded by the pharmacist shall be $8 per bag, $14
282.11 	per bag for cancer chemotherapy products, and $30 per bag for
282.12 	total parenteral nutritional products dispensed in one liter
282.13 	quantities, or $44 per bag for total parenteral nutritional
282.14 	products dispensed in quantities greater than one liter.  Actual
282.15 	acquisition cost includes quantity and other special discounts
282.16 	except time and cash discounts.  The actual acquisition cost of
282.17 	a drug shall be estimated by the commissioner, at average
282.18 	wholesale price minus 11.5 percent, except that where a drug has
282.19 	had its wholesale price reduced as a result of the actions of
282.20 	the National Association of Medicaid Fraud Control Units, the
282.21 	estimated actual acquisition cost shall be the reduced average
282.22 	wholesale price, without the 11.5 percent deduction.  The
282.23 	maximum allowable cost of a multisource drug may be set by the
282.24 	commissioner and it shall be comparable to, but no higher than,
282.25 	the maximum amount paid by other third-party payors in this
282.26 	state who have maximum allowable cost programs.  Establishment
282.27 	of the amount of payment for drugs shall not be subject to the
282.28 	requirements of the Administrative Procedure Act.
282.29 	(b) An additional dispensing fee of $.30 may be added to
282.30 	the dispensing fee paid to pharmacists for legend drug
282.31 	prescriptions dispensed to residents of long-term care
282.32 	facilities when a unit dose blister card system, approved by the
282.33 	department, is used.  Under this type of dispensing system, the
282.34 	pharmacist must dispense a 30-day supply of drug.  The National
282.35 	Drug Code (NDC) from the drug container used to fill the blister
282.36 	card must be identified on the claim to the department.  The
283.1 	unit dose blister card containing the drug must meet the
283.2 	packaging standards set forth in Minnesota Rules, part
283.3 	6800.2700, that govern the return of unused drugs to the
283.4 	pharmacy for reuse.  The pharmacy provider will be required to
283.5 	credit the department for the actual acquisition cost of all
283.6 	unused drugs that are eligible for reuse.  Over-the-counter
283.7 	medications must be dispensed in the manufacturer's unopened
283.8 	package.  The commissioner may permit the drug clozapine to be
283.9 	dispensed in a quantity that is less than a 30-day supply.
283.10 	(c) Whenever a generically equivalent product is available,
283.11 	payment shall be on the basis of the actual acquisition cost of
283.12 	the generic drug, or on the maximum allowable cost established
283.13 	by the commissioner.
283.14 	(d) The basis for determining the amount of payment for
283.15 	drugs administered in an outpatient setting shall be the lower
283.16 	of the usual and customary cost submitted by the provider, the
283.17 	average wholesale price minus five percent, or the maximum
283.18 	allowable cost set by the federal government under United States
283.19 	Code, title 42, chapter 7, section 1396r-8(e), and Code of
283.20 	Federal Regulations, title 42, section 447.332, or by the
283.21 	commissioner under paragraphs (a) to (c).
283.22 	(e) The commissioner may consider the prices reported under
283.23 	section 151.52, when determining reimbursement payments under
283.24 	this subdivision.

283.25 	Sec. 8. Minnesota Statutes 2004, section 295.582, is
283.26 	amended to read:
283.27 	295.582 AUTHORITY.
283.28 		Subdivision 1.Wholesale drug distributor tax. (a) A
283.29 	hospital, surgical center, or health care provider that is
283.30 	subject to a tax under section 295.52, or a pharmacy that has
283.31 	paid additional expense transferred under this section by a
283.32 	wholesale drug distributor, may transfer additional expense
283.33 	generated by section 295.52 obligations on to all third-party
283.34 	contracts for the purchase of health care services on behalf of
283.35 	a patient or consumer. Nothing shall prohibit a pharmacy from
283.36 	transferring the additional expense generated under section
284.1 	295.52 to a pharmacy benefits manager.The additional expense
284.2 	transferred to the third-party purchaser or a pharmacy benefits
284.3 	manager must not exceed the tax percentage specified in section
284.4 	295.52 multiplied against the gross revenues received under the
284.5 	third-party contract, and the tax percentage specified in
284.6 	section 295.52 multiplied against co-payments and deductibles
284.7 	paid by the individual patient or consumer.  The expense must
284.8 	not be generated on revenues derived from payments that are
284.9 	excluded from the tax under section 295.53.  All third-party
284.10 	purchasers of health care services including, but not limited
284.11 	to, third-party purchasers regulated under chapter 60A, 62A,
284.12 	62C, 62D, 62H, 62N, 64B, 65A, 65B, 79, or 79A, or under section
284.13 	471.61 or 471.617, and pharmacy benefits managers must pay the
284.14 	transferred expense in addition to any payments due under
284.15 	existing contracts with the hospital, surgical center, pharmacy,
284.16 	or health care provider, to the extent allowed under federal
284.17 	law.  A third-party purchaser of health care services includes,
284.18 	but is not limited to, a health carrier or community integrated
284.19 	service network that pays for health care services on behalf of
284.20 	patients or that reimburses, indemnifies, compensates, or
284.21 	otherwise insures patients for health care services. For
284.22 	purposes of this section, a pharmacy benefits manager means an
284.23 	entity that performs pharmacy benefits management.A
284.24 	third-party purchaser or pharmacy benefits manager shall comply
284.25 	with this section regardless of whether the third-party
284.26 	purchaser or pharmacy benefits manager is a for-profit,
284.27 	not-for-profit, or nonprofit entity.  A wholesale drug
284.28 	distributor may transfer additional expense generated by section
284.29 	295.52 obligations to entities that purchase from the
284.30 	wholesaler, and the entities must pay the additional expense.
284.31 	Nothing in this section limits the ability of a hospital,
284.32 	surgical center, pharmacy, wholesale drug distributor, or health
284.33 	care provider to recover all or part of the section 295.52
284.34 	obligation by other methods, including increasing fees or
284.35 	charges.
284.36 	(b) Each third-party purchaser regulated under any chapter
285.1 	cited in paragraph (a) shall include with its annual renewal for
285.2 	certification of authority or licensure documentation indicating
285.3 	compliance with paragraph (a).
285.4 	(c) Any hospital, surgical center, or health care provider
285.5 	subject to a tax under section 295.52 or a pharmacy that has
285.6 	paid additional expense transferred under this section by a
285.7 	wholesale drug distributor may file a complaint with the
285.8 	commissioner responsible for regulating the third-party
285.9 	purchaser if at any time the third-party purchaser fails to
285.10 	comply with paragraph (a).
285.11 	(d) If the commissioner responsible for regulating the
285.12 	third-party purchaser finds at any time that the third-party
285.13 	purchaser has not complied with paragraph (a), the commissioner
285.14 	may take enforcement action against a third-party purchaser
285.15 	which is subject to the commissioner's regulatory jurisdiction
285.16 	and which does not allow a hospital, surgical center, pharmacy,
285.17 	or provider to pass-through the tax.  The commissioner may by
285.18 	order fine or censure the third-party purchaser or revoke or
285.19 	suspend the certificate of authority or license of the
285.20 	third-party purchaser to do business in this state if the
285.21 	commissioner finds that the third-party purchaser has not
285.22 	complied with this section.  The third-party purchaser may
285.23 	appeal the commissioner's order through a contested case hearing
285.24 	in accordance with chapter 14.
285.25 		Subd. 2.Agreement. A contracting agreement between a
285.26 	third-party purchaser or a pharmacy benefits manager and a
285.27 	resident or nonresident pharmacy registered under chapter 151,
285.28 	may not prohibit:
285.29 	(1) a pharmacy that has paid additional expense transferred
285.30 	under this section by a wholesale drug distributor from
285.31 	exercising its option under this section to transfer such
285.32 	additional expenses generated by the section 295.52 obligations
285.33 	on to the third-party purchaser or pharmacy benefits manager; or 
285.34 	(2) a pharmacy that is subject to tax under section 295.52,
285.35 	subdivision 4, from exercising its option under this section to
285.36 	recover all or part of the section 295.52 obligations from the
286.1 	third-party purchaser or a pharmacy benefits manager.

286.2 	Sec. 9. Minnesota Statutes 2004, section 641.15,
286.3 	subdivision 2, is amended to read:
286.4 		Subd. 2.Medical aid.  Except as provided in section
286.5 	466.101, the county board shall pay the costs of medical
286.6 	services provided to prisoners.  The amount paid by the Anoka
286.7 	county board and Dakota County boards for a medical service
286.8 	shall not exceed the maximum allowed medical assistance payment
286.9 	rate for the service, as determined by the commissioner of human
286.10 	services.  The county is entitled to reimbursement from the
286.11 	prisoner for payment of medical bills to the extent that the
286.12 	prisoner to whom the medical aid was provided has the ability to
286.13 	pay the bills.  The prisoner shall, at a minimum, incur
286.14 	co-payment obligations for health care services provided by a
286.15 	county correctional facility.  The county board shall determine
286.16 	the co-payment amount.  Notwithstanding any law to the contrary,
286.17 	the co-payment shall be deducted from any of the prisoner's
286.18 	funds held by the county, to the extent possible.  If there is a
286.19 	disagreement between the county and a prisoner concerning the
286.20 	prisoner's ability to pay, the court with jurisdiction over the
286.21 	defendant shall determine the extent, if any, of the prisoner's
286.22 	ability to pay for the medical services.  If a prisoner is
286.23 	covered by health or medical insurance or other health plan when
286.24 	medical services are provided, the county providing the medical
286.25 	services has a right of subrogation to be reimbursed by the
286.26 	insurance carrier for all sums spent by it for medical services
286.27 	to the prisoner that are covered by the policy of insurance or
286.28 	health plan, in accordance with the benefits, limitations,
286.29 	exclusions, provider restrictions, and other provisions of the
286.30 	policy or health plan.  The county may maintain an action to
286.31 	enforce this subrogation right.  The county does not have a
286.32 	right of subrogation against the medical assistance program or
286.33 	the general assistance medical care program.

286.34 	Sec. 10. Laws 2003, First Special Session chapter 14,
286.35 	article 13C, section 2, subdivision 6, is amended to read:

286.36 	Sec. 2. COMMISSIONER OF
287.1 	HUMAN SERVICES
 287.2 		Subd. 6.Basic Health Care Grants
287.3 	Summary by Fund
287.4 	General           1,499,941,000 1,533,016,000
287.5 	Health Care Access  268,151,000   282,605,000
287.6 	[UPDATING FEDERAL POVERTY GUIDELINES.]
287.7 	Annual updates to the federal poverty
287.8 	guidelines are effective each July 1,
287.9 	following publication by the United
287.10 	States Department of Health and Human
287.11 	Services for health care programs under
287.12 	Minnesota Statutes, chapters 256, 256B,
287.13 	256D, and 256L.
287.14 	The amounts that may be spent from this
287.15 	appropriation for each purpose are as
287.16 	follows:
287.17 	(a) MinnesotaCare Grants
287.18 	Health Care Access 267,401,000   281,855,000
287.19 	[MINNESOTACARE FEDERAL RECEIPTS.]
287.20 	Receipts received as a result of
287.21 	federal participation pertaining to
287.22 	administrative costs of the Minnesota
287.23 	health care reform waiver shall be
287.24 	deposited as nondedicated revenue in
287.25 	the health care access fund.  Receipts
287.26 	received as a result of federal
287.27 	participation pertaining to grants
287.28 	shall be deposited in the federal fund
287.29 	and shall offset health care access
287.30 	funds for payments to providers.
287.31 	[MINNESOTACARE FUNDING.] The
287.32 	commissioner may expend money
287.33 	appropriated from the health care
287.34 	access fund for MinnesotaCare in either
287.35 	fiscal year of the biennium.
287.36 	(b) MA Basic Health Care Grants -
287.37 	Families and Children
287.38 	General             568,254,000   582,161,000
287.39 	[SERVICES TO PREGNANT WOMEN.] The
287.40 	commissioner shall use available
287.41 	federal money for the State-Children's
287.42 	Health Insurance Program for medical
287.43 	assistance services provided to
287.44 	pregnant women who are not otherwise
287.45 	eligible for federal financial
287.46 	participation beginning in fiscal year
287.47 	2003.  This federal money shall be
287.48 	deposited in the federal fund and shall
287.49 	offset general funds for payments to
287.50 	providers.  Notwithstanding section 14,
287.51 	this paragraph shall not expire.
287.52 	[MANAGED CARE RATE INCREASE.] (a)
287.53 	Effective January 1, 2004, the
287.54 	commissioner of human services shall
287.55 	increase the total payments to managed
287.56 	care plans under Minnesota Statutes,
287.57 	section 256B.69, by an amount equal to
288.1 	the cost increases to the managed care
288.2 	plans from by the elimination of: (1)
288.3 	the exemption from the taxes imposed
288.4 	under Minnesota Statutes, section
288.5 	297I.05, subdivision 5, for premiums
288.6 	paid by the state for medical
288.7 	assistance, general assistance medical
288.8 	care, and the MinnesotaCare program;
288.9 	and (2) the exemption of gross revenues
288.10 	subject to the taxes imposed under
288.11 	Minnesota Statutes, sections 295.50 to
288.12 	295.57, for payments paid by the state
288.13 	for services provided under medical
288.14 	assistance, general assistance medical
288.15 	care, and the MinnesotaCare program.
288.16 	Any increase based on clause (2) must
288.17 	be reflected in provider rates paid by
288.18 	the managed care plan unless the
288.19 	managed care plan is a staff model
288.20 	health plan company.
288.21 	(b) The commissioner of human services
288.22 	shall increase by two percent the
288.23 	applicable tax rate in effect under
288.24 	Minnesota Statutes, section 295.52,the
288.25 	fee-for-service payments under medical
288.26 	assistance, general assistance medical
288.27 	care, and the MinnesotaCare program for
288.28 	services subject to the hospital,
288.29 	surgical center, or health care
288.30 	provider taxes under Minnesota
288.31 	Statutes, sections 295.50 to 295.57,
288.32 	effective for services rendered on or
288.33 	after January 1, 2004.
288.34 	(c) The commissioner of finance shall
288.35 	transfer from the health care access
288.36 	fund to the general fund the following
288.37 	amounts in the fiscal years indicated:
288.38 	2004, $16,587,000; 2005, $46,322,000;
288.39 	2006, $49,413,000; and 2007,
288.40 	$52,659,000.
288.41 	(d) For fiscal years after 2007, the
288.42 	commissioner of finance shall transfer
288.43 	from the health care access fund to the
288.44 	general fund an amount equal to the
288.45 	revenue collected by the commissioner
288.46 	of revenue on the following:
288.47 	(1) gross revenues received by
288.48 	hospitals, surgical centers, and health
288.49 	care providers as payments for services
288.50 	provided under medical assistance,
288.51 	general assistance medical care, and
288.52 	the MinnesotaCare program, including
288.53 	payments received directly from the
288.54 	state or from a prepaid plan, under
288.55 	Minnesota Statutes, sections 295.50 to
288.56 	295.57; and
288.57 	(2) premiums paid by the state under
288.58 	medical assistance, general assistance
288.59 	medical care, and the MinnesotaCare
288.60 	program under Minnesota Statutes,
288.61 	section 297I.05, subdivision 5.
288.62 	The commissioner of finance shall
288.63 	monitor and adjust if necessary the
288.64 	amount transferred each fiscal year
288.65 	from the health care access fund to the
289.1 	general fund to ensure that the amount
289.2 	transferred equals the tax revenue
289.3 	collected for the items described in
289.4 	clauses (1) and (2) for that fiscal
289.5 	year.
289.6 	(e) Notwithstanding section 14, these
289.7 	provisions shall not expire.
289.8 	(c) MA Basic Health Care Grants - Elderly
289.9 	and Disabled
289.10 	General             695,421,000   741,605,000
289.11 	[DELAY MEDICAL ASSISTANCE
289.12 	FEE-FOR-SERVICE - ACUTE CARE.] The
289.13 	following payments in fiscal year 2005
289.14 	from the Medicaid Management
289.15 	Information System that would otherwise
289.16 	have been made to providers for medical
289.17 	assistance and general assistance
289.18 	medical care services shall be delayed
289.19 	and included in the first payment in
289.20 	fiscal year 2006:
289.21 	(1) for hospitals, the last two
289.22 	payments; and
289.23 	(2) for nonhospital providers, the last
289.24 	payment.
289.25 	This payment delay shall not include
289.26 	payments to skilled nursing facilities,
289.27 	intermediate care facilities for mental
289.28 	retardation, prepaid health plans, home
289.29 	health agencies, personal care nursing
289.30 	providers, and providers of only waiver
289.31 	services.  The provisions of Minnesota
289.32 	Statutes, section 16A.124, shall not
289.33 	apply to these delayed payments.
289.34 	Notwithstanding section 14, this
289.35 	provision shall not expire.
289.36 	[DEAF AND HARD-OF-HEARING SERVICES.]
289.37 	If, after making reasonable efforts,
289.38 	the service provider for mental health
289.39 	services to persons who are deaf or
289.40 	hearing impaired is not able to earn
289.41 	$227,000 through participation in
289.42 	medical assistance intensive
289.43 	rehabilitation services in fiscal year
289.44 	2005, the commissioner shall transfer
289.45 	$227,000 minus medical assistance
289.46 	earnings achieved by the grantee to
289.47 	deaf and hard-of-hearing grants to
289.48 	enable the provider to continue
289.49 	providing services to eligible persons.
289.50 	(d) General Assistance Medical Care
289.51 	Grants
289.52 	General             223,960,000   196,617,000
289.53 	(e) Health Care Grants - Other
289.54 	Assistance
289.55 	General               3,067,000     3,407,000
289.56 	Health Care Access      750,000       750,000
289.57 	[MINNESOTA PRESCRIPTION DRUG DEDICATED
290.1 	FUND.] Of the general fund
290.2 	appropriation, $284,000 in fiscal year
290.3 	2005 is appropriated to the
290.4 	commissioner for the prescription drug
290.5 	dedicated fund established under the
290.6 	prescription drug discount program.
290.7 	[DENTAL ACCESS GRANTS CARRYOVER
290.8 	AUTHORITY.] Any unspent portion of the
290.9 	appropriation from the health care
290.10 	access fund in fiscal years 2002 and
290.11 	2003 for dental access grants under
290.12 	Minnesota Statutes, section 256B.53,
290.13 	shall not cancel but shall be allowed
290.14 	to carry forward to be spent in the
290.15 	biennium beginning July 1, 2003, for
290.16 	these purposes.
290.17 	[STOP-LOSS FUND ACCOUNT.] The
290.18 	appropriation to the purchasing
290.19 	alliance stop-loss fund account
290.20 	established under Minnesota Statutes,
290.21 	section 256.956, subdivision 2, for
290.22 	fiscal years 2004 and 2005 shall only
290.23 	be available for claim reimbursements
290.24 	for qualifying enrollees who are
290.25 	members of purchasing alliances that
290.26 	meet the requirements described under
290.27 	Minnesota Statutes, section 256.956,
290.28 	subdivision 1, paragraph (f), clauses
290.29 	(1), (2), and (3).
290.30 	(f) Prescription Drug Program
290.31 	General               9,239,000     9,226,000
290.32 	[PRESCRIPTION DRUG ASSISTANCE PROGRAM.]
290.33 	Of the general fund appropriation,
290.34 	$702,000 in fiscal year 2004 and
290.35 	$887,000 in fiscal year 2005 are for
290.36 	the commissioner to establish and
290.37 	administer the prescription drug
290.38 	assistance program through the
290.39 	Minnesota board on aging.
290.40 	[REBATE REVENUE RECAPTURE.] Any funds
290.41 	received by the state from a drug
290.42 	manufacturer due to errors in the
290.43 	pharmaceutical pricing used by the
290.44 	manufacturer in determining the
290.45 	prescription drug rebate are
290.46 	appropriated to the commissioner to
290.47 	augment funding of the prescription
290.48 	drug program established in Minnesota
290.49 	Statutes, section 256.955.

290.50 	Sec. 11. LANGUAGE INTERPRETER SERVICES STUDY.
 290.51 	The commissioner of commerce, in consultation with the
290.52 	commissioners of health, human services, and employee relations,
290.53 	and representatives of health plan companies, health care
290.54 	providers, and limited-English-speaking communities, and
290.55 	communities that communicate through sign language shall study
290.56 	and make recommendations on providing language interpreter
290.57 	services to limited-English-speaking patients and patients who
291.1 	communicate through sign language in order to facilitate the
291.2 	provision of health care services by health care providers and
291.3 	health care facilities.  The recommendations shall include:
291.4 	(1) ways to address the needed availability of professional
291.5 	interpreter services;
291.6 	(2) an accreditation system for language interpreters,
291.7 	including appropriate standards for education, training, and
291.8 	credentialing; and 
291.9 	(3) criteria for determining financial responsibility for
291.10 	providing interpreter services to patients, including the
291.11 	responsible parties for arranging interpreter services and for
291.12 	reimbursement for these services.
291.13 	The commissioner of commerce shall submit these
291.14 	recommendations to the legislature by January 15, 2006.

291.15 	Sec. 12. REBATE REVENUE RECAPTURE.
 291.16 	Any money received by the state from a drug manufacturer
291.17 	due to errors in the pharmaceutical pricing used by the
291.18 	manufacturer in determining the prescription drug rebate shall
291.19 	be deposited in the health care quality improvement account
291.20 	established in Minnesota Statutes, section 256.957.

291.21 	Sec. 13. REPEALER.
 291.22 	Minnesota Statutes 2004, section 119B.074, is repealed.

291.23 	ARTICLE 8
291.24 	APPROPRIATIONS

291.25 	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 291.26 	The sums in the columns marked "APPROPRIATIONS" are added
291.27 	to, or, if shown in parentheses, are subtracted from the
291.28 	appropriations to the specified agencies in 2005 S.F. No. 1879,
291.29 	article 11, if enacted.  The appropriations are from the general
291.30 	fund, unless another fund is named, and are available for the
291.31 	fiscal year indicated for each purpose.  The figures "2006" and
291.32 	"2007," where used in this article, mean that the additions to
291.33 	or subtractions from the appropriations listed under them are
291.34 	for the fiscal year ending June 30, 2006, or June 30, 2007,
291.35 	respectively.  The "first year" is fiscal year 2006.  The
291.36 	"second year" is fiscal year 2007.  The "biennium" is fiscal
292.1 	years 2006 and 2007.
292.2 	SUMMARY BY FUND
292.3 	BIENNIAL
292.4 	                           2006          2007           TOTAL
292.5 	General            $   38,148,000 $   63,783,000 $  101,931,000
292.6 	State Government
292.7 	Special Revenue         7,151,000     12,625,000     19,776,000
292.8 	Health Care
292.9 	Access                 42,451,000     65,060,000    107,511,000
292.10 	Federal TANF           (3,665,000)    11,064,000      7,399,000
292.11 	Lottery Prize
292.12 	Fund                      400,000        400,000        800,000
292.13 	TOTAL              $   84,485,000 $  152,932,000 $  237,417,000
292.14 	APPROPRIATIONS
292.15 	                                       Available for the Year
292.16 	                                           Ending June 30
292.17 	                                          2006         2007

292.18 	Sec. 2. COMMISSIONER OF
292.19 	HUMAN SERVICES
 292.20 		Subdivision 1.Total
292.21 	Appropriation                     $   75,897,000 $  137,808,000
292.22 	Summary by Fund
292.23 	General              36,781,000    61,354,000
292.24 	Health Care
292.25 	Access               42,381,000    64,990,000
292.26 	Federal TANF         (3,665,000)   11,064,000
292.27 	Lottery Cash
292.28 	Flow                    400,000       400,000
292.29 		Subd. 2.Agency Management
292.30 	Summary by Fund
292.31 	General                (165,000)     (231,000)
292.32 	Health Care Access    1,623,000     1,701,000
292.33 	The amounts that may be spent from the
292.34 	appropriation for each purpose are as
292.35 	follows:
292.36 	(a) Financial Operations
292.37 	General                 424,000       424,000
292.38 	Health Care Access      152,000       183,000
292.39 	[ADMINISTRATIVE REDUCTION.] The general
292.40 	fund appropriation in this section
292.41 	includes a department-wide
292.42 	administrative reduction of $6,885,000
292.43 	the first year and $7,201,000 the
292.44 	second year.  The commissioner shall
292.45 	ensure that any staff reductions made
292.46 	under this paragraph comply with
293.1 	Minnesota Statutes, section 43A.046.
293.2 	(b) Legal and
293.3 	Regulation Operations
293.4 	General              (5,208,000)   (5,482,000)
293.5 	Health Care Access       75,000        75,000
293.6 	(c) Information Technology
293.7 	Operations
293.8 	General               4,619,000     4,827,000
293.9 	Health Care Access    1,396,000     1,443,000
293.10 		Subd. 3.Revenue and Pass-Through
293.11 	Federal TANF        (16,956,000)   (5,221,000)
293.12 	[REDUCED TANF TRANSFER.]
293.13 	Notwithstanding Laws 2000, chapter 488,
293.14 	article 8, section 2, subdivision 6,
293.15 	with respect to TANF funds used as
293.16 	refinancing for the state share of the
293.17 	child support pass-through under
293.18 	Minnesota Statutes, section 256.741,
293.19 	subdivision 15, and notwithstanding
293.20 	Minnesota Statutes, section 290.0671,
293.21 	subdivision 6a, with respect to the
293.22 	TANF-funded expansion of the Minnesota
293.23 	working family credit, the commissioner
293.24 	shall reduce the combined amount of the
293.25 	TANF funds transferred to the
293.26 	commissioner of revenue for deposit in
293.27 	the general fund by $11,020,000 in
293.28 	fiscal year 2006, by $6,860,000 in
293.29 	fiscal year 2007, and by $7,000,000 in
293.30 	fiscal year 2008 and subsequent years.
293.31 	Notwithstanding section 7, this
293.32 	paragraph shall not expire.
293.33 	[TANF TRANSFER TO FEDERAL CHILD CARE
293.34 	AND DEVELOPMENT FUND.] The following
293.35 	amounts are appropriated to the
293.36 	commissioner for the purposes of MFIP
293.37 	transition year child care under
293.38 	Minnesota Statutes, section 119B.05;
293.39 	$756,000 in fiscal year 2006;
293.40 	$4,831,000 in fiscal year 2007;
293.41 	$5,183,000 in fiscal year 2008; and
293.42 	$1,127,000 in fiscal year 2009.  The
293.43 	commissioner shall authorize the
293.44 	transfer of sufficient TANF funds to
293.45 	the federal child care and development
293.46 	fund to meet this appropriation and
293.47 	shall ensure that all transferred funds
293.48 	are expended according to the federal
293.49 	child care and development fund
293.50 	regulations.  Notwithstanding section
293.51 	7, this paragraph expires June 30, 2009.
293.52 	Subd. 4.  Economic Support Grants
293.53 	Summary by Fund
293.54 	General               1,722,000     7,109,000
293.55 	Federal TANF         13,291,000    16,285,000
293.56 	The amounts that may be spent from this
294.1 	appropriation for each purpose are as
294.2 	follows:
294.3 	(a) Minnesota Family Investment Program
294.4 	General                 -0-         3,740,000
294.5 	Federal TANF         13,151,000    16,145,000
294.6 	(b) MFIP Child Care Assistance Grants
294.7 	-0-         (3,740,000)
294.8 	(c) Children Services Grants
294.9 	1,119,000      6,074,000
294.10 	(d) Children and Community Services
294.11 	Grants
294.12 	General Fund             3,000        11,000
294.13 	Federal TANF           140,000       140,000
294.14 	[NEW CHANCE PROGRAM.] Of the TANF
294.15 	appropriation, $140,000 each year is to
294.16 	the commissioner for a grant to the new
294.17 	chance program.  The new chance program
294.18 	shall provide comprehensive services
294.19 	through a private, nonprofit agency to
294.20 	young parents in Hennepin County who
294.21 	have dropped out of school and are
294.22 	receiving public assistance.  The
294.23 	program administrator shall report
294.24 	annually to the commissioner on skills
294.25 	development, education, job training,
294.26 	and job placement outcomes for program
294.27 	participants.
294.28 	(e) Minnesota Supplemental Aid Grants
294.29 	118,000        363,000
294.30 	(f) Group Residential Housing Grants
294.31 	122,000        301,000
294.32 	(g) Other Children's and Economic
294.33 	Assistance Grants
294.34 	360,000        360,000
294.35 	[TRANSITIONAL HOUSING.] This
294.36 	appropriation is to the commissioner
294.37 	for the transitional housing program
294.38 	established in the 2005 Environment,
294.39 	Agriculture, and Economic Development
294.40 	omnibus appropriations bill.
294.41 		Subd. 5.Children and Economic
294.42 	Assistance Management
294.43 	467,000        291,000
294.44 		Subd. 6.Basic Health Care Grants
294.45 	Summary by Fund
294.46 	General                 190,000     6,424,000
294.47 	Health Care Access   30,843,000    51,903,000
295.1 	The amounts that may be spent from this
295.2 	appropriation for each purpose are as
295.3 	follows:
295.4 	(a) MinnesotaCare Grants
295.5 	Health Care Access  30,843,000    51,903,000
295.6 	[HEALTHMATCH DELAY.] Of this
295.7 	appropriation, $3,112,000 the first
295.8 	year and $7,541,000 the second year is
295.9 	for the MinnesotaCare program costs
295.10 	related to a one-month delay in
295.11 	implementation of the HealthMatch
295.12 	program.
295.13 	(b) MA Basic Health Care Grants -
295.14 	Families and Children
295.15 	516,000      3,326,000
295.16 	[GREATER MINNESOTA HOSPITAL PAYMENT
295.17 	ADJUSTMENT.] Of the general fund
295.18 	appropriation for medical assistance
295.19 	basic health care grants - families and
295.20 	children, medical assistance basic
295.21 	health care grants - elderly and
295.22 	disabled, and general assistance
295.23 	medical care, $400,000 each year is for
295.24 	greater Minnesota payment adjustments
295.25 	under Minnesota Statutes, section
295.26 	256.969, subdivision 26, for admissions
295.27 	occurring on or after July 1, 2005.
295.28 	[PROVIDER RATES NOT TO INCREASE.]
295.29 	Provider rates under medical assistance
295.30 	and general assistance medical care,
295.31 	except for rates paid for dental
295.32 	services and pharmacy services, in
295.33 	effect on June 30, 2005, shall not be
295.34 	increased as a result of the repeal of
295.35 	recipient co-payments effective July 1,
295.36 	2005.
295.37 	(c) MA Basic Health Care Grants - Elderly
295.38 	and Disabled
295.39 	1,146,000        727,000
295.40 	(d) General Assistance Medical Care
295.41 	Grants
295.42 	1,029,000      4,349,000
295.43 	(e) Health Care Grants - Other
295.44 	Assistance
295.45 	(2,500,000)     (1,978,000)
295.46 	[PRESCRIPTION DRUG DISCOUNT PROGRAM.]
295.47 	Of the general fund appropriation for
295.48 	the second year, $1,022,000 is to be
295.49 	transferred to the Minnesota
295.50 	prescription drug dedicated fund
295.51 	established in Minnesota Statutes,
295.52 	section 256.9545, subdivision 11.  This
295.53 	is a onetime appropriation and shall
295.54 	not become part of base level funding
295.55 	for the biennium beginning July 1, 2007.
295.56 		Subd. 7.Health Care Management
296.1 	Summary by Fund
296.2 	General               4,670,000     4,411,000
296.3 	Health Care Access    9,915,000    11,386,000
296.4 	The amounts that may be spent from this
296.5 	appropriation for each purpose are as
296.6 	follows:
296.7 	(a) Health Care Administration
296.8 	General               4,206,000     4,157,000
296.9 	Health Care Access    7,465,000    10,693,000
296.10 	[TICKET TO WORK.] Effective the day
296.11 	following final enactment, supplemental
296.12 	funding made available by the Centers
296.13 	for Medicare and Medicaid Services
296.14 	under the Ticket to Work Medicaid
296.15 	Infrastructure Grant to support
296.16 	outreach and education activities on
296.17 	Medicare Part D for persons receiving
296.18 	medical assistance for employed persons
296.19 	with disabilities is appropriated to
296.20 	the commissioner for required grant and
296.21 	administrative activities.
296.22 	(b) Health Care Operations
296.23 	General                 464,000       254,000
296.24 	Health Care Access    2,450,000       693,000
296.25 		Subd. 8.Continuing Care Grants
296.26 	Summary by Fund
296.27 	General               6,616,000    36,090,000
296.28 	Lottery Prize Fund      400,000       400,000
296.29 	The amounts that may be spent from this
296.30 	appropriation for each purpose are as
296.31 	follows:
296.32 	(a) Aging and Adult Service Grant
296.33 	3,000         10,000
296.34 	(b) Alternative Care Grants
296.35 	10,468,000     19,442,000
296.36 	(c) Medical Assistance Long-Term
296.37 	Care Facilities Grants
296.38 	(2,799,000)   (12,569,000)
296.39 	[RATE ADJUSTMENTS UNDER NEW NURSING
296.40 	FACILITY REIMBURSEMENT SYSTEM.] Of this
296.41 	appropriation, $12,992,000 the second
296.42 	year is to adjust nursing facility
296.43 	rates in order to facilitate the
296.44 	transition from the current ratesetting
296.45 	system to the system developed under
296.46 	Minnesota Statutes, section 256B.440.
296.47 	[NURSING HOME MORATORIUM EXCEPTIONS.]
296.48 	During the first year, the commissioner
297.1 	of health may approve moratorium
297.2 	exception projects under Minnesota
297.3 	Statutes, section 144A.073, for which
297.4 	the full annualized state share of
297.5 	medical assistance costs does not
297.6 	exceed $3,000,000.
297.7 	[ICF/MR DOWNSIZING.] Of this
297.8 	appropriation, $300,000 each year is
297.9 	for rate adjustments for intermediate
297.10 	care facilities for persons with mental
297.11 	retardation that are downsizing.
297.12 	(d) Medical Assistance Long-Term
297.13 	Care Waivers and Home Care Grants
297.14 	(4,354,000)    (3,279,000)
297.15 	[LIMITING WAIVER GROWTH.] For each year
297.16 	of the biennium ending June 30, 2007,
297.17 	the commissioner of human services
297.18 	shall make available additional
297.19 	allocations for community alternatives
297.20 	for disabled individuals waivered
297.21 	services covered under Minnesota
297.22 	Statutes, section 256B.49, at a rate of
297.23 	105 per month or 1,260 per year, plus
297.24 	any additional legislatively authorized
297.25 	growth.  Priorities for the allocation
297.26 	of funds shall be for individuals
297.27 	anticipated to be discharged from
297.28 	institutional settings or who are at
297.29 	imminent risk of a placement in an
297.30 	institutional setting.
297.31 	For each year of the biennium ending
297.32 	June 30, 2007, the commissioner shall
297.33 	make available additional allocations
297.34 	for traumatic brain injury waivered
297.35 	services covered under Minnesota
297.36 	Statutes, section 256B.49, at a rate of
297.37 	165 per year.  Priorities for the
297.38 	allocation of funds shall be for
297.39 	individuals anticipated to be
297.40 	discharged from institutional settings
297.41 	or who are at imminent risk of a
297.42 	placement in an institutional setting.
297.43 	Notwithstanding 2005 S.F. No. 1879,
297.44 	article 11, section 2, subdivision 8,
297.45 	paragraph (d), if enacted, for each
297.46 	year of the biennium ending June 30,
297.47 	2007, the commissioner shall limit the
297.48 	new diversion caseload growth in the
297.49 	mental retardation and related
297.50 	conditions waiver to 75 additional
297.51 	allocations.  Notwithstanding Minnesota
297.52 	Statutes, section 256B.0916,
297.53 	subdivision 5, paragraph (b), the
297.54 	available diversion allocations shall
297.55 	be awarded to support individuals whose
297.56 	health and safety needs result in an
297.57 	imminent risk of an institutional
297.58 	placement at any time during the fiscal
297.59 	year.
297.60 	(e) Mental Health Grants
297.61 	General                 950,000     1,888,000
297.62 	Lottery Prize Fund      400,000       400,000
298.1 	[ALTERNATIVES TO ANOKA-METRO REGIONAL
298.2 	TREATMENT CENTER.] Of this
298.3 	appropriation, $350,000 the first year
298.4 	and $145,000 the second year is to the
298.5 	commissioner to develop community
298.6 	alternatives to Anoka-Metro Regional
298.7 	Treatment Center under Minnesota
298.8 	Statutes, section 245.4661,
298.9 	subdivisions 8 to 11.  Any amount of
298.10 	this appropriation that is unspent
298.11 	shall not cancel but shall be available
298.12 	until expended.  Notwithstanding
298.13 	section 7, this paragraph shall not
298.14 	expire.
298.15 	(f) Deaf and Hard-of-Hearing
298.16 	Service Grants
298.17 	9,000         33,000
298.18 	(g) Chemical Dependency
298.19 	Entitlement Grants
298.20 	2,144,000      4,762,000
298.21 	(h) Other Continuing Care
298.22 	195,000        665,000
298.23 		Subd. 9.Continuing Care Management
298.24 	599,000        465,000
298.25 	[TASK FORCE ON COLLABORATIVE SERVICES.]
298.26 	The commissioner, in collaboration with
298.27 	the commissioner of education, shall
298.28 	create a task force to discuss
298.29 	collaboration between schools and
298.30 	mental health providers to:  promote
298.31 	colocation and integrated services;
298.32 	identify barriers to collaboration;
298.33 	develop a model contract; and identify
298.34 	examples of successful collaboration.
298.35 	The task force shall also develop
298.36 	recommendations on how to pay for
298.37 	children's mental health screenings.
298.38 	The task force shall include
298.39 	representatives of school boards;
298.40 	administrative personnel; special
298.41 	education directors; counties; parent
298.42 	advocacy organizations; school social
298.43 	workers, counselors, nurses, and
298.44 	psychologists; community mental health
298.45 	professionals; health plans; and other
298.46 	interested parties.  The task force
298.47 	shall present a report to the chairs of
298.48 	the education and health policy
298.49 	committees by February 1, 2006.
298.50 	Of the general fund appropriation,
298.51 	$5,000 the first year is to the
298.52 	commissioner to contract with a
298.53 	nonprofit organization that is
298.54 	knowledgeable about children's mental
298.55 	health issues to provide the research
298.56 	necessary for the task force to make
298.57 	recommendations and complete the report.
298.58 		Subd. 10.State-Operated Services
298.59 	22,682,000      6,796,000
299.1 	[EVIDENCE-BASED PRACTICE FOR
299.2 	METHAMPHETAMINE TREATMENT.] Of the
299.3 	general fund appropriation, $300,000
299.4 	each year is to support development of
299.5 	evidence-based practices for the
299.6 	treatment of methamphetamine abuse at
299.7 	the state-operated services chemical
299.8 	dependency program in Willmar.  These
299.9 	funds shall be used to support research
299.10 	on evidence-based practices for the
299.11 	treatment of methamphetamine abuse,
299.12 	dissemination of the results of the
299.13 	evidence-based practice research
299.14 	statewide, and creation of training for
299.15 	addiction counselors specializing in
299.16 	the treatment of methamphetamine abuse.

299.17 	Sec. 3. COMMISSIONER OF HEALTH
 299.18 		Subdivision 1.Total
299.19 	Appropriation                          6,271,000     13,118,000
299.20 	Summary by Fund
299.21 	General               1,367,000     2,429,000
299.22 	State Government
299.23 	Special Revenue       4,834,000    10,619,000
299.24 	Health Care Access       70,000        70,000
299.25 	[RENTAL COSTS, ADMINISTRATIVE
299.26 	REDUCTIONS, FEE INCREASES, AND REVENUE
299.27 	TRANSFER.] (a) Of this appropriation,
299.28 	$1,208,000 the first year and
299.29 	$3,069,000 the second year is for
299.30 	rental costs in the new public health
299.31 	laboratory building.
299.32 	(b) The general fund appropriation in
299.33 	this section includes a department-wide
299.34 	administrative reduction of $242,000
299.35 	the first year and $1,007,000 the
299.36 	second year.  The commissioner shall
299.37 	ensure that any staff reductions made
299.38 	under this paragraph comply with
299.39 	Minnesota Statutes, section 43A.046.
299.40 	(c) The commissioner shall increase all
299.41 	fees levied by the commissioner a pro
299.42 	rata amount in order to generate
299.43 	revenue of $731,000 the first year and
299.44 	$1,823,000 the second year.  These
299.45 	amounts shall be deposited in the
299.46 	general fund.  This paragraph shall not
299.47 	apply to fees paid by occupational
299.48 	therapists.
299.49 	(d) $254,000 each year shall be
299.50 	transferred from the state government
299.51 	special revenue fund to the general
299.52 	fund.
299.53 		Subd. 2.Community and Family
299.54 	Health Improvement
299.55 	Summary by Fund
299.56 	General                 159,000      (640,000)
299.57 	State Government
300.1 	Special Revenue         335,000       335,000
300.2 	Health Care Access       70,000        70,000
300.3 	[TANF CARRYFORWARD.] Any unexpended
300.4 	balance of the TANF appropriation in
300.5 	the first year of the biennium in this
300.6 	section and 2005 S.F. No. 1879, article
300.7 	11, section 3, if enacted, does not
300.8 	cancel but is available for the second
300.9 	year.
300.10 	[WORK GROUP ON CHILDHOOD OBESITY.] (a)
300.11 	Of the general fund appropriation,
300.12 	$5,000 the first year and $1,000 the
300.13 	second year is to the commissioner to
300.14 	convene an interagency work group with
300.15 	the commissioners of human services and
300.16 	education to study and make
300.17 	recommendations on reducing the rate of
300.18 	obesity among the children in Minnesota.
300.19 	(b) The work group shall determine the
300.20 	number of children who are currently
300.21 	obese and set a goal, including
300.22 	measurable outcomes for the state in
300.23 	terms of reducing the rate of childhood
300.24 	obesity.  The work group shall make
300.25 	recommendations on how to achieve this
300.26 	goal, including, but not limited to,
300.27 	increasing physical activities;
300.28 	exploring opportunities to promote
300.29 	physical education and healthy eating
300.30 	programs; improving the nutritional
300.31 	offerings through breakfast and lunch
300.32 	menus; and evaluating the availability
300.33 	and choice of nutritional products
300.34 	offered in public schools.
300.35 	(c) The work group may include
300.36 	representatives of the Minnesota
300.37 	Medical Association; the Minnesota
300.38 	Nurses Association; the Local Public
300.39 	Health Association of Minnesota; the
300.40 	Minnesota Dietetic Association; the
300.41 	Minnesota School Food Service
300.42 	Association; the Minnesota Association
300.43 	of Health, Physical Education,
300.44 	Recreation, and Dance; the Minnesota
300.45 	School Boards Association; the
300.46 	Minnesota School Administrators
300.47 	Association; the Minnesota Secondary
300.48 	Principals Association; the vending
300.49 	industry; and consumers.
300.50 	(d) The commissioner must submit the
300.51 	recommendations of the work group to
300.52 	the legislature by January 15, 2007.
300.53 		Subd. 3.Policy Quality and
300.54 	Compliance
300.55 	Summary by Fund
300.56 	State Government
300.57 	Special Revenue         770,000       770,000
300.58 	[STATEWIDE TRAUMA SYSTEM.] (a) Of the
300.59 	general fund appropriation, $382,000
300.60 	the first year and $352,000 the second
300.61 	year is for development of a statewide
301.1 	trauma system.
301.2 	(b) The commissioner shall increase
301.3 	hospital licensing fees a pro rata
301.4 	amount to increase fee revenue by
301.5 	$382,000 the first year and $352,000
301.6 	the second year.  This revenue shall be
301.7 	deposited in the general fund.
301.8 	[AIDS PREVENTION FOR AFRICAN-BORN
301.9 	RESIDENTS.] For fiscal year 2006 only,
301.10 	the commissioner shall reallocate
301.11 	$300,000 from the grant program under
301.12 	Minnesota Statutes, section 145.928,
301.13 	for grants in accordance with Minnesota
301.14 	Statutes, section 145.924, paragraph
301.15 	(b), for a public education and
301.16 	awareness campaign targeting
301.17 	communities of African-born Minnesota
301.18 	residents.  The grants shall be
301.19 	designed to:
301.20 	(1) promote knowledge and understanding
301.21 	about HIV and to increase knowledge in
301.22 	order to eliminate and reduce the risk
301.23 	for HIV infection;
301.24 	(2) encourage screening and testing for
301.25 	HIV; and
301.26 	(3) connect individuals to public
301.27 	health and health care resources.  The
301.28 	grants must be awarded to collaborative
301.29 	efforts that bring together nonprofit
301.30 	community-based groups with
301.31 	demonstrated experience in addressing
301.32 	the public health, health care, and
301.33 	social service needs of African-born
301.34 	communities.
301.35 	[FAMILY PLANNING GRANTS.] Of the
301.36 	general fund appropriation, $500,000
301.37 	each year is to the commissioner for
301.38 	grants under Minnesota Statutes,
301.39 	section 145.925, to family planning
301.40 	clinics serving outstate Minnesota that
301.41 	demonstrate financial need.
301.42 		Subd. 4.Health Protection
301.43 	Summary by Fund
301.44 	State Government
301.45 	Special Revenue       3,729,000     9,514,000
301.46 		Subd. 5.Administrative Support
301.47 	Services
301.48 	1,208,000      3,069,000

301.49 	Sec. 4. VETERANS NURSING HOMES BOARD
 301.50 	[VETERANS HOMES SPECIAL REVENUE
301.51 	ACCOUNT.] The general fund
301.52 	appropriations made to the board in
301.53 	2005 S.F. No. 1879, if enacted, may be
301.54 	transferred to a veterans homes special
301.55 	revenue account in the special revenue
301.56 	fund in the same manner as other
301.57 	receipts are deposited according to
301.58 	Minnesota Statutes, section 198.34, and
302.1 	are appropriated to the board for the
302.2 	operation of board facilities and
302.3 	programs.

302.4 	Sec. 5. HEALTH-RELATED BOARDS
 302.5 		Subdivision 1.Total
302.6 	Appropriation                          2,317,000      2,006,000
302.7 	Summary by Fund
302.8 	State Government
302.9 	Special Revenue       2,317,000     2,006,000
302.10 	[STATE GOVERNMENT SPECIAL REVENUE
302.11 	FUND.] The appropriations in this
302.12 	section are from the state government
302.13 	special revenue fund, except where
302.14 	noted.
302.15 	[NO SPENDING IN EXCESS OF REVENUES.]
302.16 	The commissioner of finance shall not
302.17 	permit the allotment, encumbrance, or
302.18 	expenditure of money appropriated in
302.19 	this section in excess of the
302.20 	anticipated biennial revenues or
302.21 	accumulated surplus revenues from fees
302.22 	collected by the boards.  Neither this
302.23 	provision nor Minnesota Statutes,
302.24 	section 214.06, applies to transfers
302.25 	from the general contingent account.
302.26 		Subd. 2.Board of Dentistry
302.27 	Summary by Fund
302.28 	State Government
302.29 	Special Revenue         150,000       -0-
302.30 	[ORAL HEALTH PILOT PROJECT.] Of this
302.31 	appropriation, $150,000 the first year
302.32 	is to be transferred to the
302.33 	commissioner of human services for an
302.34 	oral health care system pilot project.
302.35 		Subd. 3.Board of Nursing
302.36 	1,563,000      1,407,000
302.37 	[MINNESOTA CENTER OF NURSING.] (a) Of
302.38 	this appropriation, $500,000 in fiscal
302.39 	year 2006 is to be used as start-up
302.40 	funding to establish a Minnesota Center
302.41 	of Nursing.  The goals of the center
302.42 	shall be to:
302.43 	(1) maintain information on the current
302.44 	and projected supply and demand of
302.45 	nurses through the collection and
302.46 	analysis of data on the nursing
302.47 	workforce;
302.48 	(2) develop a strategic statewide plan
302.49 	for the nursing workforce;
302.50 	(3) convene work groups of stakeholders
302.51 	to examine issues and make
302.52 	recommendations regarding factors
302.53 	affecting nursing education,
302.54 	recruitment, and retention;
303.1 	(4) promote recognition, reward, and
303.2 	renewal activities for nurses in
303.3 	Minnesota; and
303.4 	(5) provide consultation, technical
303.5 	assistance, and data on the nursing
303.6 	workforce to the legislature.
303.7 	(b) The board shall report to the
303.8 	legislature by January 15, 2007, on the
303.9 	Center of Nursing's progress, the
303.10 	center's collaboration efforts with
303.11 	other organizations and governmental
303.12 	entities, and the activities conducted
303.13 	by the center in achieving the goals
303.14 	outlined.
303.15 	[TRANSFERS FROM SPECIAL REVENUE FUND.]
303.16 	Of this appropriation, the following
303.17 	transfers shall be made as directed
303.18 	from the state government special
303.19 	revenue fund:
303.20 	(a) $938,000 the first year and
303.21 	$1,207,000 the second year shall be
303.22 	transferred to the commissioner of
303.23 	human services for the long-term care
303.24 	and home and community-based care
303.25 	employee scholarship program.  This
303.26 	appropriation shall not become part of
303.27 	base level funding for the biennium
303.28 	beginning July 1, 2007.
303.29 	(b) $125,000 the first year and
303.30 	$200,000 the second year shall be
303.31 	transferred to the health professional
303.32 	education loan forgiveness program
303.33 	account for loan forgiveness for nurses
303.34 	under Minnesota Statutes, section
303.35 	144.1501.  This appropriation shall
303.36 	become part of base level funding for
303.37 	the commissioner for the biennium
303.38 	beginning July 1, 2007, but shall not
303.39 	be part of base level funding for the
303.40 	biennium beginning July 1, 2009.
303.41 	Notwithstanding section 7, this
303.42 	paragraph expires on June 30, 2009.
303.43 		Subd. 4.Board of Pharmacy
303.44 	499,000        499,000
303.45 	[RURAL PHARMACY PROGRAM.] Of this
303.46 	appropriation, $200,000 each year shall
303.47 	be transferred to the commissioner of
303.48 	health for the rural pharmacy planning
303.49 	and transition grant program under
303.50 	Minnesota Statutes, section 144.1476.
303.51 	Of this transferred amount, $20,000
303.52 	each year may be retained by the
303.53 	commissioner for related administrative
303.54 	costs.  This appropriation shall become
303.55 	part of base level funding for the
303.56 	commissioner for the biennium beginning
303.57 	July 1, 2007.  Notwithstanding section
303.58 	7, this paragraph expires on June 30,
303.59 	2009.
303.60 	[PHARMACIST LOAN FORGIVENESS.] $200,000
303.61 	each year shall be transferred to the
303.62 	health professional education loan
304.1 	forgiveness program account for loan
304.2 	forgiveness for pharmacists under
304.3 	Minnesota Statutes, section 144.501.
304.4 	This appropriation shall become part of
304.5 	base level funding for the commissioner
304.6 	for the biennium beginning July 1,
304.7 	2007.  Notwithstanding section 7, this
304.8 	paragraph expires on June 30, 2009.
304.9 	[DRUG MANUFACTURER PRICING DISCLOSURE.]
304.10 	(a) The board shall increase the
304.11 	licensing or registration fee for
304.12 	wholesale drug distributors and drug
304.13 	manufacturers required under Minnesota
304.14 	Statutes, chapter 151, by $65 per year
304.15 	beginning July 1, 2005.
304.16 	(b) Of the appropriation in this
304.17 	subdivision, $74,000 each year is to be
304.18 	transferred to the commissioner of
304.19 	human services for the data received
304.20 	under Minnesota Statutes, section
304.21 	151.52.
304.22 	[CANCER DRUG REPOSITORY PROGRAM.] Of
304.23 	this appropriation, $25,000 each year
304.24 	is for the cancer drug repository
304.25 	program under Minnesota Statutes,
304.26 	section 151.55.  This appropriation
304.27 	shall become part of base level funding
304.28 	for the board for the biennium
304.29 	beginning July 1, 2007, but shall not
304.30 	be part of the base for the biennium
304.31 	beginning July 1, 2009.
304.32 	Notwithstanding section 7, this
304.33 	paragraph expires June 30, 2009.
304.34 		Subd. 5.Board of Social
304.35 	Work
304.36 	105,000        100,000
304.37 	[ADMINISTRATIVE MANAGEMENT.] This
304.38 	appropriation is to provide
304.39 	administrative management under
304.40 	Minnesota Statutes, section 148B.61,
304.41 	subdivision 4.  The following boards
304.42 	shall be assessed a prorated amount
304.43 	depending on the number of licensees
304.44 	under the board's regulatory authority
304.45 	providing mental health services within
304.46 	their scope of practice:  Board of
304.47 	Medical Practice, the Board of Nursing,
304.48 	the Board of Psychology, the Board of
304.49 	Social Work, the Board of Marriage and
304.50 	Family Therapy, and the Board of
304.51 	Behavioral Health and Therapy.

304.52 	Sec. 6. BASE LEVEL FUNDING ADJUSTMENTS.
 304.53 	Base level funding for the biennium beginning July 1, 2007,
304.54 	for nonentitlement grants and administration appropriations in
304.55 	this article shall be shown in legislative tracking documents.
304.56 	Notwithstanding section 7, this section shall expire on June 30,
304.57 	2009.

304.58 	Sec. 7. SUNSET OF UNCODIFIED LANGUAGE.
 305.1 	All uncodified language in this article expires on June 30,
305.2 	2007, unless a different expiration date is explicit.