1.1 	A bill for an act
1.2 	relating to the operation of state government; making
1.3 	changes to health and human services programs;
1.4 	modifying human services policy; modifying health
1.5 	policy; changing licensing provisions; changing
1.6 	provisions for mental and chemical health;
1.7 	establishing treatment foster care and transitional
1.8 	youth intensive rehab mental health services;
1.9 	enhancing family support; providing training for child
1.10 	care providers and hospitals on dangers of shaking
1.11 	infants and children; establishing long-term homeless
1.12 	supportive services; establishing the tobacco health
1.13 	impact fee; establishing a cancer drug repository
1.14 	program; establishing a health information technology
1.15 	and infrastructure advisory committee and a rural
1.16 	pharmacy planning and transition grant program;
1.17 	establishing a statewide trauma system and trauma
1.18 	registry; changing long-term care provisions and
1.19 	establishing a partnership; establishing a nursing
1.20 	facility reimbursement system; modifying health care
1.21 	programs; changing certain fees; appropriating money;
1.22 	amending Minnesota Statutes 2004, sections 13.46,
1.23 	subdivision 4, as amended; 16A.724; 62J.692,
1.24 	subdivision 3, as amended; 62Q.251, as added; 62Q.37,
1.25 	subdivision 7; 103I.101, subdivision 6; 103I.208,
1.26 	subdivisions 1, as amended, 2, as amended; 103I.235,
1.27 	subdivision 1; 103I.601, subdivision 2; 119B.13,
1.28 	subdivision 1, by adding a subdivision; 144.122, as
1.29 	amended; 144.147, subdivisions 1, 2; 144.148,
1.30 	subdivision 1; 144.1483; 144.1501, subdivisions 1, 2,
1.31 	3, 4; 144.226, subdivisions 1, as amended, 4, as
1.32 	amended, by adding subdivisions; 144.3831, subdivision
1.33 	1; 144.551, subdivision 1; 144.562, subdivision 2;
1.34 	144.9504, subdivision 2; 144.98, subdivision 3;
1.35 	144A.073, subdivision 10, by adding a subdivision;
1.36 	144E.101, by adding a subdivision; 145.4242; 145.56,
1.37 	subdivisions 2, 5; 145.9268; 147A.08; 148D.220,
1.38 	subdivision 8, as added; 150A.22; 157.011, by adding a
1.39 	subdivision; 157.15, by adding a subdivision; 157.16,
1.40 	subdivisions 2, 3, by adding subdivisions; 157.20,
1.41 	subdivisions 2, 2a; 241.01, by adding a subdivision;
1.42 	243.166, subdivisions 4b, as added, 7, as amended;
1.43 	245.4661, subdivisions 2, 6, by adding a subdivision;
1.44 	245.4874, as amended; 245.4885, subdivisions 1, 2, by
1.45 	adding a subdivision; 245A.02, subdivision 17;
1.46 	245A.03, subdivisions 2, 3; 245A.035, subdivisions 1,
2.1 	5; 245A.04, subdivisions 7, 13; 245A.06, by adding a
2.2 	subdivision; 245A.07, subdivisions 1, 3, by adding a
2.3 	subdivision; 245A.08, subdivisions 2a, 5; 245A.10,
2.4 	subdivisions 4, 5; 245A.14, by adding subdivisions;
2.5 	245A.144; 245A.16, subdivisions 1, 4; 245A.18;
2.6 	245B.02, subdivision 10; 245B.055, subdivision 7;
2.7 	245B.07, subdivision 8; 245C.03, subdivision 1;
2.8 	245C.07; 245C.08, subdivisions 1, 2; 245C.10,
2.9 	subdivisions 2, 3; 245C.15, subdivisions 1, as
2.10 	amended, 2, 3, 4; 245C.21, subdivision 2; 245C.22,
2.11 	subdivisions 3, 4, 7, as added; 245C.23, subdivision
2.12 	1; 245C.24, subdivisions 2, as amended, 3; 245C.27,
2.13 	subdivision 1; 245C.28, subdivision 3; 245C.30,
2.14 	subdivisions 1, 2; 245C.32, subdivision 2; 246.0136,
2.15 	subdivision 1; 246.13, as amended; 252.27, subdivision
2.16 	2a; 253.20; 254A.035, subdivision 2; 254A.04; 256.01,
2.17 	subdivision 2, by adding subdivisions; 256.019,
2.18 	subdivision 1; 256.045, subdivisions 3, as amended,
2.19 	3a; 256.046, subdivision 1; 256.741, subdivision 4;
2.20 	256.9657, by adding a subdivision; 256.969,
2.21 	subdivisions 3a, 9, 26, by adding a subdivision;
2.22 	256.975, subdivision 9; 256B.02, subdivision 12;
2.23 	256B.04, by adding a subdivision; 256B.055, by adding
2.24 	a subdivision; 256B.056, subdivisions 5, 5a, 5b, 7, by
2.25 	adding subdivisions; 256B.057, subdivision 9;
2.26 	256B.0575; 256B.06, subdivision 4; 256B.0621,
2.27 	subdivisions 2, 3, 4, 5, 6, 7, by adding a
2.28 	subdivision; 256B.0622, subdivision 2; 256B.0625,
2.29 	subdivisions 2, 3a, 9, 13, 13a, 13c, 13d, 13e, as
2.30 	amended, 13f, as amended, 17, 19c, by adding
2.31 	subdivisions; 256B.0627, subdivisions 1, as amended,
2.32 	4, 5, as amended, 9, by adding a subdivision;
2.33 	256B.0631, subdivisions 1, 3; 256B.075, subdivision 2;
2.34 	256B.0911, subdivision 1a; 256B.0913, subdivisions 2,
2.35 	4, 5, 5a; 256B.0916, by adding a subdivision;
2.36 	256B.0924, subdivision 3; 256B.093, subdivision 1;
2.37 	256B.0943, subdivision 3; 256B.095; 256B.0951,
2.38 	subdivision 1; 256B.0952, subdivision 5; 256B.0953,
2.39 	subdivision 1; 256B.15, subdivisions 1, 4, by adding
2.40 	subdivisions; 256B.19, subdivisions 1, 1c; 256B.195,
2.41 	subdivision 3; 256B.431, by adding subdivisions;
2.42 	256B.432, subdivisions 1, 2, 5, by adding
2.43 	subdivisions; 256B.434, subdivisions 3, 4, by adding a
2.44 	subdivision; 256B.49, subdivision 16; 256B.5012, by
2.45 	adding a subdivision; 256B.69, subdivisions 4, 23;
2.46 	256D.03, subdivisions 3, as amended, 4; 256D.045;
2.47 	256D.06, subdivisions 5, 7; 256D.44, subdivision 5;
2.48 	256I.05, subdivision 1e; 256I.06, by adding a
2.49 	subdivision; 256J.37, subdivision 3b; 256J.515;
2.50 	256L.01, subdivisions 4, 5; 256L.03, subdivisions 1,
2.51 	1b, 5; 256L.035; 256L.04, subdivision 2, by adding
2.52 	subdivisions; 256L.05, subdivisions 2, 3, 3a, by
2.53 	adding a subdivision; 256L.06, subdivision 3; 256L.07,
2.54 	subdivisions 1, as amended, 3, by adding subdivisions;
2.55 	256L.12, by adding a subdivision; 256L.15,
2.56 	subdivisions 2, as amended, 3, by adding a
2.57 	subdivision; 256L.17, by adding a subdivision;
2.58 	256M.40, subdivision 2; 260.835; 260B.163, subdivision
2.59 	6; 260C.163, subdivision 5; 295.582, as amended;
2.60 	297F.185; 299C.093, as amended; 325D.32, subdivision
2.61 	9; 326.42, subdivision 2; 471.61, by adding a
2.62 	subdivision; 514.981, subdivision 6; 518.165, by
2.63 	adding subdivisions; 549.02, by adding a subdivision;
2.64 	549.04; 609A.03, subdivision 7, as amended; 626.556,
2.65 	subdivision 10i, as amended; 626.557, subdivisions 9d,
2.66 	14, as amended; 641.15, subdivision 2; Laws 2003,
2.67 	First Special Session chapter 14, article 12, section
2.68 	93; Laws 2003, First Special Session chapter 14,
2.69 	article 13C, section 2, subdivision 6; Laws 2005,
2.70 	chapter 107, article 1, section 6; Laws 2005, chapter
2.71 	159, article 1, section 14; proposing coding for new
3.1 	law in Minnesota Statutes, chapters 16A; 62J; 144;
3.2 	145; 151; 245A; 245C; 256; 256B; 256K; 641; repealing
3.3 	Minnesota Statutes 2004, sections 119B.074, as
3.4 	amended; 144.1486; 144.1502; 157.215; 256.955;
3.5 	256B.075, subdivision 5; 256D.54, subdivision 3;
3.6 	256L.04, subdivision 11; 256M.40, subdivision 2;
3.7 	514.991; 514.992; 514.993; 514.994; 514.995; Laws
3.8 	2003, First Special Session chapter 14, article 9,
3.9 	section 34; Laws 2005, chapter 107, article 2, section
3.10 	51.
3.11 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.12 	ARTICLE 1
3.13 	LICENSING PROVISIONS

3.14 	Section 1. Minnesota Statutes 2004, section 13.46,
3.15 	subdivision 4, as amended by Laws 2005, chapter 163, section 40,
3.16 	is amended to read:
3.17 		Subd. 4.Licensing data. (a) As used in this subdivision:
3.18 	(1) "licensing data" means all data collected, maintained,
3.19 	used, or disseminated by the welfare system pertaining to
3.20 	persons licensed or registered or who apply for licensure or
3.21 	registration or who formerly were licensed or registered under
3.22 	the authority of the commissioner of human services;
3.23 	(2) "client" means a person who is receiving services from
3.24 	a licensee or from an applicant for licensure; and
3.25 	(3) "personal and personal financial data" means Social
3.26 	Security numbers, identity of and letters of reference,
3.27 	insurance information, reports from the Bureau of Criminal
3.28 	Apprehension, health examination reports, and social/home
3.29 	studies.
3.30 	(b)(1) Except as provided in paragraph (c), the following
3.31 	data on current and former licensees are public:  name, address,
3.32 	telephone number of licensees, date of receipt of a completed
3.33 	application, dates of licensure, licensed capacity, type of
3.34 	client preferred, variances granted, record of training and
3.35 	education in child care and child development, type of dwelling,
3.36 	name and relationship of other family members, previous license
3.37 	history, class of license, the existence and status of
3.38 	complaints, and the number of serious injuries to or deaths of
3.39 	individuals in the licensed program as reported to the
3.40 	commissioner of human services, the local social services
4.1 	agency, or any other county welfare agency.  For purposes of
4.2 	this clause, a serious injury is one that is treated by a
4.3 	physician.  When a correction order or fine has been issued, a
4.4 	license is suspended, immediately suspended, revoked, denied, or
4.5 	made conditional, or a complaint is resolved, the following data
4.6 	on current and former licensees are public:  the substance and
4.7 	investigative findings of the licensing or maltreatment
4.8 	complaint, licensing violation, or substantiated maltreatment;
4.9 	the record of informal resolution of a licensing violation;
4.10 	orders of hearing; findings of fact; conclusions of law;
4.11 	specifications of the final correction order, fine, suspension,
4.12 	immediate suspension, revocation, denial, or conditional license
4.13 	contained in the record of licensing action; and the status of
4.14 	any appeal of these actions.
4.15 	(2) Notwithstanding sections 626.556, subdivision 11, and
4.16 	626.557, subdivision 12b, when any person subject to
4.17 	disqualification under section 245C.14 in connection with a
4.18 	license to provide family day care for children, child care
4.19 	center services, foster care for children in the provider's
4.20 	home, or foster care or day care services for adults in the
4.21 	provider's home is a substantiated perpetrator of maltreatment,
4.22 	and the substantiated maltreatment is a reason for a licensing
4.23 	action, the identity of the substantiated perpetrator of
4.24 	maltreatment is public data.  For purposes of this clause, a
4.25 	person is a substantiated perpetrator if the maltreatment
4.26 	determination has been upheld under section 256.045; 626.556,
4.27 	subdivision 10i; 626.557, subdivision 9d; or chapter 14, or if
4.28 	an individual or facility has not timely exercised appeal rights
4.29 	under these sections.
4.30 	(3) For applicants who withdraw their application prior to
4.31 	licensure or denial of a license, the following data are
4.32 	public:  the name of the applicant, the city and county in which
4.33 	the applicant was seeking licensure, the dates of the
4.34 	commissioner's receipt of the initial application and completed
4.35 	application, the type of license sought, and the date of
4.36 	withdrawal of the application.
5.1 	(4) For applicants who are denied a license, the following
5.2 	data are public:  the name of the applicant, the city and county
5.3 	in which the applicant was seeking licensure, the dates of the
5.4 	commissioner's receipt of the initial application and completed
5.5 	application, the type of license sought, the date of denial of
5.6 	the application, the nature of the basis for the denial, and the
5.7 	status of any appeal of the denial.
5.8 	(5) The following data on persons subject to
5.9 	disqualification under section 245C.14 in connection with a
5.10 	license to provide family day care for children, child care
5.11 	center services, foster care for children in the provider's
5.12 	home, or foster care or day care services for adults in the
5.13 	provider's home, are public:  the nature of any disqualification
5.14 	set aside under section 245C.22, subdivisions 2 and 4, and the
5.15 	reasons for setting aside the disqualification; the nature of
5.16 	any disqualification for which a variance was granted under
5.17 	sections 245A.04, subdivision 9; and 245C.30, and the reasons
5.18 	for granting any variance under section 245A.04, subdivision 9;
5.19 	and, if applicable, the disclosure that any person subject to a
5.20 	background study under section 245C.03, subdivision 1, has
5.21 	successfully passed a background study.
5.22 	(6) When maltreatment is substantiated under section
5.23 	626.556 or 626.557 and the victim and the substantiated
5.24 	perpetrator are affiliated with a program licensed under chapter
5.25 	245A, the commissioner of human services, local social services
5.26 	agency, or county welfare agency may inform the license holder
5.27 	where the maltreatment occurred of the identity of the
5.28 	substantiated perpetrator and the victim.
5.29 	(c) The following are private data on individuals under
5.30 	section 13.02, subdivision 12, or nonpublic data under section
5.31 	13.02, subdivision 9:  personal and personal financial data on
5.32 	family day care program and family foster care program
5.33 	applicants and licensees and their family members who provide
5.34 	services under the license.
5.35 	(d) The following are private data on individuals:  the
5.36 	identity of persons who have made reports concerning licensees
6.1 	or applicants that appear in inactive investigative data, and
6.2 	the records of clients or employees of the licensee or applicant
6.3 	for licensure whose records are received by the licensing agency
6.4 	for purposes of review or in anticipation of a contested
6.5 	matter.  The names of reporters under sections 626.556 and
6.6 	626.557 may be disclosed only as provided in section 626.556,
6.7 	subdivision 11, or 626.557, subdivision 12b.
6.8 	(e) Data classified as private, confidential, nonpublic, or
6.9 	protected nonpublic under this subdivision become public data if
6.10 	submitted to a court or administrative law judge as part of a
6.11 	disciplinary proceeding in which there is a public hearing
6.12 	concerning a license which has been suspended, immediately
6.13 	suspended, revoked, or denied.
6.14 	(f) Data generated in the course of licensing
6.15 	investigations that relate to an alleged violation of law are
6.16 	investigative data under subdivision 3.
6.17 	(g) Data that are not public data collected, maintained,
6.18 	used, or disseminated under this subdivision that relate to or
6.19 	are derived from a report as defined in section 626.556,
6.20 	subdivision 2, or 626.5572, subdivision 18, are subject to the
6.21 	destruction provisions of sections 626.556, subdivision 11c, and
6.22 	626.557, subdivision 12b.
6.23 	(h) Upon request, not public data collected, maintained,
6.24 	used, or disseminated under this subdivision that relate to or
6.25 	are derived from a report of substantiated maltreatment as
6.26 	defined in section 626.556 or 626.557 may be exchanged with the
6.27 	Department of Health for purposes of completing background
6.28 	studies pursuant to section 144.057 and with the Department of
6.29 	Corrections for purposes of completing background studies
6.30 	pursuant to section 241.021.
6.31 	(i) Data on individuals collected according to licensing
6.32 	activities under chapters 245A and 245C, and data on individuals
6.33 	collected by the commissioner of human services according to
6.34 	maltreatment investigations under sections 626.556 and 626.557,
6.35 	may be shared with the Department of Human Rights, the
6.36 	Department of Health, the Department of Corrections, the
7.1 	Ombudsman for Mental Health and Retardation, and the
7.2 	individual's professional regulatory board when there is reason
7.3 	to believe that laws or standards under the jurisdiction of
7.4 	those agencies may have been violated.
7.5 	(j) In addition to the notice of determinations required
7.6 	under section 626.556, subdivision 10f, if the commissioner or
7.7 	the local social services agency has determined that an
7.8 	individual is a substantiated perpetrator of maltreatment of a
7.9 	child based on sexual abuse, as defined in section 626.556,
7.10 	subdivision 2, and the commissioner or local social services
7.11 	agency knows that the individual is a person responsible for a
7.12 	child's care in another facility, the commissioner or local
7.13 	social services agency shall notify the head of that facility of
7.14 	this determination.  The notification must include an
7.15 	explanation of the individual's available appeal rights and the
7.16 	status of any appeal.  If a notice is given under this
7.17 	paragraph, the government entity making the notification shall
7.18 	provide a copy of the notice to the individual who is the
7.19 	subject of the notice.
7.20 	(k) All not public data collected, maintained, used, or
7.21 	disseminated under this subdivision and subdivision 3 may be
7.22 	exchanged between the Department of Human Services, Licensing
7.23 	Division, and the Department of Corrections for purposes of
7.24 	regulating services for which the Department of Human Services
7.25 	and the Department of Corrections have regulatory authority.
7.26 	
EFFECTIVE DATE. This section is effective the day
7.27 	following final enactment.

7.28 	Sec. 2. Minnesota Statutes 2004, section 243.166,
7.29 	subdivision 4b, as added by Laws 2005, chapter 136, article 3,
7.30 	section 8, is amended to read:
7.31 		Subd. 4b.Health care facility; notice of status. (a) As
7.32 	used in paragraphs (b) and (c),For the purposes of this
7.33 	subdivision,"health care facility" means a hospital or other
7.34 	entity licensed under sections 144.50 to 144.58, a nursing home
7.35 	licensed to serve adults under section 144A.02, or a group
7.36 	residential housing facility or an intermediate care facility
8.1 	for the mentally retarded licensed under chapter 245A.  As used
8.2 	in paragraph (d), "health care facility" means a nursing home
8.3 	licensed to serve adults under section 144A.02, or a group
8.4 	residential housing facility or an intermediate care facility
8.5 	for the mentally retarded licensed under chapter 245A facility
8.6 	licensed by:
8.7 	(1) the commissioner of health as a hospital, boarding care
8.8 	home or supervised living facility under sections 144.50 to
8.9 	144.58, or a nursing home under chapter 144A; or 
8.10 	(2) the commissioner of human services as a residential
8.11 	facility under chapter 245A to provide adult foster care, adult
8.12 	mental health treatment, chemical dependency treatment to
8.13 	adults, or residential services to persons with developmental
8.14 	disabilities.
8.15 	(b) Upon admittance to a health care facility, a person
8.16 	required to register under this section shall disclose to:
8.17 	(1) the health care facility employee processing the
8.18 	admission the person's status as a registered predatory offender
8.19 	under this section; and
8.20 	(2) the person's corrections agent, or if the person does
8.21 	not have an assigned corrections agent, the law enforcement
8.22 	authority with whom the person is currently required to
8.23 	register, that inpatient admission has occurred.
8.24 	(c) A law enforcement authority or corrections agent who
8.25 	receives notice under paragraph (b) or who knows that a person
8.26 	required to register under this section has been admitted and is
8.27 	receiving health care at a health care facility shall notify the
8.28 	administrator of the facility.
8.29 	(d) Except for a hospital licensed under sections 144.50 to
8.30 	144.58,a health care facility that receives notice under this
8.31 	subdivision that a predatory offender has been admitted to the
8.32 	facility shall notify other patients residents at the facility
8.33 	of this fact.  If the facility determines that notice to
8.34 	a patient resident is not appropriate given the patient's 
8.35 	resident's medical, emotional, or mental status, the facility
8.36 	shall notify the patient's next of kin or emergency contact.
9.1 	
EFFECTIVE DATE. This section is effective the day
9.2 	following final enactment.

9.3 	Sec. 3. Minnesota Statutes 2004, section 243.166,
9.4 	subdivision 7, as amended by Laws 2005, chapter 136, article 5,
9.5 	section 1, is amended to read:
9.6 		Subd. 7.Use of data. Except as otherwise provided in
9.7 	subdivision 7a or sections 244.052 and 299C.093, the data
9.8 	provided under this section is private data on individuals under
9.9 	section 13.02, subdivision 12.  The data may be used only for
9.10 	law enforcement and corrections purposes.  State-operated
9.11 	services, as defined in section 246.014, are also authorized to
9.12 	have access to the data for the purposes described in section
9.13 	246.13, subdivision 2, paragraph (c) (b).
9.14 	
EFFECTIVE DATE. This section is effective the day
9.15 	following final enactment.

9.16 	Sec. 4. Minnesota Statutes 2004, section 245A.02,
9.17 	subdivision 17, is amended to read:
9.18 		Subd. 17.School age child care program.  "School age
9.19 	child care program" means a program licensed or required to be
9.20 	licensed as a child care center, serving more than ten children
9.21 	with the primary purpose of providing child care for school age
9.22 	children. School age child care program does not include
9.23 	programs such as scouting, boys clubs, girls clubs, nor sports
9.24 	or art programs.

9.25 	Sec. 5. Minnesota Statutes 2004, section 245A.03,
9.26 	subdivision 2, is amended to read:
9.27 		Subd. 2.Exclusion from licensure.  (a) This chapter does
9.28 	not apply to:
9.29 	(1) residential or nonresidential programs that are
9.30 	provided to a person by an individual who is related unless the
9.31 	residential program is a child foster care placement made by a
9.32 	local social services agency or a licensed child-placing agency,
9.33 	except as provided in subdivision 2a;
9.34 	(2) nonresidential programs that are provided by an
9.35 	unrelated individual to persons from a single related family;
9.36 	(3) residential or nonresidential programs that are
10.1 	provided to adults who do not abuse chemicals or who do not have
10.2 	a chemical dependency, a mental illness, mental retardation or a
10.3 	related condition, a functional impairment, or a physical
10.4 	handicap;
10.5 	(4) sheltered workshops or work activity programs that are
10.6 	certified by the commissioner of economic security;
10.7 	(5) programs operated by a public school for children 33
10.8 	months or older;
10.9 	(6) nonresidential programs primarily for children that
10.10 	provide care or supervision for periods of less than three hours
10.11 	a day while the child's parent or legal guardian is in the same
10.12 	building as the nonresidential program or present within another
10.13 	building that is directly contiguous to the building in which
10.14 	the nonresidential program is located;
10.15 	(7) nursing homes or hospitals licensed by the commissioner
10.16 	of health except as specified under section 245A.02;
10.17 	(8) board and lodge facilities licensed by the commissioner
10.18 	of health that provide services for five or more persons whose
10.19 	primary diagnosis is mental illness that do not provide
10.20 	intensive residential treatment;
10.21 	(9) homes providing programs for persons placed there by a
10.22 	licensed agency for legal adoption, unless the adoption is not
10.23 	completed within two years;
10.24 	(10) programs licensed by the commissioner of corrections;
10.25 	(11) recreation programs for children or adults that are
10.26 	operated or approved by a park and recreation board whose
10.27 	primary purpose is to provide social and recreational
10.28 	activities;
10.29 	(12) programs operated by a school as defined in section
10.30 	120A.22, subdivision 4, whose primary purpose is to provide
10.31 	child care to school-age children;
10.32 	(13) Head Start nonresidential programs which operate for
10.33 	less than 31 45 days in each calendar year;
10.34 	(14) noncertified boarding care homes unless they provide
10.35 	services for five or more persons whose primary diagnosis is
10.36 	mental illness or mental retardation;
11.1 	(15) programs for children such as scouting, boys clubs,
11.2 	girls clubs, and sports and art programs, and nonresidential
11.3 	programs for children provided for a cumulative total of less
11.4 	than 30 days in any 12-month period;
11.5 	(16) residential programs for persons with mental illness,
11.6 	that are located in hospitals;
11.7 	(17) the religious instruction of school-age children;
11.8 	Sabbath or Sunday schools; or the congregate care of children by
11.9 	a church, congregation, or religious society during the period
11.10 	used by the church, congregation, or religious society for its
11.11 	regular worship;
11.12 	(18) camps licensed by the commissioner of health under
11.13 	Minnesota Rules, chapter 4630;
11.14 	(19) mental health outpatient services for adults with
11.15 	mental illness or children with emotional disturbance;
11.16 	(20) residential programs serving school-age children whose
11.17 	sole purpose is cultural or educational exchange, until the
11.18 	commissioner adopts appropriate rules;
11.19 	(21) unrelated individuals who provide out-of-home respite
11.20 	care services to persons with mental retardation or related
11.21 	conditions from a single related family for no more than 90 days
11.22 	in a 12-month period and the respite care services are for the
11.23 	temporary relief of the person's family or legal representative;
11.24 	(22) respite care services provided as a home and
11.25 	community-based service to a person with mental retardation or a
11.26 	related condition, in the person's primary residence;
11.27 	(23) community support services programs as defined in
11.28 	section 245.462, subdivision 6, and family community support
11.29 	services as defined in section 245.4871, subdivision 17;
11.30 	(24) the placement of a child by a birth parent or legal
11.31 	guardian in a preadoptive home for purposes of adoption as
11.32 	authorized by section 259.47;
11.33 	(25) settings registered under chapter 144D which provide
11.34 	home care services licensed by the commissioner of health to
11.35 	fewer than seven adults; or
11.36 	(26) consumer-directed community support service funded
12.1 	under the Medicaid waiver for persons with mental retardation
12.2 	and related conditions when the individual who provided the
12.3 	service is:
12.4 	(i) the same individual who is the direct payee of these
12.5 	specific waiver funds or paid by a fiscal agent, fiscal
12.6 	intermediary, or employer of record; and
12.7 	(ii) not otherwise under the control of a residential or
12.8 	nonresidential program that is required to be licensed under
12.9 	this chapter when providing the service.
12.10 	(b) For purposes of paragraph (a), clause (6), a building
12.11 	is directly contiguous to a building in which a nonresidential
12.12 	program is located if it shares a common wall with the building
12.13 	in which the nonresidential program is located or is attached to
12.14 	that building by skyway, tunnel, atrium, or common roof.
12.15 	(c) Nothing in this chapter shall be construed to require
12.16 	licensure for any services provided and funded according to an
12.17 	approved federal waiver plan where licensure is specifically
12.18 	identified as not being a condition for the services and funding.

12.19 	Sec. 6. Minnesota Statutes 2004, section 245A.03,
12.20 	subdivision 3, is amended to read:
12.21 		Subd. 3.Unlicensed programs.  (a) It is a misdemeanor
12.22 	for an individual, corporation, partnership, voluntary
12.23 	association, other organization, or a controlling individual to
12.24 	provide a residential or nonresidential program without a
12.25 	license and in willful disregard of this chapter unless the
12.26 	program is excluded from licensure under subdivision 2.
12.27 	(b) The commissioner may ask the appropriate county
12.28 	attorney or the attorney general to begin proceedings to secure
12.29 	a court order against the continued operation of the program, if
12.30 	an individual, corporation, partnership, voluntary association,
12.31 	other organization, or controlling individual has:
12.32 	(1) failed to apply for a license after receiving notice
12.33 	that a license is required or continues to operate without a
12.34 	license after receiving notice that a license is required;
12.35 	(2) continued to operate without a license after the
12.36 	license has been revoked or suspended under section 245A.07, and
13.1 	the commissioner has issued a final order affirming the
13.2 	revocation or suspension, or the license holder did not timely
13.3 	appeal the sanction; or
13.4 	(3) continued to operate without a license after the
13.5 	license has been temporarily suspended under section 245A.07.
13.6 	The county attorney and the attorney general have a duty to
13.7 	cooperate with the commissioner.

13.8 	Sec. 7. Minnesota Statutes 2004, section 245A.035,
13.9 	subdivision 1, is amended to read:
13.10 		Subdivision 1.Grant of emergency license.
 13.11 	Notwithstanding section 245A.03, subdivision 2a, or 245C.13,
13.12 	subdivision 2,a county agency may place a child for foster care
13.13 	with a relative who is not licensed to provide foster care,
13.14 	provided the requirements of subdivision 2 are met.  As used in
13.15 	this section, the term "relative" has the meaning given it under
13.16 	section 260C.007, subdivision 27.
13.17 	
EFFECTIVE DATE. This section is effective the day
13.18 	following final enactment.

13.19 	Sec. 8. Minnesota Statutes 2004, section 245A.035,
13.20 	subdivision 5, is amended to read:
13.21 		Subd. 5.Child foster care license application. (a) The
13.22 	emergency license holder shall complete the child foster care
13.23 	license application and necessary paperwork within ten days of
13.24 	the placement.  The county agency shall assist the emergency
13.25 	license holder to complete the application.  The granting of a
13.26 	child foster care license to a relative shall be under the
13.27 	procedures in this chapter and according to the standards set
13.28 	forth by foster care rule.  In licensing a relative, the
13.29 	commissioner shall consider the importance of maintaining the
13.30 	child's relationship with relatives as an additional significant
13.31 	factor in determining whether to set aside a licensing
13.32 	disqualifier under section 245C.22, or to grant a variance of
13.33 	licensing requirements under sections 245C.21 to 245C.27.
13.34 	(b) When the county or private child-placing agency is
13.35 	processing an application for child foster care licensure of a
13.36 	relative as defined in section 260B.007, subdivision 12, or
14.1 	260C.007, subdivision 27, the county agency or child-placing
14.2 	agency must explain the licensing process to the prospective
14.3 	licensee, including the background study process and the
14.4 	procedure for reconsideration of an initial disqualification for
14.5 	licensure.  The county or private child-placing agency must also
14.6 	provide the prospective relative licensee with information
14.7 	regarding appropriate options for legal representation in the
14.8 	pertinent geographic area.  If a relative is initially
14.9 	disqualified under section 245C.14, the county or child-placing
14.10 	agency must provide written notice of the reasons for the
14.11 	disqualification and the right to request a reconsideration by
14.12 	the commissioner as required under section 245C.17.
14.13 	(c) The commissioner shall maintain licensing data so that
14.14 	activities related to applications and licensing actions for
14.15 	relative foster care providers may be distinguished from other
14.16 	child foster care settings.

14.17 	Sec. 9. Minnesota Statutes 2004, section 245A.04,
14.18 	subdivision 7, is amended to read:
14.19 		Subd. 7.Issuance of a license; extension of a license.
 14.20 	(a) If the commissioner determines that the program complies
14.21 	with all applicable rules and laws, the commissioner shall issue
14.22 	a license.  At minimum, the license shall state:
14.23 	(1) the name of the license holder;
14.24 	(2) the address of the program;
14.25 	(3) the effective date and expiration date of the license;
14.26 	(4) the type of license;
14.27 	(5) the maximum number and ages of persons that may receive
14.28 	services from the program; and
14.29 	(6) any special conditions of licensure.
14.30 	(b) The commissioner may issue an initial license for a
14.31 	period not to exceed two years if:
14.32 	(1) the commissioner is unable to conduct the evaluation or
14.33 	observation required by subdivision 4, paragraph (a), clauses (3)
14.34 	and (4), because the program is not yet operational;
14.35 	(2) certain records and documents are not available because
14.36 	persons are not yet receiving services from the program; and
15.1 	(3) the applicant complies with applicable laws and rules
15.2 	in all other respects.
15.3 	(c) A decision by the commissioner to issue a license does
15.4 	not guarantee that any person or persons will be placed or cared
15.5 	for in the licensed program.  A license shall not be
15.6 	transferable to another individual, corporation, partnership,
15.7 	voluntary association, other organization, or controlling or to
15.8 	another location.
15.9 	(d) A license holder must notify the commissioner and
15.10 	obtain the commissioner's approval before making any changes
15.11 	that would alter the license information listed under paragraph
15.12 	(a).
15.13 	(e) The commissioner shall not issue a license if the
15.14 	applicant, license holder, or controlling individual has:
15.15 	(1) been disqualified and the disqualification was not set
15.16 	aside;
15.17 	(2) has been denied a license within the past two years; or
15.18 	(3) had a license revoked within the past five years.
15.19 	(f) The commissioner shall not issue a license if an
15.20 	individual living in the household where the licensed services
15.21 	will be provided as specified under section 245C.03, subdivision
15.22 	1, has been disqualified and the disqualification has not been
15.23 	set aside.
15.24 	For purposes of reimbursement for meals only, under the
15.25 	Child and Adult Care Food Program, Code of Federal Regulations,
15.26 	title 7, subtitle B, chapter II, subchapter A, part 226,
15.27 	relocation within the same county by a licensed family day care
15.28 	provider, shall be considered an extension of the license for a
15.29 	period of no more than 30 calendar days or until the new license
15.30 	is issued, whichever occurs first, provided the county agency
15.31 	has determined the family day care provider meets licensure
15.32 	requirements at the new location.
15.33 	Unless otherwise specified by statute, all licenses expire
15.34 	at 12:01 a.m. on the day after the expiration date stated on the
15.35 	license.  A license holder must apply for and be granted a new
15.36 	license to operate the program or the program must not be
16.1 	operated after the expiration date.

16.2 	Sec. 10. Minnesota Statutes 2004, section 245A.04,
16.3 	subdivision 13, is amended to read:
16.4 		Subd. 13.residential programs handling resident funds
16.5 	and property; additional requirements.  (a) A license holder
16.6 	must ensure that residents persons served by the program retain
16.7 	the use and availability of personal funds or property unless
16.8 	restrictions are justified in the resident's person's individual
16.9 	plan. This subdivision does not apply to programs governed by
16.10 	the provisions in section 245B.07, subdivision 10.
16.11 	(b) The license holder must ensure separation of resident 
16.12 	funds of persons served by the program from funds of the license
16.13 	holder, the residential program, or program staff.
16.14 	(c) Whenever the license holder assists a resident person
16.15 	served by the program with the safekeeping of funds or other
16.16 	property, the license holder must:
16.17 	(1) immediately document receipt and disbursement of the
16.18 	resident's person's funds or other property at the time of
16.19 	receipt or disbursement, including the person's signature of the
16.20 	resident, or the signature of the conservator,or payee; and 
16.21 	(2) provide a statement, at least quarterly, itemizing
16.22 	receipts and disbursements of resident funds or other property;
16.23 	and 
16.24 	(3) return to the resident person upon the
16.25 	resident's person's request, funds and property in the license
16.26 	holder's possession subject to restrictions in the resident's 
16.27 	person's treatment plan, as soon as possible, but no later than
16.28 	three working days after the date of request.
16.29 	(d) License holders and program staff must not:
16.30 	(1) borrow money from a resident person served by the
16.31 	program;
16.32 	(2) purchase personal items from a resident person served
16.33 	by the program;
16.34 	(3) sell merchandise or personal services to a resident 
16.35 	person served by the program;
16.36 	(4) require a resident person served by the program to
17.1 	purchase items for which the license holder is eligible for
17.2 	reimbursement; or
17.3 	(5) use resident funds of persons served by the program to
17.4 	purchase items for which the facility is already receiving
17.5 	public or private payments.

17.6 	Sec. 11. Minnesota Statutes 2004, section 245A.06, is
17.7 	amended by adding a subdivision to read:
17.8 		Subd. 8.Family child care and child care centers posting
17.9 	of order. For licensed family child care providers and child
17.10 	care centers, upon receipt of any correction order or order of
17.11 	conditional license issued by the commissioner under this
17.12 	section, and notwithstanding a pending request for
17.13 	reconsideration of the correction order or order of conditional
17.14 	license by the license holder, the license holder shall post the
17.15 	correction order or order of conditional license in a place that
17.16 	is conspicuous to the people receiving services and all visitors
17.17 	to the facility for two years.  When the correction order or
17.18 	order of conditional license is accompanied by a maltreatment
17.19 	investigation memorandum prepared under section 626.556 or
17.20 	626.557, the investigation memoranda must be posted with the
17.21 	correction order or order of conditional license.

17.22 	Sec. 12. Minnesota Statutes 2004, section 245A.07,
17.23 	subdivision 1, is amended to read:
17.24 		Subdivision 1.Sanctions available; appeals; temporary
17.25 	provisional license. (a) In addition to making a license
17.26 	conditional under section 245A.06, the commissioner may propose
17.27 	to suspend or revoke the license, impose a fine, or secure an
17.28 	injunction against the continuing operation of the program of a
17.29 	license holder who does not comply with applicable law or rule.
17.30 	When applying sanctions authorized under this section, the
17.31 	commissioner shall consider the nature, chronicity, or severity
17.32 	of the violation of law or rule and the effect of the violation
17.33 	on the health, safety, or rights of persons served by the
17.34 	program.
17.35 	(b) If a license holder appeals the suspension or
17.36 	revocation of a license and the license holder continues to
18.1 	operate the program pending a final order on the appeal, and the
18.2 	license expires during this time period, the commissioner shall
18.3 	issue the license holder a temporary provisional license.  The
18.4 	temporary provisional license is effective on the date issued
18.5 	and expires on the date that a final order is issued.  Unless
18.6 	otherwise specified by the commissioner, variances in effect on
18.7 	the date of the license sanction under appeal continue under the
18.8 	temporary provisional license.  If a license holder fails to
18.9 	comply with applicable law or rule while operating under a
18.10 	temporary provisional license, the commissioner may impose
18.11 	sanctions under this section and section 245A.06, and may
18.12 	terminate any prior variance.  If the license holder prevails on
18.13 	the appeal and the effective period of the previous license has
18.14 	expired, a new license shall be issued to the license holder
18.15 	upon payment of any fee required under section 245A.10.  The
18.16 	effective date of the new license shall be retroactive to the
18.17 	date the license would have shown had no sanction been
18.18 	initiated.  The expiration date shall be the expiration date of
18.19 	that license had no license sanction been initiated.
18.20 	(c) If a license holder is under investigation and the
18.21 	license is due to expire before completion of the investigation,
18.22 	the program shall be issued a new license upon completion of the
18.23 	reapplication requirements.  Upon completion of the
18.24 	investigation, a licensing sanction may be imposed against the
18.25 	new license under this section, section 245A.06, or 245A.08.
18.26 	(d) Failure to reapply or closure of a license by the
18.27 	license holder prior to the completion of any investigation
18.28 	shall not preclude the commissioner from issuing a licensing
18.29 	sanction under this section, section 245A.06, or 245A.08 at the
18.30 	conclusion of the investigation.

18.31 	Sec. 13. Minnesota Statutes 2004, section 245A.07,
18.32 	subdivision 3, is amended to read:
18.33 		Subd. 3.License suspension, revocation, or fine. (a) 
18.34 	The commissioner may suspend or revoke a license, or impose a
18.35 	fine if a license holder fails to comply fully with applicable
18.36 	laws or rules, if a license holder or an individual living in
19.1 	the household where the licensed services are provided has a
19.2 	disqualification which has not been set aside under section
19.3 	245C.22, or if a license holder knowingly withholds relevant
19.4 	information from or gives false or misleading information to the
19.5 	commissioner in connection with an application for a license, in
19.6 	connection with the background study status of an individual, or
19.7 	during an investigation.  A license holder who has had a license
19.8 	suspended, revoked, or has been ordered to pay a fine must be
19.9 	given notice of the action by certified mail or personal
19.10 	service.  If mailed, the notice must be mailed to the address
19.11 	shown on the application or the last known address of the
19.12 	license holder.  The notice must state the reasons the license
19.13 	was suspended, revoked, or a fine was ordered.
19.14 	(a) (b) If the license was suspended or revoked, the notice
19.15 	must inform the license holder of the right to a contested case
19.16 	hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to
19.17 	1400.8612.  The license holder may appeal an order suspending or
19.18 	revoking a license.  The appeal of an order suspending or
19.19 	revoking a license must be made in writing by certified mail or
19.20 	personal service.  If mailed, the appeal must be postmarked and
19.21 	sent to the commissioner within ten calendar days after the
19.22 	license holder receives notice that the license has been
19.23 	suspended or revoked.  If a request is made by personal service,
19.24 	it must be received by the commissioner within ten calendar days
19.25 	after the license holder received the order.  Except as provided
19.26 	in subdivision 2a, paragraph (c), a timely appeal of an order
19.27 	suspending or revoking a license shall stay the suspension or
19.28 	revocation until the commissioner issues a final order.
19.29 	(b) (c) (1) If the license holder was ordered to pay a fine,
19.30 	the notice must inform the license holder of the responsibility
19.31 	for payment of fines and the right to a contested case hearing
19.32 	under chapter 14 and Minnesota Rules, parts 1400.8505 to
19.33 	1400.8612.  The appeal of an order to pay a fine must be made in
19.34 	writing by certified mail or personal service.  If mailed, the
19.35 	appeal must be postmarked and sent to the commissioner within
19.36 	ten calendar days after the license holder receives notice that
20.1 	the fine has been ordered.  If a request is made by personal
20.2 	service, it must be received by the commissioner within ten
20.3 	calendar days after the license holder received the order.
20.4 	(2) The license holder shall pay the fines assessed on or
20.5 	before the payment date specified.  If the license holder fails
20.6 	to fully comply with the order, the commissioner may issue a
20.7 	second fine or suspend the license until the license holder
20.8 	complies.  If the license holder receives state funds, the
20.9 	state, county, or municipal agencies or departments responsible
20.10 	for administering the funds shall withhold payments and recover
20.11 	any payments made while the license is suspended for failure to
20.12 	pay a fine.  A timely appeal shall stay payment of the fine
20.13 	until the commissioner issues a final order.
20.14 	(3) A license holder shall promptly notify the commissioner
20.15 	of human services, in writing, when a violation specified in the
20.16 	order to forfeit a fine is corrected.  If upon reinspection the
20.17 	commissioner determines that a violation has not been corrected
20.18 	as indicated by the order to forfeit a fine, the commissioner
20.19 	may issue a second fine.  The commissioner shall notify the
20.20 	license holder by certified mail or personal service that a
20.21 	second fine has been assessed.  The license holder may appeal
20.22 	the second fine as provided under this subdivision.
20.23 	(4) Fines shall be assessed as follows:  the license holder
20.24 	shall forfeit $1,000 for each determination of maltreatment of a
20.25 	child under section 626.556 or the maltreatment of a vulnerable
20.26 	adult under section 626.557; the license holder shall forfeit
20.27 	$200 for each occurrence of a violation of law or rule governing
20.28 	matters of health, safety, or supervision, including but not
20.29 	limited to the provision of adequate staff-to-child or adult
20.30 	ratios, and failure to submit a background study; and the
20.31 	license holder shall forfeit $100 for each occurrence of a
20.32 	violation of law or rule other than those subject to a $1,000 or
20.33 	$200 fine above.  For purposes of this section, "occurrence"
20.34 	means each violation identified in the commissioner's fine order.
20.35 	(5) When a fine has been assessed, the license holder may
20.36 	not avoid payment by closing, selling, or otherwise transferring
21.1 	the licensed program to a third party.  In such an event, the
21.2 	license holder will be personally liable for payment.  In the
21.3 	case of a corporation, each controlling individual is personally
21.4 	and jointly liable for payment.

21.5 	Sec. 14. Minnesota Statutes 2004, section 245A.07, is
21.6 	amended by adding a subdivision to read:
21.7 		Subd. 5.Family child care and child care centers posting
21.8 	of order. For licensed family child care providers and child
21.9 	care centers, upon receipt of any order of license suspension,
21.10 	temporary immediate suspension, fine, or revocation issued by
21.11 	the commissioner under this section, and notwithstanding a
21.12 	pending appeal of the order of license suspension, temporary
21.13 	immediate suspension, fine, or revocation by the license holder,
21.14 	the license holder shall post the order of license suspension,
21.15 	temporary immediate suspension, fine, or revocation in a place
21.16 	that is conspicuous to the people receiving services and all
21.17 	visitors to the facility for two years.  When the order of
21.18 	license suspension, temporary immediate suspension, fine, or
21.19 	revocation is accompanied by a maltreatment investigation
21.20 	memorandum prepared under section 626.556 or 626.557, the
21.21 	investigation memoranda must be posted with the order of license
21.22 	suspension, temporary immediate suspension, fine, or revocation.

21.23 	Sec. 15. Minnesota Statutes 2004, section 245A.08,
21.24 	subdivision 2a, is amended to read:
21.25 		Subd. 2a.Consolidated contested case hearings for
21.26 	sanctions based on maltreatment determinations and
21.27 	disqualifications.  (a) When a denial of a license under section
21.28 	245A.05 or a licensing sanction under section 245A.07,
21.29 	subdivision 3, is based on a disqualification for which
21.30 	reconsideration was requested and which was not set aside under
21.31 	section 245C.22, the scope of the contested case hearing shall
21.32 	include the disqualification and the licensing sanction or
21.33 	denial of a license.  When the licensing sanction or denial of a
21.34 	license is based on a determination of maltreatment under
21.35 	section 626.556 or 626.557, or a disqualification for serious or
21.36 	recurring maltreatment which was not set aside, the scope of the
22.1 	contested case hearing shall include the maltreatment
22.2 	determination, disqualification, and the licensing sanction or
22.3 	denial of a license.  In such cases, a fair hearing under
22.4 	section 256.045 shall not be conducted as provided for in
22.5 	sections 626.556, subdivision 10i, and 626.557, subdivision 9d.
22.6 	When a fine is based on a determination that the license holder
22.7 	is responsible for maltreatment and the fine is issued at the
22.8 	same time as the maltreatment determination, if the license
22.9 	holder appeals the maltreatment and fine, the scope of the
22.10 	contested case hearing shall include the maltreatment
22.11 	determination and fine and reconsideration of the maltreatment
22.12 	determination shall not be conducted as provided for in sections
22.13 	626.556, subdivision 10i, and 626.557, subdivision 9d.
22.14 	(b) In consolidated contested case hearings regarding
22.15 	sanctions issued in family child care, child foster care, family
22.16 	adult day services,and adult foster care, the county attorney
22.17 	shall defend the commissioner's orders in accordance with
22.18 	section 245A.16, subdivision 4.
22.19 	(c) The commissioner's final order under subdivision 5 is
22.20 	the final agency action on the issue of maltreatment and
22.21 	disqualification, including for purposes of subsequent
22.22 	background studies under chapter 245C and is the only
22.23 	administrative appeal of the final agency determination,
22.24 	specifically, including a challenge to the accuracy and
22.25 	completeness of data under section 13.04.
22.26 	(d) When consolidated hearings under this subdivision
22.27 	involve a licensing sanction based on a previous maltreatment
22.28 	determination for which the commissioner has issued a final
22.29 	order in an appeal of that determination under section 256.045,
22.30 	or the individual failed to exercise the right to appeal the
22.31 	previous maltreatment determination under section 626.556,
22.32 	subdivision 10i, or 626.557, subdivision 9d, the commissioner's
22.33 	order is conclusive on the issue of maltreatment.  In such
22.34 	cases, the scope of the administrative law judge's review shall
22.35 	be limited to the disqualification and the licensing sanction or
22.36 	denial of a license.  In the case of a denial of a license or a
23.1 	licensing sanction issued to a facility based on a maltreatment
23.2 	determination regarding an individual who is not the license
23.3 	holder or a household member, the scope of the administrative
23.4 	law judge's review includes the maltreatment determination.
23.5 	(e) If a maltreatment determination or disqualification,
23.6 	which was not set aside under section 245C.22, is the basis for
23.7 	a denial of a license under section 245A.05 or a licensing
23.8 	sanction under section 245A.07, and the disqualified subject is
23.9 	an individual other than the license holder and upon whom a
23.10 	background study must be conducted under section 245C.03, the
23.11 	hearings of all parties may be consolidated into a single
23.12 	contested case hearing upon consent of all parties and the
23.13 	administrative law judge.
23.14 	(f) Notwithstanding section 245C.27, subdivision 1,
23.15 	paragraph (c), when a denial of a license under section 245A.05
23.16 	or a licensing sanction under section 245A.07 is based on a
23.17 	disqualification for which reconsideration was requested and was
23.18 	not set aside under section 245C.22, and the disqualification
23.19 	was based on a conviction or an admission to any crimes listed
23.20 	in section 245C.15, the scope of the administrative law judge's
23.21 	review shall include the denial or sanction and a determination
23.22 	whether the disqualification should be set aside.  In
23.23 	determining whether the disqualification should be set aside,
23.24 	the administrative law judge shall consider the factors under
23.25 	section 245C.22, subdivision 4, to determine whether the
23.26 	individual poses a risk of harm to any person receiving services
23.27 	from the license holder.
23.28 	(g) Notwithstanding section 245C.30, subdivision 5, when a
23.29 	licensing sanction under section 245A.07 is based on the
23.30 	termination of a variance under section 245C.30, subdivision 4,
23.31 	the scope of the administrative law judge's review shall include
23.32 	the sanction and a determination whether the disqualification
23.33 	should be set aside.  In determining whether the
23.34 	disqualification should be set aside, the administrative law
23.35 	judge shall consider the factors under section 245C.22,
23.36 	subdivision 4, to determine whether the individual poses a risk
24.1 	of harm to any person receiving services from the license holder.

24.2 	Sec. 16. Minnesota Statutes 2004, section 245A.08,
24.3 	subdivision 5, is amended to read:
24.4 		Subd. 5.Notice of the commissioner's final order.  After
24.5 	considering the findings of fact, conclusions, and
24.6 	recommendations of the administrative law judge, the
24.7 	commissioner shall issue a final order.  The commissioner shall
24.8 	consider, but shall not be bound by, the recommendations of the
24.9 	administrative law judge.  The appellant must be notified of the
24.10 	commissioner's final order as required by chapter 14 and
24.11 	Minnesota Rules, parts 1400.8505 to 1400.8612.  The notice must
24.12 	also contain information about the appellant's rights under
24.13 	chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612.
24.14 	The institution of proceedings for judicial review of the
24.15 	commissioner's final order shall not stay the enforcement of the
24.16 	final order except as provided in section 14.65.
24.17 		Subd. 5a.Effect of final order on granting a subsequent
24.18 	license. (a) A license holder and each controlling individual
24.19 	of a license holder whose license has been revoked because of
24.20 	noncompliance with applicable law or rule must not be granted a
24.21 	license for five years following the
24.22 	revocation. Notwithstanding the five-year restriction, when a
24.23 	license is revoked because a person, other than the license
24.24 	holder, resides in the home where services are provided and that
24.25 	person has a disqualification that is not set aside and no
24.26 	variance has been granted, the former license holder may reapply
24.27 	for a license when:
24.28 	(1) the person with a disqualification, who is not a minor
24.29 	child, is no longer residing in the home and is prohibited from
24.30 	residing in or returning to the home; or 
24.31 	(2) the person with the disqualification is a minor child,
24.32 	the restriction applies until the minor child becomes an adult
24.33 	and permanently moves away from the home or five years,
24.34 	whichever is less.
24.35 	(b) An applicant whose application was denied must not be
24.36 	granted a license for two years following a denial, unless the
25.1 	applicant's subsequent application contains new information
25.2 	which constitutes a substantial change in the conditions that
25.3 	caused the previous denial.

25.4 	Sec. 17. Minnesota Statutes 2004, section 245A.14, is
25.5 	amended by adding a subdivision to read:
25.6 		Subd. 12.First aid training requirements for staff in
25.7 	child care centers and family child care. Notwithstanding
25.8 	Minnesota Rules, part 9503.0035, subpart 2, when children are
25.9 	present in a family child care home governed by Minnesota Rules,
25.10 	parts 9502.0315 to 9502.0445, or a child care center governed by
25.11 	Minnesota Rules, parts 9503.0005 to 9503.0170, at least one
25.12 	staff person must be present in the center or home who has been
25.13 	trained in first aid.  The first aid training must have been
25.14 	provided by an individual approved to provide first aid
25.15 	instruction.  First aid training may be less than eight hours
25.16 	and persons qualified to provide first aid training shall
25.17 	include individuals approved as first aid instructors.
25.18 	
EFFECTIVE DATE. This section is effective January 1, 2006.

25.19 	Sec. 18. Minnesota Statutes 2004, section 245A.14, is
25.20 	amended by adding a subdivision to read:
25.21 		Subd. 13.Cardiopulmonary resuscitation (cpr) training
25.22 	requirement. (a) When children are present in a child care
25.23 	center governed by Minnesota Rules, parts 9503.0005 to
25.24 	9503.0170, or in a family child care home governed by Minnesota
25.25 	Rules, parts 9502.0315 to 9502.0445, at least one staff person
25.26 	must be present in the center or home who has been trained in
25.27 	cardiopulmonary resuscitation (CPR) and in the treatment of
25.28 	obstructed airways.  The CPR training must have been provided by
25.29 	an individual approved to provide CPR instruction, must be
25.30 	repeated at least once every three years, and must be documented
25.31 	in the staff person's records.
25.32 	(b) Notwithstanding Minnesota Rules, part 9503.0035,
25.33 	subpart 3, item A, cardiopulmonary resuscitation training may be
25.34 	provided for less than four hours.
25.35 	(c) Notwithstanding Minnesota Rules, part 9503.0035,
25.36 	subpart 3, item C, persons qualified to provide cardiopulmonary
26.1 	resuscitation training shall include individuals approved as
26.2 	cardiopulmonary resuscitation instructors.
26.3 	
EFFECTIVE DATE. This section is effective January 1, 2006.

26.4 	Sec. 19. Minnesota Statutes 2004, section 245A.144, is
26.5 	amended to read:
26.6 	245A.144 REDUCTION OF RISK OF SUDDEN INFANT DEATH SYNDROME
26.7 	AND SHAKEN BABY SYNDROME IN CHILD CARE AND CHILD FOSTER CARE 
26.8 	PROGRAMS.
26.9 	(a) License holders must ensure document that before staff
26.10 	persons, caregivers, and helpers assist in the care of infants,
26.11 	they receive training on reducing the risk of sudden infant
26.12 	death syndrome and shaken baby syndrome.  The training on
26.13 	reducing the risk of sudden infant death syndrome and shaken
26.14 	baby syndrome may be provided as:
26.15 	(1) orientation training to child care center staff under
26.16 	Minnesota Rules, part 9503.0035, subpart 1, as and to child
26.17 	foster care providers, who care for infants, under Minnesota
26.18 	Rules, part 2960.3070, subpart 1;
26.19 	(2) initial training to family and group family child care
26.20 	providers under Minnesota Rules, part 9502.0385, subpart 2, as ;
26.21 	(3) in-service training to child care center staff under
26.22 	Minnesota Rules, part 9503.0035, subpart 4, and to child foster
26.23 	care providers, who care for infants, under Minnesota Rules,
26.24 	part 2960.3070, subpart 2;or as 
26.25 	(4) ongoing training to family and group family child care
26.26 	providers under Minnesota Rules, part 9502.0385, subpart 3.
26.27 	(b) Training required under this section must be at least
26.28 	one hour in length and must be completed at least once every
26.29 	five years.  At a minimum, the training must address the risk
26.30 	factors related to sudden infant death syndrome and shaken baby
26.31 	syndrome, means of reducing the risk of sudden infant death
26.32 	syndrome and shaken baby syndrome in child care, and license
26.33 	holder communication with parents regarding reducing the risk of
26.34 	sudden infant death syndrome and shaken baby syndrome.
26.35 	(c) Training for family and group family child care
26.36 	providers must be approved by the county licensing agency
27.1 	according to Minnesota Rules, part 9502.0385.
27.2 	(d) Training for child foster care providers must be
27.3 	approved by the county licensing agency and fulfills, in part,
27.4 	training required under Minnesota Rules, part 2960.3070.

27.5 	EFFECTIVE DATE. This section is effective January 1, 2006.

27.6 	Sec. 20. Minnesota Statutes 2004, section 245A.16,
27.7 	subdivision 1, is amended to read:
27.8 		Subdivision 1.Delegation of authority to agencies.  (a)
27.9 	County agencies and private agencies that have been designated
27.10 	or licensed by the commissioner to perform licensing functions
27.11 	and activities under section 245A.04 and chapter 245C, to
27.12 	recommend denial of applicants under section 245A.05, to issue
27.13 	correction orders, to issue variances, and recommend a
27.14 	conditional license under section 245A.06, or to recommend
27.15 	suspending or revoking a license or issuing a fine under section
27.16 	245A.07, shall comply with rules and directives of the
27.17 	commissioner governing those functions and with this section.
27.18 	The following variances are excluded from the delegation of
27.19 	variance authority and may be issued only by the commissioner:
27.20 	(1) dual licensure of family child care and child foster
27.21 	care, dual licensure of child and adult foster care, and adult
27.22 	foster care and family child care;
27.23 	(2) adult foster care maximum capacity;
27.24 	(3) adult foster care minimum age requirement;
27.25 	(4) child foster care maximum age requirement;
27.26 	(5) variances regarding disqualified individuals except
27.27 	that county agencies may issue variances under section 245C.30
27.28 	regarding disqualified individuals when the county is
27.29 	responsible for conducting a consolidated reconsideration
27.30 	according to sections 245C.25 and 245C.27, subdivision 2,
27.31 	clauses (a) and (b), of a county maltreatment determination and
27.32 	a disqualification based on serious or recurring maltreatment;
27.33 	and
27.34 	(6) the required presence of a caregiver in the adult
27.35 	foster care residence during normal sleeping hours.
27.36 	(b) County agencies must report:
28.1 	(1) information about disqualification reconsiderations
28.2 	under sections 245C.25 and 245C.27, subdivision 2, clauses (a)
28.3 	and (b), and variances granted under paragraph (a), clause (5),
28.4 	to the commissioner at least monthly in a format prescribed by
28.5 	the commissioner; and 
28.6 	(2) for relative child foster care applicants and license
28.7 	holders, the number of relatives, as defined in section
28.8 	260C.007, subdivision 27, and household members of relatives who
28.9 	are disqualified under section 245C.14; the disqualifying
28.10 	characteristics under section 245C.15; the number of these
28.11 	individuals who requested reconsideration under section 245C.21;
28.12 	the number of set-asides under section 245C.22; and variances
28.13 	under section 245C.30 issued.  This information shall be
28.14 	reported to the commissioner annually by January 15 of each year
28.15 	in a format prescribed by the commissioner.
28.16 	(c) For family day care programs, the commissioner may
28.17 	authorize licensing reviews every two years after a licensee has
28.18 	had at least one annual review.
28.19 	(d) For family adult day services programs, the
28.20 	commissioner may authorize licensing reviews every two years
28.21 	after a licensee has had at least one annual review.
28.22 	(e) A license issued under this section may be issued for
28.23 	up to two years.

28.24 	Sec. 21. Minnesota Statutes 2004, section 245A.16,
28.25 	subdivision 4, is amended to read:
28.26 		Subd. 4.Enforcement of the commissioner's orders.  The
28.27 	county or private agency shall enforce the commissioner's orders
28.28 	under sections 245A.07, 245A.08, subdivision 5, and chapter
28.29 	245C, according to the instructions of the commissioner.  The
28.30 	county attorney shall assist the county agency in the
28.31 	enforcement and defense of the commissioner's orders under
28.32 	sections 245A.07, 245A.08, and chapter 245C, according to the
28.33 	instructions of the commissioner, unless a conflict of interest
28.34 	exists between the county attorney and the commissioner. For
28.35 	purposes of this section, a conflict of interest means that the
28.36 	county attorney has a direct or shared financial interest with
29.1 	the license holder or has a personal relationship or family
29.2 	relationship with a party in the licensing action.

29.3 	Sec. 22. Minnesota Statutes 2004, section 245A.18, is
29.4 	amended to read:
29.5 	245A.18  SEAT BELT USE REQUIRED CHILD PASSENGER RESTRAINT
29.6 	SYSTEMS; TRAINING REQUIREMENT.
29.7 	(a) When a nonresidential license holder provides or
29.8 	arranges for transportation for children served by the license
29.9 	holder, children four years old and older must be restrained by
29.10 	a properly adjusted and fastened seat belt and children under
29.11 	age four must be properly fastened in a child passenger
29.12 	restraint system meeting federal motor vehicle safety
29.13 	standards.  A child passenger restraint system is not required
29.14 	for a child who, in the judgment of a licensed physician, cannot
29.15 	be safely transported in a child passenger restraint system
29.16 	because of a medical condition, body size, or physical
29.17 	disability, if the license holder possesses a written statement
29.18 	from the physician that satisfies the requirements in section
29.19 	169.685, subdivision 6, paragraph (b).
29.20 	(b) Paragraph (a) does not apply to transportation of
29.21 	children in a school bus inspected under section 169.451 that
29.22 	has a gross vehicle weight rating of more than 10,000 pounds, is
29.23 	designed for carrying more than ten persons, and was
29.24 	manufactured after 1977.
29.25 		Subdivision 1.Seat belt use. A license holder must
29.26 	comply with all seat belt and child passenger restraint system
29.27 	requirements under section 169.685.
29.28 		Subd. 2.Child passenger restraint systems; training
29.29 	requirement.
 29.30 	(a) Family and group family child care, child care centers,
29.31 	child foster care, and other programs licensed by the Department
29.32 	of Human Services that serve a child or children under nine
29.33 	years of age must document training that fulfills the
29.34 	requirements in this subdivision.
29.35 	(b) Before a license holder, staff person, caregiver, or
29.36 	helper transports a child or children under age nine in a motor
30.1 	vehicle, the person transporting the child must satisfactorily
30.2 	complete training on the proper use and installation of child
30.3 	restraint systems in motor vehicles.  Training completed under
30.4 	this section may be used to meet initial or ongoing training
30.5 	under the following:
30.6 	(1) Minnesota Rules, part 2960.3070, subparts 1 and 2;
30.7 	(2) Minnesota Rules, part 9502.0385, subparts 2 and 3; and 
30.8 	(3) Minnesota Rules, part 9503.0035, subparts 1 and 4.
30.9 	(c) Training required under this section must be at least
30.10 	one hour in length, completed at orientation or initial
30.11 	training, and repeated at least once every five years.  At a
30.12 	minimum, the training must address the proper use of child
30.13 	restraint systems based on the child's size, weight, and age,
30.14 	and the proper installation of a car seat or booster seat in the
30.15 	motor vehicle used by the license holder to transport the child
30.16 	or children.
30.17 	(d) Training under paragraph (c) must be provided by
30.18 	individuals who are certified and approved by the Department of
30.19 	Public Safety, Office of Traffic Safety.  License holders may
30.20 	obtain a list of certified and approved trainers through the
30.21 	Department of Public Safety Web site or by contacting the agency.
30.22 	
EFFECTIVE DATE. This section is effective January 1, 2006.

30.23 	Sec. 23. Minnesota Statutes 2004, section 245B.02,
30.24 	subdivision 10, is amended to read:
30.25 		Subd. 10.Incident.  "Incident" means any of the
30.26 	following:
30.27 	(1) serious injury as determined by section 245.91,
30.28 	subdivision 6;
30.29 	(2) a consumer's death;
30.30 	(3) any medical emergencies, unexpected serious illnesses,
30.31 	or accidents that require physician treatment or
30.32 	hospitalization;
30.33 	(4) a consumer's unauthorized absence;
30.34 	(5) any fires or other events that require the relocation
30.35 	of services for more than 24 hours, or circumstances involving a
30.36 	law enforcement agency or fire department related to the health,
31.1 	safety, or supervision of a consumer;
31.2 	(6) physical aggression by a consumer against another
31.3 	consumer that causes physical pain, injury, or persistent
31.4 	emotional distress, including, but not limited to, hitting,
31.5 	slapping, kicking, scratching, pinching, biting, pushing, and
31.6 	spitting;
31.7 	(7) any sexual activity between consumers involving force
31.8 	or coercion as defined under section 609.341, subdivisions 3 and
31.9 	14; or
31.10 	(8) a report of child or vulnerable adult maltreatment
31.11 	under section 626.556 or 626.557.

31.12 	Sec. 24. Minnesota Statutes 2004, section 245B.055,
31.13 	subdivision 7, is amended to read:
31.14 		Subd. 7.Determining number of direct service staff
31.15 	required.  The minimum number of direct service staff members
31.16 	required at any one time to meet the combined staff ratio
31.17 	requirements of the persons present at that time can be
31.18 	determined by following the steps in clauses (1) through (4):
31.19 	(1) assign each person in attendance the three-digit
31.20 	decimal below that corresponds to the staff ratio requirement
31.21 	assigned to that person.  A staff ratio requirement of one to
31.22 	four equals 0.250.  A staff ratio requirement of one to eight
31.23 	equals 0.125.  A staff ratio requirement of one to six equals
31.24 	0.166.  A staff ratio requirement of one to ten equals 0.100;
31.25 	(2) add all of the three-digit decimals (one three-digit
31.26 	decimal for every person in attendance) assigned in clause (1);
31.27 	(3) when the sum in clause (2) falls between two whole
31.28 	numbers, round off the sum to the larger of the two whole
31.29 	numbers; and
31.30 	(4) the larger of the two whole numbers in clause (3)
31.31 	equals the number of direct service staff members needed to meet
31.32 	the staff ratio requirements of the persons in attendance.

31.33 	Sec. 25. Minnesota Statutes 2004, section 245B.07,
31.34 	subdivision 8, is amended to read:
31.35 		Subd. 8.Policies and procedures.  The license holder
31.36 	must develop and implement the policies and procedures in
32.1 	paragraphs (1) to (3).
32.2 	(1) Policies and procedures that promote consumer health
32.3 	and safety by ensuring:
32.4 	(i) consumer safety in emergency situations as identified
32.5 	in section 245B.05, subdivision 7;
32.6 	(ii) consumer health through sanitary practices;
32.7 	(iii) safe transportation, when the license holder is
32.8 	responsible for transportation of consumers, with provisions for
32.9 	handling emergency situations;
32.10 	(iv) a system of record keeping for both individuals and
32.11 	the organization, for review of incidents and emergencies, and
32.12 	corrective action if needed;
32.13 	(v) a plan for responding to all incidents, as defined in
32.14 	section 245B.02, subdivision 10, fires, severe weather and
32.15 	natural disasters, bomb threats, and other threats and reporting
32.16 	all incidents required to be reported under section 245B.05,
32.17 	subdivision 7;
32.18 	(vi) safe medication administration as identified in
32.19 	section 245B.05, subdivision 5, incorporating an observed skill
32.20 	assessment to ensure that staff demonstrate the ability to
32.21 	administer medications consistent with the license holder's
32.22 	policy and procedures;
32.23 	(vii) psychotropic medication monitoring when the consumer
32.24 	is prescribed a psychotropic medication, including the use of
32.25 	the psychotropic medication use checklist.  If the
32.26 	responsibility for implementing the psychotropic medication use
32.27 	checklist has not been assigned in the individual service plan
32.28 	and the consumer lives in a licensed site, the residential
32.29 	license holder shall be designated; and
32.30 	(viii) criteria for admission or service initiation
32.31 	developed by the license holder;.
32.32 	(2) Policies and procedures that protect consumer rights
32.33 	and privacy by ensuring:
32.34 	(i) consumer data privacy, in compliance with the Minnesota
32.35 	Data Practices Act, chapter 13; and
32.36 	(ii) that complaint procedures provide consumers with a
33.1 	simple process to bring grievances and consumers receive a
33.2 	response to the grievance within a reasonable time period.  The
33.3 	license holder must provide a copy of the program's grievance
33.4 	procedure and time lines for addressing grievances.  The
33.5 	program's grievance procedure must permit consumers served by
33.6 	the program and the authorized representatives to bring a
33.7 	grievance to the highest level of authority in the program; and .
33.8 	(3) Policies and procedures that promote continuity and
33.9 	quality of consumer supports by ensuring:
33.10 	(i) continuity of care and service coordination, including
33.11 	provisions for service termination, temporary service
33.12 	suspension, and efforts made by the license holder to coordinate
33.13 	services with other vendors who also provide support to the
33.14 	consumer.  The policy must include the following requirements:
33.15 	(A) the license holder must notify the consumer or
33.16 	consumer's legal representative and the consumer's case manager
33.17 	in writing of the intended termination or temporary service
33.18 	suspension and the consumer's right to seek a temporary order
33.19 	staying the termination or suspension of service according to
33.20 	the procedures in section 256.045, subdivision 4a or subdivision
33.21 	6, paragraph (c);
33.22 	(B) notice of the proposed termination of services,
33.23 	including those situations that began with a temporary service
33.24 	suspension, must be given at least 60 days before the proposed
33.25 	termination is to become effective;
33.26 	(C) the license holder must provide information requested
33.27 	by the consumer or consumer's legal representative or case
33.28 	manager when services are temporarily suspended or upon notice
33.29 	of termination;
33.30 	(D) use of temporary service suspension procedures are
33.31 	restricted to situations in which the consumer's behavior causes
33.32 	immediate and serious danger to the health and safety of the
33.33 	individual or others;
33.34 	(E) prior to giving notice of service termination or
33.35 	temporary service suspension, the license holder must document
33.36 	actions taken to minimize or eliminate the need for service
34.1 	termination or temporary service suspension; and
34.2 	(F) during the period of temporary service suspension, the
34.3 	license holder will work with the appropriate county agency to
34.4 	develop reasonable alternatives to protect the individual and
34.5 	others; and
34.6 	(ii) quality services measured through a program evaluation
34.7 	process including regular evaluations of consumer satisfaction
34.8 	and sharing the results of the evaluations with the consumers
34.9 	and legal representatives.

34.10 	Sec. 26. Minnesota Statutes 2004, section 245C.03,
34.11 	subdivision 1, is amended to read:
34.12 		Subdivision 1.Licensed programs.  (a) The commissioner
34.13 	shall conduct a background study on:
34.14 	(1) the person or persons applying for a license;
34.15 	(2) an individual age 13 and over living in the household
34.16 	where the licensed program will be provided;
34.17 	(3) current or prospective employees or contractors of the
34.18 	applicant who will have direct contact with persons served by
34.19 	the facility, agency, or program;
34.20 	(4) volunteers or student volunteers who will have direct
34.21 	contact with persons served by the program to provide program
34.22 	services if the contact is not under the continuous, direct
34.23 	supervision by an individual listed in clause (1) or (3);
34.24 	(5) an individual age ten to 12 living in the household
34.25 	where the licensed services will be provided when the
34.26 	commissioner has reasonable cause;
34.27 	(6) an individual who, without providing direct contact
34.28 	services at a licensed program, may have unsupervised access to
34.29 	children or vulnerable adults receiving services from a program
34.30 	licensed to provide:, when the commissioner has reasonable
34.31 	cause; and 
34.32 	(i) family child care for children;
34.33 	(ii) foster care for children in the provider's own home;
34.34 	or 
34.35 	(iii) foster care or day care services for adults in the
34.36 	provider's own home; and 
35.1 	(7) all managerial officials as defined under section
35.2 	245A.02, subdivision 5a.
35.3 	The commissioner must have reasonable cause to study an
35.4 	individual under this subdivision.
35.5 	(b) For family child foster care settings, a short-term
35.6 	substitute caregiver providing direct contact services for a
35.7 	child for less than 72 hours of continuous care is not required
35.8 	to receive a background study under this chapter.

35.9 	Sec. 27. Minnesota Statutes 2004, section 245C.07, is
35.10 	amended to read:
35.11 	245C.07 STUDY SUBJECT AFFILIATED WITH MULTIPLE LICENSED 
35.12 	FACILITIES.
35.13 	(a) When a license holder owns multiple facilities that are
35.14 	licensed by the Department of Human Services, only one
35.15 	background study is required for an individual who provides
35.16 	direct contact services in one or more of the licensed
35.17 	facilities if:
35.18 	(1) the license holder designates one individual with one
35.19 	address and telephone number as the person to receive sensitive
35.20 	background study information for the multiple licensed programs
35.21 	that depend on the same background study; and 
35.22 	(2) the individual designated to receive the sensitive
35.23 	background study information is capable of determining, upon
35.24 	request of the department, whether a background study subject is
35.25 	providing direct contact services in one or more of the license
35.26 	holder's programs and, if so, at which location or locations.
35.27 	(b) When a background study is being initiated by a
35.28 	licensed facility or a foster care provider that is also
35.29 	registered under chapter 144D, a study subject affiliated with
35.30 	multiple licensed facilities may attach to the background study
35.31 	form a cover letter indicating the additional facilities' names,
35.32 	addresses, and background study identification numbers.
35.33 	When the commissioner receives a notice, the commissioner
35.34 	shall notify each facility identified by the background study
35.35 	subject of the study results.
35.36 	The background study notice the commissioner sends to the
36.1 	subsequent agencies shall satisfy those facilities'
36.2 	responsibilities for initiating a background study on that
36.3 	individual.

36.4 	Sec. 28. Minnesota Statutes 2004, section 245C.08,
36.5 	subdivision 1, is amended to read:
36.6 		Subdivision 1.Background studies conducted by
36.7 	commissioner of human services. (a) For a background study
36.8 	conducted by the commissioner, the commissioner shall review:
36.9 	(1) information related to names of substantiated
36.10 	perpetrators of maltreatment of vulnerable adults that has been
36.11 	received by the commissioner as required under section 626.557,
36.12 	subdivision 9c, paragraph (i);
36.13 	(2) the commissioner's records relating to the maltreatment
36.14 	of minors in licensed programs, and from county agency findings
36.15 	of maltreatment of minors as indicated through the social
36.16 	service information system;
36.17 	(3) information from juvenile courts as required in
36.18 	subdivision 4 for individuals listed in section 245C.03,
36.19 	subdivision 1, clauses (2), (5), and (6); and
36.20 	(4) information from the Bureau of Criminal Apprehension.
36.21 	(b) Notwithstanding expungement by a court, the
36.22 	commissioner may consider information obtained under paragraph
36.23 	(a), clauses (3) and (4), unless the commissioner received
36.24 	notice of the petition for expungement and the court order for
36.25 	expungement is directed specifically to the commissioner.

36.26 	Sec. 29. Minnesota Statutes 2004, section 245C.08,
36.27 	subdivision 2, is amended to read:
36.28 		Subd. 2.Background studies conducted by a county or
36.29 	private agency; foster care and family child care.  (a) For a
36.30 	background study conducted by a county or private agency for
36.31 	child foster care, adult foster care, and family child care
36.32 	homes, the commissioner shall review:
36.33 	(1) information from the county agency's record of
36.34 	substantiated maltreatment of adults and the maltreatment of
36.35 	minors;
36.36 	(2) information from juvenile courts as required in
37.1 	subdivision 4 for individuals listed in section 245C.03,
37.2 	subdivision 1, clauses (2), (5), and (6);
37.3 	(3) information from the Bureau of Criminal Apprehension;
37.4 	and
37.5 	(4) arrest and investigative records maintained by the
37.6 	Bureau of Criminal Apprehension, county attorneys, county
37.7 	sheriffs, courts, county agencies, local police, the National
37.8 	Criminal Records Repository, and criminal records from other
37.9 	states.
37.10 	(b) If the individual has resided in the county for less
37.11 	than five years, the study shall include the records specified
37.12 	under paragraph (a) for the previous county or counties of
37.13 	residence for the past five years.
37.14 	(c) Notwithstanding expungement by a court, the county or
37.15 	private agency may consider information obtained under paragraph
37.16 	(a), clauses (3) and (4), unless the commissioner received
37.17 	notice of the petition for expungement and the court order for
37.18 	expungement is directed specifically to the commissioner.

37.19 	Sec. 30. Minnesota Statutes 2004, section 245C.15,
37.20 	subdivision 1, as amended by Laws 2005, chapter 136, article 6,
37.21 	section 2, is amended to read:
37.22 		Subdivision 1.Permanent disqualification. (a) An
37.23 	individual is disqualified under section 245C.14 if:  (1)
37.24 	regardless of how much time has passed since the discharge of
37.25 	the sentence imposed, if any,for the offense; and (2) unless
37.26 	otherwise specified, regardless of the level of the conviction 
37.27 	offense, the individual is convicted of has committed any of the
37.28 	following offenses:  sections 609.185 (murder in the first
37.29 	degree); 609.19 (murder in the second degree); 609.195 (murder
37.30 	in the third degree); 609.20 (manslaughter in the first degree);
37.31 	609.205 (manslaughter in the second degree); 609.221 or 609.222
37.32 	(assault in the first or second degree); a felony offense under
37.33 	sections 609.2242 and 609.2243 (domestic assault), spousal
37.34 	abuse, child abuse or neglect, or a crime against children;
37.35 	609.228 (great bodily harm caused by distribution of drugs);
37.36 	609.245 (aggravated robbery); 609.25 (kidnapping); 609.2661
38.1 	(murder of an unborn child in the first degree); 609.2662
38.2 	(murder of an unborn child in the second degree); 609.2663
38.3 	(murder of an unborn child in the third degree); 609.322
38.4 	(solicitation, inducement, and promotion of prostitution); a
38.5 	felony offense under 609.324, subdivision 1 (other prohibited
38.6 	acts); 609.342 (criminal sexual conduct in the first degree);
38.7 	609.343 (criminal sexual conduct in the second degree); 609.344
38.8 	(criminal sexual conduct in the third degree); 609.345 (criminal
38.9 	sexual conduct in the fourth degree); 609.3451 (criminal sexual
38.10 	conduct in the fifth degree); 609.3453 (criminal sexual
38.11 	predatory conduct); 609.352 (solicitation of children to engage
38.12 	in sexual conduct); 609.365 (incest); a felony offense under
38.13 	609.377 (malicious punishment of a child); a felony offense
38.14 	under 609.378 (neglect or endangerment of a child); 609.561
38.15 	(arson in the first degree); 609.66, subdivision 1e (drive-by
38.16 	shooting); 609.749, subdivision 3, 4, or 5 (felony-level
38.17 	harassment; stalking); 609.855, subdivision 5 (shooting at or in
38.18 	a public transit vehicle or facility); 617.246 (use of minors in
38.19 	sexual performance prohibited); or 617.247 (possession of
38.20 	pictorial representations of minors).  An individual also is
38.21 	disqualified under section 245C.14 regardless of how much time
38.22 	has passed since the involuntary termination of the individual's
38.23 	parental rights under section 260C.301.
38.24 	(b) An individual's aiding and abetting,attempt,or
38.25 	conspiracy to commit any of the offenses listed in paragraph
38.26 	(a), as each of these offenses is defined in Minnesota Statutes,
38.27 	permanently disqualifies the individual under section 245C.14.
38.28 	(c) An individual's offense in any other state or country,
38.29 	where the elements of the offense are substantially similar to
38.30 	any of the offenses listed in paragraph (a), permanently
38.31 	disqualifies the individual under section 245C.14.
38.32 	(d) When a disqualification is based on a judicial
38.33 	determination other than a conviction, the disqualification
38.34 	period begins from the date of the court order.  When a
38.35 	disqualification is based on an admission, the disqualification
38.36 	period begins from the date of an admission in court.  When a
39.1 	disqualification is based on a preponderance of evidence of a
39.2 	disqualifying act, the disqualification date begins from the
39.3 	date of the dismissal, the date of discharge of the sentence
39.4 	imposed for a conviction for a disqualifying crime of similar
39.5 	elements, or the date of the incident, whichever occurs last.

39.6 	Sec. 31. Minnesota Statutes 2004, section 245C.15,
39.7 	subdivision 2, is amended to read:
39.8 		Subd. 2.15-year disqualification.  (a) An individual is
39.9 	disqualified under section 245C.14 if:  (1) less than 15 years
39.10 	have passed since the discharge of the sentence imposed, if any,
39.11 	for the offense; and (2) the individual has received a felony
39.12 	conviction for committed a felony-level violation of any of the
39.13 	following offenses:  sections 260C.301 (grounds for termination
39.14 	of parental rights) 256.98 (wrongfully obtaining
39.15 	assistance); 268.182 (false representation; concealment of
39.16 	facts); 393.07, subdivision 10, paragraph (c) (federal Food
39.17 	Stamp Program fraud);609.165 (felon ineligible to possess
39.18 	firearm); 609.21 (criminal vehicular homicide and injury);
39.19 	609.215 (suicide); 609.223 or 609.2231 (assault in the third or
39.20 	fourth degree); repeat offenses under 609.224 (assault in the
39.21 	fifth degree); 609.2325 (criminal abuse of a vulnerable adult);
39.22 	609.2335 (financial exploitation of a vulnerable adult); 609.235
39.23 	(use of drugs to injure or facilitate crime); 609.24 (simple
39.24 	robbery); 609.255 (false imprisonment); 609.2664 (manslaughter
39.25 	of an unborn child in the first degree); 609.2665 (manslaughter
39.26 	of an unborn child in the second degree); 609.267 (assault of an
39.27 	unborn child in the first degree); 609.2671 (assault of an
39.28 	unborn child in the second degree); 609.268 (injury or death of
39.29 	an unborn child in the commission of a crime); 609.27
39.30 	(coercion); 609.275 (attempt to coerce); repeat offenses under
39.31 	609.3451 (criminal sexual conduct in the fifth degree); 609.466
39.32 	(medical assistance fraud);609.498, subdivision 1 or 1b
39.33 	(aggravated first degree or first degree tampering with a
39.34 	witness); 609.52 (theft); 609.521 (possession of shoplifting
39.35 	gear); 609.525 (bringing stolen goods into Minnesota); 609.527
39.36 	(identity theft); 609.53 (receiving stolen property); 609.535
40.1 	(issuance of dishonored checks);609.562 (arson in the second
40.2 	degree); 609.563 (arson in the third degree); 609.582
40.3 	(burglary); 609.611 (insurance fraud);609.625 (aggravated
40.4 	forgery); 609.63 (forgery); 609.631 (check forgery; offering a
40.5 	forged check); 609.635 (obtaining signature by false pretense);
40.6 	609.66 (dangerous weapons); 609.67 (machine guns and
40.7 	short-barreled shotguns); 609.687 (adulteration); 609.71 (riot);
40.8 	609.713 (terroristic threats); 609.82 (fraud in obtaining
40.9 	credit); 609.821 (financial transaction card fraud);repeat
40.10 	offenses under 617.23 (indecent exposure; penalties); repeat
40.11 	offenses under 617.241 (obscene materials and performances;
40.12 	distribution and exhibition prohibited; penalty); chapter 152
40.13 	(drugs; controlled substance); or a felony-level conviction
40.14 	involving alcohol or drug use.
40.15 	(b) An individual is disqualified under section 245C.14 if
40.16 	less than 15 years has passed since the individual's aiding and
40.17 	abetting,attempt,or conspiracy to commit any of the offenses
40.18 	listed in paragraph (a), as each of these offenses is defined in
40.19 	Minnesota Statutes.
40.20 	(c) For foster care and family child care an individual is
40.21 	disqualified under section 245C.14 if less than 15 years has
40.22 	passed since the individual's voluntary termination of the
40.23 	individual's parental rights under section 260C.301, subdivision
40.24 	1, paragraph (b), or 260C.301, subdivision 3.
40.25 	(d) An individual is disqualified under section 245C.14 if
40.26 	less than 15 years has passed since the discharge of the
40.27 	sentence imposed for an offense in any other state or country,
40.28 	the elements of which are substantially similar to the elements
40.29 	of the offenses listed in paragraph (a).
40.30 	(d) (e) If the individual studied is convicted of one of
40.31 	the felonies listed in paragraph (a), but the sentence is a
40.32 	gross misdemeanor or misdemeanor disposition, the individual is
40.33 	disqualified but the disqualification lookback period for the
40.34 	conviction is the period applicable to the gross misdemeanor or
40.35 	misdemeanor disposition.
40.36 	(f) When a disqualification is based on a judicial
41.1 	determination other than a conviction, the disqualification
41.2 	period begins from the date of the court order.  When a
41.3 	disqualification is based on an admission, the disqualification
41.4 	period begins from the date of an admission in court.  When a
41.5 	disqualification is based on a preponderance of evidence of a
41.6 	disqualifying act, the disqualification date begins from the
41.7 	date of the dismissal, the date of discharge of the sentence
41.8 	imposed for a conviction for a disqualifying crime of similar
41.9 	elements, or the date of the incident, whichever occurs last.

41.10 	Sec. 32. Minnesota Statutes 2004, section 245C.15,
41.11 	subdivision 3, is amended to read:
41.12 		Subd. 3.Ten-year disqualification.  (a) An individual is
41.13 	disqualified under section 245C.14 if:  (1) less than ten years
41.14 	have passed since the discharge of the sentence imposed, if any,
41.15 	for the offense; and (2) the individual has received committed a
41.16 	gross misdemeanor conviction for a misdemeanor-level violation
41.17 	of any of the following offenses:  sections 256.98 (wrongfully
41.18 	obtaining assistance); 268.182 (false representation;
41.19 	concealment of facts); 393.07, subdivision 10, paragraph (c)
41.20 	(federal Food Stamp Program fraud);609.224 (assault in the
41.21 	fifth degree); 609.224, subdivision 2, paragraph (c) (assault in
41.22 	the fifth degree by a caregiver against a vulnerable adult);
41.23 	609.2242 and 609.2243 (domestic assault); 609.23 (mistreatment
41.24 	of persons confined); 609.231 (mistreatment of residents or
41.25 	patients); 609.2325 (criminal abuse of a vulnerable adult);
41.26 	609.233 (criminal neglect of a vulnerable adult); 609.2335
41.27 	(financial exploitation of a vulnerable adult); 609.234 (failure
41.28 	to report maltreatment of a vulnerable adult); 609.265
41.29 	(abduction); 609.275 (attempt to coerce); 609.324, subdivision
41.30 	1a (other prohibited acts; minor engaged in prostitution);
41.31 	609.33 (disorderly house); 609.3451 (criminal sexual conduct in
41.32 	the fifth degree); 609.377 (malicious punishment of a child);
41.33 	609.378 (neglect or endangerment of a child); 609.446 (medical
41.34 	assistance fraud);609.52 (theft); 609.525 (bringing stolen
41.35 	goods into Minnesota); 609.527 (identify theft); 609.53
41.36 	(receiving stolen property); 609.535 (issuance of dishonored
42.1 	checks);609.582 (burglary); 609.611 (insurance fraud);609.631
42.2 	(check forgery; offering a forged check); 609.66 (dangerous
42.3 	weapons); 609.71 (riot); 609.72, subdivision 3 (disorderly
42.4 	conduct against a vulnerable adult); repeat offenses under
42.5 	609.746 (interference with privacy); 609.749, subdivision 2
42.6 	(harassment; stalking); repeat offenses under 617.23 (indecent
42.7 	exposure); 617.241 (obscene materials and performances); 617.243
42.8 	(indecent literature, distribution); 617.293 (harmful materials;
42.9 	dissemination and display to minors prohibited); or violation of
42.10 	an order for protection under section 518B.01, subdivision 14.
42.11 	(b) An individual is disqualified under section 245C.14 if
42.12 	less than ten years has passed since the individual's aiding and
42.13 	abetting,attempt,or conspiracy to commit any of the offenses
42.14 	listed in paragraph (a), as each of these offenses is defined in
42.15 	Minnesota Statutes.
42.16 	(c) An individual is disqualified under section 245C.14 if
42.17 	less than ten years has passed since the discharge of the
42.18 	sentence imposed for an offense in any other state or country,
42.19 	the elements of which are substantially similar to the elements
42.20 	of any of the offenses listed in paragraph (a).
42.21 	(d) If the defendant is convicted of one of the gross
42.22 	misdemeanors listed in paragraph (a), but the sentence is a
42.23 	misdemeanor disposition, the individual is disqualified but the
42.24 	disqualification lookback period for the conviction is the
42.25 	period applicable to misdemeanors.
42.26 	(e) When a disqualification is based on a judicial
42.27 	determination other than a conviction, the disqualification
42.28 	period begins from the date of the court order.  When a
42.29 	disqualification is based on an admission, the disqualification
42.30 	period begins from the date of an admission in court.  When a
42.31 	disqualification is based on a preponderance of evidence of a
42.32 	disqualifying act, the disqualification date begins from the
42.33 	date of the dismissal, the date of discharge of the sentence
42.34 	imposed for a conviction for a disqualifying crime of similar
42.35 	elements, or the date of the incident, whichever occurs last.

42.36 	Sec. 33. Minnesota Statutes 2004, section 245C.15,
43.1 	subdivision 4, is amended to read:
43.2 		Subd. 4.Seven-year disqualification.  (a) An individual
43.3 	is disqualified under section 245C.14 if:  (1) less than seven
43.4 	years has passed since the discharge of the sentence imposed, if
43.5 	any,for the offense; and (2) the individual has received 
43.6 	committed a misdemeanor conviction for a misdemeanor-level 
43.7 	violation of any of the following offenses:  sections 256.98
43.8 	(wrongfully obtaining assistance); 268.182 (false
43.9 	representation; concealment of facts); 393.07, subdivision 10,
43.10 	paragraph (c) (federal Food Stamp Program fraud);609.224
43.11 	(assault in the fifth degree); 609.2242 (domestic assault);
43.12 	609.2335 (financial exploitation of a vulnerable adult); 609.234
43.13 	(failure to report maltreatment of a vulnerable adult); 609.2672
43.14 	(assault of an unborn child in the third degree); 609.27
43.15 	(coercion); violation of an order for protection under 609.3232
43.16 	(protective order authorized; procedures; penalties); 609.466
43.17 	(medical assistance fraud);609.52 (theft); 609.525 (bringing
43.18 	stolen goods into Minnesota); 609.527 (identity theft); 609.53
43.19 	(receiving stolen property); 609.535 (issuance of dishonored
43.20 	checks); 609.611 (insurance fraud);609.66 (dangerous weapons);
43.21 	609.665 (spring guns); 609.746 (interference with privacy);
43.22 	609.79 (obscene or harassing phone telephone calls); 609.795
43.23 	(letter, telegram, or package; opening; harassment); 609.82
43.24 	(fraud in obtaining credit); 609.821 (financial transaction card
43.25 	fraud);617.23 (indecent exposure; penalties); 617.293 (harmful
43.26 	materials; dissemination and display to minors prohibited); or
43.27 	violation of an order for protection under section 518B.01
43.28 	(Domestic Abuse Act).
43.29 	(b) An individual is disqualified under section 245C.14 if
43.30 	less than seven years has passed since a determination or
43.31 	disposition of the individual's:
43.32 	(1) failure to make required reports under section 626.556,
43.33 	subdivision 3, or 626.557, subdivision 3, for incidents in
43.34 	which:  (i) the final disposition under section 626.556 or
43.35 	626.557 was substantiated maltreatment, and (ii) the
43.36 	maltreatment was recurring or serious; or
44.1 	(2) substantiated serious or recurring maltreatment of a
44.2 	minor under section 626.556, a vulnerable adult under section
44.3 	626.557, or serious or recurring maltreatment in any other
44.4 	state, the elements of which are substantially similar to the
44.5 	elements of maltreatment under section 626.556 or 626.557 for
44.6 	which:  (i) there is a preponderance of evidence that the
44.7 	maltreatment occurred, and (ii) the subject was responsible for
44.8 	the maltreatment.
44.9 	(c) An individual is disqualified under section 245C.14 if
44.10 	less than seven years has passed since the individual's aiding
44.11 	and abetting,attempt,or conspiracy to commit any of the
44.12 	offenses listed in paragraphs (a) and (b), as each of these
44.13 	offenses is defined in Minnesota Statutes.
44.14 	(d) An individual is disqualified under section 245C.14 if
44.15 	less than seven years has passed since the discharge of the
44.16 	sentence imposed for an offense in any other state or country,
44.17 	the elements of which are substantially similar to the elements
44.18 	of any of the offenses listed in paragraphs (a) and (b).
44.19 	(e) When a disqualification is based on a judicial
44.20 	determination other than a conviction, the disqualification
44.21 	period begins from the date of the court order.  When a
44.22 	disqualification is based on an admission, the disqualification
44.23 	period begins from the date of an admission in court.  When a
44.24 	disqualification is based on a preponderance of evidence of a
44.25 	disqualifying act, the disqualification date begins from the
44.26 	date of the dismissal, the date of discharge of the sentence
44.27 	imposed for a conviction for a disqualifying crime of similar
44.28 	elements, or the date of the incident, whichever occurs last.

44.29 	Sec. 34. Minnesota Statutes 2004, section 245C.21,
44.30 	subdivision 2, is amended to read:
44.31 		Subd. 2.Time frame for requesting reconsideration of a
44.32 	disqualification.  (a) When the commissioner sends an individual
44.33 	a notice of disqualification based on a finding under section
44.34 	245C.16, subdivision 2, paragraph (a), clause (1) or (2), the
44.35 	disqualified individual must submit the request for a
44.36 	reconsideration within 30 calendar days of the individual's
45.1 	receipt of the notice of disqualification. If mailed, the
45.2 	request for reconsideration must be postmarked and sent to the
45.3 	commissioner within 30 calendar days of the individual's receipt
45.4 	of the notice of disqualification.  If a request for
45.5 	reconsideration is made by personal service, it must be received
45.6 	by the commissioner within 30 calendar days after the
45.7 	individual's receipt of the notice of disqualification.Upon
45.8 	showing that the information under subdivision 3 cannot be
45.9 	obtained within 30 days, the disqualified individual may request
45.10 	additional time, not to exceed 30 days, to obtain the
45.11 	information.
45.12 	(b) When the commissioner sends an individual a notice of
45.13 	disqualification based on a finding under section 245C.16,
45.14 	subdivision 2, paragraph (a), clause (3), the disqualified
45.15 	individual must submit the request for reconsideration within 15
45.16 	calendar days of the individual's receipt of the notice of
45.17 	disqualification. If mailed, the request for reconsideration
45.18 	must be postmarked and sent to the commissioner within 15
45.19 	calendar days of the individual's receipt of the notice of
45.20 	disqualification.  If a request for reconsideration is made by
45.21 	personal service, it must be received by the commissioner within
45.22 	15 calendar days after the individual's receipt of the notice of
45.23 	disqualification.
45.24 	(c) An individual who was determined to have maltreated a
45.25 	child under section 626.556 or a vulnerable adult under section
45.26 	626.557, and who is disqualified on the basis of serious or
45.27 	recurring maltreatment, may request a reconsideration of both
45.28 	the maltreatment and the disqualification determinations.  The
45.29 	request must be submitted within 30 calendar days of the
45.30 	individual's receipt of the notice of disqualification. If
45.31 	mailed, the request for reconsideration must be postmarked and
45.32 	sent to the commissioner within 30 calendar days of the
45.33 	individual's receipt of the notice of disqualification.  If a
45.34 	request for reconsideration is made by personal service, it must
45.35 	be received by the commissioner within 30 calendar days after
45.36 	the individual's receipt of the notice of disqualification.

46.1 	Sec. 35. Minnesota Statutes 2004, section 245C.22,
46.2 	subdivision 3, is amended to read:
46.3 		Subd. 3.Preeminent weight given to safety of persons
46.4 	being served.  In reviewing a request for reconsideration of a
46.5 	disqualification, the commissioner shall give preeminent weight
46.6 	to the safety of each person served by the license holder,
46.7 	applicant, or other entities as provided in this chapter over
46.8 	the interests of the disqualified individual,license holder,
46.9 	applicant, or other entity as provided in this chapter, and any
46.10 	single factor under subdivision 4, paragraph (b), may be
46.11 	determinative of the commissioner's decision whether to set
46.12 	aside the individual's disqualification.

46.13 	Sec. 36. Minnesota Statutes 2004, section 245C.22,
46.14 	subdivision 4, is amended to read:
46.15 		Subd. 4.Risk of harm; set aside.  (a) The commissioner
46.16 	may set aside the disqualification if the commissioner finds
46.17 	that the individual has submitted sufficient information to
46.18 	demonstrate that the individual does not pose a risk of harm to
46.19 	any person served by the applicant, license holder, or other
46.20 	entities as provided in this chapter.
46.21 	(b) In determining whether the individual has met the
46.22 	burden of proof by demonstrating the individual does not pose a
46.23 	risk of harm, the commissioner shall consider:
46.24 	(1) the nature, severity, and consequences of the event or
46.25 	events that led to the disqualification;
46.26 	(2) whether there is more than one disqualifying event;
46.27 	(3) the age and vulnerability of the victim at the time of
46.28 	the event;
46.29 	(4) the harm suffered by the victim;
46.30 	(5) the similarity between the victim and persons served by
46.31 	the program;
46.32 	(6) the time elapsed without a repeat of the same or
46.33 	similar event;
46.34 	(7) documentation of successful completion by the
46.35 	individual studied of training or rehabilitation pertinent to
46.36 	the event; and
47.1 	(8) any other information relevant to reconsideration.
47.2 	(c) If the individual requested reconsideration on the
47.3 	basis that the information relied upon to disqualify the
47.4 	individual was incorrect or inaccurate and the commissioner
47.5 	determines that the information relied upon to disqualify the
47.6 	individual is correct, the commissioner must also determine if
47.7 	the individual poses a risk of harm to persons receiving
47.8 	services in accordance with paragraph (b).

47.9 	Sec. 37. Minnesota Statutes 2004, section 245C.22,
47.10 	subdivision 7, as added by Laws 2005, chapter 136, article 6,
47.11 	section 6, is amended to read:
47.12 		Subd. 7.Classification of certain data as public or
47.13 	private. (a) Notwithstanding section 13.46, upon setting aside
47.14 	a disqualification under this section, the identity of the
47.15 	disqualified individual who received the set aside and the
47.16 	individual's disqualifying characteristics are public data if
47.17 	the set aside was:
47.18 	(1) for any disqualifying characteristic under section
47.19 	245C.15, when the set aside relates to a child care center or a
47.20 	family child care provider licensed under chapter 245A; or
47.21 	(2) for a disqualifying characteristic under section
47.22 	245C.15, subdivision 2.
47.23 	(b) Notwithstanding section 13.46, upon granting a variance
47.24 	to a license holder under section 245C.30, the identity of the
47.25 	disqualified individual who is the subject of the variance, the
47.26 	individual's disqualifying characteristics under section
47.27 	245C.15, and the terms of the variance are public data, when the
47.28 	variance:
47.29 	(1) is issued to a child care center or a family child care
47.30 	provider licensed under chapter 245A; or
47.31 	(2) relates to an individual with a disqualifying
47.32 	characteristic under section 245C.15, subdivision 2.
47.33 	(c) The identity of a disqualified individual and the
47.34 	reason for disqualification remain private data when:
47.35 	(1) a disqualification is not set aside and no variance is
47.36 	granted;
48.1 	(2) the data are not public under paragraph (a) or (b); or 
48.2 	(3) the disqualification is rescinded because the
48.3 	information relied upon to disqualify the individual is
48.4 	incorrect; or 
48.5 	(4) the disqualification relates to a license to provide
48.6 	relative child foster care.  As used in this clause, "relative"
48.7 	has the meaning given it under section 260C.007, subdivision 27.
48.8 	(d) Licensed family day care providers and child care
48.9 	centers must notify parents considering enrollment of a child or
48.10 	parents of a child attending the family day care or child care
48.11 	center if the program employs or has living in the home any
48.12 	individual who is the subject of either a set aside or variance.
48.13 	
EFFECTIVE DATE. This section is effective the day
48.14 	following final enactment.

48.15 	Sec. 38. Minnesota Statutes 2004, section 245C.23,
48.16 	subdivision 1, is amended to read:
48.17 		Subdivision 1.Commissioner's notice of disqualification
48.18 	that is rescinded or set aside. (a) Except as provided under
48.19 	paragraph (c),If the commissioner rescinds or sets aside a
48.20 	disqualification, the commissioner shall notify the
48.21 	applicant or ,license holder, or other entity in writing or by
48.22 	electronic transmission of the decision. In the notice from the
48.23 	commissioner that a disqualification has been rescinded, the
48.24 	commissioner must inform the applicant, license holder, or other
48.25 	entity that the information relied upon to disqualify the
48.26 	individual was incorrect.In the notice from the commissioner
48.27 	that a disqualification has been set aside, the commissioner
48.28 	must inform the applicant,license holder that information about
48.29 	the nature , or other entity of the reason for the individual's 
48.30 	disqualification and that information about which factors under
48.31 	section 245C.22, subdivision 4, were the basis of the decision
48.32 	to set aside the disqualification are available to the license
48.33 	holder upon request without the consent of the background study
48.34 	subject.
48.35 	(b) With the written consent of the background study
48.36 	subject, the commissioner may release to the license holder
49.1 	copies of all information related to the background study
49.2 	subject's disqualification and the commissioner's decision to
49.3 	set aside the disqualification as specified in the written
49.4 	consent.
49.5 	(c) If the individual studied submits a timely request for
49.6 	reconsideration under section 245C.21 and the license holder was
49.7 	previously sent a notice under section 245C.17, subdivision 3,
49.8 	paragraph (d), and if the commissioner sets aside the
49.9 	disqualification for that license holder under section 245C.22,
49.10 	the commissioner shall send the license holder the same
49.11 	notification received by license holders in cases where the
49.12 	individual studied has no disqualifying characteristic.
49.13 	
EFFECTIVE DATE. This section is effective the day
49.14 	following final enactment.

49.15 	Sec. 39. Minnesota Statutes 2004, section 245C.24,
49.16 	subdivision 2, as amended by Laws 2005, chapter 136, article 6,
49.17 	section 7, is amended to read:
49.18 		Subd. 2.Permanent bar to set aside a disqualification.
 49.19 	The commissioner may not set aside the disqualification of an 
49.20 	any individual in connection with a license issued or in
49.21 	application status under chapter 245A disqualified pursuant to
49.22 	this chapter, regardless of how much time has passed, if
49.23 	the provider individual was disqualified for a crime or conduct
49.24 	listed in section 245C.15, subdivision 1.
49.25 	
EFFECTIVE DATE. This section is effective the day
49.26 	following final enactment.

49.27 	Sec. 40. Minnesota Statutes 2004, section 245C.24,
49.28 	subdivision 3, is amended to read:
49.29 		Subd. 3.Ten-year bar to set aside disqualification.  (a)
49.30 	The commissioner may not set aside the disqualification of an
49.31 	individual in connection with a license to provide family child
49.32 	care for children, foster care for children in the provider's
49.33 	home, or foster care or day care services for adults in the
49.34 	provider's home if:  (1) less than ten years has passed since
49.35 	the discharge of the sentence imposed, if any,for the offense;
49.36 	and or (2) when disqualified based on a preponderance of
50.1 	evidence determination under section 245A.14, subdivision 1,
50.2 	paragraph (a), clause (2), or an admission under section
50.3 	245A.14, subdivision 1, paragraph (a), clause (1), and less than
50.4 	ten years has passed since the individual committed the act or
50.5 	admitted to committing the act, whichever is later; and (3) the
50.6 	individual has been convicted of committed a violation of any of
50.7 	the following offenses:  sections 609.165 (felon ineligible to
50.8 	possess firearm); criminal vehicular homicide under 609.21
50.9 	(criminal vehicular homicide and injury); 609.215 (aiding
50.10 	suicide or aiding attempted suicide); felony violations under
50.11 	609.223 or 609.2231 (assault in the third or fourth degree);
50.12 	609.713 (terroristic threats); 609.235 (use of drugs to injure
50.13 	or to facilitate crime); 609.24 (simple robbery); 609.255 (false
50.14 	imprisonment); 609.562 (arson in the second degree); 609.71
50.15 	(riot); 609.498, subdivision 1 or 1b (aggravated first degree or
50.16 	first degree tampering with a witness); burglary in the first or
50.17 	second degree under 609.582 (burglary); 609.66 (dangerous
50.18 	weapon); 609.665 (spring guns); 609.67 (machine guns and
50.19 	short-barreled shotguns); 609.749, subdivision 2 (gross
50.20 	misdemeanor harassment; stalking); 152.021 or 152.022
50.21 	(controlled substance crime in the first or second degree);
50.22 	152.023, subdivision 1, clause (3) or (4) or subdivision 2,
50.23 	clause (4) (controlled substance crime in the third degree);
50.24 	152.024, subdivision 1, clause (2), (3), or (4) (controlled
50.25 	substance crime in the fourth degree); 609.224, subdivision 2,
50.26 	paragraph (c) (fifth-degree assault by a caregiver against a
50.27 	vulnerable adult); 609.23 (mistreatment of persons confined);
50.28 	609.231 (mistreatment of residents or patients); 609.2325
50.29 	(criminal abuse of a vulnerable adult); 609.233 (criminal
50.30 	neglect of a vulnerable adult); 609.2335 (financial exploitation
50.31 	of a vulnerable adult); 609.234 (failure to report); 609.265
50.32 	(abduction); 609.2664 to 609.2665 (manslaughter of an unborn
50.33 	child in the first or second degree); 609.267 to 609.2672
50.34 	(assault of an unborn child in the first, second, or third
50.35 	degree); 609.268 (injury or death of an unborn child in the
50.36 	commission of a crime); 617.293 (disseminating or displaying
51.1 	harmful material to minors); a felony-level conviction involving
51.2 	alcohol or drug use, a gross misdemeanor offense under 609.324,
51.3 	subdivision 1 (other prohibited acts); a gross misdemeanor
51.4 	offense under 609.378 (neglect or endangerment of a child); a
51.5 	gross misdemeanor offense under 609.377 (malicious punishment of
51.6 	a child); or 609.72, subdivision 3 (disorderly conduct against a
51.7 	vulnerable adult).
51.8 	(b) The commissioner may not set aside the disqualification
51.9 	of an individual if less than ten years have passed since the
51.10 	individual's aiding and abetting,attempt,or conspiracy to
51.11 	commit any of the offenses listed in paragraph (a) as each of
51.12 	these offenses is defined in Minnesota Statutes.
51.13 	(c) The commissioner may not set aside the disqualification
51.14 	of an individual if less than ten years have passed since the
51.15 	discharge of the sentence imposed for an offense in any other
51.16 	state or country, the elements of which are substantially
51.17 	similar to the elements of any of the offenses listed in
51.18 	paragraph (a).

51.19 	Sec. 41. Minnesota Statutes 2004, section 245C.27,
51.20 	subdivision 1, is amended to read:
51.21 		Subdivision 1.Fair hearing when disqualification is not
51.22 	set aside.  (a) If the commissioner does not set aside or
51.23 	rescind a disqualification of an individual under section
51.24 	245C.22 who is disqualified on the basis of a preponderance of
51.25 	evidence that the individual committed an act or acts that meet
51.26 	the definition of any of the crimes listed in section 245C.15;
51.27 	for a determination under section 626.556 or 626.557 of
51.28 	substantiated maltreatment that was serious or recurring under
51.29 	section 245C.15; or for failure to make required reports under
51.30 	section 626.556, subdivision 3; or 626.557, subdivision 3,
51.31 	pursuant to section 245C.15, subdivision 4, paragraph (b),
51.32 	clause (1), the individual may request a fair hearing under
51.33 	section 256.045, unless the disqualification is deemed
51.34 	conclusive under section 245C.29.
51.35 	(b) The fair hearing is the only administrative appeal of
51.36 	the final agency determination for purposes of appeal by the
52.1 	disqualified individual.  The disqualified individual does not
52.2 	have the right to challenge the accuracy and completeness of
52.3 	data under section 13.04.
52.4 	(c) If the individual was disqualified based on a
52.5 	conviction or admission to any crimes listed in section 245C.15,
52.6 	subdivisions 1 to 4, the reconsideration decision under section
52.7 	245C.22 is the final agency determination for purposes of appeal
52.8 	by the disqualified individual and is not subject to a hearing
52.9 	under section 256.045. If the individual was disqualified based
52.10 	on a judicial determination, that determination is treated the
52.11 	same as a conviction for purposes of appeal.
52.12 	(d) This subdivision does not apply to a public employee's
52.13 	appeal of a disqualification under section 245C.28, subdivision
52.14 	3.
52.15 	(e) Notwithstanding paragraph (c), if the commissioner does
52.16 	not set aside a disqualification of an individual who was
52.17 	disqualified based on both a preponderance of evidence and a
52.18 	conviction or admission, the individual may request a fair
52.19 	hearing under section 256.045, unless the disqualifications are
52.20 	deemed conclusive under section 245C.29.  The scope of the
52.21 	hearing conducted under section 256.045 with regard to the
52.22 	disqualification based on a conviction or admission shall be
52.23 	limited solely to whether the individual poses a risk of harm,
52.24 	according to section 256.045, subdivision 3b.

52.25 	Sec. 42. Minnesota Statutes 2004, section 245C.28,
52.26 	subdivision 3, is amended to read:
52.27 		Subd. 3.Employees of public employer.  (a) If the
52.28 	commissioner does not set aside the disqualification of an
52.29 	individual who is an employee of an employer, as defined in
52.30 	section 179A.03, subdivision 15, the individual may request a
52.31 	contested case hearing under chapter 14.  The request for a
52.32 	contested case hearing must be made in writing and must be
52.33 	postmarked and mailed sent within 30 calendar days after the
52.34 	employee receives notice that the disqualification has not been
52.35 	set aside. If the individual was disqualified based on a
52.36 	conviction or admission to any crimes listed in section 245C.15,
53.1 	the scope of the contested case hearing shall be limited solely
53.2 	to whether the individual poses a risk of harm pursuant to
53.3 	section 245C.22.
53.4 	(b) If the commissioner does not set aside or rescind a
53.5 	disqualification that is based on a maltreatment determination,
53.6 	the scope of the contested case hearing must include the
53.7 	maltreatment determination and the disqualification.  In such
53.8 	cases, a fair hearing must not be conducted under section
53.9 	256.045.
53.10 	(c) Rules adopted under this chapter may not preclude an
53.11 	employee in a contested case hearing for a disqualification from
53.12 	submitting evidence concerning information gathered under this
53.13 	chapter.
53.14 	(d) When a person an individual has been disqualified from
53.15 	multiple licensed programs and the disqualifications have not
53.16 	been set aside under section 245C.22, if at least one of the
53.17 	disqualifications entitles the person to a contested case
53.18 	hearing under this subdivision, the scope of the contested case
53.19 	hearing shall include all disqualifications from licensed
53.20 	programs which were not set aside.
53.21 	(e) In determining whether the disqualification should be
53.22 	set aside, the administrative law judge shall consider all of
53.23 	the characteristics that cause the individual to be
53.24 	disqualified, including those characteristics that were not
53.25 	subject to review under paragraph (b),in order to determine
53.26 	whether the individual poses a risk of harm.  The administrative
53.27 	law judge's recommendation and the commissioner's order to set
53.28 	aside a disqualification that is the subject of the hearing
53.29 	constitutes a determination that the individual does not pose a
53.30 	risk of harm and that the individual may provide direct contact
53.31 	services in the individual program specified in the set aside.

53.32 	Sec. 43. Minnesota Statutes 2004, section 245C.30,
53.33 	subdivision 1, is amended to read:
53.34 		Subdivision 1.License holder variance.  (a) Except for
53.35 	any disqualification under section 245C.15, subdivision 1,when
53.36 	the commissioner has not set aside a background study subject's
54.1 	disqualification, and there are conditions under which the
54.2 	disqualified individual may provide direct contact services or
54.3 	have access to people receiving services that minimize the risk
54.4 	of harm to people receiving services, the commissioner may grant
54.5 	a time-limited variance to a license holder.
54.6 	(b) The variance shall state the reason for the
54.7 	disqualification, the services that may be provided by the
54.8 	disqualified individual, and the conditions with which the
54.9 	license holder or applicant must comply for the variance to
54.10 	remain in effect.
54.11 	(c) Except for programs licensed to provide family child
54.12 	care, foster care for children in the provider's own home, or
54.13 	foster care or day care services for adults in the provider's
54.14 	own home, the variance must be requested by the license holder.
54.15 	
EFFECTIVE DATE. This section is effective the day
54.16 	following final enactment.

54.17 	Sec. 44. Minnesota Statutes 2004, section 245C.30,
54.18 	subdivision 2, is amended to read:
54.19 		Subd. 2.Disclosure of reason for disqualification.  (a)
54.20 	The commissioner may not grant a variance for a disqualified
54.21 	individual unless the applicant or license holder requests the
54.22 	variance and the disqualified individual provides written
54.23 	consent for the commissioner to disclose to the applicant or
54.24 	license holder the reason for the disqualification.
54.25 	(b) This subdivision does not apply to programs licensed to
54.26 	provide family child care for children, foster care for children
54.27 	in the provider's own home, or foster care or day care services
54.28 	for adults in the provider's own home. When the commissioner
54.29 	grants a variance for a disqualified individual in connection
54.30 	with a license to provide the services specified in this
54.31 	paragraph, the disqualified individual's consent is not required
54.32 	to disclose the reason for the disqualification to the license
54.33 	holder in the variance issued under subdivision 1.
54.34 	
EFFECTIVE DATE. This section is effective the day
54.35 	following final enactment.

54.36 	Sec. 45. [245C.301] NOTIFICATION OF SET-ASIDE OR
55.1 	VARIANCE.
55.2 	Licensed family child care providers and child care centers
55.3 	must provide a written notification to parents considering
55.4 	enrollment of a child or parents of a child attending the family
55.5 	child care or child care center if the program employs or has
55.6 	living in the home any individual who is the subject of either a
55.7 	set-aside or variance.

55.8 	Sec. 46. Minnesota Statutes 2004, section 246.13, as
55.9 	amended by Laws 2005, chapter 136, article 5, section 2, is
55.10 	amended to read:
55.11 	246.13 [RECORDS OF PATIENTS AND RESIDENTS RECEIVING
55.12 	STATE-OPERATED SERVICES.]
55.13 		Subdivision 1.Powers, duties, and authority of
55.14 	commissioner. (a) The commissioner of human services' office
55.15 	shall have, accessible only by consent of the commissioner or on
55.16 	the order of a judge or court of record, a record showing the
55.17 	residence, sex, age, nativity, occupation, civil condition, and
55.18 	date of entrance or commitment of every person, in the
55.19 	state-operated services facilities as defined under section
55.20 	246.014 under exclusive control of the commissioner; the date of
55.21 	discharge and whether such discharge was final; the condition of
55.22 	the person when the person left the state-operated services
55.23 	facility; the vulnerable adult abuse prevention associated with
55.24 	the person; and the date and cause of all deaths.  The record
55.25 	shall state every transfer from one state-operated services
55.26 	facility to another, naming each state-operated services
55.27 	facility.  This information shall be furnished to the
55.28 	commissioner of human services by each public agency, along with
55.29 	other obtainable facts as the commissioner may require.  When a
55.30 	patient or resident in a state-operated services facility is
55.31 	discharged, transferred, or dies, the head of the state-operated
55.32 	services facility or designee shall inform the commissioner of
55.33 	human services of these events within ten days on forms
55.34 	furnished by the commissioner.
55.35 	(b) The commissioner of human services shall cause to be
55.36 	devised, installed, and operated an adequate system of records
56.1 	and statistics which shall consist of all basic record forms,
56.2 	including patient personal records and medical record forms, and
56.3 	the manner of their use shall be precisely uniform throughout
56.4 	all state-operated services facilities.
56.5 		Subd. 2.Definitions; risk assessment and management. (a)
56.6 	As used in this section:
56.7 	(1) "appropriate and necessary medical and other records"
56.8 	includes patient medical records and other protected health
56.9 	information as defined by Code of Federal Regulations, title 45,
56.10 	section 164.501, relating to a patient in a state-operated
56.11 	services facility including, but not limited to, the patient's
56.12 	treatment plan and abuse prevention plan that is pertinent to
56.13 	the patient's ongoing care, treatment, or placement in a
56.14 	community-based treatment facility or a health care facility
56.15 	that is not operated by state-operated services, and includes
56.16 	information describing the level of risk posed by a patient when
56.17 	the patient enters such a the facility;
56.18 	(2) "community-based treatment" means the community support
56.19 	services listed in section 253B.02, subdivision 4b;
56.20 	(3) "criminal history data" means those data maintained or
56.21 	used by the Departments of Corrections and Public Safety and by
56.22 	the supervisory authorities listed in section 13.84, subdivision
56.23 	1, that relate to an individual's criminal history or propensity
56.24 	for violence;,including data in the Corrections Offender
56.25 	Management System (COMS) and Statewide Supervision System (S3)
56.26 	maintained by the Department of Corrections; the Criminal
56.27 	Justice Information System (CJIS) and the Predatory Offender
56.28 	Registration (POR) system maintained by the Department of Public
56.29 	Safety; and the CriMNet system;
56.30 	(4) "designated agency" means the agency defined in section
56.31 	253B.02, subdivision 5;
56.32 	(5) "law enforcement agency" means the law enforcement
56.33 	agency having primary jurisdiction over the location where the
56.34 	offender expects to reside upon release;
56.35 	(6) "predatory offender" and "offender" mean a person who
56.36 	is required to register as a predatory offender under section
57.1 	243.166; and
57.2 	(7) "treatment facility" means a facility as defined in
57.3 	section 253B.02, subdivision 19.
57.4 	(b) To promote public safety and for the purposes and
57.5 	subject to the requirements of this paragraph (c), the
57.6 	commissioner or the commissioner's designee shall have access
57.7 	to, and may review and disclose, medical and criminal history
57.8 	data as provided by this section.
57.9 	(c) The commissioner or the commissioner's designee shall
57.10 	disseminate data to designated treatment facility staff, special
57.11 	review board members, and end-of-confinement review committee
57.12 	members in accordance with Minnesota Rules, part 1205.0400, to ,
57.13 	as necessary to comply with Minnesota Rules, part 1205.0400:
57.14 	(1) to determine whether a patient is required under state
57.15 	law to register as a predatory offender according to section
57.16 	243.166;
57.17 	(2) to facilitate and expedite the responsibilities of the
57.18 	special review board and end-of-confinement review committees by
57.19 	corrections institutions and state treatment facilities;
57.20 	(3) to prepare, amend, or revise the abuse prevention plans
57.21 	required under section 626.557, subdivision 14, and individual
57.22 	patient treatment plans required under section 253B.03,
57.23 	subdivision 7;
57.24 	(4) to facilitate changes of the custody and transfers ,
57.25 	supervision, and transport of individuals transferred between
57.26 	the Department of Corrections and the Department of Human
57.27 	Services; and or 
57.28 	(5) facilitate the exchange of data between to effectively
57.29 	monitor and supervise individuals who are under the authority of 
57.30 	the Department of Corrections, the Department of Human Services,
57.31 	and any of the supervisory authorities listed in section
57.32 	13.84, regarding an individual under the authority of one or
57.33 	more of these entities subdivision 1.
57.34 	(c) The state-operated services treatment facility must
57.35 	make a good faith effort to obtain written authorization from
57.36 	the patient before releasing information from the patient's
58.1 	medical record.
58.2 	(d) If the patient refuses or is unable to give informed
58.3 	consent to authorize the release of information required above,
58.4 	the chief executive officer for state-operated services shall
58.5 	provide the appropriate and necessary medical and other
58.6 	records.  The chief executive officer shall comply with the
58.7 	minimum necessary requirements.
58.8 	(d) If approved by the United States Department of Justice,
58.9 	(e) The commissioner may have access to national criminal
58.10 	history information the National Crime Information Center (NCIC)
58.11 	database, through the Department of Public Safety, in support of
58.12 	the law enforcement function functions described in paragraph
58.13 	(c).  If approval of the United States Department of Justice is
58.14 	not obtained by the commissioner before July 1, 2007, the
58.15 	authorization in this paragraph sunsets on that date (b).
58.16 		Subd. 3.Community-based treatment and medical
58.17 	treatment. (a) When a patient under the care and supervision of
58.18 	state-operated services is released to a community-based
58.19 	treatment facility or facility that provides health care
58.20 	services, state-operated services may disclose all appropriate
58.21 	and necessary health and other information relating to the
58.22 	patient.
58.23 	(b) The information that must be provided to the designated
58.24 	agency, community-based treatment facility, or facility that
58.25 	provides health care services includes, but is not limited to,
58.26 	the patient's abuse prevention plan required under section
58.27 	626.557, subdivision 14, paragraph (b).
58.28 		Subd. 4.Predatory offender registration notification.
 58.29 	(a) When a state-operated facility determines that a patient is
58.30 	required under section 243.166, subdivision 1, to register as a
58.31 	predatory offender or, under section 243.166, subdivision 4a, to
58.32 	provide notice of a change in status, the facility shall provide
58.33 	written notice to the patient of the requirement.
58.34 	(b) If the patient refuses, is unable, or lacks capacity to
58.35 	comply with the requirement described in paragraph (a) within
58.36 	five days after receiving the notification of the duty to
59.1 	comply, state-operated services staff shall obtain and disclose
59.2 	the necessary data to complete the registration form or change
59.3 	of status notification for the patient.  The treatment facility
59.4 	shall also forward the registration or change of status data
59.5 	that it completes to the Bureau of Criminal Apprehension and, as
59.6 	applicable, the patient's corrections agent and the law
59.7 	enforcement agency in the community in which the patient
59.8 	currently resides.  If, after providing notification, the
59.9 	patient refuses to comply with the requirements described in
59.10 	paragraph (a), the treatment facility shall also notify the
59.11 	county attorney in the county in which the patient is currently
59.12 	residing of the refusal.
59.13 	(c) The duties of state-operated services described in this
59.14 	subdivision do not relieve the patient of the ongoing individual
59.15 	duty to comply with the requirements of section 243.166.
59.16 		Subd. 5.limitations on use of procedure for bloodborne
59.17 	pathogen test results pathogens. Sections 246.71, 246.711,
59.18 	246.712, 246.713, 246.714, 246.715, 246.716, 246.717, 246.718,
59.19 	246.719, 246.72, 246.721, and to 246.722 apply to state-operated
59.20 	services facilities.
59.21 	
EFFECTIVE DATE. This section is effective the day
59.22 	following final enactment.

59.23 	Sec. 47. Minnesota Statutes 2004, section 260B.163,
59.24 	subdivision 6, is amended to read:
59.25 		Subd. 6.Guardian ad litem.  (a) The court shall appoint
59.26 	a guardian ad litem to protect the interests of the minor when
59.27 	it appears, at any stage of the proceedings, that the minor is
59.28 	without a parent or guardian, or that the minor's parent is a
59.29 	minor or incompetent, or that the parent or guardian is
59.30 	indifferent or hostile to the minor's interests.  In any other
59.31 	case the court may appoint a guardian ad litem to protect the
59.32 	interests of the minor when the court feels that such an
59.33 	appointment is desirable.  The court shall appoint the guardian
59.34 	ad litem on its own motion or in the manner provided for the
59.35 	appointment of a guardian ad litem in the district court.  The
59.36 	court may appoint separate counsel for the guardian ad litem if
60.1 	necessary.
60.2 	(b) A guardian ad litem shall carry out the following
60.3 	responsibilities:
60.4 	(1) conduct an independent investigation to determine the
60.5 	facts relevant to the situation of the child and the family,
60.6 	which must include, unless specifically excluded by the court,
60.7 	reviewing relevant documents; meeting with and observing the
60.8 	child in the home setting and considering the child's wishes, as
60.9 	appropriate; and interviewing parents, caregivers, and others
60.10 	with knowledge relevant to the case;
60.11 	(2) advocate for the child's best interests by
60.12 	participating in appropriate aspects of the case and advocating
60.13 	for appropriate community services when necessary;
60.14 	(3) maintain the confidentiality of information related to
60.15 	a case, with the exception of sharing information as permitted
60.16 	by law to promote cooperative solutions that are in the best
60.17 	interests of the child;
60.18 	(4) monitor the child's best interests throughout the
60.19 	judicial proceeding; and
60.20 	(5) present written reports on the child's best interests
60.21 	that include conclusions and recommendations and the facts upon
60.22 	which they are based.
60.23 	(c) The court may waive the appointment of a guardian ad
60.24 	litem pursuant to paragraph (a), whenever counsel has been
60.25 	appointed pursuant to subdivision 2 or is retained otherwise,
60.26 	and the court is satisfied that the interests of the minor are
60.27 	protected.
60.28 	(d) In appointing a guardian ad litem pursuant to paragraph
60.29 	(a), the court shall not appoint the party, or any agent or
60.30 	employee thereof, filing a petition pursuant to section 260B.141
60.31 	and 260C.141.
60.32 	(e) The following factors shall be considered when
60.33 	appointing a guardian ad litem in a case involving an Indian or
60.34 	minority child:
60.35 	(1) whether a person is available who is the same racial or
60.36 	ethnic heritage as the child or, if that is not possible;
61.1 	(2) whether a person is available who knows and appreciates
61.2 	the child's racial or ethnic heritage.
61.3 	(f) The court shall require a background study for each
61.4 	guardian ad litem as provided under section 518.165.  The court
61.5 	shall have access to data collected pursuant to section 245C.32
61.6 	for purposes of the background study.
61.7 	
EFFECTIVE DATE. This section is effective the day
61.8 	following final enactment.

61.9 	Sec. 48. Minnesota Statutes 2004, section 260C.163,
61.10 	subdivision 5, is amended to read:
61.11 		Subd. 5.Guardian ad litem.  (a) The court shall appoint
61.12 	a guardian ad litem to protect the interests of the minor when
61.13 	it appears, at any stage of the proceedings, that the minor is
61.14 	without a parent or guardian, or that the minor's parent is a
61.15 	minor or incompetent, or that the parent or guardian is
61.16 	indifferent or hostile to the minor's interests, and in every
61.17 	proceeding alleging a child's need for protection or services
61.18 	under section 260C.007, subdivision 6, except proceedings where
61.19 	the sole allegation is that the child is a runaway or habitual
61.20 	truant.  In any other case the court may appoint a guardian ad
61.21 	litem to protect the interests of the minor when the court feels
61.22 	that such an appointment is desirable.  The court shall appoint
61.23 	the guardian ad litem on its own motion or in the manner
61.24 	provided for the appointment of a guardian ad litem in the
61.25 	district court.  The court may appoint separate counsel for the
61.26 	guardian ad litem if necessary.
61.27 	(b) A guardian ad litem shall carry out the following
61.28 	responsibilities:
61.29 	(1) conduct an independent investigation to determine the
61.30 	facts relevant to the situation of the child and the family,
61.31 	which must include, unless specifically excluded by the court,
61.32 	reviewing relevant documents; meeting with and observing the
61.33 	child in the home setting and considering the child's wishes, as
61.34 	appropriate; and interviewing parents, caregivers, and others
61.35 	with knowledge relevant to the case;
61.36 	(2) advocate for the child's best interests by
62.1 	participating in appropriate aspects of the case and advocating
62.2 	for appropriate community services when necessary;
62.3 	(3) maintain the confidentiality of information related to
62.4 	a case, with the exception of sharing information as permitted
62.5 	by law to promote cooperative solutions that are in the best
62.6 	interests of the child;
62.7 	(4) monitor the child's best interests throughout the
62.8 	judicial proceeding; and
62.9 	(5) present written reports on the child's best interests
62.10 	that include conclusions and recommendations and the facts upon
62.11 	which they are based.
62.12 	(c) Except in cases where the child is alleged to have been
62.13 	abused or neglected, the court may waive the appointment of a
62.14 	guardian ad litem pursuant to clause (a), whenever counsel has
62.15 	been appointed pursuant to subdivision 2 or is retained
62.16 	otherwise, and the court is satisfied that the interests of the
62.17 	minor are protected.
62.18 	(d) In appointing a guardian ad litem pursuant to clause
62.19 	(a), the court shall not appoint the party, or any agent or
62.20 	employee thereof, filing a petition pursuant to section 260C.141.
62.21 	(e) The following factors shall be considered when
62.22 	appointing a guardian ad litem in a case involving an Indian or
62.23 	minority child:
62.24 	(1) whether a person is available who is the same racial or
62.25 	ethnic heritage as the child or, if that is not possible;
62.26 	(2) whether a person is available who knows and appreciates
62.27 	the child's racial or ethnic heritage.
62.28 	(f) The court shall require a background study for each
62.29 	guardian ad litem as provided under section 518.165.  The court
62.30 	shall have access to data collected pursuant to section 245C.32
62.31 	for purposes of the background study.
62.32 	
EFFECTIVE DATE. This section is effective the day
62.33 	following final enactment.

62.34 	Sec. 49. Minnesota Statutes 2004, section 299C.093, as
62.35 	amended by Laws 2005, chapter 136, article 5, section 4, is
62.36 	amended to read:
63.1 	299C.093 [DATABASE OF REGISTERED PREDATORY OFFENDERS.]
63.2 	The superintendent of the bureau of criminal apprehension
63.3 	shall maintain a computerized data system relating to
63.4 	individuals required to register as predatory offenders under
63.5 	section 243.166.  To the degree feasible, the system must
63.6 	include the data required to be provided under section 243.166,
63.7 	subdivisions 4 and 4a, and indicate the time period that the
63.8 	person is required to register.  The superintendent shall
63.9 	maintain this data in a manner that ensures that it is readily
63.10 	available to law enforcement agencies.  This data is private
63.11 	data on individuals under section 13.02, subdivision 12, but may
63.12 	be used for law enforcement and corrections purposes.
63.13 	State-operated services, as defined in section 246.014, are is 
63.14 	also authorized to have access to the data for the purposes
63.15 	described in section 246.13, subdivision 2, paragraph (c) (b).

63.16 	EFFECTIVE DATE. This section is effective the day
63.17 	following final enactment.

63.18 	Sec. 50. Minnesota Statutes 2004, section 518.165, is
63.19 	amended by adding a subdivision to read:
63.20 		Subd. 4.Background study of guardian ad litem. (a) The
63.21 	court shall initiate a background study through the commissioner
63.22 	of human services under section 245C.32 on every guardian ad
63.23 	litem appointed under this section if a background study has not
63.24 	been completed on the guardian ad litem within the past three
63.25 	years.  The background study must be completed before the court
63.26 	appoints the guardian ad litem, unless the court determines that
63.27 	it is in the best interest of the child to appoint a guardian ad
63.28 	litem before a background study can be completed by the
63.29 	commissioner.  The court shall initiate a subsequent background
63.30 	study under this paragraph once every three years after the
63.31 	guardian has been appointed as long as the individual continues
63.32 	to serve as a guardian ad litem.
63.33 	(b) The background study must include criminal history data
63.34 	from the Bureau of Criminal Apprehension, other criminal history
63.35 	data held by the commissioner of human services, and data
63.36 	regarding whether the person has been a perpetrator of
64.1 	substantiated maltreatment of a minor or a vulnerable adult.
64.2 	When the information from the Bureau of Criminal Apprehension
64.3 	indicates that the subject of a study under paragraph (a) is a
64.4 	multistate offender or that the subject's multistate offender
64.5 	status is undetermined, the court shall require a search of the
64.6 	National Criminal Records Repository, and shall provide the
64.7 	commissioner a set of classifiable fingerprints of the subject
64.8 	of the study.
64.9 	(c) The Minnesota Supreme Court shall pay the commissioner
64.10 	a fee for conducting a background study under section 245C.32.
64.11 	(d) Nothing precludes the court from initiating background
64.12 	studies using court data on criminal convictions.
64.13 	
EFFECTIVE DATE. This section is effective the day
64.14 	following final enactment.

64.15 	Sec. 51. Minnesota Statutes 2004, section 518.165, is
64.16 	amended by adding a subdivision to read:
64.17 		Subd. 5.Procedure, criminal history, and maltreatment
64.18 	records background study. (a) When the court requests a
64.19 	background study under subdivision 4, paragraph (a), the request
64.20 	shall be submitted to the Department of Human Services through
64.21 	the department's electronic online background study system.
64.22 	(b) When the court requests a search of the National
64.23 	Criminal Records Repository, the court must provide a set of
64.24 	classifiable fingerprints of the subject of the study on a
64.25 	fingerprint card provided by the commissioner of human services.
64.26 	(c) The commissioner of human services shall provide the
64.27 	court with information from the Bureau of Criminal
64.28 	Apprehension's Criminal Justice Information System, other
64.29 	criminal history data held by the commissioner of human
64.30 	services, and data regarding substantiated maltreatment of a
64.31 	minor under section 626.556, and substantiated maltreatment of a
64.32 	vulnerable adult under section 626.557, within 15 working days
64.33 	of receipt of a request.  If the subject of the study has been
64.34 	determined by the Department of Human Services or the Department
64.35 	of Health to be the perpetrator of substantiated maltreatment of
64.36 	a minor or vulnerable adult in a licensed facility, the response
65.1 	must include a copy of the public portion of the investigation
65.2 	memorandum under section 626.556, subdivision 10f, or the public
65.3 	portion of the investigation memorandum under section 626.557,
65.4 	subdivision 12b.  When the background study shows that the
65.5 	subject has been determined by a county adult protection or
65.6 	child protection agency to have been responsible for
65.7 	maltreatment, the court shall be informed of the county, the
65.8 	date of the finding, and the nature of the maltreatment that was
65.9 	substantiated.  The commissioner shall provide the court with
65.10 	information from the National Criminal Records Repository within
65.11 	three working days of the commissioner's receipt of the data.
65.12 	When the commissioner finds no criminal history or substantiated
65.13 	maltreatment on a background study subject, the commissioner
65.14 	shall make these results available to the court electronically
65.15 	through the secure online background study system.
65.16 	(d) Notwithstanding section 626.556, subdivision 10f, or
65.17 	626.557, subdivision 12b, if the commissioner or county lead
65.18 	agency has information that a person on whom a background study
65.19 	was previously done under this section has been determined to be
65.20 	a perpetrator of maltreatment of a minor or vulnerable adult,
65.21 	the commissioner or the county may provide this information to
65.22 	the court that requested the background study.
65.23 	
EFFECTIVE DATE. This section is effective the day
65.24 	following final enactment.

65.25 	Sec. 52. Minnesota Statutes 2004, section 518.165, is
65.26 	amended by adding a subdivision to read:
65.27 		Subd. 6.Rights. The court shall notify the subject of a
65.28 	background study that the subject has the following rights:
65.29 	(1) the right to be informed that the court will request a
65.30 	background study on the subject for the purpose of determining
65.31 	whether the person's appointment or continued appointment is in
65.32 	the best interests of the child;
65.33 	(2) the right to be informed of the results of the study
65.34 	and to obtain from the court a copy of the results; and 
65.35 	(3) the right to challenge the accuracy and completeness of
65.36 	the information contained in the results to the agency
66.1 	responsible for creation of the data except to the extent
66.2 	precluded by section 256.045, subdivision 3.
66.3 	
EFFECTIVE DATE. This section is effective the day
66.4 	following final enactment.

66.5 	Sec. 53. Minnesota Statutes 2004, section 609A.03,
66.6 	subdivision 7, as amended by Laws 2005, chapter 136, article 12,
66.7 	section 11, is amended to read:
66.8 		Subd. 7.Limitations of order. (a) Upon issuance of an
66.9 	expungement order related to a charge supported by probable
66.10 	cause, the DNA samples and DNA records held by the Bureau of
66.11 	Criminal Apprehension and collected under authority other than
66.12 	section 299C.105, shall not be sealed, returned to the subject
66.13 	of the record, or destroyed.
66.14 	(b) Notwithstanding the issuance of an expungement order:
66.15 	(1) an expunged record may be opened for purposes of a
66.16 	criminal investigation, prosecution, or sentencing, upon an ex
66.17 	parte court order; and 
66.18 	(2) an expunged record of a conviction may be opened for
66.19 	purposes of evaluating a prospective employee in a criminal
66.20 	justice agency without a court order; and 
66.21 	(3) an expunged record of a conviction may be opened for
66.22 	purposes of a background study under section 245C.08 unless the
66.23 	court order for expungement is directed specifically to the
66.24 	commissioner of human services.
66.25 	Upon request by law enforcement, prosecution, or
66.26 	corrections authorities, an agency or jurisdiction subject to an
66.27 	expungement order shall inform the requester of the existence of
66.28 	a sealed record and of the right to obtain access to it as
66.29 	provided by this paragraph.  For purposes of this section, a
66.30 	"criminal justice agency" means courts or a government agency
66.31 	that performs the administration of criminal justice under
66.32 	statutory authority.

66.33 	Sec. 54. Minnesota Statutes 2004, section 626.556,
66.34 	subdivision 10i, as amended by Laws 2005, chapter 159, article
66.35 	1, section 9, is amended to read:
66.36 		Subd. 10i.Administrative reconsideration of final
67.1 	determination of maltreatment and disqualification based on
67.2 	serious or recurring maltreatment; review panel. (a)
67.3 	Administrative reconsideration is not applicable in family
67.4 	assessments since no determination concerning maltreatment is
67.5 	made.  For investigations, except as provided under paragraph
67.6 	(e), an individual or facility that the commissioner of human
67.7 	services, a local social service agency, or the commissioner of
67.8 	education determines has maltreated a child, an interested
67.9 	person acting on behalf of the child, regardless of the
67.10 	determination, who contests the investigating agency's final
67.11 	determination regarding maltreatment, may request the
67.12 	investigating agency to reconsider its final determination
67.13 	regarding maltreatment.  The request for reconsideration must be
67.14 	submitted in writing to the investigating agency within 15
67.15 	calendar days after receipt of notice of the final determination
67.16 	regarding maltreatment or, if the request is made by an
67.17 	interested person who is not entitled to notice, within 15 days
67.18 	after receipt of the notice by the parent or guardian of the
67.19 	child. If mailed, the request for reconsideration must be
67.20 	postmarked and sent to the investigating agency within 15
67.21 	calendar days of the individual's or facility's receipt of the
67.22 	final determination.  If the request for reconsideration is made
67.23 	by personal service, it must be received by the investigating
67.24 	agency within 15 calendar days after the individual's or
67.25 	facility's receipt of the final determination.Effective
67.26 	January 1, 2002, an individual who was determined to have
67.27 	maltreated a child under this section and who was disqualified
67.28 	on the basis of serious or recurring maltreatment under sections
67.29 	245C.14 and 245C.15, may request reconsideration of the
67.30 	maltreatment determination and the disqualification.  The
67.31 	request for reconsideration of the maltreatment determination
67.32 	and the disqualification must be submitted within 30 calendar
67.33 	days of the individual's receipt of the notice of
67.34 	disqualification under sections 245C.16 and 245C.17. If mailed,
67.35 	the request for reconsideration of the maltreatment
67.36 	determination and the disqualification must be postmarked and
68.1 	sent to the investigating agency within 30 calendar days of the
68.2 	individual's receipt of the maltreatment determination and
68.3 	notice of disqualification.  If the request for reconsideration
68.4 	is made by personal service, it must be received by the
68.5 	investigating agency within 30 calendar days after the
68.6 	individual's receipt of the notice of disqualification.
68.7 	(b) Except as provided under paragraphs (e) and (f), if the
68.8 	investigating agency denies the request or fails to act upon the
68.9 	request within 15 calendar working days after receiving the
68.10 	request for reconsideration, the person or facility entitled to
68.11 	a fair hearing under section 256.045 may submit to the
68.12 	commissioner of human services or the commissioner of education
68.13 	a written request for a hearing under that section.  Section
68.14 	256.045 also governs hearings requested to contest a final
68.15 	determination of the commissioner of education.  For reports
68.16 	involving maltreatment of a child in a facility, an interested
68.17 	person acting on behalf of the child may request a review by the
68.18 	Child Maltreatment Review Panel under section 256.022 if the
68.19 	investigating agency denies the request or fails to act upon the
68.20 	request or if the interested person contests a reconsidered
68.21 	determination.  The investigating agency shall notify persons
68.22 	who request reconsideration of their rights under this
68.23 	paragraph.  The request must be submitted in writing to the
68.24 	review panel and a copy sent to the investigating agency within
68.25 	30 calendar days of receipt of notice of a denial of a request
68.26 	for reconsideration or of a reconsidered determination.  The
68.27 	request must specifically identify the aspects of the agency
68.28 	determination with which the person is dissatisfied.
68.29 	(c) If, as a result of a reconsideration or review, the
68.30 	investigating agency changes the final determination of
68.31 	maltreatment, that agency shall notify the parties specified in
68.32 	subdivisions 10b, 10d, and 10f.
68.33 	(d) Except as provided under paragraph (f), if an
68.34 	individual or facility contests the investigating agency's final
68.35 	determination regarding maltreatment by requesting a fair
68.36 	hearing under section 256.045, the commissioner of human
69.1 	services shall assure that the hearing is conducted and a
69.2 	decision is reached within 90 days of receipt of the request for
69.3 	a hearing.  The time for action on the decision may be extended
69.4 	for as many days as the hearing is postponed or the record is
69.5 	held open for the benefit of either party.
69.6 	(e) Effective January 1, 2002, if an individual was
69.7 	disqualified under sections 245C.14 and 245C.15, on the basis of
69.8 	a determination of maltreatment, which was serious or recurring,
69.9 	and the individual has requested reconsideration of the
69.10 	maltreatment determination under paragraph (a) and requested
69.11 	reconsideration of the disqualification under sections 245C.21
69.12 	to 245C.27, reconsideration of the maltreatment determination
69.13 	and reconsideration of the disqualification shall be
69.14 	consolidated into a single reconsideration.  If reconsideration
69.15 	of the maltreatment determination is denied or the
69.16 	disqualification is not set aside under sections 245C.21 to
69.17 	245C.27, the individual may request a fair hearing under section
69.18 	256.045.  If an individual requests a fair hearing on the
69.19 	maltreatment determination and the disqualification, the scope
69.20 	of the fair hearing shall include both the maltreatment
69.21 	determination and the disqualification.
69.22 	(f) Effective January 1, 2002, if a maltreatment
69.23 	determination or a disqualification based on serious or
69.24 	recurring maltreatment is the basis for a denial of a license
69.25 	under section 245A.05 or a licensing sanction under section
69.26 	245A.07, the license holder has the right to a contested case
69.27 	hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to
69.28 	1400.8612.  As provided for under section 245A.08, subdivision
69.29 	2a, the scope of the contested case hearing shall include the
69.30 	maltreatment determination, disqualification, and licensing
69.31 	sanction or denial of a license.  In such cases, a fair hearing
69.32 	regarding the maltreatment determination shall not be conducted
69.33 	under paragraph (b). When a fine is based on a determination
69.34 	that the license holder is responsible for maltreatment and the
69.35 	fine is issued at the same time as the maltreatment
69.36 	determination, if the license holder appeals the maltreatment
70.1 	and fine, reconsideration of the maltreatment determination
70.2 	shall not be conducted under this section.If the disqualified
70.3 	subject is an individual other than the license holder and upon
70.4 	whom a background study must be conducted under chapter 245C,
70.5 	the hearings of all parties may be consolidated into a single
70.6 	contested case hearing upon consent of all parties and the
70.7 	administrative law judge.
70.8 	(g) For purposes of this subdivision, "interested person
70.9 	acting on behalf of the child" means a parent or legal guardian;
70.10 	stepparent; grandparent; guardian ad litem; adult stepbrother,
70.11 	stepsister, or sibling; or adult aunt or uncle; unless the
70.12 	person has been determined to be the perpetrator of the
70.13 	maltreatment.

70.14 	Sec. 55. Minnesota Statutes 2004, section 626.557,
70.15 	subdivision 9d, is amended to read:
70.16 		Subd. 9d.Administrative reconsideration of final
70.17 	disposition of maltreatment and disqualification based on
70.18 	serious or recurring maltreatment; review panel.  (a) Except as
70.19 	provided under paragraph (e), any individual or facility which a
70.20 	lead agency determines has maltreated a vulnerable adult, or the
70.21 	vulnerable adult or an interested person acting on behalf of the
70.22 	vulnerable adult, regardless of the lead agency's determination,
70.23 	who contests the lead agency's final disposition of an
70.24 	allegation of maltreatment, may request the lead agency to
70.25 	reconsider its final disposition.  The request for
70.26 	reconsideration must be submitted in writing to the lead agency
70.27 	within 15 calendar days after receipt of notice of final
70.28 	disposition or, if the request is made by an interested person
70.29 	who is not entitled to notice, within 15 days after receipt of
70.30 	the notice by the vulnerable adult or the vulnerable adult's
70.31 	legal guardian. If mailed, the request for reconsideration must
70.32 	be postmarked and sent to the lead agency within 15 calendar
70.33 	days of the individual's or facility's receipt of the final
70.34 	disposition.  If the request for reconsideration is made by
70.35 	personal service, it must be received by the lead agency within
70.36 	15 calendar days of the individual's or facility's receipt of
71.1 	the final disposition.An individual who was determined to have
71.2 	maltreated a vulnerable adult under this section and who was
71.3 	disqualified on the basis of serious or recurring maltreatment
71.4 	under sections 245C.14 and 245C.15, may request reconsideration
71.5 	of the maltreatment determination and the disqualification.  The
71.6 	request for reconsideration of the maltreatment determination
71.7 	and the disqualification must be submitted in writing within 30
71.8 	calendar days of the individual's receipt of the notice of
71.9 	disqualification under sections 245C.16 and 245C.17. If mailed,
71.10 	the request for reconsideration of the maltreatment
71.11 	determination and the disqualification must be postmarked and
71.12 	sent to the lead agency within 30 calendar days of the
71.13 	individual's receipt of the notice of disqualification.  If the
71.14 	request for reconsideration is made by personal service, it must
71.15 	be received by the lead agency within 30 calendar days after the
71.16 	individual's receipt of the notice of disqualification.
71.17 	(b) Except as provided under paragraphs (e) and (f), if the
71.18 	lead agency denies the request or fails to act upon the request
71.19 	within 15 calendar working days after receiving the request for
71.20 	reconsideration, the person or facility entitled to a fair
71.21 	hearing under section 256.045, may submit to the commissioner of
71.22 	human services a written request for a hearing under that
71.23 	statute.  The vulnerable adult, or an interested person acting
71.24 	on behalf of the vulnerable adult, may request a review by the
71.25 	Vulnerable Adult Maltreatment Review Panel under section 256.021
71.26 	if the lead agency denies the request or fails to act upon the
71.27 	request, or if the vulnerable adult or interested person
71.28 	contests a reconsidered disposition.  The lead agency shall
71.29 	notify persons who request reconsideration of their rights under
71.30 	this paragraph.  The request must be submitted in writing to the
71.31 	review panel and a copy sent to the lead agency within 30
71.32 	calendar days of receipt of notice of a denial of a request for
71.33 	reconsideration or of a reconsidered disposition.  The request
71.34 	must specifically identify the aspects of the agency
71.35 	determination with which the person is dissatisfied.
71.36 	(c) If, as a result of a reconsideration or review, the
72.1 	lead agency changes the final disposition, it shall notify the
72.2 	parties specified in subdivision 9c, paragraph (d).
72.3 	(d) For purposes of this subdivision, "interested person
72.4 	acting on behalf of the vulnerable adult" means a person
72.5 	designated in writing by the vulnerable adult to act on behalf
72.6 	of the vulnerable adult, or a legal guardian or conservator or
72.7 	other legal representative, a proxy or health care agent
72.8 	appointed under chapter 145B or 145C, or an individual who is
72.9 	related to the vulnerable adult, as defined in section 245A.02,
72.10 	subdivision 13.
72.11 	(e) If an individual was disqualified under sections
72.12 	245C.14 and 245C.15, on the basis of a determination of
72.13 	maltreatment, which was serious or recurring, and the individual
72.14 	has requested reconsideration of the maltreatment determination
72.15 	under paragraph (a) and reconsideration of the disqualification
72.16 	under sections 245C.21 to 245C.27, reconsideration of the
72.17 	maltreatment determination and requested reconsideration of the
72.18 	disqualification shall be consolidated into a single
72.19 	reconsideration.  If reconsideration of the maltreatment
72.20 	determination is denied or if the disqualification is not set
72.21 	aside under sections 245C.21 to 245C.27, the individual may
72.22 	request a fair hearing under section 256.045.  If an individual
72.23 	requests a fair hearing on the maltreatment determination and
72.24 	the disqualification, the scope of the fair hearing shall
72.25 	include both the maltreatment determination and the
72.26 	disqualification.
72.27 	(f) If a maltreatment determination or a disqualification
72.28 	based on serious or recurring maltreatment is the basis for a
72.29 	denial of a license under section 245A.05 or a licensing
72.30 	sanction under section 245A.07, the license holder has the right
72.31 	to a contested case hearing under chapter 14 and Minnesota
72.32 	Rules, parts 1400.8505 to 1400.8612.  As provided for under
72.33 	section 245A.08, the scope of the contested case hearing shall
72.34 	include the maltreatment determination, disqualification, and
72.35 	licensing sanction or denial of a license.  In such cases, a
72.36 	fair hearing shall not be conducted under paragraph (b). When a
73.1 	fine is based on a determination that the license holder is
73.2 	responsible for maltreatment and the fine is issued at the same
73.3 	time as the maltreatment determination, if the license holder
73.4 	appeals the maltreatment and fine, reconsideration of the
73.5 	maltreatment determination shall not be conducted under this
73.6 	section.If the disqualified subject is an individual other
73.7 	than the license holder and upon whom a background study must be
73.8 	conducted under chapter 245C, the hearings of all parties may be
73.9 	consolidated into a single contested case hearing upon consent
73.10 	of all parties and the administrative law judge.
73.11 	(g) Until August 1, 2002, an individual or facility that
73.12 	was determined by the commissioner of human services or the
73.13 	commissioner of health to be responsible for neglect under
73.14 	section 626.5572, subdivision 17, after October 1, 1995, and
73.15 	before August 1, 2001, that believes that the finding of neglect
73.16 	does not meet an amended definition of neglect may request a
73.17 	reconsideration of the determination of neglect.  The
73.18 	commissioner of human services or the commissioner of health
73.19 	shall mail a notice to the last known address of individuals who
73.20 	are eligible to seek this reconsideration.  The request for
73.21 	reconsideration must state how the established findings no
73.22 	longer meet the elements of the definition of neglect.  The
73.23 	commissioner shall review the request for reconsideration and
73.24 	make a determination within 15 calendar days.  The
73.25 	commissioner's decision on this reconsideration is the final
73.26 	agency action.
73.27 	(1) For purposes of compliance with the data destruction
73.28 	schedule under subdivision 12b, paragraph (d), when a finding of
73.29 	substantiated maltreatment has been changed as a result of a
73.30 	reconsideration under this paragraph, the date of the original
73.31 	finding of a substantiated maltreatment must be used to
73.32 	calculate the destruction date.
73.33 	(2) For purposes of any background studies under chapter
73.34 	245C, when a determination of substantiated maltreatment has
73.35 	been changed as a result of a reconsideration under this
73.36 	paragraph, any prior disqualification of the individual under
74.1 	chapter 245C that was based on this determination of
74.2 	maltreatment shall be rescinded, and for future background
74.3 	studies under chapter 245C the commissioner must not use the
74.4 	previous determination of substantiated maltreatment as a basis
74.5 	for disqualification or as a basis for referring the
74.6 	individual's maltreatment history to a health-related licensing
74.7 	board under section 245C.31.

74.8 	Sec. 56. Minnesota Statutes 2004, section 626.557,
74.9 	subdivision 14, as amended by Laws 2005, chapter 136, article 5,
74.10 	section 5, is amended to read:
74.11 		Subd. 14.Abuse prevention plans. (a) Each facility,
74.12 	except home health agencies and personal care attendant services
74.13 	providers, shall establish and enforce an ongoing written abuse
74.14 	prevention plan.  The plan shall contain an assessment of the
74.15 	physical plant, its environment, and its population identifying
74.16 	factors which may encourage or permit abuse, and a statement of
74.17 	specific measures to be taken to minimize the risk of abuse.
74.18 	The plan shall comply with any rules governing the plan
74.19 	promulgated by the licensing agency.
74.20 	(b) Each facility, including a home health care agency and
74.21 	personal care attendant services providers, shall develop an
74.22 	individual abuse prevention plan for each vulnerable adult
74.23 	residing there or receiving services from them.  The plan shall
74.24 	contain an individualized assessment of:  (1) the person's
74.25 	susceptibility to abuse by other individuals, including other
74.26 	vulnerable adults; (2) the person's risk of abusing other
74.27 	vulnerable adults; and (3) statements of the specific measures
74.28 	to be taken to minimize the risk of abuse to that person and
74.29 	other vulnerable adults.  For the purposes of this paragraph,
74.30 	the term "abuse" includes self-abuse.
74.31 	(c) If the facility, except home health agencies and
74.32 	personal care attendant services providers, knows that the
74.33 	vulnerable adult has committed a violent crime or an act of
74.34 	physical aggression toward others, the individual abuse
74.35 	prevention plan must detail the measures to be taken to minimize
74.36 	the risk that the vulnerable adult might reasonably be expected
75.1 	to pose to visitors to the facility and persons outside the
75.2 	facility, if unsupervised.  Under this section, a facility knows
75.3 	of a vulnerable adult's history of criminal misconduct or
75.4 	physical aggression if it receives such information from a law
75.5 	enforcement authority or through a medical record prepared by
75.6 	another facility, another health care provider, or the
75.7 	facility's ongoing assessments of the vulnerable adult.
75.8 	
EFFECTIVE DATE. This section is effective August 1, 2005.

75.9 	Sec. 57. EFFECTIVE DATE.
 75.10 	This article is effective August 1, 2005, unless specified
75.11 	otherwise.

75.12 	ARTICLE 2
75.13 	MENTAL AND CHEMICAL HEALTH

75.14 	Section 1. Minnesota Statutes 2004, section 62J.692,
75.15 	subdivision 3, as amended by Laws 2005, chapter 84, section 1,
75.16 	is amended to read:
75.17 		Subd. 3.Application process. (a) A clinical medical
75.18 	education program conducted in Minnesota by a teaching
75.19 	institution to train physicians, doctor of pharmacy
75.20 	practitioners, dentists, chiropractors, or physician assistants
75.21 	is eligible for funds under subdivision 4 if the program:
75.22 	(1) is funded, in part, by patient care revenues;
75.23 	(2) occurs in patient care settings that face increased
75.24 	financial pressure as a result of competition with nonteaching
75.25 	patient care entities; and
75.26 	(3) emphasizes primary care or specialties that are in
75.27 	undersupply in Minnesota.
75.28 	A clinical medical education program that trains
75.29 	pediatricians is requested to include in its program curriculum
75.30 	training in case management and medication management for
75.31 	children suffering from mental illness to be eligible for funds
75.32 	under subdivision 4.
75.33 	(b) A clinical medical education program for advanced
75.34 	practice nursing is eligible for funds under subdivision 4 if
75.35 	the program meets the eligibility requirements in paragraph (a),
75.36 	clauses (1) to (3), and is sponsored by the University of
76.1 	Minnesota Academic Health Center, the Mayo Foundation, or
76.2 	institutions that are part of the Minnesota State Colleges and
76.3 	Universities system or members of the Minnesota Private College
76.4 	Council.
76.5 	(c) Applications must be submitted to the commissioner by a
76.6 	sponsoring institution on behalf of an eligible clinical medical
76.7 	education program and must be received by October 31 of each
76.8 	year for distribution in the following year.  An application for
76.9 	funds must contain the following information:
76.10 	(1) the official name and address of the sponsoring
76.11 	institution and the official name and site address of the
76.12 	clinical medical education programs on whose behalf the
76.13 	sponsoring institution is applying;
76.14 	(2) the name, title, and business address of those persons
76.15 	responsible for administering the funds;
76.16 	(3) for each clinical medical education program for which
76.17 	funds are being sought; the type and specialty orientation of
76.18 	trainees in the program; the name, site address, and medical
76.19 	assistance provider number of each training site used in the
76.20 	program; the total number of trainees at each training site; and
76.21 	the total number of eligible trainee FTEs at each site; and
76.22 	(4) other supporting information the commissioner deems
76.23 	necessary to determine program eligibility based on the criteria
76.24 	in paragraphs (a) and (b) and to ensure the equitable
76.25 	distribution of funds.
76.26 	(d) An application must include the information specified
76.27 	in clauses (1) to (3) for each clinical medical education
76.28 	program on an annual basis for three consecutive years.  After
76.29 	that time, an application must include the information specified
76.30 	in clauses (1) to (3) when requested, at the discretion of the
76.31 	commissioner:
76.32 	(1) audited clinical training costs per trainee for each
76.33 	clinical medical education program when available or estimates
76.34 	of clinical training costs based on audited financial data;
76.35 	(2) a description of current sources of funding for
76.36 	clinical medical education costs, including a description and
77.1 	dollar amount of all state and federal financial support,
77.2 	including Medicare direct and indirect payments; and
77.3 	(3) other revenue received for the purposes of clinical
77.4 	training.
77.5 	(e) An applicant that does not provide information
77.6 	requested by the commissioner shall not be eligible for funds
77.7 	for the current funding cycle.

77.8 	Sec. 2. Minnesota Statutes 2004, section 245.4661, is
77.9 	amended by adding a subdivision to read:
77.10 		Subd. 8.Budget flexibility. The commissioner may make
77.11 	budget transfers that do not increase the state share of costs
77.12 	to effectively implement the restructuring of adult mental
77.13 	health services.

77.14 	Sec. 3. Minnesota Statutes 2004, section 245.4874, as
77.15 	amended by Laws 2005, chapter 98, article 3, section 11, is
77.16 	amended to read:
77.17 	245.4874 [DUTIES OF COUNTY BOARD.]
77.18 	(a) The county board must:
77.19 	(1) develop a system of affordable and locally available
77.20 	children's mental health services according to sections 245.487
77.21 	to 245.4887;
77.22 	(2) establish a mechanism providing for interagency
77.23 	coordination as specified in section 245.4875, subdivision 6;
77.24 	(3) consider the assessment of unmet needs in the county as
77.25 	reported by the local children's mental health advisory council
77.26 	under section 245.4875, subdivision 5, paragraph (b), clause
77.27 	(3).  The county shall provide, upon request of the local
77.28 	children's mental health advisory council, readily available
77.29 	data to assist in the determination of unmet needs;
77.30 	(4) assure that parents and providers in the county receive
77.31 	information about how to gain access to services provided
77.32 	according to sections 245.487 to 245.4887;
77.33 	(5) coordinate the delivery of children's mental health
77.34 	services with services provided by social services, education,
77.35 	corrections, health, and vocational agencies to improve the
77.36 	availability of mental health services to children and the
78.1 	cost-effectiveness of their delivery;
78.2 	(6) assure that mental health services delivered according
78.3 	to sections 245.487 to 245.4887 are delivered expeditiously and
78.4 	are appropriate to the child's diagnostic assessment and
78.5 	individual treatment plan;
78.6 	(7) provide the community with information about predictors
78.7 	and symptoms of emotional disturbances and how to access
78.8 	children's mental health services according to sections 245.4877
78.9 	and 245.4878;
78.10 	(8) provide for case management services to each child with
78.11 	severe emotional disturbance according to sections 245.486;
78.12 	245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3,
78.13 	and 5;
78.14 	(9) provide for screening of each child under section
78.15 	245.4885 upon admission to a residential treatment facility,
78.16 	acute care hospital inpatient treatment, or informal admission
78.17 	to a regional treatment center;
78.18 	(10) prudently administer grants and purchase-of-service
78.19 	contracts that the county board determines are necessary to
78.20 	fulfill its responsibilities under sections 245.487 to 245.4887;
78.21 	(11) assure that mental health professionals, mental health
78.22 	practitioners, and case managers employed by or under contract
78.23 	to the county to provide mental health services are qualified
78.24 	under section 245.4871;
78.25 	(12) assure that children's mental health services are
78.26 	coordinated with adult mental health services specified in
78.27 	sections 245.461 to 245.486 so that a continuum of mental health
78.28 	services is available to serve persons with mental illness,
78.29 	regardless of the person's age;
78.30 	(13) assure that culturally informed mental health
78.31 	consultants are used as necessary to assist the county board in
78.32 	assessing and providing appropriate treatment for children of
78.33 	cultural or racial minority heritage; and
78.34 	(14) consistent with section 245.486, arrange for or
78.35 	provide a children's mental health screening to a child
78.36 	receiving child protective services or a child in out-of-home
79.1 	placement, a child for whom parental rights have been
79.2 	terminated, a child found to be delinquent, and a child found to
79.3 	have committed a juvenile petty offense for the third or
79.4 	subsequent time, unless a screening has been performed within
79.5 	the previous 180 days, or the child is currently under the care
79.6 	of a mental health professional.  The court or county agency
79.7 	must notify a parent or guardian whose parental rights have not
79.8 	been terminated of the potential mental health screening and the
79.9 	option to prevent the screening by notifying the court or county
79.10 	agency in writing.  The screening shall be conducted with a
79.11 	screening instrument approved by the commissioner of human
79.12 	services according to criteria that are updated and issued
79.13 	annually to ensure that approved screening instruments are valid
79.14 	and useful for child welfare and juvenile justice populations,
79.15 	and shall be conducted by a mental health practitioner as
79.16 	defined in section 245.4871, subdivision 26, or a probation
79.17 	officer or local social services agency staff person who is
79.18 	trained in the use of the screening instrument.  Training in the
79.19 	use of the instrument shall include training in the
79.20 	administration of the instrument, the interpretation of its
79.21 	validity given the child's current circumstances, the state and
79.22 	federal data practices laws and confidentiality standards, the
79.23 	parental consent requirement, and providing respect for families
79.24 	and cultural values.  If the screen indicates a need for
79.25 	assessment, the child's family, or if the family lacks mental
79.26 	health insurance, the local social services agency, in
79.27 	consultation with the child's family, shall have conducted a
79.28 	diagnostic assessment, including a functional assessment, as
79.29 	defined in section 245.4871.  The administration of the
79.30 	screening shall safeguard the privacy of children receiving the
79.31 	screening and their families and shall comply with the Minnesota
79.32 	Government Data Practices Act, chapter 13, and the federal
79.33 	Health Insurance Portability and Accountability Act of 1996,
79.34 	Public Law 104-191.  Screening results shall be considered
79.35 	private data and the commissioner shall not collect individual
79.36 	screening results.
80.1 	(b) When the county board refers clients to providers of
80.2 	children's therapeutic services and supports under section
80.3 	256B.0943, the county board must clearly identify the desired
80.4 	services components not covered under section 256B.0943 and
80.5 	identify the reimbursement source for those requested services,
80.6 	the method of payment, and the payment rate to the provider.

80.7 	Sec. 4. Minnesota Statutes 2004, section 245.4885,
80.8 	subdivision 1, is amended to read:
80.9 		Subdivision 1.screening required admission criteria.
 80.10 	The county board shall, prior to admission, except in the case
80.11 	of emergency admission, screen determine the needed level of
80.12 	care for all children referred for treatment of severe emotional
80.13 	disturbance to in a treatment foster care setting,residential
80.14 	treatment facility,or informally admitted to a regional
80.15 	treatment center if public funds are used to pay for the
80.16 	services.  The county board shall also screen determine the
80.17 	needed level of care for all children admitted to an acute care
80.18 	hospital for treatment of severe emotional disturbance if public
80.19 	funds other than reimbursement under chapters 256B and 256D are
80.20 	used to pay for the services. If a child is admitted to a
80.21 	residential treatment facility or acute care hospital for
80.22 	emergency treatment or held for emergency care by a regional
80.23 	treatment center under section 253B.05, subdivision 1, screening
80.24 	must occur within three working days of admission.
80.25 	Screening The level of care determination shall determine
80.26 	whether the proposed treatment:
80.27 	(1) is necessary;
80.28 	(2) is appropriate to the child's individual treatment
80.29 	needs;
80.30 	(3) cannot be effectively provided in the child's home; and
80.31 	(4) provides a length of stay as short as possible
80.32 	consistent with the individual child's need.
80.33 	When a screening level of care determination is conducted,
80.34 	the county board may not determine that referral or admission to
80.35 	a treatment foster care setting,residential treatment facility,
80.36 	or acute care hospital is not appropriate solely because
81.1 	services were not first provided to the child in a less
81.2 	restrictive setting and the child failed to make progress toward
81.3 	or meet treatment goals in the less restrictive
81.4 	setting. Screening shall include both The level of care
81.5 	determination must be based on a diagnostic assessment and that
81.6 	includes a functional assessment which evaluates family, school,
81.7 	and community living situations; and an assessment of the
81.8 	child's need for care out of the home using a validated tool
81.9 	which assesses a child's functional status and assigns an
81.10 	appropriate level of care.  The validated tool must be approved
81.11 	by the commissioner of human services.  If a diagnostic
81.12 	assessment or including a functional assessment has been
81.13 	completed by a mental health professional within the past 180
81.14 	days, a new diagnostic or functional assessment need not be
81.15 	completed unless in the opinion of the current treating mental
81.16 	health professional the child's mental health status has changed
81.17 	markedly since the assessment was completed.  The child's parent
81.18 	shall be notified if an assessment will not be completed and of
81.19 	the reasons.  A copy of the notice shall be placed in the
81.20 	child's file.  Recommendations developed as part of
81.21 	the screening level of care determination process shall include
81.22 	specific community services needed by the child and, if
81.23 	appropriate, the child's family, and shall indicate whether or
81.24 	not these services are available and accessible to the child and
81.25 	family.
81.26 	During the screening level of care determination process,
81.27 	the child, child's family, or child's legal representative, as
81.28 	appropriate, must be informed of the child's eligibility for
81.29 	case management services and family community support services
81.30 	and that an individual family community support plan is being
81.31 	developed by the case manager, if assigned.
81.32 	Screening The level of care determination shall be in
81.33 	compliance comply with section 260C.212.  Wherever possible, the
81.34 	parent shall be consulted in the screening process, unless
81.35 	clinically inappropriate.
81.36 	The screening process level of care determination, and
82.1 	placement decision, and recommendations for mental health
82.2 	services must be documented in the child's record.
82.3 	An alternate review process may be approved by the
82.4 	commissioner if the county board demonstrates that an alternate
82.5 	review process has been established by the county board and the
82.6 	times of review, persons responsible for the review, and review
82.7 	criteria are comparable to the standards in clauses (1) to (4).
82.8 	
EFFECTIVE DATE. This section is effective July 1, 2006.

82.9 	Sec. 5. Minnesota Statutes 2004, section 245.4885, is
82.10 	amended by adding a subdivision to read:
82.11 		Subd. 1a.Emergency admission. Effective July 1, 2006,
82.12 	if a child is admitted to a treatment foster care setting,
82.13 	residential treatment facility, or acute care hospital for
82.14 	emergency treatment or held for emergency care by a regional
82.15 	treatment center under section 253B.05, subdivision 1, the level
82.16 	of care determination must occur within three working days of
82.17 	admission.

82.18 	Sec. 6. Minnesota Statutes 2004, section 245.4885,
82.19 	subdivision 2, is amended to read:
82.20 		Subd. 2.Qualifications. No later than July 1, 1991,
82.21 	Screening Level of care determination of children for treatment
82.22 	foster care,residential,and inpatient services must be
82.23 	conducted by a mental health professional.  Where appropriate
82.24 	and available, culturally informed mental health consultants
82.25 	must participate in the screening level of care determination.
82.26 	Mental health professionals providing screening level of care
82.27 	determination for treatment foster care,inpatient,and
82.28 	residential services must not be financially affiliated with any
82.29 	acute care inpatient hospital, residential treatment facility,
82.30 	or regional treatment center nongovernment entity which may be
82.31 	providing those services. The commissioner may waive this
82.32 	requirement for mental health professional participation after
82.33 	July 1, 1991, if the county documents that:
82.34 	(1) mental health professionals or mental health
82.35 	practitioners are unavailable to provide this service; and 
82.36 	(2) services are provided by a designated person with
83.1 	training in human services who receives clinical supervision
83.2 	from a mental health professional.
83.3 	
EFFECTIVE DATE. This section is effective July 1, 2006.

83.4 	Sec. 7. Minnesota Statutes 2004, section 256B.0622,
83.5 	subdivision 2, is amended to read:
83.6 		Subd. 2.Definitions.  For purposes of this section, the
83.7 	following terms have the meanings given them.
83.8 	(a) "Intensive nonresidential rehabilitative mental health
83.9 	services" means adult rehabilitative mental health services as
83.10 	defined in section 256B.0623, subdivision 2, paragraph (a),
83.11 	except that these services are provided by a multidisciplinary
83.12 	staff using a total team approach consistent with assertive
83.13 	community treatment, the Fairweather Lodge treatment model, as
83.14 	defined by the standards established by the National Coalition
83.15 	for Community Living,and other evidence-based practices, and
83.16 	directed to recipients with a serious mental illness who require
83.17 	intensive services.
83.18 	(b) "Intensive residential rehabilitative mental health
83.19 	services" means short-term, time-limited services provided in a
83.20 	residential setting to recipients who are in need of more
83.21 	restrictive settings and are at risk of significant functional
83.22 	deterioration if they do not receive these services.  Services
83.23 	are designed to develop and enhance psychiatric stability,
83.24 	personal and emotional adjustment, self-sufficiency, and skills
83.25 	to live in a more independent setting.  Services must be
83.26 	directed toward a targeted discharge date with specified client
83.27 	outcomes and must be consistent with the Fairweather Lodge
83.28 	treatment model as defined in paragraph (a), and other 
83.29 	evidence-based practices.
83.30 	(c) "Evidence-based practices" are nationally recognized
83.31 	mental health services that are proven by substantial research
83.32 	to be effective in helping individuals with serious mental
83.33 	illness obtain specific treatment goals.
83.34 	(d) "Overnight staff" means a member of the intensive
83.35 	residential rehabilitative mental health treatment team who is
83.36 	responsible during hours when recipients are typically asleep.
84.1 	(e) "Treatment team" means all staff who provide services
84.2 	under this section to recipients.  At a minimum, this includes
84.3 	the clinical supervisor, mental health professionals, mental
84.4 	health practitioners, and mental health rehabilitation workers.

84.5 	Sec. 8. Minnesota Statutes 2004, section 256B.0625, is
84.6 	amended by adding a subdivision to read:
84.7 		Subd. 46.Mental health telemedicine. Effective January
84.8 	1, 2006, and subject to federal approval, mental health services
84.9 	that are otherwise covered by medical assistance as direct
84.10 	face-to-face services may be provided via two-way interactive
84.11 	video.  Use of two-way interactive video must be medically
84.12 	appropriate to the condition and needs of the person being
84.13 	served.  Reimbursement is at the same rates and under the same
84.14 	conditions that would otherwise apply to the service.  The
84.15 	interactive video equipment and connection must comply with
84.16 	Medicare standards in effect at the time the service is provided.

84.17 	Sec. 9. Minnesota Statutes 2004, section 256B.0625, is
84.18 	amended by adding a subdivision to read:
84.19 		Subd. 47.Treatment foster care services. Effective July
84.20 	1, 2006, and subject to federal approval, medical assistance
84.21 	covers treatment foster care services according to section
84.22 	256B.0946.

84.23 	Sec. 10. Minnesota Statutes 2004, section 256B.0625, is
84.24 	amended by adding a subdivision to read:
84.25 		Subd. 48.Psychiatric consultation to primary care
84.26 	practitioners. Effective January 1, 2006, medical assistance
84.27 	covers consultation provided by a psychiatrist via telephone,
84.28 	e-mail, facsimile, or other means of communication to primary
84.29 	care practitioners, including pediatricians.  The need for
84.30 	consultation and the receipt of the consultation must be
84.31 	documented in the patient record maintained by the primary care
84.32 	practitioner.  If the patient consents, and subject to federal
84.33 	limitations and data privacy provisions, the consultation may be
84.34 	provided without the patient present.

84.35 	Sec. 11. Minnesota Statutes 2004, section 256B.0943,
84.36 	subdivision 3, is amended to read:
85.1 		Subd. 3.Determination of client eligibility.  A client's
85.2 	eligibility to receive children's therapeutic services and
85.3 	supports under this section shall be determined based on a
85.4 	diagnostic assessment by a mental health professional that is
85.5 	performed within 180 days of the initial start of service.  The
85.6 	diagnostic assessment must:
85.7 	(1) include current diagnoses on all five axes of the
85.8 	client's current mental health status;
85.9 	(2) determine whether a child under age 18 has a diagnosis
85.10 	of emotional disturbance or, if the person is between the ages
85.11 	of 18 and 21, whether the person has a mental illness;
85.12 	(3) document children's therapeutic services and supports
85.13 	as medically necessary to address an identified disability,
85.14 	functional impairment, and the individual client's needs and
85.15 	goals;
85.16 	(4) be used in the development of the individualized
85.17 	treatment plan; and
85.18 	(5) be completed annually until age 18. A client with
85.19 	autism spectrum disorder or pervasive developmental disorder may
85.20 	receive a diagnostic assessment once every three years, at the
85.21 	request of the parent or guardian, if a mental health
85.22 	professional agrees there has been little change in the
85.23 	condition and that an annual assessment is not needed.For
85.24 	individuals between age 18 and 21, unless a client's mental
85.25 	health condition has changed markedly since the client's most
85.26 	recent diagnostic assessment, annual updating is necessary.  For
85.27 	the purpose of this section, "updating" means a written summary,
85.28 	including current diagnoses on all five axes, by a mental health
85.29 	professional of the client's current mental health status and
85.30 	service needs.

85.31 	Sec. 12. [256B.0946] TREATMENT FOSTER CARE.
85.32 		Subdivision 1.Covered service. (a) Effective July 1,
85.33 	2006, and subject to federal approval, medical assistance covers
85.34 	medically necessary services described under paragraph (b) that
85.35 	are provided by a provider entity eligible under subdivision 3
85.36 	to a client eligible under subdivision 2 who is placed in a
86.1 	treatment foster home licensed under Minnesota Rules, parts
86.2 	2960.3000 to 2960.3340.
86.3 	(b) Services to children with severe emotional disturbance
86.4 	residing in treatment foster care settings must meet the
86.5 	relevant standards for mental health services under sections
86.6 	245.487 to 245.4887.  In addition, specific service components
86.7 	reimbursed by medical assistance must meet the following
86.8 	standards:
86.9 	(1) case management service component must meet the
86.10 	standards in Minnesota Rules, parts 9520.0900 to 9520.0926 and
86.11 	9505.0322, excluding subparts 6 and 10;
86.12 	(2) psychotherapy and skills training components must meet
86.13 	the standards for children's therapeutic services and supports
86.14 	in section 256B.0943; and 
86.15 	(3) family psychoeducation services under supervision of a
86.16 	mental health professional.
86.17 		Subd. 2.Determination of client eligibility. A client's
86.18 	eligibility to receive treatment foster care under this section
86.19 	shall be determined by a diagnostic assessment, an evaluation of
86.20 	level of care needed, and development of an individual treatment
86.21 	plan, as defined in paragraphs (a) to (c).
86.22 	(a) The diagnostic assessment must:
86.23 	(1) be conducted by a psychiatrist, licensed psychologist,
86.24 	or licensed independent clinical social worker that is performed
86.25 	within 180 days prior to the start of service;
86.26 	(2) include current diagnoses on all five axes of the
86.27 	client's current mental health status;
86.28 	(3) determine whether or not a child meets the criteria for
86.29 	severe emotional disturbance in section 245.4871, subdivision 6,
86.30 	or for serious and persistent mental illness in section 245.462,
86.31 	subdivision 20; and 
86.32 	(4) be completed annually until age 18.  For individuals
86.33 	between age 18 and 21, unless a client's mental health condition
86.34 	has changed markedly since the client's most recent diagnostic
86.35 	assessment, annual updating is necessary.  For the purpose of
86.36 	this section, "updating" means a written summary, including
87.1 	current diagnoses on all five axes, by a mental health
87.2 	professional of the client's current mental status and service
87.3 	needs.
87.4 	(b) The evaluation of level of care must be conducted by
87.5 	the placing county with an instrument approved by the
87.6 	commissioner of human services.  The commissioner shall update
87.7 	the list of approved level of care instruments annually.
87.8 	(c) The individual treatment plan must be:
87.9 	(1) based on the information in the client's diagnostic
87.10 	assessment;
87.11 	(2) developed through a child-centered, family driven
87.12 	planning process that identifies service needs and
87.13 	individualized, planned, and culturally appropriate
87.14 	interventions that contain specific measurable treatment goals
87.15 	and objectives for the client and treatment strategies for the
87.16 	client's family and foster family;
87.17 	(3) reviewed at least once every 90 days and revised; and 
87.18 	(4) signed by the client or, if appropriate, by the
87.19 	client's parent or other person authorized by statute to consent
87.20 	to mental health services for the client.
87.21 		Subd. 3.Eligible providers. For purposes of this
87.22 	section, a provider agency must have an individual placement
87.23 	agreement for each recipient and must be a licensed child
87.24 	placing agency, under Minnesota Rules, parts 9543.0010 to
87.25 	9543.0150, and either:
87.26 	(1) a county;
87.27 	(2) an Indian Health Services facility operated by a tribe
87.28 	or tribal organization under funding authorized by United States
87.29 	Code, title 25, sections 450f to 450n, or title 3 of the Indian
87.30 	Self-Determination Act, Public Law 93-638, section 638
87.31 	(facilities or providers); or 
87.32 	(3) a noncounty entity under contract with a county board.
87.33 		Subd. 4.Eligible provider responsibilities. (a) To be
87.34 	an eligible provider under this section, a provider must develop
87.35 	written policies and procedures for treatment foster care
87.36 	services consistent with subdivision 1, paragraph (b), clauses
88.1 	(1), (2), and (3).
88.2 	(b) In delivering services under this section, a treatment
88.3 	foster care provider must ensure that staff caseload size
88.4 	reasonably enables the provider to play an active role in
88.5 	service planning, monitoring, delivering, and reviewing for
88.6 	discharge planning to meet the needs of the client, the client's
88.7 	foster family, and the birth family, as specified in each
88.8 	client's individual treatment plan.
88.9 		Subd. 5.Service authorization. The commissioner will
88.10 	administer authorizations for services under this section in
88.11 	compliance with section 256B.0625, subdivision 25.
88.12 		Subd. 6.Excluded services. (a) Services in clauses (1)
88.13 	to (4) are not eligible as components of treatment foster care
88.14 	services:
88.15 	(1) treatment foster care services provided in violation of
88.16 	medical assistance policy in Minnesota Rules, part 9505.0220;
88.17 	(2) service components of children's therapeutic services
88.18 	and supports simultaneously provided by more than one treatment
88.19 	foster care provider;
88.20 	(3) home and community-based waiver services; and 
88.21 	(4) treatment foster care services provided to a child
88.22 	without a level of care determination according to section
88.23 	245.4885, subdivision 1.
88.24 	(b) Children receiving treatment foster care services are
88.25 	not eligible for medical assistance reimbursement for the
88.26 	following services while receiving treatment foster care:
88.27 	(1) mental health case management services under section
88.28 	256B.0625, subdivision 20; and 
88.29 	(2) psychotherapy and skill training components of
88.30 	children's therapeutic services and supports under section
88.31 	256B.0625, subdivision 35b.

88.32 	Sec. 13. [256B.0947] TRANSITIONAL YOUTH INTENSIVE
88.33 	REHABILITATIVE MENTAL HEALTH SERVICES.
88.34 		Subdivision 1.Scope. Subject to federal approval,
88.35 	medical assistance covers medically necessary, intensive
88.36 	nonresidential rehabilitative mental health services as defined
89.1 	in subdivision 2, for recipients as defined in subdivision 3,
89.2 	when the services are provided by an entity meeting the
89.3 	standards in this section.
89.4 		Subd. 2.Definitions. For purposes of this section, the
89.5 	following terms have the meanings given them.
89.6 	(a) "Intensive nonresidential rehabilitative mental health
89.7 	services" means child rehabilitative mental health services as
89.8 	defined in section 256B.0943, except that these services are
89.9 	provided by a multidisciplinary staff using a total team
89.10 	approach consistent with assertive community treatment, or other
89.11 	evidence-based practices, and directed to recipients with a
89.12 	serious mental illness who require intensive services.
89.13 	(b) "Evidence-based practices" are nationally recognized
89.14 	mental health services that are proven by substantial research
89.15 	to be effective in helping individuals with serious mental
89.16 	illness obtain specific treatment goals.
89.17 	(c) "Treatment team" means all staff who provide services
89.18 	to recipients under this section.  At a minimum, this includes
89.19 	the clinical supervisor, mental health professionals, mental
89.20 	health practitioners, mental health behavioral aides, and a
89.21 	school representative familiar with the recipient's individual
89.22 	education plan (IEP) if applicable.
89.23 		Subd. 3.Eligibility for transitional youth. An eligible
89.24 	recipient under the age of 18 is an individual who:
89.25 	(1) is age 16 or 17;
89.26 	(2) is diagnosed with a medical condition, such as an
89.27 	emotional disturbance or traumatic brain injury, for which
89.28 	intensive nonresidential rehabilitative mental health services
89.29 	are needed;
89.30 	(3) has substantial disability and functional impairment in
89.31 	three or more of the areas listed in section 245.462,
89.32 	subdivision 11a, so that self-sufficiency upon adulthood or
89.33 	emancipation is unlikely; and 
89.34 	(4) has had a recent diagnostic assessment by a qualified
89.35 	professional that documents that intensive nonresidential
89.36 	rehabilitative mental health services are medically necessary to
90.1 	address identified disability and functional impairments and
90.2 	individual recipient goals.
90.3 		Subd. 4.Provider certification and contract
90.4 	requirements. (a) The intensive nonresidential rehabilitative
90.5 	mental health services provider must:
90.6 	(1) have a contract with the host county to provide
90.7 	intensive transition youth rehabilitative mental health
90.8 	services; and 
90.9 	(2) be certified by the commissioner as being in compliance
90.10 	with this section and section 256B.0943.
90.11 	(b) The commissioner shall develop procedures for counties
90.12 	and providers to submit contracts and other documentation as
90.13 	needed to allow the commissioner to determine whether the
90.14 	standards in this section are met.
90.15 		Subd. 5.Standards applicable to nonresidential
90.16 	providers. (a) Services must be provided by a certified
90.17 	provider entity as defined in section 256B.0943, subdivision 4
90.18 	that meets the requirements in section 245B.0943, subdivisions 5
90.19 	and 6.
90.20 	(b) The clinical supervisor must be an active member of the
90.21 	treatment team.  The treatment team must meet with the clinical
90.22 	supervisor at least weekly to discuss recipients' progress and
90.23 	make rapid adjustments to meet recipients' needs.  The team
90.24 	meeting shall include recipient-specific case reviews and
90.25 	general treatment discussions among team members.
90.26 	Recipient-specific case reviews and planning must be documented
90.27 	in the individual recipient's treatment record.
90.28 	(c) Treatment staff must have prompt access in person or by
90.29 	telephone to a mental health practitioner or mental health
90.30 	professional.  The provider must have the capacity to promptly
90.31 	and appropriately respond to emergent needs and make any
90.32 	necessary staffing adjustments to assure the health and safety
90.33 	of recipients.
90.34 	(d) The initial functional assessment must be completed
90.35 	within ten days of intake and updated at least every three
90.36 	months or prior to discharge from the service, whichever comes
91.1 	first.
91.2 	(e) The initial individual treatment plan must be completed
91.3 	within ten days of intake and reviewed and updated at least
91.4 	monthly with the recipient.
91.5 		Subd. 6.Additional standards for nonresidential
91.6 	services. The standards in this subdivision apply to intensive
91.7 	nonresidential rehabilitative mental health services.
91.8 	(1) The treatment team must use team treatment, not an
91.9 	individual treatment model.
91.10 	(2) The clinical supervisor must function as a practicing
91.11 	clinician at least on a part-time basis.
91.12 	(3) The staffing ratio must not exceed ten recipients to
91.13 	one full-time equivalent treatment team position.
91.14 	(4) Services must be available at times that meet client
91.15 	needs.
91.16 	(5) The treatment team must actively and assertively engage
91.17 	and reach out to the recipient's family members and significant
91.18 	others, after obtaining the recipient's permission.
91.19 	(6) The treatment team must establish ongoing communication
91.20 	and collaboration between the team, family, and significant
91.21 	others and educate the family and significant others about
91.22 	mental illness, symptom management, and the family's role in
91.23 	treatment.
91.24 	(7) The treatment team must provide interventions to
91.25 	promote positive interpersonal relationships.
91.26 		Subd. 7.Medical assistance payment for intensive
91.27 	rehabilitative mental health services. (a) Payment for
91.28 	nonresidential services in this section shall be based on one
91.29 	daily rate per provider inclusive of the following services
91.30 	received by an eligible recipient in a given calendar day: all
91.31 	rehabilitative services under this section, staff travel time to
91.32 	provide rehabilitative services under this section, and
91.33 	nonresidential crisis stabilization services under section
91.34 	256B.0944.
91.35 	(b) Except as indicated in paragraph (c), payment will not
91.36 	be made to more than one entity for each recipient for services
92.1 	provided under this section on a given day.  If services under
92.2 	this section are provided by a team that includes staff from
92.3 	more than one entity, the team must determine how to distribute
92.4 	the payment among the members.
92.5 	(c) The host county shall recommend to the commissioner one
92.6 	rate for each entity that will bill medical assistance for
92.7 	nonresidential intensive rehabilitative mental health services.
92.8 	In developing these rates, the host county shall consider and
92.9 	document:
92.10 	(1) the cost for similar services in the local trade area;
92.11 	(2) actual costs incurred by entities providing the
92.12 	services;
92.13 	(3) the intensity and frequency of services to be provided
92.14 	to each recipient;
92.15 	(4) the degree to which recipients will receive services
92.16 	other than services under this section; and 
92.17 	(5) the costs of other services that will be separately
92.18 	reimbursed.
92.19 	(d) The rate for intensive rehabilitative mental health
92.20 	services must exclude medical assistance room and board rate, as
92.21 	defined in section 256I.03, subdivision 6, and services not
92.22 	covered under this section, such as partial hospitalization and
92.23 	inpatient services.  Physician services are not a component of
92.24 	the treatment team and may be billed separately.  The county's
92.25 	recommendation shall specify the period for which the rate will
92.26 	be applicable, not to exceed two years.
92.27 	(e) When services under this section are provided by an
92.28 	assertive community team, case management functions must be an
92.29 	integral part of the team.
92.30 	(f) The rate for a provider must not exceed the rate
92.31 	charged by that provider for the same service to other payors.
92.32 	(g) The commissioner shall approve or reject the county's
92.33 	rate recommendation, based on the commissioner's own analysis of
92.34 	the criteria in paragraph (c).
92.35 		Subd. 8.Provider enrollment; rate setting for
92.36 	county-operated entities. Counties that employ their own staff
93.1 	to provide services under this section shall apply directly to
93.2 	the commissioner for enrollment and rate setting.  In this case,
93.3 	a county contract is not required and the commissioner shall
93.4 	perform the program review and rate setting duties which would
93.5 	otherwise be required of counties under this section.
93.6 	
EFFECTIVE DATE. This section is effective July 1, 2006.

93.7 	Sec. 14. Minnesota Statutes 2004, section 256B.19,
93.8 	subdivision 1, is amended to read:
93.9 		Subdivision 1.Division of cost.  The state and county
93.10 	share of medical assistance costs not paid by federal funds
93.11 	shall be as follows:
93.12 	(1) beginning January 1, 1992, 50 percent state funds and
93.13 	50 percent county funds for the cost of placement of severely
93.14 	emotionally disturbed children in regional treatment centers;
93.15 	(2) beginning January 1, 2003, 80 percent state funds and
93.16 	20 percent county funds for the costs of nursing facility
93.17 	placements of persons with disabilities under the age of 65 that
93.18 	have exceeded 90 days.  This clause shall be subject to chapter
93.19 	256G and shall not apply to placements in facilities not
93.20 	certified to participate in medical assistance;
93.21 	(3) beginning July 1, 2004, 80 90 percent state funds and
93.22 	20 ten percent county funds for the costs of placements that
93.23 	have exceeded 90 days in intermediate care facilities for
93.24 	persons with mental retardation or a related condition that have
93.25 	seven or more beds.  This provision includes pass-through
93.26 	payments made under section 256B.5015; and
93.27 	(4) beginning July 1, 2004, when state funds are used to
93.28 	pay for a nursing facility placement due to the facility's
93.29 	status as an institution for mental diseases (IMD), the county
93.30 	shall pay 20 percent of the nonfederal share of costs that have
93.31 	exceeded 90 days.  This clause is subject to chapter 256G.
93.32 	For counties that participate in a Medicaid demonstration
93.33 	project under sections 256B.69 and 256B.71, the division of the
93.34 	nonfederal share of medical assistance expenses for payments
93.35 	made to prepaid health plans or for payments made to health
93.36 	maintenance organizations in the form of prepaid capitation
94.1 	payments, this division of medical assistance expenses shall be
94.2 	95 percent by the state and five percent by the county of
94.3 	financial responsibility.
94.4 	In counties where prepaid health plans are under contract
94.5 	to the commissioner to provide services to medical assistance
94.6 	recipients, the cost of court ordered treatment ordered without
94.7 	consulting the prepaid health plan that does not include
94.8 	diagnostic evaluation, recommendation, and referral for
94.9 	treatment by the prepaid health plan is the responsibility of
94.10 	the county of financial responsibility.
94.11 	
EFFECTIVE DATE. This section is effective the day
94.12 	following final enactment.

94.13 	Sec. 15. Minnesota Statutes 2004, section 256D.03,
94.14 	subdivision 4, is amended to read:
94.15 		Subd. 4.General assistance medical care; services.
 94.16 	(a)(i) For a person who is eligible under subdivision 3,
94.17 	paragraph (a), clause (2), item (i), general assistance medical
94.18 	care covers, except as provided in paragraph (c):
94.19 	(1) inpatient hospital services;
94.20 	(2) outpatient hospital services;
94.21 	(3) services provided by Medicare certified rehabilitation
94.22 	agencies;
94.23 	(4) prescription drugs and other products recommended
94.24 	through the process established in section 256B.0625,
94.25 	subdivision 13;
94.26 	(5) equipment necessary to administer insulin and
94.27 	diagnostic supplies and equipment for diabetics to monitor blood
94.28 	sugar level;
94.29 	(6) eyeglasses and eye examinations provided by a physician
94.30 	or optometrist;
94.31 	(7) hearing aids;
94.32 	(8) prosthetic devices;
94.33 	(9) laboratory and X-ray services;
94.34 	(10) physician's services;
94.35 	(11) medical transportation except special transportation;
94.36 	(12) chiropractic services as covered under the medical
95.1 	assistance program;
95.2 	(13) podiatric services;
95.3 	(14) dental services and dentures, subject to the
95.4 	limitations specified in section 256B.0625, subdivision 9;
95.5 	(15) outpatient services provided by a mental health center
95.6 	or clinic that is under contract with the county board and is
95.7 	established under section 245.62;
95.8 	(16) day treatment services for mental illness provided
95.9 	under contract with the county board;
95.10 	(17) prescribed medications for persons who have been
95.11 	diagnosed as mentally ill as necessary to prevent more
95.12 	restrictive institutionalization;
95.13 	(18) psychological services, medical supplies and
95.14 	equipment, and Medicare premiums, coinsurance and deductible
95.15 	payments;
95.16 	(19) medical equipment not specifically listed in this
95.17 	paragraph when the use of the equipment will prevent the need
95.18 	for costlier services that are reimbursable under this
95.19 	subdivision;
95.20 	(20) services performed by a certified pediatric nurse
95.21 	practitioner, a certified family nurse practitioner, a certified
95.22 	adult nurse practitioner, a certified obstetric/gynecological
95.23 	nurse practitioner, a certified neonatal nurse practitioner, or
95.24 	a certified geriatric nurse practitioner in independent
95.25 	practice, if (1) the service is otherwise covered under this
95.26 	chapter as a physician service, (2) the service provided on an
95.27 	inpatient basis is not included as part of the cost for
95.28 	inpatient services included in the operating payment rate, and
95.29 	(3) the service is within the scope of practice of the nurse
95.30 	practitioner's license as a registered nurse, as defined in
95.31 	section 148.171;
95.32 	(21) services of a certified public health nurse or a
95.33 	registered nurse practicing in a public health nursing clinic
95.34 	that is a department of, or that operates under the direct
95.35 	authority of, a unit of government, if the service is within the
95.36 	scope of practice of the public health nurse's license as a
96.1 	registered nurse, as defined in section 148.171; and 
96.2 	(22) telemedicine consultations, to the extent they are
96.3 	covered under section 256B.0625, subdivision 3b; and 
96.4 	(23) mental health telemedicine and psychiatric
96.5 	consultation as covered under section 256B.0625, subdivisions 46
96.6 	and 48.
96.7 	(ii) Effective October 1, 2003, for a person who is
96.8 	eligible under subdivision 3, paragraph (a), clause (2), item
96.9 	(ii), general assistance medical care coverage is limited to
96.10 	inpatient hospital services, including physician services
96.11 	provided during the inpatient hospital stay.  A $1,000
96.12 	deductible is required for each inpatient hospitalization.
96.13 	(b) Gender reassignment surgery and related services are
96.14 	not covered services under this subdivision unless the
96.15 	individual began receiving gender reassignment services prior to
96.16 	July 1, 1995.
96.17 	(c) In order to contain costs, the commissioner of human
96.18 	services shall select vendors of medical care who can provide
96.19 	the most economical care consistent with high medical standards
96.20 	and shall where possible contract with organizations on a
96.21 	prepaid capitation basis to provide these services.  The
96.22 	commissioner shall consider proposals by counties and vendors
96.23 	for prepaid health plans, competitive bidding programs, block
96.24 	grants, or other vendor payment mechanisms designed to provide
96.25 	services in an economical manner or to control utilization, with
96.26 	safeguards to ensure that necessary services are provided.
96.27 	Before implementing prepaid programs in counties with a county
96.28 	operated or affiliated public teaching hospital or a hospital or
96.29 	clinic operated by the University of Minnesota, the commissioner
96.30 	shall consider the risks the prepaid program creates for the
96.31 	hospital and allow the county or hospital the opportunity to
96.32 	participate in the program in a manner that reflects the risk of
96.33 	adverse selection and the nature of the patients served by the
96.34 	hospital, provided the terms of participation in the program are
96.35 	competitive with the terms of other participants considering the
96.36 	nature of the population served.  Payment for services provided
97.1 	pursuant to this subdivision shall be as provided to medical
97.2 	assistance vendors of these services under sections 256B.02,
97.3 	subdivision 8, and 256B.0625.  For payments made during fiscal
97.4 	year 1990 and later years, the commissioner shall consult with
97.5 	an independent actuary in establishing prepayment rates, but
97.6 	shall retain final control over the rate methodology.
97.7 	(d) Recipients eligible under subdivision 3, paragraph (a),
97.8 	clause (2), item (i), shall pay the following co-payments for
97.9 	services provided on or after October 1, 2003:
97.10 	(1) $3 per nonpreventive visit.  For purposes of this
97.11 	subdivision, a visit means an episode of service which is
97.12 	required because of a recipient's symptoms, diagnosis, or
97.13 	established illness, and which is delivered in an ambulatory
97.14 	setting by a physician or physician ancillary, chiropractor,
97.15 	podiatrist, nurse midwife, advanced practice nurse, audiologist,
97.16 	optician, or optometrist;
97.17 	(2) $25 for eyeglasses;
97.18 	(3) $25 for nonemergency visits to a hospital-based
97.19 	emergency room;
97.20 	(4) $3 per brand-name drug prescription and $1 per generic
97.21 	drug prescription, subject to a $20 per month maximum for
97.22 	prescription drug co-payments.  No co-payments shall apply to
97.23 	antipsychotic drugs when used for the treatment of mental
97.24 	illness; and
97.25 	(5) 50 percent coinsurance on restorative dental services.
97.26 	(e) Co-payments shall be limited to one per day per
97.27 	provider for nonpreventive visits, eyeglasses, and nonemergency
97.28 	visits to a hospital-based emergency room.  Recipients of
97.29 	general assistance medical care are responsible for all
97.30 	co-payments in this subdivision.  The general assistance medical
97.31 	care reimbursement to the provider shall be reduced by the
97.32 	amount of the co-payment, except that reimbursement for
97.33 	prescription drugs shall not be reduced once a recipient has
97.34 	reached the $20 per month maximum for prescription drug
97.35 	co-payments.  The provider collects the co-payment from the
97.36 	recipient.  Providers may not deny services to recipients who
98.1 	are unable to pay the co-payment, except as provided in
98.2 	paragraph (f).
98.3 	(f) If it is the routine business practice of a provider to
98.4 	refuse service to an individual with uncollected debt, the
98.5 	provider may include uncollected co-payments under this
98.6 	section.  A provider must give advance notice to a recipient
98.7 	with uncollected debt before services can be denied.
98.8 	(g) Any county may, from its own resources, provide medical
98.9 	payments for which state payments are not made.
98.10 	(h) Chemical dependency services that are reimbursed under
98.11 	chapter 254B must not be reimbursed under general assistance
98.12 	medical care.
98.13 	(i) The maximum payment for new vendors enrolled in the
98.14 	general assistance medical care program after the base year
98.15 	shall be determined from the average usual and customary charge
98.16 	of the same vendor type enrolled in the base year.
98.17 	(j) The conditions of payment for services under this
98.18 	subdivision are the same as the conditions specified in rules
98.19 	adopted under chapter 256B governing the medical assistance
98.20 	program, unless otherwise provided by statute or rule.
98.21 	(k) Inpatient and outpatient payments shall be reduced by
98.22 	five percent, effective July 1, 2003.  This reduction is in
98.23 	addition to the five percent reduction effective July 1, 2003,
98.24 	and incorporated by reference in paragraph (i).
98.25 	(l) Payments for all other health services except
98.26 	inpatient, outpatient, and pharmacy services shall be reduced by
98.27 	five percent, effective July 1, 2003.
98.28 	(m) Payments to managed care plans shall be reduced by five
98.29 	percent for services provided on or after October 1, 2003.
98.30 	(n) A hospital receiving a reduced payment as a result of
98.31 	this section may apply the unpaid balance toward satisfaction of
98.32 	the hospital's bad debts.
98.33 	
EFFECTIVE DATE. This section is effective January 1, 2006.

98.34 	Sec. 16. Minnesota Statutes 2004, section 256D.44,
98.35 	subdivision 5, is amended to read:
98.36 		Subd. 5.Special needs.  In addition to the state
99.1 	standards of assistance established in subdivisions 1 to 4,
99.2 	payments are allowed for the following special needs of
99.3 	recipients of Minnesota supplemental aid who are not residents
99.4 	of a nursing home, a regional treatment center, or a group
99.5 	residential housing facility.
99.6 	(a) The county agency shall pay a monthly allowance for
99.7 	medically prescribed diets if the cost of those additional
99.8 	dietary needs cannot be met through some other maintenance
99.9 	benefit.  The need for special diets or dietary items must be
99.10 	prescribed by a licensed physician.  Costs for special diets
99.11 	shall be determined as percentages of the allotment for a
99.12 	one-person household under the thrifty food plan as defined by
99.13 	the United States Department of Agriculture.  The types of diets
99.14 	and the percentages of the thrifty food plan that are covered
99.15 	are as follows:
99.16 	(1) high protein diet, at least 80 grams daily, 25 percent
99.17 	of thrifty food plan;
99.18 	(2) controlled protein diet, 40 to 60 grams and requires
99.19 	special products, 100 percent of thrifty food plan;
99.20 	(3) controlled protein diet, less than 40 grams and
99.21 	requires special products, 125 percent of thrifty food plan;
99.22 	(4) low cholesterol diet, 25 percent of thrifty food plan;
99.23 	(5) high residue diet, 20 percent of thrifty food plan;
99.24 	(6) pregnancy and lactation diet, 35 percent of thrifty
99.25 	food plan;
99.26 	(7) gluten-free diet, 25 percent of thrifty food plan;
99.27 	(8) lactose-free diet, 25 percent of thrifty food plan;
99.28 	(9) antidumping diet, 15 percent of thrifty food plan;
99.29 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
99.30 	(11) ketogenic diet, 25 percent of thrifty food plan.
99.31 	(b) Payment for nonrecurring special needs must be allowed
99.32 	for necessary home repairs or necessary repairs or replacement
99.33 	of household furniture and appliances using the payment standard
99.34 	of the AFDC program in effect on July 16, 1996, for these
99.35 	expenses, as long as other funding sources are not available.
99.36 	(c) A fee for guardian or conservator service is allowed at
100.1 	a reasonable rate negotiated by the county or approved by the
100.2 	court.  This rate shall not exceed five percent of the
100.3 	assistance unit's gross monthly income up to a maximum of $100
100.4 	per month.  If the guardian or conservator is a member of the
100.5 	county agency staff, no fee is allowed.
100.6 	(d) The county agency shall continue to pay a monthly
100.7 	allowance of $68 for restaurant meals for a person who was
100.8 	receiving a restaurant meal allowance on June 1, 1990, and who
100.9 	eats two or more meals in a restaurant daily.  The allowance
100.10 	must continue until the person has not received Minnesota
100.11 	supplemental aid for one full calendar month or until the
100.12 	person's living arrangement changes and the person no longer
100.13 	meets the criteria for the restaurant meal allowance, whichever
100.14 	occurs first.
100.15 	(e) A fee of ten percent of the recipient's gross income or
100.16 	$25, whichever is less, is allowed for representative payee
100.17 	services provided by an agency that meets the requirements under
100.18 	SSI regulations to charge a fee for representative payee
100.19 	services.  This special need is available to all recipients of
100.20 	Minnesota supplemental aid regardless of their living
100.21 	arrangement.
100.22 	(f) Notwithstanding the language in this subdivision, an
100.23 	amount equal to the maximum allotment authorized by the federal
100.24 	Food Stamp Program for a single individual which is in effect on
100.25 	the first day of January of the previous year will be added to
100.26 	the standards of assistance established in subdivisions 1 to 4
100.27 	for individuals under the age of 65 who are relocating from an
100.28 	institution, or an adult mental health residential treatment
100.29 	program under section 256B.0622,and who are shelter needy.  An
100.30 	eligible individual who receives this benefit prior to age 65
100.31 	may continue to receive the benefit after the age of 65.
100.32 	"Shelter needy" means that the assistance unit incurs
100.33 	monthly shelter costs that exceed 40 percent of the assistance
100.34 	unit's gross income before the application of this special needs
100.35 	standard.  "Gross income" for the purposes of this section is
100.36 	the applicant's or recipient's income as defined in section
101.1 	256D.35, subdivision 10, or the standard specified in
101.2 	subdivision 3, whichever is greater.  A recipient of a federal
101.3 	or state housing subsidy, that limits shelter costs to a
101.4 	percentage of gross income, shall not be considered shelter
101.5 	needy for purposes of this paragraph.
101.6 	
EFFECTIVE DATE. This section is effective January 1, 2006.

101.7 	Sec. 17. Minnesota Statutes 2004, section 256L.03,
101.8 	subdivision 1, is amended to read:
101.9 		Subdivision 1.Covered health services.  For individuals
101.10 	under section 256L.04, subdivision 7, with income no greater
101.11 	than 75 percent of the federal poverty guidelines or for
101.12 	families with children under section 256L.04, subdivision 1, all
101.13 	subdivisions of this section apply.  "Covered health services"
101.14 	means the health services reimbursed under chapter 256B, with
101.15 	the exception of inpatient hospital services, special education
101.16 	services, private duty nursing services, adult dental care
101.17 	services other than services covered under section 256B.0625,
101.18 	subdivision 9, paragraph (b), orthodontic services, nonemergency
101.19 	medical transportation services, personal care assistant and
101.20 	case management services, nursing home or intermediate care
101.21 	facilities services, inpatient mental health services, and
101.22 	chemical dependency services.  Outpatient mental health services
101.23 	covered under the MinnesotaCare program are limited to
101.24 	diagnostic assessments, psychological testing, explanation of
101.25 	findings, mental health telemedicine, psychiatric consultation,
101.26 	medication management by a physician, day treatment, partial
101.27 	hospitalization, and individual, family, and group psychotherapy.
101.28 	No public funds shall be used for coverage of abortion
101.29 	under MinnesotaCare except where the life of the female would be
101.30 	endangered or substantial and irreversible impairment of a major
101.31 	bodily function would result if the fetus were carried to term;
101.32 	or where the pregnancy is the result of rape or incest.
101.33 	Covered health services shall be expanded as provided in
101.34 	this section.
101.35 	
EFFECTIVE DATE. This section is effective January 1, 2006.

101.36 	Sec. 18. [641.155] DISCHARGE PLANS; OFFENDERS WITH
102.1 	SERIOUS AND PERSISTENT MENTAL ILLNESS.
102.2 	The commissioner of corrections shall develop a model
102.3 	discharge planning process for every offender with a serious and
102.4 	persistent mental illness, as defined in section 245.462,
102.5 	subdivision 20, paragraph (c), who has been convicted and
102.6 	sentenced to serve three or more months and is being released
102.7 	from a county jail or county regional jail.
102.8 	An offender with a serious and persistent mental illness,
102.9 	as defined in section 245.462, subdivision 20, paragraph (c),
102.10 	who has been convicted and sentenced to serve three or more
102.11 	months and is being released from a county jail or county
102.12 	regional jail shall be referred to the appropriate staff in the
102.13 	county human services department at least 60 days before being
102.14 	released.  The county human services department may carry out
102.15 	provisions of the model discharge planning process such as:
102.16 	(1) providing assistance in filling out an application for
102.17 	medical assistance, general assistance medical care, or
102.18 	MinnesotaCare;
102.19 	(2) making a referral for case management as outlined under
102.20 	section 245.467, subdivision 4;
102.21 	(3) providing assistance in obtaining a state photo
102.22 	identification;
102.23 	(4) securing a timely appointment with a psychiatrist or
102.24 	other appropriate community mental health providers; and 
102.25 	(5) providing prescriptions for a 30-day supply of all
102.26 	necessary medications.

102.27 	Sec. 19. PRIORITY IN JANITORIAL CONTRACTS.
 102.28 	When awarding contracts to provide the janitorial services
102.29 	for the new Department of Human Services and Department of
102.30 	Health buildings, the commissioner of administration shall give
102.31 	priority to supported work vendors, provided those vendors
102.32 	submit a bid that is equal to or less than bids submitted by
102.33 	other vendors.

102.34 	Sec. 20. ENHANCED SEPARATION.
 102.35 	A state employee covered by a collective bargaining
102.36 	agreement negotiated by the exclusive representatives of the
103.1 	American Federation of State, County and Municipal Employees
103.2 	Council 5, who separates from employment at the Willmar Regional
103.3 	Treatment Center after the center ceases to be a state facility,
103.4 	is governed by the enhanced separation package agreed to by the
103.5 	state of Minnesota and the American Federation of State, County
103.6 	and Municipal Employees Council 5 that is scheduled to take
103.7 	effect August 1, 2005, even if the center ceases to be a state
103.8 	facility before August 1, 2005.  This section is repealed on
103.9 	August 1, 2005, or on the date the memorandum of understanding
103.10 	that includes the enhanced separation package is ratified,
103.11 	whichever occurs later.

103.12 	Sec. 21. PENSION COVERAGE.
 103.13 	(a) This section applies to an employee of the Willmar
103.14 	Regional Treatment Center whose position at the treatment center
103.15 	changes from state employment to Kandiyohi County employment
103.16 	during the biennium ending June 30, 2007.  Notwithstanding any
103.17 	law to the contrary, an employee to whom this section applies
103.18 	remains a member of the Minnesota State Retirement System while
103.19 	employed by Kandiyohi County unless the member elects to become
103.20 	a member of the Public Employees Retirement Association.
103.21 	(b) An election to become a member of the Public Employees
103.22 	Retirement Association under this section must be made within
103.23 	six months from the date the position changes from state
103.24 	employment to Kandiyohi County employment, is irrevocable, and
103.25 	must be made in a manner specified by the executive directors of
103.26 	the Minnesota State Retirement System and the Public Employees
103.27 	Retirement Association.

103.28 	Sec. 22. EFFECTIVE DATE.
 103.29 	Sections 20 and 21 are effective the day following final
103.30 	enactment.

103.31 	ARTICLE 3
103.32 	FAMILY SUPPORT

103.33 	Section 1. Minnesota Statutes 2004, section 119B.13,
103.34 	subdivision 1, is amended to read:
103.35 		Subdivision 1.Subsidy restrictions. The maximum rate
103.36 	paid for child care assistance under the child care fund may not
104.1 	exceed the 75th percentile rate for like-care arrangements in
104.2 	the county as surveyed by the commissioner.(a)(i) Effective
104.3 	July 1, 2005, the commissioner of human services shall modify
104.4 	the rate tables for child care centers published in Department
104.5 	of Human Services Bulletin No. 03-68-07 so that in counties with
104.6 	regional or statewide cells, the higher of the 100th percentile
104.7 	of the 2002 market rate survey data or the rate currently
104.8 	identified in the bulletin will be the maximum rate.  The rates
104.9 	established in this clause will be considered as the previous
104.10 	year's rates for purposes of the increase in item (iii), and
104.11 	shall be compared to the 100th percentile of current market
104.12 	rates.
104.13 	(ii) For the period between July 1, 2005, and through the
104.14 	full implementation of the new rates under item (iii), the rates
104.15 	published in Department of Human Services Bulletin No. 03-68-07
104.16 	as adjusted by item (i) shall remain in effect.
104.17 	(iii) Beginning January 1, 2006, the maximum rate paid for
104.18 	child care assistance in any county or multicounty region under
104.19 	the child care fund shall be the lesser of the 75th percentile
104.20 	rate for like-care arrangements in the county or multicounty
104.21 	region as surveyed by the commissioner or the previous year's
104.22 	rate for like-care arrangements in the county increased by 1.75
104.23 	percent.
104.24 	(iv) Rate changes shall be implemented for services
104.25 	provided in March 2006 unless a participant eligibility
104.26 	redetermination or a new provider agreement is completed between
104.27 	January 1, 2006, and February 28, 2006.
104.28 	As necessary, appropriate notice of adverse action must be
104.29 	made according to Minnesota Rules, part 3400.0185, subparts 3
104.30 	and 4.
104.31 	New cases approved on or after January 1, 2006, shall have
104.32 	the maximum rates under item (iii) implemented immediately.
104.33 	(b) Not less than once every two years, the commissioner
104.34 	shall survey rates charged by child care providers in Minnesota
104.35 	to determine the 75th percentile for like-care arrangements in
104.36 	counties.  When the commissioner determines that, using the
105.1 	commissioner's established protocol, the number of providers
105.2 	responding to the survey is too small to determine the 75th
105.3 	percentile rate for like-care arrangements in a county or
105.4 	multicounty region, the commissioner may establish the 75th
105.5 	percentile maximum rate based on like-care arrangements in a
105.6 	county, region, or category that the commissioner deems to be
105.7 	similar.
105.8 	(c) A rate which includes a special needs rate paid under
105.9 	subdivision 3 may be in excess of the maximum rate allowed under
105.10 	this subdivision.
105.11 	(d) The department shall monitor the effect of this
105.12 	paragraph on provider rates.  The county shall pay the
105.13 	provider's full charges for every child in care up to the
105.14 	maximum established.  The commissioner shall determine the
105.15 	maximum rate for each type of care on an hourly, full-day, and
105.16 	weekly basis, including special needs and handicapped care. Not
105.17 	less than once every two years, the commissioner shall evaluate
105.18 	market practices for payment of absences and shall establish
105.19 	policies for payment of absent days that reflect current market
105.20 	practice.
105.21 	(e) When the provider charge is greater than the maximum
105.22 	provider rate allowed, the parent is responsible for payment of
105.23 	the difference in the rates in addition to any family co-payment
105.24 	fee.

105.25 	Sec. 2. Minnesota Statutes 2004, section 119B.13, is
105.26 	amended by adding a subdivision to read:
105.27 		Subd. 7.Absent days. Child care providers may not be
105.28 	reimbursed for more than 25 absent days per child, excluding
105.29 	holidays, in a fiscal year, or for more than ten consecutive
105.30 	absent days, unless the child has a documented medical condition
105.31 	that causes more frequent absences.  Documentation of medical
105.32 	conditions must be on the forms and submitted according to the
105.33 	timelines established by the commissioner.
105.34 	
EFFECTIVE DATE. This section is effective October 1, 2005.

105.35 	Sec. 3. [245A.1445] CHILD CARE PROVIDER TRAINING; DANGERS
105.36 	OF SHAKING INFANTS AND YOUNG CHILDREN.
106.1 	The commissioner shall make available for viewing by all
106.2 	licensed and legal nonlicensed child care providers a video
106.3 	presentation on the dangers associated with shaking infants and
106.4 	young children.  The video presentation shall be part of the
106.5 	initial and annual training of licensed child care providers.
106.6 	Legal nonlicensed child care providers may participate at their
106.7 	option in a video presentation session offered under this
106.8 	section.  The commissioner shall provide to child care providers
106.9 	and interested individuals, at cost, copies of a video approved
106.10 	by the commissioner of health under section 144.574 on the
106.11 	dangers associated with shaking infants and young children.

106.12 	Sec. 4. Minnesota Statutes 2004, section 245A.10,
106.13 	subdivision 4, is amended to read:
106.14 		Subd. 4.Annual license or certification fee for programs
106.15 	with licensed capacity.  (a) Child care centers and programs
106.16 	with a licensed capacity shall pay an annual nonrefundable
106.17 	license or certification fee based on the following schedule:
106.18 	Licensed Capacity          Child Care         Other
106.19 	                               Center             Program
106.20 	                               License Fee        License Fee
106.21 	     1 to 24 persons $300 $225 $400
106.22 	     25 to 49 persons $450 $340 $600
106.23 	     50 to 74 persons $600 $450 $800
106.24 	     75 to 99 persons $750 $565 $1,000
106.25 	     100 to 124 persons $900 $675 $1,200
106.26 	     125 to 149 persons $1,200 $900 $1,400
106.27 	     150 to 174 persons $1,400 $1,050 $1,600
106.28 	     175 to 199 persons $1,600 $1,200 $1,800
106.29 	     200 to 224 persons $1,800 $1,350 $2,000
106.30 	     225 or more persons $2,000 $1,500 $2,500
106.31 	(b) A day training and habilitation program serving persons
106.32 	with developmental disabilities or related conditions shall be
106.33 	assessed a license fee based on the schedule in paragraph (a)
106.34 	unless the license holder serves more than 50 percent of the
106.35 	same persons at two or more locations in the community.  When a
106.36 	day training and habilitation program serves more than 50
107.1 	percent of the same persons in two or more locations in a
107.2 	community, the day training and habilitation program shall pay a
107.3 	license fee based on the licensed capacity of the largest
107.4 	facility and the other facility or facilities shall be charged a
107.5 	license fee based on a licensed capacity of a residential
107.6 	program serving one to 24 persons.

107.7 	Sec. 5. Minnesota Statutes 2004, section 252.27,
107.8 	subdivision 2a, is amended to read:
107.9 		Subd. 2a.Contribution amount.  (a) The natural or
107.10 	adoptive parents of a minor child, including a child determined
107.11 	eligible for medical assistance without consideration of
107.12 	parental income, must contribute to the cost of services used by
107.13 	making monthly payments on a sliding scale based on income,
107.14 	unless the child is married or has been married, parental rights
107.15 	have been terminated, or the child's adoption is subsidized
107.16 	according to section 259.67 or through title IV-E of the Social
107.17 	Security Act.
107.18 	(b) For households with adjusted gross income equal to or
107.19 	greater than 100 percent of federal poverty guidelines, the
107.20 	parental contribution shall be computed by applying the
107.21 	following schedule of rates to the adjusted gross income of the
107.22 	natural or adoptive parents:
107.23 	(1) if the adjusted gross income is equal to or greater
107.24 	than 100 percent of federal poverty guidelines and less than 175
107.25 	percent of federal poverty guidelines, the parental contribution
107.26 	is $4 per month;
107.27 	(2) if the adjusted gross income is equal to or greater
107.28 	than 175 percent of federal poverty guidelines and less than or
107.29 	equal to 375 545 percent of federal poverty guidelines, the
107.30 	parental contribution shall be determined using a sliding fee
107.31 	scale established by the commissioner of human services which
107.32 	begins at one percent of adjusted gross income at 175 percent of
107.33 	federal poverty guidelines and increases to 7.5 percent of
107.34 	adjusted gross income for those with adjusted gross income up to
107.35 	375 545 percent of federal poverty guidelines;
107.36 	(3) if the adjusted gross income is greater than 375 545 
108.1 	percent of federal poverty guidelines and less than 675 percent
108.2 	of federal poverty guidelines, the parental contribution shall
108.3 	be 7.5 percent of adjusted gross income;
108.4 	(4) if the adjusted gross income is equal to or greater
108.5 	than 675 percent of federal poverty guidelines and less than 975
108.6 	percent of federal poverty guidelines, the parental contribution
108.7 	shall be determined using a sliding fee scale established by the
108.8 	commissioner of human services which begins at 7.5 percent of
108.9 	adjusted gross income at 675 percent of federal poverty
108.10 	guidelines and increases to ten percent of adjusted gross income
108.11 	for those with adjusted gross income up to 975 percent of
108.12 	federal poverty guidelines; and
108.13 	(5) if the adjusted gross income is equal to or greater
108.14 	than 975 percent of federal poverty guidelines, the parental
108.15 	contribution shall be 12.5 percent of adjusted gross income.
108.16 	If the child lives with the parent, the annual adjusted
108.17 	gross income is reduced by $2,400 prior to calculating the
108.18 	parental contribution.  If the child resides in an institution
108.19 	specified in section 256B.35, the parent is responsible for the
108.20 	personal needs allowance specified under that section in
108.21 	addition to the parental contribution determined under this
108.22 	section.  The parental contribution is reduced by any amount
108.23 	required to be paid directly to the child pursuant to a court
108.24 	order, but only if actually paid.
108.25 	(c) The household size to be used in determining the amount
108.26 	of contribution under paragraph (b) includes natural and
108.27 	adoptive parents and their dependents, including the child
108.28 	receiving services.  Adjustments in the contribution amount due
108.29 	to annual changes in the federal poverty guidelines shall be
108.30 	implemented on the first day of July following publication of
108.31 	the changes.
108.32 	(d) For purposes of paragraph (b), "income" means the
108.33 	adjusted gross income of the natural or adoptive parents
108.34 	determined according to the previous year's federal tax form,
108.35 	except, effective retroactive to July 1, 2003, taxable capital
108.36 	gains to the extent the funds have been used to purchase a home
109.1 	shall not be counted as income.
109.2 	(e) The contribution shall be explained in writing to the
109.3 	parents at the time eligibility for services is being
109.4 	determined.  The contribution shall be made on a monthly basis
109.5 	effective with the first month in which the child receives
109.6 	services.  Annually upon redetermination or at termination of
109.7 	eligibility, if the contribution exceeded the cost of services
109.8 	provided, the local agency or the state shall reimburse that
109.9 	excess amount to the parents, either by direct reimbursement if
109.10 	the parent is no longer required to pay a contribution, or by a
109.11 	reduction in or waiver of parental fees until the excess amount
109.12 	is exhausted.
109.13 	(f) The monthly contribution amount must be reviewed at
109.14 	least every 12 months; when there is a change in household size;
109.15 	and when there is a loss of or gain in income from one month to
109.16 	another in excess of ten percent.  The local agency shall mail a
109.17 	written notice 30 days in advance of the effective date of a
109.18 	change in the contribution amount.  A decrease in the
109.19 	contribution amount is effective in the month that the parent
109.20 	verifies a reduction in income or change in household size.
109.21 	(g) Parents of a minor child who do not live with each
109.22 	other shall each pay the contribution required under paragraph
109.23 	(a).  An amount equal to the annual court-ordered child support
109.24 	payment actually paid on behalf of the child receiving services
109.25 	shall be deducted from the adjusted gross income of the parent
109.26 	making the payment prior to calculating the parental
109.27 	contribution under paragraph (b).
109.28 	(h) The contribution under paragraph (b) shall be increased
109.29 	by an additional five percent if the local agency determines
109.30 	that insurance coverage is available but not obtained for the
109.31 	child.  For purposes of this section, "available" means the
109.32 	insurance is a benefit of employment for a family member at an
109.33 	annual cost of no more than five percent of the family's annual
109.34 	income.  For purposes of this section, "insurance" means health
109.35 	and accident insurance coverage, enrollment in a nonprofit
109.36 	health service plan, health maintenance organization,
110.1 	self-insured plan, or preferred provider organization.
110.2 	Parents who have more than one child receiving services
110.3 	shall not be required to pay more than the amount for the child
110.4 	with the highest expenditures.  There shall be no resource
110.5 	contribution from the parents.  The parent shall not be required
110.6 	to pay a contribution in excess of the cost of the services
110.7 	provided to the child, not counting payments made to school
110.8 	districts for education-related services.  Notice of an increase
110.9 	in fee payment must be given at least 30 days before the
110.10 	increased fee is due.
110.11 	(i) The contribution under paragraph (b) shall be reduced
110.12 	by $300 per fiscal year if, in the 12 months prior to July 1:
110.13 	(1) the parent applied for insurance for the child;
110.14 	(2) the insurer denied insurance;
110.15 	(3) the parents submitted a complaint or appeal, in writing
110.16 	to the insurer, submitted a complaint or appeal, in writing, to
110.17 	the commissioner of health or the commissioner of commerce, or
110.18 	litigated the complaint or appeal; and
110.19 	(4) as a result of the dispute, the insurer reversed its
110.20 	decision and granted insurance.
110.21 	For purposes of this section, "insurance" has the meaning
110.22 	given in paragraph (h).
110.23 	A parent who has requested a reduction in the contribution
110.24 	amount under this paragraph shall submit proof in the form and
110.25 	manner prescribed by the commissioner or county agency,
110.26 	including, but not limited to, the insurer's denial of
110.27 	insurance, the written letter or complaint of the parents, court
110.28 	documents, and the written response of the insurer approving
110.29 	insurance.  The determinations of the commissioner or county
110.30 	agency under this paragraph are not rules subject to chapter 14.
110.31 	
EFFECTIVE DATE. This section is effective retroactively
110.32 	from July 1, 2005.

110.33 	Sec. 6. Minnesota Statutes 2004, section 254A.035,
110.34 	subdivision 2, is amended to read:
110.35 		Subd. 2.Membership terms, compensation, removal and
110.36 	expiration.  The membership of this council shall be composed of
111.1 	17 persons who are American Indians and who are appointed by the
111.2 	commissioner.  The commissioner shall appoint one representative
111.3 	from each of the following groups:  Red Lake Band of Chippewa
111.4 	Indians; Fond du Lac Band, Minnesota Chippewa Tribe; Grand
111.5 	Portage Band, Minnesota Chippewa Tribe; Leech Lake Band,
111.6 	Minnesota Chippewa Tribe; Mille Lacs Band, Minnesota Chippewa
111.7 	Tribe; Bois Forte Band, Minnesota Chippewa Tribe; White Earth
111.8 	Band, Minnesota Chippewa Tribe; Lower Sioux Indian Reservation;
111.9 	Prairie Island Sioux Indian Reservation; Shakopee Mdewakanton
111.10 	Sioux Indian Reservation; Upper Sioux Indian Reservation;
111.11 	International Falls Northern Range; Duluth Urban Indian
111.12 	Community; and two representatives from the Minneapolis Urban
111.13 	Indian Community and two from the St. Paul Urban Indian
111.14 	Community.  The terms, compensation, and removal of American
111.15 	Indian Advisory Council members shall be as provided in section
111.16 	15.059.  The council expires June 30, 2001 2008.
111.17 	
EFFECTIVE DATE. This section is effective retroactively
111.18 	from June 30, 2001.

111.19 	Sec. 7. Minnesota Statutes 2004, section 254A.04, is
111.20 	amended to read:
111.21 	254A.04 CITIZENS ADVISORY COUNCIL.
111.22 	There is hereby created an Alcohol and Other Drug Abuse
111.23 	Advisory Council to advise the Department of Human Services
111.24 	concerning the problems of alcohol and other drug dependency and
111.25 	abuse, composed of ten members.  Five members shall be
111.26 	individuals whose interests or training are in the field of
111.27 	alcohol dependency and abuse; and five members whose interests
111.28 	or training are in the field of dependency and abuse of drugs
111.29 	other than alcohol.  The terms, compensation and removal of
111.30 	members shall be as provided in section 15.059.  The council
111.31 	expires June 30, 2001 2008.  The commissioner of human services
111.32 	shall appoint members whose terms end in even-numbered years.
111.33 	The commissioner of health shall appoint members whose terms end
111.34 	in odd-numbered years.

111.35 	EFFECTIVE DATE. This section is effective retroactively
111.36 	from June 30, 2001.

112.1 	Sec. 8. Minnesota Statutes 2004, section 256.01, is
112.2 	amended by adding a subdivision to read:
112.3 		Subd. 14b.American indian child welfare projects. (a)
112.4 	The commissioner of human services may authorize projects to
112.5 	test tribal delivery of child welfare services to American
112.6 	Indian children and their parents and custodians living on the
112.7 	reservation.  The commissioner has authority to solicit and
112.8 	determine which tribes may participate in a project.  Grants may
112.9 	be issued to Minnesota Indian tribes to support the projects.
112.10 	The commissioner may waive existing state rules as needed to
112.11 	accomplish the projects.  Notwithstanding section 626.556, the
112.12 	commissioner may authorize projects to use alternative methods
112.13 	of investigating and assessing reports of child maltreatment,
112.14 	provided that the projects comply with the provisions of section
112.15 	626.556 dealing with the rights of individuals who are subjects
112.16 	of reports or investigations, including notice and appeal rights
112.17 	and data practices requirements.  The commissioner may seek any
112.18 	federal approvals necessary to carry out the projects as well as
112.19 	seek and use any funds available to the commissioner, including
112.20 	use of federal funds, foundation funds, existing grant funds,
112.21 	and other funds.  The commissioner is authorized to advance
112.22 	state funds as necessary to operate the projects.  Federal
112.23 	reimbursement applicable to the projects is appropriated to the
112.24 	commissioner for the purposes of the projects.  The projects
112.25 	must be required to address responsibility for safety,
112.26 	permanency, and well-being of children.
112.27 	(b) For the purposes of this section, "American Indian
112.28 	child" means a person under 18 years of age who is a tribal
112.29 	member or eligible for membership in one of the tribes chosen
112.30 	for a project under this subdivision and who is residing on the
112.31 	reservation of that tribe.
112.32 	(c) In order to qualify for an American Indian child
112.33 	welfare project, a tribe must:
112.34 	(1) be one of the existing tribes with reservation land in
112.35 	Minnesota;
112.36 	(2) have a tribal court with jurisdiction over child
113.1 	custody proceedings;
113.2 	(3) have a substantial number of children for whom
113.3 	determinations of maltreatment have occurred;
113.4 	(4) have capacity to respond to reports of abuse and
113.5 	neglect under section 626.556;
113.6 	(5) provide a wide range of services to families in need of
113.7 	child welfare services; and 
113.8 	(6) have a tribal-state title IV-E agreement in effect.
113.9 	(d) Grants awarded under this section may be used for the
113.10 	nonfederal costs of providing child welfare services to American
113.11 	Indian children on the tribe's reservation, including costs
113.12 	associated with:
113.13 	(1) assessment and prevention of child abuse and neglect;
113.14 	(2) family preservation;
113.15 	(3) facilitative, supportive, and reunification services;
113.16 	(4) out-of-home placement for children removed from the
113.17 	home for child protective purposes; and 
113.18 	(5) other activities and services approved by the
113.19 	commissioner that further the goals of providing safety,
113.20 	permanency, and well-being of American Indian children.
113.21 	(e) When a tribe has initiated a project and has been
113.22 	approved by the commissioner to assume child welfare
113.23 	responsibilities for American Indian children of that tribe
113.24 	under this section, the affected county social service agency is
113.25 	relieved of responsibility for responding to reports of abuse
113.26 	and neglect under section 626.556 for those children during the
113.27 	time within which the tribal project is in effect and funded.
113.28 	The commissioner shall work with tribes and affected counties to
113.29 	develop procedures for data collection, evaluation, and
113.30 	clarification of ongoing role and financial responsibilities of
113.31 	the county and tribe for child welfare services prior to
113.32 	initiation of the project.  Children who have not been
113.33 	identified by the tribe as participating in the project shall
113.34 	remain the responsibility of the county.  Nothing in this
113.35 	section shall alter responsibilities of the county for law
113.36 	enforcement or court services.
114.1 	(f) The commissioner shall collect information on outcomes
114.2 	relating to child safety, permanency, and well-being of American
114.3 	Indian children who are served in the projects.  Participating
114.4 	tribes must provide information to the state in a format and
114.5 	completeness deemed acceptable by the state to meet state and
114.6 	federal reporting requirements.

114.7 	Sec. 9. Minnesota Statutes 2004, section 256B.0924,
114.8 	subdivision 3, is amended to read:
114.9 		Subd. 3.Eligibility.  Persons are eligible to receive
114.10 	targeted case management services under this section if the
114.11 	requirements in paragraphs (a) and (b) are met.
114.12 	(a) The person must be assessed and determined by the local
114.13 	county agency to:
114.14 	(1) be age 18 or older;
114.15 	(2) be receiving medical assistance;
114.16 	(3) have significant functional limitations; and
114.17 	(4) be in need of service coordination to attain or
114.18 	maintain living in an integrated community setting.
114.19 	(b) The person must be a vulnerable adult in need of adult
114.20 	protection as defined in section 626.5572, or is an adult with
114.21 	mental retardation as defined in section 252A.02, subdivision 2,
114.22 	or a related condition as defined in section 252.27, subdivision
114.23 	1a, and is not receiving home and community-based waiver
114.24 	services, or is an adult who lacks a permanent residence and who
114.25 	has been without a permanent residence for at least one year or
114.26 	on at least four occasions in the last three years.

114.27 	Sec. 10. Minnesota Statutes 2004, section 256B.093,
114.28 	subdivision 1, is amended to read:
114.29 		Subdivision 1.State traumatic brain injury program.  The
114.30 	commissioner of human services shall:
114.31 	(1) maintain a statewide traumatic brain injury program;
114.32 	(2) supervise and coordinate services and policies for
114.33 	persons with traumatic brain injuries;
114.34 	(3) contract with qualified agencies or employ staff to
114.35 	provide statewide administrative case management and
114.36 	consultation;
115.1 	(4) maintain an advisory committee to provide
115.2 	recommendations in reports to the commissioner regarding program
115.3 	and service needs of persons with traumatic brain injuries;
115.4 	(5) investigate the need for the development of rules or
115.5 	statutes for the traumatic brain injury home and community-based
115.6 	services waiver;
115.7 	(6) investigate present and potential models of service
115.8 	coordination which can be delivered at the local level; and
115.9 	(7) the advisory committee required by clause (4) must
115.10 	consist of no fewer than ten members and no more than 30
115.11 	members.  The commissioner shall appoint all advisory committee
115.12 	members to one- or two-year terms and appoint one member as
115.13 	chair.  Notwithstanding section 15.059, subdivision 5, the
115.14 	advisory committee does not terminate until June 30, 2005 2008.

115.15 	Sec. 11. Minnesota Statutes 2004, section 256D.06,
115.16 	subdivision 5, is amended to read:
115.17 		Subd. 5.Eligibility; requirements. (a) Any applicant,
115.18 	otherwise eligible for general assistance and possibly eligible
115.19 	for maintenance benefits from any other source shall (a) (1) 
115.20 	make application for those benefits within 30 days of the
115.21 	general assistance application; and (b) (2) execute an interim
115.22 	assistance authorization agreement on a form as directed by the
115.23 	commissioner.
115.24 	(b) The commissioner shall review a denial of an
115.25 	application for other maintenance benefits and may require a
115.26 	recipient of general assistance to file an appeal of the denial
115.27 	if appropriate.  If found eligible for benefits from other
115.28 	sources, and a payment received from another source relates to
115.29 	the period during which general assistance was also being
115.30 	received, the recipient shall be required to reimburse the
115.31 	county agency for the interim assistance paid.  Reimbursement
115.32 	shall not exceed the amount of general assistance paid during
115.33 	the time period to which the other maintenance benefits apply
115.34 	and shall not exceed the state standard applicable to that time
115.35 	period.
115.36 	(c) The commissioner shall adopt rules authorizing county
116.1 	agencies or other client representatives to retain from the
116.2 	amount recovered under an interim assistance agreement 25
116.3 	percent plus actual reasonable fees, costs, and disbursements of
116.4 	appeals and litigation, of providing special assistance to the
116.5 	recipient in processing the recipient's claim for maintenance
116.6 	benefits from another source.  The may contract with the county
116.7 	agencies, qualified agencies, organizations, or persons to
116.8 	provide advocacy and support services to process claims for
116.9 	federal disability benefits for applicants or recipients of
116.10 	services or benefits supervised by the commissioner using money
116.11 	retained under this section shall be from the state share of the
116.12 	recovery.  The commissioner or the county agency may contract
116.13 	with qualified persons to provide the special assistance.
116.14 	(d) The rules adopted by the commissioner shall include the 
116.15 	may provide methods by which county agencies shall identify,
116.16 	refer, and assist recipients who may be eligible for benefits
116.17 	under federal programs for the disabled. This subdivision does
116.18 	not require repayment of per diem payments made to shelters for
116.19 	battered women pursuant to section 256D.05, subdivision 3.
116.20 	(e) The total amount of interim assistance recoveries
116.21 	retained under this section for advocacy, support, and claim
116.22 	processing services shall not exceed 35 percent of the interim
116.23 	assistance recoveries in the prior fiscal year.

116.24 	Sec. 12. Minnesota Statutes 2004, section 256D.06,
116.25 	subdivision 7, is amended to read:
116.26 		Subd. 7.Ssi conversions and back claims.  (a)  [SSI
116.27 	CONVERSIONS.] The commissioner of human services shall contract
116.28 	with agencies or organizations capable of ensuring that clients
116.29 	who are presently receiving assistance under sections 256D.01 to
116.30 	256D.21, and who may be eligible for benefits under the federal
116.31 	Supplemental Security Income program, apply and, when eligible,
116.32 	are converted to the federal income assistance program and made
116.33 	eligible for health care benefits under the medical assistance
116.34 	program.  The commissioner shall ensure that money owing to the
116.35 	state under interim assistance agreements is collected.
116.36 	(b)  [BACK CLAIMS FOR FEDERAL HEALTH CARE BENEFITS.] The
117.1 	commissioner shall also directly or through contract implement
117.2 	procedures for collecting federal Medicare and medical
117.3 	assistance funds for which clients converted to SSI are
117.4 	retroactively eligible.
117.5 	(c)  [ADDITIONAL REQUIREMENTS.] The commissioner shall
117.6 	begin contracting contract with agencies to ensure
117.7 	implementation of this section within 14 days after April 29,
117.8 	1992.  County contracts with providers for residential services
117.9 	shall include the requirement that providers screen residents
117.10 	who may be eligible for federal benefits and provide that
117.11 	information to the local agency.  The commissioner shall modify
117.12 	the MAXIS computer system to provide information on clients who
117.13 	have been on general assistance for two years or longer.  The
117.14 	list of clients shall be provided to local services for
117.15 	screening under this section.
117.16 	(d)  [REPORT.] The commissioner shall report to the
117.17 	legislature by January 15, 1993, on the implementation of this
117.18 	section.  The report shall contain information on the following:
117.19 	(1) the number of clients converted from general assistance
117.20 	to SSI, by county;
117.21 	(2) information on the organizations involved;
117.22 	(3) the amount of money collected through interim
117.23 	assistance agreements;
117.24 	(4) the amount of money collected in federal Medicare or
117.25 	Medicaid funds;
117.26 	(5) problems encountered in processing conversions and back
117.27 	claims; and 
117.28 	(6) recommended changes to enhance recoveries and maximize
117.29 	the receipt of federal money in the most efficient way possible.

117.30 	Sec. 13. Minnesota Statutes 2004, section 256I.05,
117.31 	subdivision 1e, is amended to read:
117.32 		Subd. 1e.Supplementary rate for certain facilities.
 117.33 	Notwithstanding the provisions of subdivisions 1a and 1c,
117.34 	beginning July 1, 2001 2005, a county agency shall negotiate a
117.35 	supplementary rate in addition to the rate specified in
117.36 	subdivision 1, equal to 46 percent of the amount specified in
118.1 	subdivision 1a not to exceed $700 per month, including any
118.2 	legislatively authorized inflationary adjustments, for a group
118.3 	residential housing provider that:
118.4 	(1) is located in Hennepin County and has had a group
118.5 	residential housing contract with the county since June 1996;
118.6 	(2) operates in three separate locations a 71-bed 75-bed 
118.7 	facility, a 50-bed facility,and two 40-bed facilities a 26-bed
118.8 	facility; and
118.9 	(3) serves a chemically dependent clientele, providing 24
118.10 	hours per day supervision and limiting a resident's maximum
118.11 	length of stay to 13 months out of a consecutive 24-month period.

118.12 	Sec. 14. Minnesota Statutes 2004, section 256J.37,
118.13 	subdivision 3b, is amended to read:
118.14 		Subd. 3b.Treatment of supplemental security income.
 118.15 	Effective July 1, 2003,The county shall reduce the cash portion
118.16 	of the MFIP grant by up to $125 per for an MFIP assistance unit
118.17 	that includes one or more SSI recipient recipients who
118.18 	resides reside in the household, and who would otherwise be
118.19 	included in the MFIP assistance unit under section 256J.24,
118.20 	subdivision 2, but is are excluded solely due to the SSI
118.21 	recipient status under section 256J.24, subdivision 3, paragraph
118.22 	(a), clause (1).  If the SSI recipient receives or recipients
118.23 	receive less than $125 of SSI, only the amount received shall be
118.24 	used in calculating the MFIP cash assistance payment.  This
118.25 	provision does not apply to relative caregivers who could elect
118.26 	to be included in the MFIP assistance unit under section
118.27 	256J.24, subdivision 4, unless the caregiver's children or
118.28 	stepchildren are included in the MFIP assistance unit.
118.29 	
EFFECTIVE DATE. This section is effective the first day
118.30 	of the second month after the date of approval by the United
118.31 	States Department of Agriculture.

118.32 	Sec. 15. Minnesota Statutes 2004, section 256J.515, is
118.33 	amended to read:
118.34 	256J.515 OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.
118.35 	During the first meeting with participants, job counselors
118.36 	must ensure that an overview of employment and training services
119.1 	is provided that:
119.2 	(1) stresses the necessity and opportunity of immediate
119.3 	employment;
119.4 	(2) outlines the job search resources offered;
119.5 	(3) outlines education or training opportunities available;
119.6 	(4) describes the range of work activities, including
119.7 	activities under section 256J.49, subdivision 13, clause (18),
119.8 	that are allowable under MFIP to meet the individual needs of
119.9 	participants;
119.10 	(5) explains the requirements to comply with an employment
119.11 	plan;
119.12 	(6) explains the consequences for failing to comply;
119.13 	(7) explains the services that are available to support job
119.14 	search and work and education; and 
119.15 	(8) provides referral information about shelters and
119.16 	programs for victims of family violence and the time limit
119.17 	exemption for family violence victims; and 
119.18 	(9) explains the probationary employment periods new
119.19 	employees may serve after being hired and any assistance with
119.20 	job retention services that may be available.
119.21 	Failure to attend the overview of employment and training
119.22 	services without good cause results in the imposition of a
119.23 	sanction under section 256J.46.
119.24 	An applicant who requests and qualifies for a family
119.25 	violence waiver is exempt from attending a group overview.
119.26 	Information usually presented in an overview must be covered
119.27 	during the development of an employment plan under section
119.28 	256J.521, subdivision 3.

119.29 	Sec. 16. [256K.26] LONG-TERM HOMELESS SUPPORTIVE
119.30 	SERVICES.
119.31 		Subdivision 1.Establishment and purpose. The
119.32 	commissioner shall establish the long-term homeless supportive
119.33 	services fund to provide integrated services needed to stabilize
119.34 	individuals, families, and youth living in supportive housing
119.35 	developed to further the goals set forth in Laws 2003, chapter
119.36 	128, article 15, section 9.
120.1 		Subd. 2.Implementation. The commissioner, in
120.2 	consultation with the commissioners of the Department of
120.3 	Corrections and the Minnesota Housing Finance Agency, counties,
120.4 	providers and funders of supportive housing and services, shall
120.5 	develop application requirements and make funds available
120.6 	according to this section, with the goal of providing maximum
120.7 	flexibility in program design.
120.8 		Subd. 3.Definitions. For purposes of this section, the
120.9 	following terms have the meanings given:
120.10 	(1) "long-term homelessness" means lacking a permanent
120.11 	place to live continuously for one year or more or at least four
120.12 	times in the past three years; and 
120.13 	(2) "household" means an individual, family, or
120.14 	unaccompanied minor experiencing long-term homelessness.
120.15 		Subd. 4.County eligibility. Counties are eligible for
120.16 	funding under this section.  Priority will be given to proposals
120.17 	submitted on behalf of multicounty partnerships.
120.18 		Subd. 5.Content of proposals. Proposals will be
120.19 	evaluated on the extent to which they:
120.20 	(1) include partnerships with providers of services or
120.21 	other partners;
120.22 	(2) develop strategies to enhance housing stability for
120.23 	people experiencing long-term homelessness by integrating
120.24 	services and establishing consistent services and procedures
120.25 	across jurisdictions as appropriate;
120.26 	(3) evidence a commitment to working with the commissioners
120.27 	of human services, corrections, and the Housing Finance Agency
120.28 	to identify appropriate households to be served under this
120.29 	section and serve households as defined in subdivision 3.  The
120.30 	commissioner may also set criteria for serving people at
120.31 	significant risk of experiencing long-term homelessness, with a
120.32 	priority on serving families with minor children;
120.33 	(4) ensure that projects make maximum use of mainstream
120.34 	resources, including employment, social, and health services,
120.35 	and leverage additional public and private resources in order to
120.36 	serve the maximum number of households;
121.1 	(5) demonstrate cost-effectiveness by identifying and
121.2 	prioritizing those services most necessary for housing
121.3 	stability; and 
121.4 	(6) evaluate and report on outcomes of the projects
121.5 	according to protocols developed by the commissioner of human
121.6 	services in cooperation with the commissioners of corrections
121.7 	and the Housing Finance Agency.  Evaluation would include
121.8 	methods for determining the quality of the integrated service
121.9 	approach, improvement in outcomes, cost savings, or reduction in
121.10 	service disparities that may result.
121.11 		Subd. 6.Outcomes. Projects will be selected to further
121.12 	the following outcomes:
121.13 	(1) reduce the number of Minnesota individuals and families
121.14 	that experience long-term homelessness;
121.15 	(2) increase the number of housing opportunities with
121.16 	supportive services;
121.17 	(3) develop integrated, cost-effective service models that
121.18 	address the multiple barriers to obtaining housing stability
121.19 	faced by people experiencing long-term homelessness, including
121.20 	abuse, neglect, chemical dependency, disability, chronic health
121.21 	problems, or other factors including ethnicity and race that may
121.22 	result in poor outcomes or service disparities;
121.23 	(4) encourage partnerships among counties, community
121.24 	agencies, schools, and other providers so that the service
121.25 	delivery system is seamless for people experiencing long-term
121.26 	homelessness;
121.27 	(5) increase employability, self-sufficiency, and other
121.28 	social outcomes for individuals and families experiencing
121.29 	long-term homelessness; and 
121.30 	(6) reduce inappropriate use of emergency health care,
121.31 	shelter, chemical dependency, foster care, child protection,
121.32 	corrections, and similar services used by people experiencing
121.33 	long-term homelessness.
121.34 		Subd. 7.Eligible services. Services eligible for
121.35 	funding under this section are all services needed to maintain
121.36 	households in permanent supportive housing, as determined by the
122.1 	county or counties administering the project or projects.
122.2 		Subd. 8.Families experiencing long-term
122.3 	homelessness. The commissioner, in consultation with the
122.4 	commissioners of housing finance and corrections, shall assess
122.5 	whether the definition of long-term homelessness impacts the
122.6 	ability of families with minor children experiencing
122.7 	homelessness to obtain services necessary to support housing
122.8 	stability.
122.9 	
EFFECTIVE DATE. This section is effective retroactively
122.10 	from July 1, 2005.

122.11 	Sec. 17. Minnesota Statutes 2004, section 260.835, is
122.12 	amended to read:
122.13 	260.835 AMERICAN INDIAN CHILD WELFARE ADVISORY COUNCIL.
122.14 		Subdivision 1.Creation. The commissioner shall appoint
122.15 	an American Indian Advisory Council to help formulate policies
122.16 	and procedures relating to Indian child welfare services and to
122.17 	make recommendations regarding approval of grants provided under
122.18 	section 260.785, subdivisions 1, 2, and 3.  The council shall
122.19 	consist of 17 members appointed by the commissioner and must
122.20 	include representatives of each of the 11 Minnesota reservations
122.21 	who are authorized by tribal resolution, one representative from
122.22 	the Duluth Urban Indian Community, three representatives from
122.23 	the Minneapolis Urban Indian Community, and two representatives
122.24 	from the St. Paul Urban Indian Community.  Representatives from
122.25 	the urban Indian communities must be selected through an open
122.26 	appointments process under section 15.0597.  The terms,
122.27 	compensation, and removal of American Indian Child Welfare
122.28 	Advisory Council members shall be as provided in section 15.059.
122.29 		Subd. 2.Expiration. Notwithstanding section 15.059,
122.30 	subdivision 5, the American Indian Child Welfare Advisory
122.31 	Council expires June 30, 2008.
122.32 	
EFFECTIVE DATE. This section is effective retroactively
122.33 	from June 30, 2003.

122.34 	Sec. 18. RECOMMENDATIONS ON STANDARD STATEWIDE CHILD CARE
122.35 	LICENSE FEE; REPORT.
 122.36 	The commissioner of human services in conjunction with the
123.1 	Minnesota Association of County Social Service Administrators
123.2 	and the Minnesota Licensed Family Child Care Association, shall
123.3 	examine the feasibility of a statewide standard for setting
123.4 	license fees and background study fees for licensed family child
123.5 	care providers, and shall make recommendations on the
123.6 	feasibility of a statewide standard for setting license fees and
123.7 	background study fees in a report to the chairs of the senate
123.8 	and house of representatives committees having jurisdiction over
123.9 	child care issues.  The report is due January 15, 2006.

123.10 	Sec. 19. PARENT FEE SCHEDULE.
 123.11 	(a) Notwithstanding Minnesota Rules, part 3400.0100,
123.12 	subpart 4, the parent fee schedule is as follows:
123.13 	Income Range (as a Co-payment (as a
123.14 	percent of the federal percentage of adjusted
123.15 	poverty guidelines) gross income) 
123.16 	0-74.99% $0/month
123.17 	75.00-99.99% $5/month
123.18 	100.00-104.99% 3.23%
123.19 	105.00-109.99% 3.23%
123.20 	110.00-114.99% 3.23%
123.21 	115.00-119.99% 3.23%
123.22 	120.00-124.99% 3.60%
123.23 	125.00-129.99% 3.60%
123.24 	130.00-134.99% 3.60%
123.25 	135.00-139.99% 3.60%
123.26 	140.00-144.99% 3.97%
123.27 	145.00-149.99% 3.97%
123.28 	150.00-154.99% 3.97%
123.29 	155.00-159.99% 4.75%
123.30 	160.00-164.99% 4.75%
123.31 	165.00-169.99% 5.51%
123.32 	170.00-174.99% 5.88%
123.33 	175.00-179.99% 6.25%
123.34 	180.00-184.99% 6.98%
123.35 	185.00-189.99% 7.35%
123.36 	190.00-194.99% 7.72%
123.37 	195.00-199.99% 8.45%
124.1 	200.00-204.99% 9.92%
124.2 	205.00-209.99% 12.22%
124.3 	210.00-214.99% 12.65%
124.4 	215.00-219.99% 13.09%
124.5 	220.00-224.99% 13.52%
124.6 	225.00-229.99% 14.35%
124.7 	230.00-234.99% 15.71%
124.8 	235.00-239.99% 16.28%
124.9 	240.00-244.99% 17.37%
124.10 	245.00-249.99% 18.00%
124.11 	          250% ineligible 
124.12 	(b) This schedule is effective January 1, 2006, and shall
124.13 	be implemented at or before the participant's next eligibility
124.14 	redetermination.  The parent fee schedule in Laws 2003, First
124.15 	Special Session chapter 14, article 9, section 36, shall remain
124.16 	in effect until the schedule in this section is fully
124.17 	implemented.
124.18 	(c) A family's monthly co-payment fee is the fixed
124.19 	percentage established for the income range multiplied by the
124.20 	highest possible income within that income range.

124.21 	Sec. 20. REPEALER.
 124.22 	(a) Laws 2003, First Special Session chapter 14, article 9,
124.23 	section 34, is repealed.
124.24 	(b) Minnesota Statutes 2004, sections 119B.074, 256D.54,
124.25 	subdivision 3, and 256M.40, subdivision 2, are repealed.

124.26 	Sec. 21. EFFECTIVE DATE.
 124.27 	The sections in this article are effective August 1, 2005,
124.28 	unless otherwise specified.

124.29 	ARTICLE 4
124.30 	HEALTH IMPACT FEE

124.31 	Section 1. [16A.725] HEALTH IMPACT FUND AND FUND
124.32 	REIMBURSEMENTS.
124.33 		Subdivision 1.Health impact fund. There is created in
124.34 	the state treasury a health impact fund to which must be
124.35 	credited all revenue from the health impact fee under section
124.36 	256.9658 and any floor stocks fee enacted into law.
125.1 		Subd. 2.Certified tobacco expenditures. By April 30 of
125.2 	each year, the commissioner of human services shall certify to
125.3 	the commissioner of finance the state share, by fund, of tobacco
125.4 	use attributable costs for the previous fiscal year in Minnesota
125.5 	health care programs, including medical assistance, general
125.6 	assistance medical care, and MinnesotaCare, or other applicable
125.7 	expenditures.
125.8 		Subd. 3.Fund reimbursements. (a) Each fiscal year, the
125.9 	commissioner of finance shall first transfer from the health
125.10 	impact fund to the general fund an amount sufficient to offset
125.11 	the general fund cost of the certified expenditures under
125.12 	subdivision 2 or the balance of the fund, whichever is less.
125.13 	(b) If any balance remains in the health impact fund after
125.14 	the transfer in paragraph (a), the commissioner of finance shall
125.15 	transfer to the health care access fund the amount sufficient to
125.16 	offset the health care access fund cost of the certified
125.17 	expenditures in subdivision 2, or the balance of the fund,
125.18 	whichever is less.
125.19 	
EFFECTIVE DATE. This section is effective August 1, 2005.

125.20 	Sec. 2. [256.9658] TOBACCO HEALTH IMPACT FEE.
125.21 		Subdivision 1.Purpose. A tobacco use health impact fee
125.22 	is imposed on and collected from cigarette distributors and
125.23 	tobacco products distributors to recover for the state health
125.24 	costs related to or caused by tobacco use and to reduce tobacco
125.25 	use, particularly by youths.
125.26 		Subd. 2.Definitions. The definitions under section
125.27 	297F.01 apply to this section.
125.28 		Subd. 3.Fee imposed. (a) A fee is imposed upon the sale
125.29 	of cigarettes in this state, upon having cigarettes in
125.30 	possession in this state with intent to sell, upon any person
125.31 	engaged in business as a distributor, and upon the use or
125.32 	storage by consumers of cigarettes.  The fee is imposed at the
125.33 	following rates:
125.34 	(1) on cigarettes weighing not more than three pounds per
125.35 	thousand, 37.5 mills on each cigarette; and 
125.36 	(2) on cigarettes weighing more than three pounds per
126.1 	thousand, 75 mills on each cigarette.
126.2 	(b) A fee is imposed upon all tobacco products in this
126.3 	state and upon any person engaged in business as a distributor
126.4 	in an amount equal to the liability for tax under section
126.5 	297F.05, subdivision 3, or on a consumer of tobacco products
126.6 	equal to the tax under section 297F.05, subdivision 4.
126.7 	Liability for the fee is in addition to the tax under section
126.8 	297F.05, subdivision 3 or 4.
126.9 		Subd. 4.Payment. A distributor must pay the fee at the
126.10 	same time and in the same manner as provided for payment of tax
126.11 	under chapter 297F.
126.12 		Subd. 5.Fee on use of unstamped cigarettes. Any person,
126.13 	other than a distributor, that purchases or possesses cigarettes
126.14 	that have not been stamped and on which the fee imposed under
126.15 	this section has not been paid is liable for the fee under this
126.16 	section on the possession or use of those cigarettes.
126.17 		Subd. 6.Administration. The audit, assessment,
126.18 	interest, appeal, refund, penalty, enforcement, administrative,
126.19 	and collection provisions of chapters 270C and 297F apply to the
126.20 	fee imposed under this section.
126.21 		Subd. 7.Cigarette stamp. (a) The stamp in section
126.22 	297F.08 must be affixed to each package and is prima facie
126.23 	evidence that the fee imposed by this section has been paid.
126.24 	(b) Notwithstanding any other provisions of this section,
126.25 	the fee due on the return is based upon actual stamps purchased
126.26 	during the reporting period.
126.27 		Subd. 8.License revocation. The commissioner of revenue
126.28 	may revoke or suspend the license of a distributor for failure
126.29 	to pay the fee or otherwise comply with the requirements under
126.30 	this section.  The provisions and procedures under section
126.31 	297F.04 apply to a suspension or revocation under this
126.32 	subdivision.
126.33 		Subd. 9.Deposit of revenues. The commissioner of
126.34 	revenue shall deposit the revenues from the fee under this
126.35 	section in the state treasury and credit them to the health
126.36 	impact fund.
127.1 	
EFFECTIVE DATE. This section is effective August 1, 2005.

127.2 	Sec. 3. Minnesota Statutes 2004, section 297F.185, is
127.3 	amended to read:
127.4 	297F.185 REVOCATION OF SALES AND USE TAX PERMITS.
127.5 	(a) If a retailer purchases for resale from an unlicensed
127.6 	seller more than 20,000 cigarettes or $500 or more worth of
127.7 	tobacco products, the commissioner may revoke the person's sales
127.8 	and use tax permit as provided in section 297A.86.
127.9 	(b) The commissioner may revoke a retailer's sales or use
127.10 	permit as provided in section 297A.86 if the retailer, directly
127.11 	or indirectly, purchases for resale cigarettes without the
127.12 	proper stamp affixed.

127.13 	EFFECTIVE DATE. This section is effective for violations
127.14 	occurring on or after August 1, 2005.

127.15 	Sec. 4. Minnesota Statutes 2004, section 325D.32,
127.16 	subdivision 9, is amended to read:
127.17 		Subd. 9.Basic cost of cigarettes.  "Basic cost of
127.18 	cigarettes" means the gross invoice cost of cigarettes to the
127.19 	wholesaler or retailer plus the full face value of any stamps
127.20 	which may be required by any cigarette tax or fee act of this
127.21 	state, unless included by the manufacturer in the list price.
127.22 	
EFFECTIVE DATE. This section is effective August 1, 2005.

127.23 	Sec. 5. FLOOR STOCKS FEE.
 127.24 		Subdivision 1.Cigarettes. A floor stocks cigarette fee
127.25 	is imposed on every person engaged in the business in this state
127.26 	as a distributor, retailer, subjobber, vendor, manufacturer, or
127.27 	manufacturer's representative of cigarettes, on the stamped
127.28 	cigarettes and unaffixed stamps in the person's possession or
127.29 	under the person's control at 12:01 a.m. on August 1, 2005.  The
127.30 	fee is imposed at the following rates:
127.31 	(1) on cigarettes weighing not more than three pounds per
127.32 	thousand, 37.5 mills on each cigarette; and 
127.33 	(2) on cigarettes weighing more than three pounds per
127.34 	thousand, 75 mills on each cigarette.
127.35 	Each distributor, on or before August 10, 2005, shall file
127.36 	a return with the commissioner of revenue, in the form the
128.1 	commissioner prescribes, showing the stamped cigarettes and
128.2 	unaffixed stamps on hand at 12:01 a.m. on August 1, 2005, and
128.3 	the amount of fee due on the cigarettes and unaffixed stamps.
128.4 	Each retailer, subjobber, vendor, manufacturer, or
128.5 	manufacturer's representative, on or before August 10, 2005,
128.6 	shall file a return with the commissioner of revenue, in the
128.7 	form the commissioner prescribes, showing the cigarettes on hand
128.8 	at 12:01 a.m. on August 1, 2005, and the amount of fee due on
128.9 	the cigarettes.  The fee imposed by this section is due and
128.10 	payable on or before September 7, 2005, and after that date
128.11 	bears interest at the rate of one percent per month.
128.12 		Subd. 2.Audit and enforcement. The fee imposed by this
128.13 	section is subject to the audit, assessment, interest, appeal,
128.14 	refund, penalty, enforcement, administrative, and collection
128.15 	provisions of Minnesota Statutes, chapters 270C and 297F.  The
128.16 	commissioner of revenue may require a distributor to receive and
128.17 	maintain copies of floor stocks fee returns filed by all persons
128.18 	requesting a credit for returned cigarettes.
128.19 		Subd. 3.Deposit of proceeds. The commissioner of
128.20 	revenue shall deposit the revenues from the fee under this
128.21 	section in the state treasury and credit them to the health
128.22 	impact fund.
128.23 	
EFFECTIVE DATE. This section is effective August 1, 2005.

128.24 	Sec. 6. TOBACCO PRODUCTS FLOOR STOCKS FEE.
 128.25 	A floor stocks fee is imposed upon every person engaged in
128.26 	business in this state as a distributor of tobacco products, at
128.27 	the rate of 35 percent of the wholesale sales price of each
128.28 	tobacco product in the distributor's possession or under the
128.29 	distributor's control at 12:01 a.m. on August 1, 2005.  Each
128.30 	distributor, by August 10, 2005, shall file a return with the
128.31 	commissioner, in the form the commissioner prescribes, showing
128.32 	the tobacco products on hand at 12:01 a.m. on August 1, 2005,
128.33 	and the amount of fees due on them.  The fee imposed by this
128.34 	section is due and payable by September 7, 2005, and after that
128.35 	bears interest at the rate of one percent a month.

128.36 	EFFECTIVE DATE. This section is effective August 1, 2005.

129.1 	ARTICLE 5
129.2 	MISCELLANEOUS

129.3 	Section 1. Minnesota Statutes 2004, section 148D.220,
129.4 	subdivision 8, as added by Laws 2005, chapter 147, article 1,
129.5 	section 49, is amended to read:
129.6 		Subd. 8.Sexual conduct with a former client. (a) A
129.7 	social worker who has engaged in diagnosing, counseling, or
129.8 	treating a client with mental, emotional, or behavioral
129.9 	disorders must not engage in or suggest sexual conduct with the
129.10 	former client under any circumstances for a period of two years
129.11 	following the termination of the professional relationship.
129.12 	After two years following the termination of the professional
129.13 	relationship, a social worker who has engaged in diagnosing,
129.14 	counseling, or treating a client with mental, emotional, or
129.15 	behavioral disorder must not engage in or suggest sexual conduct
129.16 	with the former client under any circumstances unless:
129.17 	(1) the social worker did not intentionally or
129.18 	unintentionally coerce, exploit, deceive, or manipulate the
129.19 	former client at any time;
129.20 	(2) the social worker did not represent to the former
129.21 	client that sexual conduct with the social worker is consistent
129.22 	with or part of the client's treatment;
129.23 	(3) the social worker's sexual conduct was not detrimental
129.24 	to the former client at any time;
129.25 	(4) the former client is not emotionally dependent on the
129.26 	social worker and does not continue to relate to the social
129.27 	worker as a client; and
129.28 	(5) the social worker is not emotionally dependent on the
129.29 	client and does not continue to relate to the former client as a
129.30 	social worker.
129.31 	(b) If there is an alleged violation of paragraph (a), the
129.32 	social worker assumes the full burden of demonstrating to the
129.33 	board that the social worker did not intentionally or
129.34 	unintentionally coerce, exploit, deceive, or manipulate the
129.35 	client, and the social worker's sexual conduct was not
129.36 	detrimental to the client at any time.  Upon request, a social
130.1 	worker must provide information to the board addressing:
130.2 	(1) the amount of time that has passed since termination of
130.3 	services;
130.4 	(2) the duration, intensity, and nature of services;
130.5 	(3) the circumstances of termination of services;
130.6 	(4) the former client's emotional, mental, and behavioral
130.7 	history;
130.8 	(5) the former client's current emotional, mental, and
130.9 	behavioral status;
130.10 	(6) the likelihood of adverse impact on the former client;
130.11 	and
130.12 	(7) the existence of actions, conduct, or statements made
130.13 	by the social worker during the course of services suggesting or
130.14 	inviting the possibility of a sexual relationship with the
130.15 	client following termination of services.
130.16 	(c) A social worker who has provided social work services
130.17 	other than those described in paragraph (a) to a client must not
130.18 	engage in or suggest sexual conduct with the former client if a
130.19 	reasonable and prudent social worker would conclude after
130.20 	appropriate assessment that engaging in such behavior with the
130.21 	former client would create an unacceptable risk of harm to the
130.22 	former client.

130.23 	Sec. 2. [151.55] CANCER DRUG REPOSITORY PROGRAM.
130.24 		Subdivision 1.Definitions. (a) For the purposes of this
130.25 	section, the terms defined in this subdivision have the meanings
130.26 	given.
130.27 	(b) "Board" means the Board of Pharmacy.
130.28 	(c) "Cancer drug" means a prescription drug that is used to
130.29 	treat:
130.30 	(1) cancer or the side effects of cancer; or 
130.31 	(2) the side effects of any prescription drug that is used
130.32 	to treat cancer or the side effects of cancer.
130.33 	(d) "Cancer drug repository" means a medical facility or
130.34 	pharmacy that has notified the board of its election to
130.35 	participate in the cancer drug repository program.
130.36 	(e) "Cancer supply" or "supplies" means prescription and
131.1 	nonprescription cancer supplies needed to administer a cancer
131.2 	drug.
131.3 	(f) "Dispense" has the meaning given in section 151.01,
131.4 	subdivision 30.
131.5 	(g) "Distribute" means to deliver, other than by
131.6 	administering or dispensing.
131.7 	(h) "Donor" means an individual and not a drug manufacturer
131.8 	or wholesale drug distributor who donates a cancer drug or
131.9 	supply according to the requirements of the cancer drug
131.10 	repository program.
131.11 	(i) "Medical facility" means an institution defined in
131.12 	section 144.50, subdivision 2.
131.13 	(j) "Medical supplies" means any prescription and
131.14 	nonprescription medical supply needed to administer a cancer
131.15 	drug.
131.16 	(k) "Pharmacist" has the meaning given in section 151.01,
131.17 	subdivision 3.
131.18 	(l) "Pharmacy" means any pharmacy registered with the Board
131.19 	of Pharmacy according to section 151.19, subdivision 1.
131.20 	(m) "Practitioner" has the meaning given in section 151.01,
131.21 	subdivision 23.
131.22 	(n) "Prescription drug" means a legend drug as defined in
131.23 	section 151.01, subdivision 17.
131.24 	(o) "Side effects of cancer" means symptoms of cancer.
131.25 	(p) "Single-unit-dose packaging" means a single-unit
131.26 	container for articles intended for administration as a single
131.27 	dose, direct from the container.
131.28 	(q) "Tamper-evident unit dose packaging" means a container
131.29 	within which a drug is sealed so that the contents cannot be
131.30 	opened without obvious destruction of the seal.
131.31 		Subd. 2.Establishment. The Board of Pharmacy shall
131.32 	establish and maintain a cancer drug repository program, under
131.33 	which any person may donate a cancer drug or supply for use by
131.34 	an individual who meets the eligibility criteria specified under
131.35 	subdivision 4.  Under the program, donations may be made on the
131.36 	premises of a medical facility or pharmacy that elects to
132.1 	participate in the program and meets the requirements specified
132.2 	under subdivision 3.
132.3 		Subd. 3.Requirements for participation by pharmacies and
132.4 	medical facilities. (a) To be eligible for participation in the
132.5 	cancer drug repository program, a pharmacy or medical facility
132.6 	must be licensed and in compliance with all applicable federal
132.7 	and state laws and administrative rules.
132.8 	(b) Participation in the cancer drug repository program is
132.9 	voluntary.  A pharmacy or medical facility may elect to
132.10 	participate in the cancer drug repository program by submitting
132.11 	the following information to the board, in a form provided by
132.12 	the board:
132.13 	(1) the name, street address, and telephone number of the
132.14 	pharmacy or medical facility;
132.15 	(2) the name and telephone number of a pharmacist who is
132.16 	employed by or under contract with the pharmacy or medical
132.17 	facility, or other contact person who is familiar with the
132.18 	pharmacy's or medical facility's participation in the cancer
132.19 	drug repository program; and 
132.20 	(3) a statement indicating that the pharmacy or medical
132.21 	facility meets the eligibility requirements under paragraph (a)
132.22 	and the chosen level of participation under paragraph (c).
132.23 	(c) A pharmacy or medical facility may fully participate in
132.24 	the cancer drug repository program by accepting, storing, and
132.25 	dispensing or administering donated drugs and supplies, or may
132.26 	limit its participation to only accepting and storing donated
132.27 	drugs and supplies.  If a pharmacy or facility chooses to limit
132.28 	its participation, the pharmacy or facility shall distribute any
132.29 	donated drugs to a fully participating cancer drug repository
132.30 	according to subdivision 8.
132.31 	(d) A pharmacy or medical facility may withdraw from
132.32 	participation in the cancer drug repository program at any time
132.33 	upon notification to the board.  A notice to withdraw from
132.34 	participation may be given by telephone or regular mail.
132.35 		Subd. 4.Individual eligibility requirements. Any
132.36 	Minnesota resident who is diagnosed with cancer is eligible to
133.1 	receive drugs or supplies under the cancer drug repository
133.2 	program.  Drugs and supplies shall be dispensed or administered
133.3 	according to the priority given under subdivision 6, paragraph
133.4 	(d).
133.5 		Subd. 5.Donations of cancer drugs and supplies. (a) Any
133.6 	one of the following persons may donate legally obtained cancer
133.7 	drugs or supplies to a cancer drug repository, if the drugs or
133.8 	supplies meet the requirements under paragraph (b) or (c) as
133.9 	determined by a pharmacist who is employed by or under contract
133.10 	with a cancer drug repository:
133.11 	(1) an individual who is 18 years old or older; or 
133.12 	(2) a pharmacy, medical facility, drug manufacturer, or
133.13 	wholesale drug distributor, if the donated drugs have not been
133.14 	previously dispensed.
133.15 	(b) A cancer drug is eligible for donation under the cancer
133.16 	drug repository program only if the following requirements are
133.17 	met:
133.18 	(1) the donation is accompanied by a cancer drug repository
133.19 	donor form described under paragraph (d) that is signed by the
133.20 	person making the donation or that person's authorized
133.21 	representative;
133.22 	(2) the drug's expiration date is at least six months later
133.23 	than the date that the drug was donated;
133.24 	(3) the drug is in its original, unopened, tamper-evident
133.25 	unit dose packaging that includes the drug's lot number and
133.26 	expiration date.  Single-unit dose drugs may be accepted if the
133.27 	single-unit-dose packaging is unopened; and 
133.28 	(4) the drug is not adulterated or misbranded.
133.29 	(c) Cancer supplies are eligible for donation under the
133.30 	cancer drug repository program only if the following
133.31 	requirements are met:
133.32 	(1) the supplies are not adulterated or misbranded;
133.33 	(2) the supplies are in their original, unopened, sealed
133.34 	packaging; and 
133.35 	(3) the donation is accompanied by a cancer drug repository
133.36 	donor form described under paragraph (d) that is signed by the
134.1 	person making the donation or that person's authorized
134.2 	representative.
134.3 	(d) The cancer drug repository donor form must be provided
134.4 	by the board and shall state that to the best of the donor's
134.5 	knowledge the donated drug or supply has been properly stored
134.6 	and that the drug or supply has never been opened, used,
134.7 	tampered with, adulterated, or misbranded.  The board shall make
134.8 	the cancer drug repository donor form available on the Board of
134.9 	Pharmacy's Web site.
134.10 	(e) Controlled substances and drugs and supplies that do
134.11 	not meet the criteria under this subdivision are not eligible
134.12 	for donation or acceptance under the cancer drug repository
134.13 	program.
134.14 	(f) Drugs and supplies may be donated on the premises of a
134.15 	cancer drug repository to a pharmacist designated by the
134.16 	repository.  A drop box may not be used to deliver or accept
134.17 	donations.
134.18 	(g) Cancer drugs and supplies donated under the cancer drug
134.19 	repository program must be stored in a secure storage area under
134.20 	environmental conditions appropriate for the drugs or supplies
134.21 	being stored.  Donated drugs and supplies may not be stored with
134.22 	nondonated inventory.
134.23 		Subd. 6.Dispensing requirements. (a) Drugs and supplies
134.24 	must be dispensed by a licensed pharmacist pursuant to a
134.25 	prescription by a practitioner or may be dispensed or
134.26 	administered by a practitioner according to the requirements of
134.27 	chapter 151 and within the practitioner's scope of practice.
134.28 	(b) Cancer drugs and supplies shall be visually inspected
134.29 	by the pharmacist or practitioner before being dispensed or
134.30 	administered for adulteration, misbranding, and date of
134.31 	expiration.  Drugs or supplies that have expired or appear upon
134.32 	visual inspection to be adulterated, misbranded, or tampered
134.33 	with in any way may not be dispensed or administered.
134.34 	(c) Before a cancer drug or supply may be dispensed or
134.35 	administered to an individual, the individual must sign a cancer
134.36 	drug repository recipient form provided by the board
135.1 	acknowledging that the individual understands the information
135.2 	stated on the form.  The form shall include the following
135.3 	information:
135.4 	(1) that the drug or supply being dispensed or administered
135.5 	has been donated and may have been previously dispensed;
135.6 	(2) that a visual inspection has been conducted by the
135.7 	pharmacist or practitioner to ensure that the drug has not
135.8 	expired, has not been adulterated or misbranded, and is in its
135.9 	original, unopened packaging; and 
135.10 	(3) that the dispensing pharmacist, the dispensing or
135.11 	administering practitioner, the cancer drug repository, the
135.12 	Board of Pharmacy, and any other participant of the cancer drug
135.13 	repository program cannot guarantee the safety of the drug or
135.14 	supply being dispensed or administered and that the pharmacist
135.15 	or practitioner has determined that the drug or supply is safe
135.16 	to dispense or administer based on the accuracy of the donor's
135.17 	form submitted with the donated drug or supply and the visual
135.18 	inspection required to be performed by the pharmacist or
135.19 	practitioner before dispensing or administering.
135.20 	The board shall make the cancer drug repository form available
135.21 	on the Board of Pharmacy's Web site.
135.22 	(d) Drugs and supplies shall only be dispensed or
135.23 	administered to individuals who meet the eligibility
135.24 	requirements in subdivision 4 and in the following order of
135.25 	priority:
135.26 	(1) individuals who are uninsured;
135.27 	(2) individuals who are enrolled in medical assistance,
135.28 	general assistance medical care, MinnesotaCare, Medicare, or
135.29 	other public assistance health care; and 
135.30 	(3) all other individuals who are otherwise eligible under
135.31 	subdivision 4 to receive drugs or supplies from a cancer drug
135.32 	repository.
135.33 		Subd. 7.Handling fees. A cancer drug repository may
135.34 	charge the individual receiving a drug or supply a handling fee
135.35 	of no more than 250 percent of the medical assistance program
135.36 	dispensing fee for each cancer drug or supply dispensed or
136.1 	administered.
136.2 		Subd. 8.Distribution of donated cancer drugs and
136.3 	supplies. (a) Cancer drug repositories may distribute drugs and
136.4 	supplies donated under the cancer drug repository program to
136.5 	other repositories if requested by a participating repository.
136.6 	(b) A cancer drug repository that has elected not to
136.7 	dispense donated drugs or supplies shall distribute any donated
136.8 	drugs and supplies to a participating repository upon request of
136.9 	the repository.
136.10 	(c) If a cancer drug repository distributes drugs or
136.11 	supplies under paragraph (a) or (b), the repository shall
136.12 	complete a cancer drug repository donor form provided by the
136.13 	board.  The completed form and a copy of the donor form that was
136.14 	completed by the original donor under subdivision 5 shall be
136.15 	provided to the fully participating cancer drug repository at
136.16 	the time of distribution.
136.17 		Subd. 9.Resale of donated drugs or supplies. Donated
136.18 	drugs and supplies may not be resold.
136.19 		Subd. 10.Record-keeping requirements. (a) Cancer drug
136.20 	repository donor and recipient forms shall be maintained for at
136.21 	least five years.
136.22 	(b) A record of destruction of donated drugs and supplies
136.23 	that are not dispensed under subdivision 6 shall be maintained
136.24 	by the dispensing repository for at least five years.  For each
136.25 	drug or supply destroyed, the record shall include the following
136.26 	information:
136.27 	(1) the date of destruction;
136.28 	(2) the name, strength, and quantity of the cancer drug
136.29 	destroyed;
136.30 	(3) the name of the person or firm that destroyed the drug;
136.31 	and 
136.32 	(4) the source of the drugs or supplies destroyed.
136.33 		Subd. 11.Liability. (a) The manufacturer of a drug or
136.34 	supply is not subject to criminal or civil liability for injury,
136.35 	death, or loss to a person or to property for causes of action
136.36 	described in clauses (1) and (2).  A manufacturer is not liable
137.1 	for:
137.2 	(1) the intentional or unintentional alteration of the drug
137.3 	or supply by a party not under the control of the manufacturer;
137.4 	or 
137.5 	(2) the failure of a party not under the control of the
137.6 	manufacturer to transfer or communicate product or consumer
137.7 	information or the expiration date of the donated drug or supply.
137.8 	(b) A medical facility or pharmacy participating in the
137.9 	program, a pharmacist dispensing a drug or supply pursuant to
137.10 	the program, a practitioner dispensing or administering a drug
137.11 	or supply pursuant to the program, or a donor of a cancer drug
137.12 	or supply as defined in subdivision 1 is immune from civil
137.13 	liability for an act or omission that causes injury to or the
137.14 	death of an individual to whom the cancer drug or supply is
137.15 	dispensed and no disciplinary action shall be taken against a
137.16 	pharmacist or practitioner so long as the drug or supply is
137.17 	donated, accepted, distributed, and dispensed according to the
137.18 	requirements of this section.  This immunity does not apply if
137.19 	the act or omission involves reckless, wanton, or intentional
137.20 	misconduct, or malpractice unrelated to the quality of the
137.21 	cancer drug or supply.
137.22 	
EFFECTIVE DATE. This section is effective August 1, 2005.

137.23 	Sec. 3. Minnesota Statutes 2004, section 241.01, is
137.24 	amended by adding a subdivision to read:
137.25 		Subd. 10.Purchasing for prescription drugs. In
137.26 	accordance with section 241.021, subdivision 4, the commissioner
137.27 	may contract with a separate entity to purchase prescription
137.28 	drugs for persons confined in institutions under the control of
137.29 	the commissioner.  Local governments may participate in this
137.30 	purchasing pool in order to purchase prescription drugs for
137.31 	those persons confined in local correctional facilities in which
137.32 	the local government has responsibility for providing health
137.33 	care.  If any county participates, the commissioner shall
137.34 	appoint a county representative to any committee convened by the
137.35 	commissioner for the purpose of establishing a drug formulary to
137.36 	be used for state and local correctional facilities.
138.1 	
EFFECTIVE DATE. This section is effective the day
138.2 	following final enactment.

138.3 	Sec. 4. Minnesota Statutes 2004, section 245.4661,
138.4 	subdivision 2, is amended to read:
138.5 		Subd. 2.Program design and implementation.  (a) The
138.6 	pilot projects shall be established to design, plan, and improve
138.7 	the mental health service delivery system for adults with
138.8 	serious and persistent mental illness that would:
138.9 	(1) provide an expanded array of services from which
138.10 	clients can choose services appropriate to their needs;
138.11 	(2) be based on purchasing strategies that improve access
138.12 	and coordinate services without cost shifting;
138.13 	(3) incorporate existing state facilities and resources
138.14 	into the community mental health infrastructure through creative
138.15 	partnerships with local vendors; and
138.16 	(4) utilize existing categorical funding streams and
138.17 	reimbursement sources in combined and creative ways, except
138.18 	appropriations to regional treatment centers and all funds that
138.19 	are attributable to the operation of state-operated services are
138.20 	excluded unless appropriated specifically by the legislature for
138.21 	a purpose consistent with this section or section 246.0136,
138.22 	subdivision 1.
138.23 	(b) All projects funded by January 1, 1997, must complete
138.24 	the planning phase and be operational by June 30, 1997; all
138.25 	projects funded by January 1, 1998, must be operational by June
138.26 	30, 1998.
138.27 	
EFFECTIVE DATE. This section is effective the day
138.28 	following final enactment.

138.29 	Sec. 5. Minnesota Statutes 2004, section 245.4661,
138.30 	subdivision 6, is amended to read:
138.31 		Subd. 6.Duties of commissioner.  (a) For purposes of the
138.32 	pilot projects, the commissioner shall facilitate integration of
138.33 	funds or other resources as needed and requested by each
138.34 	project.  These resources may include:
138.35 	(1) residential services funds administered under Minnesota
138.36 	Rules, parts 9535.2000 to 9535.3000, in an amount to be
139.1 	determined by mutual agreement between the project's managing
139.2 	entity and the commissioner of human services after an
139.3 	examination of the county's historical utilization of facilities
139.4 	located both within and outside of the county and licensed under
139.5 	Minnesota Rules, parts 9520.0500 to 9520.0690;
139.6 	(2) community support services funds administered under
139.7 	Minnesota Rules, parts 9535.1700 to 9535.1760;
139.8 	(3) other mental health special project funds;
139.9 	(4) medical assistance, general assistance medical care,
139.10 	MinnesotaCare and group residential housing if requested by the
139.11 	project's managing entity, and if the commissioner determines
139.12 	this would be consistent with the state's overall health care
139.13 	reform efforts; and
139.14 	(5) regional treatment center nonfiscal resources to the
139.15 	extent agreed to by the project's managing entity and the
139.16 	regional treatment center consistent with section 246.0136,
139.17 	subdivision 1.
139.18 	(b) The commissioner shall consider the following criteria
139.19 	in awarding start-up and implementation grants for the pilot
139.20 	projects:
139.21 	(1) the ability of the proposed projects to accomplish the
139.22 	objectives described in subdivision 2;
139.23 	(2) the size of the target population to be served; and
139.24 	(3) geographical distribution.
139.25 	(c) The commissioner shall review overall status of the
139.26 	projects initiatives at least every two years and recommend any
139.27 	legislative changes needed by January 15 of each odd-numbered
139.28 	year.
139.29 	(d) The commissioner may waive administrative rule
139.30 	requirements which are incompatible with the implementation of
139.31 	the pilot project.
139.32 	(e) The commissioner may exempt the participating counties
139.33 	from fiscal sanctions for noncompliance with requirements in
139.34 	laws and rules which are incompatible with the implementation of
139.35 	the pilot project.
139.36 	(f) The commissioner may award grants to an entity
140.1 	designated by a county board or group of county boards to pay
140.2 	for start-up and implementation costs of the pilot project.
140.3 	
EFFECTIVE DATE. This section is effective the day
140.4 	following final enactment.

140.5 	Sec. 6. Minnesota Statutes 2004, section 245A.10,
140.6 	subdivision 5, is amended to read:
140.7 		Subd. 5.Annual license or certification fee for programs
140.8 	without a licensed capacity.  (a) Except as provided
140.9 	in paragraph paragraphs (b) and (c), a program without a stated
140.10 	licensed capacity shall pay a license or certification fee of
140.11 	$400.
140.12 	(b) A mental health center or mental health clinic
140.13 	requesting certification for purposes of insurance and
140.14 	subscriber contract reimbursement under Minnesota Rules, parts
140.15 	9520.0750 to 9520.0870, shall pay a certification fee of $1,000
140.16 	per year.  If the mental health center or mental health clinic
140.17 	provides services at a primary location with satellite
140.18 	facilities, the satellite facilities shall be certified with the
140.19 	primary location without an additional charge.
140.20 	(c) A program licensed to provide residential-based
140.21 	habilitation services under the home and community-based waiver
140.22 	for persons with developmental disabilities shall pay an annual
140.23 	license fee that includes a base rate of $250 plus $38 times the
140.24 	number of clients served on the first day of August of the
140.25 	current license year.  State-operated programs are exempt from
140.26 	the license fee under this paragraph.
140.27 	
EFFECTIVE DATE. This section is effective August 1, 2005.

140.28 	Sec. 7. Minnesota Statutes 2004, section 245C.10,
140.29 	subdivision 2, is amended to read:
140.30 		Subd. 2.Supplemental nursing services agencies.  The
140.31 	commissioner shall recover the cost of the background studies
140.32 	initiated by supplemental nursing services agencies registered
140.33 	under section 144A.71, subdivision 1, through a fee of no more
140.34 	than $8 $20 per study charged to the agency.  The fees collected
140.35 	under this subdivision are appropriated to the commissioner for
140.36 	the purpose of conducting background studies.
141.1 	
EFFECTIVE DATE. This section is effective August 1, 2005.

141.2 	Sec. 8. Minnesota Statutes 2004, section 245C.10,
141.3 	subdivision 3, is amended to read:
141.4 		Subd. 3.Personal care provider organizations.  The
141.5 	commissioner shall recover the cost of background studies
141.6 	initiated by a personal care provider organization under section
141.7 	256B.0627 through a fee of no more than $12 $20 per study
141.8 	charged to the organization responsible for submitting the
141.9 	background study form.  The fees collected under this
141.10 	subdivision are appropriated to the commissioner for the purpose
141.11 	of conducting background studies.
141.12 	
EFFECTIVE DATE. This section is effective August 1, 2005.

141.13 	Sec. 9. Minnesota Statutes 2004, section 245C.32,
141.14 	subdivision 2, is amended to read:
141.15 		Subd. 2.Use.  (a) The commissioner may also use these
141.16 	systems and records to obtain and provide criminal history data
141.17 	from the Bureau of Criminal Apprehension, criminal history data
141.18 	held by the commissioner, and data about substantiated
141.19 	maltreatment under section 626.556 or 626.557, for other
141.20 	purposes, provided that:
141.21 	(1) the background study is specifically authorized in
141.22 	statute; or
141.23 	(2) the request is made with the informed consent of the
141.24 	subject of the study as provided in section 13.05, subdivision 4.
141.25 	(b) An individual making a request under paragraph (a),
141.26 	clause (2), must agree in writing not to disclose the data to
141.27 	any other individual without the consent of the subject of the
141.28 	data.
141.29 	(c) The commissioner may recover the cost of obtaining and
141.30 	providing background study data by charging the individual or
141.31 	entity requesting the study a fee of no more than $12 $20 per
141.32 	study.  The fees collected under this paragraph are appropriated
141.33 	to the commissioner for the purpose of conducting background
141.34 	studies.
141.35 	
EFFECTIVE DATE. This section is effective August 1, 2005.

141.36 	Sec. 10. Minnesota Statutes 2004, section 246.0136,
142.1 	subdivision 1, is amended to read:
142.2 		Subdivision 1.Planning for enterprise activities.  The
142.3 	commissioner of human services is directed to study and make
142.4 	recommendations to the legislature on establishing enterprise
142.5 	activities within state-operated services.  Before implementing
142.6 	an enterprise activity, the commissioner must obtain statutory
142.7 	authorization for its implementation, except that the
142.8 	commissioner has authority to implement enterprise activities
142.9 	for adult mental health,adolescent services,and to establish a
142.10 	public group practice without statutory authorization.
142.11 	Enterprise activities are defined as the range of services,
142.12 	which are delivered by state employees, needed by people with
142.13 	disabilities and are fully funded by public or private
142.14 	third-party health insurance or other revenue sources available
142.15 	to clients that provide reimbursement for the services
142.16 	provided.  Enterprise activities within state-operated services
142.17 	shall specialize in caring for vulnerable people for whom no
142.18 	other providers are available or for whom state-operated
142.19 	services may be the provider selected by the payer.  In
142.20 	subsequent biennia after an enterprise activity is established
142.21 	within a state-operated service, the base state appropriation
142.22 	for that state-operated service shall be reduced proportionate
142.23 	to the size of the enterprise activity.
142.24 	
EFFECTIVE DATE. This section is effective the day
142.25 	following final enactment.

142.26 	Sec. 11. Minnesota Statutes 2004, section 253.20, is
142.27 	amended to read:
142.28 	253.20 MINNESOTA SECURITY HOSPITAL.
142.29 	The commissioner of human services shall erect, equip, and
142.30 	maintain in St. Peter a and other geographic locations under the
142.31 	control of the commissioner of human services suitable
142.32 	building buildings to be known as the Minnesota Security
142.33 	Hospital, for the purpose of providing a secure treatment
142.34 	facility as defined in section 253B.02, subdivision 18a, for
142.35 	persons who may be committed there by courts, or otherwise, or
142.36 	transferred there by the commissioner of human services, and for
143.1 	persons who are found to be mentally ill while confined in any
143.2 	correctional facility, or who may be found to be mentally ill
143.3 	and dangerous, and the commissioner shall supervise and manage
143.4 	the same as in the case of other state hospitals.

143.5 	EFFECTIVE DATE. This section is effective the day
143.6 	following final enactment.

143.7 	Sec. 12. Minnesota Statutes 2004, section 256.01,
143.8 	subdivision 2, is amended to read:
143.9 		Subd. 2.Specific powers.  Subject to the provisions of
143.10 	section 241.021, subdivision 2, the commissioner of human
143.11 	services shall carry out the specific duties in paragraphs (a)
143.12 	through (aa) (bb):
143.13 	(a) Administer and supervise all forms of public assistance
143.14 	provided for by state law and other welfare activities or
143.15 	services as are vested in the commissioner.  Administration and
143.16 	supervision of human services activities or services includes,
143.17 	but is not limited to, assuring timely and accurate distribution
143.18 	of benefits, completeness of service, and quality program
143.19 	management.  In addition to administering and supervising human
143.20 	services activities vested by law in the department, the
143.21 	commissioner shall have the authority to:
143.22 	(1) require county agency participation in training and
143.23 	technical assistance programs to promote compliance with
143.24 	statutes, rules, federal laws, regulations, and policies
143.25 	governing human services;
143.26 	(2) monitor, on an ongoing basis, the performance of county
143.27 	agencies in the operation and administration of human services,
143.28 	enforce compliance with statutes, rules, federal laws,
143.29 	regulations, and policies governing welfare services and promote
143.30 	excellence of administration and program operation;
143.31 	(3) develop a quality control program or other monitoring
143.32 	program to review county performance and accuracy of benefit
143.33 	determinations;
143.34 	(4) require county agencies to make an adjustment to the
143.35 	public assistance benefits issued to any individual consistent
143.36 	with federal law and regulation and state law and rule and to
144.1 	issue or recover benefits as appropriate;
144.2 	(5) delay or deny payment of all or part of the state and
144.3 	federal share of benefits and administrative reimbursement
144.4 	according to the procedures set forth in section 256.017;
144.5 	(6) make contracts with and grants to public and private
144.6 	agencies and organizations, both profit and nonprofit, and
144.7 	individuals, using appropriated funds; and
144.8 	(7) enter into contractual agreements with federally
144.9 	recognized Indian tribes with a reservation in Minnesota to the
144.10 	extent necessary for the tribe to operate a federally approved
144.11 	family assistance program or any other program under the
144.12 	supervision of the commissioner.  The commissioner shall consult
144.13 	with the affected county or counties in the contractual
144.14 	agreement negotiations, if the county or counties wish to be
144.15 	included, in order to avoid the duplication of county and tribal
144.16 	assistance program services.  The commissioner may establish
144.17 	necessary accounts for the purposes of receiving and disbursing
144.18 	funds as necessary for the operation of the programs.
144.19 	(b) Inform county agencies, on a timely basis, of changes
144.20 	in statute, rule, federal law, regulation, and policy necessary
144.21 	to county agency administration of the programs.
144.22 	(c) Administer and supervise all child welfare activities;
144.23 	promote the enforcement of laws protecting handicapped,
144.24 	dependent, neglected and delinquent children, and children born
144.25 	to mothers who were not married to the children's fathers at the
144.26 	times of the conception nor at the births of the children;
144.27 	license and supervise child-caring and child-placing agencies
144.28 	and institutions; supervise the care of children in boarding and
144.29 	foster homes or in private institutions; and generally perform
144.30 	all functions relating to the field of child welfare now vested
144.31 	in the State Board of Control.
144.32 	(d) Administer and supervise all noninstitutional service
144.33 	to handicapped persons, including those who are visually
144.34 	impaired, hearing impaired, or physically impaired or otherwise
144.35 	handicapped.  The commissioner may provide and contract for the
144.36 	care and treatment of qualified indigent children in facilities
145.1 	other than those located and available at state hospitals when
145.2 	it is not feasible to provide the service in state hospitals.
145.3 	(e) Assist and actively cooperate with other departments,
145.4 	agencies and institutions, local, state, and federal, by
145.5 	performing services in conformity with the purposes of Laws
145.6 	1939, chapter 431.
145.7 	(f) Act as the agent of and cooperate with the federal
145.8 	government in matters of mutual concern relative to and in
145.9 	conformity with the provisions of Laws 1939, chapter 431,
145.10 	including the administration of any federal funds granted to the
145.11 	state to aid in the performance of any functions of the
145.12 	commissioner as specified in Laws 1939, chapter 431, and
145.13 	including the promulgation of rules making uniformly available
145.14 	medical care benefits to all recipients of public assistance, at
145.15 	such times as the federal government increases its participation
145.16 	in assistance expenditures for medical care to recipients of
145.17 	public assistance, the cost thereof to be borne in the same
145.18 	proportion as are grants of aid to said recipients.
145.19 	(g) Establish and maintain any administrative units
145.20 	reasonably necessary for the performance of administrative
145.21 	functions common to all divisions of the department.
145.22 	(h) Act as designated guardian of both the estate and the
145.23 	person of all the wards of the state of Minnesota, whether by
145.24 	operation of law or by an order of court, without any further
145.25 	act or proceeding whatever, except as to persons committed as
145.26 	mentally retarded.  For children under the guardianship of the
145.27 	commissioner whose interests would be best served by adoptive
145.28 	placement, the commissioner may contract with a licensed
145.29 	child-placing agency or a Minnesota tribal social services
145.30 	agency to provide adoption services.  A contract with a licensed
145.31 	child-placing agency must be designed to supplement existing
145.32 	county efforts and may not replace existing county programs,
145.33 	unless the replacement is agreed to by the county board and the
145.34 	appropriate exclusive bargaining representative or the
145.35 	commissioner has evidence that child placements of the county
145.36 	continue to be substantially below that of other counties.
146.1 	Funds encumbered and obligated under an agreement for a specific
146.2 	child shall remain available until the terms of the agreement
146.3 	are fulfilled or the agreement is terminated.
146.4 	(i) Act as coordinating referral and informational center
146.5 	on requests for service for newly arrived immigrants coming to
146.6 	Minnesota.
146.7 	(j) The specific enumeration of powers and duties as
146.8 	hereinabove set forth shall in no way be construed to be a
146.9 	limitation upon the general transfer of powers herein contained.
146.10 	(k) Establish county, regional, or statewide schedules of
146.11 	maximum fees and charges which may be paid by county agencies
146.12 	for medical, dental, surgical, hospital, nursing and nursing
146.13 	home care and medicine and medical supplies under all programs
146.14 	of medical care provided by the state and for congregate living
146.15 	care under the income maintenance programs.
146.16 	(l) Have the authority to conduct and administer
146.17 	experimental projects to test methods and procedures of
146.18 	administering assistance and services to recipients or potential
146.19 	recipients of public welfare.  To carry out such experimental
146.20 	projects, it is further provided that the commissioner of human
146.21 	services is authorized to waive the enforcement of existing
146.22 	specific statutory program requirements, rules, and standards in
146.23 	one or more counties.  The order establishing the waiver shall
146.24 	provide alternative methods and procedures of administration,
146.25 	shall not be in conflict with the basic purposes, coverage, or
146.26 	benefits provided by law, and in no event shall the duration of
146.27 	a project exceed four years.  It is further provided that no
146.28 	order establishing an experimental project as authorized by the
146.29 	provisions of this section shall become effective until the
146.30 	following conditions have been met:
146.31 	(1) the secretary of health and human services of the
146.32 	United States has agreed, for the same project, to waive state
146.33 	plan requirements relative to statewide uniformity; and
146.34 	(2) a comprehensive plan, including estimated project
146.35 	costs, shall be approved by the Legislative Advisory Commission
146.36 	and filed with the commissioner of administration.
147.1 	(m) According to federal requirements, establish procedures
147.2 	to be followed by local welfare boards in creating citizen
147.3 	advisory committees, including procedures for selection of
147.4 	committee members.
147.5 	(n) Allocate federal fiscal disallowances or sanctions
147.6 	which are based on quality control error rates for the aid to
147.7 	families with dependent children program formerly codified in
147.8 	sections 256.72 to 256.87, medical assistance, or food stamp
147.9 	program in the following manner:
147.10 	(1) one-half of the total amount of the disallowance shall
147.11 	be borne by the county boards responsible for administering the
147.12 	programs.  For the medical assistance and the AFDC program
147.13 	formerly codified in sections 256.72 to 256.87, disallowances
147.14 	shall be shared by each county board in the same proportion as
147.15 	that county's expenditures for the sanctioned program are to the
147.16 	total of all counties' expenditures for the AFDC program
147.17 	formerly codified in sections 256.72 to 256.87, and medical
147.18 	assistance programs.  For the food stamp program, sanctions
147.19 	shall be shared by each county board, with 50 percent of the
147.20 	sanction being distributed to each county in the same proportion
147.21 	as that county's administrative costs for food stamps are to the
147.22 	total of all food stamp administrative costs for all counties,
147.23 	and 50 percent of the sanctions being distributed to each county
147.24 	in the same proportion as that county's value of food stamp
147.25 	benefits issued are to the total of all benefits issued for all
147.26 	counties.  Each county shall pay its share of the disallowance
147.27 	to the state of Minnesota.  When a county fails to pay the
147.28 	amount due hereunder, the commissioner may deduct the amount
147.29 	from reimbursement otherwise due the county, or the attorney
147.30 	general, upon the request of the commissioner, may institute
147.31 	civil action to recover the amount due; and
147.32 	(2) notwithstanding the provisions of clause (1), if the
147.33 	disallowance results from knowing noncompliance by one or more
147.34 	counties with a specific program instruction, and that knowing
147.35 	noncompliance is a matter of official county board record, the
147.36 	commissioner may require payment or recover from the county or
148.1 	counties, in the manner prescribed in clause (1), an amount
148.2 	equal to the portion of the total disallowance which resulted
148.3 	from the noncompliance, and may distribute the balance of the
148.4 	disallowance according to clause (1).
148.5 	(o) Develop and implement special projects that maximize
148.6 	reimbursements and result in the recovery of money to the
148.7 	state.  For the purpose of recovering state money, the
148.8 	commissioner may enter into contracts with third parties.  Any
148.9 	recoveries that result from projects or contracts entered into
148.10 	under this paragraph shall be deposited in the state treasury
148.11 	and credited to a special account until the balance in the
148.12 	account reaches $1,000,000.  When the balance in the account
148.13 	exceeds $1,000,000, the excess shall be transferred and credited
148.14 	to the general fund.  All money in the account is appropriated
148.15 	to the commissioner for the purposes of this paragraph.
148.16 	(p) Have the authority to make direct payments to
148.17 	facilities providing shelter to women and their children
148.18 	according to section 256D.05, subdivision 3.  Upon the written
148.19 	request of a shelter facility that has been denied payments
148.20 	under section 256D.05, subdivision 3, the commissioner shall
148.21 	review all relevant evidence and make a determination within 30
148.22 	days of the request for review regarding issuance of direct
148.23 	payments to the shelter facility.  Failure to act within 30 days
148.24 	shall be considered a determination not to issue direct payments.
148.25 	(q) Have the authority to establish and enforce the
148.26 	following county reporting requirements:
148.27 	(1) the commissioner shall establish fiscal and statistical
148.28 	reporting requirements necessary to account for the expenditure
148.29 	of funds allocated to counties for human services programs.
148.30 	When establishing financial and statistical reporting
148.31 	requirements, the commissioner shall evaluate all reports, in
148.32 	consultation with the counties, to determine if the reports can
148.33 	be simplified or the number of reports can be reduced;
148.34 	(2) the county board shall submit monthly or quarterly
148.35 	reports to the department as required by the commissioner.
148.36 	Monthly reports are due no later than 15 working days after the
149.1 	end of the month.  Quarterly reports are due no later than 30
149.2 	calendar days after the end of the quarter, unless the
149.3 	commissioner determines that the deadline must be shortened to
149.4 	20 calendar days to avoid jeopardizing compliance with federal
149.5 	deadlines or risking a loss of federal funding.  Only reports
149.6 	that are complete, legible, and in the required format shall be
149.7 	accepted by the commissioner;
149.8 	(3) if the required reports are not received by the
149.9 	deadlines established in clause (2), the commissioner may delay
149.10 	payments and withhold funds from the county board until the next
149.11 	reporting period.  When the report is needed to account for the
149.12 	use of federal funds and the late report results in a reduction
149.13 	in federal funding, the commissioner shall withhold from the
149.14 	county boards with late reports an amount equal to the reduction
149.15 	in federal funding until full federal funding is received;
149.16 	(4) a county board that submits reports that are late,
149.17 	illegible, incomplete, or not in the required format for two out
149.18 	of three consecutive reporting periods is considered
149.19 	noncompliant.  When a county board is found to be noncompliant,
149.20 	the commissioner shall notify the county board of the reason the
149.21 	county board is considered noncompliant and request that the
149.22 	county board develop a corrective action plan stating how the
149.23 	county board plans to correct the problem.  The corrective
149.24 	action plan must be submitted to the commissioner within 45 days
149.25 	after the date the county board received notice of
149.26 	noncompliance;
149.27 	(5) the final deadline for fiscal reports or amendments to
149.28 	fiscal reports is one year after the date the report was
149.29 	originally due.  If the commissioner does not receive a report
149.30 	by the final deadline, the county board forfeits the funding
149.31 	associated with the report for that reporting period and the
149.32 	county board must repay any funds associated with the report
149.33 	received for that reporting period;
149.34 	(6) the commissioner may not delay payments, withhold
149.35 	funds, or require repayment under clause (3) or (5) if the
149.36 	county demonstrates that the commissioner failed to provide
150.1 	appropriate forms, guidelines, and technical assistance to
150.2 	enable the county to comply with the requirements.  If the
150.3 	county board disagrees with an action taken by the commissioner
150.4 	under clause (3) or (5), the county board may appeal the action
150.5 	according to sections 14.57 to 14.69; and
150.6 	(7) counties subject to withholding of funds under clause
150.7 	(3) or forfeiture or repayment of funds under clause (5) shall
150.8 	not reduce or withhold benefits or services to clients to cover
150.9 	costs incurred due to actions taken by the commissioner under
150.10 	clause (3) or (5).
150.11 	(r) Allocate federal fiscal disallowances or sanctions for
150.12 	audit exceptions when federal fiscal disallowances or sanctions
150.13 	are based on a statewide random sample for the foster care
150.14 	program under title IV-E of the Social Security Act, United
150.15 	States Code, title 42, in direct proportion to each county's
150.16 	title IV-E foster care maintenance claim for that period.
150.17 	(s) Be responsible for ensuring the detection, prevention,
150.18 	investigation, and resolution of fraudulent activities or
150.19 	behavior by applicants, recipients, and other participants in
150.20 	the human services programs administered by the department.
150.21 	(t) Require county agencies to identify overpayments,
150.22 	establish claims, and utilize all available and cost-beneficial
150.23 	methodologies to collect and recover these overpayments in the
150.24 	human services programs administered by the department.
150.25 	(u) Have the authority to administer a drug rebate program
150.26 	for drugs purchased pursuant to the prescription drug program
150.27 	established under section 256.955 after the beneficiary's
150.28 	satisfaction of any deductible established in the program.  The
150.29 	commissioner shall require a rebate agreement from all
150.30 	manufacturers of covered drugs as defined in section 256B.0625,
150.31 	subdivision 13.  Rebate agreements for prescription drugs
150.32 	delivered on or after July 1, 2002, must include rebates for
150.33 	individuals covered under the prescription drug program who are
150.34 	under 65 years of age.  For each drug, the amount of the rebate
150.35 	shall be equal to the rebate as defined for purposes of the
150.36 	federal rebate program in United States Code, title 42, section
151.1 	1396r-8.  The manufacturers must provide full payment within 30
151.2 	days of receipt of the state invoice for the rebate within the
151.3 	terms and conditions used for the federal rebate program
151.4 	established pursuant to section 1927 of title XIX of the Social
151.5 	Security Act.  The manufacturers must provide the commissioner
151.6 	with any information necessary to verify the rebate determined
151.7 	per drug.  The rebate program shall utilize the terms and
151.8 	conditions used for the federal rebate program established
151.9 	pursuant to section 1927 of title XIX of the Social Security Act.
151.10 	(v) Have the authority to administer the federal drug
151.11 	rebate program for drugs purchased under the medical assistance
151.12 	program as allowed by section 1927 of title XIX of the Social
151.13 	Security Act and according to the terms and conditions of
151.14 	section 1927.  Rebates shall be collected for all drugs that
151.15 	have been dispensed or administered in an outpatient setting and
151.16 	that are from manufacturers who have signed a rebate agreement
151.17 	with the United States Department of Health and Human Services.
151.18 	(w) Have the authority to administer a supplemental drug
151.19 	rebate program for drugs purchased under the medical assistance
151.20 	program.  The commissioner may enter into supplemental rebate
151.21 	contracts with pharmaceutical manufacturers and may require
151.22 	prior authorization for drugs that are from manufacturers that
151.23 	have not signed a supplemental rebate contract.  Prior
151.24 	authorization of drugs shall be subject to the provisions of
151.25 	section 256B.0625, subdivision 13.
151.26 	(x) Operate the department's communication systems account
151.27 	established in Laws 1993, First Special Session chapter 1,
151.28 	article 1, section 2, subdivision 2, to manage shared
151.29 	communication costs necessary for the operation of the programs
151.30 	the commissioner supervises.  A communications account may also
151.31 	be established for each regional treatment center which operates
151.32 	communications systems.  Each account must be used to manage
151.33 	shared communication costs necessary for the operations of the
151.34 	programs the commissioner supervises.  The commissioner may
151.35 	distribute the costs of operating and maintaining communication
151.36 	systems to participants in a manner that reflects actual usage.
152.1 	Costs may include acquisition, licensing, insurance,
152.2 	maintenance, repair, staff time and other costs as determined by
152.3 	the commissioner.  Nonprofit organizations and state, county,
152.4 	and local government agencies involved in the operation of
152.5 	programs the commissioner supervises may participate in the use
152.6 	of the department's communications technology and share in the
152.7 	cost of operation.  The commissioner may accept on behalf of the
152.8 	state any gift, bequest, devise or personal property of any
152.9 	kind, or money tendered to the state for any lawful purpose
152.10 	pertaining to the communication activities of the department.
152.11 	Any money received for this purpose must be deposited in the
152.12 	department's communication systems accounts.  Money collected by
152.13 	the commissioner for the use of communication systems must be
152.14 	deposited in the state communication systems account and is
152.15 	appropriated to the commissioner for purposes of this section.
152.16 	(y) Receive any federal matching money that is made
152.17 	available through the medical assistance program for the
152.18 	consumer satisfaction survey.  Any federal money received for
152.19 	the survey is appropriated to the commissioner for this
152.20 	purpose.  The commissioner may expend the federal money received
152.21 	for the consumer satisfaction survey in either year of the
152.22 	biennium.
152.23 	(z) Designate community information and referral call
152.24 	centers and incorporate cost reimbursement claims from the
152.25 	designated community information and referral call centers into
152.26 	the federal cost reimbursement claiming processes of the
152.27 	department according to federal law, rule, and regulations.
152.28 	Existing information and referral centers provided by Greater
152.29 	Twin Cities United Way or existing call centers for which
152.30 	Greater Twin Cities United Way has legal authority to represent,
152.31 	shall be included in these designations upon review by the
152.32 	commissioner and assurance that these services are accredited
152.33 	and in compliance with national standards.  Any reimbursement is
152.34 	appropriated to the commissioner and all designated information
152.35 	and referral centers shall receive payments according to normal
152.36 	department schedules established by the commissioner upon final
153.1 	approval of allocation methodologies from the United States
153.2 	Department of Health and Human Services Division of Cost
153.3 	Allocation or other appropriate authorities.
153.4 	(aa) Develop recommended standards for foster care homes
153.5 	that address the components of specialized therapeutic services
153.6 	to be provided by foster care homes with those services.
153.7 	(bb) Authorize the method of payment to or from the
153.8 	department as part of the human services programs administered
153.9 	by the department.  This authorization includes the receipt or
153.10 	disbursement of funds held by the department in a fiduciary
153.11 	capacity as part of the human services programs administered by
153.12 	the department.
153.13 	
EFFECTIVE DATE. This section is effective August 1, 2005.

153.14 	Sec. 13. Minnesota Statutes 2004, section 256.741,
153.15 	subdivision 4, is amended to read:
153.16 		Subd. 4.Effect of assignment.  Assignments in this
153.17 	section take effect upon a determination that the applicant is
153.18 	eligible for public assistance.  The amount of support assigned
153.19 	under this subdivision may not exceed the total amount of public
153.20 	assistance issued or the total support obligation, whichever is
153.21 	less.  Child care support collections made according to an
153.22 	assignment under subdivision 2, paragraph (c), must be
153.23 	deposited, subject to any limitations of federal law, by the
153.24 	commissioner of human services in the child support collection
153.25 	account in the special revenue fund and appropriated to the
153.26 	commissioner of education for child care assistance under
153.27 	section 119B.03.  These collections are in addition to state and
153.28 	federal funds appropriated to the child care in the general fund.
153.29 	
EFFECTIVE DATE. This section is effective August 1, 2005.

153.30 	Sec. 14. Minnesota Statutes 2004, section 256M.40,
153.31 	subdivision 2, is amended to read:
153.32 		Subd. 2.Project of regional significance; study.  The
153.33 	commissioner shall study whether and how to dedicate a portion
153.34 	of the allocated funds for projects of regional significance.
153.35 	The study shall include an analysis of the amount of annual
153.36 	funding to be dedicated for projects of regional significance
154.1 	and what efforts these projects must support.  The commissioner
154.2 	shall submit a report to the chairs of the house and senate
154.3 	committees with jurisdiction over children and community
154.4 	services grants by January 15, 2005. The commissioner of
154.5 	finance, in preparing the proposed biennial budget for fiscal
154.6 	years 2006 and 2007, is instructed to include $25 million each
154.7 	year in funding for projects of regional significance under this
154.8 	chapter.
154.9 	
EFFECTIVE DATE. This section is effective the day
154.10 	following final enactment.

154.11 	Sec. 15. Minnesota Statutes 2004, section 295.582, as
154.12 	amended by Laws 2005, chapter 77, section 7, is amended to read:
154.13 	295.582 [AUTHORITY.]
154.14 		Subdivision 1.Wholesale drug distributor tax. (a) A
154.15 	hospital, surgical center, or health care provider that is
154.16 	subject to a tax under section 295.52, or a pharmacy that has
154.17 	paid additional expense transferred under this section by a
154.18 	wholesale drug distributor, may transfer additional expense
154.19 	generated by section 295.52 obligations on to all third-party
154.20 	contracts for the purchase of health care services on behalf of
154.21 	a patient or consumer. Nothing shall prohibit a pharmacy from
154.22 	transferring the additional expense generated under section
154.23 	295.52 to a pharmacy benefits manager.The additional expense
154.24 	transferred to the third-party purchaser or a pharmacy benefits
154.25 	manager must not exceed the tax percentage specified in section
154.26 	295.52 multiplied against the gross revenues received under the
154.27 	third-party contract, and the tax percentage specified in
154.28 	section 295.52 multiplied against co-payments and deductibles
154.29 	paid by the individual patient or consumer.  The expense must
154.30 	not be generated on revenues derived from payments that are
154.31 	excluded from the tax under section 295.53.  All third-party
154.32 	purchasers of health care services including, but not limited
154.33 	to, third-party purchasers regulated under chapter 60A, 62A,
154.34 	62C, 62D, 62H, 62N, 64B, 65A, 65B, 79, or 79A, or under section
154.35 	471.61 or 471.617, and pharmacy benefits managers must pay the
154.36 	transferred expense in addition to any payments due under
155.1 	existing contracts with the hospital, surgical center, pharmacy,
155.2 	or health care provider, to the extent allowed under federal
155.3 	law.  A third-party purchaser of health care services includes,
155.4 	but is not limited to, a health carrier or community integrated
155.5 	service network that pays for health care services on behalf of
155.6 	patients or that reimburses, indemnifies, compensates, or
155.7 	otherwise insures patients for health care services. For
155.8 	purposes of this section, a pharmacy benefits manager means an
155.9 	entity that performs pharmacy benefits management.A
155.10 	third-party purchaser or pharmacy benefits manager shall comply
155.11 	with this section regardless of whether the third-party
155.12 	purchaser or pharmacy benefits manager is a for-profit,
155.13 	not-for-profit, or nonprofit entity.  A wholesale drug
155.14 	distributor may transfer additional expense generated by section
155.15 	295.52 obligations to entities that purchase from the
155.16 	wholesaler, and the entities must pay the additional expense.
155.17 	Nothing in this section limits the ability of a hospital,
155.18 	surgical center, pharmacy, wholesale drug distributor, or health
155.19 	care provider to recover all or part of the section 295.52
155.20 	obligation by other methods, including increasing fees or
155.21 	charges.
155.22 	(b) Any hospital, surgical center, or health care provider
155.23 	subject to a tax under section 295.52 or a pharmacy that has
155.24 	paid additional expense transferred under this section by a
155.25 	wholesale drug distributor may file a complaint with the
155.26 	commissioner responsible for regulating the third-party
155.27 	purchaser if at any time the third-party purchaser fails to
155.28 	comply with paragraph (a).
155.29 	(c) If the commissioner responsible for regulating the
155.30 	third-party purchaser finds at any time that the third-party
155.31 	purchaser has not complied with paragraph (a), the commissioner
155.32 	may take enforcement action against a third-party purchaser
155.33 	which is subject to the commissioner's regulatory jurisdiction
155.34 	and which does not allow a hospital, surgical center, pharmacy,
155.35 	or provider to pass-through the tax.  The commissioner may by
155.36 	order fine or censure the third-party purchaser or revoke or
156.1 	suspend the certificate of authority or license of the
156.2 	third-party purchaser to do business in this state if the
156.3 	commissioner finds that the third-party purchaser has not
156.4 	complied with this section.  The third-party purchaser may
156.5 	appeal the commissioner's order through a contested case hearing
156.6 	in accordance with chapter 14.
156.7 		Subd. 2.Agreement. A contracting agreement between a
156.8 	third-party purchaser or a pharmacy benefits manager and a
156.9 	resident or nonresident pharmacy registered under chapter 151,
156.10 	may not prohibit:
156.11 	(1) a pharmacy that has paid additional expense transferred
156.12 	under this section by a wholesale drug distributor from
156.13 	exercising its option under this section to transfer such
156.14 	additional expenses generated by the section 295.52 obligations
156.15 	on to the third-party purchaser or pharmacy benefits manager; or 
156.16 	(2) a pharmacy that is subject to tax under section 295.52,
156.17 	subdivision 4, from exercising its option under this section to
156.18 	recover all or part of the section 295.52 obligations from the
156.19 	third-party purchaser or a pharmacy benefits manager.
156.20 	
EFFECTIVE DATE. This section is effective the day
156.21 	following final enactment.

156.22 	Sec. 16. Minnesota Statutes 2004, section 471.61, is
156.23 	amended by adding a subdivision to read:
156.24 		Subd. 5.Provision of long-term care insurance. Any
156.25 	political subdivision, or any two or more political subdivisions
156.26 	acting jointly, may contract with an insurance company licensed
156.27 	to do business in this state for the voluntary purchase of
156.28 	long-term care insurance by the employees and their dependents
156.29 	of the political subdivision or subdivisions.  The coverage may
156.30 	be through a group policy or through individual coverage.

156.31 	Sec. 17. Minnesota Statutes 2004, section 641.15,
156.32 	subdivision 2, is amended to read:
156.33 		Subd. 2.Medical aid.  Except as provided in section
156.34 	466.101, the county board shall pay the costs of medical
156.35 	services provided to prisoners.  The amount paid by the Anoka
156.36 	county board for a medical service shall not exceed the maximum
157.1 	allowed medical assistance payment rate for the service, as
157.2 	determined by the commissioner of human services. For all other
157.3 	counties, medical providers shall charge no higher than the rate
157.4 	negotiated between the county and the provider.  In the absence
157.5 	of an agreement between the county and the provider, the
157.6 	provider may charge no more than the discounted rate the
157.7 	provider has negotiated with the nongovernmental third-party
157.8 	payer that provided the most revenue to the provider during the
157.9 	previous calendar year.The county is entitled to reimbursement
157.10 	from the prisoner for payment of medical bills to the extent
157.11 	that the prisoner to whom the medical aid was provided has the
157.12 	ability to pay the bills.  The prisoner shall, at a minimum,
157.13 	incur co-payment obligations for health care services provided
157.14 	by a county correctional facility.  The county board shall
157.15 	determine the co-payment amount.  Notwithstanding any law to the
157.16 	contrary, the co-payment shall be deducted from any of the
157.17 	prisoner's funds held by the county, to the extent possible.  If
157.18 	there is a disagreement between the county and a prisoner
157.19 	concerning the prisoner's ability to pay, the court with
157.20 	jurisdiction over the defendant shall determine the extent, if
157.21 	any, of the prisoner's ability to pay for the medical services.
157.22 	If a prisoner is covered by health or medical insurance or other
157.23 	health plan when medical services are provided, the county
157.24 	providing the medical services has a right of subrogation to be
157.25 	reimbursed by the insurance carrier for all sums spent by it for
157.26 	medical services to the prisoner that are covered by the policy
157.27 	of insurance or health plan, in accordance with the benefits,
157.28 	limitations, exclusions, provider restrictions, and other
157.29 	provisions of the policy or health plan.  The county may
157.30 	maintain an action to enforce this subrogation right.  The
157.31 	county does not have a right of subrogation against the medical
157.32 	assistance program or the general assistance medical care
157.33 	program.
157.34 	
EFFECTIVE DATE. This section is effective August 1, 2005.

157.35 	Sec. 18. Laws 2003, First Special Session chapter 14,
157.36 	article 13C, section 2, subdivision 6, is amended to read:
158.1 		Subd. 6.Basic Health Care Grants
158.2 	Summary by Fund
158.3 	General           1,499,941,000 1,533,016,000
158.4 	Health Care Access  268,151,000   282,605,000
158.5 	[UPDATING FEDERAL POVERTY GUIDELINES.]
158.6 	Annual updates to the federal poverty
158.7 	guidelines are effective each July 1,
158.8 	following publication by the United
158.9 	States Department of Health and Human
158.10 	Services for health care programs under
158.11 	Minnesota Statutes, chapters 256, 256B,
158.12 	256D, and 256L.
158.13 	The amounts that may be spent from this
158.14 	appropriation for each purpose are as
158.15 	follows:
158.16 	(a) MinnesotaCare Grants
158.17 	Health Care Access 267,401,000   281,855,000
158.18 	[MINNESOTACARE FEDERAL RECEIPTS.]
158.19 	Receipts received as a result of
158.20 	federal participation pertaining to
158.21 	administrative costs of the Minnesota
158.22 	health care reform waiver shall be
158.23 	deposited as nondedicated revenue in
158.24 	the health care access fund.  Receipts
158.25 	received as a result of federal
158.26 	participation pertaining to grants
158.27 	shall be deposited in the federal fund
158.28 	and shall offset health care access
158.29 	funds for payments to providers.
158.30 	[MINNESOTACARE FUNDING.] The
158.31 	commissioner may expend money
158.32 	appropriated from the health care
158.33 	access fund for MinnesotaCare in either
158.34 	fiscal year of the biennium.
158.35 	(b) MA Basic Health Care Grants -
158.36 	Families and Children
158.37 	General             568,254,000   582,161,000
158.38 	[SERVICES TO PREGNANT WOMEN.] The
158.39 	commissioner shall use available
158.40 	federal money for the State-Children's
158.41 	Health Insurance Program for medical
158.42 	assistance services provided to
158.43 	pregnant women who are not otherwise
158.44 	eligible for federal financial
158.45 	participation beginning in fiscal year
158.46 	2003.  This federal money shall be
158.47 	deposited in the federal fund and shall
158.48 	offset general funds for payments to
158.49 	providers.  Notwithstanding section 14,
158.50 	this paragraph shall not expire.
158.51 	[MANAGED CARE RATE INCREASE.] (a)
158.52 	Effective January 1, 2004, the
158.53 	commissioner of human services shall
158.54 	increase the total payments to managed
158.55 	care plans under Minnesota Statutes,
158.56 	section 256B.69, by an amount equal to
158.57 	the cost increases to the managed care
158.58 	plans from by the elimination of: (1)
159.1 	the exemption from the taxes imposed
159.2 	under Minnesota Statutes, section
159.3 	297I.05, subdivision 5, for premiums
159.4 	paid by the state for medical
159.5 	assistance, general assistance medical
159.6 	care, and the MinnesotaCare program;
159.7 	and (2) the exemption of gross revenues
159.8 	subject to the taxes imposed under
159.9 	Minnesota Statutes, sections 295.50 to
159.10 	295.57, for payments paid by the state
159.11 	for services provided under medical
159.12 	assistance, general assistance medical
159.13 	care, and the MinnesotaCare program.
159.14 	Any increase based on clause (2) must
159.15 	be reflected in provider rates paid by
159.16 	the managed care plan unless the
159.17 	managed care plan is a staff model
159.18 	health plan company.
159.19 	(b) The commissioner of human services
159.20 	shall increase by two percent the
159.21 	applicable tax rate in effect under
159.22 	Minnesota Statutes, section 295.52,the
159.23 	fee-for-service payments under medical
159.24 	assistance, general assistance medical
159.25 	care, and the MinnesotaCare program for
159.26 	services subject to the hospital,
159.27 	surgical center, or health care
159.28 	provider taxes under Minnesota
159.29 	Statutes, sections 295.50 to 295.57,
159.30 	effective for services rendered on or
159.31 	after January 1, 2004.
159.32 	(c) The commissioner of finance shall
159.33 	transfer from the health care access
159.34 	fund to the general fund the following
159.35 	amounts in the fiscal years indicated:
159.36 	2004, $16,587,000; 2005, $46,322,000;
159.37 	2006, $49,413,000; and 2007,
159.38 	$52,659,000.
159.39 	(d) For fiscal years after 2007, the
159.40 	commissioner of finance shall transfer
159.41 	from the health care access fund to the
159.42 	general fund an amount equal to the
159.43 	revenue collected by the commissioner
159.44 	of revenue on the following:
159.45 	(1) gross revenues received by
159.46 	hospitals, surgical centers, and health
159.47 	care providers as payments for services
159.48 	provided under medical assistance,
159.49 	general assistance medical care, and
159.50 	the MinnesotaCare program, including
159.51 	payments received directly from the
159.52 	state or from a prepaid plan, under
159.53 	Minnesota Statutes, sections 295.50 to
159.54 	295.57; and
159.55 	(2) premiums paid by the state under
159.56 	medical assistance, general assistance
159.57 	medical care, and the MinnesotaCare
159.58 	program under Minnesota Statutes,
159.59 	section 297I.05, subdivision 5.
159.60 	The commissioner of finance shall
159.61 	monitor and adjust if necessary the
159.62 	amount transferred each fiscal year
159.63 	from the health care access fund to the
159.64 	general fund to ensure that the amount
159.65 	transferred equals the tax revenue
160.1 	collected for the items described in
160.2 	clauses (1) and (2) for that fiscal
160.3 	year.
160.4 	(e) Notwithstanding section 14, these
160.5 	provisions shall not expire.
160.6 	(c) MA Basic Health Care Grants - Elderly
160.7 	and Disabled
160.8 	General             695,421,000   741,605,000
160.9 	[DELAY MEDICAL ASSISTANCE
160.10 	FEE-FOR-SERVICE - ACUTE CARE.] The
160.11 	following payments in fiscal year 2005
160.12 	from the Medicaid Management
160.13 	Information System that would otherwise
160.14 	have been made to providers for medical
160.15 	assistance and general assistance
160.16 	medical care services shall be delayed
160.17 	and included in the first payment in
160.18 	fiscal year 2006:
160.19 	(1) for hospitals, the last two
160.20 	payments; and
160.21 	(2) for nonhospital providers, the last
160.22 	payment.
160.23 	This payment delay shall not include
160.24 	payments to skilled nursing facilities,
160.25 	intermediate care facilities for mental
160.26 	retardation, prepaid health plans, home
160.27 	health agencies, personal care nursing
160.28 	providers, and providers of only waiver
160.29 	services.  The provisions of Minnesota
160.30 	Statutes, section 16A.124, shall not
160.31 	apply to these delayed payments.
160.32 	Notwithstanding section 14, this
160.33 	provision shall not expire.
160.34 	[DEAF AND HARD-OF-HEARING SERVICES.]
160.35 	If, after making reasonable efforts,
160.36 	the service provider for mental health
160.37 	services to persons who are deaf or
160.38 	hearing impaired is not able to earn
160.39 	$227,000 through participation in
160.40 	medical assistance intensive
160.41 	rehabilitation services in fiscal year
160.42 	2005, the commissioner shall transfer
160.43 	$227,000 minus medical assistance
160.44 	earnings achieved by the grantee to
160.45 	deaf and hard-of-hearing grants to
160.46 	enable the provider to continue
160.47 	providing services to eligible persons.
160.48 	(d) General Assistance Medical Care
160.49 	Grants
160.50 	General             223,960,000   196,617,000
160.51 	(e) Health Care Grants - Other
160.52 	Assistance
160.53 	General               3,067,000     3,407,000
160.54 	Health Care Access      750,000       750,000
160.55 	[MINNESOTA PRESCRIPTION DRUG DEDICATED
160.56 	FUND.] Of the general fund
160.57 	appropriation, $284,000 in fiscal year
161.1 	2005 is appropriated to the
161.2 	commissioner for the prescription drug
161.3 	dedicated fund established under the
161.4 	prescription drug discount program.
161.5 	[DENTAL ACCESS GRANTS CARRYOVER
161.6 	AUTHORITY.] Any unspent portion of the
161.7 	appropriation from the health care
161.8 	access fund in fiscal years 2002 and
161.9 	2003 for dental access grants under
161.10 	Minnesota Statutes, section 256B.53,
161.11 	shall not cancel but shall be allowed
161.12 	to carry forward to be spent in the
161.13 	biennium beginning July 1, 2003, for
161.14 	these purposes.
161.15 	[STOP-LOSS FUND ACCOUNT.] The
161.16 	appropriation to the purchasing
161.17 	alliance stop-loss fund account
161.18 	established under Minnesota Statutes,
161.19 	section 256.956, subdivision 2, for
161.20 	fiscal years 2004 and 2005 shall only
161.21 	be available for claim reimbursements
161.22 	for qualifying enrollees who are
161.23 	members of purchasing alliances that
161.24 	meet the requirements described under
161.25 	Minnesota Statutes, section 256.956,
161.26 	subdivision 1, paragraph (f), clauses
161.27 	(1), (2), and (3).
161.28 	(f) Prescription Drug Program
161.29 	General               9,239,000     9,226,000
161.30 	[PRESCRIPTION DRUG ASSISTANCE PROGRAM.]
161.31 	Of the general fund appropriation,
161.32 	$702,000 in fiscal year 2004 and
161.33 	$887,000 in fiscal year 2005 are for
161.34 	the commissioner to establish and
161.35 	administer the prescription drug
161.36 	assistance program through the
161.37 	Minnesota board on aging.
161.38 	[REBATE REVENUE RECAPTURE.] Any funds
161.39 	received by the state from a drug
161.40 	manufacturer due to errors in the
161.41 	pharmaceutical pricing used by the
161.42 	manufacturer in determining the
161.43 	prescription drug rebate are
161.44 	appropriated to the commissioner to
161.45 	augment funding of the prescription
161.46 	drug program established in Minnesota
161.47 	Statutes, section 256.955.
161.48 	
EFFECTIVE DATE. This section is effective the day
161.49 	following final enactment.

161.50 	Sec. 19. REPEALER.
 161.51 	Minnesota Statutes 2004, section 119B.074, as amended by
161.52 	Laws 2005, chapter 98, article 1, section 5, is repealed
161.53 	effective August 1, 2005.

161.54 	ARTICLE 6
161.55 	HEALTH DEPARTMENT

161.56 	Section 1. [62J.495] HEALTH INFORMATION TECHNOLOGY AND
162.1 	INFRASTRUCTURE ADVISORY COMMITTEE.
162.2 		Subdivision 1.Establishment; members; duties. (a) The
162.3 	commissioner shall establish a Health Information Technology and
162.4 	Infrastructure Advisory Committee governed by section 15.059 to
162.5 	advise the commissioner on the following matters:
162.6 	(1) assessment of the use of health information technology
162.7 	by the state, licensed health care providers and facilities, and
162.8 	local public health agencies;
162.9 	(2) recommendations for implementing a statewide
162.10 	interoperable health information infrastructure, to include
162.11 	estimates of necessary resources, and for determining standards
162.12 	for administrative data exchange, clinical support programs,
162.13 	patient privacy requirements, and maintenance of the security
162.14 	and confidentiality of individual patient data; and 
162.15 	(3) other related issues as requested by the commissioner.
162.16 	(b) The members of the Health Information Technology and
162.17 	Infrastructure Advisory Committee shall include the
162.18 	commissioners, or commissioners' designees, of health, human
162.19 	services, administration, and commerce and additional members to
162.20 	be appointed by the commissioner to include persons representing
162.21 	Minnesota's local public health agencies, licensed hospitals and
162.22 	other licensed facilities and providers, private purchasers, the
162.23 	medical and nursing professions, health insurers and health
162.24 	plans, the state quality improvement organization, academic and
162.25 	research institutions, consumer advisory organizations with an
162.26 	interest and expertise in health information technology, and
162.27 	other stakeholders as identified by the Health Information
162.28 	Technology and Infrastructure Advisory Committee.
162.29 		Subd. 2.Annual report. The commissioner shall prepare
162.30 	and issue an annual report not later than January 30 of each
162.31 	year outlining progress to date in implementing a statewide
162.32 	health information infrastructure and recommending future
162.33 	projects.
162.34 		Subd. 3.Expiration. Notwithstanding section 15.059,
162.35 	this section expires June 30, 2009.
162.36 	
EFFECTIVE DATE. This section is effective the day
163.1 	following final enactment.

163.2 	Sec. 2. Minnesota Statutes 2004, section 103I.101,
163.3 	subdivision 6, is amended to read:
163.4 		Subd. 6.Fees for variances.  The commissioner shall
163.5 	charge a nonrefundable application fee of $150 $175 to cover the
163.6 	administrative cost of processing a request for a variance or
163.7 	modification of rules adopted by the commissioner under this
163.8 	chapter.
163.9 	
EFFECTIVE DATE. This section is effective July 1, 2006.

163.10 	Sec. 3. Minnesota Statutes 2004, section 103I.208,
163.11 	subdivision 1, as amended by Laws 2005, chapter 106, section 24,
163.12 	is amended to read:
163.13 		Subdivision 1.Well notification fee. The well
163.14 	notification fee to be paid by a property owner is:
163.15 	(1) for a new water supply well, $150 $175, which includes
163.16 	the state core function fee;
163.17 	(2) for a well sealing, $30 $35 for each well, which
163.18 	includes the state core function fee, except that for monitoring
163.19 	wells constructed on a single property, having depths within a
163.20 	25 foot range, and sealed within 48 hours of start of
163.21 	construction, a single fee of $30 $35; and
163.22 	(3) for construction of a dewatering well, $150 $175, which
163.23 	includes the state core function fee, for each dewatering well
163.24 	except a dewatering project comprising five or more dewatering
163.25 	wells shall be assessed a single fee of $750 $875 for the
163.26 	dewatering wells recorded on the notification.
163.27 	
EFFECTIVE DATE. This section is effective July 1, 2006.

163.28 	Sec. 4. Minnesota Statutes 2004, section 103I.208,
163.29 	subdivision 2, as amended by Laws 2005, chapter 106, section 25,
163.30 	is amended to read:
163.31 		Subd. 2.Permit fee. The permit fee to be paid by a
163.32 	property owner is:
163.33 	(1) for a water supply well that is not in use under a
163.34 	maintenance permit, $125 $150 annually;
163.35 	(2) for construction of a monitoring well, $150 $175, which
163.36 	includes the state core function fee;
164.1 	(3) for a monitoring well that is unsealed under a
164.2 	maintenance permit, $125 $150 annually;
164.3 	(4) for monitoring wells used as a leak detection device at
164.4 	a single motor fuel retail outlet, a single petroleum bulk
164.5 	storage site excluding tank farms, or a single agricultural
164.6 	chemical facility site, the construction permit fee
164.7 	is $150 $175, which includes the state core function fee, per
164.8 	site regardless of the number of wells constructed on the site,
164.9 	and the annual fee for a maintenance permit for unsealed
164.10 	monitoring wells is $125 $150 per site regardless of the number
164.11 	of monitoring wells located on site;
164.12 	(5) for a groundwater thermal exchange device, in addition
164.13 	to the notification fee for water supply wells, $150 $175, which
164.14 	includes the state core function fee;
164.15 	(6) for a vertical heat exchanger, $150 $175;
164.16 	(7) for a dewatering well that is unsealed under a
164.17 	maintenance permit, $125 $150 annually for each dewatering well,
164.18 	except a dewatering project comprising more than five dewatering
164.19 	wells shall be issued a single permit for $625 $750 annually for
164.20 	dewatering wells recorded on the permit; and
164.21 	(8) for an elevator boring, $150 $175 for each boring.
164.22 	
EFFECTIVE DATE. This section is effective July 1, 2006.

164.23 	Sec. 5. Minnesota Statutes 2004, section 103I.235,
164.24 	subdivision 1, is amended to read:
164.25 		Subdivision 1.Disclosure of wells to buyer.  (a) Before
164.26 	signing an agreement to sell or transfer real property, the
164.27 	seller must disclose in writing to the buyer information about
164.28 	the status and location of all known wells on the property, by
164.29 	delivering to the buyer either a statement by the seller that
164.30 	the seller does not know of any wells on the property, or a
164.31 	disclosure statement indicating the legal description and
164.32 	county, and a map drawn from available information showing the
164.33 	location of each well to the extent practicable.  In the
164.34 	disclosure statement, the seller must indicate, for each well,
164.35 	whether the well is in use, not in use, or sealed.
164.36 	(b) At the time of closing of the sale, the disclosure
165.1 	statement information, name and mailing address of the buyer,
165.2 	and the quartile, section, township, and range in which each
165.3 	well is located must be provided on a well disclosure
165.4 	certificate signed by the seller or a person authorized to act
165.5 	on behalf of the seller.
165.6 	(c) A well disclosure certificate need not be provided if
165.7 	the seller does not know of any wells on the property and the
165.8 	deed or other instrument of conveyance contains the statement:
165.9 	"The Seller certifies that the Seller does not know of any wells
165.10 	on the described real property."
165.11 	(d) If a deed is given pursuant to a contract for deed, the
165.12 	well disclosure certificate required by this subdivision shall
165.13 	be signed by the buyer or a person authorized to act on behalf
165.14 	of the buyer.  If the buyer knows of no wells on the property, a
165.15 	well disclosure certificate is not required if the following
165.16 	statement appears on the deed followed by the signature of the
165.17 	grantee or, if there is more than one grantee, the signature of
165.18 	at least one of the grantees:  "The Grantee certifies that the
165.19 	Grantee does not know of any wells on the described real
165.20 	property."  The statement and signature of the grantee may be on
165.21 	the front or back of the deed or on an attached sheet and an
165.22 	acknowledgment of the statement by the grantee is not required
165.23 	for the deed to be recordable.
165.24 	(e) This subdivision does not apply to the sale, exchange,
165.25 	or transfer of real property:
165.26 	(1) that consists solely of a sale or transfer of severed
165.27 	mineral interests; or
165.28 	(2) that consists of an individual condominium unit as
165.29 	described in chapters 515 and 515B.
165.30 	(f) For an area owned in common under chapter 515 or 515B
165.31 	the association or other responsible person must report to the
165.32 	commissioner by July 1, 1992, the location and status of all
165.33 	wells in the common area.  The association or other responsible
165.34 	person must notify the commissioner within 30 days of any change
165.35 	in the reported status of wells.
165.36 	(g) For real property sold by the state under section
166.1 	92.67, the lessee at the time of the sale is responsible for
166.2 	compliance with this subdivision.
166.3 	(h) If the seller fails to provide a required well
166.4 	disclosure certificate, the buyer, or a person authorized to act
166.5 	on behalf of the buyer, may sign a well disclosure certificate
166.6 	based on the information provided on the disclosure statement
166.7 	required by this section or based on other available information.
166.8 	(i) A county recorder or registrar of titles may not record
166.9 	a deed or other instrument of conveyance dated after October 31,
166.10 	1990, for which a certificate of value is required under section
166.11 	272.115, or any deed or other instrument of conveyance dated
166.12 	after October 31, 1990, from a governmental body exempt from the
166.13 	payment of state deed tax, unless the deed or other instrument
166.14 	of conveyance contains the statement made in accordance with
166.15 	paragraph (c) or (d) or is accompanied by the well disclosure
166.16 	certificate containing all the information required by paragraph
166.17 	(b) or (d).  The county recorder or registrar of titles must not
166.18 	accept a certificate unless it contains all the required
166.19 	information.  The county recorder or registrar of titles shall
166.20 	note on each deed or other instrument of conveyance accompanied
166.21 	by a well disclosure certificate that the well disclosure
166.22 	certificate was received.  The notation must include the
166.23 	statement "No wells on property" if the disclosure certificate
166.24 	states there are no wells on the property.  The well disclosure
166.25 	certificate shall not be filed or recorded in the records
166.26 	maintained by the county recorder or registrar of titles.  After
166.27 	noting "No wells on property" on the deed or other instrument of
166.28 	conveyance, the county recorder or registrar of titles shall
166.29 	destroy or return to the buyer the well disclosure certificate.
166.30 	The county recorder or registrar of titles shall collect from
166.31 	the buyer or the person seeking to record a deed or other
166.32 	instrument of conveyance, a fee of $30 $40 for receipt of a
166.33 	completed well disclosure certificate.  By the tenth day of each
166.34 	month, the county recorder or registrar of titles shall transmit
166.35 	the well disclosure certificates to the commissioner of health.
166.36 	By the tenth day after the end of each calendar quarter, the
167.1 	county recorder or registrar of titles shall transmit to the
167.2 	commissioner of health $27.50 $32.50 of the fee for each well
167.3 	disclosure certificate received during the quarter.  The
167.4 	commissioner shall maintain the well disclosure certificate for
167.5 	at least six years.  The commissioner may store the certificate
167.6 	as an electronic image.  A copy of that image shall be as valid
167.7 	as the original.
167.8 	(j) No new well disclosure certificate is required under
167.9 	this subdivision if the buyer or seller, or a person authorized
167.10 	to act on behalf of the buyer or seller, certifies on the deed
167.11 	or other instrument of conveyance that the status and number of
167.12 	wells on the property have not changed since the last previously
167.13 	filed well disclosure certificate.  The following statement, if
167.14 	followed by the signature of the person making the statement, is
167.15 	sufficient to comply with the certification requirement of this
167.16 	paragraph:  "I am familiar with the property described in this
167.17 	instrument and I certify that the status and number of wells on
167.18 	the described real property have not changed since the last
167.19 	previously filed well disclosure certificate."  The
167.20 	certification and signature may be on the front or back of the
167.21 	deed or on an attached sheet and an acknowledgment of the
167.22 	statement is not required for the deed or other instrument of
167.23 	conveyance to be recordable.
167.24 	(k) The commissioner in consultation with county recorders
167.25 	shall prescribe the form for a well disclosure certificate and
167.26 	provide well disclosure certificate forms to county recorders
167.27 	and registrars of titles and other interested persons.
167.28 	(l) Failure to comply with a requirement of this
167.29 	subdivision does not impair:
167.30 	(1) the validity of a deed or other instrument of
167.31 	conveyance as between the parties to the deed or instrument or
167.32 	as to any other person who otherwise would be bound by the deed
167.33 	or instrument; or
167.34 	(2) the record, as notice, of any deed or other instrument
167.35 	of conveyance accepted for filing or recording contrary to the
167.36 	provisions of this subdivision.
168.1 	
EFFECTIVE DATE. This section is effective July 1, 2006.

168.2 	Sec. 6. Minnesota Statutes 2004, section 103I.601,
168.3 	subdivision 2, is amended to read:
168.4 		Subd. 2.License required to make borings.  (a) Except as
168.5 	provided in paragraph (b) (d), a person may must not make an
168.6 	exploratory boring without an exploratory borer's explorer's 
168.7 	license. The fee for an explorer's license is $75.  The
168.8 	explorer's license is valid until the date prescribed in the
168.9 	license by the commissioner.
168.10 	(b) A person must file an application and renewal
168.11 	application fee to renew the explorer's license by the date
168.12 	stated in the license.  The renewal application fee is $75.
168.13 	(c) If the licensee submits an application fee after the
168.14 	required renewal date, the licensee:
168.15 	(1) must include a late fee of $75; and 
168.16 	(2) may not conduct activities authorized by an explorer's
168.17 	license until the renewal application, renewal application fee,
168.18 	late fee, and sealing reports required in subdivision 9 are
168.19 	submitted.
168.20 	(d) An explorer may must designate a responsible individual
168.21 	to supervise and oversee the making of exploratory borings.
168.22 	Before an individual supervises or oversees an exploratory
168.23 	boring, the individual must file an application and application
168.24 	fee of $75 to qualify as a responsible individual.  The
168.25 	individual must take and pass an examination relating to
168.26 	construction, location, and sealing of exploratory borings.  A
168.27 	professional engineer registered or geoscientist licensed under
168.28 	sections 326.02 to 326.15 or a certified professional geologist
168.29 	certified by the American Institute of Professional Geologists 
168.30 	is not required to take the examination required in this
168.31 	subdivision,but must be licensed certified as a responsible
168.32 	individual to make supervise an exploratory boring.
168.33 	
EFFECTIVE DATE. This section is effective the day
168.34 	following final enactment.

168.35 	Sec. 7. Minnesota Statutes 2004, section 144.122, as
168.36 	amended by Laws 2005, chapter 85, section 1, is amended to read:
169.1 	144.122 [LICENSE, PERMIT, AND SURVEY FEES.]
169.2 	(a) The state commissioner of health, by rule, may
169.3 	prescribe reasonable procedures and fees for filing with the
169.4 	commissioner as prescribed by statute and for the issuance of
169.5 	original and renewal permits, licenses, registrations, and
169.6 	certifications issued under authority of the commissioner.  The
169.7 	expiration dates of the various licenses, permits,
169.8 	registrations, and certifications as prescribed by the rules
169.9 	shall be plainly marked thereon.  Fees may include application
169.10 	and examination fees and a penalty fee for renewal applications
169.11 	submitted after the expiration date of the previously issued
169.12 	permit, license, registration, and certification.  The
169.13 	commissioner may also prescribe, by rule, reduced fees for
169.14 	permits, licenses, registrations, and certifications when the
169.15 	application therefor is submitted during the last three months
169.16 	of the permit, license, registration, or certification period.
169.17 	Fees proposed to be prescribed in the rules shall be first
169.18 	approved by the Department of Finance.  All fees proposed to be
169.19 	prescribed in rules shall be reasonable.  The fees shall be in
169.20 	an amount so that the total fees collected by the commissioner
169.21 	will, where practical, approximate the cost to the commissioner
169.22 	in administering the program.  All fees collected shall be
169.23 	deposited in the state treasury and credited to the state
169.24 	government special revenue fund unless otherwise specifically
169.25 	appropriated by law for specific purposes.
169.26 	(b) The commissioner may charge a fee for voluntary
169.27 	certification of medical laboratories and environmental
169.28 	laboratories, and for environmental and medical laboratory
169.29 	services provided by the department, without complying with
169.30 	paragraph (a) or chapter 14.  Fees charged for environment and
169.31 	medical laboratory services provided by the department must be
169.32 	approximately equal to the costs of providing the services.
169.33 	(c) The commissioner may develop a schedule of fees for
169.34 	diagnostic evaluations conducted at clinics held by the services
169.35 	for children with handicaps program.  All receipts generated by
169.36 	the program are annually appropriated to the commissioner for
170.1 	use in the maternal and child health program.
170.2 	(d) The commissioner shall set license fees for hospitals
170.3 	and nursing homes that are not boarding care homes at the
170.4 	following levels:
170.5 	Joint Commission on Accreditation of Healthcare
170.6 	Organizations (JCAHO)
170.7 	and American Osteopathic
170.8 	Association (AOA) hospitals $7,055 $7,555 plus $13 per bed 
170.9 	Non-JCAHO and non-AOA hospitals $4,680 $5,180 plus $234 
170.10 	$247 per bed
170.11 	Nursing home                     $183 plus $91 per bed
170.12 	The commissioner shall set license fees for outpatient
170.13 	surgical centers, boarding care homes, and supervised living
170.14 	facilities at the following levels:
170.15 	Outpatient surgical centers $1,512 $3,349 
170.16 	Boarding care homes              $183 plus $91 per bed
170.17 	Supervised living facilities     $183 plus $91 per bed.
170.18 	(e) Unless prohibited by federal law, the commissioner of
170.19 	health shall charge applicants the following fees to cover the
170.20 	cost of any initial certification surveys required to determine
170.21 	a provider's eligibility to participate in the Medicare or
170.22 	Medicaid program:
170.23 	Prospective payment surveys for          $  900
170.24 	hospitals
170.26 	Swing bed surveys for nursing homes      $1,200
170.28 	Psychiatric hospitals                    $1,400
170.30 	Rural health facilities                  $1,100
170.32 	Portable x-ray providers                 $  500
170.34 	Home health agencies                     $1,800
170.36 	Outpatient therapy agencies              $  800
170.38 	End stage renal dialysis providers       $2,100
170.40 	Independent therapists                   $  800
170.42 	Comprehensive rehabilitation             $1,200
170.43 	outpatient facilities
170.45 	Hospice providers                        $1,700
170.47 	Ambulatory surgical providers            $1,800
170.49 	Hospitals                                $4,200
171.2 	Other provider categories or             Actual surveyor costs:
171.3 	additional resurveys required            average surveyor cost x
171.4 	to complete initial certification        number of hours for the
171.5 	                                         survey process.
171.6 	These fees shall be submitted at the time of the
171.7 	application for federal certification and shall not be
171.8 	refunded.  All fees collected after the date that the imposition
171.9 	of fees is not prohibited by federal law shall be deposited in
171.10 	the state treasury and credited to the state government special
171.11 	revenue fund.
171.12 	(f) The commissioner shall charge the following fees for
171.13 	examinations, registrations, licenses, and inspections:
171.14 	Plumbing examination $ 50
171.15 	Water conditioning examination $ 50
171.16 	Plumbing bond registration fee $ 40
171.17 	Water conditioning bond registration fee $ 40
171.18 	Master plumber's license $120
171.19 	Journeyman plumber's license $ 55
171.20 	Apprentice registration $ 25
171.21 	Water conditioning contractor license $ 70
171.22 	Water conditioning installer license $ 35
171.23 	Residential inspection fee (each visit) $ 50 
171.24 	Public, commercial, and Inspection fee
171.25 	industrial inspections
171.26 	   25 or fewer drainage
171.27 	   fixture units $ 300
171.28 	   26 to 50 drainage
171.29 	   fixture units $ 900
171.30 	   51 to 150 drainage
171.31 	   fixture units $1,200
171.32 	   151 to 249 drainage
171.33 	   fixture units $1,500
171.34 	   250 or more drainage
171.35 	   fixture units $1,800
171.36 	   Callback fee (each visit) $ 100 

171.37 	EFFECTIVE DATE. This section is effective August 1, 2005.

171.38 	Sec. 8. Minnesota Statutes 2004, section 144.147,
172.1 	subdivision 1, is amended to read:
172.2 		Subdivision 1.Definition.  "Eligible rural hospital"
172.3 	means any nonfederal, general acute care hospital that:
172.4 	(1) is either located in a rural area, as defined in the
172.5 	federal Medicare regulations, Code of Federal Regulations, title
172.6 	42, section 405.1041, or located in a community with a
172.7 	population of less than 10,000 15,000, according to United
172.8 	States Census Bureau statistics, outside the seven-county
172.9 	metropolitan area;
172.10 	(2) has 50 or fewer beds; and
172.11 	(3) is not for profit.
172.12 	
EFFECTIVE DATE. This section is effective the day
172.13 	following final enactment.

172.14 	Sec. 9. Minnesota Statutes 2004, section 144.147,
172.15 	subdivision 2, is amended to read:
172.16 		Subd. 2.Grants authorized.  The commissioner shall
172.17 	establish a program of grants to assist eligible rural
172.18 	hospitals.  The commissioner shall award grants to hospitals and
172.19 	communities for the purposes set forth in paragraphs (a) and (b).
172.20 	(a) Grants may be used by hospitals and their communities
172.21 	to develop strategic plans for preserving or enhancing access to
172.22 	health services.  At a minimum, a strategic plan must consist of:
172.23 	(1) a needs assessment to determine what health services
172.24 	are needed and desired by the community.  The assessment must
172.25 	include interviews with or surveys of area health professionals,
172.26 	local community leaders, and public hearings;
172.27 	(2) an assessment of the feasibility of providing needed
172.28 	health services that identifies priorities and timeliness for
172.29 	potential changes; and
172.30 	(3) an implementation plan.
172.31 	The strategic plan must be developed by a committee that
172.32 	includes representatives from the hospital, local public health
172.33 	agencies, other health providers, and consumers from the
172.34 	community.
172.35 	(b) The grants may also be used by eligible rural hospitals
172.36 	that have developed strategic plans to implement transition
173.1 	projects to modify the type and extent of services provided, in
173.2 	order to reflect the needs of that plan.  Grants may be used by
173.3 	hospitals under this paragraph to develop hospital-based
173.4 	physician practices that integrate hospital and existing medical
173.5 	practice facilities that agree to transfer their practices,
173.6 	equipment, staffing, and administration to the hospital.  The
173.7 	grants may also be used by the hospital to establish a health
173.8 	provider cooperative, a telemedicine system, an electronic
173.9 	health records system,or a rural health care system or to cover
173.10 	expenses associated with being designated as a critical access
173.11 	hospital for the Medicare rural hospital flexibility program.
173.12 	Not more than one-third of any grant shall be used to offset
173.13 	losses incurred by physicians agreeing to transfer their
173.14 	practices to hospitals.
173.15 	
EFFECTIVE DATE. This section is effective the day
173.16 	following final enactment.

173.17 	Sec. 10. [144.1476] RURAL PHARMACY PLANNING AND
173.18 	TRANSITION GRANT PROGRAM.
173.19 		Subdivision 1.Definitions. (a) For the purposes of this
173.20 	section, the following definitions apply.
173.21 	(b) "Eligible rural community" means:
173.22 	(1) a Minnesota community that is located in a rural area,
173.23 	as defined in the federal Medicare regulations, Code of Federal
173.24 	Regulations, title 42, section 405.1041; or 
173.25 	(2) a Minnesota community that has a population of less
173.26 	than 10,000, according to the United States Bureau of
173.27 	Statistics, and that is outside the seven-county metropolitan
173.28 	area, excluding the cities of Duluth, Mankato, Moorhead,
173.29 	Rochester, and St. Cloud.
173.30 	(c) "Health care provider" means a hospital, clinic,
173.31 	pharmacy, long-term care institution, or other health care
173.32 	facility that is licensed, certified, or otherwise authorized by
173.33 	the laws of this state to provide health care.
173.34 	(d) "Pharmacist" means an individual with a valid license
173.35 	issued under chapter 151 to practice pharmacy.
173.36 	(e) "Pharmacy" has the meaning given under section 151.01,
174.1 	subdivision 2.
174.2 		Subd. 2.Grants authorized; eligibility. (a) The
174.3 	commissioner of health shall establish a program to award grants
174.4 	to eligible rural communities or health care providers in
174.5 	eligible rural communities for planning, establishing, keeping
174.6 	in operation, or providing health care services that preserve
174.7 	access to prescription medications and the skills of a
174.8 	pharmacist according to sections 151.01 to 151.40.
174.9 	(b) To be eligible for a grant, an applicant must develop a
174.10 	strategic plan for preserving or enhancing access to
174.11 	prescription medications and the skills of a pharmacist.  At a
174.12 	minimum, a strategic plan must consist of:
174.13 	(1) a needs assessment to determine what pharmacy services
174.14 	are needed and desired by the community.  The assessment must
174.15 	include interviews with or surveys of area and local health
174.16 	professionals, local community leaders, and public officials;
174.17 	(2) an assessment of the feasibility of providing needed
174.18 	pharmacy services that identifies priorities and timelines for
174.19 	potential changes; and 
174.20 	(3) an implementation plan.
174.21 	(c) A grant may be used by a recipient that has developed a
174.22 	strategic plan to implement transition projects to modify the
174.23 	type and extent of pharmacy services provided, in order to
174.24 	reflect the needs of the community.  Grants may also be used by
174.25 	recipients:
174.26 	(1) to develop pharmacy practices that integrate pharmacy
174.27 	and existing health care provider facilities; or 
174.28 	(2) to establish a pharmacy provider cooperative or
174.29 	initiatives that maintain local access to prescription
174.30 	medications and the skills of a pharmacist.
174.31 		Subd. 3.Consideration of grants. In determining which
174.32 	applicants shall receive grants under this section, the
174.33 	commissioner of health shall appoint a committee comprised of
174.34 	members with experience and knowledge about rural pharmacy
174.35 	issues including, but not limited to, two rural pharmacists with
174.36 	a community pharmacy background, two health care providers from
175.1 	rural communities, one representative from a statewide
175.2 	pharmacist organization, and one representative of the Board of
175.3 	Pharmacy.  A representative of the commissioner may serve on the
175.4 	committee in an ex officio status.  In determining who shall
175.5 	receive a grant, the committee shall take into account:
175.6 	(1) improving or maintaining access to prescription
175.7 	medications and the skills of a pharmacist;
175.8 	(2) changes in service populations;
175.9 	(3) the extent community pharmacy needs are not currently
175.10 	met by other providers in the area;
175.11 	(4) the financial condition of the applicant;
175.12 	(5) the integration of pharmacy services into existing
175.13 	health care services; and 
175.14 	(6) community support.
175.15 	The commissioner may also take into account other relevant
175.16 	factors.
175.17 		Subd. 4.Allocation of grants. (a) The commissioner
175.18 	shall establish a deadline for receiving applications and must
175.19 	make a final decision on the funding of each application within
175.20 	60 days of the deadline.  An applicant must apply no later than
175.21 	March 1 of each fiscal year for grants awarded for that fiscal
175.22 	year.
175.23 	(b) Any grant awarded must not exceed $50,000 a year and
175.24 	may not exceed a one-year term.
175.25 	(c) Applicants may apply to the program each year they are
175.26 	eligible.
175.27 	(d) Project grants may not be used to retire debt incurred
175.28 	with respect to any capital expenditure made prior to the date
175.29 	on which the project is initiated.
175.30 		Subd. 5.Evaluation. The commissioner shall evaluate the
175.31 	overall effectiveness of the grant program and may collect
175.32 	progress reports and other information from grantees needed for
175.33 	program evaluation.  An academic institution that has the
175.34 	expertise in evaluating rural pharmacy outcomes may participate
175.35 	in the program evaluation if asked by a grantee or the
175.36 	commissioner.  The commissioner shall compile summaries of
176.1 	successful grant projects and other model community efforts to
176.2 	preserve access to prescription medications and the skills of a
176.3 	pharmacist, and make this information available to Minnesota
176.4 	communities seeking to address local pharmacy issues.
176.5 	
EFFECTIVE DATE. This section is effective August 1, 2005.

176.6 	Sec. 11. Minnesota Statutes 2004, section 144.148,
176.7 	subdivision 1, is amended to read:
176.8 		Subdivision 1.Definition.  (a) For purposes of this
176.9 	section, the following definitions apply.
176.10 	(b) "Eligible rural hospital" means any nonfederal, general
176.11 	acute care hospital that:
176.12 	(1) is either located in a rural area, as defined in the
176.13 	federal Medicare regulations, Code of Federal Regulations, title
176.14 	42, section 405.1041, or located in a community with a
176.15 	population of less than 10,000 15,000, according to United
176.16 	States Census Bureau statistics, outside the seven-county
176.17 	metropolitan area;
176.18 	(2) has 50 or fewer beds; and
176.19 	(3) is not for profit.
176.20 	(c) "Eligible project" means a modernization project to
176.21 	update, remodel, or replace aging hospital facilities and
176.22 	equipment necessary to maintain the operations of a hospital,
176.23 	including establishing an electronic health records system.
176.24 	
EFFECTIVE DATE. This section is effective the day
176.25 	following final enactment.

176.26 	Sec. 12. Minnesota Statutes 2004, section 144.1483, is
176.27 	amended to read:
176.28 	144.1483 RURAL HEALTH INITIATIVES.
176.29 	The commissioner of health, through the Office of Rural
176.30 	Health, and consulting as necessary with the commissioner of
176.31 	human services, the commissioner of commerce, the Higher
176.32 	Education Services Office, and other state agencies, shall:
176.33 	(1) develop a detailed plan regarding the feasibility of
176.34 	coordinating rural health care services by organizing individual
176.35 	medical providers and smaller hospitals and clinics into
176.36 	referral networks with larger rural hospitals and clinics that
177.1 	provide a broader array of services;
177.2 	(2) develop and implement a program to assist rural
177.3 	communities in establishing community health centers, as
177.4 	required by section 144.1486;
177.5 	(3) develop recommendations regarding health education and
177.6 	training programs in rural areas, including but not limited to a
177.7 	physician assistants' training program, continuing education
177.8 	programs for rural health care providers, and rural outreach
177.9 	programs for nurse practitioners within existing training
177.10 	programs;
177.11 	(4) (3) develop a statewide, coordinated recruitment
177.12 	strategy for health care personnel and maintain a database on
177.13 	health care personnel as required under section 144.1485;
177.14 	(5) (4) develop and administer technical assistance
177.15 	programs to assist rural communities in:  (i) planning and
177.16 	coordinating the delivery of local health care services; and
177.17 	(ii) hiring physicians, nurse practitioners, public health
177.18 	nurses, physician assistants, and other health personnel;
177.19 	(6) (5) study and recommend changes in the regulation of
177.20 	health care personnel, such as nurse practitioners and physician
177.21 	assistants, related to scope of practice, the amount of on-site
177.22 	physician supervision, and dispensing of medication, to address
177.23 	rural health personnel shortages;
177.24 	(7) (6) support efforts to ensure continued funding for
177.25 	medical and nursing education programs that will increase the
177.26 	number of health professionals serving in rural areas;
177.27 	(8) (7) support efforts to secure higher reimbursement for
177.28 	rural health care providers from the Medicare and medical
177.29 	assistance programs;
177.30 	(9) (8) coordinate the development of a statewide plan for
177.31 	emergency medical services, in cooperation with the Emergency
177.32 	Medical Services Advisory Council;
177.33 	(10) (9) establish a Medicare rural hospital flexibility
177.34 	program pursuant to section 1820 of the federal Social Security
177.35 	Act, United States Code, title 42, section 1395i-4, by
177.36 	developing a state rural health plan and designating, consistent
178.1 	with the rural health plan, rural nonprofit or public hospitals
178.2 	in the state as critical access hospitals.  Critical access
178.3 	hospitals shall include facilities that are certified by the
178.4 	state as necessary providers of health care services to
178.5 	residents in the area.  Necessary providers of health care
178.6 	services are designated as critical access hospitals on the
178.7 	basis of being more than 20 miles, defined as official mileage
178.8 	as reported by the Minnesota Department of Transportation, from
178.9 	the next nearest hospital, being the sole hospital in the
178.10 	county, being a hospital located in a county with a designated
178.11 	medically underserved area or health professional shortage area,
178.12 	or being a hospital located in a county contiguous to a county
178.13 	with a medically underserved area or health professional
178.14 	shortage area.  A critical access hospital located in a county
178.15 	with a designated medically underserved area or a health
178.16 	professional shortage area or in a county contiguous to a county
178.17 	with a medically underserved area or health professional
178.18 	shortage area shall continue to be recognized as a critical
178.19 	access hospital in the event the medically underserved area or
178.20 	health professional shortage area designation is subsequently
178.21 	withdrawn; and
178.22 	(11) (10) carry out other activities necessary to address
178.23 	rural health problems.

178.24 	EFFECTIVE DATE. This section is effective the day
178.25 	following final enactment.

178.26 	Sec. 13. Minnesota Statutes 2004, section 144.1501,
178.27 	subdivision 1, is amended to read:
178.28 		Subdivision 1.Definitions.  (a) For purposes of this
178.29 	section, the following definitions apply.
178.30 	(b) "Dentist" means an individual who is licensed to
178.31 	practice dentistry.
178.32 	(c) "Designated rural area" means:
178.33 	(1) an area in Minnesota outside the counties of Anoka,
178.34 	Carver, Dakota, Hennepin, Ramsey, Scott, and Washington,
178.35 	excluding the cities of Duluth, Mankato, Moorhead, Rochester,
178.36 	and St. Cloud; or
179.1 	(2) a municipal corporation, as defined under section
179.2 	471.634, that is physically located, in whole or in part, in an
179.3 	area defined as a designated rural area under clause (1).
179.4 	(c) (d) "Emergency circumstances" means those conditions
179.5 	that make it impossible for the participant to fulfill the
179.6 	service commitment, including death, total and permanent
179.7 	disability, or temporary disability lasting more than two years.
179.8 	(d) (e) "Medical resident" means an individual
179.9 	participating in a medical residency in family practice,
179.10 	internal medicine, obstetrics and gynecology, pediatrics, or
179.11 	psychiatry.
179.12 	(e) (f) "Midlevel practitioner" means a nurse practitioner,
179.13 	nurse-midwife, nurse anesthetist, advanced clinical nurse
179.14 	specialist, or physician assistant.
179.15 	(f) (g) "Nurse" means an individual who has completed
179.16 	training and received all licensing or certification necessary
179.17 	to perform duties as a licensed practical nurse or registered
179.18 	nurse.
179.19 	(g) (h) "Nurse-midwife" means a registered nurse who has
179.20 	graduated from a program of study designed to prepare registered
179.21 	nurses for advanced practice as nurse-midwives.
179.22 	(h) (i) "Nurse practitioner" means a registered nurse who
179.23 	has graduated from a program of study designed to prepare
179.24 	registered nurses for advanced practice as nurse practitioners.
179.25 	(i) (j) "Pharmacist" means an individual with a valid
179.26 	license issued under chapter 151.
179.27 	(k) "Physician" means an individual who is licensed to
179.28 	practice medicine in the areas of family practice, internal
179.29 	medicine, obstetrics and gynecology, pediatrics, or psychiatry.
179.30 	(j) (l) "Physician assistant" means a person registered
179.31 	under chapter 147A.
179.32 	(k) (m) "Qualified educational loan" means a government,
179.33 	commercial, or foundation loan for actual costs paid for
179.34 	tuition, reasonable education expenses, and reasonable living
179.35 	expenses related to the graduate or undergraduate education of a
179.36 	health care professional.
180.1 	(l) (n) "Underserved urban community" means a Minnesota
180.2 	urban area or population included in the list of designated
180.3 	primary medical care health professional shortage areas (HPSAs),
180.4 	medically underserved areas (MUAs), or medically underserved
180.5 	populations (MUPs) maintained and updated by the United States
180.6 	Department of Health and Human Services.
180.7 	
EFFECTIVE DATE. This section is effective August 1, 2005.

180.8 	Sec. 14. Minnesota Statutes 2004, section 144.1501,
180.9 	subdivision 2, is amended to read:
180.10 		Subd. 2.Creation of account. (a) A health professional
180.11 	education loan forgiveness program account is established.  The
180.12 	commissioner of health shall use money from the account to
180.13 	establish a loan forgiveness program:
180.14 	(1) for medical residents agreeing to practice in
180.15 	designated rural areas or underserved urban communities,or
180.16 	specializing in the area of pediatric psychiatry;
180.17 	(2) for midlevel practitioners agreeing to practice in
180.18 	designated rural areas, and or to teach for at least 20 hours
180.19 	per week in the nursing field in a postsecondary program;
180.20 	(3) for nurses who agree to practice in a Minnesota nursing
180.21 	home or intermediate care facility for persons with mental
180.22 	retardation or related conditions or to teach for at least 20
180.23 	hours per week in the nursing field in a postsecondary program;
180.24 	(4) for other health care technicians agreeing to teach for
180.25 	at least 20 hours per week in their designated field in a
180.26 	postsecondary program.  The commissioner, in consultation with
180.27 	the Healthcare Education-Industry Partnership, shall determine
180.28 	the health care fields where the need is the greatest,
180.29 	including, but not limited to, respiratory therapy, clinical
180.30 	laboratory technology, radiologic technology, and surgical
180.31 	technology;
180.32 	(5) for pharmacists who agree to practice in designated
180.33 	rural areas; and 
180.34 	(6) for dentists agreeing to deliver at least 25 percent of
180.35 	the dentist's yearly patient encounters to state public program
180.36 	enrollees or patients receiving sliding fee schedule discounts
181.1 	through a formal sliding fee schedule meeting the standards
181.2 	established by the United States Department of Health and Human
181.3 	Services under Code of Federal Regulations, title 42, section
181.4 	51, chapter 303.
181.5 	(b) Appropriations made to the account do not cancel and
181.6 	are available until expended, except that at the end of each
181.7 	biennium, any remaining balance in the account that is not
181.8 	committed by contract and not needed to fulfill existing
181.9 	commitments shall cancel to the fund.
181.10 	
EFFECTIVE DATE. This section is effective August 1, 2005.

181.11 	Sec. 15. Minnesota Statutes 2004, section 144.1501,
181.12 	subdivision 3, is amended to read:
181.13 		Subd. 3.Eligibility.  (a) To be eligible to participate
181.14 	in the loan forgiveness program, an individual must:
181.15 	(1) be a medical or dental resident, a licensed pharmacist 
181.16 	or be enrolled in a dentist,midlevel practitioner, registered
181.17 	nurse, or a licensed practical nurse training program; and
181.18 	(2) submit an application to the commissioner of
181.19 	health. If fewer applications are submitted by dental students
181.20 	or residents than there are dentist participant slots available,
181.21 	the commissioner may consider applications submitted by dental
181.22 	program graduates who are licensed dentists.
181.23 	(b) An applicant selected to participate must sign a
181.24 	contract to agree to serve a minimum three-year full-time
181.25 	service obligation according to subdivision 2, which shall begin
181.26 	no later than March 31 following completion of required training.
181.27 	
EFFECTIVE DATE. This section is effective August 1, 2005.

181.28 	Sec. 16. Minnesota Statutes 2004, section 144.1501,
181.29 	subdivision 4, is amended to read:
181.30 		Subd. 4.Loan forgiveness.  The commissioner of health
181.31 	may select applicants each year for participation in the loan
181.32 	forgiveness program, within the limits of available funding. The
181.33 	commissioner shall distribute available funds for loan
181.34 	forgiveness proportionally among the eligible professions
181.35 	according to the vacancy rate for each profession in the
181.36 	required geographic area or ,facility type, teaching area,
182.1 	patient group, or specialty type specified in subdivision 2.
182.2 	The commissioner shall allocate funds for physician loan
182.3 	forgiveness so that 75 percent of the funds available are used
182.4 	for rural physician loan forgiveness and 25 percent of the funds
182.5 	available are used for underserved urban communities and
182.6 	pediatric psychiatry loan forgiveness.  If the commissioner does
182.7 	not receive enough qualified applicants each year to use the
182.8 	entire allocation of funds for urban underserved communities any
182.9 	eligible profession, the remaining funds may be allocated for
182.10 	rural physician loan forgiveness proportionally among the other
182.11 	eligible professions according to the vacancy rate for each
182.12 	profession in the required geographic area, patient group, or
182.13 	facility type specified in subdivision 2.  Applicants are
182.14 	responsible for securing their own qualified educational loans.
182.15 	The commissioner shall select participants based on their
182.16 	suitability for practice serving the required geographic area or
182.17 	facility type specified in subdivision 2, as indicated by
182.18 	experience or training.  The commissioner shall give preference
182.19 	to applicants closest to completing their training.  For each
182.20 	year that a participant meets the service obligation required
182.21 	under subdivision 3, up to a maximum of four years, the
182.22 	commissioner shall make annual disbursements directly to the
182.23 	participant equivalent to 15 percent of the average educational
182.24 	debt for indebted graduates in their profession in the year
182.25 	closest to the applicant's selection for which information is
182.26 	available, not to exceed the balance of the participant's
182.27 	qualifying educational loans.  Before receiving loan repayment
182.28 	disbursements and as requested, the participant must complete
182.29 	and return to the commissioner an affidavit of practice form
182.30 	provided by the commissioner verifying that the participant is
182.31 	practicing as required under subdivisions 2 and 3.  The
182.32 	participant must provide the commissioner with verification that
182.33 	the full amount of loan repayment disbursement received by the
182.34 	participant has been applied toward the designated loans.  After
182.35 	each disbursement, verification must be received by the
182.36 	commissioner and approved before the next loan repayment
183.1 	disbursement is made.  Participants who move their practice
183.2 	remain eligible for loan repayment as long as they practice as
183.3 	required under subdivision 2.
183.4 	
EFFECTIVE DATE. This section is effective August 1, 2005.

183.5 	Sec. 17. Minnesota Statutes 2004, section 144.226,
183.6 	subdivision 1, as amended by Laws 2005, chapter 60, section 4,
183.7 	is amended to read:
183.8 		Subdivision 1.Which services are for fee. The fees for
183.9 	the following services shall be the following or an amount
183.10 	prescribed by rule of the commissioner:
183.11 	(a) The fee for the issuance of a certified vital record or
183.12 	a certification that the vital record cannot be found is $8 $9.
183.13 	No fee shall be charged for a certified birth, stillbirth, or
183.14 	death record that is reissued within one year of the original
183.15 	issue, if an amendment is made to the vital record and if the
183.16 	previously issued vital record is surrendered. The fee is
183.17 	nonrefundable.
183.18 	(b) The fee for processing a request for the replacement of
183.19 	a birth record for all events, except when filing a recognition
183.20 	of parentage pursuant to section 257.73, subdivision 1,
183.21 	is $20 $40. The fee is payable at the time of application and
183.22 	is nonrefundable.
183.23 	(c) The fee for processing a request for the filing of a
183.24 	delayed registration of birth, stillbirth, or death is $20 $40.
183.25 	The fee is payable at the time of application and is
183.26 	nonrefundable.  This fee includes one subsequent review of the
183.27 	request if the request is not acceptable upon the initial
183.28 	receipt.
183.29 	(d) The fee for processing a request for the amendment of
183.30 	any vital record when requested more than 45 days after the
183.31 	filing of the vital record is $20 $40.  No fee shall be charged
183.32 	for an amendment requested within 45 days after the filing of
183.33 	the vital record. The fee is payable at the time of application
183.34 	and is nonrefundable.  This fee includes one subsequent review
183.35 	of the request if the request is not acceptable upon the initial
183.36 	receipt.
184.1 	(e) The fee for processing a request for the verification
184.2 	of information from vital records is $8 $9 when the applicant
184.3 	furnishes the specific information to locate the vital record.
184.4 	When the applicant does not furnish specific information, the
184.5 	fee is $20 per hour for staff time expended.  Specific
184.6 	information includes the correct date of the event and the
184.7 	correct name of the registrant.  Fees charged shall approximate
184.8 	the costs incurred in searching and copying the vital records.
184.9 	The fee shall be is payable at the time of application and is
184.10 	nonrefundable.
184.11 	(f) The fee for processing a request for the issuance of a
184.12 	copy of any document on file pertaining to a vital record or
184.13 	statement that a related document cannot be found is $8 $9. The
184.14 	fee is payable at the time of application and is nonrefundable.
184.15 	
EFFECTIVE DATE. This section is effective August 1, 2005.

184.16 	Sec. 18. Minnesota Statutes 2004, section 144.226,
184.17 	subdivision 4, as amended by Laws 2005, chapter 60, section 6,
184.18 	is amended to read:
184.19 		Subd. 4.Vital records surcharge. (a) In addition to any
184.20 	fee prescribed under subdivision 1, there is a nonrefundable
184.21 	surcharge of $2 for each certified and noncertified birth,
184.22 	stillbirth, or death record, and for a certification that the
184.23 	record cannot be found.  The local or state registrar shall
184.24 	forward this amount to the commissioner of finance to be
184.25 	deposited into the state government special revenue fund.  This
184.26 	surcharge shall not be charged under those circumstances in
184.27 	which no fee for a birth, stillbirth, or death record is
184.28 	permitted under subdivision 1, paragraph (a).
184.29 	(b) Effective August 1, 2005, to June 30, 2009, the
184.30 	surcharge in paragraph (a) shall be $4.

184.31 	Sec. 19. Minnesota Statutes 2004, section 144.226, is
184.32 	amended by adding a subdivision to read:
184.33 		Subd. 5.Electronic verification. A fee for the
184.34 	electronic verification of a vital event, when the information
184.35 	being verified is obtained from a certified birth or death
184.36 	record, shall be established through contractual or interagency
185.1 	agreements with interested local, state, or federal government
185.2 	agencies.
185.3 	
EFFECTIVE DATE. This section is effective August 1, 2005.

185.4 	Sec. 20. Minnesota Statutes 2004, section 144.226, is
185.5 	amended by adding a subdivision to read:
185.6 		Subd. 6.Alternative payment methods. Notwithstanding
185.7 	subdivision 1, alternative payment methods may be approved and
185.8 	implemented by the state registrar or a local registrar.
185.9 	
EFFECTIVE DATE. This section is effective August 1, 2005.

185.10 	Sec. 21. Minnesota Statutes 2004, section 144.3831,
185.11 	subdivision 1, is amended to read:
185.12 		Subdivision 1.Fee setting.  The commissioner of health
185.13 	may assess an annual fee of $5.21 $6.36 for every service
185.14 	connection to a public water supply that is owned or operated by
185.15 	a home rule charter city, a statutory city, a city of the first
185.16 	class, or a town.  The commissioner of health may also assess an
185.17 	annual fee for every service connection served by a water user
185.18 	district defined in section 110A.02.
185.19 	
EFFECTIVE DATE. This section is effective July 1, 2006.

185.20 	Sec. 22. Minnesota Statutes 2004, section 144.551,
185.21 	subdivision 1, is amended to read:
185.22 		Subdivision 1.Restricted construction or modification.
 185.23 	(a) The following construction or modification may not be
185.24 	commenced:
185.25 	(1) any erection, building, alteration, reconstruction,
185.26 	modernization, improvement, extension, lease, or other
185.27 	acquisition by or on behalf of a hospital that increases the bed
185.28 	capacity of a hospital, relocates hospital beds from one
185.29 	physical facility, complex, or site to another, or otherwise
185.30 	results in an increase or redistribution of hospital beds within
185.31 	the state; and
185.32 	(2) the establishment of a new hospital.
185.33 	(b) This section does not apply to:
185.34 	(1) construction or relocation within a county by a
185.35 	hospital, clinic, or other health care facility that is a
185.36 	national referral center engaged in substantial programs of
186.1 	patient care, medical research, and medical education meeting
186.2 	state and national needs that receives more than 40 percent of
186.3 	its patients from outside the state of Minnesota;
186.4 	(2) a project for construction or modification for which a
186.5 	health care facility held an approved certificate of need on May
186.6 	1, 1984, regardless of the date of expiration of the
186.7 	certificate;
186.8 	(3) a project for which a certificate of need was denied
186.9 	before July 1, 1990, if a timely appeal results in an order
186.10 	reversing the denial;
186.11 	(4) a project exempted from certificate of need
186.12 	requirements by Laws 1981, chapter 200, section 2;
186.13 	(5) a project involving consolidation of pediatric
186.14 	specialty hospital services within the Minneapolis-St. Paul
186.15 	metropolitan area that would not result in a net increase in the
186.16 	number of pediatric specialty hospital beds among the hospitals
186.17 	being consolidated;
186.18 	(6) a project involving the temporary relocation of
186.19 	pediatric-orthopedic hospital beds to an existing licensed
186.20 	hospital that will allow for the reconstruction of a new
186.21 	philanthropic, pediatric-orthopedic hospital on an existing site
186.22 	and that will not result in a net increase in the number of
186.23 	hospital beds.  Upon completion of the reconstruction, the
186.24 	licenses of both hospitals must be reinstated at the capacity
186.25 	that existed on each site before the relocation;
186.26 	(7) the relocation or redistribution of hospital beds
186.27 	within a hospital building or identifiable complex of buildings
186.28 	provided the relocation or redistribution does not result in:
186.29 	(i) an increase in the overall bed capacity at that site; (ii)
186.30 	relocation of hospital beds from one physical site or complex to
186.31 	another; or (iii) redistribution of hospital beds within the
186.32 	state or a region of the state;
186.33 	(8) relocation or redistribution of hospital beds within a
186.34 	hospital corporate system that involves the transfer of beds
186.35 	from a closed facility site or complex to an existing site or
186.36 	complex provided that:  (i) no more than 50 percent of the
187.1 	capacity of the closed facility is transferred; (ii) the
187.2 	capacity of the site or complex to which the beds are
187.3 	transferred does not increase by more than 50 percent; (iii) the
187.4 	beds are not transferred outside of a federal health systems
187.5 	agency boundary in place on July 1, 1983; and (iv) the
187.6 	relocation or redistribution does not involve the construction
187.7 	of a new hospital building;
187.8 	(9) a construction project involving up to 35 new beds in a
187.9 	psychiatric hospital in Rice County that primarily serves
187.10 	adolescents and that receives more than 70 percent of its
187.11 	patients from outside the state of Minnesota;
187.12 	(10) a project to replace a hospital or hospitals with a
187.13 	combined licensed capacity of 130 beds or less if:  (i) the new
187.14 	hospital site is located within five miles of the current site;
187.15 	and (ii) the total licensed capacity of the replacement
187.16 	hospital, either at the time of construction of the initial
187.17 	building or as the result of future expansion, will not exceed
187.18 	70 licensed hospital beds, or the combined licensed capacity of
187.19 	the hospitals, whichever is less;
187.20 	(11) the relocation of licensed hospital beds from an
187.21 	existing state facility operated by the commissioner of human
187.22 	services to a new or existing facility, building, or complex
187.23 	operated by the commissioner of human services; from one
187.24 	regional treatment center site to another; or from one building
187.25 	or site to a new or existing building or site on the same
187.26 	campus;
187.27 	(12) the construction or relocation of hospital beds
187.28 	operated by a hospital having a statutory obligation to provide
187.29 	hospital and medical services for the indigent that does not
187.30 	result in a net increase in the number of hospital beds,
187.31 	notwithstanding section 144.552, 27 beds, of which 12 serve
187.32 	mental health needs, may be transferred from Hennepin County
187.33 	Medical Center to Regions Hospital under this clause;
187.34 	(13) a construction project involving the addition of up to
187.35 	31 new beds in an existing nonfederal hospital in Beltrami
187.36 	County;
188.1 	(14) a construction project involving the addition of up to
188.2 	eight new beds in an existing nonfederal hospital in Otter Tail
188.3 	County with 100 licensed acute care beds;
188.4 	(15) a construction project involving the addition of 20
188.5 	new hospital beds used for rehabilitation services in an
188.6 	existing hospital in Carver County serving the southwest
188.7 	suburban metropolitan area.  Beds constructed under this clause
188.8 	shall not be eligible for reimbursement under medical
188.9 	assistance, general assistance medical care, or MinnesotaCare;
188.10 	(16) a project for the construction or relocation of up to
188.11 	20 hospital beds for the operation of up to two psychiatric
188.12 	facilities or units for children provided that the operation of
188.13 	the facilities or units have received the approval of the
188.14 	commissioner of human services;
188.15 	(17) a project involving the addition of 14 new hospital
188.16 	beds to be used for rehabilitation services in an existing
188.17 	hospital in Itasca County; or 
188.18 	(18) a project to add 20 licensed beds in existing space at
188.19 	a hospital in Hennepin County that closed 20 rehabilitation beds
188.20 	in 2002, provided that the beds are used only for rehabilitation
188.21 	in the hospital's current rehabilitation building.  If the beds
188.22 	are used for another purpose or moved to another location, the
188.23 	hospital's licensed capacity is reduced by 20 beds; or 
188.24 	(19) a critical access hospital established under section
188.25 	144.1483, clause (9), and section 1820 of the federal Social
188.26 	Security Act, United States Code, title 42, section 1395i-4,
188.27 	that delicensed beds since enactment of the Balanced Budget Act
188.28 	of 1997, Public Law 105-33, to the extent that the critical
188.29 	access hospital does not seek to exceed the maximum number of
188.30 	beds permitted such hospital under federal law.
188.31 	
EFFECTIVE DATE. This section is effective the day
188.32 	following final enactment.

188.33 	Sec. 23. Minnesota Statutes 2004, section 144.562,
188.34 	subdivision 2, is amended to read:
188.35 		Subd. 2.Eligibility for license condition. (a) A
188.36 	hospital is not eligible to receive a license condition for
189.1 	swing beds unless (1) it either has a licensed bed capacity of
189.2 	less than 50 beds defined in the federal Medicare regulations,
189.3 	Code of Federal Regulations, title 42, section 482.66, or it has
189.4 	a licensed bed capacity of 50 beds or more and has swing beds
189.5 	that were approved for Medicare reimbursement before May 1,
189.6 	1985, or it has a licensed bed capacity of less than 65 beds and
189.7 	the available nursing homes within 50 miles have had, in the
189.8 	aggregate, an average occupancy rate of 96 percent or higher in
189.9 	the most recent two years as documented on the statistical
189.10 	reports to the Department of Health; and (2) it is located in a
189.11 	rural area as defined in the federal Medicare regulations, Code
189.12 	of Federal Regulations, title 42, section 482.66.
189.13 	(b) Except for those critical access hospitals established
189.14 	under section 144.1483, clause (9), and section 1820 of the
189.15 	federal Social Security Act, United States Code, title 42,
189.16 	section 1395i-4, that have an attached nursing home or that
189.17 	owned a nursing home located in the same municipality as of May
189.18 	1, 2005,eligible hospitals are allowed a total of 1,460 2,000 
189.19 	days of swing bed use per year, provided that no more than ten
189.20 	hospital beds are used as swing beds at any one time. Critical
189.21 	access hospitals that have an attached nursing home or that
189.22 	owned a nursing home located in the same municipality as of May
189.23 	1, 2005, are allowed swing bed use as provided in federal law.
189.24 	(c) Except for critical access hospitals that have an
189.25 	attached nursing home or that owned a nursing home located in
189.26 	the same municipality as of May 1, 2005,the commissioner of
189.27 	health must may approve swing bed use beyond 1,460 2,000 days as
189.28 	long as there are no Medicare certified skilled nursing facility
189.29 	beds available within 25 miles of that hospital that are willing
189.30 	to admit the patient.  Critical access hospitals exceeding 2,000
189.31 	swing bed days must maintain documentation that they have
189.32 	contacted skilled nursing facilities within 25 miles to
189.33 	determine if any skilled nursing facility beds are available
189.34 	that are willing to admit the patient.
189.35 	(d) After reaching 2,000 days of swing bed use in a year,
189.36 	an eligible hospital to which this limit applies may admit six
190.1 	additional patients to swing beds each year without seeking
190.2 	approval from the commissioner or being in violation of this
190.3 	subdivision.  These six swing bed admissions are exempt from the
190.4 	limit of 2,000 annual swing bed days for hospitals subject to
190.5 	this limit.
190.6 	(e) A health care system that is in full compliance with
190.7 	this subdivision may allocate its total limit of swing bed days
190.8 	among the hospitals within the system, provided that no hospital
190.9 	in the system without an attached nursing home may exceed 2,000
190.10 	swing bed days per year.
190.11 	
EFFECTIVE DATE. This section is effective the day
190.12 	following final enactment.

190.13 	Sec. 24. [144.574] EDUCATION ABOUT THE DANGERS OF SHAKING
190.14 	INFANTS AND YOUNG CHILDREN.
190.15 		Subdivision 1.Education by hospitals. (a) A hospital
190.16 	licensed under sections 144.50 to 144.56 shall make available
190.17 	for viewing by the parents of each newborn baby delivered in the
190.18 	hospital a video presentation on the dangers associated with
190.19 	shaking infants and young children.
190.20 	(b) A hospital shall use a video obtained from the
190.21 	commissioner or approved by the commissioner.  The commissioner
190.22 	shall provide to a hospital and any interested individuals, at
190.23 	cost, copies of an approved video.  The commissioner shall
190.24 	review other video presentations for possible approval upon the
190.25 	request of a hospital.  The commissioner shall not require a
190.26 	hospital to use videos that would require the hospital to pay
190.27 	royalties for use of the video, restrict viewing in order to
190.28 	comply with public viewing or other restrictions, or be subject
190.29 	to other costs or restrictions associated with copyrights.
190.30 	(c) A hospital shall, whenever possible, request both
190.31 	parents to view the video.
190.32 	(d) The showing or distribution of the video shall not
190.33 	subject any person or facility to any action for damages or
190.34 	other relief provided the person or facility acted in good faith.
190.35 		Subd. 2.Education by health care providers. The
190.36 	commissioner shall establish a protocol for health care
191.1 	providers to educate parents and primary caregivers about the
191.2 	dangers associated with shaking infants and young children.  The
191.3 	commissioner shall request family practice physicians,
191.4 	pediatricians, and other pediatric health care providers to
191.5 	review these dangers with the parents and primary caregivers of
191.6 	infants and young children up to the age of three at each
191.7 	well-baby visit.
191.8 	
EFFECTIVE DATE. This section is effective August 1, 2005.

191.9 	Sec. 25. [144.602] DEFINITIONS.
191.10 		Subdivision 1.Applicability. For purposes of sections
191.11 	144.601 to 144.608, the terms defined in this section have the
191.12 	meanings given them.
191.13 		Subd. 2.Commissioner. "Commissioner" means the
191.14 	commissioner of health.
191.15 		Subd. 3.Major trauma. "Major trauma" means a sudden
191.16 	severe injury or damage to the body caused by an external force
191.17 	that results in potentially life-threatening injuries or that
191.18 	could result in the following disabilities:
191.19 	(1) impairment of cognitive or mental abilities;
191.20 	(2) impairment of physical functioning; or 
191.21 	(3) disturbance of behavioral or emotional functioning.
191.22 		Subd. 4.Trauma hospital. "Trauma hospital" means a
191.23 	hospital that voluntarily meets the commissioner's criteria
191.24 	under section 144.603 and that has been designated as a trauma
191.25 	hospital under section 144.605.
191.26 	
EFFECTIVE DATE. This section is effective the day
191.27 	following final enactment.

191.28 	Sec. 26. [144.603] STATEWIDE TRAUMA SYSTEM CRITERIA.
191.29 		Subdivision 1.Criteria established. The commissioner
191.30 	shall adopt criteria to ensure that severely injured people are
191.31 	promptly transported and treated at trauma hospitals appropriate
191.32 	to the severity of injury.  Minimum criteria shall address
191.33 	emergency medical service trauma triage and transportation
191.34 	guidelines as approved under section 144E.101, subdivision 14,
191.35 	designation of hospitals as trauma hospitals, interhospital
191.36 	transfers, a trauma registry, and a trauma system governance
192.1 	structure.
192.2 		Subd. 2.Basis; verification. The commissioner shall
192.3 	base the establishment, implementation, and modifications to the
192.4 	criteria under subdivision 1 on the department-published
192.5 	Minnesota comprehensive statewide trauma system plan.  The
192.6 	commissioner shall seek the advice of the Trauma Advisory
192.7 	Council in implementing and updating the criteria, using
192.8 	accepted and prevailing trauma transport, treatment, and
192.9 	referral standards of the American College of Surgeons, the
192.10 	American College of Emergency Physicians, the Minnesota
192.11 	Emergency Medical Services Regulatory Board, the national Trauma
192.12 	Resources Network, and other widely recognized trauma experts.
192.13 	The commissioner shall adapt and modify the standards as
192.14 	appropriate to accommodate Minnesota's unique geography and the
192.15 	state's hospital and health professional distribution and shall
192.16 	verify that the criteria are met by each hospital voluntarily
192.17 	participating in the statewide trauma system.
192.18 		Subd. 3.Rule exemption and report to the
192.19 	legislature. In developing and adopting the criteria under this
192.20 	section, the commissioner of health is exempt from chapter 14,
192.21 	including section 14.386.  By September 1, 2009, the
192.22 	commissioner must report to the legislature on implementation of
192.23 	the voluntary trauma system, including recommendations on the
192.24 	need for including the trauma system criteria in rule.
192.25 	
EFFECTIVE DATE. This section is effective the day
192.26 	following final enactment.

192.27 	Sec. 27. [144.604] TRAUMA TRIAGE AND TRANSPORTATION.
192.28 		Subdivision 1.Transport requirement. Unless the
192.29 	Emergency Medical Services Regulatory Board has approved a
192.30 	licensed ambulance service's deviation from the guidelines under
192.31 	section 144E.101, subdivision 14, the ambulance service must
192.32 	transport major trauma patients from the scene to the highest
192.33 	state-designated trauma hospital within 30 minutes' transport
192.34 	time.
192.35 		Subd. 2.Ground ambulance exceptions. Notwithstanding
192.36 	subdivision 1, ground ambulances must comply with the following:
193.1 	(1) patients with compromised airways must be transported
193.2 	immediately to the nearest designated trauma hospital; and 
193.3 	(2) level II trauma hospitals capable of providing
193.4 	definitive trauma care must not be bypassed to reach a level I
193.5 	trauma hospital.
193.6 		Subd. 3.Undesignated hospitals. No major trauma patient
193.7 	shall be transported to a hospital not participating in the
193.8 	statewide trauma system unless no trauma hospital is available
193.9 	within 30 minutes' transport time.
193.10 	
EFFECTIVE DATE. This section is effective July 1, 2009.

193.11 	Sec. 28. [144.605] DESIGNATING TRAUMA HOSPITALS.
193.12 		Subdivision 1.Naming privileges. Unless it has been
193.13 	designated a trauma hospital by the commissioner, no hospital
193.14 	shall use the term trauma center or trauma hospital in its name
193.15 	or its advertising or shall otherwise indicate it has trauma
193.16 	treatment capabilities.
193.17 		Subd. 2.Designation; reverification. The commissioner
193.18 	shall designate four levels of trauma hospitals.  A hospital
193.19 	that voluntarily meets the criteria for a particular level of
193.20 	trauma hospital shall apply to the commissioner for designation
193.21 	and, upon the commissioner's verifying the hospital meets the
193.22 	criteria, be designated a trauma hospital at the appropriate
193.23 	level for a three-year period.  Prior to the expiration of the
193.24 	three-year designation, a hospital seeking to remain part of the
193.25 	voluntary system must apply for and successfully complete a
193.26 	reverification process, be awaiting the site visit for the
193.27 	reverification, or be awaiting the results of the site visit.
193.28 	The commissioner may extend a hospital's existing designation
193.29 	for up to 18 months on a provisional basis if the hospital has
193.30 	applied for reverification in a timely manner but has not yet
193.31 	completed the reverification process within the expiration of
193.32 	the three-year designation and the extension is in the best
193.33 	interest of trauma system patient safety.  To be granted a
193.34 	provisional extension, the hospital must be:
193.35 	(1) scheduled and awaiting the site visit for
193.36 	reverification;
194.1 	(2) awaiting the results of the site visit; or 
194.2 	(3) responding to and correcting identified deficiencies
194.3 	identified in the site visit.
194.4 		Subd. 3.Acs verification. The commissioner shall grant
194.5 	the appropriate level I, II, or III trauma hospital designation
194.6 	to a hospital that successfully completes and passes the
194.7 	American College of Surgeons (ACS) verification standards at the
194.8 	hospital's cost, submits verification documentation to the
194.9 	Trauma Advisory Council, and formally notifies the Trauma
194.10 	Advisory Council of ACS verification.
194.11 		Subd. 4.Level iii designation; not acs verified. (a)
194.12 	The commissioner shall grant the appropriate level III trauma
194.13 	hospital designation to a hospital that is not ACS verified but
194.14 	that successfully completes the designation process under
194.15 	paragraph (b).
194.16 	(b) The hospital must complete and submit a self-reported
194.17 	survey and application to the Trauma Advisory Council for
194.18 	review, verifying that the hospital meets the criteria as a
194.19 	level III trauma hospital.  When the Trauma Advisory Council is
194.20 	satisfied the application is complete, the commissioner shall
194.21 	arrange a site review visit.  Upon successful completion of the
194.22 	site review, the review team shall make written recommendations
194.23 	to the Trauma Advisory Council.  If approved by the Trauma
194.24 	Advisory Council, a letter of recommendation shall be sent to
194.25 	the commissioner for final approval and designation.
194.26 		Subd. 5.Level iv designation. (a) The commissioner
194.27 	shall grant the appropriate level IV trauma hospital designation
194.28 	to a hospital that successfully completes the designation
194.29 	process under paragraph (b).
194.30 	(b) The hospital must complete and submit a self-reported
194.31 	survey and application to the Trauma Advisory Council for
194.32 	review, verifying that the hospital meets the criteria as a
194.33 	level IV trauma hospital.  When the Trauma Advisory Council is
194.34 	satisfied the application is complete, the council shall review
194.35 	the application and, if the council approves the application,
194.36 	send a letter of recommendation to the commissioner for final
195.1 	approval and designation.  The commissioner shall grant a level
195.2 	IV designation and shall arrange a site review visit within
195.3 	three years of the designation and every three years thereafter,
195.4 	to coincide with the three-year reverification process.
195.5 		Subd. 6.Changes in designation. Changes in a trauma
195.6 	hospital's ability to meet the criteria for the hospital's level
195.7 	of designation must be self-reported to the Trauma Advisory
195.8 	Council and to other regional hospitals and local emergency
195.9 	medical services providers and authorities.  If the hospital
195.10 	cannot correct its ability to meet the criteria for its level
195.11 	within six months, the hospital may apply for redesignation at a
195.12 	different level.
195.13 		Subd. 7.Higher designation. A trauma hospital may apply
195.14 	for a higher trauma hospital designation one time during the
195.15 	hospital's three-year designation by completing the designation
195.16 	process for that level of trauma hospital.
195.17 		Subd. 8.Loss of designation. The commissioner may
195.18 	refuse to designate or redesignate or may revoke a previously
195.19 	issued trauma hospital designation if a hospital does not meet
195.20 	the criteria of the statewide trauma plan, in the interests of
195.21 	patient safety, or if a hospital denies or refuses a reasonable
195.22 	request by the commissioner or the commissioner's designee to
195.23 	verify information by correspondence or an on-site visit.
195.24 	
EFFECTIVE DATE. This section is effective the day
195.25 	following final enactment.

195.26 	Sec. 29. [144.606] INTERHOSPITAL TRANSFERS.
195.27 		Subdivision 1.Written procedures required. A level III
195.28 	or IV trauma hospital must have predetermined, written
195.29 	procedures that direct the internal process for rapidly and
195.30 	efficiently transferring a major trauma patient to definitive
195.31 	care, including:
195.32 	(1) clearly identified anatomic and physiologic criteria
195.33 	that, if met, will immediately initiate transfer to definitive
195.34 	care;
195.35 	(2) a listing of appropriate ground and air transport
195.36 	services, including primary and secondary telephone contact
196.1 	numbers; and 
196.2 	(3) immediately available supplies, records, or other
196.3 	necessary resources that will accompany a patient.
196.4 		Subd. 2.Transfer agreements. (a) A level III or IV
196.5 	trauma hospital may transfer patients to a hospital with which
196.6 	the trauma hospital has a written transfer agreement.
196.7 	(b) Each agreement must be current and with a trauma
196.8 	hospital or trauma hospitals capable of caring for major trauma
196.9 	injuries.
196.10 	(c) A level III or IV trauma hospital must have a current
196.11 	transfer agreement with a hospital that has special capabilities
196.12 	in the treatment of burn injuries and a transfer agreement with
196.13 	a second hospital that has special capabilities in the treatment
196.14 	of burn injuries, should the primary transfer hospital be unable
196.15 	to accept a burn patient.
196.16 	
EFFECTIVE DATE. This section is effective the day
196.17 	following final enactment.

196.18 	Sec. 30. [144.607] TRAUMA REGISTRY.
196.19 		Subdivision 1.Registry participation required. A trauma
196.20 	hospital must participate in the statewide trauma registry.
196.21 		Subd. 2.Trauma reporting. A trauma hospital must report
196.22 	major trauma injuries as part of the reporting for the traumatic
196.23 	brain injury and spinal cord injury registry required in
196.24 	sections 144.661 to 144.665.
196.25 		Subd. 3.Application of other law. Sections 144.661 to
196.26 	144.665 apply to a major trauma reported to the statewide trauma
196.27 	registry, with the exception of sections 144.662, clause (2),
196.28 	and 144.664, subdivision 3.
196.29 	
EFFECTIVE DATE. This section is effective the day
196.30 	following final enactment.

196.31 	Sec. 31. [144.608] TRAUMA ADVISORY COUNCIL.
196.32 		Subdivision 1.Trauma advisory council established. (a)
196.33 	A Trauma Advisory Council is established to advise, consult
196.34 	with, and make recommendations to the commissioner on the
196.35 	development, maintenance, and improvement of a statewide trauma
196.36 	system.
197.1 	(b) The council shall consist of the following members:
197.2 	(1) a trauma surgeon certified by the American College of
197.3 	Surgeons who practices in a level I or II trauma hospital;
197.4 	(2) a general surgeon certified by the American College of
197.5 	Surgeons whose practice includes trauma and who practices in a
197.6 	designated rural area as defined under section 144.1501,
197.7 	subdivision 1, paragraph (b);
197.8 	(3) a neurosurgeon certified by the American Board of
197.9 	Neurological Surgery who practices in a level I or II trauma
197.10 	hospital;
197.11 	(4) a trauma program nurse manager or coordinator
197.12 	practicing in a level I or II trauma hospital;
197.13 	(5) an emergency physician certified by the American
197.14 	College of Emergency Physicians whose practice includes
197.15 	emergency room care in a level I, II, III, or IV trauma
197.16 	hospital;
197.17 	(6) an emergency room nurse manager who practices in a
197.18 	level III or IV trauma hospital;
197.19 	(7) a family practice physician whose practice includes
197.20 	emergency room care in a level III or IV trauma hospital located
197.21 	in a designated rural area as defined under section 144.1501,
197.22 	subdivision 1, paragraph (b);
197.23 	(8) a nurse practitioner, as defined under section
197.24 	144.1501, subdivision 1, paragraph (h), or a physician
197.25 	assistant, as defined under section 144.1501, subdivision 1,
197.26 	paragraph (j), whose practice includes emergency room care in a
197.27 	level IV trauma hospital located in a designated rural area as
197.28 	defined under section 144.1501, subdivision 1, paragraph (b);
197.29 	(9) a pediatrician certified by the American Academy of
197.30 	Pediatrics whose practice includes emergency room care in a
197.31 	level I, II, III, or IV trauma hospital;
197.32 	(10) an orthopedic surgeon certified by the American Board
197.33 	of Orthopaedic Surgery whose practice includes trauma and who
197.34 	practices in a level I, II, or III trauma hospital;
197.35 	(11) the state emergency medical services medical director
197.36 	appointed by the Emergency Medical Services Regulatory Board;
198.1 	(12) a hospital administrator of a level III or IV trauma
198.2 	hospital located in a designated rural area as defined under
198.3 	section 144.1501, subdivision 1, paragraph (b);
198.4 	(13) a rehabilitation specialist whose practice includes
198.5 	rehabilitation of patients with major trauma injuries or
198.6 	traumatic brain injuries and spinal cord injuries as defined
198.7 	under section 144.661;
198.8 	(14) an attendant or ambulance director who is an EMT,
198.9 	EMT-I, or EMT-P within the meaning of section 144E.001 and who
198.10 	actively practices with a licensed ambulance service in a
198.11 	primary service area located in a designated rural area as
198.12 	defined under section 144.1501, subdivision 1, paragraph (b);
198.13 	and 
198.14 	(15) the commissioner of public safety or the
198.15 	commissioner's designee.
198.16 	(c) Council members whose appointment is dependent on
198.17 	practice in a level III or IV trauma hospital may be appointed
198.18 	to an initial term based upon their statements that the hospital
198.19 	intends to become a level III or IV facility by July 1, 2009.
198.20 		Subd. 2.Council administration. (a) The council must
198.21 	meet at least twice a year but may meet more frequently at the
198.22 	call of the chair, a majority of the council members, or the
198.23 	commissioner.
198.24 	(b) The terms, compensation, and removal of members of the
198.25 	council are governed by section 15.059, except that the council
198.26 	expires June 30, 2015.
198.27 	(c) The council may appoint subcommittees and workgroups.
198.28 	Subcommittees shall consist of council members.  Workgroups may
198.29 	include noncouncil members.  Noncouncil members shall be
198.30 	compensated for workgroup activities under section 15.059,
198.31 	subdivision 3, but shall receive expenses only.
198.32 		Subd. 3.Regional trauma advisory councils. (a) Up to
198.33 	eight regional trauma advisory councils may be formed as needed.
198.34 	(b) Regional trauma advisory councils shall advise, consult
198.35 	with, and make recommendation to the state Trauma Advisory
198.36 	Council on suggested regional modifications to the statewide
199.1 	trauma criteria that will improve patient care and accommodate
199.2 	specific regional needs.
199.3 	(c) Each regional advisory council must have no more than
199.4 	15 members.  The commissioner, in consultation with the
199.5 	Emergency Medical Services Regulatory Board, shall name the
199.6 	council members.
199.7 	(d) Regional council members may receive expenses in the
199.8 	same manner and amount as authorized by the plan adopted under
199.9 	section 43A.18, subdivision 2.
199.10 	
EFFECTIVE DATE. This section is effective the day
199.11 	following final enactment.

199.12 	Sec. 32. Minnesota Statutes 2004, section 144.9504,
199.13 	subdivision 2, is amended to read:
199.14 		Subd. 2.Lead risk assessment.  (a) An assessing agency
199.15 	shall conduct a lead risk assessment of a residence according to
199.16 	the venous blood lead level and time frame set forth in clauses
199.17 	(1) to (5) (4) for purposes of secondary prevention:
199.18 	(1) within 48 hours of a child or pregnant female in the
199.19 	residence being identified to the agency as having a venous
199.20 	blood lead level equal to or greater than 70 60 micrograms of
199.21 	lead per deciliter of whole blood;
199.22 	(2) within five working days of a child or pregnant female
199.23 	in the residence being identified to the agency as having a
199.24 	venous blood lead level equal to or greater than 45 micrograms
199.25 	of lead per deciliter of whole blood;
199.26 	(3) within ten working days of a child in the residence
199.27 	being identified to the agency as having a venous blood lead
199.28 	level equal to or greater than 20 15 micrograms of lead per
199.29 	deciliter of whole blood; or 
199.30 	(4) within ten working days of a child in the residence
199.31 	being identified to the agency as having a venous blood lead
199.32 	level that persists in the range of 15 to 19 micrograms of lead
199.33 	per deciliter of whole blood for 90 days after initial
199.34 	identification; or 
199.35 	(5) within ten working days of a pregnant female in the
199.36 	residence being identified to the agency as having a venous
200.1 	blood lead level equal to or greater than ten micrograms of lead
200.2 	per deciliter of whole blood.
200.3 	(b) Within the limits of available local, state, and
200.4 	federal appropriations, an assessing agency may also conduct a
200.5 	lead risk assessment for children with any elevated blood lead
200.6 	level.
200.7 	(c) In a building with two or more dwelling units, an
200.8 	assessing agency shall assess the individual unit in which the
200.9 	conditions of this section are met and shall inspect all common
200.10 	areas accessible to a child.  If a child visits one or more
200.11 	other sites such as another residence, or a residential or
200.12 	commercial child care facility, playground, or school, the
200.13 	assessing agency shall also inspect the other sites.  The
200.14 	assessing agency shall have one additional day added to the time
200.15 	frame set forth in this subdivision to complete the lead risk
200.16 	assessment for each additional site.
200.17 	(d) Within the limits of appropriations, the assessing
200.18 	agency shall identify the known addresses for the previous 12
200.19 	months of the child or pregnant female with venous blood lead
200.20 	levels of at least 20 15 micrograms per deciliter for the child
200.21 	or at least ten micrograms per deciliter for the pregnant
200.22 	female; notify the property owners, landlords, and tenants at
200.23 	those addresses that an elevated blood lead level was found in a
200.24 	person who resided at the property; and give them primary
200.25 	prevention information.  Within the limits of appropriations,
200.26 	the assessing agency may perform a risk assessment and issue
200.27 	corrective orders in the properties, if it is likely that the
200.28 	previous address contributed to the child's or pregnant female's
200.29 	blood lead level.  The assessing agency shall provide the notice
200.30 	required by this subdivision without identifying the child or
200.31 	pregnant female with the elevated blood lead level.  The
200.32 	assessing agency is not required to obtain the consent of the
200.33 	child's parent or guardian or the consent of the pregnant female
200.34 	for purposes of this subdivision.  This information shall be
200.35 	classified as private data on individuals as defined under
200.36 	section 13.02, subdivision 12.
201.1 	(e) The assessing agency shall conduct the lead risk
201.2 	assessment according to rules adopted by the commissioner under
201.3 	section 144.9508.  An assessing agency shall have lead risk
201.4 	assessments performed by lead risk assessors licensed by the
201.5 	commissioner according to rules adopted under section 144.9508.
201.6 	If a property owner refuses to allow a lead risk assessment, the
201.7 	assessing agency shall begin legal proceedings to gain entry to
201.8 	the property and the time frame for conducting a lead risk
201.9 	assessment set forth in this subdivision no longer applies.  A
201.10 	lead risk assessor or assessing agency may observe the
201.11 	performance of lead hazard reduction in progress and shall
201.12 	enforce the provisions of this section under section 144.9509.
201.13 	Deteriorated painted surfaces, bare soil, and dust must be
201.14 	tested with appropriate analytical equipment to determine the
201.15 	lead content, except that deteriorated painted surfaces or bare
201.16 	soil need not be tested if the property owner agrees to engage
201.17 	in lead hazard reduction on those surfaces.  The lead content of
201.18 	drinking water must be measured if another probable source of
201.19 	lead exposure is not identified.  Within a standard metropolitan
201.20 	statistical area, an assessing agency may order lead hazard
201.21 	reduction of bare soil without measuring the lead content of the
201.22 	bare soil if the property is in a census tract in which soil
201.23 	sampling has been performed according to rules established by
201.24 	the commissioner and at least 25 percent of the soil samples
201.25 	contain lead concentrations above the standard in section
201.26 	144.9508.
201.27 	(f) Each assessing agency shall establish an administrative
201.28 	appeal procedure which allows a property owner to contest the
201.29 	nature and conditions of any lead order issued by the assessing
201.30 	agency.  Assessing agencies must consider appeals that propose
201.31 	lower cost methods that make the residence lead safe.  The
201.32 	commissioner shall use the authority and appeal procedure
201.33 	granted under sections 144.989 to 144.993.
201.34 	(g) Sections 144.9501 to 144.9509 neither authorize nor
201.35 	prohibit an assessing agency from charging a property owner for
201.36 	the cost of a lead risk assessment.
202.1 	
EFFECTIVE DATE. This section is effective August 1, 2005.

202.2 	Sec. 33. Minnesota Statutes 2004, section 144.98,
202.3 	subdivision 3, is amended to read:
202.4 		Subd. 3.Fees.  (a) An application for certification
202.5 	under subdivision 1 must be accompanied by the biennial fee
202.6 	specified in this subdivision.  The fees are for:
202.7 	(1) nonrefundable base certification fee, $1,200 
202.8 	$1,600; and 
202.9 	(2) sample preparation techniques fees, $100 per technique;
202.10 	and 
202.11 	(3) test category certification fees:
202.12 	Test Category                                   Certification Fee
202.13 	Clean water program bacteriology $600 $800 
202.14 	Safe drinking water program bacteriology $600 $800 
202.15 	Clean water program inorganic chemistry $600 $800 
202.16 	Safe drinking water program inorganic chemistry $600 $800 
202.17 	Clean water program chemistry metals $800 $1,200 
202.18 	Safe drinking water program chemistry metals $800 $1,200 
202.19 	Resource conservation and recovery program
202.20 	  chemistry metals $800 $1,200 
202.21 	Clean water program volatile organic compounds $1,200 $1,500 
202.22 	Safe drinking water program
202.23 	  volatile organic compounds $1,200 $1,500 
202.24 	Resource conservation and recovery program
202.25 	  volatile organic compounds $1,200 $1,500 
202.26 	Underground storage tank program
202.27 	  volatile organic compounds $1,200 $1,500 
202.28 	Clean water program other organic compounds $1,200 $1,500 
202.29 	Safe drinking water program other organic compounds $1,200 $1,500 
202.30 	Resource conservation and recovery program
202.31 	  other organic compounds $1,200 $1,500
202.32 	Clean water program radiochemistry $2,500
202.33 	Safe drinking water program radiochemistry $2,500
202.34 	Resource conservation and recovery program
202.35 	  agricultural contaminants $2,500
202.36 	Resource conservation and recovery program
203.1 	  emerging contaminants $2,500 
203.2 	(b) The total biennial certification fee is the base fee
203.3 	plus the applicable test category fees.
203.4 	(c) Laboratories located outside of this state that require
203.5 	an on-site survey will inspection shall be assessed an
203.6 	additional $2,500 $3,750 fee.
203.7 	(c) The total biennial certification fee includes the base
203.8 	fee, the sample preparation techniques fees, the test category
203.9 	fees, and, when applicable, the on-site inspection fee.
203.10 	(d) Fees must be set so that the total fees support the
203.11 	laboratory certification program.  Direct costs of the
203.12 	certification service include program administration,
203.13 	inspections, the agency's general support costs, and attorney
203.14 	general costs attributable to the fee function.
203.15 	(e) A change fee shall be assessed if a laboratory requests
203.16 	additional analytes or methods at any time other than when
203.17 	applying for or renewing its certification.  The change fee is
203.18 	equal to the test category certification fee for the analyte.
203.19 	(f) A variance fee shall be assessed if a laboratory
203.20 	requests and is granted a variance from a rule adopted under
203.21 	this section.  The variance fee is $500 per variance.
203.22 	(g) Refunds or credits shall not be made for analytes or
203.23 	methods requested but not approved.
203.24 	(h) Certification of a laboratory shall not be awarded
203.25 	until all fees are paid.
203.26 	
EFFECTIVE DATE. This section is effective August 1, 2005.

203.27 	Sec. 34. Minnesota Statutes 2004, section 144E.101, is
203.28 	amended by adding a subdivision to read:
203.29 		Subd. 14.Trauma triage and transport guidelines. By
203.30 	July 1, 2009, a licensee shall have written age appropriate
203.31 	trauma triage and transport guidelines consistent with the
203.32 	criteria issued by the Trauma Advisory Council established under
203.33 	section 144.608 and approved by the board.  The board may
203.34 	approve a licensee's requested deviations to the guidelines due
203.35 	to the availability of local or regional trauma resources if the
203.36 	changes are in the best interest of the patient's health.
204.1 	
EFFECTIVE DATE. This section is effective the day
204.2 	following final enactment.

204.3 	Sec. 35. Minnesota Statutes 2004, section 145.4242, is
204.4 	amended to read:
204.5 	145.4242 INFORMED CONSENT.
204.6 	(a) No abortion shall be performed in this state except
204.7 	with the voluntary and informed consent of the female upon whom
204.8 	the abortion is to be performed.  Except in the case of a
204.9 	medical emergency, consent to an abortion is voluntary and
204.10 	informed only if:
204.11 	(1) the female is told the following, by telephone or in
204.12 	person, by the physician who is to perform the abortion or by a
204.13 	referring physician, at least 24 hours before the abortion:
204.14 	(i) the particular medical risks associated with the
204.15 	particular abortion procedure to be employed including, when
204.16 	medically accurate, the risks of infection, hemorrhage, breast
204.17 	cancer, danger to subsequent pregnancies, and infertility;
204.18 	(ii) the probable gestational age of the unborn child at
204.19 	the time the abortion is to be performed; and 
204.20 	(iii) the medical risks associated with carrying her child
204.21 	to term; and 
204.22 	(iv) for abortions after 20 weeks gestational, whether or
204.23 	not an anesthetic or analgesic would eliminate or alleviate
204.24 	organic pain to the unborn child caused by the particular method
204.25 	of abortion to be employed and the particular medical benefits
204.26 	and risks associated with the particular anesthetic or analgesic.
204.27 	The information required by this clause may be provided by
204.28 	telephone without conducting a physical examination or tests of
204.29 	the patient, in which case the information required to be
204.30 	provided may be based on facts supplied to the physician by the
204.31 	female and whatever other relevant information is reasonably
204.32 	available to the physician.  It may not be provided by a tape
204.33 	recording, but must be provided during a consultation in which
204.34 	the physician is able to ask questions of the female and the
204.35 	female is able to ask questions of the physician.  If a physical
204.36 	examination, tests, or the availability of other information to
205.1 	the physician subsequently indicate, in the medical judgment of
205.2 	the physician, a revision of the information previously supplied
205.3 	to the patient, that revised information may be communicated to
205.4 	the patient at any time prior to the performance of the
205.5 	abortion.  Nothing in this section may be construed to preclude
205.6 	provision of required information in a language understood by
205.7 	the patient through a translator;
205.8 	(2) the female is informed, by telephone or in person, by
205.9 	the physician who is to perform the abortion, by a referring
205.10 	physician, or by an agent of either physician at least 24 hours
205.11 	before the abortion:
205.12 	(i) that medical assistance benefits may be available for
205.13 	prenatal care, childbirth, and neonatal care;
205.14 	(ii) that the father is liable to assist in the support of
205.15 	her child, even in instances when the father has offered to pay
205.16 	for the abortion; and
205.17 	(iii) that she has the right to review the printed
205.18 	materials described in section 145.4243, that these materials
205.19 	are available on a state-sponsored Web site, and what the Web
205.20 	site address is.  The physician or the physician's agent shall
205.21 	orally inform the female that the materials have been provided
205.22 	by the state of Minnesota and that they describe the unborn
205.23 	child, list agencies that offer alternatives to abortion, and
205.24 	contain information on fetal pain.  If the female chooses to
205.25 	view the materials other than on the Web site, they shall either
205.26 	be given to her at least 24 hours before the abortion or mailed
205.27 	to her at least 72 hours before the abortion by certified mail,
205.28 	restricted delivery to addressee, which means the postal
205.29 	employee can only deliver the mail to the addressee.
205.30 	The information required by this clause may be provided by
205.31 	a tape recording if provision is made to record or otherwise
205.32 	register specifically whether the female does or does not choose
205.33 	to have the printed materials given or mailed to her;
205.34 	(3) the female certifies in writing, prior to the abortion,
205.35 	that the information described in clauses (1) and (2) has been
205.36 	furnished to her and that she has been informed of her
206.1 	opportunity to review the information referred to in clause (2),
206.2 	subclause (iii); and
206.3 	(4) prior to the performance of the abortion, the physician
206.4 	who is to perform the abortion or the physician's agent obtains
206.5 	a copy of the written certification prescribed by clause (3) and
206.6 	retains it on file with the female's medical record for at least
206.7 	three years following the date of receipt.
206.8 	(b) Prior to administering the anesthetic or analgesic as
206.9 	described in paragraph (a), clause (1), item (iv), the physician
206.10 	must disclose to the woman any additional cost of the procedure
206.11 	for the administration of the anesthetic or analgesic.  If the
206.12 	woman consents to the administration of the anesthetic or
206.13 	analgesic, the physician shall administer the anesthetic or
206.14 	analgesic or arrange to have the anesthetic or analgesic
206.15 	administered.

206.16 	EFFECTIVE DATE. This section is effective August 1, 2005.

206.17 	Sec. 36. Minnesota Statutes 2004, section 145.56,
206.18 	subdivision 2, is amended to read:
206.19 		Subd. 2.Community-based programs. (a) To the extent
206.20 	funds are appropriated for the purposes of this subdivision,the
206.21 	commissioner shall establish a grant program to fund:
206.22 	(1) community-based programs to provide education,
206.23 	outreach, and advocacy services to populations who may be at
206.24 	risk for suicide;
206.25 	(2) community-based programs that educate community helpers
206.26 	and gatekeepers, such as family members, spiritual leaders,
206.27 	coaches, and business owners, employers, and coworkers on how to
206.28 	prevent suicide by encouraging help-seeking behaviors;
206.29 	(3) community-based programs that educate populations at
206.30 	risk for suicide and community helpers and gatekeepers that must
206.31 	include information on the symptoms of depression and other
206.32 	psychiatric illnesses, the warning signs of suicide, skills for
206.33 	preventing suicides, and making or seeking effective referrals
206.34 	to intervention and community resources; and
206.35 	(4) community-based programs to provide evidence-based
206.36 	suicide prevention and intervention education to school staff,
207.1 	parents, and students in grades kindergarten through 12.
207.2 	
EFFECTIVE DATE. This section is effective the day
207.3 	following final enactment.

207.4 	Sec. 37. Minnesota Statutes 2004, section 145.56,
207.5 	subdivision 5, is amended to read:
207.6 		Subd. 5.Periodic evaluations; biennial reports. To the
207.7 	extent funds are appropriated for the purposes of this
207.8 	subdivision,the commissioner shall conduct periodic evaluations
207.9 	of the impact of and outcomes from implementation of the state's
207.10 	suicide prevention plan and each of the activities specified in
207.11 	this section.  By July 1, 2002, and July 1 of each even-numbered
207.12 	year thereafter, the commissioner shall report the results of
207.13 	these evaluations to the chairs of the policy and finance
207.14 	committees in the house and senate with jurisdiction over health
207.15 	and human services issues.
207.16 	
EFFECTIVE DATE. This section is effective the day
207.17 	following final enactment.

207.18 	Sec. 38. [145.906] POSTPARTUM DEPRESSION EDUCATION AND
207.19 	INFORMATION.
207.20 	(a) The commissioner of health shall work with health care
207.21 	facilities, licensed health and mental health care
207.22 	professionals, mental health advocates, consumers, and families
207.23 	in the state to develop materials and information about
207.24 	postpartum depression, including treatment resources, and
207.25 	develop policies and procedures to comply with this section.
207.26 	(b) Physicians, traditional midwives, and other licensed
207.27 	health care professionals providing prenatal care to women must
207.28 	have available to women and their families information about
207.29 	postpartum depression.
207.30 	(c) Hospitals and other health care facilities in the state
207.31 	must provide departing new mothers and fathers and other family
207.32 	members, as appropriate, with written information about
207.33 	postpartum depression, including its symptoms, methods of coping
207.34 	with the illness, and treatment resources.

207.35 	EFFECTIVE DATE. This section is effective August 1, 2005.

207.36 	Sec. 39. Minnesota Statutes 2004, section 145.9268, is
208.1 	amended to read:
208.2 	145.9268 COMMUNITY CLINIC GRANTS.
208.3 		Subdivision 1.Definition. For purposes of this section,
208.4 	"eligible community clinic" means:
208.5 	(1) a nonprofit clinic that provides is established to
208.6 	provide health services under conditions as defined in Minnesota
208.7 	Rules, part 9505.0255,to low income or rural population groups;
208.8 	provides medical, preventive, dental, or mental health primary
208.9 	care services;and utilizes a sliding fee scale or other
208.10 	procedure to determine eligibility for charity care or to ensure
208.11 	that no person will be denied services because of inability to
208.12 	pay;
208.13 	(2) a governmental entity or an Indian tribal government or
208.14 	Indian health service unit that provides services and utilizes a
208.15 	sliding fee scale or other procedure as described under clause
208.16 	(1); or 
208.17 	(3) a consortium of clinics comprised of entities under
208.18 	clause (1) or (2); or 
208.19 	(4) a nonprofit, tribal, or governmental entity proposing
208.20 	the establishment of a clinic that will provide services and
208.21 	utilize a sliding fee scale or other procedure as described
208.22 	under clause (1).
208.23 		Subd. 2.Grants authorized. The commissioner of health
208.24 	shall award grants to eligible community clinics to plan,
208.25 	establish, or operate services to improve the ongoing viability
208.26 	of Minnesota's clinic-based safety net providers.  Grants shall
208.27 	be awarded to support the capacity of eligible community clinics
208.28 	to serve low-income populations, reduce current or future
208.29 	uncompensated care burdens, or provide for improved care
208.30 	delivery infrastructure.  The commissioner shall award grants to
208.31 	community clinics in metropolitan and rural areas of the state,
208.32 	and shall ensure geographic representation in grant awards among
208.33 	all regions of the state.
208.34 		Subd. 3.Allocation of grants. (a) To receive a grant
208.35 	under this section, an eligible community clinic must submit an
208.36 	application to the commissioner of health by the deadline
209.1 	established by the commissioner.  A grant may be awarded upon
209.2 	the signing of a grant contract.  Community clinics may apply
209.3 	for and the commissioner may award grants for one-year or
209.4 	two-year periods.
209.5 	(b) An application must be on a form and contain
209.6 	information as specified by the commissioner but at a minimum
209.7 	must contain:
209.8 	(1) a description of the purpose or project for which grant
209.9 	funds will be used;
209.10 	(2) a description of the problem or problems the grant
209.11 	funds will be used to address; and 
209.12 	(3) a description of achievable objectives, a workplan, and
209.13 	a timeline for implementation and completion of processes or
209.14 	projects enabled by the grant; and 
209.15 	(4) a process for documenting and evaluating results of the
209.16 	grant.
209.17 	(c) The commissioner shall review each application to
209.18 	determine whether the application is complete and whether the
209.19 	applicant and the project are eligible for a grant.  In
209.20 	evaluating applications according to paragraph (d), the
209.21 	commissioner shall establish criteria including, but not limited
209.22 	to:  the priority level eligibility of the project; the
209.23 	applicant's thoroughness and clarity in describing the problem
209.24 	grant funds are intended to address; a description of the
209.25 	applicant's proposed project; a description of the population
209.26 	demographics and service area of the proposed project;the
209.27 	manner in which the applicant will demonstrate the effectiveness
209.28 	of any projects undertaken; and evidence of efficiencies and
209.29 	effectiveness gained through collaborative efforts.  The
209.30 	commissioner may also take into account other relevant factors,
209.31 	including, but not limited to, the percentage for which
209.32 	uninsured patients represent the applicant's patient base and
209.33 	the degree to which grant funds will be used to support services
209.34 	increasing or maintaining access to health care services.
209.35 	During application review, the commissioner may request
209.36 	additional information about a proposed project, including
210.1 	information on project cost.  Failure to provide the information
210.2 	requested disqualifies an applicant.  The commissioner has
210.3 	discretion over the number of grants awarded.
210.4 	(d) In determining which eligible community clinics will
210.5 	receive grants under this section, the commissioner shall give
210.6 	preference to those grant applications that show evidence of
210.7 	collaboration with other eligible community clinics, hospitals,
210.8 	health care providers, or community organizations. In addition,
210.9 	the commissioner shall give priority, in declining order, to
210.10 	grant applications for projects that:
210.11 		Subd. 3a.Awarding grants. (a) The commissioner may
210.12 	award grants for activities to:
210.13 	(1) provide a direct offset to expenses incurred for
210.14 	services provided to the clinic's target population;
210.15 	(2) establish, update, or improve information, data
210.16 	collection, or billing systems, including electronic health
210.17 	records systems;
210.18 	(3) procure, modernize, remodel, or replace equipment used
210.19 	in the delivery of direct patient care at a clinic;
210.20 	(4) provide improvements for care delivery, such as
210.21 	increased translation and interpretation services; or 
210.22 	(5) build a new clinic or expand an existing facility; or 
210.23 	(6) other projects determined by the commissioner to
210.24 	improve the ability of applicants to provide care to the
210.25 	vulnerable populations they serve.
210.26 	(e) (b) A grant awarded to an eligible community clinic may
210.27 	not exceed $300,000 per eligible community clinic.  For an
210.28 	applicant applying as a consortium of clinics, a grant may not
210.29 	exceed $300,000 per clinic included in the consortium.  The
210.30 	commissioner has discretion over the number of grants awarded.
210.31 		Subd. 4.Evaluation and report. The commissioner of
210.32 	health shall evaluate the overall effectiveness of the grant
210.33 	program.  The commissioner shall collect progress reports to
210.34 	evaluate the grant program from the eligible community clinics
210.35 	receiving grants.  Every two years, as part of this evaluation,
210.36 	the commissioner shall report to the legislature on priority
211.1 	areas for grants set under subdivision 3 the needs of community
211.2 	clinics and provide any recommendations for adding or
211.3 	changing priority areas eligible activities.
211.4 	
EFFECTIVE DATE. This section is effective the day
211.5 	following final enactment.

211.6 	Sec. 40. Minnesota Statutes 2004, section 147A.08, is
211.7 	amended to read:
211.8 	147A.08 EXEMPTIONS.
211.9 	(a) This chapter does not apply to, control, prevent, or
211.10 	restrict the practice, service, or activities of persons listed
211.11 	in section 147.09, clauses (1) to (6) and (8) to (13), persons
211.12 	regulated under section 214.01, subdivision 2, or persons
211.13 	defined in section 144.1501, subdivision 1, paragraphs
211.14 	(e) (f), (g) (h), and (h) (i).
211.15 	(b) Nothing in this chapter shall be construed to require
211.16 	registration of:
211.17 	(1) a physician assistant student enrolled in a physician
211.18 	assistant or surgeon assistant educational program accredited by
211.19 	the Committee on Allied Health Education and Accreditation or by
211.20 	its successor agency approved by the board;
211.21 	(2) a physician assistant employed in the service of the
211.22 	federal government while performing duties incident to that
211.23 	employment; or
211.24 	(3) technicians, other assistants, or employees of
211.25 	physicians who perform delegated tasks in the office of a
211.26 	physician but who do not identify themselves as a physician
211.27 	assistant.

211.28 	EFFECTIVE DATE. This section is effective August 1, 2005.

211.29 	Sec. 41. Minnesota Statutes 2004, section 150A.22, is
211.30 	amended to read:
211.31 	150A.22 DONATED DENTAL SERVICES.
211.32 	(a) The Board of Dentistry commissioner of health shall
211.33 	contract with the Minnesota Dental Association, or another
211.34 	appropriate and qualified organization to develop and operate a
211.35 	donated dental services program to provide dental care to public
211.36 	program recipients and the uninsured through dentists who
212.1 	volunteer their services without compensation.  As part of the
212.2 	contract, the board commissioner shall include specific
212.3 	performance and outcome measures that the contracting
212.4 	organization must meet.  The donated dental services program
212.5 	shall:
212.6 	(1) establish a network of volunteer dentists, including
212.7 	dental specialties, to donate dental services to eligible
212.8 	individuals;
212.9 	(2) establish a system to refer eligible individuals to the
212.10 	appropriate volunteer dentists; and
212.11 	(3) develop and implement a public awareness campaign to
212.12 	educate eligible individuals about the availability of the
212.13 	program.
212.14 	(b) Funding for the program may be used for administrative
212.15 	or technical support.  The organization contracting with the
212.16 	board commissioner shall provide an annual report that accounts
212.17 	for funding appropriated to the program by the state, documents
212.18 	the number of individuals served by the program and the number
212.19 	of dentists participating as program providers, and provides
212.20 	data on meeting the specific performance and outcome measures
212.21 	identified by the board commissioner.

212.22 	EFFECTIVE DATE. This section is effective retroactively
212.23 	from July 1, 2005.

212.24 	Sec. 42. Minnesota Statutes 2004, section 157.011, is
212.25 	amended by adding a subdivision to read:
212.26 		Subd. 3.Rule exemption. Notwithstanding any rule to the
212.27 	contrary, no food establishment shall be required to acquire
212.28 	equipment or change construction solely because ownership of the
212.29 	food establishment has been transferred.
212.30 	
EFFECTIVE DATE. This section is effective the day
212.31 	following final enactment.

212.32 	Sec. 43. Minnesota Statutes 2004, section 157.15, is
212.33 	amended by adding a subdivision to read:
212.34 		Subd. 19.Statewide hospitality fee. "Statewide
212.35 	hospitality fee" means a fee to fund statewide food, beverage,
212.36 	and lodging program development activities, including training
213.1 	for inspection staff, technical assistance, maintenance of a
213.2 	statewide integrated food safety and security information
213.3 	system, and other related statewide activities that support the
213.4 	food, beverage, and lodging program activities.
213.5 	
EFFECTIVE DATE. This section is effective August 1, 2005.

213.6 	Sec. 44. Minnesota Statutes 2004, section 157.16,
213.7 	subdivision 2, is amended to read:
213.8 		Subd. 2.License renewal.  Initial and renewal licenses
213.9 	for all food and beverage service establishments, hotels,
213.10 	motels, lodging establishments, and resorts shall be issued for
213.11 	the calendar year for which application is made and shall expire
213.12 	on December 31 of such year.  Any person who operates a place of
213.13 	business after the expiration date of a license or without
213.14 	having submitted an application and paid the fee shall be deemed
213.15 	to have violated the provisions of this chapter and shall be
213.16 	subject to enforcement action, as provided in the Health
213.17 	Enforcement Consolidation Act, sections 144.989 to 144.993.  In
213.18 	addition, a penalty of $25 $50 shall be added to the total of
213.19 	the license fee for any food and beverage service establishment
213.20 	operating without a license as a mobile food unit, a seasonal
213.21 	temporary or seasonal permanent food stand, or a special event
213.22 	food stand, and a penalty of $50 $100 shall be added to the
213.23 	total of the license fee for all restaurants, food carts,
213.24 	hotels, motels, lodging establishments, and resorts operating
213.25 	without a license for a period of up to 30 days.  A late fee of
213.26 	$300 shall be added to the license fee for establishments
213.27 	operating more than 30 days without a license.
213.28 	
EFFECTIVE DATE. This section is effective August 1, 2005.

213.29 	Sec. 45. Minnesota Statutes 2004, section 157.16, is
213.30 	amended by adding a subdivision to read:
213.31 		Subd. 2a.Food manager certification. An applicant for
213.32 	certification or certification renewal as a food manager must
213.33 	submit to the commissioner a $28 nonrefundable certification fee
213.34 	payable to the Department of Health.
213.35 	
EFFECTIVE DATE. This section is effective August 1, 2005.

213.36 	Sec. 46. Minnesota Statutes 2004, section 157.16,
214.1 	subdivision 3, is amended to read:
214.2 		Subd. 3.Establishment fees; definitions.  (a) The
214.3 	following fees are required for food and beverage service
214.4 	establishments, hotels, motels, lodging establishments, and
214.5 	resorts licensed under this chapter.  Food and beverage service
214.6 	establishments must pay the highest applicable fee under
214.7 	paragraph (e) (d), clause (1), (2), (3), or (4), and
214.8 	establishments serving alcohol must pay the highest applicable
214.9 	fee under paragraph (e) (d), clause (6) or (7).  The license fee
214.10 	for new operators previously licensed under this chapter for the
214.11 	same calendar year is one-half of the appropriate annual license
214.12 	fee, plus any penalty that may be required.  The license fee for
214.13 	operators opening on or after October 1 is one-half of the
214.14 	appropriate annual license fee, plus any penalty that may be
214.15 	required.
214.16 	(b) All food and beverage service establishments, except
214.17 	special event food stands, and all hotels, motels, lodging
214.18 	establishments, and resorts shall pay an annual base fee of
214.19 	$145 $150.
214.20 	(c) A special event food stand shall pay a flat fee
214.21 	of $35 $40 annually.  "Special event food stand" means a fee
214.22 	category where food is prepared or served in conjunction with
214.23 	celebrations, county fairs, or special events from a special
214.24 	event food stand as defined in section 157.15.
214.25 	(d) In addition to the base fee in paragraph (b), each food
214.26 	and beverage service establishment, other than a special event
214.27 	food stand, and each hotel, motel, lodging establishment, and
214.28 	resort shall pay an additional annual fee for each fee category
214.29 	as , additional food service, or required additional inspection 
214.30 	specified in this paragraph:
214.31 	(1) Limited food menu selection, $40 $50.  "Limited food
214.32 	menu selection" means a fee category that provides one or more
214.33 	of the following:
214.34 	(i) prepackaged food that receives heat treatment and is
214.35 	served in the package;
214.36 	(ii) frozen pizza that is heated and served;
215.1 	(iii) a continental breakfast such as rolls, coffee, juice,
215.2 	milk, and cold cereal;
215.3 	(iv) soft drinks, coffee, or nonalcoholic beverages; or
215.4 	(v) cleaning for eating, drinking, or cooking utensils,
215.5 	when the only food served is prepared off site.
215.6 	(2) Small establishment, including boarding establishments,
215.7 	$75 $100.  "Small establishment" means a fee category that has
215.8 	no salad bar and meets one or more of the following:
215.9 	(i) possesses food service equipment that consists of no
215.10 	more than a deep fat fryer, a grill, two hot holding containers,
215.11 	and one or more microwave ovens;
215.12 	(ii) serves dipped ice cream or soft serve frozen desserts;
215.13 	(iii) serves breakfast in an owner-occupied bed and
215.14 	breakfast establishment;
215.15 	(iv) is a boarding establishment; or
215.16 	(v) meets the equipment criteria in clause (3), item (i) or
215.17 	(ii), and has a maximum patron seating capacity of not more than
215.18 	50.
215.19 	(3) Medium establishment, $210 $260.  "Medium establishment"
215.20 	means a fee category that meets one or more of the following:
215.21 	(i) possesses food service equipment that includes a range,
215.22 	oven, steam table, salad bar, or salad preparation area;
215.23 	(ii) possesses food service equipment that includes more
215.24 	than one deep fat fryer, one grill, or two hot holding
215.25 	containers; or
215.26 	(iii) is an establishment where food is prepared at one
215.27 	location and served at one or more separate locations.
215.28 	Establishments meeting criteria in clause (2), item (v),
215.29 	are not included in this fee category.
215.30 	(4) Large establishment, $350 $460.  "Large establishment"
215.31 	means either:
215.32 	(i) a fee category that (A) meets the criteria in clause
215.33 	(3), items (i) or (ii), for a medium establishment, (B) seats
215.34 	more than 175 people, and (C) offers the full menu selection an
215.35 	average of five or more days a week during the weeks of
215.36 	operation; or
216.1 	(ii) a fee category that (A) meets the criteria in clause
216.2 	(3), item (iii), for a medium establishment, and (B) prepares
216.3 	and serves 500 or more meals per day.
216.4 	(5) Other food and beverage service, including food carts,
216.5 	mobile food units, seasonal temporary food stands, and seasonal
216.6 	permanent food stands, $40 $50.
216.7 	(6) Beer or wine table service, $40 $50.  "Beer or wine
216.8 	table service" means a fee category where the only alcoholic
216.9 	beverage service is beer or wine, served to customers seated at
216.10 	tables.
216.11 	(7) Alcoholic beverage service, other than beer or wine
216.12 	table service, $105 $135.
216.13 	"Alcohol beverage service, other than beer or wine table
216.14 	service" means a fee category where alcoholic mixed drinks are
216.15 	served or where beer or wine are served from a bar.
216.16 	(8) Lodging per sleeping accommodation unit, $6 $8,
216.17 	including hotels, motels, lodging establishments, and resorts,
216.18 	up to a maximum of $600 $800.  "Lodging per sleeping
216.19 	accommodation unit" means a fee category including the number of
216.20 	guest rooms, cottages, or other rental units of a hotel, motel,
216.21 	lodging establishment, or resort; or the number of beds in a
216.22 	dormitory.
216.23 	(9) First public swimming pool, $140 $180; each additional
216.24 	public swimming pool, $80 $100.  "Public swimming pool" means a
216.25 	fee category that has the meaning given in Minnesota Rules, part
216.26 	4717.0250, subpart 8.
216.27 	(10) First spa, $80 $110; each additional spa, $40 $50.
216.28 	"Spa pool" means a fee category that has the meaning given in
216.29 	Minnesota Rules, part 4717.0250, subpart 9.
216.30 	(11) Private sewer or water, $40 $50.  "Individual private
216.31 	water" means a fee category with a water supply other than a
216.32 	community public water supply as defined in Minnesota Rules,
216.33 	chapter 4720.  "Individual private sewer" means a fee category
216.34 	with an individual sewage treatment system which uses subsurface
216.35 	treatment and disposal.
216.36 	(12) Additional food service, $130.  "Additional food
217.1 	service" means a location at a food service establishment, other
217.2 	than the primary food preparation and service area, used to
217.3 	prepare or serve food to the public.
217.4 	(13) Additional inspection fee, $300.  "Additional
217.5 	inspection fee" means a fee to conduct the second inspection
217.6 	each year for elementary and secondary education facility school
217.7 	lunch programs when required by the Richard B. Russell National
217.8 	School Lunch Act.
217.9 	(e) A fee of $150 $350 for review of the construction plans
217.10 	must accompany the initial license application for food and
217.11 	beverage service establishments restaurants, hotels, motels,
217.12 	lodging establishments, or resorts with five or more sleeping
217.13 	units.
217.14 	(f) When existing food and beverage service establishments,
217.15 	hotels, motels, lodging establishments, or resorts are
217.16 	extensively remodeled, a fee of $150 $250 must be submitted with
217.17 	the remodeling plans. A fee of $250 must be submitted for new
217.18 	construction or remodeling for a restaurant with a limited food
217.19 	menu selection, a seasonal permanent food stand, a mobile food
217.20 	unit, or a food cart, or for a hotel, motel, resort, or lodging
217.21 	establishment addition of less than five sleeping units.
217.22 	(g) Seasonal temporary food stands and special event food
217.23 	stands are not required to submit construction or remodeling
217.24 	plans for review.
217.25 	
EFFECTIVE DATE. This section is effective August 1, 2005.

217.26 	Sec. 47. Minnesota Statutes 2004, section 157.16, is
217.27 	amended by adding a subdivision to read:
217.28 		Subd. 3a.Statewide hospitality fee. Every person, firm,
217.29 	or corporation that operates a licensed boarding establishment,
217.30 	food and beverage service establishment, seasonal temporary or
217.31 	permanent food stand, special event food stand, mobile food
217.32 	unit, food cart, resort, hotel, motel, or lodging establishment
217.33 	in Minnesota must submit to the commissioner a $35 annual
217.34 	statewide hospitality fee for each licensed activity.  The fee
217.35 	for establishments licensed by the Department of Health is
217.36 	required at the same time the licensure fee is due.  For
218.1 	establishments licensed by local governments, the fee is due by
218.2 	July 1 of each year.
218.3 	
EFFECTIVE DATE. This section is effective August 1, 2005.

218.4 	Sec. 48. Minnesota Statutes 2004, section 157.20,
218.5 	subdivision 2, is amended to read:
218.6 		Subd. 2.Inspection frequency.  The frequency of
218.7 	inspections of the establishments shall be based on the degree
218.8 	of health risk.
218.9 	(a) High-risk establishments must be inspected at least
218.10 	once a year every 12 months.
218.11 	(b) Medium-risk establishments must be inspected at least
218.12 	once every 18 months.
218.13 	(c) Low-risk establishments must be inspected at least once
218.14 	every two years 24 months.
218.15 	
EFFECTIVE DATE. This section is effective August 1, 2005.

218.16 	Sec. 49. Minnesota Statutes 2004, section 157.20,
218.17 	subdivision 2a, is amended to read:
218.18 		Subd. 2a.Risk categories.  (a)  [HIGH-RISK
218.19 	ESTABLISHMENT.] "High-risk establishment" means any food and
218.20 	beverage service establishment, hotel, motel, lodging
218.21 	establishment, or resort that:
218.22 	(1) serves potentially hazardous foods that require
218.23 	extensive processing on the premises, including manual handling,
218.24 	cooling, reheating, or holding for service;
218.25 	(2) prepares foods several hours or days before service;
218.26 	(3) serves menu items that epidemiologic experience has
218.27 	demonstrated to be common vehicles of food-borne illness;
218.28 	(4) has a public swimming pool; or
218.29 	(5) draws its drinking water from a surface water supply.
218.30 	(b)  [MEDIUM-RISK ESTABLISHMENT.] "Medium-risk
218.31 	establishment" means a food and beverage service establishment,
218.32 	hotel, motel, lodging establishment, or resort that:
218.33 	(1) serves potentially hazardous foods but with minimal
218.34 	holding between preparation and service; or
218.35 	(2) serves foods, such as pizza, that require extensive
218.36 	handling followed by heat treatment.
219.1 	(c)  [LOW-RISK ESTABLISHMENT.] "Low-risk establishment"
219.2 	means a food and beverage service establishment, hotel, motel,
219.3 	lodging establishment, or resort that is not a high-risk or
219.4 	medium-risk establishment.
219.5 	(d)  [RISK EXCEPTIONS.] Mobile food units, seasonal
219.6 	permanent and seasonal temporary food stands, food carts, and
219.7 	special event food stands are not inspected on an established
219.8 	schedule and therefore are not defined as high-risk,
219.9 	medium-risk, or low-risk establishments.
219.10 	(e) [SCHOOL INSPECTION FREQUENCY.] Elementary and
219.11 	secondary school food service establishments must be inspected
219.12 	according to the assigned risk category or by the frequency
219.13 	required in the Richard B. Russell National School Lunch Act,
219.14 	whichever frequency is more restrictive.
219.15 	
EFFECTIVE DATE. This section is effective August 1, 2005.

219.16 	Sec. 50. Minnesota Statutes 2004, section 326.42,
219.17 	subdivision 2, is amended to read:
219.18 		Subd. 2.Fees.  Plumbing system plans and specifications
219.19 	that are submitted to the commissioner for review shall be
219.20 	accompanied by the appropriate plan examination fees.  If the
219.21 	commissioner determines, upon review of the plans, that
219.22 	inadequate fees were paid, the necessary additional fees shall
219.23 	be paid prior to plan approval.  The commissioner shall charge
219.24 	the following fees for plan reviews and audits of plumbing
219.25 	installations for public, commercial, and industrial buildings:
219.26 	(1) systems with both water distribution and drain, waste,
219.27 	and vent systems and having:
219.28 	(i) 25 or fewer drainage fixture units, $150;
219.29 	(ii) 26 to 50 drainage fixture units, $250;
219.30 	(iii) 51 to 150 drainage fixture units, $350;
219.31 	(iv) 151 to 249 drainage fixture units, $500;
219.32 	(v) 250 or more drainage fixture units, $3 per drainage
219.33 	fixture unit to a maximum of $4,000; and
219.34 	(vi) interceptors, separators, or catch basins, $70 per
219.35 	interceptor, separator, or catch basin design;
219.36 	(2) building sewer service only, $150;
220.1 	(3) building water service only, $150;
220.2 	(4) building water distribution system only, no drainage
220.3 	system, $5 per supply fixture unit or $150, whichever is
220.4 	greater;
220.5 	(5) storm drainage system, a minimum fee of $150 or:
220.6 	(i) $50 per drain opening, up to a maximum of $500; and
220.7 	(ii) $70 per interceptor, separator, or catch basin design;
220.8 	(6) manufactured home park or campground, one to 25 sites,
220.9 	$300;
220.10 	(7) manufactured home park or campground, 26 to 50 sites,
220.11 	$350;
220.12 	(8) manufactured home park or campground, 51 to 125 sites,
220.13 	$400;
220.14 	(9) manufactured home park or campground, more than 125
220.15 	sites, $500;
220.16 	(10) accelerated review, double the regular fee, one-half
220.17 	to be refunded if no response from the commissioner within 15
220.18 	business days; and
220.19 	(11) revision to previously reviewed or incomplete plans:
220.20 	(i) review of plans for which commissioner has issued two
220.21 	or more requests for additional information, per review, $100 or
220.22 	ten percent of the original fee, whichever is greater;
220.23 	(ii) proposer-requested revision with no increase in
220.24 	project scope, $50 or ten percent of original fee, whichever is
220.25 	greater; and
220.26 	(iii) proposer-requested revision with an increase in
220.27 	project scope, $50 plus the difference between the original
220.28 	project fee and the revised project fee.
220.29 	
EFFECTIVE DATE. This section is effective the day
220.30 	following final enactment.

220.31 	Sec. 51. Laws 2005, chapter 107, article 1, section 6, is
220.32 	amended to read:
220.33 	Sec. 6COMMISSIONER OF HEALTH           95,000        155,000
 220.34 	To the commissioner of health to
220.35 	implement new Minnesota Statutes,
220.36 	section 144.1498 144.1501.

220.37 	EFFECTIVE DATE. This section is effective the day
221.1 	following final enactment.

221.2 	Sec. 52. CERVICAL CANCER ELIMINATION STUDY.
 221.3 	(a) The commissioner of health shall develop a statewide
221.4 	integrated and comprehensive cervical cancer prevention plan,
221.5 	including strategies for promoting and implementing the plan.
221.6 	The plan must include activities that identify and implement
221.7 	methods to improve the cervical cancer screening rates in
221.8 	Minnesota, including, but not limited to:
221.9 	(1) identifying and disseminating appropriate
221.10 	evidence-based cervical cancer screening guidelines to be used
221.11 	in Minnesota;
221.12 	(2) increasing the use of appropriate screening based on
221.13 	these guidelines for patients seen by medical groups in
221.14 	Minnesota and monitoring results of these medical groups; and 
221.15 	(3) reducing the number of women who should but have not
221.16 	been screened.
221.17 	(b) In developing the plan, the commissioner shall also
221.18 	identify and examine limitations and barriers in providing
221.19 	cervical cancer screening, diagnosis tools, and treatment,
221.20 	including, but not limited to, medical care reimbursement,
221.21 	treatment costs, and the availability of insurance coverage.
221.22 	(c) The commissioner may work with one or more nonprofit
221.23 	quality improvement organizations in Minnesota to identify
221.24 	evidence-based guidelines for cervical cancer screening and to
221.25 	identify methods to improve the cervical cancer screening rates
221.26 	among medical groups; and may work with one or more nonprofit
221.27 	health care result reporting organizations to monitor results by
221.28 	medical groups in Minnesota.
221.29 	(d) The commissioner may convene an advisory committee that
221.30 	includes representatives of health care providers, the American
221.31 	Cancer Society, health plan companies, the University of
221.32 	Minnesota Academic Health Center, community health boards, and
221.33 	the general public.
221.34 	(e) The commissioner shall submit a report to the
221.35 	legislature by January 15, 2006, on:
221.36 	(1) the statewide cervical cancer prevention plan,
222.1 	including a description of the plan activities and strategies
222.2 	developed for promoting and implementing the plan;
222.3 	(2) methods for monitoring the results by medical groups
222.4 	and by the entire state of cervical cancer screening improvement
222.5 	activities; and 
222.6 	(3) recommended changes to existing laws, programs, or
222.7 	services in terms of reducing the occurrence of cervical cancer
222.8 	by improving insurance coverage for the prevention, diagnosis,
222.9 	and treatment for cervical cancer.

222.10 	EFFECTIVE DATE. This section is effective August 1, 2005.

222.11 	Sec. 53. PUBLIC HEALTH INFORMATION NETWORK.
 222.12 	(a) The commissioner of health shall work with local public
222.13 	health departments to develop a public health information
222.14 	network.  The development of the network must be consistent with
222.15 	the recommendations, goals, and strategies of the Minnesota
222.16 	public health information network report to the 2005 legislature
222.17 	and the e-health initiative.
222.18 	(b) The commissioner of health shall work with the
222.19 	commissioner of human services to determine how data from care
222.20 	systems can be utilized to assist with population health needs
222.21 	assessments and targeted prevention efforts.
222.22 	(c) Before the next biennium, the commissioner of health
222.23 	shall submit to the legislature a status report on the progress
222.24 	of the information network and the e-health initiative.

222.25 	EFFECTIVE DATE. This section is effective the day
222.26 	following final enactment.

222.27 	Sec. 54. REPORT TO LEGISLATURE ON SWING BED USAGE.
 222.28 	The commissioner of health shall review swing bed and
222.29 	related data reported under Minnesota Statutes, sections
222.30 	144.562, subdivision 3, paragraph (f); 144.564; and 144.698.
222.31 	The commissioner shall report and make any appropriate
222.32 	recommendations to the legislature by January 31, 2007, on:
222.33 	(1) the use of swing bed days by all hospitals and by
222.34 	critical access hospitals;
222.35 	(2) occupancy rates in skilled nursing facilities within 25
222.36 	miles of hospitals with swing beds; and 
223.1 	(3) information provided by rural providers on the use of
223.2 	swing beds and the adequacy of rural services across the
223.3 	continuum of care.

223.4 	EFFECTIVE DATE. This section is effective the day
223.5 	following final enactment.

223.6 	Sec. 55. IMPLEMENTATION OF AN ELECTRONIC HEALTH RECORDS
223.7 	SYSTEM.
 223.8 	The commissioner of health, in consultation with the
223.9 	electronic health record planning work group established in Laws
223.10 	2004, chapter 288, article 7, section 7, shall develop a
223.11 	statewide plan for all hospitals and physician group practices
223.12 	to have in place an interoperable electronic health records
223.13 	system by January 1, 2015.  In developing the plan, the
223.14 	commissioner shall consider:
223.15 	(1) creating financial assistance to hospitals and
223.16 	providers for implementing or updating an electronic health
223.17 	records system, including, but not limited to, the establishment
223.18 	of grants, financial incentives, or low-interest loans;
223.19 	(2) addressing specific needs and concerns of safety-net
223.20 	hospitals, community health clinics, and other health care
223.21 	providers who serve low-income patients in implementing an
223.22 	electronic records system within the hospital or practice; and 
223.23 	(3) providing assistance in the development of possible
223.24 	alliances or collaborations among providers.
223.25 	The commissioner shall provide preliminary reports to the
223.26 	chairs of the senate and house committees with jurisdiction over
223.27 	health care policy and finance biennially beginning January 15,
223.28 	2007, on the status of reaching the goal for all hospitals and
223.29 	physician group practices to have an interoperable electronic
223.30 	health records system in place by January 1, 2015.  The reports
223.31 	shall include recommendations on statutory language necessary to
223.32 	implement the plan, including possible financing options.

223.33 	EFFECTIVE DATE. This section is effective the day
223.34 	following final enactment.

223.35 	Sec. 56. RULE AMENDMENT.
 223.36 	The commissioner of health shall amend Minnesota Rules,
224.1 	part 4626.2015, subparts 3, item C; and 6, item B, to conform
224.2 	with Minnesota Statutes, section 157.16, subdivision 2a.  The
224.3 	commissioner may use the good cause exemption under Minnesota
224.4 	Statutes, section 14.388, subdivision 1, clause (3).  Minnesota
224.5 	Statutes, section 14.386, does not apply, except to the extent
224.6 	provided under Minnesota Statutes, section 14.388.

224.7 	EFFECTIVE DATE. This section is effective August 1, 2005.

224.8 	Sec. 57. DIRECTION TO COMMISSIONER; DENTAL REVIEW.
 224.9 	The commissioner of health, in consultation with the
224.10 	relevant dental associations, licensed dental and public health
224.11 	professionals, and others, shall review the leadership and
224.12 	advisory role of the Department of Health relative to dental
224.13 	health including the usefulness of utilizing a dental director.

224.14 	EFFECTIVE DATE. This section is effective the day
224.15 	following final enactment.

224.16 	Sec. 58. REPEALER.
 224.17 	(a) Minnesota Statutes 2004, sections 144.1486; 144.1502;
224.18 	and 157.215, are repealed effective the day following final
224.19 	enactment.
224.20 	(b) Laws 2005, chapter 107, article 2, section 51, is
224.21 	repealed effective the day following final enactment.

224.22 	ARTICLE 7
224.23 	LONG-TERM CARE AND CONTINUING CARE

224.24 	Section 1. Minnesota Statutes 2004, section 144A.073, is
224.25 	amended by adding a subdivision to read:
224.26 		Subd. 3d.Project amendment authorized. Notwithstanding
224.27 	the provisions of subdivision 3b:
224.28 	(1) the commissioner may approve a request by a nursing
224.29 	facility located in the city of Duluth with 48 licensed beds as
224.30 	of January 1, 2005, that received approval under this section in
224.31 	2002 for a moratorium exception project for amendment of the
224.32 	project design that:
224.33 	(i) reduces the total amount of common space devoted to
224.34 	resident and family uses by more than five percent if the total
224.35 	amount of common space in the facility, including that added by
224.36 	the project, is at least 175 percent of the state requirement
225.1 	for common space; and 
225.2 	(ii) reduces the space for no more than two residents'
225.3 	living areas by increasing the size of a majority of the
225.4 	single-bed rooms from the size in the project design as
225.5 	originally approved and converting two single-bed rooms in the
225.6 	project design as originally approved to one semi-private room;
225.7 	and 
225.8 	(2) the commissioner may approve a request by a nursing
225.9 	facility located in the city of Duluth with 129 licensed beds as
225.10 	of January 1, 2005, that received approval under this section in
225.11 	2002 for a moratorium exception project for amendment of the
225.12 	project design that:
225.13 	(i) reduces the total amount of common space devoted to
225.14 	resident and family uses by more than five percent if the total
225.15 	amount of common space in the facility, including that added by
225.16 	the project, is at least 175 percent of the state requirement
225.17 	for common space; and 
225.18 	(ii) reduces the space for no more than four residents'
225.19 	living areas by increasing the size of a majority of the
225.20 	single-bed rooms from the size in the project design as
225.21 	originally approved and converting four single-bed rooms in the
225.22 	project design as originally approved to two semi-private rooms;
225.23 	and 
225.24 	(3) the amended project designs in clauses (1) and (2) must
225.25 	provide solutions to all of the problems addressed by the
225.26 	original application that are at least as effective as the
225.27 	original solutions.

225.28 	Sec. 2. Minnesota Statutes 2004, section 144A.073,
225.29 	subdivision 10, is amended to read:
225.30 		Subd. 10.Extension of approval of moratorium exception.
 225.31 	Notwithstanding subdivision 3, the commissioner of health shall
225.32 	extend project approval for an additional 18 36 months for any
225.33 	proposed exception to the nursing home licensure and
225.34 	certification moratorium if the proposal was approved under this
225.35 	section between July 1, 2001, and June 30, 2003.

225.36 	Sec. 3. [256B.0185] REQUIRED REPORT.
226.1 		Subdivision 1.Pending application. By December 15 of
226.2 	both 2005 and 2006, the commissioner must deliver to the
226.3 	legislature a report that identifies:
226.4 	(1) each county in which an application for medical
226.5 	assistance from a person identified as residing in a long-term
226.6 	care facility is or was pending, at any time between January 1
226.7 	and December 1 of the calendar year to which the report relates,
226.8 	for more than 60 days in the case of a person who is disabled,
226.9 	or for more than 45 days in the case of a person who is age 65
226.10 	or older; and 
226.11 	(2) for each of the identified counties:  the number of
226.12 	applications described in clause (1), the average number of days
226.13 	the applications were pending, the distribution of days for
226.14 	applications that were pending, and what percentage of the
226.15 	applications, respectively, the county approved and denied.
226.16 		Subd. 2.Time to process application. The report must
226.17 	include specific recommendations for how counties, as a group,
226.18 	could shorten the time it takes to act on the applications
226.19 	described in subdivision 1, clause (1).

226.20 	Sec. 4. Minnesota Statutes 2004, section 256B.057,
226.21 	subdivision 9, is amended to read:
226.22 		Subd. 9.Employed persons with disabilities.  (a) Medical
226.23 	assistance may be paid for a person who is employed and who:
226.24 	(1) meets the definition of disabled under the supplemental
226.25 	security income program;
226.26 	(2) is at least 16 but less than 65 years of age;
226.27 	(3) meets the asset limits in paragraph (b); and
226.28 	(4) effective November 1, 2003, pays a premium and other
226.29 	obligations under paragraph (d).
226.30 	Any spousal income or assets shall be disregarded for purposes
226.31 	of eligibility and premium determinations.
226.32 	After the month of enrollment, a person enrolled in medical
226.33 	assistance under this subdivision who:
226.34 	(1) is temporarily unable to work and without receipt of
226.35 	earned income due to a medical condition, as verified by a
226.36 	physician, may retain eligibility for up to four calendar
227.1 	months; or
227.2 	(2) effective January 1, 2004, loses employment for reasons
227.3 	not attributable to the enrollee, may retain eligibility for up
227.4 	to four consecutive months after the month of job loss.  To
227.5 	receive a four-month extension, enrollees must verify the
227.6 	medical condition or provide notification of job loss.  All
227.7 	other eligibility requirements must be met and the enrollee must
227.8 	pay all calculated premium costs for continued eligibility.
227.9 	(b) For purposes of determining eligibility under this
227.10 	subdivision, a person's assets must not exceed $20,000,
227.11 	excluding:
227.12 	(1) all assets excluded under section 256B.056;
227.13 	(2) retirement accounts, including individual accounts,
227.14 	401(k) plans, 403(b) plans, Keogh plans, and pension plans; and
227.15 	(3) medical expense accounts set up through the person's
227.16 	employer.
227.17 	(c)(1) Effective January 1, 2004, for purposes of
227.18 	eligibility, there will be a $65 earned income disregard.  To be
227.19 	eligible, a person applying for medical assistance under this
227.20 	subdivision must have earned income above the disregard level.
227.21 	(2) Effective January 1, 2004, to be considered earned
227.22 	income, Medicare, Social Security, and applicable state and
227.23 	federal income taxes must be withheld.  To be eligible, a person
227.24 	must document earned income tax withholding.
227.25 	(d)(1) A person whose earned and unearned income is equal
227.26 	to or greater than 100 percent of federal poverty guidelines for
227.27 	the applicable family size must pay a premium to be eligible for
227.28 	medical assistance under this subdivision.  The premium shall be
227.29 	based on the person's gross earned and unearned income and the
227.30 	applicable family size using a sliding fee scale established by
227.31 	the commissioner, which begins at one percent of income at 100
227.32 	percent of the federal poverty guidelines and increases to 7.5
227.33 	percent of income for those with incomes at or above 300 percent
227.34 	of the federal poverty guidelines.  Annual adjustments in the
227.35 	premium schedule based upon changes in the federal poverty
227.36 	guidelines shall be effective for premiums due in July of each
228.1 	year.
228.2 	(2) Effective January 1, 2004, all enrollees must pay a
228.3 	premium to be eligible for medical assistance under this
228.4 	subdivision.  An enrollee shall pay the greater of a $35 premium
228.5 	or the premium calculated in clause (1).
228.6 	(3) Effective November 1, 2003, all enrollees who receive
228.7 	unearned income must pay one-half of one percent of unearned
228.8 	income in addition to the premium amount.
228.9 	(4) Effective November 1, 2003, for enrollees whose income
228.10 	does not exceed 200 percent of the federal poverty guidelines
228.11 	and who are also enrolled in Medicare, the commissioner must
228.12 	reimburse the enrollee for Medicare Part B premiums under
228.13 	section 256B.0625, subdivision 15, paragraph (a).
228.14 	(5) Increases in benefits under title II of the Social
228.15 	Security Act shall not be counted as income for purposes of this
228.16 	subdivision until July 1 of each year.
228.17 	(e) A person's eligibility and premium shall be determined
228.18 	by the local county agency.  Premiums must be paid to the
228.19 	commissioner.  All premiums are dedicated to the commissioner.
228.20 	(f) Any required premium shall be determined at application
228.21 	and redetermined at the enrollee's six-month income review or
228.22 	when a change in income or household size is reported.
228.23 	Enrollees must report any change in income or household size
228.24 	within ten days of when the change occurs.  A decreased premium
228.25 	resulting from a reported change in income or household size
228.26 	shall be effective the first day of the next available billing
228.27 	month after the change is reported.  Except for changes
228.28 	occurring from annual cost-of-living increases, a change
228.29 	resulting in an increased premium shall not affect the premium
228.30 	amount until the next six-month review.
228.31 	(g) Premium payment is due upon notification from the
228.32 	commissioner of the premium amount required.  Premiums may be
228.33 	paid in installments at the discretion of the commissioner.
228.34 	(h) Nonpayment of the premium shall result in denial or
228.35 	termination of medical assistance unless the person demonstrates
228.36 	good cause for nonpayment.  Good cause exists if the
229.1 	requirements specified in Minnesota Rules, part 9506.0040,
229.2 	subpart 7, items B to D, are met.  Except when an installment
229.3 	agreement is accepted by the commissioner, all persons
229.4 	disenrolled for nonpayment of a premium must pay any past due
229.5 	premiums as well as current premiums due prior to being
229.6 	reenrolled.  Nonpayment shall include payment with a returned,
229.7 	refused, or dishonored instrument.  The commissioner may require
229.8 	a guaranteed form of payment as the only means to replace a
229.9 	returned, refused, or dishonored instrument.

229.10 	Sec. 5. [256B.0571] LONG-TERM CARE PARTNERSHIP.
229.11 		Subdivision 1.Definitions. For purposes of this
229.12 	section, the following terms have the meanings given them.
229.13 		Subd. 2.Home care service. "Home care service" means
229.14 	care described in section 144A.43.
229.15 		Subd. 3.Long-term care insurance. "Long-term care
229.16 	insurance" means a policy described in section 62S.01.
229.17 		Subd. 4.Medical assistance. "Medical assistance" means
229.18 	the program of medical assistance established under section
229.19 	256B.01.
229.20 		Subd. 5.Nursing home. "Nursing home" means a nursing
229.21 	home as described in section 144A.01.
229.22 		Subd. 6.Partnership policy. "Partnership policy" means
229.23 	a long-term care insurance policy that meets the requirements
229.24 	under subdivision 10 or 11, regardless of when the policy was
229.25 	first issued.
229.26 		Subd. 7.Partnership program. "Partnership program"
229.27 	means the Minnesota partnership for long-term care program
229.28 	established under this section.
229.29 		Subd. 8.Program established. (a) The commissioner, in
229.30 	cooperation with the commissioner of commerce, shall establish
229.31 	the Minnesota partnership for long-term care program to provide
229.32 	for the financing of long-term care through a combination of
229.33 	private insurance and medical assistance.
229.34 	(b) An individual who meets the requirements in this
229.35 	paragraph is eligible to participate in the partnership
229.36 	program.  The individual must:
230.1 	(1) be a Minnesota resident;
230.2 	(2) purchase a partnership policy that is delivered, issued
230.3 	for delivery, or renewed on or after the effective date of this
230.4 	section, and maintain the partnership policy in effect
230.5 	throughout the period of participation in the partnership
230.6 	program; and 
230.7 	(3) exhaust the minimum benefits under the partnership
230.8 	policy as described in this section.  Benefits received under a
230.9 	long-term care insurance policy before the effective date of
230.10 	this section do not count toward the exhaustion of benefits
230.11 	required in this subdivision.
230.12 		Subd. 9.Medical assistance eligibility. (a) Upon
230.13 	application of an individual who meets the requirements
230.14 	described in subdivision 8, the commissioner shall determine the
230.15 	individual's eligibility for medical assistance according to
230.16 	paragraphs (b) and (c).
230.17 	(b) After disregarding financial assets exempted under
230.18 	medical assistance eligibility requirements, the commissioner
230.19 	shall disregard an additional amount of financial assets equal
230.20 	to the dollar amount of coverage utilized under the partnership
230.21 	policy.
230.22 	(c) The commissioner shall consider the individual's income
230.23 	according to medical assistance eligibility requirements.
230.24 		Subd. 10.Dollar-for-dollar asset protection
230.25 	policies. (a) A dollar-for-dollar asset protection policy must
230.26 	meet all of the requirements in paragraphs (b) to (e).
230.27 	(b) The policy must satisfy the requirements of chapter 62S.
230.28 	(c) The policy must offer an elimination period of not more
230.29 	than 180 days for an adjusted premium.
230.30 	(d) The policy must satisfy the requirements established by
230.31 	the commissioner of human services under subdivision 14.
230.32 	(e) Minimum daily benefits shall be $130 for nursing home
230.33 	care or $65 for home care, with inflation protection provided in
230.34 	the policy as described in section 62S.23, subdivision 1, clause
230.35 	(1).  These minimum daily benefit amounts shall be adjusted by
230.36 	the commissioner on October 1 of each year by a percentage equal
231.1 	to the inflation protection feature described in section 62S.23,
231.2 	subdivision 1, clause (1), for purposes of setting minimum
231.3 	requirements that a policy must meet in future years in order to
231.4 	initially qualify as an approved policy under this subdivision.
231.5 	Adjusted minimum daily benefit amounts shall be rounded to the
231.6 	nearest whole dollar.
231.7 		Subd. 11.Total asset protection policies. (a) A total
231.8 	asset protection policy must meet all of the requirements in
231.9 	subdivision 10, paragraphs (b) to (d), and this subdivision.
231.10 	(b) Minimum coverage shall be for a period of not less than
231.11 	three years and for a dollar amount equal to 36 months of
231.12 	nursing home care at the minimum daily benefit rate determined
231.13 	and adjusted under paragraph (c).
231.14 	(c) Minimum daily benefits shall be $150 for nursing home
231.15 	care or $75 for home care, with inflation protection provided in
231.16 	the policy as described in section 62S.23, subdivision 1, clause
231.17 	(1).  These minimum daily benefit amounts shall also be adjusted
231.18 	by the commissioner on October 1 of each year by a percentage
231.19 	equal to the inflation protection feature described in section
231.20 	62S.23, subdivision 1, clause (1), for purposes of setting
231.21 	minimum requirements that a policy must meet in future years in
231.22 	order to initially qualify as an approved policy under this
231.23 	subdivision.  Adjusted minimum daily benefit amounts shall be
231.24 	rounded to the nearest whole dollar.
231.25 	(d) The policy must cover all of the following services:
231.26 	(1) nursing home stay;
231.27 	(2) home care service; and 
231.28 	(3) care management.
231.29 		Subd. 12.Compliance with federal law. An issuer of a
231.30 	partnership policy must comply with any federal law authorizing
231.31 	partnership policies in Minnesota, including any federal
231.32 	regulations, as amended, adopted under that law.  This paragraph
231.33 	does not require compliance with any provision of this federal
231.34 	law until the date upon which the law requires compliance with
231.35 	the provision.  The commissioner has authority to enforce this
231.36 	paragraph.
232.1 		Subd. 13.Limitations on estate recovery. (a) For an
232.2 	individual who exhausts the minimum benefits of a
232.3 	dollar-for-dollar asset protection policy under subdivision 10,
232.4 	and is determined eligible for medical assistance under
232.5 	subdivision 9, the state shall limit recovery under the
232.6 	provisions of section 256B.15 against the estate of the
232.7 	individual or individual's spouse for medical assistance
232.8 	benefits received by that individual to an amount that exceeds
232.9 	the dollar amount of coverage utilized under the partnership
232.10 	policy.
232.11 	(b) For an individual who exhausts the minimum benefits of
232.12 	a total asset protection policy under subdivision 11, and is
232.13 	determined eligible for medical assistance under subdivision 9,
232.14 	the state shall not seek recovery under the provisions of
232.15 	section 256B.15 against the estate of the individual or
232.16 	individual's spouse for medical assistance benefits received by
232.17 	that individual.
232.18 		Subd. 14.Implementation. (a) If federal law is amended
232.19 	or a federal waiver is granted to permit implementation of this
232.20 	section, the commissioner, in consultation with the commissioner
232.21 	of commerce, may alter the requirements of subdivisions 10 and
232.22 	11, and may establish additional requirements for approved
232.23 	policies in order to conform with federal law or waiver
232.24 	authority.  In establishing these requirements, the commissioner
232.25 	shall seek to maximize purchase of qualifying policies by
232.26 	Minnesota residents while controlling medical assistance costs.
232.27 	(b) The commissioner is authorized to suspend
232.28 	implementation of this section until the next session of the
232.29 	legislature if the commissioner, in consultation with the
232.30 	commissioner of commerce, determines that the federal
232.31 	legislation or federal waiver authorizing a partnership program
232.32 	in Minnesota is likely to impose substantial unforeseen costs on
232.33 	the state budget.
232.34 	(c) The commissioner must take action under paragraph (a)
232.35 	or (b) within 45 days of final federal action authorizing a
232.36 	partnership policy in Minnesota.
233.1 	(d) The commissioner must notify the appropriate
233.2 	legislative committees of action taken under this subdivision
233.3 	within 50 days of final federal action authorizing a partnership
233.4 	policy in Minnesota.
233.5 	(e) The commissioner must publish a notice in the State
233.6 	Register of implementation decisions made under this subdivision
233.7 	as soon as practicable.
233.8 	
EFFECTIVE DATE. (a) If any provision of this section is
233.9 	prohibited by federal law, no provision shall become effective
233.10 	until federal law is changed to permit its full implementation.
233.11 	The commissioner of human services shall notify the revisor of
233.12 	statutes when federal law is enacted or other federal approval
233.13 	is received and publish a notice in the State Register.  The
233.14 	commissioner must include the notice in the first State Register
233.15 	published after the effective date of the federal changes.
233.16 	(b) If federal law is changed to permit a waiver of any
233.17 	provisions prohibited by federal law, the commissioner of human
233.18 	services shall apply to the federal government for a waiver of
233.19 	those prohibitions or other federal authority, and that
233.20 	provision shall become effective upon receipt of a federal
233.21 	waiver or other federal approval, notification to the revisor of
233.22 	statutes, and publication of a notice in the State Register to
233.23 	that effect.

233.24 	Sec. 6. Minnesota Statutes 2004, section 256B.0621,
233.25 	subdivision 2, is amended to read:
233.26 		Subd. 2.Targeted case management; definitions.  For
233.27 	purposes of subdivisions 3 to 10, the following terms have the
233.28 	meanings given them:
233.29 	(1) "home care service recipients" means those individuals
233.30 	receiving the following services under section 256B.0627:
233.31 	skilled nursing visits, home health aide visits, private duty
233.32 	nursing, personal care assistants, or therapies provided through
233.33 	a home health agency;
233.34 	(2) "home care targeted case management" means the
233.35 	provision of targeted case management services for the purpose
233.36 	of assisting home care service recipients to gain access to
234.1 	needed services and supports so that they may remain in the
234.2 	community;
234.3 	(3) "institutions" means hospitals, consistent with Code of
234.4 	Federal Regulations, title 42, section 440.10; regional
234.5 	treatment center inpatient services, consistent with section
234.6 	245.474; nursing facilities; and intermediate care facilities
234.7 	for persons with mental retardation;
234.8 	(4) "relocation targeted case management" means includes 
234.9 	the provision of both county targeted case management and public
234.10 	or private vendor service coordination services for the purpose
234.11 	of assisting recipients to gain access to needed services and
234.12 	supports if they choose to move from an institution to the
234.13 	community.  Relocation targeted case management may be provided
234.14 	during the last 180 consecutive days of an eligible recipient's
234.15 	institutional stay; and
234.16 	(5) "targeted case management" means case management
234.17 	services provided to help recipients gain access to needed
234.18 	medical, social, educational, and other services and supports.

234.19 	Sec. 7. Minnesota Statutes 2004, section 256B.0621,
234.20 	subdivision 3, is amended to read:
234.21 		Subd. 3.Eligibility.  The following persons are eligible
234.22 	for relocation targeted case management or home care-targeted 
234.23 	care targeted case management:
234.24 	(1) medical assistance eligible persons residing in
234.25 	institutions who choose to move into the community are eligible
234.26 	for relocation targeted case management services; and
234.27 	(2) medical assistance eligible persons receiving home care
234.28 	services, who are not eligible for any other medical assistance
234.29 	reimbursable case management service, are eligible for home
234.30 	care-targeted care targeted case management services beginning
234.31 	January 1, 2003 July 1, 2005.

234.32 	Sec. 8. Minnesota Statutes 2004, section 256B.0621,
234.33 	subdivision 4, is amended to read:
234.34 		Subd. 4.Relocation targeted county case management
234.35 	provider qualifications.  (a) A relocation targeted county case
234.36 	management provider is an enrolled medical assistance provider
235.1 	who is determined by the commissioner to have all of the
235.2 	following characteristics:
235.3 	(1) the legal authority to provide public welfare under
235.4 	sections 393.01, subdivision 7; and 393.07; or a federally
235.5 	recognized Indian tribe;
235.6 	(2) the demonstrated capacity and experience to provide the
235.7 	components of case management to coordinate and link community
235.8 	resources needed by the eligible population;
235.9 	(3) the administrative capacity and experience to serve the
235.10 	target population for whom it will provide services and ensure
235.11 	quality of services under state and federal requirements;
235.12 	(4) the legal authority to provide complete investigative
235.13 	and protective services under section 626.556, subdivision 10;
235.14 	and child welfare and foster care services under section 393.07,
235.15 	subdivisions 1 and 2; or a federally recognized Indian tribe;
235.16 	(5) a financial management system that provides accurate
235.17 	documentation of services and costs under state and federal
235.18 	requirements; and
235.19 	(6) the capacity to document and maintain individual case
235.20 	records under state and federal requirements.
235.21 	(b) A provider of targeted case management under section
235.22 	256B.0625, subdivision 20, may be deemed a certified provider of
235.23 	relocation targeted case management.
235.24 	(c) A relocation targeted county case management provider
235.25 	may subcontract with another provider to deliver relocation
235.26 	targeted case management services.  Subcontracted providers must
235.27 	demonstrate the ability to provide the services outlined in
235.28 	subdivision 6, and have a procedure in place that notifies the
235.29 	recipient and the recipient's legal representative of any
235.30 	conflict of interest if the contracted targeted case management
235.31 	provider also provides, or will provide, the recipient's
235.32 	services and supports. Counties must require that contracted
235.33 	providers must provide information on all conflicts of interest
235.34 	and obtain the recipient's informed consent or provide the
235.35 	recipient with alternatives.

235.36 	Sec. 9. Minnesota Statutes 2004, section 256B.0621,
236.1 	subdivision 5, is amended to read:
236.2 		Subd. 5.Home care targeted case management and
236.3 	relocation service coordination provider qualifications. The
236.4 	following qualifications and certification standards must be met
236.5 	by Providers of home care targeted case management and
236.6 	relocation service coordination must meet the qualifications
236.7 	under subdivision 4 for county vendors or the qualifications and
236.8 	certification standards under paragraphs (a) and (b) for private
236.9 	vendors.
236.10 	(a) The commissioner must certify each provider of home
236.11 	care targeted case management and relocation service
236.12 	coordination before enrollment.  The certification process shall
236.13 	examine the provider's ability to meet the requirements in this
236.14 	subdivision and other state and federal requirements of this
236.15 	service.
236.16 	(b) A Both home care targeted case management provider is
236.17 	an providers and relocation service coordination providers are 
236.18 	enrolled medical assistance provider providers who has have a
236.19 	minimum of a bachelor's degree or a license in a health or human
236.20 	services field, comparable training and two years of experience
236.21 	in human services, or who have been credentialed by an American
236.22 	Indian tribe under section 256B.02, subdivision 7,and is have
236.23 	been determined by the commissioner to have all of the following
236.24 	characteristics:
236.25 	(1) the demonstrated capacity and experience to provide the
236.26 	components of case management to coordinate and link community
236.27 	resources needed by the eligible population;
236.28 	(2) the administrative capacity and experience to serve the
236.29 	target population for whom it will provide services and ensure
236.30 	quality of services under state and federal requirements;
236.31 	(3) a financial management system that provides accurate
236.32 	documentation of services and costs under state and federal
236.33 	requirements;
236.34 	(4) the capacity to document and maintain individual case
236.35 	records under state and federal requirements; and 
236.36 	(5) the capacity to coordinate with county administrative
237.1 	functions;
237.2 	(6) have no financial interest in the provision of
237.3 	out-of-home residential services to persons for whom home care
237.4 	targeted case management or relocation service coordination is
237.5 	provided; and 
237.6 	(7) if a provider has a financial interest in services
237.7 	other than out-of-home residential services provided to persons
237.8 	for whom home care targeted case management or relocation
237.9 	service coordination is also provided, the county must determine
237.10 	each year that:
237.11 	(i) any possible conflict of interest is explained annually
237.12 	at a face-to-face meeting and in writing and the person provides
237.13 	written informed consent consistent with section 256B.77,
237.14 	subdivision 2, paragraph (p); and 
237.15 	(ii) information on a range of other feasible service
237.16 	provider options has been provided.
237.17 	(c) The state of Minnesota, a county board, or agency
237.18 	acting on behalf of a county board shall not be liable for
237.19 	damages, injuries, or liabilities sustained because of services
237.20 	provided to a client by a private service coordination vendor.

237.21 	Sec. 10. Minnesota Statutes 2004, section 256B.0621,
237.22 	subdivision 6, is amended to read:
237.23 		Subd. 6.Eligible services. (a) Services eligible for
237.24 	medical assistance reimbursement as targeted case management
237.25 	include:
237.26 	(1) assessment of the recipient's need for targeted case
237.27 	management services and for persons choosing to relocate, the
237.28 	county must provide service coordination provider options at the
237.29 	first contact and upon request;
237.30 	(2) development, completion, and regular review of a
237.31 	written individual service plan, which is based upon the
237.32 	assessment of the recipient's needs and choices, and which will
237.33 	ensure access to medical, social, educational, and other related
237.34 	services and supports;
237.35 	(3) routine contact or communication with the recipient,
237.36 	recipient's family, primary caregiver, legal representative,
238.1 	substitute care provider, service providers, or other relevant
238.2 	persons identified as necessary to the development or
238.3 	implementation of the goals of the individual service plan;
238.4 	(4) coordinating referrals for, and the provision of, case
238.5 	management services for the recipient with appropriate service
238.6 	providers, consistent with section 1902(a)(23) of the Social
238.7 	Security Act;
238.8 	(5) coordinating and monitoring the overall service
238.9 	delivery and engaging in advocacy as needed to ensure quality of
238.10 	services, appropriateness, and continued need;
238.11 	(6) completing and maintaining necessary documentation that
238.12 	supports and verifies the activities in this subdivision;
238.13 	(7) traveling assisting individuals in order to access
238.14 	needed services, including travel to conduct a visit with the
238.15 	recipient or other relevant person necessary to develop or
238.16 	implement the goals of the individual service plan; and
238.17 	(8) coordinating with the institution discharge planner in
238.18 	the 180-day period before the recipient's discharge.
238.19 	(b) Relocation targeted county case management includes
238.20 	services under paragraph (a), clauses (1), (2), and (4).
238.21 	Relocation service coordination includes services under
238.22 	paragraph (a), clauses (3) and (5) to (8).  Home care targeted
238.23 	case management includes services under paragraph (a), clauses
238.24 	(1) to (8).

238.25 	Sec. 11. Minnesota Statutes 2004, section 256B.0621,
238.26 	subdivision 7, is amended to read:
238.27 		Subd. 7.Time lines.  The following time lines must be
238.28 	met for assigning a case manager:
238.29 	(a) For relocation targeted case management, an eligible
238.30 	recipient must be assigned a county case manager who visits the
238.31 	person within 20 working days of requesting a case manager from
238.32 	their county of financial responsibility as determined under
238.33 	chapter 256G.
238.34 	(1) If a county agency, its contractor, or federally
238.35 	recognized tribe does not provide case management services as
238.36 	required, the recipient may obtain targeted relocation case
239.1 	management services relocation service coordination from an
239.2 	alternative a provider of targeted case management services
239.3 	enrolled by the commissioner qualified under subdivision 5.
239.4 	(2) The commissioner may waive the provider requirements in
239.5 	subdivision 4, paragraph (a), clauses (1) and (4), to ensure
239.6 	recipient access to the assistance necessary to move from an
239.7 	institution to the community.  The recipient or the recipient's
239.8 	legal guardian shall provide written notice to the county or
239.9 	tribe of the decision to obtain services from an alternative
239.10 	provider.
239.11 	(3) Providers of relocation targeted case management
239.12 	enrolled under this subdivision shall:
239.13 	(i) meet the provider requirements under subdivision 4 that
239.14 	are not waived by the commissioner;
239.15 	(ii) be qualified to provide the services specified in
239.16 	subdivision 6;
239.17 	(iii) coordinate efforts with local social service agencies
239.18 	and tribes; and
239.19 	(iv) comply with the conflict of interest provisions
239.20 	established under subdivision 4, paragraph (c).
239.21 	(4) Local social service agencies and federally recognized
239.22 	tribes shall cooperate with providers certified by the
239.23 	commissioner under this subdivision to facilitate the
239.24 	recipient's successful relocation from an institution to the
239.25 	community.
239.26 	(b) For home care targeted case management, an eligible
239.27 	recipient must be assigned a case manager within 20 working days
239.28 	of requesting a case manager from a home care targeted case
239.29 	management provider, as defined in subdivision 5.

239.30 	Sec. 12. Minnesota Statutes 2004, section 256B.0621, is
239.31 	amended by adding a subdivision to read:
239.32 		Subd. 11.Data use agreement and notice of relocation
239.33 	targeted case management availability. The commissioner shall
239.34 	execute a data use agreement with the Centers for Medicare and
239.35 	Medicaid Services to obtain the long-term care minimum data set
239.36 	data to assist residents of nursing facilities who have
240.1 	indicated a desire to live in the community.  The commissioner
240.2 	shall in turn enter into agreements with the Centers for
240.3 	Independent Living to provide information about assistance for
240.4 	persons who want to move to the community.  The commissioner
240.5 	shall work with the Centers for Independent Living on both the
240.6 	content of the information to be provided and privacy
240.7 	protections for the individual residents.

240.8 	Sec. 13. Minnesota Statutes 2004, section 256B.0625,
240.9 	subdivision 2, is amended to read:
240.10 		Subd. 2.Skilled and intermediate nursing care.  Medical
240.11 	assistance covers skilled nursing home services and services of
240.12 	intermediate care facilities, including training and
240.13 	habilitation services, as defined in section 252.41, subdivision
240.14 	3, for persons with mental retardation or related conditions who
240.15 	are residing in intermediate care facilities for persons with
240.16 	mental retardation or related conditions.  Medical assistance
240.17 	must not be used to pay the costs of nursing care provided to a
240.18 	patient in a swing bed as defined in section 144.562, unless (a)
240.19 	the facility in which the swing bed is located is eligible as a
240.20 	sole community provider, as defined in Code of Federal
240.21 	Regulations, title 42, section 412.92, or the facility is a
240.22 	public hospital owned by a governmental entity with 15 or fewer
240.23 	licensed acute care beds; (b) the Centers for Medicare and
240.24 	Medicaid Services approves the necessary state plan amendments;
240.25 	(c) the patient was screened as provided by law; (d) the patient
240.26 	no longer requires acute care services; and (e) no nursing home
240.27 	beds are available within 25 miles of the facility. The
240.28 	commissioner shall exempt a facility from compliance with the
240.29 	sole community provider requirement in clause (a) if, as of
240.30 	January 1, 2004, the facility had an agreement with the
240.31 	commissioner to provide medical assistance swing bed services.
240.32 	Medical assistance also covers up to ten days of nursing care
240.33 	provided to a patient in a swing bed if:  (1) the patient's
240.34 	physician certifies that the patient has a terminal illness or
240.35 	condition that is likely to result in death within 30 days and
240.36 	that moving the patient would not be in the best interests of
241.1 	the patient and patient's family; (2) no open nursing home beds
241.2 	are available within 25 miles of the facility; and (3) no open
241.3 	beds are available in any Medicare hospice program within 50
241.4 	miles of the facility.  The daily medical assistance payment for
241.5 	nursing care for the patient in the swing bed is the statewide
241.6 	average medical assistance skilled nursing care per diem as
241.7 	computed annually by the commissioner on July 1 of each year.
241.8 	
EFFECTIVE DATE. This section is effective the day
241.9 	following final enactment and applies to medical assistance
241.10 	payments for swing bed services provided on or after July 1,
241.11 	2005.

241.12 	Sec. 14. Minnesota Statutes 2004, section 256B.0625,
241.13 	subdivision 19c, is amended to read:
241.14 		Subd. 19c.Personal care.  Medical assistance covers
241.15 	personal care assistant services provided by an individual who
241.16 	is qualified to provide the services according to subdivision
241.17 	19a and section 256B.0627, where the services are prescribed 
241.18 	have a statement of need by a physician, provided in accordance
241.19 	with a plan of treatment ,and are supervised by the recipient or
241.20 	a qualified professional. The physician's statement of need for
241.21 	personal care assistant services shall be documented on a form
241.22 	approved by the commissioner and include the diagnosis or
241.23 	condition of the person that results in a need for personal care
241.24 	assistant services and be updated when the person's medical
241.25 	condition requires a change, but at least annually if the need
241.26 	for personal care assistant services is ongoing.
241.27 	"Qualified professional" means a mental health professional as
241.28 	defined in section 245.462, subdivision 18, or 245.4871,
241.29 	subdivision 27; or a registered nurse as defined in sections
241.30 	148.171 to 148.285, or a licensed social worker as defined in
241.31 	section 148B.21.  As part of the assessment, the county public
241.32 	health nurse will assist the recipient or responsible party to
241.33 	identify the most appropriate person to provide supervision of
241.34 	the personal care assistant.  The qualified professional shall
241.35 	perform the duties described in Minnesota Rules, part 9505.0335,
241.36 	subpart 4.

242.1 	Sec. 15. Minnesota Statutes 2004, section 256B.0627,
242.2 	subdivision 1, as amended by Laws 2005, chapter 10, article 1,
242.3 	section 49, is amended to read:
242.4 		Subdivision 1.Definition. (a) "Activities of daily
242.5 	living" includes eating, toileting, grooming, dressing, bathing,
242.6 	transferring, mobility, and positioning.
242.7 	(b) "Assessment" means a review and evaluation of a
242.8 	recipient's need for home care services conducted in person.
242.9 	Assessments for private duty nursing shall be conducted by a
242.10 	registered private duty nurse.  Assessments for home health
242.11 	agency services shall be conducted by a home health agency
242.12 	nurse.  Assessments for personal care assistant services shall
242.13 	be conducted by the county public health nurse or a certified
242.14 	public health nurse under contract with the county.  A
242.15 	face-to-face assessment must include:  documentation of health
242.16 	status, determination of need, evaluation of service
242.17 	effectiveness, identification of appropriate services, service
242.18 	plan development or modification, coordination of services,
242.19 	referrals and follow-up to appropriate payers and community
242.20 	resources, completion of required reports, recommendation of
242.21 	service authorization, and consumer education.  Once the need
242.22 	for personal care assistant services is determined under this
242.23 	section, the county public health nurse or certified public
242.24 	health nurse under contract with the county is responsible for
242.25 	communicating this recommendation to the commissioner and the
242.26 	recipient.  A face-to-face assessment for personal care
242.27 	assistant services is conducted on those recipients who have
242.28 	never had a county public health nurse assessment.  A
242.29 	face-to-face assessment must occur at least annually or when
242.30 	there is a significant change in the recipient's condition or
242.31 	when there is a change in the need for personal care assistant
242.32 	services.  A service update may substitute for the annual
242.33 	face-to-face assessment when there is not a significant change
242.34 	in recipient condition or a change in the need for personal care
242.35 	assistant service.  A service update or review for temporary
242.36 	increase includes a review of initial baseline data, evaluation
243.1 	of service effectiveness, redetermination of service need,
243.2 	modification of service plan and appropriate referrals, update
243.3 	of initial forms, obtaining service authorization, and on going
243.4 	consumer education.  Assessments for medical assistance home
243.5 	care services for mental retardation or related conditions and
243.6 	alternative care services for developmentally disabled home and
243.7 	community-based waivered recipients may be conducted by the
243.8 	county public health nurse to ensure coordination and avoid
243.9 	duplication.  Assessments must be completed on forms provided by
243.10 	the commissioner within 30 days of a request for home care
243.11 	services by a recipient or responsible party.
243.12 	(c) "Care plan" means a written description of personal
243.13 	care assistant services developed by the qualified professional
243.14 	or the recipient's physician with the recipient or responsible
243.15 	party to be used by the personal care assistant with a copy
243.16 	provided to the recipient or responsible party.
243.17 	(d) "Complex and regular private duty nursing care" means:
243.18 	(1) complex care is private duty nursing provided to
243.19 	recipients who are ventilator dependent or for whom a physician
243.20 	has certified that were it not for private duty nursing the
243.21 	recipient would meet the criteria for inpatient hospital
243.22 	intensive care unit (ICU) level of care; and
243.23 	(2) regular care is private duty nursing provided to all
243.24 	other recipients.
243.25 	(e) "Health-related functions" means functions that can be
243.26 	delegated or assigned by a licensed health care professional
243.27 	under state law to be performed by a personal care assistant.
243.28 	(f) "Home care services" means a health service, determined
243.29 	by the commissioner as medically necessary, that is ordered by a
243.30 	physician and documented in a service plan that is reviewed by
243.31 	the physician at least once every 60 days for the provision of
243.32 	home health services, or private duty nursing, or at least once
243.33 	every 365 days for personal care.  Home care services are
243.34 	provided to the recipient at the recipient's residence that is a
243.35 	place other than a hospital or long-term care facility or as
243.36 	specified in section 256B.0625.
244.1 	(g) "Instrumental activities of daily living" includes meal
244.2 	planning and preparation, managing finances, shopping for food,
244.3 	clothing, and other essential items, performing essential
244.4 	household chores, communication by telephone and other media,
244.5 	and getting around and participating in the community.
244.6 	(h) "Medically necessary" has the meaning given in
244.7 	Minnesota Rules, parts 9505.0170 to 9505.0475.
244.8 	(i) "Personal care assistant" means a person who:
244.9 	(1) is at least 18 years old, except for persons 16 to 18
244.10 	years of age who participated in a related school-based job
244.11 	training program or have completed a certified home health aide
244.12 	competency evaluation;
244.13 	(2) is able to effectively communicate with the recipient
244.14 	and personal care provider organization;
244.15 	(3) effective July 1, 1996, has completed one of the
244.16 	training requirements as specified in Minnesota Rules, part
244.17 	9505.0335, subpart 3, items A to D;
244.18 	(4) has the ability to, and provides covered personal care
244.19 	assistant services according to the recipient's care plan,
244.20 	responds appropriately to recipient needs, and reports changes
244.21 	in the recipient's condition to the supervising qualified
244.22 	professional or physician;
244.23 	(5) is not a consumer of personal care assistant services;
244.24 	and 
244.25 	(6) maintains daily written records detailing:
244.26 	(i) the actual services provided to the recipient; and 
244.27 	(ii) the amount of time spent providing the services; and 
244.28 	(7) is subject to criminal background checks and procedures
244.29 	specified in chapter 245C.
244.30 	(j) "Personal care provider organization" means an
244.31 	organization enrolled to provide personal care assistant
244.32 	services under the medical assistance program that complies with
244.33 	the following:
244.34 	(1) owners who have a five percent interest or more, and
244.35 	managerial officials are subject to a background study as
244.36 	provided in chapter 245C.  This applies to currently enrolled
245.1 	personal care provider organizations and those agencies seeking
245.2 	enrollment as a personal care provider organization.  An
245.3 	organization will be barred from enrollment if an owner or
245.4 	managerial official of the organization has been convicted of a
245.5 	crime specified in chapter 245C, or a comparable crime in
245.6 	another jurisdiction, unless the owner or managerial official
245.7 	meets the reconsideration criteria specified in chapter 245C;
245.8 	(2) the organization must maintain a surety bond and
245.9 	liability insurance throughout the duration of enrollment and
245.10 	provides proof thereof.  The insurer must notify the Department
245.11 	of Human Services of the cancellation or lapse of policy;and
245.12 	(3) the organization must maintain documentation of services as
245.13 	specified in Minnesota Rules, part 9505.2175, subpart 7, as well
245.14 	as evidence of compliance with personal care assistant training
245.15 	requirements;
245.16 	(3) the organization must maintain documentation and a
245.17 	recipient file and satisfy communication requirements in
245.18 	subdivision 4, paragraph (f); and 
245.19 	(4) the organization must comply with all laws and rules
245.20 	governing the provision of personal care assistant services.
245.21 	(k) "Responsible party" means an individual who is capable
245.22 	of providing the support necessary to assist the recipient to
245.23 	live in the community, is at least 18 years old, actively
245.24 	participates in planning and directing of personal care
245.25 	assistant services, and is not the personal care assistant.  The
245.26 	responsible party must be accessible to the recipient and the
245.27 	personal care assistant when personal care services are being
245.28 	provided and monitor the services at least weekly according to
245.29 	the plan of care.  The responsible party must be identified at
245.30 	the time of assessment and listed on the recipient's service
245.31 	agreement and care plan.  Responsible parties who are parents of
245.32 	minors or guardians of minors or incapacitated persons may
245.33 	delegate the responsibility to another adult who is not the
245.34 	personal care assistant during a temporary absence of at least
245.35 	24 hours but not more than six months.  The person delegated as
245.36 	a responsible party must be able to meet the definition of
246.1 	responsible party, except that the delegated responsible party
246.2 	is required to reside with the recipient only while serving as
246.3 	the responsible party.  The delegated responsible party is not
246.4 	required to reside with the recipient while serving as the
246.5 	responsible party if competent supervision to ensure the health
246.6 	and safety of the recipient and monitoring of services provided
246.7 	are stated as part of the person's individual service plan under
246.8 	a home care service or home and community-based waiver program
246.9 	or in conjunction with a home care targeted case management
246.10 	service provider or other case manager.  The responsible party
246.11 	must assure that the delegate performs the functions of the
246.12 	responsible party, is identified at the time of the assessment,
246.13 	and is listed on the service agreement and the care plan.
246.14 	Foster care license holders may be designated the responsible
246.15 	party for residents of the foster care home if case management
246.16 	is provided as required in section 256B.0625, subdivision 19a.
246.17 	For persons who, as of April 1, 1992, are sharing personal care
246.18 	assistant services in order to obtain the availability of
246.19 	24-hour coverage, an employee of the personal care provider
246.20 	organization may be designated as the responsible party if case
246.21 	management is provided as required in section 256B.0625,
246.22 	subdivision 19a.
246.23 	(l) "Service plan" means a written description of the
246.24 	services needed based on the assessment developed by the nurse
246.25 	who conducts the assessment together with the recipient or
246.26 	responsible party.  The service plan shall include a description
246.27 	of the covered home care services, frequency and duration of
246.28 	services, and expected outcomes and goals.  The recipient and
246.29 	the provider chosen by the recipient or responsible party must
246.30 	be given a copy of the completed service plan within 30 calendar
246.31 	days of the request for home care services by the recipient or
246.32 	responsible party.
246.33 	(m) "Skilled nurse visits" are provided in a recipient's
246.34 	residence under a plan of care or service plan that specifies a
246.35 	level of care which the nurse is qualified to provide.  These
246.36 	services are:
247.1 	(1) nursing services according to the written plan of care
247.2 	or service plan and accepted standards of medical and nursing
247.3 	practice in accordance with chapter 148;
247.4 	(2) services which due to the recipient's medical condition
247.5 	may only be safely and effectively provided by a registered
247.6 	nurse or a licensed practical nurse;
247.7 	(3) assessments performed only by a registered nurse; and
247.8 	(4) teaching and training the recipient, the recipient's
247.9 	family, or other caregivers requiring the skills of a registered
247.10 	nurse or licensed practical nurse.
247.11 	(n) "Telehomecare" means the use of telecommunications
247.12 	technology by a home health care professional to deliver home
247.13 	health care services, within the professional's scope of
247.14 	practice, to a patient located at a site other than the site
247.15 	where the practitioner is located.

247.16 	Sec. 16. Minnesota Statutes 2004, section 256B.0627,
247.17 	subdivision 4, is amended to read:
247.18 		Subd. 4.Personal care assistant services.  (a) The
247.19 	personal care assistant services that are eligible for payment
247.20 	are services and supports furnished to an individual, as needed,
247.21 	to assist in accomplishing activities of daily living;
247.22 	instrumental activities of daily living; health-related
247.23 	functions through hands-on assistance, supervision, and cuing;
247.24 	and redirection and intervention for behavior including
247.25 	observation and monitoring.
247.26 	(b) Payment for services will be made within the limits
247.27 	approved using the prior authorized process established in
247.28 	subdivision 5.
247.29 	(c) The amount and type of services authorized shall be
247.30 	based on an assessment of the recipient's needs in these areas:
247.31 	(1) bowel and bladder care;
247.32 	(2) skin care to maintain the health of the skin;
247.33 	(3) repetitive maintenance range of motion, muscle
247.34 	strengthening exercises, and other tasks specific to maintaining
247.35 	a recipient's optimal level of function;
247.36 	(4) respiratory assistance;
248.1 	(5) transfers and ambulation;
248.2 	(6) bathing, grooming, and hairwashing necessary for
248.3 	personal hygiene;
248.4 	(7) turning and positioning;
248.5 	(8) assistance with furnishing medication that is
248.6 	self-administered;
248.7 	(9) application and maintenance of prosthetics and
248.8 	orthotics;
248.9 	(10) cleaning medical equipment;
248.10 	(11) dressing or undressing;
248.11 	(12) assistance with eating and meal preparation and
248.12 	necessary grocery shopping;
248.13 	(13) accompanying a recipient to obtain medical diagnosis
248.14 	or treatment;
248.15 	(14) assisting, monitoring, or prompting the recipient to
248.16 	complete the services in clauses (1) to (13);
248.17 	(15) redirection, monitoring, and observation that are
248.18 	medically necessary and an integral part of completing the
248.19 	personal care assistant services described in clauses (1) to
248.20 	(14);
248.21 	(16) redirection and intervention for behavior, including
248.22 	observation and monitoring;
248.23 	(17) interventions for seizure disorders, including
248.24 	monitoring and observation if the recipient has had a seizure
248.25 	that requires intervention within the past three months;
248.26 	(18) tracheostomy suctioning using a clean procedure if the
248.27 	procedure is properly delegated by a registered nurse.  Before
248.28 	this procedure can be delegated to a personal care assistant, a
248.29 	registered nurse must determine that the tracheostomy suctioning
248.30 	can be accomplished utilizing a clean rather than a sterile
248.31 	procedure and must ensure that the personal care assistant has
248.32 	been taught the proper procedure; and
248.33 	(19) incidental household services that are an integral
248.34 	part of a personal care service described in clauses (1) to (18).
248.35 	For purposes of this subdivision, monitoring and observation
248.36 	means watching for outward visible signs that are likely to
249.1 	occur and for which there is a covered personal care service or
249.2 	an appropriate personal care intervention.  For purposes of this
249.3 	subdivision, a clean procedure refers to a procedure that
249.4 	reduces the numbers of microorganisms or prevents or reduces the
249.5 	transmission of microorganisms from one person or place to
249.6 	another.  A clean procedure may be used beginning 14 days after
249.7 	insertion.
249.8 	(d) The personal care assistant services that are not
249.9 	eligible for payment are the following:
249.10 	(1) services not ordered by the physician provided without
249.11 	a physician's statement of need as required by section
249.12 	256B.0625, subdivision 19c, and included in the personal care
249.13 	provider agency's file for the recipient;
249.14 	(2) assessments by personal care assistant provider
249.15 	organizations or by independently enrolled registered nurses;
249.16 	(3) services that are not in the service plan;
249.17 	(4) services provided by the recipient's spouse, legal
249.18 	guardian for an adult or child recipient, or parent of a
249.19 	recipient under age 18;
249.20 	(5) services provided by a foster care provider of a
249.21 	recipient who cannot direct the recipient's own care, unless
249.22 	monitored by a county or state case manager under section
249.23 	256B.0625, subdivision 19a;
249.24 	(6) services provided by the residential or program license
249.25 	holder in a residence for more than four persons;
249.26 	(7) services that are the responsibility of a residential
249.27 	or program license holder under the terms of a service agreement
249.28 	and administrative rules;
249.29 	(8) sterile procedures;
249.30 	(9) injections of fluids into veins, muscles, or skin;
249.31 	(10) homemaker services that are not an integral part of a
249.32 	personal care assistant services;
249.33 	(11) home maintenance or chore services;
249.34 	(12) services not specified under paragraph (a); and
249.35 	(13) services not authorized by the commissioner or the
249.36 	commissioner's designee.
250.1 	(e) The recipient or responsible party may choose to
250.2 	supervise the personal care assistant or to have a qualified
250.3 	professional, as defined in section 256B.0625, subdivision 19c,
250.4 	provide the supervision.  As required under section 256B.0625,
250.5 	subdivision 19c, the county public health nurse, as a part of
250.6 	the assessment, will assist the recipient or responsible party
250.7 	to identify the most appropriate person to provide supervision
250.8 	of the personal care assistant.  Health-related delegated tasks
250.9 	performed by the personal care assistant will be under the
250.10 	supervision of a qualified professional or the direction of the
250.11 	recipient's physician.  If the recipient has a qualified
250.12 	professional, Minnesota Rules, part 9505.0335, subpart 4,
250.13 	applies.
250.14 	(f) In order to be paid for personal care assistant
250.15 	services, personal care provider organizations, and personal
250.16 	care assistant choice providers are required:
250.17 	(1) to maintain a recipient file for each recipient for
250.18 	whom services are being billed that contains:
250.19 	(i) the current physician's statement of need as required
250.20 	by section 256B.0625, subdivision 19c;
250.21 	(ii) the service plan, including the monthly authorized
250.22 	hours, or flexible use plan;
250.23 	(iii) the care plan, signed by the recipient and the
250.24 	qualified professional, if required or designated, detailing the
250.25 	personal care assistant services to be provided;
250.26 	(iv) documentation, on a form approved by the commissioner
250.27 	and signed by the personal care assistant, specifying the day,
250.28 	month, year, arrival, and departure times, with AM and PM
250.29 	notation, for all services provided to the recipient.  The form
250.30 	must include a notice that it is a federal crime to provide
250.31 	false information on personal care service billings for medical
250.32 	assistance payment; and 
250.33 	(v) all notices to the recipient regarding personal care
250.34 	service use exceeding authorized hours; and 
250.35 	(2) to communicate, by telephone if available, and in
250.36 	writing, with the recipient or the responsible party about the
251.1 	schedule for use of authorized hours and to notify the recipient
251.2 	and the county public health nurse in advance and as soon as
251.3 	possible, on a form approved by the commissioner, if the monthly
251.4 	number of hours authorized is likely to be exceeded for the
251.5 	month.
251.6 	(g) The commissioner shall establish an ongoing audit
251.7 	process for potential fraud and abuse for personal care
251.8 	assistant services.  The audit process must include, at a
251.9 	minimum, a requirement that the documentation of hours of care
251.10 	provided be on a form approved by the commissioner and include
251.11 	the personal care assistant's signature attesting that the hours
251.12 	shown on each bill were provided by the personal care assistant
251.13 	on the dates and the times specified.

251.14 	Sec. 17. Minnesota Statutes 2004, section 256B.0627,
251.15 	subdivision 5, as amended by Laws 2005, chapter 10, article 1,
251.16 	section 50, is amended to read:
251.17 		Subd. 5.Limitation on payments. Medical assistance
251.18 	payments for home care services shall be limited according to
251.19 	this subdivision.
251.20 	(a)  [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A
251.21 	recipient may receive the following home care services during a
251.22 	calendar year:
251.23 	(1) up to two face-to-face assessments to determine a
251.24 	recipient's need for personal care assistant services;
251.25 	(2) one service update done to determine a recipient's need
251.26 	for personal care assistant services; and
251.27 	(3) up to nine skilled nurse visits.
251.28 	(b)  [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care
251.29 	services above the limits in paragraph (a) must receive the
251.30 	commissioner's prior authorization, except when:
251.31 	(1) the home care services were required to treat an
251.32 	emergency medical condition that if not immediately treated
251.33 	could cause a recipient serious physical or mental disability,
251.34 	continuation of severe pain, or death.  The provider must
251.35 	request retroactive authorization no later than five working
251.36 	days after giving the initial service.  The provider must be
252.1 	able to substantiate the emergency by documentation such as
252.2 	reports, notes, and admission or discharge histories;
252.3 	(2) the home care services were provided on or after the
252.4 	date on which the recipient's eligibility began, but before the
252.5 	date on which the recipient was notified that the case was
252.6 	opened.  Authorization will be considered if the request is
252.7 	submitted by the provider within 20 working days of the date the
252.8 	recipient was notified that the case was opened;
252.9 	(3) a third-party payor for home care services has denied
252.10 	or adjusted a payment.  Authorization requests must be submitted
252.11 	by the provider within 20 working days of the notice of denial
252.12 	or adjustment.  A copy of the notice must be included with the
252.13 	request;
252.14 	(4) the commissioner has determined that a county or state
252.15 	human services agency has made an error; or
252.16 	(5) the professional nurse determines an immediate need for
252.17 	up to 40 skilled nursing or home health aide visits per calendar
252.18 	year and submits a request for authorization within 20 working
252.19 	days of the initial service date, and medical assistance is
252.20 	determined to be the appropriate payer.
252.21 	(c)  [RETROACTIVE AUTHORIZATION.] A request for retroactive
252.22 	authorization will be evaluated according to the same criteria
252.23 	applied to prior authorization requests.
252.24 	(d)  [ASSESSMENT AND SERVICE PLAN.] Assessments under
252.25 	section 256B.0627, subdivision 1, paragraph (b), shall be
252.26 	conducted initially, and at least annually thereafter, in person
252.27 	with the recipient and result in a completed service plan using
252.28 	forms specified by the commissioner.  Within 30 days of
252.29 	recipient or responsible party request for home care services,
252.30 	the assessment, the service plan, and other information
252.31 	necessary to determine medical necessity such as diagnostic or
252.32 	testing information, social or medical histories, and hospital
252.33 	or facility discharge summaries shall be submitted to the
252.34 	commissioner.  Notwithstanding the provisions of section
252.35 	256B.0627, subdivision 12, the commissioner shall maximize
252.36 	federal financial participation to pay for public health nurse
253.1 	assessments for personal care services.  For personal care
253.2 	assistant services:
253.3 	(1) The amount and type of service authorized based upon
253.4 	the assessment and service plan will follow the recipient if the
253.5 	recipient chooses to change providers.
253.6 	(2) If the recipient's medical need changes, the
253.7 	recipient's provider may assess the need for a change in service
253.8 	authorization and request the change from the county public
253.9 	health nurse.  Within 30 days of the request, the public health
253.10 	nurse will determine whether to request the change in services
253.11 	based upon the provider assessment, or conduct a home visit to
253.12 	assess the need and determine whether the change is
253.13 	appropriate. If the change in service need is due to a change
253.14 	in medical condition, a new physician's statement of need
253.15 	required by section 256B.0625, subdivision 19c, must be obtained.
253.16 	(3) To continue to receive personal care assistant services
253.17 	after the first year, the recipient or the responsible party, in
253.18 	conjunction with the public health nurse, may complete a service
253.19 	update on forms developed by the commissioner according to
253.20 	criteria and procedures in subdivision 1.
253.21 	(e)  [PRIOR AUTHORIZATION.] The commissioner, or the
253.22 	commissioner's designee, shall review the assessment, service
253.23 	update, request for temporary services, request for flexible use
253.24 	option,service plan, and any additional information that is
253.25 	submitted.  The commissioner shall, within 30 days after
253.26 	receiving a complete request, assessment, and service plan,
253.27 	authorize home care services as follows:
253.28 	(1)  [HOME HEALTH SERVICES.] All home health services
253.29 	provided by a home health aide must be prior authorized by the
253.30 	commissioner or the commissioner's designee.  Prior
253.31 	authorization must be based on medical necessity and
253.32 	cost-effectiveness when compared with other care options.  When
253.33 	home health services are used in combination with personal care
253.34 	and private duty nursing, the cost of all home care services
253.35 	shall be considered for cost-effectiveness.  The commissioner
253.36 	shall limit home health aide visits to no more than one visit
254.1 	each per day.  The commissioner, or the commissioner's designee,
254.2 	may authorize up to two skilled nurse visits per day.
254.3 	(2)  [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal
254.4 	care assistant services and supervision by a qualified
254.5 	professional, if requested by the recipient, must be prior
254.6 	authorized by the commissioner or the commissioner's designee
254.7 	except for the assessments established in paragraph (a).  The
254.8 	amount of personal care assistant services authorized must be
254.9 	based on the recipient's home care rating.  A child may not be
254.10 	found to be dependent in an activity of daily living if because
254.11 	of the child's age an adult would either perform the activity
254.12 	for the child or assist the child with the activity and the
254.13 	amount of assistance needed is similar to the assistance
254.14 	appropriate for a typical child of the same age.  Based on
254.15 	medical necessity, the commissioner may authorize:
254.16 	(A) up to two times the average number of direct care hours
254.17 	provided in nursing facilities for the recipient's comparable
254.18 	case mix level; or
254.19 	(B) up to three times the average number of direct care
254.20 	hours provided in nursing facilities for recipients who have
254.21 	complex medical needs or are dependent in at least seven
254.22 	activities of daily living and need physical assistance with
254.23 	eating or have a neurological diagnosis; or
254.24 	(C) up to 60 percent of the average reimbursement rate, as
254.25 	of July 1, 1991, for care provided in a regional treatment
254.26 	center for recipients who have Level I behavior, plus any
254.27 	inflation adjustment as provided by the legislature for personal
254.28 	care service; or
254.29 	(D) up to the amount the commissioner would pay, as of July
254.30 	1, 1991, plus any inflation adjustment provided for home care
254.31 	services, for care provided in a regional treatment center for
254.32 	recipients referred to the commissioner by a regional treatment
254.33 	center preadmission evaluation team.  For purposes of this
254.34 	clause, home care services means all services provided in the
254.35 	home or community that would be included in the payment to a
254.36 	regional treatment center; or
255.1 	(E) up to the amount medical assistance would reimburse for
255.2 	facility care for recipients referred to the commissioner by a
255.3 	preadmission screening team established under section 256B.0911
255.4 	or 256B.092; and
255.5 	(F) a reasonable amount of time for the provision of
255.6 	supervision by a qualified professional of personal care
255.7 	assistant services, if a qualified professional is requested by
255.8 	the recipient or responsible party.
255.9 	(ii) The number of direct care hours shall be determined
255.10 	according to the annual cost report submitted to the department
255.11 	by nursing facilities.  The average number of direct care hours,
255.12 	as established by May 1, 1992, shall be calculated and
255.13 	incorporated into the home care limits on July 1, 1992.  These
255.14 	limits shall be calculated to the nearest quarter hour.
255.15 	(iii) The home care rating shall be determined by the
255.16 	commissioner or the commissioner's designee based on information
255.17 	submitted to the commissioner by the county public health nurse
255.18 	on forms specified by the commissioner.  The home care rating
255.19 	shall be a combination of current assessment tools developed
255.20 	under sections 256B.0911 and 256B.501 with an addition for
255.21 	seizure activity that will assess the frequency and severity of
255.22 	seizure activity and with adjustments, additions, and
255.23 	clarifications that are necessary to reflect the needs and
255.24 	conditions of recipients who need home care including children
255.25 	and adults under 65 years of age.  The commissioner shall
255.26 	establish these forms and protocols under this section and shall
255.27 	use an advisory group, including representatives of recipients,
255.28 	providers, and counties, for consultation in establishing and
255.29 	revising the forms and protocols.
255.30 	(iv) A recipient shall qualify as having complex medical
255.31 	needs if the care required is difficult to perform and because
255.32 	of recipient's medical condition requires more time than
255.33 	community-based standards allow or requires more skill than
255.34 	would ordinarily be required and the recipient needs or has one
255.35 	or more of the following:
255.36 	(A) daily tube feedings;
256.1 	(B) daily parenteral therapy;
256.2 	(C) wound or decubiti care;
256.3 	(D) postural drainage, percussion, nebulizer treatments,
256.4 	suctioning, tracheotomy care, oxygen, mechanical ventilation;
256.5 	(E) catheterization;
256.6 	(F) ostomy care;
256.7 	(G) quadriplegia; or
256.8 	(H) other comparable medical conditions or treatments the
256.9 	commissioner determines would otherwise require institutional
256.10 	care.
256.11 	(v) A recipient shall qualify as having Level I behavior if
256.12 	there is reasonable supporting evidence that the recipient
256.13 	exhibits, or that without supervision, observation, or
256.14 	redirection would exhibit, one or more of the following
256.15 	behaviors that cause, or have the potential to cause:
256.16 	(A) injury to the recipient's own body;
256.17 	(B) physical injury to other people; or
256.18 	(C) destruction of property.
256.19 	(vi) Time authorized for personal care relating to Level I
256.20 	behavior in subclause (v), items (A) to (C), shall be based on
256.21 	the predictability, frequency, and amount of intervention
256.22 	required.
256.23 	(vii) A recipient shall qualify as having Level II behavior
256.24 	if the recipient exhibits on a daily basis one or more of the
256.25 	following behaviors that interfere with the completion of
256.26 	personal care assistant services under subdivision 4, paragraph
256.27 	(a):
256.28 	(A) unusual or repetitive habits;
256.29 	(B) withdrawn behavior; or
256.30 	(C) offensive behavior.
256.31 	(viii) A recipient with a home care rating of Level II
256.32 	behavior in subclause (vii), items (A) to (C), shall be rated as
256.33 	comparable to a recipient with complex medical needs under
256.34 	subclause (iv).  If a recipient has both complex medical needs
256.35 	and Level II behavior, the home care rating shall be the next
256.36 	complex category up to the maximum rating under subclause (i),
257.1 	item (B).
257.2 	(3)  [PRIVATE DUTY NURSING SERVICES.] All private duty
257.3 	nursing services shall be prior authorized by the commissioner
257.4 	or the commissioner's designee.  Prior authorization for private
257.5 	duty nursing services shall be based on medical necessity and
257.6 	cost-effectiveness when compared with alternative care options.
257.7 	The commissioner may authorize medically necessary private duty
257.8 	nursing services in quarter-hour units when:
257.9 	(i) the recipient requires more individual and continuous
257.10 	care than can be provided during a nurse visit; or
257.11 	(ii) the cares are outside of the scope of services that
257.12 	can be provided by a home health aide or personal care assistant.
257.13 	The commissioner may authorize:
257.14 	(A) up to two times the average amount of direct care hours
257.15 	provided in nursing facilities statewide for case mix
257.16 	classification "K" as established by the annual cost report
257.17 	submitted to the department by nursing facilities in May 1992;
257.18 	(B) private duty nursing in combination with other home
257.19 	care services up to the total cost allowed under clause (2);
257.20 	(C) up to 16 hours per day if the recipient requires more
257.21 	nursing than the maximum number of direct care hours as
257.22 	established in item (A) and the recipient meets the hospital
257.23 	admission criteria established under Minnesota Rules, parts
257.24 	9505.0501 to 9505.0540.
257.25 	The commissioner may authorize up to 16 hours per day of
257.26 	medically necessary private duty nursing services or up to 24
257.27 	hours per day of medically necessary private duty nursing
257.28 	services until such time as the commissioner is able to make a
257.29 	determination of eligibility for recipients who are
257.30 	cooperatively applying for home care services under the
257.31 	community alternative care program developed under section
257.32 	256B.49, or until it is determined by the appropriate regulatory
257.33 	agency that a health benefit plan is or is not required to pay
257.34 	for appropriate medically necessary health care services.
257.35 	Recipients or their representatives must cooperatively assist
257.36 	the commissioner in obtaining this determination.  Recipients
258.1 	who are eligible for the community alternative care program may
258.2 	not receive more hours of nursing under this section than would
258.3 	otherwise be authorized under section 256B.49.
258.4 	(4)  [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is
258.5 	ventilator-dependent, the monthly medical assistance
258.6 	authorization for home care services shall not exceed what the
258.7 	commissioner would pay for care at the highest cost hospital
258.8 	designated as a long-term hospital under the Medicare program.
258.9 	For purposes of this clause, home care services means all
258.10 	services provided in the home that would be included in the
258.11 	payment for care at the long-term hospital.
258.12 	"Ventilator-dependent" means an individual who receives
258.13 	mechanical ventilation for life support at least six hours per
258.14 	day and is expected to be or has been dependent for at least 30
258.15 	consecutive days.
258.16 	(f)  [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner
258.17 	or the commissioner's designee shall determine the time period
258.18 	for which a prior authorization shall be effective and, if
258.19 	flexible use has been requested, whether to allow the flexible
258.20 	use option.  If the recipient continues to require home care
258.21 	services beyond the duration of the prior authorization, the
258.22 	home care provider must request a new prior authorization.
258.23 	Under no circumstances, other than the exceptions in paragraph
258.24 	(b), shall a prior authorization be valid prior to the date the
258.25 	commissioner receives the request or for more than 12 months.  A
258.26 	recipient who appeals a reduction in previously authorized home
258.27 	care services may continue previously authorized services, other
258.28 	than temporary services under paragraph (h), pending an appeal
258.29 	under section 256.045.  The commissioner must provide a detailed
258.30 	explanation of why the authorized services are reduced in amount
258.31 	from those requested by the home care provider.
258.32 	(g)  [APPROVAL OF HOME CARE SERVICES.] The commissioner or
258.33 	the commissioner's designee shall determine the medical
258.34 	necessity of home care services, the level of caregiver
258.35 	according to subdivision 2, and the institutional comparison
258.36 	according to this subdivision, the cost-effectiveness of
259.1 	services, and the amount, scope, and duration of home care
259.2 	services reimbursable by medical assistance, based on the
259.3 	assessment, primary payer coverage determination information as
259.4 	required, the service plan, the recipient's age, the cost of
259.5 	services, the recipient's medical condition, and diagnosis or
259.6 	disability.  The commissioner may publish additional criteria
259.7 	for determining medical necessity according to section 256B.04.
259.8 	(h)  [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.]
259.9 	The agency nurse, the independently enrolled private duty nurse,
259.10 	or county public health nurse may request a temporary
259.11 	authorization for home care services by telephone.  The
259.12 	commissioner may approve a temporary level of home care services
259.13 	based on the assessment, and service or care plan information,
259.14 	and primary payer coverage determination information as required.
259.15 	Authorization for a temporary level of home care services
259.16 	including nurse supervision is limited to the time specified by
259.17 	the commissioner, but shall not exceed 45 days, unless extended
259.18 	because the county public health nurse has not completed the
259.19 	required assessment and service plan, or the commissioner's
259.20 	determination has not been made.  The level of services
259.21 	authorized under this provision shall have no bearing on a
259.22 	future prior authorization.
259.23 	(i)  [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.]
259.24 	Home care services provided in an adult or child foster care
259.25 	setting must receive prior authorization by the department
259.26 	according to the limits established in paragraph (a).
259.27 	The commissioner may not authorize:
259.28 	(1) home care services that are the responsibility of the
259.29 	foster care provider under the terms of the foster care
259.30 	placement agreement and administrative rules;
259.31 	(2) personal care assistant services when the foster care
259.32 	license holder is also the personal care provider or personal
259.33 	care assistant unless the recipient can direct the recipient's
259.34 	own care, or case management is provided as required in section
259.35 	256B.0625, subdivision 19a;
259.36 	(3) personal care assistant services when the responsible
260.1 	party is an employee of, or under contract with, or has any
260.2 	direct or indirect financial relationship with the personal care
260.3 	provider or personal care assistant, unless case management is
260.4 	provided as required in section 256B.0625, subdivision 19a; or
260.5 	(4) personal care assistant and private duty nursing
260.6 	services when the number of foster care residents is greater
260.7 	than four unless the county responsible for the recipient's
260.8 	foster placement made the placement prior to April 1, 1992,
260.9 	requests that personal care assistant and private duty nursing
260.10 	services be provided, and case management is provided as
260.11 	required in section 256B.0625, subdivision 19a.

260.12 	Sec. 18. Minnesota Statutes 2004, section 256B.0627,
260.13 	subdivision 9, is amended to read:
260.14 		Subd. 9.option for flexible use of personal care
260.15 	assistant hours.  (a) "Flexible use option " means the scheduled
260.16 	use of authorized hours of personal care assistant services,
260.17 	which vary within the length of the a service authorization
260.18 	period covering no more than six months,in order to more
260.19 	effectively meet the needs and schedule of the
260.20 	recipient. Authorized hours not used within the six-month
260.21 	period may not be carried over to another time period.  The
260.22 	flexible use of personal care assistant hours for a six-month
260.23 	period must be prior authorized by the commissioner, based on a
260.24 	request submitted on a form approved by the commissioner.  The
260.25 	request must include the assessment and the annual service plan
260.26 	prepared by the county public health nurse.
260.27 	(b) The recipient or responsible party, together with the
260.28 	case manager, if the recipient has case management services, and
260.29 	the county public health nurse, shall determine whether flexible
260.30 	use is an appropriate option based on the needs, abilities,
260.31 	preferences, and history of service use of the recipient or
260.32 	responsible party, and if appropriate, must ensure that the
260.33 	allocation of hours covers the ongoing needs of the recipient
260.34 	over an entire year divided into two six-month periods of
260.35 	flexible use.  A recipient who has terminated personal care
260.36 	assistant services before the end of the 12-month authorization
261.1 	period shall not receive additional hours upon reapplying during
261.2 	the same 12-month authorization period, except if a change in
261.3 	condition is documented.  Services shall be prorated for the
261.4 	remainder of the 12-month authorization period based on earlier
261.5 	assessment.
261.6 	(c) If prior authorized,recipients may use their approved
261.7 	hours flexibly within the service authorization period for
261.8 	medically necessary covered services specified in the assessment
261.9 	required in subdivision 1.  The flexible use of authorized hours
261.10 	does not increase the total amount of authorized hours available
261.11 	to a recipient as determined under subdivision 5.  The
261.12 	commissioner shall not authorize additional personal care
261.13 	assistant services to supplement a service authorization that is
261.14 	exhausted before the end date under a flexible service use plan,
261.15 	unless the county public health nurse determines a change in
261.16 	condition and a need for increased services is established.
261.17 	(b) (d) The personal care provider organization and the 
261.18 	recipient or responsible party, together with the provider,or
261.19 	the personal care assistant choice provider must work to monitor
261.20 	and document the use of authorized hours and ensure that a
261.21 	recipient is able to manage services effectively throughout the
261.22 	authorized period.  Upon request of the recipient or responsible
261.23 	party, the provider must furnish regular updates to the
261.24 	recipient or responsible party on the amount of personal care
261.25 	assistant services used develop a written month-to-month plan of
261.26 	the projected use of personal care assistant services that is
261.27 	part of the care plan and ensures:
261.28 	(1) that the health and safety needs of the recipient will
261.29 	be met;
261.30 	(2) that the total annual authorization will not be used
261.31 	before the end of the authorization period; and 
261.32 	(3) monthly monitoring will be conducted of hours used as a
261.33 	percentage of the authorized amount.
261.34 	(e) The provider shall notify the recipient or responsible
261.35 	party, any case manager for the recipient, and the county public
261.36 	health nurse in advance and as soon as possible, on a form
262.1 	approved by the commissioner, if the monthly amount of hours
262.2 	authorized is likely to be exceeded for the month.
262.3 	(f) The commissioner shall provide written notice to the
262.4 	provider, the recipient or responsible party, any case manager
262.5 	for the recipient, and the county public health nurse, when a
262.6 	flexible use recipient exceeds the personal care assistant
262.7 	service authorization for the month by an amount determined by
262.8 	the commissioner.  If the use of hours exceeds the monthly
262.9 	service authorization by the amount determined by the
262.10 	commissioner for two months during any three-month period, the
262.11 	commissioner shall notify the recipient and the county public
262.12 	health nurse that the flexible use authorization will be revoked
262.13 	beginning the following month.  The revocation will not become
262.14 	effective if, within ten working days of the commissioner's
262.15 	notice of flexible use revocation, the county public health
262.16 	nurse requests prior authorization for an increase in the
262.17 	service authorization or continuation of the flexible use
262.18 	option, or the recipient appeals and assistance pending appeal
262.19 	is ordered.  The commissioner shall determine whether to approve
262.20 	the increase and continued flexible use.
262.21 	(g) The recipient or responsible party may stop the
262.22 	flexible use of hours by notifying the personal care provider
262.23 	organization or the personal care assistance choice provider and
262.24 	county public health nurse in writing.
262.25 	(h)  The recipient or responsible party may appeal the
262.26 	commissioner's action according to section 256.045.  The denial
262.27 	or revocation of the flexible use option shall not affect the
262.28 	recipient's authorized level of personal care assistant services
262.29 	as determined under subdivision 5.

262.30 	Sec. 19. Minnesota Statutes 2004, section 256B.0627, is
262.31 	amended by adding a subdivision to read:
262.32 		Subd. 18.Oversight of enrolled personal care assistant
262.33 	services providers. The commissioner may request from providers
262.34 	documentation of compliance with laws, rules, and policies
262.35 	governing the provision of personal care assistant services.  A
262.36 	personal care assistant service provider must provide the
263.1 	requested documentation to the commissioner within ten business
263.2 	days of the request.  Failure to provide information to
263.3 	demonstrate substantial compliance with laws, rules, or policies
263.4 	may result in suspension, denial, or termination of the provider
263.5 	agreement.

263.6 	Sec. 20. Minnesota Statutes 2004, section 256B.0913,
263.7 	subdivision 2, is amended to read:
263.8 		Subd. 2.Eligibility for services.  Alternative care
263.9 	services are available to Minnesotans age 65 or older who would
263.10 	be eligible for medical assistance within 180 135 days of
263.11 	admission to a nursing facility and subject to subdivisions 4 to
263.12 	13.

263.13 	Sec. 21. Minnesota Statutes 2004, section 256B.0913,
263.14 	subdivision 4, is amended to read:
263.15 		Subd. 4.Eligibility for funding for services for
263.16 	nonmedical assistance recipients.  (a) Funding for services
263.17 	under the alternative care program is available to persons who
263.18 	meet the following criteria:
263.19 	(1) the person has been determined by a community
263.20 	assessment under section 256B.0911 to be a person who would
263.21 	require the level of care provided in a nursing facility, but
263.22 	for the provision of services under the alternative care
263.23 	program;
263.24 	(2) the person is age 65 or older;
263.25 	(3) the person would be eligible for medical assistance
263.26 	within 180 135 days of admission to a nursing facility;
263.27 	(4) the person is not ineligible for the medical assistance
263.28 	program due to an asset transfer penalty;
263.29 	(5) the person needs services that are not funded through
263.30 	other state or federal funding;
263.31 	(6) the monthly cost of the alternative care services
263.32 	funded by the program for this person does not exceed 75 percent
263.33 	of the monthly limit described under section 256B.0915,
263.34 	subdivision 3a.  This monthly limit does not prohibit the
263.35 	alternative care client from payment for additional services,
263.36 	but in no case may the cost of additional services purchased
264.1 	under this section exceed the difference between the client's
264.2 	monthly service limit defined under section 256B.0915,
264.3 	subdivision 3, and the alternative care program monthly service
264.4 	limit defined in this paragraph.  If medical supplies and
264.5 	equipment or environmental modifications are or will be
264.6 	purchased for an alternative care services recipient, the costs
264.7 	may be prorated on a monthly basis for up to 12 consecutive
264.8 	months beginning with the month of purchase.  If the monthly
264.9 	cost of a recipient's other alternative care services exceeds
264.10 	the monthly limit established in this paragraph, the annual cost
264.11 	of the alternative care services shall be determined.  In this
264.12 	event, the annual cost of alternative care services shall not
264.13 	exceed 12 times the monthly limit described in this paragraph;
264.14 	and
264.15 	(7) the person is making timely payments of the assessed
264.16 	monthly fee.
264.17 	A person is ineligible if payment of the fee is over 60 days
264.18 	past due, unless the person agrees to:
264.19 	(i) the appointment of a representative payee;
264.20 	(ii) automatic payment from a financial account;
264.21 	(iii) the establishment of greater family involvement in
264.22 	the financial management of payments; or
264.23 	(iv) another method acceptable to the county to ensure
264.24 	prompt fee payments.
264.25 	The county shall extend the client's eligibility as
264.26 	necessary while making arrangements to facilitate payment of
264.27 	past-due amounts and future premium payments.  Following
264.28 	disenrollment due to nonpayment of a monthly fee, eligibility
264.29 	shall not be reinstated for a period of 30 days.
264.30 	(b) Alternative care funding under this subdivision is not
264.31 	available for a person who is a medical assistance recipient or
264.32 	who would be eligible for medical assistance without a spenddown
264.33 	or waiver obligation.  A person whose initial application for
264.34 	medical assistance and the elderly waiver program is being
264.35 	processed may be served under the alternative care program for a
264.36 	period up to 60 days.  If the individual is found to be eligible
265.1 	for medical assistance, medical assistance must be billed for
265.2 	services payable under the federally approved elderly waiver
265.3 	plan and delivered from the date the individual was found
265.4 	eligible for the federally approved elderly waiver plan.
265.5 	Notwithstanding this provision, alternative care funds may not
265.6 	be used to pay for any service the cost of which:  (i) is
265.7 	payable by medical assistance; (ii) is used by a recipient to
265.8 	meet a waiver obligation; or (iii) is used to pay a medical
265.9 	assistance income spenddown for a person who is eligible to
265.10 	participate in the federally approved elderly waiver program
265.11 	under the special income standard provision.
265.12 	(c) Alternative care funding is not available for a person
265.13 	who resides in a licensed nursing home, certified boarding care
265.14 	home, hospital, or intermediate care facility, except for case
265.15 	management services which are provided in support of the
265.16 	discharge planning process for a nursing home resident or
265.17 	certified boarding care home resident to assist with a
265.18 	relocation process to a community-based setting.
265.19 	(d) Alternative care funding is not available for a person
265.20 	whose income is greater than the maintenance needs allowance
265.21 	under section 256B.0915, subdivision 1d, but equal to or less
265.22 	than 120 percent of the federal poverty guideline effective July
265.23 	1 in the year for which alternative care eligibility is
265.24 	determined, who would be eligible for the elderly waiver with a
265.25 	waiver obligation.

265.26 	Sec. 22. Minnesota Statutes 2004, section 256B.0913,
265.27 	subdivision 5, is amended to read:
265.28 		Subd. 5.Services covered under alternative care.
 265.29 	Alternative care funding may be used for payment of costs of:
265.30 	(1) adult foster care;
265.31 	(2) adult day care;
265.32 	(3) (2) home health aide;
265.33 	(4) (3) homemaker services;
265.34 	(5) (4) personal care;
265.35 	(6) (5) case management;
265.36 	(7) (6) respite care;
266.1 	(8) assisted living;
266.2 	(9) residential care services;
266.3 	(10) (7) care-related supplies and equipment;
266.4 	(11) (8) meals delivered to the home;
266.5 	(12) (9) transportation;
266.6 	(13) (10) nursing services;
266.7 	(14) (11) chore services;
266.8 	(15) (12) companion services;
266.9 	(16) (13) nutrition services;
266.10 	(17) (14) training for direct informal caregivers;
266.11 	(18) (15) telehome care to provide services in their own
266.12 	homes in conjunction with in-home visits;
266.13 	(19) (16) discretionary services, for which counties may
266.14 	make payment from their alternative care program allocation or
266.15 	services not otherwise defined in this section or section
266.16 	256B.0625, following approval by the commissioner;
266.17 	(20) (17) environmental modifications; and
266.18 	(21) (18) direct cash payments for which counties may make
266.19 	payment from their alternative care program allocation to
266.20 	clients for the purpose of purchasing services, following
266.21 	approval by the commissioner, and subject to the provisions of
266.22 	subdivision 5h, until approval and implementation of
266.23 	consumer-directed services through the federally approved
266.24 	elderly waiver plan.  Upon implementation, consumer-directed
266.25 	services under the alternative care program are available
266.26 	statewide and limited to the average monthly expenditures
266.27 	representative of all alternative care program participants for
266.28 	the same case mix resident class assigned in the most recent
266.29 	fiscal year for which complete expenditure data is available.
266.30 	Total annual payments for discretionary services and direct
266.31 	cash payments, until the federally approved consumer-directed
266.32 	service option is implemented statewide, for all clients within
266.33 	a county may not exceed 25 percent of that county's annual
266.34 	alternative care program base allocation.  Thereafter,
266.35 	discretionary services are limited to 25 percent of the county's
266.36 	annual alternative care program base allocation.

267.1 	Sec. 23. Minnesota Statutes 2004, section 256B.0913,
267.2 	subdivision 5a, is amended to read:
267.3 		Subd. 5a.Services; service definitions; service
267.4 	standards.  (a) Unless specified in statute, the services,
267.5 	service definitions, and standards for alternative care services
267.6 	shall be the same as the services, service definitions, and
267.7 	standards specified in the federally approved elderly waiver
267.8 	plan, except for transitional support services, assisted living
267.9 	services, adult foster care services, and residential care
267.10 	services.
267.11 	(b) The county agency must ensure that the funds are not
267.12 	used to supplant services available through other public
267.13 	assistance or services programs.  For a provider of supplies and
267.14 	equipment when the monthly cost of the supplies and equipment is
267.15 	less than $250, persons or agencies must be employed by or under
267.16 	a contract with the county agency or the public health nursing
267.17 	agency of the local board of health in order to receive funding
267.18 	under the alternative care program.  Supplies and equipment may
267.19 	be purchased from a vendor not certified to participate in the
267.20 	Medicaid program if the cost for the item is less than that of a
267.21 	Medicaid vendor.
267.22 	(c) Personal care services must meet the service standards
267.23 	defined in the federally approved elderly waiver plan, except
267.24 	that a county agency may contract with a client's relative who
267.25 	meets the relative hardship waiver requirements or a relative
267.26 	who meets the criteria and is also the responsible party under
267.27 	an individual service plan that ensures the client's health and
267.28 	safety and supervision of the personal care services by a
267.29 	qualified professional as defined in section 256B.0625,
267.30 	subdivision 19c.  Relative hardship is established by the county
267.31 	when the client's care causes a relative caregiver to do any of
267.32 	the following:  resign from a paying job, reduce work hours
267.33 	resulting in lost wages, obtain a leave of absence resulting in
267.34 	lost wages, incur substantial client-related expenses, provide
267.35 	services to address authorized, unstaffed direct care time, or
267.36 	meet special needs of the client unmet in the formal service
268.1 	plan.

268.2 	Sec. 24. Minnesota Statutes 2004, section 256B.095, is
268.3 	amended to read:
268.4 	256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
268.5 	(a) Effective July 1, 1998, a quality assurance system for
268.6 	persons with developmental disabilities, which includes an
268.7 	alternative quality assurance licensing system for programs, is
268.8 	established in Dodge, Fillmore, Freeborn, Goodhue, Houston,
268.9 	Mower, Olmsted, Rice, Steele, Wabasha, and Winona Counties for
268.10 	the purpose of improving the quality of services provided to
268.11 	persons with developmental disabilities.  A county, at its
268.12 	option, may choose to have all programs for persons with
268.13 	developmental disabilities located within the county licensed
268.14 	under chapter 245A using standards determined under the
268.15 	alternative quality assurance licensing system or may continue
268.16 	regulation of these programs under the licensing system operated
268.17 	by the commissioner.  The project expires on June 30, 2007 2009.
268.18 	(b) Effective July 1, 2003, a county not listed in
268.19 	paragraph (a) may apply to participate in the quality assurance
268.20 	system established under paragraph (a).  The commission
268.21 	established under section 256B.0951 may, at its option, allow
268.22 	additional counties to participate in the system.
268.23 	(c) Effective July 1, 2003, any county or group of counties
268.24 	not listed in paragraph (a) may establish a quality assurance
268.25 	system under this section.  A new system established under this
268.26 	section shall have the same rights and duties as the system
268.27 	established under paragraph (a).  A new system shall be governed
268.28 	by a commission under section 256B.0951.  The commissioner shall
268.29 	appoint the initial commission members based on recommendations
268.30 	from advocates, families, service providers, and counties in the
268.31 	geographic area included in the new system.  Counties that
268.32 	choose to participate in a new system shall have the duties
268.33 	assigned under section 256B.0952.  The new system shall
268.34 	establish a quality assurance process under section 256B.0953.
268.35 	The provisions of section 256B.0954 shall apply to a new system
268.36 	established under this paragraph.  The commissioner shall
269.1 	delegate authority to a new system established under this
269.2 	paragraph according to section 256B.0955.

269.3 	EFFECTIVE DATE. This section is effective retroactively
269.4 	from July 1, 2005.

269.5 	Sec. 25. Minnesota Statutes 2004, section 256B.0951,
269.6 	subdivision 1, is amended to read:
269.7 		Subdivision 1.Membership.  The Quality Assurance
269.8 	Commission is established.  The commission consists of at least
269.9 	14 but not more than 21 members as follows:  at least three but
269.10 	not more than five members representing advocacy organizations;
269.11 	at least three but not more than five members representing
269.12 	consumers, families, and their legal representatives; at least
269.13 	three but not more than five members representing service
269.14 	providers; at least three but not more than five members
269.15 	representing counties; and the commissioner of human services or
269.16 	the commissioner's designee.  The first commission shall
269.17 	establish membership guidelines for the transition and
269.18 	recruitment of membership for the commission's ongoing
269.19 	existence.  Members of the commission who do not receive a
269.20 	salary or wages from an employer for time spent on commission
269.21 	duties may receive a per diem payment when performing commission
269.22 	duties and functions.  All members may be reimbursed for
269.23 	expenses related to commission activities.  Notwithstanding the
269.24 	provisions of section 15.059, subdivision 5, the commission
269.25 	expires on June 30, 2007 2009.
269.26 	
EFFECTIVE DATE. This section is effective retroactively
269.27 	from July 1, 2005.

269.28 	Sec. 26. Minnesota Statutes 2004, section 256B.0952,
269.29 	subdivision 5, is amended to read:
269.30 		Subd. 5.Quality assurance teams.  Quality assurance
269.31 	teams shall be comprised of county staff; providers; consumers,
269.32 	families, and their legal representatives; members of advocacy
269.33 	organizations; and other involved community members.  Team
269.34 	members must satisfactorily complete the training program
269.35 	approved by the commission and must demonstrate
269.36 	performance-based competency.  Team members are not considered
270.1 	to be county employees for purposes of workers' compensation,
270.2 	unemployment insurance, or state retirement laws solely on the
270.3 	basis of participation on a quality assurance team.  The county
270.4 	may pay a per diem to team members who do not receive a salary
270.5 	or wages from an employer for time spent on alternative quality
270.6 	assurance process matters.  All team members may be reimbursed
270.7 	for expenses related to their participation in the alternative
270.8 	process.
270.9 	
EFFECTIVE DATE. This section is effective retroactively
270.10 	from July 1, 2005.

270.11 	Sec. 27. Minnesota Statutes 2004, section 256B.0953,
270.12 	subdivision 1, is amended to read:
270.13 		Subdivision 1.Process components.  (a) The quality
270.14 	assurance licensing process consists of an evaluation by a
270.15 	quality assurance team of the facility, program, or service
270.16 	according to outcome-based measurements.  The process must
270.17 	include an evaluation of a random sample of program consumers.
270.18 	The sample must be representative of each service provided.  The
270.19 	sample size must be at least five percent of consumers but not
270.20 	less than three two consumers.
270.21 	(b) All consumers must be given the opportunity to be
270.22 	included in the quality assurance process in addition to those
270.23 	chosen for the random sample.
270.24 	
EFFECTIVE DATE. This section is effective retroactively
270.25 	from July 1, 2005.

270.26 	Sec. 28. Minnesota Statutes 2004, section 256B.15,
270.27 	subdivision 1, is amended to read:
270.28 		Subdivision 1.Policy, applicability, purpose, and
270.29 	construction; definition.  (a) It is the policy of this state
270.30 	that individuals or couples, either or both of whom participate
270.31 	in the medical assistance program, use their own assets to pay
270.32 	their share of the total cost of their care during or after
270.33 	their enrollment in the program according to applicable federal
270.34 	law and the laws of this state.  The following provisions apply:
270.35 	(1) subdivisions 1c to 1k shall not apply to claims arising
270.36 	under this section which are presented under section 525.313;
271.1 	(2) the provisions of subdivisions 1c to 1k expanding the
271.2 	interests included in an estate for purposes of recovery under
271.3 	this section give effect to the provisions of United States
271.4 	Code, title 42, section 1396p, governing recoveries, but do not
271.5 	give rise to any express or implied liens in favor of any other
271.6 	parties not named in these provisions;
271.7 	(3) the continuation of a recipient's life estate or joint
271.8 	tenancy interest in real property after the recipient's death
271.9 	for the purpose of recovering medical assistance under this
271.10 	section modifies common law principles holding that these
271.11 	interests terminate on the death of the holder;
271.12 	(4) all laws, rules, and regulations governing or involved
271.13 	with a recovery of medical assistance shall be liberally
271.14 	construed to accomplish their intended purposes;
271.15 	(5) a deceased recipient's life estate and joint tenancy
271.16 	interests continued under this section shall be owned by the
271.17 	remaindermen or surviving joint tenants as their interests may
271.18 	appear on the date of the recipient's death.  They shall not be
271.19 	merged into the remainder interest or the interests of the
271.20 	surviving joint tenants by reason of ownership.  They shall be
271.21 	subject to the provisions of this section.  Any conveyance,
271.22 	transfer, sale, assignment, or encumbrance by a remainderman, a
271.23 	surviving joint tenant, or their heirs, successors, and assigns
271.24 	shall be deemed to include all of their interest in the deceased
271.25 	recipient's life estate or joint tenancy interest continued
271.26 	under this section; and
271.27 	(6) the provisions of subdivisions 1c to 1k continuing a
271.28 	recipient's joint tenancy interests in real property after the
271.29 	recipient's death do not apply to a homestead owned of record,
271.30 	on the date the recipient dies, by the recipient and the
271.31 	recipient's spouse as joint tenants with a right of
271.32 	survivorship.  Homestead means the real property occupied by the
271.33 	surviving joint tenant spouse as their sole residence on the
271.34 	date the recipient dies and classified and taxed to the
271.35 	recipient and surviving joint tenant spouse as homestead
271.36 	property for property tax purposes in the calendar year in which
272.1 	the recipient dies.  For purposes of this exemption, real
272.2 	property the recipient and their surviving joint tenant spouse
272.3 	purchase solely with the proceeds from the sale of their prior
272.4 	homestead, own of record as joint tenants, and qualify as
272.5 	homestead property under section 273.124 in the calendar year in
272.6 	which the recipient dies and prior to the recipient's death
272.7 	shall be deemed to be real property classified and taxed to the
272.8 	recipient and their surviving joint tenant spouse as homestead
272.9 	property in the calendar year in which the recipient dies.  The
272.10 	surviving spouse, or any person with personal knowledge of the
272.11 	facts, may provide an affidavit describing the homestead
272.12 	property affected by this clause and stating facts showing
272.13 	compliance with this clause.  The affidavit shall be prima facie
272.14 	evidence of the facts it states.
272.15 	(b) For purposes of this section, "medical assistance"
272.16 	includes the medical assistance program under this chapter and
272.17 	the general assistance medical care program under chapter 256D
272.18 	and alternative care for nonmedical assistance recipients under
272.19 	section 256B.0913.
272.20 	(c) All provisions in this subdivision, and subdivisions
272.21 	1d, 1f, 1g, 1h, 1i, and 1j, related to the continuation of a
272.22 	recipient's life estate or joint tenancy interests in real
272.23 	property after the recipient's death for the purpose of
272.24 	recovering medical assistance, are effective only for life
272.25 	estates and joint tenancy interests established on or after
272.26 	August 1, 2003.  For purposes of this paragraph, medical
272.27 	assistance does not include alternative care.
272.28 	
EFFECTIVE DATE. This section is effective retroactively
272.29 	from August 1, 2003.

272.30 	Sec. 29. Minnesota Statutes 2004, section 256B.15,
272.31 	subdivision 4, is amended to read:
272.32 		Subd. 4.Other survivors.  If the decedent who was single
272.33 	or the surviving spouse of a married couple is survived by one
272.34 	of the following persons, a claim exists against the estate in
272.35 	an amount not to exceed payable first from the value of the
272.36 	nonhomestead property included in the estate and the personal
273.1 	representative shall make, execute, and deliver to the county
273.2 	agency a lien against the homestead property in the estate for
273.3 	any unpaid balance of the claim to the claimant as provided
273.4 	under this section:
273.5 	(a) a sibling who resided in the decedent medical
273.6 	assistance recipient's home at least one year before the
273.7 	decedent's institutionalization and continuously since the date
273.8 	of institutionalization; or
273.9 	(b) a son or daughter or a grandchild who resided in the
273.10 	decedent medical assistance recipient's home for at least two
273.11 	years immediately before the parent's or grandparent's
273.12 	institutionalization and continuously since the date of
273.13 	institutionalization, and who establishes by a preponderance of
273.14 	the evidence having provided care to the parent or grandparent
273.15 	who received medical assistance, that the care was provided
273.16 	before institutionalization, and that the care permitted the
273.17 	parent or grandparent to reside at home rather than in an
273.18 	institution.
273.19 	
EFFECTIVE DATE. This section is effective August 1, 2005,
273.20 	and applies to persons dying on and after that date and to
273.21 	probates commenced on and after that date.

273.22 	Sec. 30. Minnesota Statutes 2004, section 256B.15, is
273.23 	amended by adding a subdivision to read:
273.24 		Subd. 6.Establishment of life estate or joint tenancy
273.25 	interest. For purposes of subdivision 1 and section 514.981,
273.26 	subdivision 6, a life estate or joint tenancy interest is
273.27 	established upon the earlier of:
273.28 	(1) the date the instrument creating the interest is
273.29 	recorded or filed in the office of the county recorder or
273.30 	registrar of titles where the real estate interest it describes
273.31 	is located;
273.32 	(2) the date of delivery by the grantor to the grantee of
273.33 	the signed instrument as stated in an affidavit made by a person
273.34 	with knowledge of the facts;
273.35 	(3) the date on which the judicial order creating the
273.36 	interest was issued by the court; or 
274.1 	(4) the date upon which the interest devolves under section
274.2 	524.3-101.
274.3 	
EFFECTIVE DATE. This section is effective retroactively
274.4 	from August 1, 2003.

274.5 	Sec. 31. Minnesota Statutes 2004, section 256B.15, is
274.6 	amended by adding a subdivision to read:
274.7 		Subd. 8.Lien notices. Medical assistance liens and
274.8 	liens under notices of potential claims that are of record
274.9 	against life estate or joint tenancy interests established prior
274.10 	to August 1, 2003, shall end, become unenforceable, and cease to
274.11 	be liens on those interests upon the death of the person named
274.12 	in the lien or notice of potential claim, shall be disregarded
274.13 	by examiners of title after the death of the life tenant or
274.14 	joint tenant, and shall not be carried forward to a subsequent
274.15 	certificate of title.  This subdivision shall not apply to life
274.16 	estates that continue to exist after the death of the person
274.17 	named in the lien or notice of potential claim under the terms
274.18 	of the instrument creating or reserving the life estate until
274.19 	the life estate ends as provided for in the instrument.
274.20 	
EFFECTIVE DATE. This section is effective retroactively
274.21 	from August 1, 2003.

274.22 	Sec. 32. Minnesota Statutes 2004, section 256B.15, is
274.23 	amended by adding a subdivision to read:
274.24 		Subd. 9.Immunity. The commissioner of human services,
274.25 	county agencies, and elected officials and their employees are
274.26 	immune from all liability for any action taken implementing Laws
274.27 	2003, First Special Session chapter 14, article 12, sections 40
274.28 	to 52 and 90, as those laws existed at the time the action was
274.29 	taken, and section 514.981, subdivision 6.
274.30 	
EFFECTIVE DATE. This section is effective retroactively
274.31 	from August 1, 2003.

274.32 	Sec. 33. Minnesota Statutes 2004, section 256B.431, is
274.33 	amended by adding a subdivision to read:
274.34 		Subd. 41.Nursing facility rate increases for october 1,
274.35 	2005, and october 1, 2006. (a) For the rate period beginning
274.36 	October 1, 2005, the commissioner shall make available to each
275.1 	nursing facility reimbursed under this section or section
275.2 	256B.434 an adjustment equal to 2.2553 percent of the total
275.3 	operating payment rate, and for the rate year beginning October
275.4 	1, 2006, the commissioner shall make available to each nursing
275.5 	facility reimbursed under this section or section 256B.434 an
275.6 	adjustment equal to 1.2553 percent of the total operating
275.7 	payment rate.
275.8 	(b) 75 percent of the money resulting from the rate
275.9 	adjustment under paragraph (a) must be used to increase wages
275.10 	and benefits and pay associated costs for all employees, except
275.11 	management fees, the administrator, and central office staff.
275.12 	Except as provided in paragraph (c), 75 percent of the money
275.13 	received by a facility as a result of the rate adjustment
275.14 	provided in paragraph (a) must be used only for wage, benefit,
275.15 	and staff increases implemented on or after the effective date
275.16 	of the rate increase each year, and must not be used for
275.17 	increases implemented prior to that date.
275.18 	(c) With respect only to the October 1, 2005, rate
275.19 	increase, a nursing facility that incurred costs for salary and
275.20 	employee benefit increases first provided after July 1, 2003,
275.21 	may count those costs towards the amount required to be spent on
275.22 	salaries and benefits under paragraph (b).  These costs must be
275.23 	reported to the commissioner in the form and manner specified by
275.24 	the commissioner.
275.25 	(d) Nursing facilities may apply for the portion of the
275.26 	rate adjustment under paragraph (a) for employee wages and
275.27 	benefits and associated costs.  The application must be made to
275.28 	the commissioner and contain a plan by which the nursing
275.29 	facility will distribute the funds according to paragraph (b).
275.30 	For nursing facilities in which the employees are represented by
275.31 	an exclusive bargaining representative, an agreement negotiated
275.32 	and agreed to by the employer and the exclusive bargaining
275.33 	representative constitutes the plan.  A negotiated agreement may
275.34 	constitute the plan only if the agreement is finalized after the
275.35 	date of enactment of all increases for the rate year and signed
275.36 	by both parties prior to submission to the commissioner.  The
276.1 	commissioner shall review the plan to ensure that the rate
276.2 	adjustments are used as provided in paragraph (b).  To be
276.3 	eligible, a facility must submit its distribution plan by March
276.4 	31, 2006, and March 31, 2007, respectively.  The commissioner
276.5 	may approve distribution plans on or before June 30, 2006, and
276.6 	June 30, 2007, respectively.  If a facility's distribution plan
276.7 	is effective after the first day of the applicable rate period
276.8 	that the funds are available, the rate adjustments are effective
276.9 	the same date as the facility's plan.
276.10 	(e) A copy of the approved distribution plan must be made
276.11 	available to all employees by giving each employee a copy or by
276.12 	posting a copy in an area of the nursing facility to which all
276.13 	employees have access.  If an employee does not receive the wage
276.14 	and benefit adjustment described in the facility's approved plan
276.15 	and is unable to resolve the problem with the facility's
276.16 	management or through the employee's union representative, the
276.17 	employee may contact the commissioner at an address or telephone
276.18 	number provided by the commissioner and included in the approved
276.19 	plan.

276.20 	Sec. 34. Minnesota Statutes 2004, section 256B.431, is
276.21 	amended by adding a subdivision to read:
276.22 		Subd. 42.Incentive to establish single-bed rooms. (a)
276.23 	Beginning July 1, 2005, the operating payment rate for nursing
276.24 	facilities reimbursed under this section, section 256B.434, or
276.25 	256B.441 shall be increased by 20 percent multiplied by the
276.26 	ratio of the number of new single-bed rooms created divided by
276.27 	the number of active beds on July 1, 2005, for each bed closure
276.28 	that results in the creation of a single-bed room after July 1,
276.29 	2005.  The commissioner may implement rate adjustments for up to
276.30 	3,000 new single-bed rooms each year.  For eligible bed closures
276.31 	for which the commissioner receives a notice from a facility
276.32 	during a calendar quarter that a bed has been delicensed and a
276.33 	new single-bed room has been established, the rate adjustment in
276.34 	this paragraph shall be effective on the first day of the second
276.35 	month following that calendar quarter.
276.36 	(b) A nursing facility is prohibited from discharging
277.1 	residents for purposes of establishing single-bed rooms.  A
277.2 	nursing facility must submit documentation to the commissioner
277.3 	in a form prescribed by the commissioner, certifying the
277.4 	occupancy status of beds closed to create single-bed rooms.  In
277.5 	the event that the commissioner determines that a facility has
277.6 	discharged a resident for purposes of establishing a single-bed
277.7 	room, the commissioner shall not provide a rate adjustment under
277.8 	paragraph (a).
277.9 	(c) If after the date of enactment of this section and
277.10 	before December 31, 2007, more than 4,000 nursing home beds are
277.11 	removed from service, a portion of the appropriation for nursing
277.12 	homes shall be transferred to the alternative care program.  The
277.13 	amount of this transfer shall equal the number of beds removed
277.14 	from service less 4,000, multiplied by the average monthly
277.15 	per-person cost for alternative care, multiplied by 12, and
277.16 	further multiplied by 0.3.

277.17 	Sec. 35. Minnesota Statutes 2004, section 256B.432,
277.18 	subdivision 1, is amended to read:
277.19 		Subdivision 1.Definitions.  For purposes of this
277.20 	section, the following terms have the meanings given them.
277.21 	(a) "Management agreement" means an agreement in which one
277.22 	or more of the following criteria exist:
277.23 	(1) the central, affiliated, or corporate office has or is
277.24 	authorized to assume day-to-day operational control of the
277.25 	nursing facility for any six-month period within a 24-month
277.26 	period.  "Day-to-day operational control" means that the
277.27 	central, affiliated, or corporate office has the authority to
277.28 	require, mandate, direct, or compel the employees of the nursing
277.29 	facility to perform or refrain from performing certain acts, or
277.30 	to supplant or take the place of the top management of the
277.31 	nursing facility.  "Day-to-day operational control" includes the
277.32 	authority to hire or terminate employees or to provide an
277.33 	employee of the central, affiliated, or corporate office to
277.34 	serve as administrator of the nursing facility;
277.35 	(2) the central, affiliated, or corporate office performs
277.36 	or is authorized to perform two or more of the following:  the
278.1 	execution of contracts; authorization of purchase orders;
278.2 	signature authority for checks, notes, or other financial
278.3 	instruments; requiring the nursing facility to use the group or
278.4 	volume purchasing services of the central, affiliated, or
278.5 	corporate office; or the authority to make annual capital
278.6 	expenditures for the nursing facility exceeding $50,000, or $500
278.7 	per licensed bed, whichever is less, without first securing the
278.8 	approval of the nursing facility board of directors;
278.9 	(3) the central, affiliated, or corporate office becomes or
278.10 	is required to become the licensee under applicable state law;
278.11 	(4) the agreement provides that the compensation for
278.12 	services provided under the agreement is directly related to any
278.13 	profits made by the nursing facility; or
278.14 	(5) the nursing facility entering into the agreement is
278.15 	governed by a governing body that meets fewer than four times a
278.16 	year, that does not publish notice of its meetings, or that does
278.17 	not keep formal records of its proceedings.
278.18 	(b) "Consulting agreement" means any agreement the purpose
278.19 	of which is for a central, affiliated, or corporate office to
278.20 	advise, counsel, recommend, or suggest to the owner or operator
278.21 	of the nonrelated nursing facility measures and methods for
278.22 	improving the operations of the nursing facility.
278.23 	(c) "Nursing facility" means a nursing facility whose
278.24 	medical assistance rates are determined according to section
278.25 	256B.431 with a medical assistance provider agreement that is
278.26 	licensed as a nursing home under chapter 144A or as a boarding
278.27 	care home under sections 144.50 to 144.56.

278.28 	Sec. 36. Minnesota Statutes 2004, section 256B.432,
278.29 	subdivision 2, is amended to read:
278.30 		Subd. 2.Effective date.  For rate years beginning on or
278.31 	after July 1, 1990, the central, affiliated, or corporate office
278.32 	cost allocations in subdivisions 3 to 6 must be used when
278.33 	determining medical assistance rates under section 256B.431,
278.34 	256B.434, or 256B.441.

278.35 	Sec. 37. Minnesota Statutes 2004, section 256B.432, is
278.36 	amended by adding a subdivision to read:
279.1 		Subd. 4a.Allocation; costs allocable on a functional
279.2 	basis. (a) Costs that have not been directly identified must be
279.3 	allocated to nursing facilities on a basis designed to equitably
279.4 	allocate the costs to the nursing facilities or activities
279.5 	receiving the benefits of the costs.  This allocation must be
279.6 	made in a manner reasonably related to the services received by
279.7 	the nursing facilities.  Where practical and the amounts are
279.8 	material, these costs must be allocated on a functional basis.
279.9 	The functions, or cost centers used to allocate central office
279.10 	costs, and the unit bases used to allocate the costs, including
279.11 	those central office costs allocated according to subdivision 5,
279.12 	must be used consistently from one central office accounting
279.13 	period to another.
279.14 	(b) If the central office wishes to change its allocation
279.15 	bases and believes the change will result in more appropriate
279.16 	and more accurate allocations, the central office must make a
279.17 	written request, with its justification, to the commissioner for
279.18 	approval of the change no later than 120 days after the
279.19 	beginning of the central office accounting period to which the
279.20 	change is to apply.  The commissioner's approval of a central
279.21 	office request will be furnished to the central office in
279.22 	writing.  Where the commissioner approves the central office
279.23 	request, the change must be applied to the accounting period for
279.24 	which the request was made, and to all subsequent central office
279.25 	accounting periods unless the commissioner approves a subsequent
279.26 	request for change by the central office.  The effective date of
279.27 	the change will be the beginning of the accounting period for
279.28 	which the request was made.

279.29 	Sec. 38. Minnesota Statutes 2004, section 256B.432,
279.30 	subdivision 5, is amended to read:
279.31 		Subd. 5.Allocation of remaining costs; allocation
279.32 	ratio.  (a) After the costs that can be directly identified
279.33 	according to subdivisions 3 and 4 have been allocated, the
279.34 	remaining central, affiliated, or corporate office costs must be
279.35 	allocated between the nursing facility operations and the other
279.36 	activities or facilities unrelated to the nursing facility
280.1 	operations based on the ratio of total operating
280.2 	costs. However, in the event that these remaining costs are
280.3 	partially attributable to the start-up of home and
280.4 	community-based services intended to fill a gap identified by
280.5 	the local agency, the facility may assign these remaining costs
280.6 	to the appropriate cost category of the facility for a period
280.7 	not to exceed two years.
280.8 	(b) For purposes of allocating these remaining central,
280.9 	affiliated, or corporate office costs, the numerator for the
280.10 	allocation ratio shall be determined as follows:
280.11 	(1) for nursing facilities that are related organizations
280.12 	or are controlled by a central, affiliated, or corporate office
280.13 	under a management agreement, the numerator of the allocation
280.14 	ratio shall be equal to the sum of the total operating costs
280.15 	incurred by each related organization or controlled nursing
280.16 	facility;
280.17 	(2) for a central, affiliated, or corporate office
280.18 	providing goods or services to related organizations that are
280.19 	not nursing facilities, the numerator of the allocation ratio
280.20 	shall be equal to the sum of the total operating costs incurred
280.21 	by the nonnursing facility related organizations;
280.22 	(3) for a central, affiliated, or corporate office
280.23 	providing goods or services to unrelated nursing facilities
280.24 	under a consulting agreement, the numerator of the allocation
280.25 	ratio shall be equal to the greater of directly identified
280.26 	central, affiliated, or corporate costs or the contracted
280.27 	amount; or
280.28 	(4) for business activities that involve the providing of
280.29 	goods or services to unrelated parties which are not nursing
280.30 	facilities, the numerator of the allocation ratio shall be equal
280.31 	to the greater of directly identified costs or revenues
280.32 	generated by the activity or function.
280.33 	(c) The denominator for the allocation ratio is the sum of
280.34 	the numerators in paragraph (b), clauses (1) to (4).

280.35 	Sec. 39. Minnesota Statutes 2004, section 256B.432, is
280.36 	amended by adding a subdivision to read:
281.1 		Subd. 6a.Related organization costs. (a) Costs
281.2 	applicable to services, capital assets, and supplies directly or
281.3 	indirectly furnished to the nursing facility by any related
281.4 	organization are includable in the allowable cost of the nursing
281.5 	facility at the purchase price paid by the related organization
281.6 	for capital assets or supplies and at the cost incurred by the
281.7 	related organization for the provision of services to the
281.8 	nursing facility if these prices or costs do not exceed the
281.9 	price of comparable services, capital assets, or supplies that
281.10 	could be purchased elsewhere.  For this purpose, the related
281.11 	organization's costs must not include an amount for markup or
281.12 	profit.
281.13 	(b) If the related organization in the normal course of
281.14 	business sells services, capital assets, or supplies to
281.15 	nonrelated organizations, the cost to the nursing facility shall
281.16 	be the nonrelated organization's price provided that sales to
281.17 	nonrelated organizations constitute at least 50 percent of total
281.18 	annual sales of similar services, capital assets, or supplies.

281.19 	Sec. 40. Minnesota Statutes 2004, section 256B.434,
281.20 	subdivision 3, is amended to read:
281.21 		Subd. 3.Duration and termination of contracts.  (a)
281.22 	Subject to available resources, the commissioner may begin to
281.23 	execute contracts with nursing facilities November 1, 1995.
281.24 	(b) All contracts entered into under this section are for a
281.25 	term of one year not to exceed four years.  Either party may
281.26 	terminate a contract at any time without cause by providing 90
281.27 	calendar days advance written notice to the other party.  The
281.28 	decision to terminate a contract is not appealable.
281.29 	Notwithstanding section 16C.05, subdivision 2, paragraph (a),
281.30 	clause (5), the contract shall be renegotiated for
281.31 	additional one-year terms of up to four years, unless either
281.32 	party provides written notice of termination.  The provisions of
281.33 	the contract shall be renegotiated annually at a minimum of
281.34 	every four years by the parties prior to the expiration date of
281.35 	the contract.  The parties may voluntarily renegotiate the terms
281.36 	of the contract at any time by mutual agreement.
282.1 	(c) If a nursing facility fails to comply with the terms of
282.2 	a contract, the commissioner shall provide reasonable notice
282.3 	regarding the breach of contract and a reasonable opportunity
282.4 	for the facility to come into compliance.  If the facility fails
282.5 	to come into compliance or to remain in compliance, the
282.6 	commissioner may terminate the contract.  If a contract is
282.7 	terminated, the contract payment remains in effect for the
282.8 	remainder of the rate year in which the contract was terminated,
282.9 	but in all other respects the provisions of this section do not
282.10 	apply to that facility effective the date the contract is
282.11 	terminated.  The contract shall contain a provision governing
282.12 	the transition back to the cost-based reimbursement system
282.13 	established under section 256B.431 and Minnesota Rules, parts
282.14 	9549.0010 to 9549.0080.  A contract entered into under this
282.15 	section may be amended by mutual agreement of the parties.

282.16 	Sec. 41. Minnesota Statutes 2004, section 256B.434,
282.17 	subdivision 4, is amended to read:
282.18 		Subd. 4.Alternate rates for nursing facilities.  (a) For
282.19 	nursing facilities which have their payment rates determined
282.20 	under this section rather than section 256B.431, the
282.21 	commissioner shall establish a rate under this subdivision.  The
282.22 	nursing facility must enter into a written contract with the
282.23 	commissioner.
282.24 	(b) A nursing facility's case mix payment rate for the
282.25 	first rate year of a facility's contract under this section is
282.26 	the payment rate the facility would have received under section
282.27 	256B.431.
282.28 	(c) A nursing facility's case mix payment rates for the
282.29 	second and subsequent years of a facility's contract under this
282.30 	section are the previous rate year's contract payment rates plus
282.31 	an inflation adjustment and, for facilities reimbursed under
282.32 	this section or section 256B.431, an adjustment to include the
282.33 	cost of any increase in Health Department licensing fees for the
282.34 	facility taking effect on or after July 1, 2001.  The index for
282.35 	the inflation adjustment must be based on the change in the
282.36 	Consumer Price Index-All Items (United States City average)
283.1 	(CPI-U) forecasted by the commissioner of finance's national
283.2 	economic consultant, as forecasted in the fourth quarter of the
283.3 	calendar year preceding the rate year.  The inflation adjustment
283.4 	must be based on the 12-month period from the midpoint of the
283.5 	previous rate year to the midpoint of the rate year for which
283.6 	the rate is being determined.  For the rate years beginning on
283.7 	July 1, 1999, July 1, 2000, July 1, 2001, July 1, 2002, July 1,
283.8 	2003, and July 1, 2004, July 1, 2005, July 1, 2006, July 1,
283.9 	2007, and July 1, 2008, this paragraph shall apply only to the
283.10 	property-related payment rate, except that adjustments to
283.11 	include the cost of any increase in Health Department licensing
283.12 	fees taking effect on or after July 1, 2001, shall be provided.
283.13 	Beginning in 2005, adjustment to the property payment rate under
283.14 	this section and section 256B.431 shall be effective on October
283.15 	1.In determining the amount of the property-related payment
283.16 	rate adjustment under this paragraph, the commissioner shall
283.17 	determine the proportion of the facility's rates that are
283.18 	property-related based on the facility's most recent cost
283.19 	report. Beginning October 1, 2006, facilities reimbursed under
283.20 	this section shall be allowed to receive a property rate
283.21 	adjustment for building projects under section 144A.071,
283.22 	subdivision 2.
283.23 	(d) The commissioner shall develop additional
283.24 	incentive-based payments of up to five percent above the
283.25 	standard contract rate for achieving outcomes specified in each
283.26 	contract.  The specified facility-specific outcomes must be
283.27 	measurable and approved by the commissioner.  The commissioner
283.28 	may establish, for each contract, various levels of achievement
283.29 	within an outcome.  After the outcomes have been specified the
283.30 	commissioner shall assign various levels of payment associated
283.31 	with achieving the outcome.  Any incentive-based payment cancels
283.32 	if there is a termination of the contract.  In establishing the
283.33 	specified outcomes and related criteria the commissioner shall
283.34 	consider the following state policy objectives:
283.35 	(1) improved cost effectiveness and quality of life as
283.36 	measured by improved clinical outcomes;
284.1 	(2) successful diversion or discharge to community
284.2 	alternatives;
284.3 	(3) decreased acute care costs;
284.4 	(4) improved consumer satisfaction;
284.5 	(5) the achievement of quality; or 
284.6 	(6) any additional outcomes proposed by a nursing facility
284.7 	that the commissioner finds desirable.
284.8 	
EFFECTIVE DATE. This section is effective retroactively
284.9 	from July 1, 2005.

284.10 	Sec. 42. Minnesota Statutes 2004, section 256B.434, is
284.11 	amended by adding a subdivision to read:
284.12 		Subd. 19.Facilities without aps contracts as of october
284.13 	1, 2006. Effective October 1, 2006, payment rates for property
284.14 	shall no longer be determined under section 256B.431.  A
284.15 	facility that does not have a contract with the commissioner
284.16 	under this section shall not be eligible for a rate increase.

284.17 	Sec. 43. [256B.441] NURSING FACILITY REIMBURSEMENT SYSTEM
284.18 	EFFECTIVE OCTOBER 1, 2007.
284.19 		Subdivision 1.In general. (a) The commissioner shall
284.20 	establish a value-based nursing facility reimbursement system
284.21 	which will provide facility-specific, prospective rates for
284.22 	nursing facilities participating in the medical assistance
284.23 	program.  The rates shall be determined using an annual
284.24 	statistical and cost report filed by each nursing facility.  The
284.25 	total payment rate shall be composed of four rate components:
284.26 	direct care services, support services, external fixed, and
284.27 	property-related rate components.  The payment rate shall be
284.28 	derived from statistical measures of actual costs incurred in
284.29 	facility operation of nursing facilities.  From this cost basis,
284.30 	the components of the total payment rate shall be adjusted for
284.31 	quality of services provided, recognition of staffing levels,
284.32 	geographic variation in labor costs, and resident acuity.
284.33 	(b) Rates shall be rebased annually.  Each cost reporting
284.34 	year shall begin on October 1 and end on the following September
284.35 	30.  Beginning in 2006, a statistical and cost report shall be
284.36 	filed by each nursing facility by January 15.  Notice of rates
285.1 	shall be distributed by August 15 and the rates shall go into
285.2 	effect on October 1 for one year.
285.3 	(c)  The commissioner shall begin to phase in the new
285.4 	reimbursement system beginning October 1, 2007.  Full phase-in
285.5 	shall be completed by October 1, 2011.
285.6 		Subd. 2.Definitions. For purposes of this section, the
285.7 	terms in subdivisions 3 to 42 have the meanings given unless
285.8 	otherwise provided for in this section.
285.9 		Subd. 3.Active beds. "Active beds" means licensed beds
285.10 	that are not currently in layaway status.
285.11 		Subd. 4.Activities costs. "Activities costs" means the
285.12 	costs for the salaries and wages of the supervisor and other
285.13 	activities workers, associated fringe benefits and payroll
285.14 	taxes, supplies, services, and consultants.
285.15 		Subd. 5.Administrative costs. "Administrative costs"
285.16 	means the direct costs for administering the overall activities
285.17 	of the nursing home.  These costs include salaries and wages of
285.18 	the administrator, assistant administrator, business office
285.19 	employees, security guards, and associated fringe benefits and
285.20 	payroll taxes, fees, contracts, or purchases related to business
285.21 	office functions, licenses, and permits except as provided in
285.22 	the external fixed costs category, employee recognition, travel
285.23 	including meals and lodging, training, voice and data
285.24 	communication or transmission, office supplies, liability
285.25 	insurance and other forms of insurance not designated to other
285.26 	areas, personnel recruitment, legal services, accounting
285.27 	services, management or business consultants, data processing,
285.28 	central or home office costs, business meetings and seminars,
285.29 	postage, fees for professional organizations, subscriptions,
285.30 	security services, advertising, board of director's fees,
285.31 	working capital interest expense, and bad debts and bad debt
285.32 	collection fees.
285.33 		Subd. 6.Allowed costs. "Allowed costs" means the
285.34 	amounts reported by the facility which are necessary for the
285.35 	operation of the facility and the care of residents and which
285.36 	are reviewed by the department for accuracy, reasonableness, and
286.1 	compliance with this section and generally accepted accounting
286.2 	principles.
286.3 		Subd. 7.Center for medicare and medicaid
286.4 	services. "Center for Medicare and Medicaid services" means the
286.5 	federal agency, in the United States Department of Health and
286.6 	Human Services that administers Medicaid, also referred to as
286.7 	"CMS." 
286.8 		Subd. 8.Commissioner. "Commissioner" means the
286.9 	commissioner of human services unless specified otherwise.
286.10 		Subd. 9.Desk audit. "Desk audit" means the
286.11 	establishment of the payment rate based on the commissioner's
286.12 	review and analysis of required reports, supporting
286.13 	documentation, and work sheets submitted by the nursing facility.
286.14 		Subd. 10.Dietary costs. "Dietary costs" means the costs
286.15 	for the salaries and wages of the dietary supervisor,
286.16 	dietitians, chefs, cooks, dishwashers, and other employees
286.17 	assigned to the kitchen and dining room, and associated fringe
286.18 	benefits and payroll taxes.  Dietary costs also includes the
286.19 	salaries or fees of dietary consultants, direct costs of raw
286.20 	food (both normal and special diet food), dietary supplies, and
286.21 	food preparation and serving.  Also included are special dietary
286.22 	supplements used for tube feeding or oral feeding, such as
286.23 	elemental high nitrogen diet, even if written as a prescription
286.24 	item by a physician.
286.25 		Subd. 11.Direct care costs category. "Direct care costs
286.26 	category" means costs for nursing services, activities, and
286.27 	social services.
286.28 		Subd. 12.Economic development regions. "Economic
286.29 	development regions" are as defined in section 462.385,
286.30 	subdivision 1.
286.31 		Subd. 13.External fixed costs category. "External fixed
286.32 	costs category" means costs related to the nursing home
286.33 	surcharge under section 256.9657, subdivision 1; licensure fees
286.34 	under section 144.122; long-term care consultation fees under
286.35 	section 256B.0911, subdivision 6; family advisory council fee
286.36 	under section 144A.35; scholarships under section 256B.431,
287.1 	subdivision 36; planned closure rate adjustments under section
287.2 	256B.437; property taxes and property insurance; and PERA.
287.3 	Subd. 14.[FACILITY AVERAGE CASE MIX INDEX
287.4 	(CMI).] "Facility average case mix index" or "CMI" means a
287.5 	numerical value score that describes the relative resource use
287.6 	for all residents within the groups under the resource
287.7 	utilization group (RUG-III) classification system prescribed by
287.8 	the commissioner based on an assessment of each resident.  The
287.9 	facility average CMI shall be computed as the standardized days
287.10 	divided by total days for all residents in the facility.
287.11 		Subd. 15.Field audit. "Field audit" means the
287.12 	examination, verification, and review of the financial records,
287.13 	statistical records, and related supporting documentation on the
287.14 	nursing home and any related organization.
287.15 		Subd. 16.Final rate. "Final rate" means the rate
287.16 	established after any adjustment by the commissioner, including,
287.17 	but not limited to, adjustments resulting from audits.
287.18 		Subd. 17.Fringe benefit costs. "Fringe benefit costs"
287.19 	means the costs for group life, health, dental, workers'
287.20 	compensation, and other employee insurances and pension,
287.21 	profit-sharing, and retirement plans for which the employer pays
287.22 	all or a portion of the costs and that are available to at least
287.23 	all employees who work at least 20 hours per week.
287.24 		Subd. 18.Generally accepted accounting principles.
 287.25 	"Generally Accepted Accounting Principles" means the body of
287.26 	pronouncements adopted by the American Institute of Certified
287.27 	Public Accountants regarding proper accounting procedures,
287.28 	guidelines, and rules.
287.29 		Subd. 19.Hospital-attached nursing facility status. (a)
287.30 	For the purpose of setting rates under this section, for rate
287.31 	years beginning after September 30, 2006, "hospital-attached
287.32 	nursing facility" means a nursing facility which meets the
287.33 	requirements of clauses (1) and (2); or (3); or (4), or had
287.34 	hospital-attached status prior to January 1, 1995, and has been
287.35 	recognized as having hospital-attached status by CMS
287.36 	continuously since that date:
288.1 	(1) the nursing facility is recognized by the federal
288.2 	Medicare program to be a hospital-based nursing facility;
288.3 	(2) the hospital and nursing facility are physically
288.4 	attached or connected by a corridor;
288.5 	(3) a nursing facility and hospital, which have applied for
288.6 	hospital-based nursing facility status under the federal
288.7 	Medicare program during the reporting year, shall be considered
288.8 	a hospital-attached nursing facility for purposes of setting
288.9 	payment rates under this section.  The nursing facility must
288.10 	file its cost report for that reporting year using Medicare
288.11 	principles and Medicare's recommended cost allocation methods
288.12 	had the Medicare program's hospital-based nursing facility
288.13 	status been granted to the nursing facility.  For each
288.14 	subsequent rate year, the nursing facility must meet the
288.15 	definition requirements in clauses (1) and (2).  If the nursing
288.16 	facility is denied hospital-based nursing facility status under
288.17 	the Medicare program, the nursing facility's payment rates for
288.18 	the rate years the nursing facility was considered to be a
288.19 	hospital-attached nursing facility according to this paragraph
288.20 	shall be recalculated treating the nursing facility as a
288.21 	non-hospital-attached nursing facility;
288.22 	(4) if a nonprofit or community-operated hospital and
288.23 	attached nursing facility suspend operation of the hospital, the
288.24 	remaining nursing facility must be allowed to continue its
288.25 	status as hospital-attached for rate calculations in the three
288.26 	rate years subsequent to the one in which the hospital ceased
288.27 	operations.
288.28 	(b) The nursing facility's cost report filed as
288.29 	hospital-attached facility shall use the same cost allocation
288.30 	principles and methods used in the reports filed for the
288.31 	Medicare program.  Direct identification of costs to the nursing
288.32 	facility cost center will be permitted only when the comparable
288.33 	hospital costs have also been directly identified to a cost
288.34 	center which is not allocated to the nursing facility.
288.35 		Subd. 20.Housekeeping costs. "Housekeeping costs" means
288.36 	the costs for the salaries and wages of the housekeeping
289.1 	supervisor, housekeepers, and other cleaning employees and
289.2 	associated fringe benefits and payroll taxes.  It also includes
289.3 	the cost of housekeeping supplies, including cleaning and
289.4 	lavatory supplies and contract services.
289.5 		Subd. 21.Labor-related portion. The "labor-related
289.6 	portion" of direct care costs and of support service costs shall
289.7 	be that portion of costs that is attributable to wages for all
289.8 	compensated hours, payroll taxes, and fringe benefits.
289.9 		Subd. 22.Laundry costs. "Laundry costs" means the costs
289.10 	for the salaries and wages of the laundry supervisor and other
289.11 	laundry employees, associated fringe benefits, and payroll
289.12 	taxes.  It also includes the costs of linen and bedding, the
289.13 	laundering of resident clothing, laundry supplies, and contract
289.14 	services.
289.15 		Subd. 23.Licensee. "Licensee" means the individual or
289.16 	organization listed on the form issued by the Minnesota
289.17 	Department of Health under chapter 144A or sections 144.50 to
289.18 	144.56.
289.19 		Subd. 24.Maintenance and plant operations
289.20 	costs. "Maintenance and plant operations costs" means the costs
289.21 	for the salaries and wages of the maintenance supervisor,
289.22 	engineers, heating-plant employees, and other maintenance
289.23 	employees and associated fringe benefits and payroll taxes.  It
289.24 	also includes direct costs for maintenance and operation of the
289.25 	building and grounds, including fuel, electricity, medical waste
289.26 	and garbage removal, water, sewer, supplies, tools, and repairs.
289.27 		Subd. 25.Normalized direct care costs per
289.28 	day. "Normalized direct care costs per day" means direct care
289.29 	costs divided by standardized days.  It is the costs per day for
289.30 	direct care services associated with a RUG's index of 1.00.
289.31 		Subd. 26.Nursing costs. "Nursing costs" means the costs
289.32 	for the wages of nursing administration, staff education, and
289.33 	direct care registered nurses, licensed practical nurses,
289.34 	certified nursing assistants, and trained medication aides;
289.35 	mental health workers and other direct care employees, and
289.36 	associated fringe benefits and payroll taxes; services from a
290.1 	supplemental nursing services agency and supplies that are
290.2 	stocked at nursing stations or on the floor and distributed or
290.3 	used individually, including:  alcohol, applicators, cotton
290.4 	balls, incontinence pads, disposable ice bags, dressings,
290.5 	bandages, water pitchers, tongue depressors, disposable gloves,
290.6 	enemas, enema equipment, soap, medication cups, diapers, plastic
290.7 	waste bags, sanitary products, thermometers, hypodermic needles
290.8 	and syringes, and clinical reagents or similar diagnostic
290.9 	agents, and drugs which are not paid on a separate fee schedule
290.10 	by the medical assistance program or any other payer.
290.11 		Subd. 27.Nursing facility. "Nursing facility" means a
290.12 	facility with a medical assistance provider agreement that is
290.13 	licensed as a nursing home under chapter 144A or as a boarding
290.14 	care home under sections 144.50 to 144.56.
290.15 		Subd. 28.Operating costs. "Operating costs" means costs
290.16 	associated with the direct care costs category and the support
290.17 	services costs category.
290.18 		Subd. 29.Payroll taxes. "Payroll taxes" means the costs
290.19 	for the employer's share of the FICA and Medicare withholding
290.20 	tax, and state and federal unemployment compensation taxes.
290.21 		Subd. 30.Peer groups. Facilities shall be classified
290.22 	into three groups, called "peer groups," which shall consist of:
290.23 	(1) C&NC/Short Stay/R80 - facilities that have three or
290.24 	more admissions per bed per year, are hospital-attached, or are
290.25 	licensed under Minnesota Rules, parts 9570.2000 to 9570.3600;
290.26 	(2) boarding care homes - facilities that have more than 50
290.27 	percent of their beds licensed as boarding care homes; and 
290.28 	(3) standard - all other facilities.
290.29 		Subd. 31.Prior rate-setting method. "Prior rate-setting
290.30 	method" means the rate determination process in effect prior to
290.31 	October 1, 2006, under Minnesota Rules and Minnesota Statutes.
290.32 		Subd. 32.Private paying resident. "Private paying
290.33 	resident" means a nursing facility resident who is not a medical
290.34 	assistance recipient and whose payment rate is not established
290.35 	by another third party, including the veterans administration or
290.36 	Medicare.
291.1 		Subd. 33.Rate year. "Rate year" means the 12-month
291.2 	period beginning on October 1 following the second most recent
291.3 	reporting year.
291.4 		Subd. 34.Related organization. "Related organization"
291.5 	means a person that furnishes goods or services to a nursing
291.6 	facility and that is a close relative of a nursing facility, an
291.7 	affiliate of a nursing facility, a close relative of an
291.8 	affiliate of a nursing facility, or an affiliate of a close
291.9 	relative of an affiliate of a nursing facility.  As used in this
291.10 	subdivision, paragraphs (a) to (d) apply:
291.11 	(a) "Affiliate" means a person that directly, or indirectly
291.12 	through one or more intermediaries, controls or is controlled
291.13 	by, or is under common control with another person.
291.14 	(b) "Person" means an individual, a corporation, a
291.15 	partnership, an association, a trust, an unincorporated
291.16 	organization, or a government or political subdivision.
291.17 	(c) "Close relative of an affiliate of a nursing facility"
291.18 	means an individual whose relationship by blood, marriage, or
291.19 	adoption to an individual who is an affiliate of a nursing
291.20 	facility is no more remote than first cousin.
291.21 	(d) "Control" including the terms "controlling,"
291.22 	"controlled by," and "under common control with" means the
291.23 	possession, direct or indirect, of the power to direct or cause
291.24 	the direction of the management, operations, or policies of a
291.25 	person, whether through the ownership of voting securities, by
291.26 	contract, or otherwise, or to influence in any manner other than
291.27 	through an arms length, legal transaction.
291.28 		Subd. 35.Reporting period. "Reporting period" means the
291.29 	one-year period beginning on October 1 and ending on the
291.30 	following September 30 during which incurred costs are
291.31 	accumulated and then reported on the statistical and cost report.
291.32 		Subd. 36.Resident day or actual resident day. "Resident
291.33 	day" or "actual resident day" means a day for which nursing
291.34 	services are rendered and billable, or a day for which a bed is
291.35 	held and billed.  The day of admission is considered a resident
291.36 	day, regardless of the time of admission.  The day of discharge
292.1 	is not considered a resident day, regardless of the time of
292.2 	discharge.
292.3 		Subd. 37.Salaries and wages. "Salaries and wages" means
292.4 	amounts earned by and paid to employees or on behalf of
292.5 	employees to compensate for necessary services provided.
292.6 	Salaries and wages include accrued vested vacation and accrued
292.7 	vested sick leave pay.  Salaries and wages must be paid within
292.8 	30 days of the end of the reporting period in order to be
292.9 	allowable costs of the reporting period.
292.10 		Subd. 38.Social services costs. "Social services costs"
292.11 	means the costs for the salaries and wages of the supervisor and
292.12 	other social work employees, associated fringe benefits and
292.13 	payroll taxes, supplies, services, and consultants.
292.14 		Subd. 39.Stakeholders. "Stakeholders" means individuals
292.15 	and representatives of organizations interested in long-term
292.16 	care, including nursing homes, consumers, and labor unions.
292.17 		Subd. 40.Standardized days. "Standardized days" means
292.18 	the sum of resident days by case mix category multiplied by the
292.19 	RUG index for each category.
292.20 		Subd. 41.Statistical and cost report. "Statistical and
292.21 	cost report" means the forms supplied by the commissioner for
292.22 	annual reporting of nursing facility expenses and statistics,
292.23 	including instructions and definitions of items in the report.
292.24 		Subd. 42.Support services costs category. "Support
292.25 	services costs category" means the costs for dietary,
292.26 	housekeeping, laundry, maintenance, and administration.
292.27 		Subd. 43.Reporting of statistical and cost
292.28 	information. (a) Beginning in 2006, all nursing facilities
292.29 	shall provide information annually to the commissioner on a form
292.30 	and in a manner determined by the commissioner.  The
292.31 	commissioner may also require nursing facilities to provide
292.32 	statistical and cost information for a subset of the items in
292.33 	the annual report on a semiannual basis.  Nursing facilities
292.34 	shall report only costs directly related to the operation of the
292.35 	nursing facility.  The facility shall not include costs which
292.36 	are separately reimbursed by residents, medical assistance, or
293.1 	other payors.  Allocations of costs from central, affiliated, or
293.2 	corporate office and related organization transactions shall be
293.3 	reported according to section 256B.432.  The commissioner may
293.4 	grant to facilities one extension of up to 15 days for the
293.5 	filing of this report if the extension is requested by December
293.6 	15 and the commissioner determines that the extension will not
293.7 	prevent the commissioner from establishing rates in a timely
293.8 	manner required by law.  The commissioner may separately require
293.9 	facilities to submit in a manner specified by the commissioner
293.10 	documentation of statistical and cost information included in
293.11 	the report to ensure accuracy in establishing payment rates and
293.12 	to perform audit and appeal review functions under this section.
293.13 	Facilities shall retain all records necessary to document
293.14 	statistical and cost information on the report for a period of
293.15 	no less than seven years.  The commissioner may amend
293.16 	information in the report according to subdivision 47.  The
293.17 	commissioner may reject a report filed by a nursing facility
293.18 	under this section if the commissioner determines that the
293.19 	report has been filed in a form that is incomplete or inaccurate
293.20 	and the information is insufficient to establish accurate
293.21 	payment rates.  In the event that a complete report is not
293.22 	submitted in a timely manner, the commissioner shall reduce the
293.23 	reimbursement payments to a nursing facility to 85 percent of
293.24 	amounts due until the information is filed.  The release of
293.25 	withheld payments shall be retroactive for no more than 90
293.26 	days.  A nursing facility that does not submit a report or whose
293.27 	report is filed in a timely manner but determined to be
293.28 	incomplete shall be given written notice that a payment
293.29 	reduction is to be implemented and allowed ten days to complete
293.30 	the report prior to any payment reduction.  The commissioner may
293.31 	delay the payment withhold under exceptional circumstances to be
293.32 	determined at the sole discretion of the commissioner.
293.33 	(b) Nursing facilities may, within 12 months of the due
293.34 	date of a statistical and cost report, file an amendment when
293.35 	errors or omissions in the annual statistical and cost report
293.36 	are discovered and an amendment would result in a rate increase
294.1 	of at least 0.15 percent of the statewide weighted average
294.2 	operating payment rate and shall, at any time, file an amendment
294.3 	which would result in a rate reduction of at least 0.15 percent
294.4 	of the statewide weighted average operating payment rate.  The
294.5 	commissioner shall make retroactive adjustments to the total
294.6 	payment rate of a nursing facility if an amendment is accepted.
294.7 	Where a retroactive adjustment is to be made as a result of an
294.8 	amended report, audit findings, or other determination of an
294.9 	incorrect payment rate, the commissioner may settle the payment
294.10 	error through a negotiated agreement with the facility and a
294.11 	gross adjustment of the payments to the facility.  Retroactive
294.12 	adjustments shall not be applied to private pay residents.  An
294.13 	error or omission for purposes of this item does not include a
294.14 	nursing facility's determination that an election between
294.15 	permissible alternatives was not advantageous and should be
294.16 	changed.
294.17 	(c) If the commissioner determines that a nursing facility
294.18 	knowingly supplied inaccurate or false information or failed to
294.19 	file an amendment to a statistical and cost report that resulted
294.20 	in or would result in an overpayment, the commissioner shall
294.21 	immediately adjust the nursing facility's payment rate and
294.22 	recover the entire overpayment.  The commissioner may also
294.23 	terminate the commissioner's agreement with the nursing facility
294.24 	and prosecute under applicable state or federal law.
294.25 		Subd. 44.Calculation of a quality score. (a) The
294.26 	commissioner shall determine a quality score for each nursing
294.27 	facility using quality measures established in section 256B.439,
294.28 	according to methods determined by the commissioner in
294.29 	consultation with stakeholders and experts.  These methods shall
294.30 	be exempt from the rulemaking requirements under chapter 14.
294.31 	(b) For each quality measure, a score shall be determined
294.32 	with a maximum number of points available and number of points
294.33 	assigned as determined by the commissioner using the methodology
294.34 	established according to this subdivision.  The scores
294.35 	determined for all quality measures shall be totaled.  The
294.36 	determination of the quality measures to be used and the methods
295.1 	of calculating scores may be revised annually by the
295.2 	commissioner.
295.3 	(c) For the initial rate year under the new payment system,
295.4 	the quality measures shall include:
295.5 	(1) staff turnover;
295.6 	(2) staff retention;
295.7 	(3) use of pool staff;
295.8 	(4) quality indicators from the minimum data set; and 
295.9 	(5) survey deficiencies.
295.10 	(d) For rate years beginning after October 1, 2006, when
295.11 	making revisions to the quality measures or method for
295.12 	calculating scores, the commissioner shall publish the
295.13 	methodology in the State Register at least 15 months prior to
295.14 	the start of the rate year for which the revised methodology is
295.15 	to be used for rate-setting purposes.  The quality score used to
295.16 	determine payment rates shall be established for a rate year
295.17 	using data submitted in the statistical and cost report from the
295.18 	associated reporting year, and using data from other sources
295.19 	related to a period beginning no more than six months prior to
295.20 	the associated reporting year.
295.21 		Subd. 45.Calculation of operating payment rate for
295.22 	direct care and support services. The commissioner shall
295.23 	provide recommendations to the legislature by February 15, 2006,
295.24 	on specific methodology for the establishment of the operating
295.25 	payment rate for direct care and support services under the new
295.26 	system.  The recommendations must not increase expenditures for
295.27 	the new payment system beyond the limits of the appropriation.
295.28 	The commissioner shall include recommendations on options for
295.29 	recognizing changes in staffing and services that may require a
295.30 	supplemental appropriation in the future.
295.31 		Subd. 46.Calculation of quality add-on. The payment
295.32 	rate for the quality add-on shall be a variable amount based on
295.33 	each facility's quality score.
295.34 	(a) For the rate year beginning October 1, 2006, the
295.35 	maximum quality add-on percent shall be 2.4 percent and this
295.36 	add-on shall not be subject to a phase-in.  The determination of
296.1 	the quality score to be used in calculating the quality add-on
296.2 	for October 1, 2006, shall be based on a report which must be
296.3 	filed with the commissioner, according to the requirements in
296.4 	subdivision 43, for a six-month period ending January 31, 2006.
296.5 	This report shall be filed with the commissioner by February 28,
296.6 	2006.  The commissioner shall prorate the six months of data to
296.7 	a full year.  When new quality measures are incorporated into
296.8 	the quality score methodology and when existing quality measures
296.9 	are updated or improved, the commissioner may increase the
296.10 	maximum quality add-on percent.
296.11 	(b) For each facility, determine the operating payment rate.
296.12 	(c) For each facility determine a ratio of the quality
296.13 	score of the facility determined in subdivision 44, less 40 and
296.14 	then divided by 60.  If this value is less than zero, use the
296.15 	value zero.
296.16 	(d) For each facility, the quality add-on shall be the
296.17 	value determined in paragraph (b) times the value determined in
296.18 	paragraph (c) times the maximum quality add-on percent.
296.19 		Subd. 47.Audit authority. (a) The commissioner may
296.20 	subject reports and supporting documentation to desk and field
296.21 	audits to determine compliance with this section.  Retroactive
296.22 	adjustments shall be made as a result of desk or field audit
296.23 	findings if the cumulative impact of the finding would result in
296.24 	a rate adjustment of at least 0.15 percent of the statewide
296.25 	weighted average operating payment rate.  If a field audit
296.26 	reveals inadequacies in a nursing facility's record keeping or
296.27 	accounting practices, the commissioner may require the nursing
296.28 	facility to engage competent professional assistance to correct
296.29 	those inadequacies within 90 days so that the field audit may
296.30 	proceed.
296.31 	(b) Field audits may cover the four most recent annual
296.32 	statistical and cost reports for which desk audits have been
296.33 	completed and payment rates have been established.  The field
296.34 	audit must be an independent review of the nursing facility's
296.35 	statistical and cost report.  All transactions, invoices, or
296.36 	other documentation that support or relate to the statistics and
297.1 	costs claimed on the annual statistical and cost reports are
297.2 	subject to review by the field auditor.  If the provider fails
297.3 	to provide the field auditor access to supporting documentation
297.4 	related to the information reported on the statistical and cost
297.5 	report within the time period specified by the commissioner, the
297.6 	commissioner shall calculate the total payment rate by
297.7 	disallowing the cost of the items for which access to the
297.8 	supporting documentation is not provided.
297.9 	(c) Changes in the total payment rate which result from
297.10 	desk or field audit adjustments to statistical and cost reports
297.11 	for reporting years earlier than the four most recent annual
297.12 	cost reports must be made to the four most recent annual
297.13 	statistical and cost reports, the current statistical and cost
297.14 	report, and future statistical and cost reports to the extent
297.15 	that those adjustments affect the total payment rate established
297.16 	by those reporting years.
297.17 	(d) The commissioner shall extend the period for retention
297.18 	of records under subdivision 43 for purposes of performing field
297.19 	audits as necessary to enforce section 256B.48 with written
297.20 	notice to the facility postmarked no later than 90 days prior to
297.21 	the expiration of the record retention requirement.

297.22 	Sec. 44. Minnesota Statutes 2004, section 256B.49,
297.23 	subdivision 16, is amended to read:
297.24 		Subd. 16.Services and supports.  (a) Services and
297.25 	supports included in the home and community-based waivers for
297.26 	persons with disabilities shall meet the requirements set out in
297.27 	United States Code, title 42, section 1396n.  The services and
297.28 	supports, which are offered as alternatives to institutional
297.29 	care, shall promote consumer choice, community inclusion,
297.30 	self-sufficiency, and self-determination.
297.31 	(b) Beginning January 1, 2003, the commissioner shall
297.32 	simplify and improve access to home and community-based waivered
297.33 	services, to the extent possible, through the establishment of a
297.34 	common service menu that is available to eligible recipients
297.35 	regardless of age, disability type, or waiver program.
297.36 	(c) Consumer directed community support services shall be
298.1 	offered as an option to all persons eligible for services under
298.2 	subdivision 11, by January 1, 2002.
298.3 	(d) Services and supports shall be arranged and provided
298.4 	consistent with individualized written plans of care for
298.5 	eligible waiver recipients.
298.6 	(e) A transitional supports allowance shall be available to
298.7 	all persons under a home and community-based waiver who are
298.8 	moving from a licensed setting to a community setting.
298.9 	"Transitional supports allowance" means a onetime payment of up
298.10 	to $3,000, to cover the costs, not covered by other sources,
298.11 	associated with moving from a licensed setting to a community
298.12 	setting.  Covered costs include:
298.13 	(1) lease or rent deposits;
298.14 	(2) security deposits;
298.15 	(3) utilities set-up costs, including telephone;
298.16 	(4) essential furnishings and supplies; and 
298.17 	(5) personal supports and transports needed to locate and
298.18 	transition to community settings.
298.19 	(f) The state of Minnesota and county agencies that
298.20 	administer home and community-based waivered services for
298.21 	persons with disabilities, shall not be liable for damages,
298.22 	injuries, or liabilities sustained through the purchase of
298.23 	supports by the individual, the individual's family, legal
298.24 	representative, or the authorized representative with funds
298.25 	received through the consumer-directed community support service
298.26 	under this section.  Liabilities include but are not limited
298.27 	to:  workers' compensation liability, the Federal Insurance
298.28 	Contributions Act (FICA), or the Federal Unemployment Tax Act
298.29 	(FUTA).
298.30 	
EFFECTIVE DATE. This section is effective upon federal
298.31 	approval and to the extent approved as a federal waiver
298.32 	amendment.

298.33 	Sec. 45. Minnesota Statutes 2004, section 256B.5012, is
298.34 	amended by adding a subdivision to read:
298.35 		Subd. 6.Icf/mr rate increases beginning october 1, 2005,
298.36 	and october 1, 2006. (a) For the rate periods beginning October
299.1 	1, 2005, and October 1, 2006, the commissioner shall make
299.2 	available to each facility reimbursed under this section an
299.3 	adjustment to the total operating payment rate of 2.2553 percent.
299.4 	(b) 75 percent of the money resulting from the rate
299.5 	adjustment under paragraph (a) must be used to increase wages
299.6 	and benefits and pay associated costs for all employees, except
299.7 	for administrative and central office employees.  75 percent of
299.8 	the money received by a facility as a result of the rate
299.9 	adjustment provided in paragraph (a) must be used only for wage,
299.10 	benefit, and staff increases implemented on or after the
299.11 	effective date of the rate increase each year, and must not be
299.12 	used for increases implemented prior to that date.
299.13 	(c) For each facility, the commissioner shall make
299.14 	available an adjustment using the percentage specified in
299.15 	paragraph (a) multiplied by the total payment rate, excluding
299.16 	the property-related payment rate, in effect on the preceding
299.17 	day.  The total payment rate shall include the adjustment
299.18 	provided in section 256B.501, subdivision 12.
299.19 	(d) A facility whose payment rates are governed by closure
299.20 	agreements, receivership agreements, or Minnesota Rules, part
299.21 	9553.0075, is not eligible for an adjustment otherwise granted
299.22 	under this subdivision.
299.23 	(e) A facility may apply for the portion of the payment
299.24 	rate adjustment provided under paragraph (a) for employee wages
299.25 	and benefits and associated costs.  The application must be made
299.26 	to the commissioner and contain a plan by which the facility
299.27 	will distribute the funds according to paragraph (b).  For
299.28 	facilities in which the employees are represented by an
299.29 	exclusive bargaining representative, an agreement negotiated and
299.30 	agreed to by the employer and the exclusive bargaining
299.31 	representative constitutes the plan.  A negotiated agreement may
299.32 	constitute the plan only if the agreement is finalized after the
299.33 	date of enactment of all rate increases for the rate year.  The
299.34 	commissioner shall review the plan to ensure that the payment
299.35 	rate adjustment per diem is used as provided in this
299.36 	subdivision.  To be eligible, a facility must submit its plan by
300.1 	March 31, 2006, and December 31, 2006, respectively.  If a
300.2 	facility's plan is effective for its employees after the first
300.3 	day of the applicable rate period that the funds are available,
300.4 	the payment rate adjustment per diem is effective the same date
300.5 	as its plan.
300.6 	(f) A copy of the approved distribution plan must be made
300.7 	available to all employees by giving each employee a copy or by
300.8 	posting it in an area of the facility to which all employees
300.9 	have access.  If an employee does not receive the wage and
300.10 	benefit adjustment described in the facility's approved plan and
300.11 	is unable to resolve the problem with the facility's management
300.12 	or through the employee's union representative, the employee may
300.13 	contact the commissioner at an address or telephone number
300.14 	provided by the commissioner and included in the approved plan.

300.15 	Sec. 46. Minnesota Statutes 2004, section 256B.69,
300.16 	subdivision 23, is amended to read:
300.17 		Subd. 23.Alternative integrated long-term care services;
300.18 	elderly and disabled persons.  (a) The commissioner may
300.19 	implement demonstration projects to create alternative
300.20 	integrated delivery systems for acute and long-term care
300.21 	services to elderly persons and persons with disabilities as
300.22 	defined in section 256B.77, subdivision 7a, that provide
300.23 	increased coordination, improve access to quality services, and
300.24 	mitigate future cost increases.  The commissioner may seek
300.25 	federal authority to combine Medicare and Medicaid capitation
300.26 	payments for the purpose of such demonstrations.  Medicare funds
300.27 	and services shall be administered according to the terms and
300.28 	conditions of the federal waiver and demonstration provisions.
300.29 	For the purpose of administering medical assistance funds,
300.30 	demonstrations under this subdivision are subject to
300.31 	subdivisions 1 to 22.  The provisions of Minnesota Rules, parts
300.32 	9500.1450 to 9500.1464, apply to these demonstrations, with the
300.33 	exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457,
300.34 	subpart 1, items B and C, which do not apply to persons
300.35 	enrolling in demonstrations under this section.  An initial open
300.36 	enrollment period may be provided.  Persons who disenroll from
301.1 	demonstrations under this subdivision remain subject to
301.2 	Minnesota Rules, parts 9500.1450 to 9500.1464.  When a person is
301.3 	enrolled in a health plan under these demonstrations and the
301.4 	health plan's participation is subsequently terminated for any
301.5 	reason, the person shall be provided an opportunity to select a
301.6 	new health plan and shall have the right to change health plans
301.7 	within the first 60 days of enrollment in the second health
301.8 	plan.  Persons required to participate in health plans under
301.9 	this section who fail to make a choice of health plan shall not
301.10 	be randomly assigned to health plans under these demonstrations.
301.11 	Notwithstanding section 256L.12, subdivision 5, and Minnesota
301.12 	Rules, part 9505.5220, subpart 1, item A, if adopted, for the
301.13 	purpose of demonstrations under this subdivision, the
301.14 	commissioner may contract with managed care organizations,
301.15 	including counties, to serve only elderly persons eligible for
301.16 	medical assistance, elderly and disabled persons, or disabled
301.17 	persons only.  For persons with primary diagnoses of mental
301.18 	retardation or a related condition, serious and persistent
301.19 	mental illness, or serious emotional disturbance, the
301.20 	commissioner must ensure that the county authority has approved
301.21 	the demonstration and contracting design.  Enrollment in these
301.22 	projects for persons with disabilities shall be voluntary.  The
301.23 	commissioner shall not implement any demonstration project under
301.24 	this subdivision for persons with primary diagnoses of mental
301.25 	retardation or a related condition, serious and persistent
301.26 	mental illness, or serious emotional disturbance, without
301.27 	approval of the county board of the county in which the
301.28 	demonstration is being implemented.
301.29 	(b) Notwithstanding chapter 245B, sections 252.40 to
301.30 	252.46, 256B.092, 256B.501 to 256B.5015, and Minnesota Rules,
301.31 	parts 9525.0004 to 9525.0036, 9525.1200 to 9525.1330, 9525.1580,
301.32 	and 9525.1800 to 9525.1930, the commissioner may implement under
301.33 	this section projects for persons with developmental
301.34 	disabilities.  The commissioner may capitate payments for ICF/MR
301.35 	services, waivered services for mental retardation or related
301.36 	conditions, including case management services, day training and
302.1 	habilitation and alternative active treatment services, and
302.2 	other services as approved by the state and by the federal
302.3 	government.  Case management and active treatment must be
302.4 	individualized and developed in accordance with a
302.5 	person-centered plan.  Costs under these projects may not exceed
302.6 	costs that would have been incurred under fee-for-service.
302.7 	Beginning July 1, 2003, and until two years after the pilot
302.8 	project implementation date, subcontractor participation in the
302.9 	long-term care developmental disability pilot is limited to a
302.10 	nonprofit long-term care system providing ICF/MR services, home
302.11 	and community-based waiver services, and in-home services to no
302.12 	more than 120 consumers with developmental disabilities in
302.13 	Carver, Hennepin, and Scott Counties.  The commissioner shall
302.14 	report to the legislature prior to expansion of the
302.15 	developmental disability pilot project.  This paragraph expires
302.16 	two years after the implementation date of the pilot project.
302.17 	(c) Before implementation of a demonstration project for
302.18 	disabled persons, the commissioner must provide information to
302.19 	appropriate committees of the house of representatives and
302.20 	senate and must involve representatives of affected disability
302.21 	groups in the design of the demonstration projects.
302.22 	(d) A nursing facility reimbursed under the alternative
302.23 	reimbursement methodology in section 256B.434 may, in
302.24 	collaboration with a hospital, clinic, or other health care
302.25 	entity provide services under paragraph (a).  The commissioner
302.26 	shall amend the state plan and seek any federal waivers
302.27 	necessary to implement this paragraph.
302.28 	(e) The commissioner, in consultation with the
302.29 	commissioners of commerce and health, may approve and implement
302.30 	programs for all-inclusive care for the elderly (PACE) according
302.31 	to federal laws and regulations governing that program and state
302.32 	laws or rules applicable to participating providers.  The
302.33 	process for approval of these programs shall begin only after
302.34 	the commissioner receives grant money in an amount sufficient to
302.35 	cover the state share of the administrative and actuarial costs
302.36 	to implement the programs during state fiscal years 2006 and
303.1 	2007.  Grant amounts for this purpose shall be deposited in an
303.2 	account in the special revenue fund and are appropriated to the
303.3 	commissioner to be used solely for the purpose of PACE
303.4 	administrative and actuarial costs.  A PACE provider is not
303.5 	required to be licensed or certified as a health plan company as
303.6 	defined in section 62Q.01, subdivision 4.  Persons age 55 and
303.7 	older who have been screened by the county and found to be
303.8 	eligible for services under the elderly waiver or community
303.9 	alternatives for disabled individuals or who are already
303.10 	eligible for Medicaid but meet level of care criteria for
303.11 	receipt of waiver services may choose to enroll in the PACE
303.12 	program.  Medicare and Medicaid services will be provided
303.13 	according to this subdivision and federal Medicare and Medicaid
303.14 	requirements governing PACE providers and programs.  PACE
303.15 	enrollees will receive Medicaid home and community-based
303.16 	services through the PACE provider as an alternative to services
303.17 	for which they would otherwise be eligible through home and
303.18 	community-based waiver programs and Medicaid State Plan
303.19 	Services.  The commissioner shall establish Medicaid rates for
303.20 	PACE providers that do not exceed costs that would have been
303.21 	incurred under fee-for-service or other relevant managed care
303.22 	programs operated by the state.
303.23 	(f) The commissioner shall seek federal approval to expand
303.24 	the Minnesota disability health options (MnDHO) program
303.25 	established under this subdivision in stages, first to regional
303.26 	population centers outside the seven-county metro area and then
303.27 	to all areas of the state.
303.28 	(g) Notwithstanding section 256B.0261, health plans
303.29 	providing services under this section are responsible for home
303.30 	care targeted case management and relocation targeted case
303.31 	management.  Services must be provided according to the terms of
303.32 	the waivers and contracts approved by the federal government.

303.33 	Sec. 47. [256B.762] REIMBURSEMENT FOR HEALTH CARE
303.34 	SERVICES.
303.35 	Effective for services provided on or after October 1,
303.36 	2005, payment rates for the following services shall be
304.1 	increased by five percent over the rates in effect on September
304.2 	30, 2005, when these services are provided as home health
304.3 	services under section 256B.0625, subdivision 6a:
304.4 	(1) skilled nursing visit;
304.5 	(2) physical therapy visit;
304.6 	(3) occupational therapy visit;
304.7 	(4) speech therapy visit; and 
304.8 	(5) home health aide visit.

304.9 	Sec. 48. Minnesota Statutes 2004, section 256I.06, is
304.10 	amended by adding a subdivision to read:
304.11 		Subd. 9.Community living adjustment. Effective August
304.12 	1, 2005, persons eligible for and residing in group residential
304.13 	housing under section 256I.04 shall receive a group residential
304.14 	housing community living adjustment of $20 per month.

304.15 	Sec. 49. Minnesota Statutes 2004, section 514.981,
304.16 	subdivision 6, is amended to read:
304.17 		Subd. 6.Time limits; claim limits; liens on life estates
304.18 	and joint tenancies.  (a) A medical assistance lien is a lien on
304.19 	the real property it describes for a period of ten years from
304.20 	the date it attaches according to section 514.981, subdivision
304.21 	2, paragraph (a), except as otherwise provided for in sections
304.22 	514.980 to 514.985.  The agency may renew a medical assistance
304.23 	lien for an additional ten years from the date it would
304.24 	otherwise expire by recording or filing a certificate of renewal
304.25 	before the lien expires.  The certificate shall be recorded or
304.26 	filed in the office of the county recorder or registrar of
304.27 	titles for the county in which the lien is recorded or filed.
304.28 	The certificate must refer to the recording or filing data for
304.29 	the medical assistance lien it renews.  The certificate need not
304.30 	be attested, certified, or acknowledged as a condition for
304.31 	recording or filing.  The registrar of titles or the recorder
304.32 	shall file, record, index, and return the certificate of renewal
304.33 	in the same manner as provided for medical assistance liens in
304.34 	section 514.982, subdivision 2.
304.35 	(b) A medical assistance lien is not enforceable against
304.36 	the real property of an estate to the extent there is a
305.1 	determination by a court of competent jurisdiction, or by an
305.2 	officer of the court designated for that purpose, that there are
305.3 	insufficient assets in the estate to satisfy the agency's
305.4 	medical assistance lien in whole or in part because of the
305.5 	homestead exemption under section 256B.15, subdivision 4, the
305.6 	rights of the surviving spouse or minor children under section
305.7 	524.2-403, paragraphs (a) and (b), or claims with a priority
305.8 	under section 524.3-805, paragraph (a), clauses (1) to (4).  For
305.9 	purposes of this section, the rights of the decedent's adult
305.10 	children to exempt property under section 524.2-403, paragraph
305.11 	(b), shall not be considered costs of administration under
305.12 	section 524.3-805, paragraph (a), clause (1).
305.13 	(c) Notwithstanding any law or rule to the contrary, the
305.14 	provisions in clauses (1) to (7) apply if a life estate subject
305.15 	to a medical assistance lien ends according to its terms, or if
305.16 	a medical assistance recipient who owns a life estate or any
305.17 	interest in real property as a joint tenant that is subject to a
305.18 	medical assistance lien dies.
305.19 	(1) The medical assistance recipient's life estate or joint
305.20 	tenancy interest in the real property shall not end upon the
305.21 	recipient's death but shall merge into the remainder interest or
305.22 	other interest in real property the medical assistance recipient
305.23 	owned in joint tenancy with others.  The medical assistance lien
305.24 	shall attach to and run with the remainder or other interest in
305.25 	the real property to the extent of the medical assistance
305.26 	recipient's interest in the property at the time of the
305.27 	recipient's death as determined under this section.
305.28 	(2) If the medical assistance recipient's interest was a
305.29 	life estate in real property, the lien shall be a lien against
305.30 	the portion of the remainder equal to the percentage factor for
305.31 	the life estate of a person the medical assistance recipient's
305.32 	age on the date the life estate ended according to its terms or
305.33 	the date of the medical assistance recipient's death as listed
305.34 	in the Life Estate Mortality Table in the health care program's
305.35 	manual.
305.36 	(3) If the medical assistance recipient owned the interest
306.1 	in real property in joint tenancy with others, the lien shall be
306.2 	a lien against the portion of that interest equal to the
306.3 	fractional interest the medical assistance recipient would have
306.4 	owned in the jointly owned interest had the medical assistance
306.5 	recipient and the other owners held title to that interest as
306.6 	tenants in common on the date the medical assistance recipient
306.7 	died.
306.8 	(4) The medical assistance lien shall remain a lien against
306.9 	the remainder or other jointly owned interest for the length of
306.10 	time and be renewable as provided in paragraph (a).
306.11 	(5) Subdivision 5, paragraph (a), clause (4), paragraph
306.12 	(b), clauses (1) and (2); and subdivision 6, paragraph (b), do
306.13 	not apply to medical assistance liens which attach to interests
306.14 	in real property as provided under this subdivision.
306.15 	(6) The continuation of a medical assistance recipient's
306.16 	life estate or joint tenancy interest in real property after the
306.17 	medical assistance recipient's death for the purpose of
306.18 	recovering medical assistance provided for in sections 514.980
306.19 	to 514.985 modifies common law principles holding that these
306.20 	interests terminate on the death of the holder.
306.21 	(7) Notwithstanding any law or rule to the contrary, no
306.22 	release, satisfaction, discharge, or affidavit under section
306.23 	256B.15 shall extinguish or terminate the life estate or joint
306.24 	tenancy interest of a medical assistance recipient subject to a
306.25 	lien under sections 514.980 to 514.985 on the date the recipient
306.26 	dies.
306.27 	(8) The provisions of clauses (1) to (7) do not apply to a
306.28 	homestead owned of record, on the date the recipient dies, by
306.29 	the recipient and the recipient's spouse as joint tenants with a
306.30 	right of survivorship.  Homestead means the real property
306.31 	occupied by the surviving joint tenant spouse as their sole
306.32 	residence on the date the recipient dies and classified and
306.33 	taxed to the recipient and surviving joint tenant spouse as
306.34 	homestead property for property tax purposes in the calendar
306.35 	year in which the recipient dies.  For purposes of this
306.36 	exemption, real property the recipient and their surviving joint
307.1 	tenant spouse purchase solely with the proceeds from the sale of
307.2 	their prior homestead, own of record as joint tenants, and
307.3 	qualify as homestead property under section 273.124 in the
307.4 	calendar year in which the recipient dies and prior to the
307.5 	recipient's death shall be deemed to be real property classified
307.6 	and taxed to the recipient and their surviving joint tenant
307.7 	spouse as homestead property in the calendar year in which the
307.8 	recipient dies.  The surviving spouse, or any person with
307.9 	personal knowledge of the facts, may provide an affidavit
307.10 	describing the homestead property affected by this clause and
307.11 	stating facts showing compliance with this clause.  The
307.12 	affidavit shall be prima facie evidence of the facts it states.
307.13 	All provisions in this paragraph related to the continuation of
307.14 	a recipient's life estate or joint tenancy interests in real
307.15 	property after the recipient's death, for the purpose of
307.16 	recovering medical assistance but not alternative care, are
307.17 	effective only for life estates and joint tenancy interests
307.18 	established on or after August 1, 2003.
307.19 	
EFFECTIVE DATE. This section is effective retroactively
307.20 	from August 1, 2003.

307.21 	Sec. 50. CONSUMER-DIRECTED COMMUNITY SUPPORTS
307.22 	METHODOLOGY.
 307.23 	(a) Effective upon federal approval, for persons using the
307.24 	home and community-based waiver for persons with developmental
307.25 	disabilities whose consumer-directed community supports budgets
307.26 	were reduced by the October 2004, state-set budget methodology,
307.27 	the commissioner of human services must allow exceptions to
307.28 	exceed the state-set budget formula up to the daily average cost
307.29 	during calendar year 2004 or for persons who graduated from
307.30 	school during 2004, the average daily cost during July through
307.31 	December 2004, less one-half of case management and home
307.32 	modifications over $5,000 when the individual's county of
307.33 	financial responsibility determines that:
307.34 	(1) necessary alternative services will cost the same or
307.35 	more than the person's current budget; and 
307.36 	(2) administrative expenses or provider rates will result
308.1 	in fewer hours of needed staffing for the person than under the
308.2 	consumer-directed community supports option.  Any exceptions the
308.3 	county grants must be within the county's allowable aggregate
308.4 	amount for the home and community-based waiver for persons with
308.5 	developmental disabilities.
308.6 	(b) This section expires on the date the commissioner of
308.7 	human services implements a new consumer-directed community
308.8 	supports budget methodology that is based on information about
308.9 	the services and supports intensity needs of persons using the
308.10 	option and that adequately accounts for the increased costs of
308.11 	adults who graduate from school and need services funded by the
308.12 	waiver during the day.

308.13 	Sec. 51. COSTS ASSOCIATED WITH PHYSICAL ACTIVITIES.
 308.14 	Effective upon federal approval, the expenses allowed for
308.15 	adults under the consumer-directed community supports option
308.16 	shall include the costs at the lowest rate available considering
308.17 	daily, monthly, semi-annual, annual, or membership rates,
308.18 	including transportation, associated with physical exercise or
308.19 	other physical activities to maintain or improve the person's
308.20 	health and functioning.

308.21 	Sec. 52. WAIVER AMENDMENT.
 308.22 	The commissioner of human services shall submit an
308.23 	amendment to the Centers for Medicare and Medicaid Services
308.24 	consistent with sections 50 and 51 by October 1, 2005.

308.25 	EFFECTIVE DATE. This section is effective the day
308.26 	following final enactment.

308.27 	Sec. 53. INDEPENDENT EVALUATION AND REVIEW OF UNALLOWABLE
308.28 	ITEMS.
 308.29 	The commissioner of human services shall include in the
308.30 	independent evaluation of the consumer-directed community
308.31 	supports option provided through the home and community-based
308.32 	services waivers for persons with disabilities under 65 years of
308.33 	age:
308.34 	(1) provision for ongoing, regular participation by
308.35 	stakeholder representatives through June 30, 2007;
308.36 	(2) recommendations on whether changes to the unallowable
309.1 	items should be made to meet the health, safety, or welfare
309.2 	needs of participants in the consumer-directed community
309.3 	supports option within the allowed budget amounts.  The
309.4 	recommendations on allowable items shall be provided to the
309.5 	senate and house of representatives committees with jurisdiction
309.6 	over human services policy and finance issues by January 15,
309.7 	2006; and 
309.8 	(3) a review of the statewide caseload changes for the
309.9 	disability waiver programs for persons under 65 years of age
309.10 	that occurred since the state-set budget methodology
309.11 	implementation on October 1, 2004, and recommendations on the
309.12 	fiscal impact of the budget methodology on use of the
309.13 	consumer-directed community supports option.

309.14 	EFFECTIVE DATE. This section is effective the day
309.15 	following final enactment.

309.16 	Sec. 54. FEDERAL APPROVAL.
 309.17 	By October 1, 2005, the commissioner of human services
309.18 	shall request any federal approval and plan amendments necessary
309.19 	to implement (1) the transitional supports allowance under
309.20 	Minnesota Statutes, sections 256B.0916, subdivision 10, and
309.21 	256B.49, subdivision 16; and (2) the choice of case management
309.22 	service coordination provisions under Minnesota Statutes,
309.23 	section 256B.0621, subdivisions 4, 5, 6, and 7.

309.24 	Sec. 55. COMMUNITY SERVICES PROVIDER RATE INCREASES.
 309.25 	(a) The commissioner of human services shall increase
309.26 	reimbursement rates or rate limits, as applicable, by 2.2553
309.27 	percent for the rate period beginning October 1, 2005, and the
309.28 	rate period beginning October 1, 2006, effective for services
309.29 	rendered on or after those dates.
309.30 	(b) The 2.2553 percent annual rate increase described in
309.31 	this section must be provided to:
309.32 	(1) home and community-based waivered services for persons
309.33 	with mental retardation or related conditions under Minnesota
309.34 	Statutes, section 256B.501;
309.35 	(2) home and community-based waivered services for the
309.36 	elderly under Minnesota Statutes, section 256B.0915;
310.1 	(3) waivered services under community alternatives for
310.2 	disabled individuals under Minnesota Statutes, section 256B.49;
310.3 	(4) community alternative care waivered services under
310.4 	Minnesota Statutes, section 256B.49;
310.5 	(5) traumatic brain injury waivered services under
310.6 	Minnesota Statutes, section 256B.49;
310.7 	(6) nursing services and home health services under
310.8 	Minnesota Statutes, section 256B.0625, subdivision 6a;
310.9 	(7) personal care services and nursing supervision of
310.10 	personal care services under Minnesota Statutes, section
310.11 	256B.0625, subdivision 19a;
310.12 	(8) private duty nursing services under Minnesota Statutes,
310.13 	section 256B.0625, subdivision 7;
310.14 	(9) day training and habilitation services for adults with
310.15 	mental retardation or related conditions under Minnesota
310.16 	Statutes, sections 252.40 to 252.46;
310.17 	(10) alternative care services under Minnesota Statutes,
310.18 	section 256B.0913;
310.19 	(11) adult residential program grants under Minnesota
310.20 	Rules, parts 9535.2000 to 9535.3000;
310.21 	(12) adult and family community support grants under
310.22 	Minnesota Rules, parts 9535.1700 to 9535.1760;
310.23 	(13) the group residential housing supplementary service
310.24 	rate under Minnesota Statutes, section 256I.05, subdivision 1a;
310.25 	(14) adult mental health integrated fund grants under
310.26 	Minnesota Statutes, section 245.4661;
310.27 	(15) semi-independent living services under Minnesota
310.28 	Statutes, section 252.275, including SILS funding under county
310.29 	social services grants formerly funded under Minnesota Statutes,
310.30 	chapter 256I;
310.31 	(16) community support services for deaf and
310.32 	hard-of-hearing adults with mental illness who use or wish to
310.33 	use sign language as their primary means of communication;
310.34 	(17) living skills training programs for persons with
310.35 	intractable epilepsy who need assistance in the transition to
310.36 	independent living;
311.1 	(18) physical therapy services under sections 256B.0625,
311.2 	subdivision 8, and 256D.03, subdivision 4;
311.3 	(19) occupational therapy services under sections
311.4 	256B.0625, subdivision 8a, and 256D.03, subdivision 4;
311.5 	(20) speech-language therapy services under section
311.6 	256D.03, subdivision 4, and Minnesota Rules, part 9505.0390; and 
311.7 	(21) respiratory therapy services under section 256D.03,
311.8 	subdivision 4, and Minnesota Rules, part 9505.0295.
311.9 	(c) Providers that receive a rate increase under this
311.10 	section shall use 75 percent of the additional revenue to
311.11 	increase wages and benefits and pay associated costs for all
311.12 	employees, except for management fees, the administrator, and
311.13 	central office staffs.
311.14 	(d) For public employees, the increase for wages and
311.15 	benefits for certain staff is available and pay rates shall be
311.16 	increased only to the extent that they comply with laws
311.17 	governing public employees collective bargaining.  Money
311.18 	received by a provider for pay increases under this section may
311.19 	be used only for increases implemented on or after the first day
311.20 	of the rate period in which the increase is available and must
311.21 	not be used for increases implemented prior to that date.
311.22 	(e) A copy of the provider's plan for complying with
311.23 	paragraph (c) must be made available to all employees by giving
311.24 	each employee a copy or by posting a copy in an area of the
311.25 	provider's operation to which all employees have access.  If an
311.26 	employee does not receive the adjustment, if any, described in
311.27 	the plan and is unable to resolve the problem with the provider,
311.28 	the employee may contact the employee's union representative.
311.29 	If the employee is not covered by a collective bargaining
311.30 	agreement, the employee may contact the commissioner at a
311.31 	telephone number provided by the commissioner and included in
311.32 	the provider's plan.

311.33 	Sec. 56. COMMISSIONER'S DUTIES RELATED TO CHANGE IN
311.34 	EFFECTIVE DATE FOR LIFE ESTATE AND JOINT TENANCY INTEREST
311.35 	PROVISIONS.
 311.36 	(a) The commissioner of human services or a county agency
312.1 	that has recovered medical assistance or alternative care
312.2 	payments for recipients after they die from their life estates
312.3 	or jointly owned interests in real property that were
312.4 	established prior to August 1, 2003, and that were continued in
312.5 	existence or merged into another interest in real property after
312.6 	their death due solely to the provisions of section 256B.15 or
312.7 	514.981, subdivision 6, paragraph (c), as those provisions
312.8 	existed prior to the amendments in this act, shall refund those
312.9 	recoveries, without interest.  The refunds shall be paid to the
312.10 	surviving record owners of the real property in which the
312.11 	recipient had a life estate or a jointly owned interest on the
312.12 	date of the recipient's death in proportion to their record
312.13 	interests on that date.  The commissioner and a county agency
312.14 	are not required to refund any other recoveries attributable to
312.15 	any other interests or assets of the deceased recipient.  For
312.16 	purposes of this paragraph, a life estate or jointly owned
312.17 	interest in real property is established as of the date provided
312.18 	for in Minnesota Statutes, section 256B.15, subdivision 6.
312.19 	(b) If the commissioner of human services or a county
312.20 	agency determines a person entitled to any refund under this act
312.21 	is dead, they may pay the refund due that person to their estate
312.22 	if it is still open.  If the person's estate is closed or if a
312.23 	court has entered a decree of distribution for that person under
312.24 	section 525.312 that is a final decree, the commissioner or the
312.25 	county agency may, in their absolute discretion, pay the
312.26 	person's refund to their heirs or devisees as finally determined
312.27 	in any completed probate or under any final decree of
312.28 	distribution.  In all other cases including, but not limited to,
312.29 	those in which the commissioner or a county agency determines
312.30 	they cannot identify or locate a person entitled to a refund
312.31 	under this section, they may, at their discretion, declare such
312.32 	person's refund to be abandoned property and pay and deliver it
312.33 	to the commissioner of commerce.  The commissioner of commerce
312.34 	shall administer and dispose of the refunds according to
312.35 	sections 345.31 to 345.60.  Neither the commissioner of human
312.36 	services, the Department of Human Services, a county agency, or
313.1 	the employees of the department or agency, shall be liable to
313.2 	anyone with respect to the refund after paying or delivering the
313.3 	refund as provided for in this section.

313.4 	EFFECTIVE DATE. This section is effective retroactively
313.5 	from August 1, 2003.

313.6 	Sec. 57. DIRECTION TO THE COMMISSIONER; LICENSING AND
313.7 	ALTERNATIVE QUALITY ASSURANCE STUDY.
 313.8 	The commissioner of human services shall arrange for a
313.9 	study, including recommendations for statewide development and
313.10 	implementation of regional or local quality assurance models for
313.11 	disability services.  The study shall include a review of
313.12 	current projects or models; make findings regarding the best
313.13 	components, role, and function of such models within a statewide
313.14 	quality assurance system; and shall estimate the cost and
313.15 	sources of funding for regional and local quality assurance
313.16 	models on a statewide basis.  The study shall be done in
313.17 	consultation with counties, consumers of service, providers, and
313.18 	representatives of the Quality Assurance Commission under
313.19 	Minnesota Statutes, section 256B.0951, subdivision 1.
313.20 	The study shall be submitted to the chairs of the
313.21 	legislative committees with jurisdiction over health and human
313.22 	services with recommendations on implementation of a statewide
313.23 	system of quality assurance and licensing by July 1, 2006.  The
313.24 	commissioner shall submit proposed legislation for
313.25 	implementation of a statewide system of quality assurance to the
313.26 	chairs of the legislative committees with jurisdiction over
313.27 	health and human services by December 15, 2006.

313.28 	Sec. 58. DISABILITY SERVICES INTERAGENCY WORK GROUP.
 313.29 		Subdivision 1.Membership. The Department of Human
313.30 	Services, the Minnesota Housing Finance Agency, and the
313.31 	Minnesota State Council on Disability shall convene an
313.32 	interagency work group which includes interested stakeholders
313.33 	including other state agencies, counties, public housing
313.34 	authorities, the Metropolitan Council, disability service
313.35 	providers, and representatives from disability advocacy
313.36 	organizations to identify barriers, strengthen coordination,
314.1 	recommend policy and funding changes, and pursue federal
314.2 	financing that will assist Minnesotans with disabilities who are
314.3 	attempting to relocate from or avoid placement in institutional
314.4 	settings.
314.5 		Subd. 2.Work group activities. The work group shall
314.6 	make recommendations to the state agencies and the legislature
314.7 	related to:
314.8 	(1) coordinating the availability of housing,
314.9 	transportation, and support services needed to discharge persons
314.10 	with disabilities from institutions;
314.11 	(2) improving information and assistance needed to make an
314.12 	informed choice about relocating from an institutional placement
314.13 	to community-based services;
314.14 	(3) identifying gaps in human services, transportation, or
314.15 	housing access which are barriers to moving to community
314.16 	services;
314.17 	(4) identifying strategies which would result in earlier
314.18 	identification of persons most at risk of institutional
314.19 	placement in order to promote diversion to community service or
314.20 	reduce length of stay in an institutional facility;
314.21 	(5) identifying funding mechanisms and financial strategies
314.22 	to assure a financially sustainable community support system
314.23 	that diverts and relocates individuals from institutional
314.24 	placement; and 
314.25 	(6) identifying state changes needed to address any federal
314.26 	changes affecting policies, benefits, or funding used to support
314.27 	persons with disabilities to avoid institutional placement.
314.28 		Subd. 3.Recommendations. Recommendations of the work
314.29 	group will be submitted to each participating state agency and
314.30 	to the chairs of the health and human services policy and
314.31 	finance committees of the senate and house of representatives by
314.32 	October 15, 2006.  This section expires October 15, 2006.

314.33 	Sec. 59. REPORT TO LEGISLATURE.
 314.34 	The commissioner shall report to the legislature by
314.35 	December 15, 2006, on the redesign of case management services.
314.36 	In preparing the report, the commissioner shall consult with
315.1 	representatives for consumers, consumer advocates, counties, and
315.2 	service providers.  The report shall include draft legislation
315.3 	for case management changes that will:
315.4 	(1) streamline administration;
315.5 	(2) improve consumer access to case management services;
315.6 	(3) address the use of a comprehensive universal assessment
315.7 	protocol for persons seeking community supports;
315.8 	(4) establish case management performance measures;
315.9 	(5) provide for consumer choice of the case management
315.10 	service vendor; and 
315.11 	(6) provide a method of payment for case management
315.12 	services that is cost-effective and best supports the draft
315.13 	legislation in clauses (1) to (5).

315.14 	Sec. 60. RECOMMENDATIONS FOR PROPERTY PAYMENT SYSTEM FOR
315.15 	NURSING FACILITIES.
 315.16 	The commissioner of human services shall provide
315.17 	recommendations to the legislature by February 15, 2007, on
315.18 	changes to the current nursing facility property payment system.

315.19 	Sec. 61. REPEALER.
 315.20 	Minnesota Statutes 2004, sections 514.991; 514.992;
315.21 	514.993; 514.994; and 514.995, are repealed retroactively from
315.22 	July 1, 2005.  On and after the repeal date all alternative care
315.23 	liens of record shall be of no force and effect, shall not be
315.24 	liens on real property, and examiners of title shall disregard
315.25 	these liens and shall not carry them forward to subsequent
315.26 	certificates of title.

315.27 	Sec. 62. EFFECTIVE DATE.
 315.28 	The sections in this article are effective August 1, 2005,
315.29 	unless another date is specified.

315.30 	ARTICLE 8
315.31 	HEALTH CARE - DEPARTMENT
315.32 	OF HUMAN SERVICES

315.33 	Section 1. Minnesota Statutes 2004, section 16A.724, is
315.34 	amended to read:
315.35 	16A.724 HEALTH CARE ACCESS FUND.
315.36 		Subdivision 1.Creation of fund. A health care access
316.1 	fund is created in the state treasury.  The fund is a direct
316.2 	appropriated special revenue fund.  The commissioner shall
316.3 	deposit to the credit of the fund money made available to the
316.4 	fund.  Notwithstanding section 11A.20, after June 30, 1997, all
316.5 	investment income and all investment losses attributable to the
316.6 	investment of the health care access fund not currently needed
316.7 	shall be credited to the health care access fund.
316.8 		Subd. 2.Transfers. (a) Notwithstanding section 295.581,
316.9 	to the extent available resources in the health care access fund
316.10 	exceed expenditures in that fund, starting in fiscal year 2006,
316.11 	the commissioner of finance shall transfer the excess funds from
316.12 	the health care access fund to the general fund on June 30 of
316.13 	each year as required under Laws 2003, First Special Session
316.14 	chapter 14, article 13c, section 2, subdivision 7, paragraph
316.15 	(a), plus an amount not to exceed $50,000,000.
316.16 	(b) For fiscal years 2006 to 2009, MinnesotaCare shall be a
316.17 	forecasted program, and, if necessary, the commissioner shall
316.18 	reduce these transfers from the health care access fund to the
316.19 	general fund to meet annual MinnesotaCare expenditures or, if
316.20 	necessary, transfer sufficient funds from the general fund to
316.21 	the health care access fund to meet annual MinnesotaCare
316.22 	expenditures.

316.23 	Sec. 2. [62J.84] HOSPITAL CHARGE DISCLOSURE.
316.24 	The Minnesota Hospital Association shall develop a
316.25 	Web-based system, available to the public free of charge, for
316.26 	reporting charge information, for Minnesota residents,
316.27 	including, but not limited to, number of discharges, average
316.28 	length of stay, average charge, average charge per day, and
316.29 	median charge, for each of the 50 most common inpatient
316.30 	diagnosis-related groups and the 25 most common outpatient
316.31 	surgical procedures as specified by the Minnesota Hospital
316.32 	Association.  The Web site must provide information that
316.33 	compares hospital-specific data to hospital statewide data.  The
316.34 	Web site must be established by October 1, 2006, and must be
316.35 	updated annually.  If a hospital does not provide this
316.36 	information to the Minnesota Hospital Association, the
317.1 	commissioner may require the hospital to do so.  The
317.2 	commissioner shall provide a link to this information on the
317.3 	department's Web site.

317.4 	EFFECTIVE DATE. This section is effective August 1, 2005.

317.5 	Sec. 3. Minnesota Statutes 2004, section 62Q.251, as added
317.6 	by Laws 2005, chapter 147, article 11, section 3, is amended to
317.7 	read:
317.8 	62Q.251 [DISCOUNTED PAYMENTS.]
317.9 	(a) Notwithstanding any other provision of law, a health
317.10 	care provider may provide care to a patient at a discounted
317.11 	payment amount, provided that the discount does not reduce the
317.12 	payment below the Medicare-approved payment level.
317.13 	(b) A health plan company or other insurer must not
317.14 	consider, in determining a provider's usual and customary
317.15 	payment, standard payment, or allowable payment used as a basis
317.16 	for determining the provider's payment by the health plan
317.17 	company or other insurer, the following discounted payment
317.18 	situations:
317.19 	(1) care provided to relatives of the provider; and 
317.20 	(2) care for which a discount is given for hardship
317.21 	situations; and 
317.22 	(3) care for which a discount is given in exchange for cash
317.23 	payment.
317.24 	(c) This section does not disallow Nothing in this section
317.25 	shall prohibit a provider from providing charity care for
317.26 	hardship situations in which the care is provided for free.
317.27 	(d) A provider may not charge an uninsured person more than
317.28 	the provider charges a health plan company or other insurer.

317.29 	EFFECTIVE DATE. This section is effective August 1, 2005.

317.30 	Sec. 4. Minnesota Statutes 2004, section 62Q.37,
317.31 	subdivision 7, is amended to read:
317.32 		Subd. 7.Human services. (a) The commissioner of human
317.33 	services shall implement this section in a manner that is
317.34 	consistent with applicable federal laws and regulations and that
317.35 	avoids the duplication of review activities performed by a
317.36 	nationally recognized independent organization.
318.1 	(b) By December 31 of each year, the commissioner shall
318.2 	submit to the legislature a written report identifying the
318.3 	number of audits performed by a nationally recognized
318.4 	independent organization that were accepted, partially accepted,
318.5 	or rejected by the commissioner under this section.  The
318.6 	commissioner shall provide the rationale for partial acceptance
318.7 	or rejection.  If the rationale for the partial acceptance or
318.8 	rejection was based on the commissioner's determination that the
318.9 	standards used in the audit were not equivalent to state law,
318.10 	regulation, or contract requirement, the report must document
318.11 	the variances between the audit standards and the applicable
318.12 	state requirements.
318.13 	
EFFECTIVE DATE. This section is effective August 1, 2005.

318.14 	Sec. 5. Minnesota Statutes 2004, section 256.01,
318.15 	subdivision 2, is amended to read:
318.16 		Subd. 2.Specific powers.  Subject to the provisions of
318.17 	section 241.021, subdivision 2, the commissioner of human
318.18 	services shall carry out the specific duties in paragraphs (a)
318.19 	through (aa) (cc):
318.20 	(a) Administer and supervise all forms of public assistance
318.21 	provided for by state law and other welfare activities or
318.22 	services as are vested in the commissioner.  Administration and
318.23 	supervision of human services activities or services includes,
318.24 	but is not limited to, assuring timely and accurate distribution
318.25 	of benefits, completeness of service, and quality program
318.26 	management.  In addition to administering and supervising human
318.27 	services activities vested by law in the department, the
318.28 	commissioner shall have the authority to:
318.29 	(1) require county agency participation in training and
318.30 	technical assistance programs to promote compliance with
318.31 	statutes, rules, federal laws, regulations, and policies
318.32 	governing human services;
318.33 	(2) monitor, on an ongoing basis, the performance of county
318.34 	agencies in the operation and administration of human services,
318.35 	enforce compliance with statutes, rules, federal laws,
318.36 	regulations, and policies governing welfare services and promote
319.1 	excellence of administration and program operation;
319.2 	(3) develop a quality control program or other monitoring
319.3 	program to review county performance and accuracy of benefit
319.4 	determinations;
319.5 	(4) require county agencies to make an adjustment to the
319.6 	public assistance benefits issued to any individual consistent
319.7 	with federal law and regulation and state law and rule and to
319.8 	issue or recover benefits as appropriate;
319.9 	(5) delay or deny payment of all or part of the state and
319.10 	federal share of benefits and administrative reimbursement
319.11 	according to the procedures set forth in section 256.017;
319.12 	(6) make contracts with and grants to public and private
319.13 	agencies and organizations, both profit and nonprofit, and
319.14 	individuals, using appropriated funds; and
319.15 	(7) enter into contractual agreements with federally
319.16 	recognized Indian tribes with a reservation in Minnesota to the
319.17 	extent necessary for the tribe to operate a federally approved
319.18 	family assistance program or any other program under the
319.19 	supervision of the commissioner.  The commissioner shall consult
319.20 	with the affected county or counties in the contractual
319.21 	agreement negotiations, if the county or counties wish to be
319.22 	included, in order to avoid the duplication of county and tribal
319.23 	assistance program services.  The commissioner may establish
319.24 	necessary accounts for the purposes of receiving and disbursing
319.25 	funds as necessary for the operation of the programs.
319.26 	(b) Inform county agencies, on a timely basis, of changes
319.27 	in statute, rule, federal law, regulation, and policy necessary
319.28 	to county agency administration of the programs.
319.29 	(c) Administer and supervise all child welfare activities;
319.30 	promote the enforcement of laws protecting handicapped,
319.31 	dependent, neglected and delinquent children, and children born
319.32 	to mothers who were not married to the children's fathers at the
319.33 	times of the conception nor at the births of the children;
319.34 	license and supervise child-caring and child-placing agencies
319.35 	and institutions; supervise the care of children in boarding and
319.36 	foster homes or in private institutions; and generally perform
320.1 	all functions relating to the field of child welfare now vested
320.2 	in the State Board of Control.
320.3 	(d) Administer and supervise all noninstitutional service
320.4 	to handicapped persons, including those who are visually
320.5 	impaired, hearing impaired, or physically impaired or otherwise
320.6 	handicapped.  The commissioner may provide and contract for the
320.7 	care and treatment of qualified indigent children in facilities
320.8 	other than those located and available at state hospitals when
320.9 	it is not feasible to provide the service in state hospitals.
320.10 	(e) Assist and actively cooperate with other departments,
320.11 	agencies and institutions, local, state, and federal, by
320.12 	performing services in conformity with the purposes of Laws
320.13 	1939, chapter 431.
320.14 	(f) Act as the agent of and cooperate with the federal
320.15 	government in matters of mutual concern relative to and in
320.16 	conformity with the provisions of Laws 1939, chapter 431,
320.17 	including the administration of any federal funds granted to the
320.18 	state to aid in the performance of any functions of the
320.19 	commissioner as specified in Laws 1939, chapter 431, and
320.20 	including the promulgation of rules making uniformly available
320.21 	medical care benefits to all recipients of public assistance, at
320.22 	such times as the federal government increases its participation
320.23 	in assistance expenditures for medical care to recipients of
320.24 	public assistance, the cost thereof to be borne in the same
320.25 	proportion as are grants of aid to said recipients.
320.26 	(g) Establish and maintain any administrative units
320.27 	reasonably necessary for the performance of administrative
320.28 	functions common to all divisions of the department.
320.29 	(h) Act as designated guardian of both the estate and the
320.30 	person of all the wards of the state of Minnesota, whether by
320.31 	operation of law or by an order of court, without any further
320.32 	act or proceeding whatever, except as to persons committed as
320.33 	mentally retarded.  For children under the guardianship of the
320.34 	commissioner whose interests would be best served by adoptive
320.35 	placement, the commissioner may contract with a licensed
320.36 	child-placing agency or a Minnesota tribal social services
321.1 	agency to provide adoption services.  A contract with a licensed
321.2 	child-placing agency must be designed to supplement existing
321.3 	county efforts and may not replace existing county programs,
321.4 	unless the replacement is agreed to by the county board and the
321.5 	appropriate exclusive bargaining representative or the
321.6 	commissioner has evidence that child placements of the county
321.7 	continue to be substantially below that of other counties.
321.8 	Funds encumbered and obligated under an agreement for a specific
321.9 	child shall remain available until the terms of the agreement
321.10 	are fulfilled or the agreement is terminated.
321.11 	(i) Act as coordinating referral and informational center
321.12 	on requests for service for newly arrived immigrants coming to
321.13 	Minnesota.
321.14 	(j) The specific enumeration of powers and duties as
321.15 	hereinabove set forth shall in no way be construed to be a
321.16 	limitation upon the general transfer of powers herein contained.
321.17 	(k) Establish county, regional, or statewide schedules of
321.18 	maximum fees and charges which may be paid by county agencies
321.19 	for medical, dental, surgical, hospital, nursing and nursing
321.20 	home care and medicine and medical supplies under all programs
321.21 	of medical care provided by the state and for congregate living
321.22 	care under the income maintenance programs.
321.23 	(l) Have the authority to conduct and administer
321.24 	experimental projects to test methods and procedures of
321.25 	administering assistance and services to recipients or potential
321.26 	recipients of public welfare.  To carry out such experimental
321.27 	projects, it is further provided that the commissioner of human
321.28 	services is authorized to waive the enforcement of existing
321.29 	specific statutory program requirements, rules, and standards in
321.30 	one or more counties.  The order establishing the waiver shall
321.31 	provide alternative methods and procedures of administration,
321.32 	shall not be in conflict with the basic purposes, coverage, or
321.33 	benefits provided by law, and in no event shall the duration of
321.34 	a project exceed four years.  It is further provided that no
321.35 	order establishing an experimental project as authorized by the
321.36 	provisions of this section shall become effective until the
322.1 	following conditions have been met:
322.2 	(1) the secretary of health and human services of the
322.3 	United States has agreed, for the same project, to waive state
322.4 	plan requirements relative to statewide uniformity; and
322.5 	(2) a comprehensive plan, including estimated project
322.6 	costs, shall be approved by the Legislative Advisory Commission
322.7 	and filed with the commissioner of administration.
322.8 	(m) According to federal requirements, establish procedures
322.9 	to be followed by local welfare boards in creating citizen
322.10 	advisory committees, including procedures for selection of
322.11 	committee members.
322.12 	(n) Allocate federal fiscal disallowances or sanctions
322.13 	which are based on quality control error rates for the aid to
322.14 	families with dependent children program formerly codified in
322.15 	sections 256.72 to 256.87, medical assistance, or food stamp
322.16 	program in the following manner:
322.17 	(1) one-half of the total amount of the disallowance shall
322.18 	be borne by the county boards responsible for administering the
322.19 	programs.  For the medical assistance and the AFDC program
322.20 	formerly codified in sections 256.72 to 256.87, disallowances
322.21 	shall be shared by each county board in the same proportion as
322.22 	that county's expenditures for the sanctioned program are to the
322.23 	total of all counties' expenditures for the AFDC program
322.24 	formerly codified in sections 256.72 to 256.87, and medical
322.25 	assistance programs.  For the food stamp program, sanctions
322.26 	shall be shared by each county board, with 50 percent of the
322.27 	sanction being distributed to each county in the same proportion
322.28 	as that county's administrative costs for food stamps are to the
322.29 	total of all food stamp administrative costs for all counties,
322.30 	and 50 percent of the sanctions being distributed to each county
322.31 	in the same proportion as that county's value of food stamp
322.32 	benefits issued are to the total of all benefits issued for all
322.33 	counties.  Each county shall pay its share of the disallowance
322.34 	to the state of Minnesota.  When a county fails to pay the
322.35 	amount due hereunder, the commissioner may deduct the amount
322.36 	from reimbursement otherwise due the county, or the attorney
323.1 	general, upon the request of the commissioner, may institute
323.2 	civil action to recover the amount due; and
323.3 	(2) notwithstanding the provisions of clause (1), if the
323.4 	disallowance results from knowing noncompliance by one or more
323.5 	counties with a specific program instruction, and that knowing
323.6 	noncompliance is a matter of official county board record, the
323.7 	commissioner may require payment or recover from the county or
323.8 	counties, in the manner prescribed in clause (1), an amount
323.9 	equal to the portion of the total disallowance which resulted
323.10 	from the noncompliance, and may distribute the balance of the
323.11 	disallowance according to clause (1).
323.12 	(o) Develop and implement special projects that maximize
323.13 	reimbursements and result in the recovery of money to the
323.14 	state.  For the purpose of recovering state money, the
323.15 	commissioner may enter into contracts with third parties.  Any
323.16 	recoveries that result from projects or contracts entered into
323.17 	under this paragraph shall be deposited in the state treasury
323.18 	and credited to a special account until the balance in the
323.19 	account reaches $1,000,000.  When the balance in the account
323.20 	exceeds $1,000,000, the excess shall be transferred and credited
323.21 	to the general fund.  All money in the account is appropriated
323.22 	to the commissioner for the purposes of this paragraph.
323.23 	(p) Have the authority to make direct payments to
323.24 	facilities providing shelter to women and their children
323.25 	according to section 256D.05, subdivision 3.  Upon the written
323.26 	request of a shelter facility that has been denied payments
323.27 	under section 256D.05, subdivision 3, the commissioner shall
323.28 	review all relevant evidence and make a determination within 30
323.29 	days of the request for review regarding issuance of direct
323.30 	payments to the shelter facility.  Failure to act within 30 days
323.31 	shall be considered a determination not to issue direct payments.
323.32 	(q) Have the authority to establish and enforce the
323.33 	following county reporting requirements:
323.34 	(1) the commissioner shall establish fiscal and statistical
323.35 	reporting requirements necessary to account for the expenditure
323.36 	of funds allocated to counties for human services programs.
324.1 	When establishing financial and statistical reporting
324.2 	requirements, the commissioner shall evaluate all reports, in
324.3 	consultation with the counties, to determine if the reports can
324.4 	be simplified or the number of reports can be reduced;
324.5 	(2) the county board shall submit monthly or quarterly
324.6 	reports to the department as required by the commissioner.
324.7 	Monthly reports are due no later than 15 working days after the
324.8 	end of the month.  Quarterly reports are due no later than 30
324.9 	calendar days after the end of the quarter, unless the
324.10 	commissioner determines that the deadline must be shortened to
324.11 	20 calendar days to avoid jeopardizing compliance with federal
324.12 	deadlines or risking a loss of federal funding.  Only reports
324.13 	that are complete, legible, and in the required format shall be
324.14 	accepted by the commissioner;
324.15 	(3) if the required reports are not received by the
324.16 	deadlines established in clause (2), the commissioner may delay
324.17 	payments and withhold funds from the county board until the next
324.18 	reporting period.  When the report is needed to account for the
324.19 	use of federal funds and the late report results in a reduction
324.20 	in federal funding, the commissioner shall withhold from the
324.21 	county boards with late reports an amount equal to the reduction
324.22 	in federal funding until full federal funding is received;
324.23 	(4) a county board that submits reports that are late,
324.24 	illegible, incomplete, or not in the required format for two out
324.25 	of three consecutive reporting periods is considered
324.26 	noncompliant.  When a county board is found to be noncompliant,
324.27 	the commissioner shall notify the county board of the reason the
324.28 	county board is considered noncompliant and request that the
324.29 	county board develop a corrective action plan stating how the
324.30 	county board plans to correct the problem.  The corrective
324.31 	action plan must be submitted to the commissioner within 45 days
324.32 	after the date the county board received notice of
324.33 	noncompliance;
324.34 	(5) the final deadline for fiscal reports or amendments to
324.35 	fiscal reports is one year after the date the report was
324.36 	originally due.  If the commissioner does not receive a report
325.1 	by the final deadline, the county board forfeits the funding
325.2 	associated with the report for that reporting period and the
325.3 	county board must repay any funds associated with the report
325.4 	received for that reporting period;
325.5 	(6) the commissioner may not delay payments, withhold
325.6 	funds, or require repayment under clause (3) or (5) if the
325.7 	county demonstrates that the commissioner failed to provide
325.8 	appropriate forms, guidelines, and technical assistance to
325.9 	enable the county to comply with the requirements.  If the
325.10 	county board disagrees with an action taken by the commissioner
325.11 	under clause (3) or (5), the county board may appeal the action
325.12 	according to sections 14.57 to 14.69; and
325.13 	(7) counties subject to withholding of funds under clause
325.14 	(3) or forfeiture or repayment of funds under clause (5) shall
325.15 	not reduce or withhold benefits or services to clients to cover
325.16 	costs incurred due to actions taken by the commissioner under
325.17 	clause (3) or (5).
325.18 	(r) Allocate federal fiscal disallowances or sanctions for
325.19 	audit exceptions when federal fiscal disallowances or sanctions
325.20 	are based on a statewide random sample for the foster care
325.21 	program under title IV-E of the Social Security Act, United
325.22 	States Code, title 42, in direct proportion to each county's
325.23 	title IV-E foster care maintenance claim for that period.
325.24 	(s) Be responsible for ensuring the detection, prevention,
325.25 	investigation, and resolution of fraudulent activities or
325.26 	behavior by applicants, recipients, and other participants in
325.27 	the human services programs administered by the department.
325.28 	(t) Require county agencies to identify overpayments,
325.29 	establish claims, and utilize all available and cost-beneficial
325.30 	methodologies to collect and recover these overpayments in the
325.31 	human services programs administered by the department.
325.32 	(u) Have the authority to administer a drug rebate program
325.33 	for drugs purchased pursuant to the prescription drug program
325.34 	established under section 256.955 after the beneficiary's
325.35 	satisfaction of any deductible established in the program.  The
325.36 	commissioner shall require a rebate agreement from all
326.1 	manufacturers of covered drugs as defined in section 256B.0625,
326.2 	subdivision 13.  Rebate agreements for prescription drugs
326.3 	delivered on or after July 1, 2002, must include rebates for
326.4 	individuals covered under the prescription drug program who are
326.5 	under 65 years of age.  For each drug, the amount of the rebate
326.6 	shall be equal to the rebate as defined for purposes of the
326.7 	federal rebate program in United States Code, title 42, section
326.8 	1396r-8.  The manufacturers must provide full payment within 30
326.9 	days of receipt of the state invoice for the rebate within the
326.10 	terms and conditions used for the federal rebate program
326.11 	established pursuant to section 1927 of title XIX of the Social
326.12 	Security Act.  The manufacturers must provide the commissioner
326.13 	with any information necessary to verify the rebate determined
326.14 	per drug.  The rebate program shall utilize the terms and
326.15 	conditions used for the federal rebate program established
326.16 	pursuant to section 1927 of title XIX of the Social Security Act.
326.17 	(v) Have the authority to administer the federal drug
326.18 	rebate program for drugs purchased under the medical assistance
326.19 	program as allowed by section 1927 of title XIX of the Social
326.20 	Security Act and according to the terms and conditions of
326.21 	section 1927.  Rebates shall be collected for all drugs that
326.22 	have been dispensed or administered in an outpatient setting and
326.23 	that are from manufacturers who have signed a rebate agreement
326.24 	with the United States Department of Health and Human Services.
326.25 	(w) Have the authority to administer a supplemental drug
326.26 	rebate program for drugs purchased under the medical assistance
326.27 	program.  The commissioner may enter into supplemental rebate
326.28 	contracts with pharmaceutical manufacturers and may require
326.29 	prior authorization for drugs that are from manufacturers that
326.30 	have not signed a supplemental rebate contract.  Prior
326.31 	authorization of drugs shall be subject to the provisions of
326.32 	section 256B.0625, subdivision 13.
326.33 	(x) Operate the department's communication systems account
326.34 	established in Laws 1993, First Special Session chapter 1,
326.35 	article 1, section 2, subdivision 2, to manage shared
326.36 	communication costs necessary for the operation of the programs
327.1 	the commissioner supervises.  A communications account may also
327.2 	be established for each regional treatment center which operates
327.3 	communications systems.  Each account must be used to manage
327.4 	shared communication costs necessary for the operations of the
327.5 	programs the commissioner supervises.  The commissioner may
327.6 	distribute the costs of operating and maintaining communication
327.7 	systems to participants in a manner that reflects actual usage.
327.8 	Costs may include acquisition, licensing, insurance,
327.9 	maintenance, repair, staff time and other costs as determined by
327.10 	the commissioner.  Nonprofit organizations and state, county,
327.11 	and local government agencies involved in the operation of
327.12 	programs the commissioner supervises may participate in the use
327.13 	of the department's communications technology and share in the
327.14 	cost of operation.  The commissioner may accept on behalf of the
327.15 	state any gift, bequest, devise or personal property of any
327.16 	kind, or money tendered to the state for any lawful purpose
327.17 	pertaining to the communication activities of the department.
327.18 	Any money received for this purpose must be deposited in the
327.19 	department's communication systems accounts.  Money collected by
327.20 	the commissioner for the use of communication systems must be
327.21 	deposited in the state communication systems account and is
327.22 	appropriated to the commissioner for purposes of this section.
327.23 	(y) Receive any federal matching money that is made
327.24 	available through the medical assistance program for the
327.25 	consumer satisfaction survey.  Any federal money received for
327.26 	the survey is appropriated to the commissioner for this
327.27 	purpose.  The commissioner may expend the federal money received
327.28 	for the consumer satisfaction survey in either year of the
327.29 	biennium.
327.30 	(z) Designate community information and referral call
327.31 	centers and incorporate cost reimbursement claims from the
327.32 	designated community information and referral call centers into
327.33 	the federal cost reimbursement claiming processes of the
327.34 	department according to federal law, rule, and regulations.
327.35 	Existing information and referral centers provided by Greater
327.36 	Twin Cities United Way or existing call centers for which
328.1 	Greater Twin Cities United Way has legal authority to represent,
328.2 	shall be included in these designations upon review by the
328.3 	commissioner and assurance that these services are accredited
328.4 	and in compliance with national standards.  Any reimbursement is
328.5 	appropriated to the commissioner and all designated information
328.6 	and referral centers shall receive payments according to normal
328.7 	department schedules established by the commissioner upon final
328.8 	approval of allocation methodologies from the United States
328.9 	Department of Health and Human Services Division of Cost
328.10 	Allocation or other appropriate authorities.
328.11 	(aa) Develop recommended standards for foster care homes
328.12 	that address the components of specialized therapeutic services
328.13 	to be provided by foster care homes with those services.
328.14 	(bb) Have the authority to administer a drug rebate program
328.15 	for drugs purchased for persons eligible for general assistance
328.16 	medical care under section 256D.03, subdivision 3.  For
328.17 	manufacturers that agree to participate in the general
328.18 	assistance medical care rebate program, the commissioner shall
328.19 	enter into a rebate agreement for covered drugs as defined in
328.20 	section 256B.0625, subdivisions 13 and 13d.  For each drug, the
328.21 	amount of the rebate shall be equal to the rebate as defined for
328.22 	purposes of the federal rebate program in United States Code,
328.23 	title 42, section 1396r-8.  The manufacturers must provide
328.24 	payment within the terms and conditions used for the federal
328.25 	rebate program established under section 1927 of title XIX of
328.26 	the Social Security Act.  The rebate program shall utilize the
328.27 	terms and conditions used for the federal rebate program
328.28 	established under section 1927 of title XIX of the Social
328.29 	Security Act.
328.30 	Effective January 1, 2006, drug coverage under general
328.31 	assistance medical care shall be limited to those prescription
328.32 	drugs that:
328.33 	(1) are covered under the medical assistance program as
328.34 	described in section 256B.0625, subdivisions 13 and 13d; and 
328.35 	(2) are provided by manufacturers that have fully executed
328.36 	general assistance medical care rebate agreements with the
329.1 	commissioner and comply with such agreements.  Prescription drug
329.2 	coverage under general assistance medical care shall conform to
329.3 	coverage under the medical assistance program according to
329.4 	section 256B.0625, subdivisions 13 to 13g.
329.5 	The rebate revenues collected under the drug rebate program
329.6 	are deposited in the general fund.
329.7 	
EFFECTIVE DATE. This section is effective August 1, 2005.

329.8 	Sec. 6. Minnesota Statutes 2004, section 256.01, is
329.9 	amended by adding a subdivision to read:
329.10 		Subd. 2a.Authorization for test sites for health care
329.11 	programs. In coordination with the development and
329.12 	implementation of HealthMatch, an automated eligibility system
329.13 	for medical assistance, general assistance medical care, and
329.14 	MinnesotaCare, the commissioner, in cooperation with county
329.15 	agencies, is authorized to test and compare a variety of
329.16 	administrative models to demonstrate and evaluate outcomes of
329.17 	integrating health care program business processes and points of
329.18 	access.  The models will be evaluated for ease of enrollment for
329.19 	health care program applicants and recipients and administrative
329.20 	efficiencies.  Test sites will combine the administration of all
329.21 	three programs and will include both local county and
329.22 	centralized statewide customer assistance.  The duration of each
329.23 	approved test site shall be no more than one year.  Based on the
329.24 	evaluation, the commissioner shall recommend the most efficient
329.25 	and effective administrative model for statewide implementation.
329.26 	
EFFECTIVE DATE. This section is effective retroactively
329.27 	from July 1, 2005.

329.28 	Sec. 7. Minnesota Statutes 2004, section 256.019,
329.29 	subdivision 1, is amended to read:
329.30 		Subdivision 1.Retention rates.  When an assistance
329.31 	recovery amount is collected and posted by a county agency under
329.32 	the provisions governing public assistance programs including
329.33 	general assistance medical care, general assistance, and
329.34 	Minnesota supplemental aid, the county may keep one-half of the
329.35 	recovery made by the county agency using any method other than
329.36 	recoupment.  For medical assistance, if the recovery is made by
330.1 	a county agency using any method other than recoupment, the
330.2 	county may keep one-half of the nonfederal share of the recovery.
330.3 	For MinnesotaCare, if the recovery is collected and posted by
330.4 	the county agency, the county may keep one-half of the
330.5 	nonfederal share of the recovery.
330.6 	This does not apply to recoveries from medical providers or
330.7 	to recoveries begun by the Department of Human Services'
330.8 	Surveillance and Utilization Review Division, State Hospital
330.9 	Collections Unit, and the Benefit Recoveries Division or, by the
330.10 	attorney general's office, or child support collections.  In the
330.11 	food stamp or food support program, the nonfederal share of
330.12 	recoveries in the federal tax offset program only will be
330.13 	divided equally between the state agency and the involved county
330.14 	agency.
330.15 	
EFFECTIVE DATE. This section is effective retroactively
330.16 	from July 1, 2005.

330.17 	Sec. 8. Minnesota Statutes 2004, section 256.045,
330.18 	subdivision 3, as amended by Laws 2005, chapter 98, article 3,
330.19 	section 18, is amended to read:
330.20 		Subd. 3.State agency hearings. (a) State agency
330.21 	hearings are available for the following:  (1) any person
330.22 	applying for, receiving or having received public assistance,
330.23 	medical care, or a program of social services granted by the
330.24 	state agency or a county agency or the federal Food Stamp Act
330.25 	whose application for assistance is denied, not acted upon with
330.26 	reasonable promptness, or whose assistance is suspended,
330.27 	reduced, terminated, or claimed to have been incorrectly paid;
330.28 	(2) any patient or relative aggrieved by an order of the
330.29 	commissioner under section 252.27; (3) a party aggrieved by a
330.30 	ruling of a prepaid health plan; (4) except as provided under
330.31 	chapter 245C, any individual or facility determined by a lead
330.32 	agency to have maltreated a vulnerable adult under section
330.33 	626.557 after they have exercised their right to administrative
330.34 	reconsideration under section 626.557; (5) any person whose
330.35 	claim for foster care payment according to a placement of the
330.36 	child resulting from a child protection assessment under section
331.1 	626.556 is denied or not acted upon with reasonable promptness,
331.2 	regardless of funding source; (6) any person to whom a right of
331.3 	appeal according to this section is given by other provision of
331.4 	law; (7) an applicant aggrieved by an adverse decision to an
331.5 	application for a hardship waiver under section 256B.15; (8) an
331.6 	applicant aggrieved by an adverse decision to an application or
331.7 	redetermination for a Medicare Part D prescription drug subsidy
331.8 	under section 256B.04, subdivision 4a; (9) except as provided
331.9 	under chapter 245A, an individual or facility determined to have
331.10 	maltreated a minor under section 626.556, after the individual
331.11 	or facility has exercised the right to administrative
331.12 	reconsideration under section 626.556; or (9) (10) except as
331.13 	provided under chapter 245C, an individual disqualified under
331.14 	sections 245C.14 and 245C.15, on the basis of serious or
331.15 	recurring maltreatment; a preponderance of the evidence that the
331.16 	individual has committed an act or acts that meet the definition
331.17 	of any of the crimes listed in section 245C.15, subdivisions 1
331.18 	to 4; or for failing to make reports required under section
331.19 	626.556, subdivision 3, or 626.557, subdivision 3.  Hearings
331.20 	regarding a maltreatment determination under clause (4)
331.21 	or (8) (9) and a disqualification under this clause in which the
331.22 	basis for a disqualification is serious or recurring
331.23 	maltreatment, which has not been set aside under sections
331.24 	245C.22 and 245C.23, shall be consolidated into a single fair
331.25 	hearing.  In such cases, the scope of review by the human
331.26 	services referee shall include both the maltreatment
331.27 	determination and the disqualification.  The failure to exercise
331.28 	the right to an administrative reconsideration shall not be a
331.29 	bar to a hearing under this section if federal law provides an
331.30 	individual the right to a hearing to dispute a finding of
331.31 	maltreatment.  Individuals and organizations specified in this
331.32 	section may contest the specified action, decision, or final
331.33 	disposition before the state agency by submitting a written
331.34 	request for a hearing to the state agency within 30 days after
331.35 	receiving written notice of the action, decision, or final
331.36 	disposition, or within 90 days of such written notice if the
332.1 	applicant, recipient, patient, or relative shows good cause why
332.2 	the request was not submitted within the 30-day time limit.
332.3 	The hearing for an individual or facility under clause (4),
332.4 	(8) (9), or (9) (10) is the only administrative appeal to the
332.5 	final agency determination specifically, including a challenge
332.6 	to the accuracy and completeness of data under section 13.04.
332.7 	Hearings requested under clause (4) apply only to incidents of
332.8 	maltreatment that occur on or after October 1, 1995.  Hearings
332.9 	requested by nursing assistants in nursing homes alleged to have
332.10 	maltreated a resident prior to October 1, 1995, shall be held as
332.11 	a contested case proceeding under the provisions of chapter 14.
332.12 	Hearings requested under clause (8) (9) apply only to incidents
332.13 	of maltreatment that occur on or after July 1, 1997.  A hearing
332.14 	for an individual or facility under clause (8) (9) is only
332.15 	available when there is no juvenile court or adult criminal
332.16 	action pending.  If such action is filed in either court while
332.17 	an administrative review is pending, the administrative review
332.18 	must be suspended until the judicial actions are completed.  If
332.19 	the juvenile court action or criminal charge is dismissed or the
332.20 	criminal action overturned, the matter may be considered in an
332.21 	administrative hearing.
332.22 	For purposes of this section, bargaining unit grievance
332.23 	procedures are not an administrative appeal.
332.24 	The scope of hearings involving claims to foster care
332.25 	payments under clause (5) shall be limited to the issue of
332.26 	whether the county is legally responsible for a child's
332.27 	placement under court order or voluntary placement agreement
332.28 	and, if so, the correct amount of foster care payment to be made
332.29 	on the child's behalf and shall not include review of the
332.30 	propriety of the county's child protection determination or
332.31 	child placement decision.
332.32 	(b) A vendor of medical care as defined in section 256B.02,
332.33 	subdivision 7, or a vendor under contract with a county agency
332.34 	to provide social services is not a party and may not request a
332.35 	hearing under this section, except if assisting a recipient as
332.36 	provided in subdivision 4.
333.1 	(c) An applicant or recipient is not entitled to receive
333.2 	social services beyond the services prescribed under chapter
333.3 	256M or other social services the person is eligible for under
333.4 	state law.
333.5 	(d) The commissioner may summarily affirm the county or
333.6 	state agency's proposed action without a hearing when the sole
333.7 	issue is an automatic change due to a change in state or federal
333.8 	law.
333.9 	
EFFECTIVE DATE. This section is effective retroactively
333.10 	from July 1, 2005.

333.11 	Sec. 9. Minnesota Statutes 2004, section 256.045,
333.12 	subdivision 3a, is amended to read:
333.13 		Subd. 3a.Prepaid health plan appeals.  (a) All prepaid
333.14 	health plans under contract to the commissioner under chapter
333.15 	256B or 256D must provide for a complaint system according to
333.16 	section 62D.11.  When a prepaid health plan denies, reduces, or
333.17 	terminates a health service or denies a request to authorize a
333.18 	previously authorized health service, the prepaid health plan
333.19 	must notify the recipient of the right to file a complaint or an
333.20 	appeal.  The notice must include the name and telephone number
333.21 	of the ombudsman and notice of the recipient's right to request
333.22 	a hearing under paragraph (b). When a complaint is filed, the
333.23 	prepaid health plan must notify the ombudsman within three
333.24 	working days.Recipients may request the assistance of the
333.25 	ombudsman in the complaint system process.  The prepaid health
333.26 	plan must issue a written resolution of the complaint to the
333.27 	recipient within 30 days after the complaint is filed with the
333.28 	prepaid health plan.  A recipient is not required to exhaust the
333.29 	complaint system procedures in order to request a hearing under
333.30 	paragraph (b).
333.31 	(b) Recipients enrolled in a prepaid health plan under
333.32 	chapter 256B or 256D may contest a prepaid health plan's denial,
333.33 	reduction, or termination of health services, a prepaid health
333.34 	plan's denial of a request to authorize a previously authorized
333.35 	health service, or the prepaid health plan's written resolution
333.36 	of a complaint by submitting a written request for a hearing
334.1 	according to subdivision 3.  A state human services referee
334.2 	shall conduct a hearing on the matter and shall recommend an
334.3 	order to the commissioner of human services.  The commissioner
334.4 	need not grant a hearing if the sole issue raised by a recipient
334.5 	is the commissioner's authority to require mandatory enrollment
334.6 	in a prepaid health plan in a county where prepaid health plans
334.7 	are under contract with the commissioner.  The state human
334.8 	services referee may order a second medical opinion from the
334.9 	prepaid health plan or may order a second medical opinion from a
334.10 	nonprepaid health plan provider at the expense of the prepaid
334.11 	health plan.  Recipients may request the assistance of the
334.12 	ombudsman in the appeal process.
334.13 	(c) In the written request for a hearing to appeal from a
334.14 	prepaid health plan's denial, reduction, or termination of a
334.15 	health service, a prepaid health plan's denial of a request to
334.16 	authorize a previously authorized service, or the prepaid health
334.17 	plan's written resolution to a complaint, a recipient may
334.18 	request an expedited hearing.  If an expedited appeal is
334.19 	warranted, the state human services referee shall hear the
334.20 	appeal and render a decision within a time commensurate with the
334.21 	level of urgency involved, based on the individual circumstances
334.22 	of the case.
334.23 	
EFFECTIVE DATE. This section is effective retroactively
334.24 	from July 1, 2005.

334.25 	Sec. 10. Minnesota Statutes 2004, section 256.046,
334.26 	subdivision 1, is amended to read:
334.27 		Subdivision 1.Hearing authority.  A local agency must
334.28 	initiate an administrative fraud disqualification hearing for
334.29 	individuals, including child care providers caring for children
334.30 	receiving child care assistance, accused of wrongfully obtaining
334.31 	assistance or intentional program violations, in lieu of a
334.32 	criminal action when it has not been pursued, in the aid to
334.33 	families with dependent children program formerly codified in
334.34 	sections 256.72 to 256.87, MFIP, the diversionary work program,
334.35 	child care assistance programs, general assistance, family
334.36 	general assistance program formerly codified in section 256D.05,
335.1 	subdivision 1, clause (15), Minnesota supplemental aid, food
335.2 	stamp programs, general assistance medical care, MinnesotaCare
335.3 	for adults without children, and upon federal approval, all
335.4 	categories of medical assistance and remaining categories of
335.5 	MinnesotaCare except for children through age 18. The
335.6 	Department of Human Services, in lieu of a local agency, may
335.7 	initiate an administrative fraud disqualification hearing when
335.8 	the state agency is directly responsible for administration of
335.9 	the health care program for which benefits were wrongfully
335.10 	obtained.The hearing is subject to the requirements of section
335.11 	256.045 and the requirements in Code of Federal Regulations,
335.12 	title 7, section 273.16, for the food stamp program and title
335.13 	45, section 235.112, as of September 30, 1995, for the cash
335.14 	grant, medical care programs, and child care assistance under
335.15 	chapter 119B.
335.16 	
EFFECTIVE DATE. This section is effective retroactively
335.17 	from July 1, 2005.

335.18 	Sec. 11. Minnesota Statutes 2004, section 256.9657, is
335.19 	amended by adding a subdivision to read:
335.20 		Subd. 7a.Withholding. If any provider obligated to pay
335.21 	an annual surcharge under this section is more than two months
335.22 	delinquent in the timely payment of a monthly surcharge
335.23 	installment payment, the provisions in paragraphs (a) to (f)
335.24 	apply.
335.25 	(a) The department may withhold some or all of the amount
335.26 	of the delinquent surcharge, together with any interest and
335.27 	penalties due and owing on those amounts, from any money the
335.28 	department owes to the provider.  The department may, at its
335.29 	discretion, also withhold future surcharge installment payments
335.30 	from any money the department owes the provider as those
335.31 	installments become due and owing.  The department may continue
335.32 	this withholding until the department determines there in no
335.33 	longer any need to do so.
335.34 	(b) The department shall give prior notice of the
335.35 	department's intention to withhold by mailing a written notice
335.36 	to the provider at the address to which remittance advices are
336.1 	mailed or faxing a copy of the notice to the provider at least
336.2 	ten business days before the date of the first payment period
336.3 	for which the withholding begins.  The notice may be sent by
336.4 	ordinary or certified mail, or facsimile, and shall be deemed
336.5 	received as of the date of mailing or receipt of the facsimile.
336.6 	The notice shall:
336.7 	(i) state the amount of the delinquent surcharge;
336.8 	(ii) state the amount of the withholding per payment
336.9 	period;
336.10 	(iii) state the date on which the withholding is to begin;
336.11 	(iv) state whether the department intends to withhold
336.12 	future installments of the provider's surcharge payments;
336.13 	(v) inform the provider of their rights to informally
336.14 	object to the proposed withholding and to appeal the withholding
336.15 	as provided for in this subdivision;
336.16 	(vi) state that the provider may prevent the withholding
336.17 	during the pendency of their appeal by posting a bond; and 
336.18 	(vii) state other contents as the department deems
336.19 	appropriate.
336.20 	(c) The provider may informally object to the withholding
336.21 	in writing anytime before the withholding begins.  An informal
336.22 	objection shall not stay or delay the commencement of the
336.23 	withholding.  The department may postpone the commencement of
336.24 	the withholding as deemed appropriate and shall not be required
336.25 	to give another notice at the end of the postponement and before
336.26 	commencing the withholding.  The provider shall have the right
336.27 	to appeal any withholding from remittances by filing an appeal
336.28 	with Ramsey County District Court and serving notice of the
336.29 	appeal on the department within 30 days of the date of the
336.30 	written notice of the withholding.  Notice shall be given and
336.31 	the appeal shall be heard no later than 45 days after the appeal
336.32 	is filed.  In a hearing of the appeal, the department's action
336.33 	shall be sustained if the department proves the amount of the
336.34 	delinquent surcharges or overpayment the provider owes, plus any
336.35 	accrued interest and penalties, has not been repaid.  The
336.36 	department may continue withholding for delinquent and current
337.1 	surcharge installment payments during the pendency of an appeal
337.2 	unless the provider posts a bond from a surety company licensed
337.3 	to do business in Minnesota in favor of the department in an
337.4 	amount equal to two times the provider's total annual surcharge
337.5 	payment for the fiscal year in which the appeal is filed with
337.6 	the department.
337.7 	(d) The department shall refund any amounts due to the
337.8 	provider under any final administrative or judicial order or
337.9 	decree which fully and finally resolves the appeal together with
337.10 	interest on those amounts at the rate of three percent per annum
337.11 	simple interest computed from the date of each withholding, as
337.12 	soon as practical after entry of the order or decree.
337.13 	(e) The commissioner, or the commissioner's designee, may
337.14 	enter into written settlement agreements with a provider to
337.15 	resolve disputes and other matters involving unpaid surcharge
337.16 	installment payments or future surcharge installment payments.
337.17 	(f) Notwithstanding any law to the contrary, all unpaid
337.18 	surcharges, plus any accrued interest and penalties, shall be
337.19 	overpayments for purposes of section 256B.0641.
337.20 	
EFFECTIVE DATE. This section is effective retroactively
337.21 	from July 1, 2005.

337.22 	Sec. 12. Minnesota Statutes 2004, section 256.969,
337.23 	subdivision 3a, is amended to read:
337.24 		Subd. 3a.Payments.  (a) Acute care hospital billings
337.25 	under the medical assistance program must not be submitted until
337.26 	the recipient is discharged.  However, the commissioner shall
337.27 	establish monthly interim payments for inpatient hospitals that
337.28 	have individual patient lengths of stay over 30 days regardless
337.29 	of diagnostic category.  Except as provided in section 256.9693,
337.30 	medical assistance reimbursement for treatment of mental illness
337.31 	shall be reimbursed based on diagnostic classifications.
337.32 	Individual hospital payments established under this section and
337.33 	sections 256.9685, 256.9686, and 256.9695, in addition to third
337.34 	party and recipient liability, for discharges occurring during
337.35 	the rate year shall not exceed, in aggregate, the charges for
337.36 	the medical assistance covered inpatient services paid for the
338.1 	same period of time to the hospital.  This payment limitation
338.2 	shall be calculated separately for medical assistance and
338.3 	general assistance medical care services.  The limitation on
338.4 	general assistance medical care shall be effective for
338.5 	admissions occurring on or after July 1, 1991.  Services that
338.6 	have rates established under subdivision 11 or 12, must be
338.7 	limited separately from other services.  After consulting with
338.8 	the affected hospitals, the commissioner may consider related
338.9 	hospitals one entity and may merge the payment rates while
338.10 	maintaining separate provider numbers.  The operating and
338.11 	property base rates per admission or per day shall be derived
338.12 	from the best Medicare and claims data available when rates are
338.13 	established.  The commissioner shall determine the best Medicare
338.14 	and claims data, taking into consideration variables of recency
338.15 	of the data, audit disposition, settlement status, and the
338.16 	ability to set rates in a timely manner.  The commissioner shall
338.17 	notify hospitals of payment rates by December 1 of the year
338.18 	preceding the rate year.  The rate setting data must reflect the
338.19 	admissions data used to establish relative values.  Base year
338.20 	changes from 1981 to the base year established for the rate year
338.21 	beginning January 1, 1991, and for subsequent rate years, shall
338.22 	not be limited to the limits ending June 30, 1987, on the
338.23 	maximum rate of increase under subdivision 1.  The commissioner
338.24 	may adjust base year cost, relative value, and case mix index
338.25 	data to exclude the costs of services that have been
338.26 	discontinued by the October 1 of the year preceding the rate
338.27 	year or that are paid separately from inpatient services.
338.28 	Inpatient stays that encompass portions of two or more rate
338.29 	years shall have payments established based on payment rates in
338.30 	effect at the time of admission unless the date of admission
338.31 	preceded the rate year in effect by six months or more.  In this
338.32 	case, operating payment rates for services rendered during the
338.33 	rate year in effect and established based on the date of
338.34 	admission shall be adjusted to the rate year in effect by the
338.35 	hospital cost index.
338.36 	(b) For fee-for-service admissions occurring on or after
339.1 	July 1, 2002, the total payment, before third-party liability
339.2 	and spenddown, made to hospitals for inpatient services is
339.3 	reduced by .5 percent from the current statutory rates.
339.4 	(c) In addition to the reduction in paragraph (b), the
339.5 	total payment for fee-for-service admissions occurring on or
339.6 	after July 1, 2003, made to hospitals for inpatient services
339.7 	before third-party liability and spenddown, is reduced five
339.8 	percent from the current statutory rates.  Mental health
339.9 	services within diagnosis related groups 424 to 432, and
339.10 	facilities defined under subdivision 16 are excluded from this
339.11 	paragraph.
339.12 	(d) In addition to the reduction in paragraphs (b) and (c),
339.13 	the total payment for fee-for-service admissions occurring on or
339.14 	after July 1, 2005, made to hospitals for inpatient services
339.15 	before third-party liability and spenddown, is reduced 6.0
339.16 	percent from the current statutory rates.  Mental health
339.17 	services within diagnosis related groups 424 to 432 and
339.18 	facilities defined under subdivision 16 are excluded from this
339.19 	paragraph.  Notwithstanding section 256.9686, subdivision 7, for
339.20 	purposes of this paragraph, medical assistance does not include
339.21 	general assistance medical care.  Payments made to managed care
339.22 	plans shall be reduced for services provided on or after January
339.23 	1, 2006, to reflect this reduction.
339.24 	
EFFECTIVE DATE. This section is effective August 1, 2005.

339.25 	Sec. 13. Minnesota Statutes 2004, section 256.969,
339.26 	subdivision 9, is amended to read:
339.27 		Subd. 9.Disproportionate numbers of low-income patients
339.28 	served.  (a) For admissions occurring on or after October 1,
339.29 	1992, through December 31, 1992, the medical assistance
339.30 	disproportionate population adjustment shall comply with federal
339.31 	law and shall be paid to a hospital, excluding regional
339.32 	treatment centers and facilities of the federal Indian Health
339.33 	Service, with a medical assistance inpatient utilization rate in
339.34 	excess of the arithmetic mean.  The adjustment must be
339.35 	determined as follows:
339.36 	(1) for a hospital with a medical assistance inpatient
340.1 	utilization rate above the arithmetic mean for all hospitals
340.2 	excluding regional treatment centers and facilities of the
340.3 	federal Indian Health Service but less than or equal to one
340.4 	standard deviation above the mean, the adjustment must be
340.5 	determined by multiplying the total of the operating and
340.6 	property payment rates by the difference between the hospital's
340.7 	actual medical assistance inpatient utilization rate and the
340.8 	arithmetic mean for all hospitals excluding regional treatment
340.9 	centers and facilities of the federal Indian Health Service; and
340.10 	(2) for a hospital with a medical assistance inpatient
340.11 	utilization rate above one standard deviation above the mean,
340.12 	the adjustment must be determined by multiplying the adjustment
340.13 	that would be determined under clause (1) for that hospital by
340.14 	1.1.  If federal matching funds are not available for all
340.15 	adjustments under this subdivision, the commissioner shall
340.16 	reduce payments on a pro rata basis so that all adjustments
340.17 	qualify for federal match.  The commissioner may establish a
340.18 	separate disproportionate population operating payment rate
340.19 	adjustment under the general assistance medical care program.
340.20 	For purposes of this subdivision medical assistance does not
340.21 	include general assistance medical care.  The commissioner shall
340.22 	report annually on the number of hospitals likely to receive the
340.23 	adjustment authorized by this paragraph.  The commissioner shall
340.24 	specifically report on the adjustments received by public
340.25 	hospitals and public hospital corporations located in cities of
340.26 	the first class.
340.27 	(b) For admissions occurring on or after July 1, 1993, the
340.28 	medical assistance disproportionate population adjustment shall
340.29 	comply with federal law and shall be paid to a hospital,
340.30 	excluding regional treatment centers and facilities of the
340.31 	federal Indian Health Service, with a medical assistance
340.32 	inpatient utilization rate in excess of the arithmetic mean.
340.33 	The adjustment must be determined as follows:
340.34 	(1) for a hospital with a medical assistance inpatient
340.35 	utilization rate above the arithmetic mean for all hospitals
340.36 	excluding regional treatment centers and facilities of the
341.1 	federal Indian Health Service but less than or equal to one
341.2 	standard deviation above the mean, the adjustment must be
341.3 	determined by multiplying the total of the operating and
341.4 	property payment rates by the difference between the hospital's
341.5 	actual medical assistance inpatient utilization rate and the
341.6 	arithmetic mean for all hospitals excluding regional treatment
341.7 	centers and facilities of the federal Indian Health Service;
341.8 	(2) for a hospital with a medical assistance inpatient
341.9 	utilization rate above one standard deviation above the mean,
341.10 	the adjustment must be determined by multiplying the adjustment
341.11 	that would be determined under clause (1) for that hospital by
341.12 	1.1.  The commissioner may establish a separate disproportionate
341.13 	population operating payment rate adjustment under the general
341.14 	assistance medical care program.  For purposes of this
341.15 	subdivision, medical assistance does not include general
341.16 	assistance medical care.  The commissioner shall report annually
341.17 	on the number of hospitals likely to receive the adjustment
341.18 	authorized by this paragraph.  The commissioner shall
341.19 	specifically report on the adjustments received by public
341.20 	hospitals and public hospital corporations located in cities of
341.21 	the first class; and 
341.22 	(3) for a hospital that had medical assistance
341.23 	fee-for-service payment volume during calendar year 1991 in
341.24 	excess of 13 percent of total medical assistance fee-for-service
341.25 	payment volume, a medical assistance disproportionate population
341.26 	adjustment shall be paid in addition to any other
341.27 	disproportionate payment due under this subdivision as follows:
341.28 	$1,515,000 due on the 15th of each month after noon, beginning
341.29 	July 15, 1995.  For a hospital that had medical assistance
341.30 	fee-for-service payment volume during calendar year 1991 in
341.31 	excess of eight percent of total medical assistance
341.32 	fee-for-service payment volume and was the primary hospital
341.33 	affiliated with the University of Minnesota, a medical
341.34 	assistance disproportionate population adjustment shall be paid
341.35 	in addition to any other disproportionate payment due under this
341.36 	subdivision as follows:  $505,000 due on the 15th of each month
342.1 	after noon, beginning July 15, 1995; and 
342.2 	(4) effective August 1, 2005, the payments in paragraph
342.3 	(b), clause (3), shall be reduced to zero.
342.4 	(c) The commissioner shall adjust rates paid to a health
342.5 	maintenance organization under contract with the commissioner to
342.6 	reflect rate increases provided in paragraph (b), clauses (1)
342.7 	and (2), on a nondiscounted hospital-specific basis but shall
342.8 	not adjust those rates to reflect payments provided in clause
342.9 	(3).
342.10 	(d) If federal matching funds are not available for all
342.11 	adjustments under paragraph (b), the commissioner shall reduce
342.12 	payments under paragraph (b), clauses (1) and (2), on a pro rata
342.13 	basis so that all adjustments under paragraph (b) qualify for
342.14 	federal match.
342.15 	(e) For purposes of this subdivision, medical assistance
342.16 	does not include general assistance medical care.
342.17 	(f) For hospital services occurring on or after July 1,
342.18 	2005, to June 30, 2007, general assistance medical care
342.19 	expenditures made by the department and by prepaid health plans
342.20 	participating in general assistance medical care shall be
342.21 	considered Medicaid disproportionate share hospital payments,
342.22 	except as limited below:
342.23 	(1) only the portion of Minnesota's disproportionate share
342.24 	hospital allotment under section 1923(f) of the Social Security
342.25 	Act that is not spent on the disproportionate population
342.26 	adjustments in paragraph (b), clauses (1) and (2), may be used
342.27 	for general assistance medical care expenditures;
342.28 	(2) only those general assistance medical care expenditures
342.29 	made to hospitals that qualify for disproportionate share
342.30 	payments under section 1923 of the Social Security Act and the
342.31 	Medicaid state plan may be considered disproportionate share
342.32 	hospital payments;
342.33 	(3) only those general assistance medical care expenditures
342.34 	made to an individual hospital that would not cause the hospital
342.35 	to exceed its individual hospital limits under section 1923 of
342.36 	the Social Security Act may be considered; and 
343.1 	(4) general assistance medical care expenditures may be
343.2 	considered only to the extent of Minnesota's aggregate allotment
343.3 	under section 1923 of the Social Security Act.
343.4 	All hospitals and prepaid health plans participating in general
343.5 	assistance medical care must provide any necessary expenditure,
343.6 	cost, and revenue information required by the commissioner as
343.7 	necessary for purposes of obtaining federal Medicaid matching
343.8 	funds for general assistance medical care expenditures.
343.9 	
EFFECTIVE DATE. Upon federal approval of the related
343.10 	state plan amendment, paragraph (f) is effective retroactively
343.11 	from July 1, 2005, or the earliest effective date approved by
343.12 	the Centers for Medicare and Medicaid Services.

343.13 	Sec. 14. Minnesota Statutes 2004, section 256.969,
343.14 	subdivision 26, is amended to read:
343.15 		Subd. 26.Greater minnesota payment adjustment after june
343.16 	30, 2001.  (a) For admissions occurring after June 30, 2001, the
343.17 	commissioner shall pay fee-for-service inpatient admissions for
343.18 	the diagnosis-related groups specified in paragraph (b) at
343.19 	hospitals located outside of the seven-county metropolitan area
343.20 	at the higher of:
343.21 	(1) the hospital's current payment rate for the diagnostic
343.22 	category to which the diagnosis-related group belongs, exclusive
343.23 	of disproportionate population adjustments received under
343.24 	subdivision 9 and hospital payment adjustments received under
343.25 	subdivision 23; or
343.26 	(2) 90 percent of the average payment rate for that
343.27 	diagnostic category for hospitals located within the
343.28 	seven-county metropolitan area, exclusive of disproportionate
343.29 	population adjustments received under subdivision 9 and hospital
343.30 	payment adjustments received under subdivisions 20 and 23. The
343.31 	commissioner may adjust this percentage each year so that the
343.32 	estimated payment increases under this paragraph are equal to
343.33 	the funding provided under section 256B.195 for this purpose.
343.34 	(b) The payment increases provided in paragraph (a) apply
343.35 	to the following diagnosis-related groups, as they fall within
343.36 	the diagnostic categories:
344.1 	(1) 370 cesarean section with complicating diagnosis;
344.2 	(2) 371 cesarean section without complicating diagnosis;
344.3 	(3) 372 vaginal delivery with complicating diagnosis;
344.4 	(4) 373 vaginal delivery without complicating diagnosis;
344.5 	(5) 386 extreme immaturity and respiratory distress
344.6 	syndrome, neonate;
344.7 	(6) 388 full-term neonates with other problems;
344.8 	(7) 390 prematurity without major problems;
344.9 	(8) 391 normal newborn;
344.10 	(9) 385 neonate, died or transferred to another acute care
344.11 	facility;
344.12 	(10) 425 acute adjustment reaction and psychosocial
344.13 	dysfunction;
344.14 	(11) 430 psychoses;
344.15 	(12) 431 childhood mental disorders; and
344.16 	(13) 164-167 appendectomy.
344.17 	
EFFECTIVE DATE. This section is effective August 1, 2005.

344.18 	Sec. 15. Minnesota Statutes 2004, section 256.969, is
344.19 	amended by adding a subdivision to read:
344.20 		Subd. 27.Quarterly payment adjustment. (a) In addition
344.21 	to any other payment under this section, the commissioner shall
344.22 	make the following payments effective July 1, 2007:
344.23 	(1) for a hospital located in Minnesota and not eligible
344.24 	for payments under subdivision 20, with a medical assistance
344.25 	inpatient utilization rate greater than 17.8 percent of total
344.26 	patient days as of the base year in effect on July 1, 2005, a
344.27 	payment equal to 13 percent of the total of the operating and
344.28 	property payment rates;
344.29 	(2) for a hospital located in Minnesota in a specified
344.30 	urban area outside of the seven-county metropolitan area and not
344.31 	eligible for payments under subdivision 20, with a medical
344.32 	assistance inpatient utilization rate less than or equal to 17.8
344.33 	percent of total patient days as of the base year in effect on
344.34 	July 1, 2005, a payment equal to ten percent of the total of the
344.35 	operating and property payment rates.  For purposes of this
344.36 	clause, the following cities are specified urban areas:  Detroit
345.1 	Lakes, Rochester, Willmar, Alexandria, Austin, Cambridge,
345.2 	Brainerd, Hibbing, Mankato, Duluth, St. Cloud, Grand Rapids,
345.3 	Wyoming, Fergus Falls, Albert Lea, Winona, Virginia, Thief River
345.4 	Falls, and Wadena; and 
345.5 	(3) for a hospital located in Minnesota but not located in
345.6 	a specified urban area under clause (2), with a medical
345.7 	assistance inpatient utilization rate less than or equal to 17.8
345.8 	percent of total patient days as of the base year in effect on
345.9 	July 1, 2005, a payment equal to four percent of the total of
345.10 	the operating and property payment rates.  A hospital located in
345.11 	Woodbury and not in existence during the base year shall be
345.12 	reimbursed under this clause.
345.13 	(b) The state share of payments under paragraph (a) shall
345.14 	be equal to federal reimbursements to the commissioner to
345.15 	reimburse nonstate expenditures reported under section
345.16 	256B.199.  The commissioner shall ratably reduce or increase
345.17 	payments under this subdivision in order to ensure that these
345.18 	payments equal the amount of reimbursement received by the
345.19 	commissioner under section 256B.199, except that payments shall
345.20 	be ratably reduced by an amount equivalent to the state share of
345.21 	a four percent reduction in MinnesotaCare and medical assistance
345.22 	payments for inpatient hospital services.
345.23 	(c) The payments under paragraph (a) shall be paid
345.24 	quarterly beginning on July 15, 2007, or upon federal approval
345.25 	of federal reimbursements under section 256B.199, whichever
345.26 	occurs later.
345.27 	(d) The commissioner shall not adjust rates paid to a
345.28 	prepaid health plan under contract with the commissioner to
345.29 	reflect payments provided in paragraph (a).
345.30 	(e) The commissioner shall maximize the use of available
345.31 	federal money for disproportionate share hospital payments and
345.32 	shall maximize payments to qualifying hospitals.  In order to
345.33 	accomplish these purposes, the commissioner may, in consultation
345.34 	with the nonstate entities identified in section 256B.199,
345.35 	adjust, on a pro rata basis if feasible, the amounts reported by
345.36 	nonstate entities under section 256B.199 when application for
346.1 	reimbursement is made to the federal government, and otherwise
346.2 	adjust the provisions of this subdivision.
346.3 	(f) By January 15 of each year, beginning January 15, 2006,
346.4 	the commissioner shall report to the chairs of the house and
346.5 	senate finance committees and divisions with jurisdiction over
346.6 	funding for the Department of Human Services the following
346.7 	estimates for the current and upcoming federal and state fiscal
346.8 	years:
346.9 	(1) the difference between the Medicare upper payment limit
346.10 	and actual or anticipated medical assistance payments for
346.11 	hospital services;
346.12 	(2) the amount of federal disproportionate share hospital
346.13 	funding available to Minnesota and the amount expected to be
346.14 	claimed by the state; and 
346.15 	(3) the methodology used to calculate the results reported
346.16 	for clauses (1) and (2).
346.17 	(g) For purposes of this subdivision, medical assistance
346.18 	does not include general assistance medical care.
346.19 	(h) This section sunsets on June 30, 2009.  The
346.20 	commissioner shall report to the legislature by December 15,
346.21 	2008, with recommendations for maximizing federal
346.22 	disproportionate share hospital payments after June 30, 2009.
346.23 	
EFFECTIVE DATE. This section is effective August 1, 2005.

346.24 	Sec. 16. Minnesota Statutes 2004, section 256.975,
346.25 	subdivision 9, is amended to read:
346.26 		Subd. 9.Prescription drug assistance. (a) The Minnesota
346.27 	Board on Aging shall establish and administer a prescription
346.28 	drug assistance program to assist individuals in accessing
346.29 	programs offered by pharmaceutical manufacturers that provide
346.30 	free or discounted prescription drugs or provide coverage for
346.31 	prescription drugs.  The board shall use computer software
346.32 	programs to:
346.33 	(1) list eligibility requirements for pharmaceutical
346.34 	assistance programs offered by manufacturers;
346.35 	(2) list drugs that are included in a supplemental rebate
346.36 	contract between the commissioner and a pharmaceutical
347.1 	manufacturer under section 256.01, subdivision 2, clause (23);
347.2 	and
347.3 	(3) link individuals with the pharmaceutical assistance
347.4 	programs most appropriate for the individual.  The board shall
347.5 	make information on the prescription drug assistance program
347.6 	available to interested individuals and health care providers
347.7 	and shall coordinate the program with the statewide information
347.8 	and assistance service provided through the Senior LinkAge Line
347.9 	under subdivision 7.
347.10 	(b) The board shall work with the commissioner and county
347.11 	social service agencies to coordinate the enrollment of
347.12 	individuals who are referred to the prescription drug assistance
347.13 	program from the prescription drug program, as required under
347.14 	section 256.955, subdivision 4a.
347.15 	
EFFECTIVE DATE. This section is effective January 1, 2006.

347.16 	Sec. 17. Minnesota Statutes 2004, section 256B.02,
347.17 	subdivision 12, is amended to read:
347.18 		Subd. 12.Third-party payer.  "Third-party payer" means a
347.19 	person, entity, or agency or government program that has a
347.20 	probable obligation to pay all or part of the costs of a medical
347.21 	assistance recipient's health services. Third-party payer
347.22 	includes an entity under contract with the recipient to cover
347.23 	all or part of the recipient's medical costs.
347.24 	
EFFECTIVE DATE. This section is effective retroactively
347.25 	from July 1, 2005.

347.26 	Sec. 18. Minnesota Statutes 2004, section 256B.04, is
347.27 	amended by adding a subdivision to read:
347.28 		Subd. 4a.Medicare prescription drug subsidy. The
347.29 	commissioner shall perform all duties necessary to administer
347.30 	eligibility determinations for the Medicare Part D prescription
347.31 	drug subsidy and facilitate the enrollment of eligible medical
347.32 	assistance recipients into Medicare prescription drug plans as
347.33 	required by the Medicare Prescription Drug, Improvement, and
347.34 	Modernization Act of 2003 (MMA), Public Law 108-173, and Code of
347.35 	Federal Regulations, title 42, sections 423.30 to 423.56 and
347.36 	423.771 to 423.800.
348.1 	
EFFECTIVE DATE. This section is effective retroactively
348.2 	from July 1, 2005.

348.3 	Sec. 19. Minnesota Statutes 2004, section 256B.055, is
348.4 	amended by adding a subdivision to read:
348.5 		Subd. 14.Persons detained by law. (a) Medical
348.6 	assistance may be paid for an inmate of a correctional facility
348.7 	who is conditionally released as authorized under section
348.8 	241.26, 244.065, or 631.425, if the individual does not require
348.9 	the security of a public detention facility and is housed in a
348.10 	halfway house or community correction center, or under house
348.11 	arrest and monitored by electronic surveillance in a residence
348.12 	approved by the commissioner of corrections, and if the
348.13 	individual meets the other eligibility requirements of this
348.14 	chapter.
348.15 	(b) An individual, regardless of age, who is considered an
348.16 	inmate of a public institution as defined in Code of Federal
348.17 	Regulations, title 42, section 435.1009, is not eligible for
348.18 	medical assistance.
348.19 	
EFFECTIVE DATE. This section is effective retroactively
348.20 	from July 1, 2005.

348.21 	Sec. 20. Minnesota Statutes 2004, section 256B.056, is
348.22 	amended by adding a subdivision to read:
348.23 		Subd. 3d.Reduction of excess assets. Assets in excess
348.24 	of the limits in subdivisions 3 to 3c may be reduced to
348.25 	allowable limits as follows:
348.26 	(a) Assets may be reduced in any of the three calendar
348.27 	months before the month of application in which the applicant
348.28 	seeks coverage by:
348.29 	(1) designating burial funds up to $1,500 for each
348.30 	applicant, spouse, and MA-eligible dependent child; and 
348.31 	(2) paying health service bills incurred in the retroactive
348.32 	period for which the applicant seeks eligibility, starting with
348.33 	the oldest bill.  After assets are reduced to allowable limits,
348.34 	eligibility begins with the next dollar of MA-covered health
348.35 	services incurred in the retroactive period.  Applicants
348.36 	reducing assets under this subdivision who also have excess
349.1 	income shall first spend excess assets to pay health service
349.2 	bills and may meet the income spenddown on remaining bills.
349.3 	(b) Assets may be reduced beginning the month of
349.4 	application by:
349.5 	(1) paying bills for health services that would otherwise
349.6 	be paid by medical assistance; and 
349.7 	(2) using any means other than a transfer of assets for
349.8 	less than fair market value as defined in section 256B.0595,
349.9 	subdivision 1, paragraph (b).
349.10 	
EFFECTIVE DATE. This section is effective retroactively
349.11 	from July 1, 2005.

349.12 	Sec. 21. Minnesota Statutes 2004, section 256B.056,
349.13 	subdivision 5, is amended to read:
349.14 		Subd. 5.Excess income.  A person who has excess income
349.15 	is eligible for medical assistance if the person has expenses
349.16 	for medical care that are more than the amount of the person's
349.17 	excess income, computed by deducting incurred medical expenses
349.18 	from the excess income to reduce the excess to the income
349.19 	standard specified in subdivision 5c.  The person shall elect to
349.20 	have the medical expenses deducted at the beginning of a
349.21 	one-month budget period or at the beginning of a six-month
349.22 	budget period.  The commissioner shall allow persons eligible
349.23 	for assistance on a one-month spenddown basis under this
349.24 	subdivision to elect to pay the monthly spenddown amount in
349.25 	advance of the month of eligibility to the state agency in order
349.26 	to maintain eligibility on a continuous basis.  If the recipient
349.27 	does not pay the spenddown amount on or before the 20th last
349.28 	business day of the month, the recipient is ineligible for this
349.29 	option for the following month.  The local agency shall code the
349.30 	Medicaid Management Information System (MMIS) to indicate that
349.31 	the recipient has elected this option.  The state agency shall
349.32 	convey recipient eligibility information relative to the
349.33 	collection of the spenddown to providers through the Electronic
349.34 	Verification System (EVS).  A recipient electing advance payment
349.35 	must pay the state agency the monthly spenddown amount on or
349.36 	before noon on the 20th last business day of the month in order
350.1 	to be eligible for this option in the following month.
350.2 	
EFFECTIVE DATE. This section is effective August 1, 2007,
350.3 	or upon HealthMatch implementation, whichever is later.

350.4 	Sec. 22. Minnesota Statutes 2004, section 256B.056,
350.5 	subdivision 5a, is amended to read:
350.6 		Subd. 5a.Individuals on fixed or excluded income.
 350.7 	Recipients of medical assistance who receive only fixed unearned
350.8 	or excluded income, when that income is excluded from
350.9 	consideration as income or unvarying in amount and timing of
350.10 	receipt throughout the year, shall report and verify their
350.11 	income annually every 12 months.  The 12-month period begins
350.12 	with the month of application.
350.13 	
EFFECTIVE DATE. This section is effective August 1, 2007,
350.14 	or upon HealthMatch implementation, whichever is later.

350.15 	Sec. 23. Minnesota Statutes 2004, section 256B.056,
350.16 	subdivision 5b, is amended to read:
350.17 		Subd. 5b.Individuals with low income.  Recipients of
350.18 	medical assistance not residing in a long-term care facility who
350.19 	have slightly fluctuating income which is below the medical
350.20 	assistance income limit shall report and verify their income on
350.21 	a semiannual basis every six months.  The six-month period
350.22 	begins the month of application.
350.23 	
EFFECTIVE DATE. This section is effective August 1, 2007,
350.24 	or upon HealthMatch implementation, whichever is later.

350.25 	Sec. 24. Minnesota Statutes 2004, section 256B.056,
350.26 	subdivision 7, is amended to read:
350.27 		Subd. 7.Period of eligibility.  Eligibility is available
350.28 	for the month of application and for three months prior to
350.29 	application if the person was eligible in those prior
350.30 	months. Eligibility for months prior to application is
350.31 	determined independently from eligibility for the month of
350.32 	application and future months.A redetermination of eligibility
350.33 	must occur every 12 months. The 12-month period begins with the
350.34 	month of application.
350.35 	
EFFECTIVE DATE. This section is effective August 1, 2007,
350.36 	or upon HealthMatch implementation, whichever is later.

351.1 	Sec. 25. Minnesota Statutes 2004, section 256B.056, is
351.2 	amended by adding a subdivision to read:
351.3 		Subd. 9.Notice. The state agency must be given notice
351.4 	of monetary claims against a person, entity, or corporation that
351.5 	may be liable to pay all or part of the cost of medical care
351.6 	when the state agency has paid or becomes liable for the cost of
351.7 	that care.  Notice must be given according to paragraphs (a) to
351.8 	(d).
351.9 	(a) An applicant for medical assistance shall notify the
351.10 	state or local agency of any possible claims when the applicant
351.11 	submits the application.  A recipient of medical assistance
351.12 	shall notify the state or local agency of any possible claims
351.13 	when those claims arise.
351.14 	(b) A person providing medical care services to a recipient
351.15 	of medical assistance shall notify the state agency when the
351.16 	person has reason to believe that a third party may be liable
351.17 	for payment of the cost of medical care.
351.18 	(c) A party to a claim that may be assigned to the state
351.19 	agency under this section shall notify the state agency of its
351.20 	potential assignment claim in writing at each of the following
351.21 	stages of a claim:
351.22 	(1) when a claim is filed;
351.23 	(2) when an action is commenced; and 
351.24 	(3) when a claim is concluded by payment, award, judgment,
351.25 	settlement, or otherwise.
351.26 	(d) Every party involved in any stage of a claim under this
351.27 	subdivision is required to provide notice to the state agency at
351.28 	that stage of the claim.  However, when one of the parties to
351.29 	the claim provides notice at that stage, every other party to
351.30 	the claim is deemed to have provided the required notice for
351.31 	that stage of the claim.  If the required notice under this
351.32 	paragraph is not provided to the state agency, all parties to
351.33 	the claim are deemed to have failed to provide the required
351.34 	notice.  A party to the claim includes the injured person or the
351.35 	person's legal representative, the plaintiff, the defendants, or
351.36 	persons alleged to be responsible for compensating the injured
352.1 	person or plaintiff, and any other party to the cause of action
352.2 	or claim, regardless of whether the party knows the state agency
352.3 	has a potential or actual assignment claim.
352.4 	
EFFECTIVE DATE. This section is effective August 1, 2005.

352.5 	Sec. 26. Minnesota Statutes 2004, section 256B.056, is
352.6 	amended by adding a subdivision to read:
352.7 		Subd. 10.Eligibility verification. (a) The commissioner
352.8 	shall require women who are applying for the continuation of
352.9 	medical assistance coverage following the end of the 60-day
352.10 	postpartum period to update their income and asset information
352.11 	and to submit any required income or asset verification.
352.12 	(b) The commissioner shall determine the eligibility of
352.13 	private-sector health care coverage for infants less than one
352.14 	year of age eligible under section 256B.055, subdivision 10, or
352.15 	256B.057, subdivision 1, paragraph (d), and shall pay for
352.16 	private-sector coverage if this is determined to be
352.17 	cost-effective.
352.18 	(c) The commissioner shall modify the application for
352.19 	Minnesota health care programs to require more detailed
352.20 	information related to verification of assets and income, and
352.21 	shall verify assets and income for all applicants, and for all
352.22 	recipients upon renewal.
352.23 	(d) The commissioner shall require Minnesota health care
352.24 	program recipients to report new or an increase in earned income
352.25 	within ten days of the change, and to verify new or an increase
352.26 	in earned income that affects eligibility within ten days of
352.27 	notification by the agency that the new or increased earned
352.28 	income affects eligibility.  Recipients who fail to verify new
352.29 	or an increase in earned income that affects eligibility shall
352.30 	be disenrolled.
352.31 	
EFFECTIVE DATE. This section is effective September 1,
352.32 	2005, except that paragraph (a) is effective September 1, 2005,
352.33 	or upon federal approval, whichever is later.  Prior to the
352.34 	implementation of HealthMatch, the commissioner shall implement
352.35 	this section to the fullest extent possible, including the use
352.36 	of manual processing.  Upon implementation of HealthMatch, the
353.1 	commissioner shall implement this section in a manner consistent
353.2 	with the procedures and requirements of HealthMatch.

353.3 	Sec. 27. Minnesota Statutes 2004, section 256B.0575, is
353.4 	amended to read:
353.5 	256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
353.6 	PERSONS.
353.7 	When an institutionalized person is determined eligible for
353.8 	medical assistance, the income that exceeds the deductions in
353.9 	paragraphs (a) and (b) must be applied to the cost of
353.10 	institutional care.
353.11 	(a) The following amounts must be deducted from the
353.12 	institutionalized person's income in the following order:
353.13 	(1) the personal needs allowance under section 256B.35 or,
353.14 	for a veteran who does not have a spouse or child, or a
353.15 	surviving spouse of a veteran having no child, the amount of an
353.16 	improved pension received from the veteran's administration not
353.17 	exceeding $90 per month;
353.18 	(2) the personal allowance for disabled individuals under
353.19 	section 256B.36;
353.20 	(3) if the institutionalized person has a legally appointed
353.21 	guardian or conservator, five percent of the recipient's gross
353.22 	monthly income up to $100 as reimbursement for guardianship or
353.23 	conservatorship services;
353.24 	(4) a monthly income allowance determined under section
353.25 	256B.058, subdivision 2, but only to the extent income of the
353.26 	institutionalized spouse is made available to the community
353.27 	spouse;
353.28 	(5) a monthly allowance for children under age 18 which,
353.29 	together with the net income of the children, would provide
353.30 	income equal to the medical assistance standard for families and
353.31 	children according to section 256B.056, subdivision 4, for a
353.32 	family size that includes only the minor children.  This
353.33 	deduction applies only if the children do not live with the
353.34 	community spouse and only to the extent that the deduction is
353.35 	not included in the personal needs allowance under section
353.36 	256B.35, subdivision 1, as child support garnished under a court
354.1 	order;
354.2 	(6) a monthly family allowance for other family members,
354.3 	equal to one-third of the difference between 122 percent of the
354.4 	federal poverty guidelines and the monthly income for that
354.5 	family member;
354.6 	(7) reparations payments made by the Federal Republic of
354.7 	Germany and reparations payments made by the Netherlands for
354.8 	victims of Nazi persecution between 1940 and 1945;
354.9 	(8) all other exclusions from income for institutionalized
354.10 	persons as mandated by federal law; and
354.11 	(9) amounts for reasonable expenses incurred for necessary
354.12 	medical or remedial care for the institutionalized person that
354.13 	are not medical assistance covered expenses and that are not
354.14 	subject to payment by a third party.
354.15 	Reasonable expenses are limited to expenses that have not
354.16 	been previously used as a deduction from income and are incurred
354.17 	during the enrollee's current period of eligibility, including
354.18 	retroactive months associated with the current period of
354.19 	eligibility, for medical assistance payment of long-term care
354.20 	services.
354.21 	For purposes of clause (6), "other family member" means a
354.22 	person who resides with the community spouse and who is a minor
354.23 	or dependent child, dependent parent, or dependent sibling of
354.24 	either spouse.  "Dependent" means a person who could be claimed
354.25 	as a dependent for federal income tax purposes under the
354.26 	Internal Revenue Code.
354.27 	(b) Income shall be allocated to an institutionalized
354.28 	person for a period of up to three calendar months, in an amount
354.29 	equal to the medical assistance standard for a family size of
354.30 	one if:
354.31 	(1) a physician certifies that the person is expected to
354.32 	reside in the long-term care facility for three calendar months
354.33 	or less;
354.34 	(2) if the person has expenses of maintaining a residence
354.35 	in the community; and
354.36 	(3) if one of the following circumstances apply:
355.1 	(i) the person was not living together with a spouse or a
355.2 	family member as defined in paragraph (a) when the person
355.3 	entered a long-term care facility; or
355.4 	(ii) the person and the person's spouse become
355.5 	institutionalized on the same date, in which case the allocation
355.6 	shall be applied to the income of one of the spouses.
355.7 	For purposes of this paragraph, a person is determined to be
355.8 	residing in a licensed nursing home, regional treatment center,
355.9 	or medical institution if the person is expected to remain for a
355.10 	period of one full calendar month or more.

355.11 	EFFECTIVE DATE. This section is effective retroactively
355.12 	from July 1, 2005.

355.13 	Sec. 28. Minnesota Statutes 2004, section 256B.06,
355.14 	subdivision 4, is amended to read:
355.15 		Subd. 4.Citizenship requirements.  (a) Eligibility for
355.16 	medical assistance is limited to citizens of the United States,
355.17 	qualified noncitizens as defined in this subdivision, and other
355.18 	persons residing lawfully in the United States.
355.19 	(b) "Qualified noncitizen" means a person who meets one of
355.20 	the following immigration criteria:
355.21 	(1) admitted for lawful permanent residence according to
355.22 	United States Code, title 8;
355.23 	(2) admitted to the United States as a refugee according to
355.24 	United States Code, title 8, section 1157;
355.25 	(3) granted asylum according to United States Code, title
355.26 	8, section 1158;
355.27 	(4) granted withholding of deportation according to United
355.28 	States Code, title 8, section 1253(h);
355.29 	(5) paroled for a period of at least one year according to
355.30 	United States Code, title 8, section 1182(d)(5);
355.31 	(6) granted conditional entrant status according to United
355.32 	States Code, title 8, section 1153(a)(7);
355.33 	(7) determined to be a battered noncitizen by the United
355.34 	States Attorney General according to the Illegal Immigration
355.35 	Reform and Immigrant Responsibility Act of 1996, title V of the
355.36 	Omnibus Consolidated Appropriations Bill, Public Law 104-200;
356.1 	(8) is a child of a noncitizen determined to be a battered
356.2 	noncitizen by the United States Attorney General according to
356.3 	the Illegal Immigration Reform and Immigrant Responsibility Act
356.4 	of 1996, title V, of the Omnibus Consolidated Appropriations
356.5 	Bill, Public Law 104-200; or
356.6 	(9) determined to be a Cuban or Haitian entrant as defined
356.7 	in section 501(e) of Public Law 96-422, the Refugee Education
356.8 	Assistance Act of 1980.
356.9 	(c) All qualified noncitizens who were residing in the
356.10 	United States before August 22, 1996, who otherwise meet the
356.11 	eligibility requirements of this chapter, are eligible for
356.12 	medical assistance with federal financial participation.
356.13 	(d) All qualified noncitizens who entered the United States
356.14 	on or after August 22, 1996, and who otherwise meet the
356.15 	eligibility requirements of this chapter, are eligible for
356.16 	medical assistance with federal financial participation through
356.17 	November 30, 1996.
356.18 	Beginning December 1, 1996, qualified noncitizens who
356.19 	entered the United States on or after August 22, 1996, and who
356.20 	otherwise meet the eligibility requirements of this chapter are
356.21 	eligible for medical assistance with federal participation for
356.22 	five years if they meet one of the following criteria:
356.23 	(i) refugees admitted to the United States according to
356.24 	United States Code, title 8, section 1157;
356.25 	(ii) persons granted asylum according to United States
356.26 	Code, title 8, section 1158;
356.27 	(iii) persons granted withholding of deportation according
356.28 	to United States Code, title 8, section 1253(h);
356.29 	(iv) veterans of the United States armed forces with an
356.30 	honorable discharge for a reason other than noncitizen status,
356.31 	their spouses and unmarried minor dependent children; or
356.32 	(v) persons on active duty in the United States armed
356.33 	forces, other than for training, their spouses and unmarried
356.34 	minor dependent children.
356.35 	Beginning December 1, 1996, qualified noncitizens who do
356.36 	not meet one of the criteria in items (i) to (v) are eligible
357.1 	for medical assistance without federal financial participation
357.2 	as described in paragraph (j).
357.3 	(e) Noncitizens who are not qualified noncitizens as
357.4 	defined in paragraph (b), who are lawfully residing in the
357.5 	United States and who otherwise meet the eligibility
357.6 	requirements of this chapter, are eligible for medical
357.7 	assistance under clauses (1) to (3).  These individuals must
357.8 	cooperate with the Immigration and Naturalization Service to
357.9 	pursue any applicable immigration status, including citizenship,
357.10 	that would qualify them for medical assistance with federal
357.11 	financial participation.
357.12 	(1) Persons who were medical assistance recipients on
357.13 	August 22, 1996, are eligible for medical assistance with
357.14 	federal financial participation through December 31, 1996.
357.15 	(2) Beginning January 1, 1997, persons described in clause
357.16 	(1) are eligible for medical assistance without federal
357.17 	financial participation as described in paragraph (j).
357.18 	(3) Beginning December 1, 1996, persons residing in the
357.19 	United States prior to August 22, 1996, who were not receiving
357.20 	medical assistance and persons who arrived on or after August
357.21 	22, 1996, are eligible for medical assistance without federal
357.22 	financial participation as described in paragraph (j).
357.23 	(f) Nonimmigrants who otherwise meet the eligibility
357.24 	requirements of this chapter are eligible for the benefits as
357.25 	provided in paragraphs (g) to (i).  For purposes of this
357.26 	subdivision, a "nonimmigrant" is a person in one of the classes
357.27 	listed in United States Code, title 8, section 1101(a)(15).
357.28 	(g) Payment shall also be made for care and services that
357.29 	are furnished to noncitizens, regardless of immigration status,
357.30 	who otherwise meet the eligibility requirements of this chapter,
357.31 	if such care and services are necessary for the treatment of an
357.32 	emergency medical condition, except for organ transplants and
357.33 	related care and services and routine prenatal care.
357.34 	(h) For purposes of this subdivision, the term "emergency
357.35 	medical condition" means a medical condition that meets the
357.36 	requirements of United States Code, title 42, section 1396b(v).
358.1 	(i) Pregnant noncitizens who are undocumented or ,
358.2 	nonimmigrants, or eligible for medical assistance as described
358.3 	in paragraph (j), and who are not covered by a group health plan
358.4 	or health insurance coverage according to Code of Federal
358.5 	Regulations, title 42, section 457.310, and who otherwise meet
358.6 	the eligibility requirements of this chapter, are eligible for
358.7 	medical assistance payment without federal financial
358.8 	participation for care and services through the period of
358.9 	pregnancy, and including labor and delivery, to the extent
358.10 	federal funds are available under Title XXI of the Social
358.11 	Security Act, and the state children's health insurance program,
358.12 	followed by 60 days postpartum, except for labor and
358.13 	delivery without federal financial participation.
358.14 	(j) Qualified noncitizens as described in paragraph (d),
358.15 	and all other noncitizens lawfully residing in the United States
358.16 	as described in paragraph (e), who are ineligible for medical
358.17 	assistance with federal financial participation and who
358.18 	otherwise meet the eligibility requirements of chapter 256B and
358.19 	of this paragraph, are eligible for medical assistance without
358.20 	federal financial participation.  Qualified noncitizens as
358.21 	described in paragraph (d) are only eligible for medical
358.22 	assistance without federal financial participation for five
358.23 	years from their date of entry into the United States.
358.24 	(k) Beginning October 1, 2003, persons who are receiving
358.25 	care and rehabilitation services from a nonprofit center
358.26 	established to serve victims of torture and are otherwise
358.27 	ineligible for medical assistance under this chapter are
358.28 	eligible for medical assistance without federal financial
358.29 	participation.  These individuals are eligible only for the
358.30 	period during which they are receiving services from the
358.31 	center.  Individuals eligible under this paragraph shall not be
358.32 	required to participate in prepaid medical assistance.
358.33 	
EFFECTIVE DATE. This section is effective September 1,
358.34 	2005.

358.35 	Sec. 29. Minnesota Statutes 2004, section 256B.0625, is
358.36 	amended by adding a subdivision to read:
359.1 		Subd. 1a.Services provided in a hospital emergency
359.2 	room. Medical assistance does not cover visits to a hospital
359.3 	emergency room that are not for emergency and emergency
359.4 	poststabilization care or urgent care, and does not pay for any
359.5 	services provided in a hospital emergency room that are not for
359.6 	emergency and emergency poststabilization care or urgent care.
359.7 	
EFFECTIVE DATE. This section is effective October 1, 2005.

359.8 	Sec. 30. Minnesota Statutes 2004, section 256B.0625,
359.9 	subdivision 3a, is amended to read:
359.10 		Subd. 3a.gender sex reassignment surgery. Gender Sex 
359.11 	reassignment surgery and other gender reassignment medical
359.12 	procedures including drug therapy for gender reassignment are is 
359.13 	not covered unless the individual began receiving gender
359.14 	reassignment services prior to July 1, 1998.
359.15 	
EFFECTIVE DATE. This section is effective August 1, 2005.

359.16 	Sec. 31. Minnesota Statutes 2004, section 256B.0625, is
359.17 	amended by adding a subdivision to read:
359.18 		Subd. 3f.Circumcision for newborns. Newborn
359.19 	circumcision is not covered, unless the procedure is medically
359.20 	necessary or required because of a well-established religious
359.21 	practice.
359.22 	
EFFECTIVE DATE. This section is effective September 1,
359.23 	2005, and applies to services provided on or after that date.

359.24 	Sec. 32. Minnesota Statutes 2004, section 256B.0625,
359.25 	subdivision 9, is amended to read:
359.26 		Subd. 9.Dental services. (a) Medical assistance covers
359.27 	dental services.  Dental services include, with prior
359.28 	authorization, fixed bridges that are cost-effective for persons
359.29 	who cannot use removable dentures because of their medical
359.30 	condition.
359.31 	(b) Coverage of dental services for adults age 21 and over
359.32 	who are not pregnant is subject to a $500 annual benefit limit
359.33 	and covered services are limited to:
359.34 	(1) diagnostic and preventative services;
359.35 	(2) restorative services; and 
359.36 	(3) emergency services.
360.1 	Emergency services, dentures, and extractions related to
360.2 	dentures are not included in the $500 annual benefit limit.
360.3 	
EFFECTIVE DATE. This section is effective January 1, 2006.

360.4 	Sec. 33. Minnesota Statutes 2004, section 256B.0625,
360.5 	subdivision 13, is amended to read:
360.6 		Subd. 13.Drugs.  (a) Medical assistance covers drugs,
360.7 	except for fertility drugs when specifically used to enhance
360.8 	fertility, if prescribed by a licensed practitioner and
360.9 	dispensed by a licensed pharmacist, by a physician enrolled in
360.10 	the medical assistance program as a dispensing physician, or by
360.11 	a physician or a nurse practitioner employed by or under
360.12 	contract with a community health board as defined in section
360.13 	145A.02, subdivision 5, for the purposes of communicable disease
360.14 	control.
360.15 	(b) The dispensed quantity of a prescription drug must not
360.16 	exceed a 34-day supply, unless authorized by the commissioner.
360.17 	(c) Medical assistance covers the following
360.18 	over-the-counter drugs when prescribed by a licensed
360.19 	practitioner or by a licensed pharmacist who meets standards
360.20 	established by the commissioner, in consultation with the board
360.21 	of pharmacy:  antacids, acetaminophen, family planning products,
360.22 	aspirin, insulin, products for the treatment of lice, vitamins
360.23 	for adults with documented vitamin deficiencies, vitamins for
360.24 	children under the age of seven and pregnant or nursing women,
360.25 	and any other over-the-counter drug identified by the
360.26 	commissioner, in consultation with the formulary committee, as
360.27 	necessary, appropriate, and cost-effective for the treatment of
360.28 	certain specified chronic diseases, conditions, or disorders,
360.29 	and this determination shall not be subject to the requirements
360.30 	of chapter 14.  A pharmacist may prescribe over-the-counter
360.31 	medications as provided under this paragraph for purposes of
360.32 	receiving reimbursement under Medicaid.  When prescribing
360.33 	over-the-counter drugs under this paragraph, licensed
360.34 	pharmacists must consult with the recipient to determine
360.35 	necessity, provide drug counseling, review drug therapy for
360.36 	potential adverse interactions, and make referrals as needed to
361.1 	other health care professionals.
361.2 	(d) Effective January 1, 2006, medical assistance shall not
361.3 	cover drugs that are coverable under Medicare Part D as defined
361.4 	in the Medicare Prescription Drug, Improvement, and
361.5 	Modernization Act of 2003, Public Law 108-173, section
361.6 	1860D-2(e), for individuals eligible for drug coverage as
361.7 	defined in the Medicare Prescription Drug, Improvement, and
361.8 	Modernization Act of 2003, Public Law 108-173, section
361.9 	1860D-1(a)(3)(A).  For these individuals, medical assistance may
361.10 	cover drugs from the drug classes listed in United States Code,
361.11 	title 42, section 1396r-8(d)(2), subject to this subdivision and
361.12 	subdivisions 13a to 13g, except that drugs listed in United
361.13 	States Code, title 42, section 1396r-8(d)(2)(E), shall not be
361.14 	covered.
361.15 	
EFFECTIVE DATE. This section is effective August 1, 2005.

361.16 	Sec. 34. Minnesota Statutes 2004, section 256B.0625,
361.17 	subdivision 13a, is amended to read:
361.18 		Subd. 13a.Drug utilization review board. The
361.19 	commissioner, after receiving recommendations from professional
361.20 	medical associations, professional pharmacy associations, and
361.21 	consumer groups shall designate a nine-member Drug Utilization
361.22 	Review Board is established.  The board is shall be comprised of
361.23 	at least three but no more than four licensed physicians
361.24 	actively engaged in the practice of medicine in Minnesota; at
361.25 	least three licensed pharmacists actively engaged in the
361.26 	practice of pharmacy in Minnesota; and one consumer
361.27 	representative; the remainder to be made up of health care
361.28 	professionals who are licensed in their field and have
361.29 	recognized knowledge in the clinically appropriate prescribing,
361.30 	dispensing, and monitoring of covered outpatient drugs.  The
361.31 	board shall be staffed by an employee of the department who
361.32 	shall serve as an ex officio nonvoting member of the board. The
361.33 	department's medical director shall also serve as an ex officio,
361.34 	nonvoting member of the board.The members of the board shall
361.35 	be appointed by the commissioner and shall serve three-year
361.36 	terms. The members shall be selected from lists submitted by
362.1 	professional associations.The commissioner shall appoint the
362.2 	initial members of the board for terms expiring as follows:
362.3 	three members for terms expiring June 30, 1996; three members
362.4 	for terms expiring June 30, 1997; and three members for terms
362.5 	expiring June 30, 1998.  Members may be reappointed once by the
362.6 	commissioner.  The board shall annually elect a chair from among
362.7 	the members.
362.8 	The commissioner shall, with the advice of the board:
362.9 	(1) implement a medical assistance retrospective and
362.10 	prospective drug utilization review program as required by
362.11 	United States Code, title 42, section 1396r-8(g)(3);
362.12 	(2) develop and implement the predetermined criteria and
362.13 	practice parameters for appropriate prescribing to be used in
362.14 	retrospective and prospective drug utilization review;
362.15 	(3) develop, select, implement, and assess interventions
362.16 	for physicians, pharmacists, and patients that are educational
362.17 	and not punitive in nature;
362.18 	(4) establish a grievance and appeals process for
362.19 	physicians and pharmacists under this section;
362.20 	(5) publish and disseminate educational information to
362.21 	physicians and pharmacists regarding the board and the review
362.22 	program;
362.23 	(6) adopt and implement procedures designed to ensure the
362.24 	confidentiality of any information collected, stored, retrieved,
362.25 	assessed, or analyzed by the board, staff to the board, or
362.26 	contractors to the review program that identifies individual
362.27 	physicians, pharmacists, or recipients;
362.28 	(7) establish and implement an ongoing process to (i)
362.29 	receive public comment regarding drug utilization review
362.30 	criteria and standards, and (ii) consider the comments along
362.31 	with other scientific and clinical information in order to
362.32 	revise criteria and standards on a timely basis; and
362.33 	(8) adopt any rules necessary to carry out this section.
362.34 	The board may establish advisory committees.  The
362.35 	commissioner may contract with appropriate organizations to
362.36 	assist the board in carrying out the board's duties.  The
363.1 	commissioner may enter into contracts for services to develop
363.2 	and implement a retrospective and prospective review program.
363.3 	The board shall report to the commissioner annually on the
363.4 	date the Drug Utilization Review Annual Report is due to the
363.5 	Centers for Medicare and Medicaid Services.  This report is to
363.6 	cover the preceding federal fiscal year.  The commissioner shall
363.7 	make the report available to the public upon request.  The
363.8 	report must include information on the activities of the board
363.9 	and the program; the effectiveness of implemented interventions;
363.10 	administrative costs; and any fiscal impact resulting from the
363.11 	program.  An honorarium of $100 per meeting and reimbursement
363.12 	for mileage shall be paid to each board member in attendance.
363.13 	
EFFECTIVE DATE. This section is effective the day
363.14 	following final enactment.

363.15 	Sec. 35. Minnesota Statutes 2004, section 256B.0625,
363.16 	subdivision 13c, is amended to read:
363.17 		Subd. 13c.Formulary committee.  The commissioner, after
363.18 	receiving recommendations from professional medical associations
363.19 	and professional pharmacy associations, and consumer groups
363.20 	shall designate a Formulary Committee to carry out duties as
363.21 	described in subdivisions 13 to 13g.  The Formulary Committee
363.22 	shall be comprised of four licensed physicians actively engaged
363.23 	in the practice of medicine in Minnesota one of whom must be
363.24 	actively engaged in the treatment of persons with mental
363.25 	illness; at least three licensed pharmacists actively engaged in
363.26 	the practice of pharmacy in Minnesota; and one consumer
363.27 	representative; the remainder to be made up of health care
363.28 	professionals who are licensed in their field and have
363.29 	recognized knowledge in the clinically appropriate prescribing,
363.30 	dispensing, and monitoring of covered outpatient drugs.  Members
363.31 	of the Formulary Committee shall not be employed by the
363.32 	Department of Human Services, but the committee shall be staffed
363.33 	by an employee of the department who shall serve as an ex
363.34 	officio, nonvoting member of the board.  The department's
363.35 	medical director shall also serve as an ex officio, nonvoting
363.36 	member for the committee.  Committee members shall serve
364.1 	three-year terms and may be reappointed by the commissioner.
364.2 	The Formulary Committee shall meet at least quarterly.  The
364.3 	commissioner may require more frequent Formulary Committee
364.4 	meetings as needed.  An honorarium of $100 per meeting and
364.5 	reimbursement for mileage shall be paid to each committee member
364.6 	in attendance.
364.7 	
EFFECTIVE DATE. This section is effective the day
364.8 	following final enactment.

364.9 	Sec. 36. Minnesota Statutes 2004, section 256B.0625,
364.10 	subdivision 13d, is amended to read:
364.11 		Subd. 13d.Drug formulary.  The commissioner shall
364.12 	establish a drug formulary.  Its establishment and publication
364.13 	shall not be subject to the requirements of the Administrative
364.14 	Procedure Act, but the Formulary Committee shall review and
364.15 	comment on the formulary contents.
364.16 	The formulary shall not include:
364.17 	(1) drugs or products for which there is no federal
364.18 	funding;
364.19 	(2) over-the-counter drugs, except as provided in
364.20 	subdivision 13;
364.21 	(3) drugs used for weight loss, except that medically
364.22 	necessary lipase inhibitors may be covered for a recipient with
364.23 	type II diabetes;
364.24 	(4) drugs when used for the treatment of impotence or
364.25 	erectile dysfunction;
364.26 	(5) drugs for which medical value has not been established;
364.27 	and
364.28 	(5) (6) drugs from manufacturers who have not signed a
364.29 	rebate agreement with the Department of Health and Human
364.30 	Services pursuant to section 1927 of title XIX of the Social
364.31 	Security Act.
364.32 	
EFFECTIVE DATE. This section is effective September 1,
364.33 	2005.

364.34 	Sec. 37. Minnesota Statutes 2004, section 256B.0625,
364.35 	subdivision 13e, as amended by Laws 2005, chapter 155, article
364.36 	3, section 5, is amended to read:
365.1 		Subd. 13e.Payment rates. (a) The basis for determining
365.2 	the amount of payment shall be the lower of the actual
365.3 	acquisition costs of the drugs plus a fixed dispensing fee; the
365.4 	maximum allowable cost set by the federal government or by the
365.5 	commissioner plus the fixed dispensing fee; or the usual and
365.6 	customary price charged to the public.  The amount of payment
365.7 	basis must be reduced to reflect all discount amounts applied to
365.8 	the charge by any provider/insurer agreement or contract for
365.9 	submitted charges to medical assistance programs.  The net
365.10 	submitted charge may not be greater than the patient liability
365.11 	for the service.  The pharmacy dispensing fee shall be $3.65,
365.12 	except that the dispensing fee for intravenous solutions which
365.13 	must be compounded by the pharmacist shall be $8 per bag, $14
365.14 	per bag for cancer chemotherapy products, and $30 per bag for
365.15 	total parenteral nutritional products dispensed in one liter
365.16 	quantities, or $44 per bag for total parenteral nutritional
365.17 	products dispensed in quantities greater than one liter.  Actual
365.18 	acquisition cost includes quantity and other special discounts
365.19 	except time and cash discounts.  The actual acquisition cost of
365.20 	a drug shall be estimated by the commissioner, at average
365.21 	wholesale price minus 11.5 12 percent, except that where a drug
365.22 	has had its wholesale price reduced as a result of the actions
365.23 	of the National Association of Medicaid Fraud Control Units, the
365.24 	estimated actual acquisition cost shall be the reduced average
365.25 	wholesale price, without the 11.5 percent deduction.  The actual
365.26 	acquisition cost of antihemophilic factor drugs shall be
365.27 	estimated at the average wholesale price minus 30 percent.  The
365.28 	maximum allowable cost of a multisource drug may be set by the
365.29 	commissioner and it shall be comparable to, but no higher than,
365.30 	the maximum amount paid by other third-party payors in this
365.31 	state who have maximum allowable cost programs.  Establishment
365.32 	of the amount of payment for drugs shall not be subject to the
365.33 	requirements of the Administrative Procedure Act.
365.34 	(b) An additional dispensing fee of $.30 may be added to
365.35 	the dispensing fee paid to pharmacists for legend drug
365.36 	prescriptions dispensed to residents of long-term care
366.1 	facilities when a unit dose blister card system, approved by the
366.2 	department, is used.  Under this type of dispensing system, the
366.3 	pharmacist must dispense a 30-day supply of drug.  The National
366.4 	Drug Code (NDC) from the drug container used to fill the blister
366.5 	card must be identified on the claim to the department.  The
366.6 	unit dose blister card containing the drug must meet the
366.7 	packaging standards set forth in Minnesota Rules, part
366.8 	6800.2700, that govern the return of unused drugs to the
366.9 	pharmacy for reuse.  The pharmacy provider will be required to
366.10 	credit the department for the actual acquisition cost of all
366.11 	unused drugs that are eligible for reuse.  Over-the-counter
366.12 	medications must be dispensed in the manufacturer's unopened
366.13 	package.  The commissioner may permit the drug clozapine to be
366.14 	dispensed in a quantity that is less than a 30-day supply.
366.15 	(c) Whenever a generically equivalent product is available,
366.16 	payment shall be on the basis of the actual acquisition cost of
366.17 	the generic drug, or on the maximum allowable cost established
366.18 	by the commissioner.
366.19 	(d) The basis for determining the amount of payment for
366.20 	drugs administered in an outpatient setting shall be the lower
366.21 	of the usual and customary cost submitted by the provider or the
366.22 	amount established for Medicare by the United States Department
366.23 	of Health and Human Services pursuant to title XVIII, section
366.24 	1847a of the federal Social Security Act.
366.25 	(e) The commissioner may negotiate lower reimbursement
366.26 	rates for specialty pharmacy products than the rates specified
366.27 	in paragraph (a).  The commissioner may require individuals
366.28 	enrolled in the health care programs administered by the
366.29 	department to obtain specialty pharmacy products from providers
366.30 	with whom the commissioner has negotiated lower reimbursement
366.31 	rates.  Specialty pharmacy products are defined as those used by
366.32 	a small number of recipients or recipients with complex and
366.33 	chronic diseases that require expensive and challenging drug
366.34 	regimens.  Examples of these conditions include, but are not
366.35 	limited to:  multiple sclerosis, HIV/AIDS, transplantation,
366.36 	hepatitis C, growth hormone deficiency, Crohn's Disease,
367.1 	rheumatoid arthritis, and certain forms of cancer.  Specialty
367.2 	pharmaceutical products include injectable and infusion
367.3 	therapies, biotechnology drugs, high-cost therapies, and
367.4 	therapies that require complex care.  The commissioner shall
367.5 	consult with the formulary committee to develop a list of
367.6 	specialty pharmacy products subject to this paragraph.  In
367.7 	consulting with the formulary committee in developing this list,
367.8 	the commissioner shall take into consideration the population
367.9 	served by specialty pharmacy products, the current delivery
367.10 	system and standard of care in the state, and access to care
367.11 	issues.  The commissioner shall have the discretion to adjust
367.12 	the reimbursement rate to prevent access to care issues.
367.13 	
EFFECTIVE DATE. This section is effective August 1, 2005.

367.14 	Sec. 38. Minnesota Statutes 2004, section 256B.0625,
367.15 	subdivision 13f, as amended by Laws 2005, chapter 155, article
367.16 	3, section 6, is amended to read:
367.17 		Subd. 13f.Prior authorization. (a) The Formulary
367.18 	Committee shall review and recommend drugs which require prior
367.19 	authorization.  The Formulary Committee shall establish general
367.20 	criteria to be used for the prior authorization of brand-name
367.21 	drugs for which generically equivalent drugs are available, but
367.22 	the committee is not required to review each brand-name drug for
367.23 	which a generically equivalent drug is available.
367.24 	(b) Prior authorization may be required by the commissioner
367.25 	before certain formulary drugs are eligible for payment.  The
367.26 	Formulary Committee may recommend drugs for prior authorization
367.27 	directly to the commissioner.  The commissioner may also request
367.28 	that the Formulary Committee review a drug for prior
367.29 	authorization.  Before the commissioner may require prior
367.30 	authorization for a drug:
367.31 	(1) the commissioner must provide information to the
367.32 	Formulary Committee on the impact that placing the drug on prior
367.33 	authorization may have on the quality of patient care and on
367.34 	program costs, information regarding whether the drug is subject
367.35 	to clinical abuse or misuse, and relevant data from the state
367.36 	Medicaid program if such data is available;
368.1 	(2) the Formulary Committee must review the drug, taking
368.2 	into account medical and clinical data and the information
368.3 	provided by the commissioner; and
368.4 	(3) the Formulary Committee must hold a public forum and
368.5 	receive public comment for an additional 15 days.
368.6 	The commissioner must provide a 15-day notice period before
368.7 	implementing the prior authorization.
368.8 	(c) Prior authorization shall not be required or utilized
368.9 	for any atypical antipsychotic drug prescribed for the treatment
368.10 	of mental illness if:
368.11 	(1) there is no generically equivalent drug available; and
368.12 	(2) the drug was initially prescribed for the recipient
368.13 	prior to July 1, 2003; or
368.14 	(3) the drug is part of the recipient's current course of
368.15 	treatment.
368.16 	This paragraph applies to any multistate preferred drug list or
368.17 	supplemental drug rebate program established or administered by
368.18 	the commissioner. Prior authorization shall automatically be
368.19 	granted for 60 days for brand name drugs prescribed for
368.20 	treatment of mental illness within 60 days of when a generically
368.21 	equivalent drug becomes available, provided that the brand name
368.22 	drug was part of the recipient's course of treatment at the time
368.23 	the generically equivalent drug became available.
368.24 	(d) Prior authorization shall not be required or utilized
368.25 	for any antihemophilic factor drug prescribed for the treatment
368.26 	of hemophilia and blood disorders where there is no generically
368.27 	equivalent drug available if the prior authorization is used in
368.28 	conjunction with any supplemental drug rebate program or
368.29 	multistate preferred drug list established or administered by
368.30 	the commissioner. This paragraph expires July 1, 2005.
368.31 	(e) The commissioner may require prior authorization for
368.32 	brand name drugs whenever a generically equivalent product is
368.33 	available, even if the prescriber specifically indicates
368.34 	"dispense as written-brand necessary" on the prescription as
368.35 	required by section 151.21, subdivision 2.
368.36 	(f) Notwithstanding this subdivision, the commissioner may
369.1 	automatically require prior authorization, for a period not to
369.2 	exceed 180 days, for any drug that is approved by the United
369.3 	States Food and Drug Administration on or after July 1, 2005.
369.4 	The 180-day period begins no later than the first day that a
369.5 	drug is available for shipment to pharmacies within the state.
369.6 	The Formulary Committee shall recommend to the commissioner
369.7 	general criteria to be used for the prior authorization of the
369.8 	drugs, but the committee is not required to review each
369.9 	individual drug.  In order to continue prior authorizations for
369.10 	a drug after the 180-day period has expired, the commissioner
369.11 	must follow the provisions of this subdivision.
369.12 	
EFFECTIVE DATE. Paragraph (c) is effective August 1,
369.13 	2005, and paragraph (d) is effective retroactively from June 30,
369.14 	2005.

369.15 	Sec. 39. Minnesota Statutes 2004, section 256B.0625, is
369.16 	amended by adding a subdivision to read:
369.17 		Subd. 13h.Medication therapy management care. (a)
369.18 	Medical assistance and general assistance medical care cover
369.19 	medication therapy management services for a recipient taking
369.20 	four or more prescriptions to treat or prevent two or more
369.21 	chronic medical conditions, or a recipient with a drug therapy
369.22 	problem that is identified or prior authorized by the
369.23 	commissioner that has resulted or is likely to result in
369.24 	significant nondrug program costs.  The commissioner may cover
369.25 	medical therapy management services under MinnesotaCare if the
369.26 	commissioner determines this is cost-effective.  For purposes of
369.27 	this subdivision, "medication therapy management" means the
369.28 	provision of the following pharmaceutical care services by a
369.29 	licensed pharmacist to optimize the therapeutic outcomes of the
369.30 	patient's medications:
369.31 	(1) performing or obtaining necessary assessments of the
369.32 	patient's health status;
369.33 	(2) formulating a medication treatment plan;
369.34 	(3) monitoring and evaluating the patient's response to
369.35 	therapy, including safety and effectiveness;
369.36 	(4) performing a comprehensive medication review to
370.1 	identify, resolve, and prevent medication-related problems,
370.2 	including adverse drug events;
370.3 	(5) documenting the care delivered and communicating
370.4 	essential information to the patient's other primary care
370.5 	providers;
370.6 	(6) providing verbal education and training designed to
370.7 	enhance patient understanding and appropriate use of the
370.8 	patient's medications;
370.9 	(7) providing information, support services, and resources
370.10 	designed to enhance patient adherence with the patient's
370.11 	therapeutic regimens; and 
370.12 	(8) coordinating and integrating medication therapy
370.13 	management services within the broader health care management
370.14 	services being provided to the patient.
370.15 	Nothing in this subdivision shall be construed to expand or
370.16 	modify the scope of practice of the pharmacist as defined in
370.17 	section 151.01, subdivision 27.
370.18 	(b) To be eligible for reimbursement for services under
370.19 	this subdivision, a pharmacist must meet the following
370.20 	requirements:
370.21 	(1) have a valid license issued under chapter 151;
370.22 	(2) have graduated from an accredited college of pharmacy
370.23 	on or after May 1996, or completed a structured and
370.24 	comprehensive education program approved by the Board of
370.25 	Pharmacy and the American Council of Pharmaceutical Education
370.26 	for the provision and documentation of pharmaceutical care
370.27 	management services that has both clinical and didactic
370.28 	elements;
370.29 	(3) be practicing in an ambulatory care setting as part of
370.30 	a multidisciplinary team or have developed a structured patient
370.31 	care process that is offered in a private or semiprivate patient
370.32 	care area that is separate from the commercial business that
370.33 	also occurs in the setting; and 
370.34 	(4) make use of an electronic patient record system that
370.35 	meets state standards.
370.36 	(c) For purposes of reimbursement for medication therapy
371.1 	management services, the commissioner may enroll individual
371.2 	pharmacists as medical assistance and general assistance medical
371.3 	care providers.  The commissioner may also establish contact
371.4 	requirements between the pharmacist and recipient, including
371.5 	limiting the number of reimbursable consultations per recipient.
371.6 	(d) The commissioner, after receiving recommendations from
371.7 	professional medical associations, professional pharmacy
371.8 	associations, and consumer groups, shall convene an 11-member
371.9 	Medication Therapy Management Advisory Committee to advise the
371.10 	commissioner on the implementation and administration of
371.11 	medication therapy management services.  The committee shall be
371.12 	comprised of:  two licensed physicians; two licensed
371.13 	pharmacists; two consumer representatives; two health plan
371.14 	company representatives; and three members with expertise in the
371.15 	area of medication therapy management, who may be licensed
371.16 	physicians or licensed pharmacists.  The committee is governed
371.17 	by section 15.059, except that committee members do not receive
371.18 	compensation or reimbursement for expenses.  The advisory
371.19 	committee expires on June 30, 2007.
371.20 	(e) The commissioner shall evaluate the effect of
371.21 	medication therapy management on quality of care, patient
371.22 	outcomes, and program costs, and shall include a description of
371.23 	any savings generated in the medical assistance and general
371.24 	assistance medical care programs that can be attributable to
371.25 	this coverage.  The evaluation shall be submitted to the
371.26 	legislature by December 15, 2007.  The commissioner may contract
371.27 	with a vendor or an academic institution that has expertise in
371.28 	evaluating health care outcomes for the purpose of completing
371.29 	the evaluation.
371.30 	
EFFECTIVE DATE. This section is effective August 1, 2005.

371.31 	Sec. 40. Minnesota Statutes 2004, section 256B.0625,
371.32 	subdivision 17, is amended to read:
371.33 		Subd. 17.Transportation costs.  (a) Medical assistance
371.34 	covers transportation costs incurred solely for obtaining
371.35 	emergency medical care or transportation costs incurred by
371.36 	eligible persons in obtaining emergency or nonemergency medical
372.1 	care when paid directly to an ambulance company, common carrier,
372.2 	or other recognized providers of transportation services.
372.3 	(b) Medical assistance covers special transportation, as
372.4 	defined in Minnesota Rules, part 9505.0315, subpart 1, item F,
372.5 	if the recipient has a physical or mental impairment that would
372.6 	prohibit the recipient from safely accessing and using a bus,
372.7 	taxi, other commercial transportation, or private automobile.
372.8 	The commissioner may use an order by the recipient's attending
372.9 	physician to certify that the recipient requires special
372.10 	transportation services.  Special transportation includes
372.11 	driver-assisted service to eligible individuals.
372.12 	Driver-assisted service includes passenger pickup at and return
372.13 	to the individual's residence or place of business, assistance
372.14 	with admittance of the individual to the medical facility, and
372.15 	assistance in passenger securement or in securing of wheelchairs
372.16 	or stretchers in the vehicle.  Special transportation providers
372.17 	must obtain written documentation from the health care service
372.18 	provider who is serving the recipient being transported,
372.19 	identifying the time that the recipient arrived.  Special
372.20 	transportation providers may not bill for separate base rates
372.21 	for the continuation of a trip beyond the original destination.
372.22 	Special transportation providers must take recipients to the
372.23 	nearest appropriate health care provider, using the most direct
372.24 	route available.  The maximum medical assistance reimbursement
372.25 	rates for special transportation services are:
372.26 	(1) $18 $17 for the base rate and $1.40 $1.35 per mile for
372.27 	services to eligible persons who need a wheelchair-accessible
372.28 	van;
372.29 	(2) $12 $11.50 for the base rate and $1.35 $1.30 per mile
372.30 	for services to eligible persons who do not need a
372.31 	wheelchair-accessible van; and
372.32 	(3) $36 $60 for the base rate and $1.40 $2.40 per mile, and
372.33 	an attendant rate of $9 per trip, for services to eligible
372.34 	persons who need a stretcher-accessible vehicle.
372.35 	
EFFECTIVE DATE. This section is effective August 1, 2005.

372.36 	Sec. 41. Minnesota Statutes 2004, section 256B.0631,
373.1 	subdivision 1, is amended to read:
373.2 		Subdivision 1.Co-payments.  (a) Except as provided in
373.3 	subdivision 2, the medical assistance benefit plan shall include
373.4 	the following co-payments for all recipients, effective for
373.5 	services provided on or after October 1, 2003:
373.6 	(1) $3 per nonpreventive visit.  For purposes of this
373.7 	subdivision, a visit means an episode of service which is
373.8 	required because of a recipient's symptoms, diagnosis, or
373.9 	established illness, and which is delivered in an ambulatory
373.10 	setting by a physician or physician ancillary, chiropractor,
373.11 	podiatrist, nurse midwife, advanced practice nurse, audiologist,
373.12 	optician, or optometrist;
373.13 	(2) $3 for eyeglasses;
373.14 	(3) $6 for nonemergency visits to a hospital-based
373.15 	emergency room; and
373.16 	(4) $3 per brand-name drug prescription and $1 per generic
373.17 	drug prescription, subject to a $20 $12 per month maximum for
373.18 	prescription drug co-payments.  No co-payments shall apply to
373.19 	antipsychotic drugs when used for the treatment of mental
373.20 	illness.
373.21 	(b) Recipients of medical assistance are responsible for
373.22 	all co-payments in this subdivision.
373.23 	
EFFECTIVE DATE. This section is effective January 1, 2006.

373.24 	Sec. 42. Minnesota Statutes 2004, section 256B.0631,
373.25 	subdivision 3, is amended to read:
373.26 		Subd. 3.Collection.  The medical assistance
373.27 	reimbursement to the provider shall be reduced by the amount of
373.28 	the co-payment, except that reimbursement for prescription drugs
373.29 	shall not be reduced once a recipient has reached the $20 $12 
373.30 	per month maximum for prescription drug co-payments.  The
373.31 	provider collects the co-payment from the recipient.  Providers
373.32 	may not deny services to recipients who are unable to pay the
373.33 	co-payment, except as provided in subdivision 4.
373.34 	
EFFECTIVE DATE. This section is effective January 1, 2006.

373.35 	Sec. 43. [256B.072] PERFORMANCE REPORTING AND QUALITY
373.36 	IMPROVEMENT SYSTEM.
374.1 	(a) The commissioner of human services shall establish a
374.2 	performance reporting system for health care providers who
374.3 	provide health care services to public program recipients
374.4 	covered under chapters 256B, 256D, and 256L, reporting
374.5 	separately for managed care and fee-for-service recipients.
374.6 	(b) The measures used for the performance reporting system
374.7 	for medical groups shall include measures of care for asthma,
374.8 	diabetes, hypertension, and coronary artery disease and measures
374.9 	of preventive care services.  The measures used for the
374.10 	performance reporting system for inpatient hospitals shall
374.11 	include measures of care for acute myocardial infarction, heart
374.12 	failure, and pneumonia, and measures of care and prevention of
374.13 	surgical infections.  In the case of a medical group, the
374.14 	measures used shall be consistent with measures published by
374.15 	nonprofit Minnesota or national organizations that produce and
374.16 	disseminate health care quality measures or evidence-based
374.17 	health care guidelines.  In the case of inpatient hospital
374.18 	measures, the commissioner shall appoint the Minnesota Hospital
374.19 	Association and Stratis Health to advise on the development of
374.20 	the performance measures to be used for hospital reporting.  To
374.21 	enable a consistent measurement process across the community,
374.22 	the commissioner may use measures of care provided for patients
374.23 	in addition to those identified in paragraph (a).  The
374.24 	commissioner shall ensure collaboration with other health care
374.25 	reporting organizations so that the measures described in this
374.26 	section are consistent with those reported by those
374.27 	organizations and used by other purchasers in Minnesota.
374.28 	(c) The commissioner may require providers to submit
374.29 	information in a required format to a health care reporting
374.30 	organization or to cooperate with the information collection
374.31 	procedures of that organization.  The commissioner may
374.32 	collaborate with a reporting organization to collect information
374.33 	reported and to prevent duplication of reporting.
374.34 	(d) By October 1, 2007, and annually thereafter, the
374.35 	commissioner shall report through a public Web site the results
374.36 	by medical groups and hospitals, where possible, of the measures
375.1 	under this section, and shall compare the results by medical
375.2 	groups and hospitals for patients enrolled in public programs to
375.3 	patients enrolled in private health plans.  To achieve this
375.4 	reporting, the commissioner may collaborate with a health care
375.5 	reporting organization that operates a Web site suitable for
375.6 	this purpose.

375.7 	EFFECTIVE DATE. This section is effective the day
375.8 	following final enactment.

375.9 	Sec. 44. Minnesota Statutes 2004, section 256B.075,
375.10 	subdivision 2, is amended to read:
375.11 		Subd. 2.Fee-for-service.  (a) The commissioner shall
375.12 	develop and implement a disease management program for medical
375.13 	assistance and general assistance medical care recipients who
375.14 	are not enrolled in the prepaid medical assistance or prepaid
375.15 	general assistance medical care programs and who are receiving
375.16 	services on a fee-for-service basis.  The commissioner may
375.17 	contract with an outside organization to provide these services.
375.18 	(b) The commissioner shall seek any federal approval
375.19 	necessary to implement this section and to obtain federal
375.20 	matching funds.
375.21 	(c) The commissioner shall develop and implement a pilot
375.22 	intensive care management program for medical assistance
375.23 	children with complex and chronic medical issues who are not
375.24 	able to participate in the metro-based U Special Kids program
375.25 	due to geographic distance.
375.26 	
EFFECTIVE DATE. This section is effective the day
375.27 	following final enactment.

375.28 	Sec. 45. Minnesota Statutes 2004, section 256B.0911,
375.29 	subdivision 1a, is amended to read:
375.30 		Subd. 1a.Definitions.  For purposes of this section, the
375.31 	following definitions apply:
375.32 	(a) "Long-term care consultation services" means:
375.33 	(1) providing information and education to the general
375.34 	public regarding availability of the services authorized under
375.35 	this section;
375.36 	(2) an intake process that provides access to the services
376.1 	described in this section;
376.2 	(3) assessment of the health, psychological, and social
376.3 	needs of referred individuals;
376.4 	(4) assistance in identifying services needed to maintain
376.5 	an individual in the least restrictive environment;
376.6 	(5) providing recommendations on cost-effective community
376.7 	services that are available to the individual;
376.8 	(6) development of an individual's community support plan;
376.9 	(7) providing information regarding eligibility for
376.10 	Minnesota health care programs;
376.11 	(8) preadmission screening to determine the need for a
376.12 	nursing facility level of care;
376.13 	(9) preliminary determination of Minnesota health care
376.14 	programs eligibility for individuals who need a nursing facility
376.15 	level of care, with appropriate referrals for final
376.16 	determination;
376.17 	(10) providing recommendations for nursing facility
376.18 	placement when there are no cost-effective community services
376.19 	available; and
376.20 	(11) assistance to transition people back to community
376.21 	settings after facility admission.
376.22 	(b) "Minnesota health care programs" means the medical
376.23 	assistance program under chapter 256B,and the alternative care
376.24 	program under section 256B.0913, and the prescription drug
376.25 	program under section 256.955.
376.26 	
EFFECTIVE DATE. This section is effective January 1, 2006.

376.27 	Sec. 46. Minnesota Statutes 2004, section 256B.0916, is
376.28 	amended by adding a subdivision to read:
376.29 		Subd. 10.Transitional supports allowance. A
376.30 	transitional supports allowance shall be available to all
376.31 	persons under a home and community-based waiver who are moving
376.32 	from a licensed setting to a community setting.  "Transitional
376.33 	supports allowance" means a onetime payment of up to $3,000, to
376.34 	cover the costs, not covered by other sources, associated with
376.35 	moving from a licensed setting to a community setting.  Covered
376.36 	costs include:
377.1 	(1) lease or rent deposits;
377.2 	(2) security deposits;
377.3 	(3) utilities set-up costs, including telephone;
377.4 	(4) essential furnishings and supplies; and 
377.5 	(5) personal supports and transports needed to locate and
377.6 	transition to community settings.
377.7 	
EFFECTIVE DATE. This section is effective upon federal
377.8 	approval and to the extent approved as a federal waiver
377.9 	amendment.

377.10 	Sec. 47. [256B.0918] EMPLOYEE SCHOLARSHIP COSTS.
377.11 		Subdivision 1.Program criteria. Beginning on or after
377.12 	October 1, 2005, within the limits of appropriations
377.13 	specifically available for this purpose, the commissioner shall
377.14 	provide funding to qualified provider applicants for employee
377.15 	scholarships for education in nursing and other health care
377.16 	fields.  Employee scholarships must be for a course of study
377.17 	that is expected to lead to career advancement with the provider
377.18 	or in the field of long-term care, including home care or care
377.19 	of persons with disabilities, or nursing.  Providers that secure
377.20 	this funding must use it to award scholarships to employees who
377.21 	work an average of at least 20 hours per week for the provider.
377.22 	Management staff, registered nurses, and therapists are not
377.23 	eligible to receive scholarships under this section.
377.24 		Subd. 2.Participating providers. The commissioner shall
377.25 	publish a request for proposals in the State Register by August
377.26 	15, 2005, specifying provider eligibility requirements, provider
377.27 	selection criteria, program specifics, funding mechanism, and
377.28 	methods of evaluation.  The commissioner may publish additional
377.29 	requests for proposals in subsequent years.  Providers who
377.30 	provide services funded through the following programs are
377.31 	eligible to apply to participate in the scholarship program:
377.32 	home and community-based waivered services for persons with
377.33 	mental retardation or related conditions under section 256B.501;
377.34 	home and community-based waivered services for the elderly under
377.35 	section 256B.0915; waivered services under community
377.36 	alternatives for disabled individuals under section 256B.49;
378.1 	community alternative care waivered services under section
378.2 	256B.49; traumatic brain injury waivered services under section
378.3 	256B.49; nursing services and home health services under section
378.4 	256B.0625, subdivision 6a; personal care services and nursing
378.5 	supervision of personal care services under section 256B.0625,
378.6 	subdivision 19a; private duty nursing services under section
378.7 	256B.0625, subdivision 7; day training and habilitation services
378.8 	for adults with mental retardation or related conditions under
378.9 	sections 252.40 to 252.46; and intermediate care facilities for
378.10 	persons with mental retardation under section 256B.5012.
378.11 		Subd. 3.Provider selection criteria. To be considered
378.12 	for scholarship funding, the provider shall submit a completed
378.13 	application within the time frame specified by the
378.14 	commissioner.  In awarding funding, the commissioner shall
378.15 	consider the following:
378.16 	(1) the size of the provider as measured in annual billing
378.17 	to the medical assistance program.  To be eligible, a provider
378.18 	must receive at least $500,000 annually in medical assistance
378.19 	payments;
378.20 	(2) the percentage of employees meeting the scholarship
378.21 	program recipient requirements;
378.22 	(3) staff retention rates for paraprofessionals; and 
378.23 	(4) other criteria determined by the commissioner.
378.24 		Subd. 4.Funding specifics. Within the limits of
378.25 	appropriations specifically available for this purpose, for the
378.26 	rate period beginning on or after October 1, 2005, to September
378.27 	30, 2007, the commissioner shall provide to each provider listed
378.28 	in subdivision 2 and awarded funds under subdivision 3 a medical
378.29 	assistance rate increase to fund scholarships up to two-tenths
378.30 	percent of the medical assistance reimbursement rate.  The
378.31 	commissioner shall require providers to repay any portion of
378.32 	funds awarded under subdivision 3 that is not used to fund
378.33 	scholarships.  If applications exceed available funding, funding
378.34 	shall be targeted to providers that employ a higher percentage
378.35 	of paraprofessional staff or have lower rates of turnover of
378.36 	paraprofessional staff.  During the subsequent years of the
379.1 	program, the rate adjustment may be recalculated, at the
379.2 	discretion of the commissioner.  In making a recalculation the
379.3 	commissioner may consider the provider's success at granting
379.4 	scholarships based on the amount spent during the previous year
379.5 	and the availability of appropriations to continue the program.
379.6 		Subd. 5.Reporting requirements. Participating providers
379.7 	shall report to the commissioner on a schedule determined by the
379.8 	commissioner and on a form supplied by the commissioner for a
379.9 	scholarship rate for rate periods beginning October 1, 2007.
379.10 	The report shall include the amount spent during the reporting
379.11 	period on eligible scholarships, and, for each scholarship
379.12 	recipient, the name of the recipient, the amount awarded, the
379.13 	educational institution attended, the nature of the educational
379.14 	program, the expected or actual program completion date, and a
379.15 	determination of the amount spent as a percentage of the
379.16 	provider's reimbursement.  The commissioner shall require
379.17 	providers to repay all of the funds awarded under subdivision 3
379.18 	if the report required in this subdivision is not filled
379.19 	according to the schedule determined by the commissioner.
379.20 		Subd. 6.Evaluation. The commissioner shall report to
379.21 	the legislature annually, beginning March 15, 2007, on the use
379.22 	of these funds.

379.23 	Sec. 48. Minnesota Statutes 2004, section 256B.19,
379.24 	subdivision 1c, is amended to read:
379.25 		Subd. 1c.Additional portion of nonfederal share.  (a)
379.26 	Hennepin County shall be responsible for a monthly transfer
379.27 	payment of $1,500,000, due before noon on the 15th of each month
379.28 	and the University of Minnesota shall be responsible for a
379.29 	monthly transfer payment of $500,000 due before noon on the 15th
379.30 	of each month, beginning July 15, 1995.  These sums shall be
379.31 	part of the designated governmental unit's portion of the
379.32 	nonfederal share of medical assistance costs.
379.33 	(b) Beginning July 1, 2001, Hennepin county's payment under
379.34 	paragraph (a) shall be $2,066,000 each month.
379.35 	(c) Beginning July 1, 2001, the commissioner shall increase
379.36 	annual capitation payments to the metropolitan health plan under
380.1 	section 256B.69 for the prepaid medical assistance program by
380.2 	approximately $3,400,000, plus any available federal matching
380.3 	funds, to recognize higher than average medical education costs.
380.4 	(d) Effective August 1, 2005, Hennepin County's payment
380.5 	under paragraphs (a) and (b) shall be reduced to $566,000, and
380.6 	the University of Minnesota's payment under paragraph (a) shall
380.7 	be reduced to zero.

380.8 	Sec. 49. Minnesota Statutes 2004, section 256B.195,
380.9 	subdivision 3, is amended to read:
380.10 		Subd. 3.Payments to certain safety net providers.  (a)
380.11 	Effective July 15, 2001, the commissioner shall make the
380.12 	following payments to the hospitals indicated after noon on the
380.13 	15th of each month:
380.14 	(1) to Hennepin County Medical Center, any federal matching
380.15 	funds available to match the payments received by the medical
380.16 	center under subdivision 2, to increase payments for medical
380.17 	assistance admissions and to recognize higher medical assistance
380.18 	costs in institutions that provide high levels of charity care;
380.19 	and
380.20 	(2) to Regions Hospital, any federal matching funds
380.21 	available to match the payments received by the hospital under
380.22 	subdivision 2, to increase payments for medical assistance
380.23 	admissions and to recognize higher medical assistance costs in
380.24 	institutions that provide high levels of charity care.
380.25 	(b) Effective July 15, 2001, the following percentages of
380.26 	the transfers under subdivision 2 shall be retained by the
380.27 	commissioner for deposit each month into the general fund:
380.28 	(1) 18 percent, plus any federal matching funds, shall be
380.29 	allocated for the following purposes:
380.30 	(i) during the fiscal year beginning July 1, 2001, of the
380.31 	amount available under this clause, 39.7 percent shall be
380.32 	allocated to make increased hospital payments under section
380.33 	256.969, subdivision 26; 34.2 percent shall be allocated to fund
380.34 	the amounts due from small rural hospitals, as defined in
380.35 	section 144.148, for overpayments under section 256.969,
380.36 	subdivision 5a, resulting from a determination that medical
381.1 	assistance and general assistance payments exceeded the charge
381.2 	limit during the period from 1994 to 1997; and 26.1 percent
381.3 	shall be allocated to the commissioner of health for rural
381.4 	hospital capital improvement grants under section 144.148; and
381.5 	(ii) during fiscal years beginning on or after July 1,
381.6 	2002, of the amount available under this clause, 55 percent
381.7 	shall be allocated to make increased hospital payments under
381.8 	section 256.969, subdivision 26, and 45 percent shall be
381.9 	allocated to the commissioner of health for rural hospital
381.10 	capital improvement grants under section 144.148; and
381.11 	(2) 11 percent shall be allocated to the commissioner of
381.12 	health to fund community clinic grants under section 145.9268.
381.13 	(c) This subdivision shall apply to fee-for-service
381.14 	payments only and shall not increase capitation payments or
381.15 	payments made based on average rates. The allocation in
381.16 	paragraph (b), clause (1), item (ii), to increase hospital
381.17 	payments under section 256.969, subdivision 26, shall not limit
381.18 	payments under that section.
381.19 	(d) Medical assistance rate or payment changes, including
381.20 	those required to obtain federal financial participation under
381.21 	section 62J.692, subdivision 8, shall precede the determination
381.22 	of intergovernmental transfer amounts determined in this
381.23 	subdivision.  Participation in the intergovernmental transfer
381.24 	program shall not result in the offset of any health care
381.25 	provider's receipt of medical assistance payment increases other
381.26 	than limits resulting from hospital-specific charge limits and
381.27 	limits on disproportionate share hospital payments.
381.28 	(e) Effective July 1, 2003, if the amount available for
381.29 	allocation under paragraph (b) is greater than the amounts
381.30 	available during March 2003, after any increase in
381.31 	intergovernmental transfers and payments that result from
381.32 	section 256.969, subdivision 3a, paragraph (c), are paid to the
381.33 	general fund, any additional amounts available under this
381.34 	subdivision after reimbursement of the transfers under
381.35 	subdivision 2 shall be allocated to increase medical assistance
381.36 	payments, subject to hospital-specific charge limits and limits
382.1 	on disproportionate share hospital payments, as follows:
382.2 	(1) if the payments under subdivision 5 are approved, the
382.3 	amount shall be paid to the largest ten percent of hospitals as
382.4 	measured by 2001 payments for medical assistance, general
382.5 	assistance medical care, and MinnesotaCare in the nonstate
382.6 	government hospital category.  Payments shall be allocated
382.7 	according to each hospital's proportionate share of the 2001
382.8 	payments; or
382.9 	(2) if the payments under subdivision 5 are not approved,
382.10 	the amount shall be paid to the largest ten percent of hospitals
382.11 	as measured by 2001 payments for medical assistance, general
382.12 	assistance medical care, and MinnesotaCare in the nonstate
382.13 	government category and to the largest ten percent of hospitals
382.14 	as measured by payments for medical assistance, general
382.15 	assistance medical care, and MinnesotaCare in the nongovernment
382.16 	hospital category.  Payments shall be allocated according to
382.17 	each hospital's proportionate share of the 2001 payments in
382.18 	their respective category of nonstate government and
382.19 	nongovernment.  The commissioner shall determine which hospitals
382.20 	are in the nonstate government and nongovernment hospital
382.21 	categories.
382.22 	
EFFECTIVE DATE. This section is effective August 1, 2005.

382.23 	Sec. 50. [256B.199] PAYMENTS REPORTED BY GOVERNMENTAL
382.24 	ENTITIES.
382.25 	(a) Hennepin County, Hennepin County Medical Center, Ramsey
382.26 	County, Regions Hospital, the University of Minnesota, and
382.27 	Fairview-University Medical Center shall report quarterly to the
382.28 	commissioner beginning June 1, 2007, payments made during the
382.29 	second previous quarter that may qualify for reimbursement under
382.30 	federal law.
382.31 	(b) Based on these reports, the commissioner shall apply
382.32 	for federal matching funds.  These funds are appropriated to the
382.33 	commissioner for the payments under section 256.969, subdivision
382.34 	27.
382.35 	(c) By May 1 of each year, beginning May 1, 2007, the
382.36 	commissioner shall inform the nonstate entities listed in
383.1 	paragraph (a) of the amount of federal disproportionate share
383.2 	hospital payment money expected to be available in the current
383.3 	federal fiscal year.
383.4 	(d) This section sunsets on June 30, 2009.  The
383.5 	commissioner shall report to the legislature by December 15,
383.6 	2008, with recommendations for maximizing federal
383.7 	disproportionate share hospital payments after June 30, 2009.

383.8 	Sec. 51. Minnesota Statutes 2004, section 256B.69,
383.9 	subdivision 4, is amended to read:
383.10 		Subd. 4.Limitation of choice.  (a) The commissioner
383.11 	shall develop criteria to determine when limitation of choice
383.12 	may be implemented in the experimental counties.  The criteria
383.13 	shall ensure that all eligible individuals in the county have
383.14 	continuing access to the full range of medical assistance
383.15 	services as specified in subdivision 6.
383.16 	(b) The commissioner shall exempt the following persons
383.17 	from participation in the project, in addition to those who do
383.18 	not meet the criteria for limitation of choice:
383.19 	(1) persons eligible for medical assistance according to
383.20 	section 256B.055, subdivision 1;
383.21 	(2) persons eligible for medical assistance due to
383.22 	blindness or disability as determined by the Social Security
383.23 	Administration or the state medical review team, unless:
383.24 	(i) they are 65 years of age or older; or
383.25 	(ii) they reside in Itasca County or they reside in a
383.26 	county in which the commissioner conducts a pilot project under
383.27 	a waiver granted pursuant to section 1115 of the Social Security
383.28 	Act;
383.29 	(3) recipients who currently have private coverage through
383.30 	a health maintenance organization;
383.31 	(4) recipients who are eligible for medical assistance by
383.32 	spending down excess income for medical expenses other than the
383.33 	nursing facility per diem expense;
383.34 	(5) recipients who receive benefits under the Refugee
383.35 	Assistance Program, established under United States Code, title
383.36 	8, section 1522(e);
384.1 	(6) children who are both determined to be severely
384.2 	emotionally disturbed and receiving case management services
384.3 	according to section 256B.0625, subdivision 20;
384.4 	(7) adults who are both determined to be seriously and
384.5 	persistently mentally ill and received case management services
384.6 	according to section 256B.0625, subdivision 20;
384.7 	(8) persons eligible for medical assistance according to
384.8 	section 256B.057, subdivision 10; and
384.9 	(9) persons with access to cost-effective
384.10 	employer-sponsored private health insurance or persons enrolled
384.11 	in an non-Medicare individual health plan determined to be
384.12 	cost-effective according to section 256B.0625, subdivision 15.
384.13 	Children under age 21 who are in foster placement may enroll in
384.14 	the project on an elective basis.  Individuals excluded under
384.15 	clauses (1), (6), and (7) may choose to enroll on an elective
384.16 	basis.  The commissioner may enroll recipients in the prepaid
384.17 	medical assistance program for seniors who are (1) age 65 and
384.18 	over, and (2) eligible for medical assistance by spending down
384.19 	excess income.
384.20 	(c) The commissioner may allow persons with a one-month
384.21 	spenddown who are otherwise eligible to enroll to voluntarily
384.22 	enroll or remain enrolled, if they elect to prepay their monthly
384.23 	spenddown to the state.
384.24 	(d) The commissioner may require those individuals to
384.25 	enroll in the prepaid medical assistance program who otherwise
384.26 	would have been excluded under paragraph (b), clauses (1), (3),
384.27 	and (8), and under Minnesota Rules, part 9500.1452, subpart 2,
384.28 	items H, K, and L.
384.29 	(e) Before limitation of choice is implemented, eligible
384.30 	individuals shall be notified and after notification, shall be
384.31 	allowed to choose only among demonstration providers.  The
384.32 	commissioner may assign an individual with private coverage
384.33 	through a health maintenance organization, to the same health
384.34 	maintenance organization for medical assistance coverage, if the
384.35 	health maintenance organization is under contract for medical
384.36 	assistance in the individual's county of residence.  After
385.1 	initially choosing a provider, the recipient is allowed to
385.2 	change that choice only at specified times as allowed by the
385.3 	commissioner.  If a demonstration provider ends participation in
385.4 	the project for any reason, a recipient enrolled with that
385.5 	provider must select a new provider but may change providers
385.6 	without cause once more within the first 60 days after
385.7 	enrollment with the second provider.
385.8 	(f) An infant born to a woman who is eligible for and
385.9 	receiving medical assistance and who is enrolled in the prepaid
385.10 	medical assistance program shall be retroactively enrolled to
385.11 	the month of birth in the same managed care plan as the mother
385.12 	once the child is enrolled in medical assistance unless the
385.13 	child is determined to be excluded from enrollment in a prepaid
385.14 	plan under this section.
385.15 	
EFFECTIVE DATE. This section is effective September 1,
385.16 	2005.

385.17 	Sec. 52. Minnesota Statutes 2004, section 256D.03,
385.18 	subdivision 3, as amended by Laws 2005, chapter 98, article 2,
385.19 	section 14, is amended to read:
385.20 		Subd. 3.General assistance medical care; eligibility.
 385.21 	(a) General assistance medical care may be paid for any person
385.22 	who is not eligible for medical assistance under chapter 256B,
385.23 	including eligibility for medical assistance based on a
385.24 	spenddown of excess income according to section 256B.056,
385.25 	subdivision 5, or MinnesotaCare as defined in paragraph (b),
385.26 	except as provided in paragraph (c), and:
385.27 	(1) who is receiving assistance under section 256D.05,
385.28 	except for families with children who are eligible under
385.29 	Minnesota family investment program (MFIP), or who is having a
385.30 	payment made on the person's behalf under sections 256I.01 to
385.31 	256I.06; or
385.32 	(2) who is a resident of Minnesota; and
385.33 	(i) who has gross countable income not in excess of 75
385.34 	percent of the federal poverty guidelines for the family size,
385.35 	using a six-month budget period and whose equity in assets is
385.36 	not in excess of $1,000 per assistance unit.  Exempt assets, the
386.1 	reduction of excess assets, and the waiver of excess assets must
386.2 	conform to the medical assistance program in section 256B.056,
386.3 	subdivision 3, with the following exception:  the maximum amount
386.4 	of undistributed funds in a trust that could be distributed to
386.5 	or on behalf of the beneficiary by the trustee, assuming the
386.6 	full exercise of the trustee's discretion under the terms of the
386.7 	trust, must be applied toward the asset maximum;
386.8 	(ii) who has gross countable income above 75 percent of the
386.9 	federal poverty guidelines but not in excess of 175 percent of
386.10 	the federal poverty guidelines for the family size, using a
386.11 	six-month budget period, whose equity in assets is not in excess
386.12 	of the limits in section 256B.056, subdivision 3c, and who
386.13 	applies during an inpatient hospitalization; or
386.14 	(iii) the commissioner shall adjust the income standards
386.15 	under this section each July 1 by the annual update of the
386.16 	federal poverty guidelines following publication by the United
386.17 	States Department of Health and Human Services.
386.18 	(b) Effective for applications and renewals processed on or
386.19 	after September 1, 2006,general assistance medical care may not
386.20 	be paid for applicants or recipients who meet all eligibility
386.21 	requirements of MinnesotaCare as defined in sections 256L.01 to
386.22 	256L.16, and are adults with dependent children under 21 whose
386.23 	gross family income is equal to or less than 275 percent of the
386.24 	federal poverty guidelines who are not described in paragraph
386.25 	(e).
386.26 	(c) Effective for applications and renewals processed on or
386.27 	after September 1, 2006, general assistance medical care may be
386.28 	paid for applicants and recipients who meet all eligibility
386.29 	requirements of paragraph (a), clause (2), item (i), for a
386.30 	temporary period beginning the date of application.  Immediately
386.31 	following approval of general assistance medical care, enrollees
386.32 	shall be enrolled in MinnesotaCare under section 256L.04,
386.33 	subdivision 7, with covered services as provided in section
386.34 	256L.03 for the rest of the six-month eligibility period, until
386.35 	their six-month renewal.
386.36 	(d) To be eligible for general assistance medical care
387.1 	following enrollment in MinnesotaCare as required by paragraph
387.2 	(c), an individual must complete a new application.
387.3 	(e) Applicants and recipients eligible under paragraph (a),
387.4 	clause (1), or who have applied for and are awaiting a
387.5 	determination of blindness or disability by the state medical
387.6 	review team or a determination of eligibility for Supplemental
387.7 	Security Income or Social Security Disability Insurance by the
387.8 	Social Security Administration, or who fail to meet the
387.9 	requirements of section 256L.09, subdivision 2, are exempt from
387.10 	the MinnesotaCare enrollment requirements of this subdivision.
387.11 	(c) (f) For applications received on or after October 1,
387.12 	2003, eligibility may begin no earlier than the date of
387.13 	application.  For individuals eligible under paragraph (a),
387.14 	clause (2), item (i), a redetermination of eligibility must
387.15 	occur every 12 months.  Individuals are eligible under paragraph
387.16 	(a), clause (2), item (ii), only during inpatient
387.17 	hospitalization but may reapply if there is a subsequent period
387.18 	of inpatient hospitalization.
387.19 	(g) Beginning January September 1, 2000 2006, Minnesota
387.20 	health care program applications and renewals completed by
387.21 	recipients and applicants who are persons described in
387.22 	paragraph (b), may be returned (c) and submitted to the county
387.23 	agency to be forwarded to the Department of Human Services or
387.24 	sent directly to the Department of Human Services for enrollment
387.25 	in MinnesotaCare shall be determined for MinnesotaCare
387.26 	eligibility by the county agency.  If all other eligibility
387.27 	requirements of this subdivision are met, eligibility for
387.28 	general assistance medical care shall be available in any month
387.29 	during which a MinnesotaCare eligibility determination and 
387.30 	enrollment are is pending.  Upon notification of eligibility for
387.31 	MinnesotaCare, notice of termination for eligibility for general
387.32 	assistance medical care shall be sent to an applicant or
387.33 	recipient.  If all other eligibility requirements of this
387.34 	subdivision are met, eligibility for general assistance medical
387.35 	care shall be available until enrollment in MinnesotaCare
387.36 	subject to the provisions of paragraph (e) paragraphs (c), (e),
388.1 	and (f).
388.2 	(d) (h) The date of an initial Minnesota health care
388.3 	program application necessary to begin a determination of
388.4 	eligibility shall be the date the applicant has provided a name,
388.5 	address, and Social Security number, signed and dated, to the
388.6 	county agency or the Department of Human Services.  If the
388.7 	applicant is unable to provide a name, address, Social Security
388.8 	number, and signature when health care is delivered due to a
388.9 	medical condition or disability, a health care provider may act
388.10 	on an applicant's behalf to establish the date of an initial
388.11 	Minnesota health care program application by providing the
388.12 	county agency or Department of Human Services with provider
388.13 	identification and a temporary unique identifier for the
388.14 	applicant.  The applicant must complete the remainder of the
388.15 	application and provide necessary verification before
388.16 	eligibility can be determined.  The county agency must assist
388.17 	the applicant in obtaining verification if necessary.
388.18 	(e) (i) County agencies are authorized to use all automated
388.19 	databases containing information regarding recipients' or
388.20 	applicants' income in order to determine eligibility for general
388.21 	assistance medical care or MinnesotaCare.  Such use shall be
388.22 	considered sufficient in order to determine eligibility and
388.23 	premium payments by the county agency.
388.24 	(f) (j) General assistance medical care is not available
388.25 	for a person in a correctional facility unless the person is
388.26 	detained by law for less than one year in a county correctional
388.27 	or detention facility as a person accused or convicted of a
388.28 	crime, or admitted as an inpatient to a hospital on a criminal
388.29 	hold order, and the person is a recipient of general assistance
388.30 	medical care at the time the person is detained by law or
388.31 	admitted on a criminal hold order and as long as the person
388.32 	continues to meet other eligibility requirements of this
388.33 	subdivision.
388.34 	(g) (k) General assistance medical care is not available
388.35 	for applicants or recipients who do not cooperate with the
388.36 	county agency to meet the requirements of medical assistance.
389.1 	(h) (l) In determining the amount of assets of an
389.2 	individual eligible under paragraph (a), clause (2), item (i),
389.3 	there shall be included any asset or interest in an asset,
389.4 	including an asset excluded under paragraph (a), that was given
389.5 	away, sold, or disposed of for less than fair market value
389.6 	within the 60 months preceding application for general
389.7 	assistance medical care or during the period of eligibility.
389.8 	Any transfer described in this paragraph shall be presumed to
389.9 	have been for the purpose of establishing eligibility for
389.10 	general assistance medical care, unless the individual furnishes
389.11 	convincing evidence to establish that the transaction was
389.12 	exclusively for another purpose.  For purposes of this
389.13 	paragraph, the value of the asset or interest shall be the fair
389.14 	market value at the time it was given away, sold, or disposed
389.15 	of, less the amount of compensation received.  For any
389.16 	uncompensated transfer, the number of months of ineligibility,
389.17 	including partial months, shall be calculated by dividing the
389.18 	uncompensated transfer amount by the average monthly per person
389.19 	payment made by the medical assistance program to skilled
389.20 	nursing facilities for the previous calendar year.  The
389.21 	individual shall remain ineligible until this fixed period has
389.22 	expired.  The period of ineligibility may exceed 30 months, and
389.23 	a reapplication for benefits after 30 months from the date of
389.24 	the transfer shall not result in eligibility unless and until
389.25 	the period of ineligibility has expired.  The period of
389.26 	ineligibility begins in the month the transfer was reported to
389.27 	the county agency, or if the transfer was not reported, the
389.28 	month in which the county agency discovered the transfer,
389.29 	whichever comes first.  For applicants, the period of
389.30 	ineligibility begins on the date of the first approved
389.31 	application.
389.32 	(i) (m) When determining eligibility for any state benefits
389.33 	under this subdivision, the income and resources of all
389.34 	noncitizens shall be deemed to include their sponsor's income
389.35 	and resources as defined in the Personal Responsibility and Work
389.36 	Opportunity Reconciliation Act of 1996, title IV, Public Law
390.1 	104-193, sections 421 and 422, and subsequently set out in
390.2 	federal rules.
390.3 	(j) (n) Undocumented noncitizens and nonimmigrants are
390.4 	ineligible for general assistance medical care.  For purposes of
390.5 	this subdivision, a nonimmigrant is an individual in one or more
390.6 	of the classes listed in United States Code, title 8, section
390.7 	1101(a)(15), and an undocumented noncitizen is an individual who
390.8 	resides in the United States without the approval or
390.9 	acquiescence of the Immigration and Naturalization Service.
390.10 	(k) (o) Notwithstanding any other provision of law, a
390.11 	noncitizen who is ineligible for medical assistance due to the
390.12 	deeming of a sponsor's income and resources, is ineligible for
390.13 	general assistance medical care.
390.14 	(l) (p) Effective July 1, 2003, general assistance medical
390.15 	care emergency services end.
390.16 	
EFFECTIVE DATE. This section is effective September 1,
390.17 	2006.

390.18 	Sec. 53. Minnesota Statutes 2004, section 256D.03,
390.19 	subdivision 4, is amended to read:
390.20 		Subd. 4.General assistance medical care; services.
 390.21 	(a)(i) For a person who is eligible under subdivision 3,
390.22 	paragraph (a), clause (2), item (i), general assistance medical
390.23 	care covers, except as provided in paragraph (c):
390.24 	(1) inpatient hospital services;
390.25 	(2) outpatient hospital services;
390.26 	(3) services provided by Medicare certified rehabilitation
390.27 	agencies;
390.28 	(4) prescription drugs and other products recommended
390.29 	through the process established in section 256B.0625,
390.30 	subdivision 13;
390.31 	(5) equipment necessary to administer insulin and
390.32 	diagnostic supplies and equipment for diabetics to monitor blood
390.33 	sugar level;
390.34 	(6) eyeglasses and eye examinations provided by a physician
390.35 	or optometrist;
390.36 	(7) hearing aids;
391.1 	(8) prosthetic devices;
391.2 	(9) laboratory and X-ray services;
391.3 	(10) physician's services;
391.4 	(11) medical transportation except special transportation;
391.5 	(12) chiropractic services as covered under the medical
391.6 	assistance program;
391.7 	(13) podiatric services;
391.8 	(14) dental services and dentures, subject to the
391.9 	limitations specified in section 256B.0625, subdivision 9as
391.10 	covered under the medical assistance program;
391.11 	(15) outpatient services provided by a mental health center
391.12 	or clinic that is under contract with the county board and is
391.13 	established under section 245.62;
391.14 	(16) day treatment services for mental illness provided
391.15 	under contract with the county board;
391.16 	(17) prescribed medications for persons who have been
391.17 	diagnosed as mentally ill as necessary to prevent more
391.18 	restrictive institutionalization;
391.19 	(18) psychological services, medical supplies and
391.20 	equipment, and Medicare premiums, coinsurance and deductible
391.21 	payments;
391.22 	(19) medical equipment not specifically listed in this
391.23 	paragraph when the use of the equipment will prevent the need
391.24 	for costlier services that are reimbursable under this
391.25 	subdivision;
391.26 	(20) services performed by a certified pediatric nurse
391.27 	practitioner, a certified family nurse practitioner, a certified
391.28 	adult nurse practitioner, a certified obstetric/gynecological
391.29 	nurse practitioner, a certified neonatal nurse practitioner, or
391.30 	a certified geriatric nurse practitioner in independent
391.31 	practice, if (1) the service is otherwise covered under this
391.32 	chapter as a physician service, (2) the service provided on an
391.33 	inpatient basis is not included as part of the cost for
391.34 	inpatient services included in the operating payment rate, and
391.35 	(3) the service is within the scope of practice of the nurse
391.36 	practitioner's license as a registered nurse, as defined in
392.1 	section 148.171;
392.2 	(21) services of a certified public health nurse or a
392.3 	registered nurse practicing in a public health nursing clinic
392.4 	that is a department of, or that operates under the direct
392.5 	authority of, a unit of government, if the service is within the
392.6 	scope of practice of the public health nurse's license as a
392.7 	registered nurse, as defined in section 148.171; and
392.8 	(22) telemedicine consultations, to the extent they are
392.9 	covered under section 256B.0625, subdivision 3b.
392.10 	(ii) Effective October 1, 2003, for a person who is
392.11 	eligible under subdivision 3, paragraph (a), clause (2), item
392.12 	(ii), general assistance medical care coverage is limited to
392.13 	inpatient hospital services, including physician services
392.14 	provided during the inpatient hospital stay.  A $1,000
392.15 	deductible is required for each inpatient hospitalization.
392.16 	(b) Gender Effective August 1, 2005, sex reassignment
392.17 	surgery and related services are is not covered services under
392.18 	this subdivision unless the individual began receiving gender
392.19 	reassignment services prior to July 1, 1995.
392.20 	(c) In order to contain costs, the commissioner of human
392.21 	services shall select vendors of medical care who can provide
392.22 	the most economical care consistent with high medical standards
392.23 	and shall where possible contract with organizations on a
392.24 	prepaid capitation basis to provide these services.  The
392.25 	commissioner shall consider proposals by counties and vendors
392.26 	for prepaid health plans, competitive bidding programs, block
392.27 	grants, or other vendor payment mechanisms designed to provide
392.28 	services in an economical manner or to control utilization, with
392.29 	safeguards to ensure that necessary services are provided.
392.30 	Before implementing prepaid programs in counties with a county
392.31 	operated or affiliated public teaching hospital or a hospital or
392.32 	clinic operated by the University of Minnesota, the commissioner
392.33 	shall consider the risks the prepaid program creates for the
392.34 	hospital and allow the county or hospital the opportunity to
392.35 	participate in the program in a manner that reflects the risk of
392.36 	adverse selection and the nature of the patients served by the
393.1 	hospital, provided the terms of participation in the program are
393.2 	competitive with the terms of other participants considering the
393.3 	nature of the population served.  Payment for services provided
393.4 	pursuant to this subdivision shall be as provided to medical
393.5 	assistance vendors of these services under sections 256B.02,
393.6 	subdivision 8, and 256B.0625.  For payments made during fiscal
393.7 	year 1990 and later years, the commissioner shall consult with
393.8 	an independent actuary in establishing prepayment rates, but
393.9 	shall retain final control over the rate methodology.
393.10 	(d) Recipients eligible under subdivision 3, paragraph (a),
393.11 	clause (2), item (i),shall pay the following co-payments for
393.12 	services provided on or after October 1, 2003:
393.13 	(1) $3 per nonpreventive visit.  For purposes of this
393.14 	subdivision, a visit means an episode of service which is
393.15 	required because of a recipient's symptoms, diagnosis, or
393.16 	established illness, and which is delivered in an ambulatory
393.17 	setting by a physician or physician ancillary, chiropractor,
393.18 	podiatrist, nurse midwife, advanced practice nurse, audiologist,
393.19 	optician, or optometrist;
393.20 	(2) $25 for eyeglasses;
393.21 	(3) (2) $25 for nonemergency visits to a hospital-based
393.22 	emergency room;
393.23 	(4) (3) $3 per brand-name drug prescription and $1 per
393.24 	generic drug prescription, subject to a $20 $12 per month
393.25 	maximum for prescription drug co-payments.  No co-payments shall
393.26 	apply to antipsychotic drugs when used for the treatment of
393.27 	mental illness; and
393.28 	(5) (4) 50 percent coinsurance on restorative dental
393.29 	services.
393.30 	(e) Co-payments shall be limited to one per day per
393.31 	provider for nonpreventive visits, eyeglasses, and nonemergency
393.32 	visits to a hospital-based emergency room.  Recipients of
393.33 	general assistance medical care are responsible for all
393.34 	co-payments in this subdivision.  The general assistance medical
393.35 	care reimbursement to the provider shall be reduced by the
393.36 	amount of the co-payment, except that reimbursement for
394.1 	prescription drugs shall not be reduced once a recipient has
394.2 	reached the $20 $12 per month maximum for prescription drug
394.3 	co-payments.  The provider collects the co-payment from the
394.4 	recipient.  Providers may not deny services to recipients who
394.5 	are unable to pay the co-payment, except as provided in
394.6 	paragraph (f).
394.7 	(f) If it is the routine business practice of a provider to
394.8 	refuse service to an individual with uncollected debt, the
394.9 	provider may include uncollected co-payments under this
394.10 	section.  A provider must give advance notice to a recipient
394.11 	with uncollected debt before services can be denied.
394.12 	(g) Any county may, from its own resources, provide medical
394.13 	payments for which state payments are not made.
394.14 	(h) Chemical dependency services that are reimbursed under
394.15 	chapter 254B must not be reimbursed under general assistance
394.16 	medical care.
394.17 	(i) The maximum payment for new vendors enrolled in the
394.18 	general assistance medical care program after the base year
394.19 	shall be determined from the average usual and customary charge
394.20 	of the same vendor type enrolled in the base year.
394.21 	(j) The conditions of payment for services under this
394.22 	subdivision are the same as the conditions specified in rules
394.23 	adopted under chapter 256B governing the medical assistance
394.24 	program, unless otherwise provided by statute or rule.
394.25 	(k) Inpatient and outpatient payments shall be reduced by
394.26 	five percent, effective July 1, 2003.  This reduction is in
394.27 	addition to the five percent reduction effective July 1, 2003,
394.28 	and incorporated by reference in paragraph (i).
394.29 	(l) Payments for all other health services except
394.30 	inpatient, outpatient, and pharmacy services shall be reduced by
394.31 	five percent, effective July 1, 2003.
394.32 	(m) Payments to managed care plans shall be reduced by five
394.33 	percent for services provided on or after October 1, 2003.
394.34 	(n) A hospital receiving a reduced payment as a result of
394.35 	this section may apply the unpaid balance toward satisfaction of
394.36 	the hospital's bad debts.
395.1 	(o) Fee-for-service payments for nonpreventive visits shall
395.2 	be reduced by $3 for services provided on or after January 1,
395.3 	2006.  For purposes of this subdivision, a visit means an
395.4 	episode of service which is required because of a recipient's
395.5 	symptoms, diagnosis, or established illness, and which is
395.6 	delivered in an ambulatory setting by a physician or physician
395.7 	ancillary, chiropractor, podiatrist, advance practice nurse,
395.8 	audiologist, optician, or optometrist.
395.9 	(p) Payments to managed care plans shall not be increased
395.10 	as a result of the removal of the $3 nonpreventive visit
395.11 	co-payment effective January 1, 2006.
395.12 	
EFFECTIVE DATE. Paragraph (b) is effective August 1,
395.13 	2005, and paragraph (d) is effective January 1, 2006.

395.14 	Sec. 54. Minnesota Statutes 2004, section 256D.045, is
395.15 	amended to read:
395.16 	256D.045 SOCIAL SECURITY NUMBER REQUIRED.
395.17 	To be eligible for general assistance under sections
395.18 	256D.01 to 256D.21, an individual must provide the individual's
395.19 	Social Security number to the county agency or submit proof that
395.20 	an application has been made. An individual who refuses to
395.21 	provide a Social Security number because of a well-established
395.22 	religious objection as described in Code of Federal Regulations,
395.23 	title 42, section 435.910, may be eligible for general
395.24 	assistance medical care under section 256D.03.The provisions
395.25 	of this section do not apply to the determination of eligibility
395.26 	for emergency general assistance under section 256D.06,
395.27 	subdivision 2.  This provision applies to eligible children
395.28 	under the age of 18 effective July 1, 1997.

395.29 	EFFECTIVE DATE. This section is effective August 1, 2007,
395.30 	or upon HealthMatch implementation, whichever is later.

395.31 	Sec. 55. Minnesota Statutes 2004, section 256L.01,
395.32 	subdivision 4, is amended to read:
395.33 		Subd. 4.Gross individual or gross family income.  (a)
395.34 	"Gross individual or gross family income" for nonfarm
395.35 	self-employed means income calculated for the six-month period
395.36 	of eligibility using as the baseline the adjusted gross income 
396.1 	the net profit or loss reported on the applicant's federal
396.2 	income tax form for the previous year and adding back in
396.3 	reported depreciation, carryover loss, and net operating loss
396.4 	amounts that apply to the business in which the family is
396.5 	currently engaged using the medical assistance families with
396.6 	children methodology for determining allowable and nonallowable
396.7 	self-employment expenses and countable income.
396.8 	(b) "Gross individual or gross family income" for farm
396.9 	self-employed means income calculated for the six-month period
396.10 	of eligibility using as the baseline the adjusted gross income
396.11 	reported on the applicant's federal income tax form for the
396.12 	previous year and adding back in reported depreciation amounts
396.13 	that apply to the business in which the family is currently
396.14 	engaged.
396.15 	(c) Applicants shall report the most recent financial
396.16 	situation of the family if it has changed from the period of
396.17 	time covered by the federal income tax form.  The report may be
396.18 	in the form of percentage increase or decrease "Gross individual
396.19 	or gross family income" means the total income for all family
396.20 	members, calculated for the six-month period of eligibility.
396.21 	
EFFECTIVE DATE. This section is effective August 1, 2007,
396.22 	or upon HealthMatch implementation, whichever is later.

396.23 	Sec. 56. Minnesota Statutes 2004, section 256L.01,
396.24 	subdivision 5, is amended to read:
396.25 		Subd. 5.Income. (a) "Income" has the meaning given for
396.26 	earned and unearned income for families and children in the
396.27 	medical assistance program, according to the state's aid to
396.28 	families with dependent children plan in effect as of July 16,
396.29 	1996.  The definition does not include medical assistance income
396.30 	methodologies and deeming requirements.  The earned income of
396.31 	full-time and part-time students under age 19 is not counted as
396.32 	income.  Public assistance payments and supplemental security
396.33 	income are not excluded income.
396.34 	(b) For purposes of this subdivision, and unless otherwise
396.35 	specified in this section, the commissioner shall use reasonable
396.36 	methods to calculate gross earned and unearned income including,
397.1 	but not limited to, projecting income based on income received
397.2 	within the past 30 days, the last 90 days, or the last 12 months.
397.3 	
EFFECTIVE DATE. This section is effective retroactively
397.4 	from July 1, 2005.

397.5 	Sec. 57. Minnesota Statutes 2004, section 256L.03,
397.6 	subdivision 1, is amended to read:
397.7 		Subdivision 1.Covered health services.  For individuals
397.8 	under section 256L.04, subdivision 7, with income no greater
397.9 	than 75 percent of the federal poverty guidelines or for
397.10 	families with children under section 256L.04, subdivision 1, all
397.11 	subdivisions of this section apply.  "Covered health services"
397.12 	means the health services reimbursed under chapter 256B, with
397.13 	the exception of inpatient hospital services, special education
397.14 	services, private duty nursing services, adult dental care
397.15 	services other than services covered under section 256B.0625,
397.16 	subdivision 9, paragraph (b),orthodontic services, nonemergency
397.17 	medical transportation services, personal care assistant and
397.18 	case management services, nursing home or intermediate care
397.19 	facilities services, inpatient mental health services, and
397.20 	chemical dependency services.  Outpatient mental health services
397.21 	covered under the MinnesotaCare program are limited to
397.22 	diagnostic assessments, psychological testing, explanation of
397.23 	findings, medication management by a physician, day treatment,
397.24 	partial hospitalization, and individual, family, and group
397.25 	psychotherapy.
397.26 	No public funds shall be used for coverage of abortion
397.27 	under MinnesotaCare except where the life of the female would be
397.28 	endangered or substantial and irreversible impairment of a major
397.29 	bodily function would result if the fetus were carried to term;
397.30 	or where the pregnancy is the result of rape or incest.
397.31 	Covered health services shall be expanded as provided in
397.32 	this section.
397.33 	
EFFECTIVE DATE. This section is effective January 1, 2006.

397.34 	Sec. 58. Minnesota Statutes 2004, section 256L.03,
397.35 	subdivision 1b, is amended to read:
397.36 		Subd. 1b.Pregnant women; eligibility for full medical
398.1 	assistance services. Beginning January 1, 1999,A pregnant 
398.2 	woman who is enrolled in MinnesotaCare when her pregnancy is
398.3 	diagnosed is eligible for coverage of all services provided
398.4 	under the medical assistance program according to chapter 256B
398.5 	retroactive to the date the pregnancy is medically diagnosed of
398.6 	conception.  Co-payments totaling $30 or more, paid after the
398.7 	date the pregnancy is diagnosed of conception, shall be refunded.
398.8 	
EFFECTIVE DATE. This section is effective September 1,
398.9 	2005.

398.10 	Sec. 59. Minnesota Statutes 2004, section 256L.03,
398.11 	subdivision 5, is amended to read:
398.12 		Subd. 5.Co-payments and coinsurance.  (a) Except as
398.13 	provided in paragraphs (b) and (c), the MinnesotaCare benefit
398.14 	plan shall include the following co-payments and coinsurance
398.15 	requirements for all enrollees:
398.16 	(1) ten percent of the paid charges for inpatient hospital
398.17 	services for adult enrollees, subject to an annual inpatient
398.18 	out-of-pocket maximum of $1,000 per individual and $3,000 per
398.19 	family;
398.20 	(2) $3 per prescription for adult enrollees;
398.21 	(3) $25 for eyeglasses for adult enrollees; and 
398.22 	(4) $3 per nonpreventive visit.  For purposes of this
398.23 	subdivision, a "visit" means an episode of service which is
398.24 	required because of a recipient's symptoms, diagnosis, or
398.25 	established illness, and which is delivered in an ambulatory
398.26 	setting by a physician or physician ancillary, chiropractor,
398.27 	podiatrist, nurse midwife, advanced practice nurse, audiologist,
398.28 	optician, or optometrist;
398.29 	(5) $6 for nonemergency visits to a hospital-based
398.30 	emergency room; and 
398.31 	(6) 50 percent of the fee-for-service rate for adult dental
398.32 	care services other than preventive care services for persons
398.33 	eligible under section 256L.04, subdivisions 1 to 7, with income
398.34 	equal to or less than 175 percent of the federal poverty
398.35 	guidelines.
398.36 	(b) Paragraph (a), clause (1), does not apply to parents
399.1 	and relative caretakers of children under the age of 21 in
399.2 	households with family income equal to or less than 175 percent
399.3 	of the federal poverty guidelines.  Paragraph (a), clause (1),
399.4 	does not apply to parents and relative caretakers of children
399.5 	under the age of 21 in households with family income greater
399.6 	than 175 percent of the federal poverty guidelines for inpatient
399.7 	hospital admissions occurring on or after January 1, 2001.
399.8 	(c) Paragraph (a), clauses (1) to (4), do not apply to
399.9 	pregnant women and children under the age of 21.
399.10 	(d) Adult enrollees with family gross income that exceeds
399.11 	175 percent of the federal poverty guidelines and who are not
399.12 	pregnant shall be financially responsible for the coinsurance
399.13 	amount, if applicable, and amounts which exceed the $10,000
399.14 	inpatient hospital benefit limit.
399.15 	(e) When a MinnesotaCare enrollee becomes a member of a
399.16 	prepaid health plan, or changes from one prepaid health plan to
399.17 	another during a calendar year, any charges submitted towards
399.18 	the $10,000 annual inpatient benefit limit, and any
399.19 	out-of-pocket expenses incurred by the enrollee for inpatient
399.20 	services, that were submitted or incurred prior to enrollment,
399.21 	or prior to the change in health plans, shall be disregarded.
399.22 	
EFFECTIVE DATE. This section is effective January 1, 2006.

399.23 	Sec. 60. Minnesota Statutes 2004, section 256L.035, is
399.24 	amended to read:
399.25 	256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE
399.26 	ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.
399.27 	(a) "Covered health services" for individuals under section
399.28 	256L.04, subdivision 7, with income above 75 percent, but not
399.29 	exceeding 175 percent, of the federal poverty guideline means:
399.30 	(1) inpatient hospitalization benefits with a ten percent
399.31 	co-payment up to $1,000 and subject to an annual limitation of
399.32 	$10,000;
399.33 	(2) physician services provided during an inpatient stay;
399.34 	and
399.35 	(3) physician services not provided during an inpatient
399.36 	stay,;outpatient hospital services,;freestanding ambulatory
400.1 	surgical center services,;chiropractic services,;lab and
400.2 	diagnostic services,; diabetic supplies and equipment;and
400.3 	prescription drugs,;subject to an aggregate cap of $2,000 per
400.4 	calendar year and the following co-payments:
400.5 	(i) $50 co-pay per emergency room visit;
400.6 	(ii) $3 co-pay per prescription drug; and
400.7 	(iii) $5 co-pay per nonpreventive physician visit.
400.8 	The services covered under this section may be provided by a
400.9 	physician, physician ancillary, chiropractor, psychologist, or
400.10 	licensed independent clinical social worker if the services are
400.11 	within the scope of practice of that health care professional.
400.12 	For purposes of this subdivision section, "a visit" means
400.13 	an episode of service which is required because of a recipient's
400.14 	symptoms, diagnosis, or established illness, and which is
400.15 	delivered in an ambulatory setting by a physician or physician
400.16 	ancillary any health care provider identified in this paragraph.
400.17 	Enrollees are responsible for all co-payments in this
400.18 	subdivision section.
400.19 	(b) The November 2006 MinnesotaCare forecast for the
400.20 	biennium beginning July 1, 2007, shall assume an adjustment in
400.21 	the aggregate cap on the services identified in paragraph (a),
400.22 	clause (3), in $1,000 increments up to a maximum of $10,000, but
400.23 	not less than $2,000, to the extent that the balance in the
400.24 	health care access fund is sufficient in each year of the
400.25 	biennium to pay for this benefit level.  The aggregate cap shall
400.26 	be adjusted according to the forecast.
400.27 	(c) Reimbursement to the providers shall be reduced by the
400.28 	amount of the co-payment, except that reimbursement for
400.29 	prescription drugs shall not be reduced once a recipient has
400.30 	reached the $20 per month maximum for prescription drug
400.31 	co-payments.  The provider collects the co-payment from the
400.32 	recipient.  Providers may not deny services to recipients who
400.33 	are unable to pay the co-payment, except as provided in
400.34 	paragraph (d) (c).
400.35 	(d) (c) If it is the routine business practice of a
400.36 	provider to refuse service to an individual with uncollected
401.1 	debt, the provider may include uncollected co-payments under
401.2 	this section.  A provider must give advance notice to a
401.3 	recipient with uncollected debt before services can be denied.

401.4 	EFFECTIVE DATE. This section is effective January 1, 2006.

401.5 	Sec. 61. Minnesota Statutes 2004, section 256L.04, is
401.6 	amended by adding a subdivision to read:
401.7 		Subd. 1a.Social security number required. (a)
401.8 	Individuals and families applying for MinnesotaCare coverage
401.9 	must provide a Social Security number.
401.10 	(b) The commissioner shall not deny eligibility to an
401.11 	otherwise eligible applicant who has applied for a Social
401.12 	Security number and is awaiting issuance of that Social Security
401.13 	number.
401.14 	(c) Newborns enrolled under section 256L.05, subdivision 3,
401.15 	are exempt from the requirements of this subdivision.
401.16 	(d) Individuals who refuse to provide a Social Security
401.17 	number because of well-established religious objections are
401.18 	exempt from the requirements of this subdivision.  The term
401.19 	"well-established religious objections" has the meaning given in
401.20 	Code of Federal Regulations, title 42, section 435.910.
401.21 	
EFFECTIVE DATE. This section is effective August 1, 2007,
401.22 	or upon HealthMatch implementation, whichever is later.

401.23 	Sec. 62. Minnesota Statutes 2004, section 256L.04,
401.24 	subdivision 2, is amended to read:
401.25 		Subd. 2.Cooperation in establishing third-party
401.26 	liability, paternity, and other medical support.  (a) To be
401.27 	eligible for MinnesotaCare, individuals and families must
401.28 	cooperate with the state agency to identify potentially liable
401.29 	third-party payers and assist the state in obtaining third-party
401.30 	payments.  "Cooperation" includes, but is not limited
401.31 	to, complying with the notice requirements in section 256B.056,
401.32 	subdivision 9,identifying any third party who may be liable for
401.33 	care and services provided under MinnesotaCare to the enrollee,
401.34 	providing relevant information to assist the state in pursuing a
401.35 	potentially liable third party, and completing forms necessary
401.36 	to recover third-party payments.
402.1 	(b) A parent, guardian, relative caretaker, or child
402.2 	enrolled in the MinnesotaCare program must cooperate with the
402.3 	Department of Human Services and the local agency in
402.4 	establishing the paternity of an enrolled child and in obtaining
402.5 	medical care support and payments for the child and any other
402.6 	person for whom the person can legally assign rights, in
402.7 	accordance with applicable laws and rules governing the medical
402.8 	assistance program.  A child shall not be ineligible for or
402.9 	disenrolled from the MinnesotaCare program solely because the
402.10 	child's parent, relative caretaker, or guardian fails to
402.11 	cooperate in establishing paternity or obtaining medical support.
402.12 	
EFFECTIVE DATE. This section is effective August 1, 2005.

402.13 	Sec. 63. Minnesota Statutes 2004, section 256L.04, is
402.14 	amended by adding a subdivision to read:
402.15 		Subd. 2a.Applications for other benefits. To be
402.16 	eligible for MinnesotaCare, individuals and families must take
402.17 	all necessary steps to obtain other benefits as described in
402.18 	Code of Federal Regulations, title 42, section 435.608.
402.19 	Applicants and enrollees must apply for other benefits within 30
402.20 	days of notification.
402.21 	
EFFECTIVE DATE. This section is effective August 1, 2007,
402.22 	or upon HealthMatch implementation, whichever is later.

402.23 	Sec. 64. Minnesota Statutes 2004, section 256L.05, is
402.24 	amended by adding a subdivision to read:
402.25 		Subd. 1b.Minnesotacare enrollment by county
402.26 	agencies. Beginning September 1, 2006, county agencies shall
402.27 	enroll single adults and households with no children formerly
402.28 	enrolled in general assistance medical care in MinnesotaCare
402.29 	according to section 256D.03, subdivision 3.  County agencies
402.30 	shall perform all duties necessary to administer the
402.31 	MinnesotaCare program ongoing for these enrollees, including the
402.32 	redetermination of MinnesotaCare eligibility at six-month
402.33 	renewal.
402.34 	
EFFECTIVE DATE. This section is effective September 1,
402.35 	2006.

402.36 	Sec. 65. Minnesota Statutes 2004, section 256L.05,
403.1 	subdivision 2, is amended to read:
403.2 		Subd. 2.Commissioner's duties. (a) The commissioner or
403.3 	county agency shall use electronic verification as the primary
403.4 	method of income verification.  If there is a discrepancy
403.5 	between reported income and electronically verified income, an
403.6 	individual may be required to submit additional verification.
403.7 	In addition, the commissioner shall perform random audits to
403.8 	verify reported income and eligibility.  The commissioner may
403.9 	execute data sharing arrangements with the Department of Revenue
403.10 	and any other governmental agency in order to perform income
403.11 	verification related to eligibility and premium payment under
403.12 	the MinnesotaCare program.
403.13 	(b) In determining eligibility for MinnesotaCare, the
403.14 	commissioner shall require applicants and enrollees seeking
403.15 	renewal of eligibility to verify both earned and unearned
403.16 	income.  The commissioner shall also require applicants and
403.17 	enrollees to submit the names of their employers and a contact
403.18 	name with a telephone number for each employer for purposes of
403.19 	verifying whether the applicant or enrollee, and any dependents,
403.20 	are eligible for employer-subsidized coverage.  Data collected
403.21 	is nonpublic data as defined in section 13.02, subdivision 9.
403.22 	
EFFECTIVE DATE. This section is effective September 1,
403.23 	2005.  Prior to the implementation of HealthMatch, the
403.24 	commissioner shall implement this section to the fullest extent
403.25 	possible, including the use of manual processing.  Upon
403.26 	implementation of HealthMatch, the commissioner shall implement
403.27 	this section in a manner consistent with the procedures and
403.28 	requirements of HealthMatch.

403.29 	Sec. 66. Minnesota Statutes 2004, section 256L.05,
403.30 	subdivision 3, is amended to read:
403.31 		Subd. 3.Effective date of coverage.  (a) The effective
403.32 	date of coverage is the first day of the month following the
403.33 	month in which eligibility is approved and the first premium
403.34 	payment has been received.  As provided in section 256B.057,
403.35 	coverage for newborns is automatic from the date of birth and
403.36 	must be coordinated with other health coverage.  The effective
404.1 	date of coverage for eligible newly adoptive children added to a
404.2 	family receiving covered health services is the date of entry
404.3 	into the family month of placement.  The effective date of
404.4 	coverage for other new recipients members added to the family
404.5 	receiving covered health services is the first day of the month
404.6 	following the month in which eligibility is approved or at
404.7 	renewal, whichever the family receiving covered health services
404.8 	prefers the change is reported.  All eligibility criteria must
404.9 	be met by the family at the time the new family member is
404.10 	added.  The income of the new family member is included with the
404.11 	family's gross income and the adjusted premium begins in the
404.12 	month the new family member is added.
404.13 	(b) The initial premium must be received by the last
404.14 	working day of the month for coverage to begin the first day of
404.15 	the following month.
404.16 	(c) Benefits are not available until the day following
404.17 	discharge if an enrollee is hospitalized on the first day of
404.18 	coverage.
404.19 	(d) Notwithstanding any other law to the contrary, benefits
404.20 	under sections 256L.01 to 256L.18 are secondary to a plan of
404.21 	insurance or benefit program under which an eligible person may
404.22 	have coverage and the commissioner shall use cost avoidance
404.23 	techniques to ensure coordination of any other health coverage
404.24 	for eligible persons.  The commissioner shall identify eligible
404.25 	persons who may have coverage or benefits under other plans of
404.26 	insurance or who become eligible for medical assistance.
404.27 	(e) The effective date of coverage for single adults and
404.28 	households with no children formerly enrolled in general
404.29 	assistance medical care and enrolled in MinnesotaCare according
404.30 	to section 256D.03, subdivision 3, is the first day of the month
404.31 	following the last day of general assistance medical care
404.32 	coverage.
404.33 	
EFFECTIVE DATE. Paragraph (a) is effective August 1,
404.34 	2007, or upon HealthMatch implementation, whichever is later,
404.35 	and paragraph (e) is effective September 1, 2006.

404.36 	Sec. 67. Minnesota Statutes 2004, section 256L.05,
405.1 	subdivision 3a, is amended to read:
405.2 		Subd. 3a.Renewal of eligibility.  (a) Beginning January
405.3 	1, 1999, an enrollee's eligibility must be renewed every 12
405.4 	months.  The 12-month period begins in the month after the month
405.5 	the application is approved.
405.6 	(b) Beginning October 1, 2004, an enrollee's eligibility
405.7 	must be renewed every six months.  The first six-month period of
405.8 	eligibility begins in the month after the month the application
405.9 	is approved received by the commissioner. The effective date of
405.10 	coverage within the first six-month period of eligibility is as
405.11 	provided in subdivision 3.Each new period of eligibility must
405.12 	take into account any changes in circumstances that impact
405.13 	eligibility and premium amount.  An enrollee must provide all
405.14 	the information needed to redetermine eligibility by the first
405.15 	day of the month that ends the eligibility period.  The premium
405.16 	for the new period of eligibility must be received as provided
405.17 	in section 256L.06 in order for eligibility to continue.
405.18 	(c) For single adults and households with no children
405.19 	formerly enrolled in general assistance medical care and
405.20 	enrolled in MinnesotaCare according to section 256D.03,
405.21 	subdivision 3, the first six-month period of eligibility begins
405.22 	the month the enrollee submitted the application or renewal for
405.23 	general assistance medical care.
405.24 	
EFFECTIVE DATE. Paragraph (b) is effective August 1,
405.25 	2007, or upon HealthMatch implementation, whichever is later,
405.26 	and paragraph (c) is effective September 1, 2006.

405.27 	Sec. 68. Minnesota Statutes 2004, section 256L.06,
405.28 	subdivision 3, is amended to read:
405.29 		Subd. 3.Commissioner's duties and payment.  (a) Premiums
405.30 	are dedicated to the commissioner for MinnesotaCare.
405.31 	(b) The commissioner shall develop and implement procedures
405.32 	to:  (1) require enrollees to report changes in income; (2)
405.33 	adjust sliding scale premium payments, based upon changes both
405.34 	increases and decreases in enrollee income, at the time the
405.35 	change in income is reported; and (3) disenroll enrollees from
405.36 	MinnesotaCare for failure to pay required premiums.  Failure to
406.1 	pay includes payment with a dishonored check, a returned
406.2 	automatic bank withdrawal, or a refused credit card or debit
406.3 	card payment.  The commissioner may demand a guaranteed form of
406.4 	payment, including a cashier's check or a money order, as the
406.5 	only means to replace a dishonored, returned, or refused payment.
406.6 	(c) Premiums are calculated on a calendar month basis and
406.7 	may be paid on a monthly, quarterly, or semiannual basis, with
406.8 	the first payment due upon notice from the commissioner of the
406.9 	premium amount required.  The commissioner shall inform
406.10 	applicants and enrollees of these premium payment options.
406.11 	Premium payment is required before enrollment is complete and to
406.12 	maintain eligibility in MinnesotaCare.  Premium payments
406.13 	received before noon are credited the same day.  Premium
406.14 	payments received after noon are credited on the next working
406.15 	day.
406.16 	(d) Nonpayment of the premium will result in disenrollment
406.17 	from the plan effective for the calendar month for which the
406.18 	premium was due.  Persons disenrolled for nonpayment or who
406.19 	voluntarily terminate coverage from the program may not reenroll
406.20 	until four calendar months have elapsed.  Persons disenrolled
406.21 	for nonpayment who pay all past due premiums as well as current
406.22 	premiums due, including premiums due for the period of
406.23 	disenrollment, within 20 days of disenrollment, shall be
406.24 	reenrolled retroactively to the first day of disenrollment.
406.25 	Persons disenrolled for nonpayment or who voluntarily terminate
406.26 	coverage from the program may not reenroll for four calendar
406.27 	months unless the person demonstrates good cause for
406.28 	nonpayment.  Good cause does not exist if a person chooses to
406.29 	pay other family expenses instead of the premium.  The
406.30 	commissioner shall define good cause in rule.
406.31 	
EFFECTIVE DATE. This section is effective September 1,
406.32 	2005, or upon federal approval, whichever is later.  Prior to
406.33 	the implementation of HealthMatch, the commissioner shall
406.34 	implement this section to the fullest extent possible, including
406.35 	the use of manual processing.  Upon implementation of
406.36 	HealthMatch, the commissioner shall implement this section in a
407.1 	manner consistent with the procedures and requirements of
407.2 	HealthMatch.

407.3 	Sec. 69. Minnesota Statutes 2004, section 256L.07,
407.4 	subdivision 1, as amended by Laws 2005, chapter 10, article 1,
407.5 	section 56, is amended to read:
407.6 		Subdivision 1.General requirements. (a) Children
407.7 	enrolled in the original children's health plan as of September
407.8 	30, 1992, children who enrolled in the MinnesotaCare program
407.9 	after September 30, 1992, pursuant to Laws 1992, chapter 549,
407.10 	article 4, section 17, and children who have family gross
407.11 	incomes that are equal to or less than 150 percent of the
407.12 	federal poverty guidelines are eligible without meeting the
407.13 	requirements of subdivision 2 and the four-month requirement in
407.14 	subdivision 3, as long as they maintain continuous coverage in
407.15 	the MinnesotaCare program or medical assistance.  Children who
407.16 	apply for MinnesotaCare on or after the implementation date of
407.17 	the employer-subsidized health coverage program as described in
407.18 	Laws 1998, chapter 407, article 5, section 45, who have family
407.19 	gross incomes that are equal to or less than 150 percent of the
407.20 	federal poverty guidelines, must meet the requirements of
407.21 	subdivision 2 to be eligible for MinnesotaCare.
407.22 	(b) Families enrolled in MinnesotaCare under section
407.23 	256L.04, subdivision 1, whose income increases above 275 percent
407.24 	of the federal poverty guidelines, are no longer eligible for
407.25 	the program and shall be disenrolled by the commissioner.
407.26 	Individuals enrolled in MinnesotaCare under section 256L.04,
407.27 	subdivision 7, whose income increases above 175 percent of the
407.28 	federal poverty guidelines are no longer eligible for the
407.29 	program and shall be disenrolled by the commissioner.  For
407.30 	persons disenrolled under this subdivision, MinnesotaCare
407.31 	coverage terminates the last day of the calendar month following
407.32 	the month in which the commissioner determines that the income
407.33 	of a family or individual exceeds program income limits.
407.34 	(c) Notwithstanding paragraph (b), children may remain
407.35 	enrolled in MinnesotaCare if ten percent of their annual gross
407.36 	individual or gross family income as defined in section 256L.01,
408.1 	subdivision 4,is less than the annual premium for a six-month 
408.2 	policy with a $500 deductible available through the Minnesota
408.3 	Comprehensive Health Association.  Children who are no longer
408.4 	eligible for MinnesotaCare under this clause shall be given a
408.5 	12-month notice period from the date that ineligibility is
408.6 	determined before disenrollment.  The premium for children
408.7 	remaining eligible under this clause shall be the maximum
408.8 	premium determined under section 256L.15, subdivision 2,
408.9 	paragraph (b).
408.10 	(d) Notwithstanding paragraphs (b) and (c), parents are not
408.11 	eligible for MinnesotaCare if gross household income exceeds
408.12 	$50,000 $25,000 for the six-month period of eligibility.
408.13 	
EFFECTIVE DATE. This section is effective August 1, 2007,
408.14 	or upon HealthMatch implementation, whichever is later.

408.15 	Sec. 70. Minnesota Statutes 2004, section 256L.07, is
408.16 	amended by adding a subdivision to read:
408.17 		Subd. 2a.Must not have access to health coverage through
408.18 	a postsecondary education institution. To be eligible, an
408.19 	individual under 21 years of age who is enrolled in a program of
408.20 	study at a postsecondary education institution, including an
408.21 	emancipated minor and an emancipated minor's spouse, must not
408.22 	have access to health coverage through the postsecondary
408.23 	education institution.
408.24 	
EFFECTIVE DATE. This section is effective September 1,
408.25 	2005, or upon federal approval, whichever is later.  Prior to
408.26 	implementation of HealthMatch, the commissioner shall implement
408.27 	the section to the fullest extent possible, including the use of
408.28 	manual processing.  Upon implementation of HealthMatch, the
408.29 	commissioner shall implement this section in a manner consistent
408.30 	with the procedures and requirements of HealthMatch.

408.31 	Sec. 71. Minnesota Statutes 2004, section 256L.07,
408.32 	subdivision 3, is amended to read:
408.33 		Subd. 3.Other health coverage.  (a) Families and
408.34 	individuals enrolled in the MinnesotaCare program must have no
408.35 	health coverage while enrolled or for at least four months prior
408.36 	to application and renewal.  Children enrolled in the original
409.1 	children's health plan and children in families with income
409.2 	equal to or less than 150 percent of the federal poverty
409.3 	guidelines, who have other health insurance, are eligible if the
409.4 	coverage:
409.5 	(1) lacks two or more of the following:
409.6 	(i) basic hospital insurance;
409.7 	(ii) medical-surgical insurance;
409.8 	(iii) prescription drug coverage;
409.9 	(iv) dental coverage; or
409.10 	(v) vision coverage;
409.11 	(2) requires a deductible of $100 or more per person per
409.12 	year; or
409.13 	(3) lacks coverage because the child has exceeded the
409.14 	maximum coverage for a particular diagnosis or the policy
409.15 	excludes a particular diagnosis.
409.16 	The commissioner may change this eligibility criterion for
409.17 	sliding scale premiums in order to remain within the limits of
409.18 	available appropriations.  The requirement of no health coverage
409.19 	does not apply to newborns.
409.20 	(b) Medical assistance, general assistance medical care,
409.21 	and the Civilian Health and Medical Program of the Uniformed
409.22 	Service, CHAMPUS, or other coverage provided under United States
409.23 	Code, title 10, subtitle A, part II, chapter 55, are not
409.24 	considered insurance or health coverage for purposes of the
409.25 	four-month requirement described in this subdivision.
409.26 	(c) For purposes of this subdivision, an applicant or
409.27 	enrollee who is entitled to Medicare Part A or enrolled in
409.28 	Medicare Part B coverage under title XVIII of the Social
409.29 	Security Act, United States Code, title 42, sections 1395c
409.30 	to 1395w-4 1395w-152, is considered to have health coverage.  An
409.31 	applicant or enrollee who is entitled to premium-free Medicare
409.32 	Part A may not refuse to apply for or enroll in Medicare
409.33 	coverage to establish eligibility for MinnesotaCare.
409.34 	(d) Applicants who were recipients of medical assistance or
409.35 	general assistance medical care within one month of application
409.36 	must meet the provisions of this subdivision and subdivision 2.
410.1 	(e) Effective October 1, 2003, applicants who were
410.2 	recipients of medical assistance and had Cost-effective health
410.3 	insurance which that was paid for by medical assistance are
410.4 	exempt from is not considered health coverage for purposes of 
410.5 	the four-month requirement under this section, except if the
410.6 	insurance continued after medical assistance no longer
410.7 	considered it cost-effective or after medical assistance closed.
410.8 	
EFFECTIVE DATE. This section is effective September 1,
410.9 	2005.

410.10 	Sec. 72. Minnesota Statutes 2004, section 256L.07, is
410.11 	amended by adding a subdivision to read:
410.12 		Subd. 6.Exception for certain adults. Single adults and
410.13 	households with no children formerly enrolled in general
410.14 	assistance medical care and enrolled in MinnesotaCare according
410.15 	to section 256D.03, subdivision 3, are eligible without meeting
410.16 	the requirements of this section until six-month renewal.
410.17 	
EFFECTIVE DATE. This section is effective September 1,
410.18 	2006.

410.19 	Sec. 73. Minnesota Statutes 2004, section 256L.12, is
410.20 	amended by adding a subdivision to read:
410.21 		Subd. 9b.Rate setting; ratable reduction. In addition
410.22 	to the reduction in subdivision 9a, the total payment made to
410.23 	managed care plans under the MinnesotaCare program shall be
410.24 	reduced for services provided on or after January 1, 2006, to
410.25 	reflect a 6.0 percent reduction in reimbursement for inpatient
410.26 	hospital services.
410.27 	
EFFECTIVE DATE. This section is effective August 1, 2005.

410.28 	Sec. 74. Minnesota Statutes 2004, section 256L.15,
410.29 	subdivision 2, as amended by Laws 2005, chapter 10, article 1,
410.30 	section 57, is amended to read:
410.31 		Subd. 2.Sliding fee scale to determine percentage of
410.32 	monthly gross individual or family income. (a) The commissioner
410.33 	shall establish a sliding fee scale to determine the percentage
410.34 	of monthly gross individual or family income that households at
410.35 	different income levels must pay to obtain coverage through the
410.36 	MinnesotaCare program.  The sliding fee scale must be based on
411.1 	the enrollee's monthly gross individual or family income.  The
411.2 	sliding fee scale must contain separate tables based on
411.3 	enrollment of one, two, or three or more persons.  The sliding
411.4 	fee scale begins with a premium of 1.5 percent of monthly gross
411.5 	individual or family income for individuals or families with
411.6 	incomes below the limits for the medical assistance program for
411.7 	families and children in effect on January 1, 1999, and proceeds
411.8 	through the following evenly spaced steps:  1.8, 2.3, 3.1, 3.8,
411.9 	4.8, 5.9, 7.4, and 8.8 percent.  These percentages are matched
411.10 	to evenly spaced income steps ranging from the medical
411.11 	assistance income limit for families and children in effect on
411.12 	January 1, 1999, to 275 percent of the federal poverty
411.13 	guidelines for the applicable family size, up to a family size
411.14 	of five.  The sliding fee scale for a family of five must be
411.15 	used for families of more than five.  Effective October 1, 2003,
411.16 	the commissioner shall increase each percentage by 0.5
411.17 	percentage points for enrollees with income greater than 100
411.18 	percent but not exceeding 200 percent of the federal poverty
411.19 	guidelines and shall increase each percentage by 1.0 percentage
411.20 	points for families and children with incomes greater than 200
411.21 	percent of the federal poverty guidelines.  The sliding fee
411.22 	scale and percentages are not subject to the provisions of
411.23 	chapter 14.  If a family or individual reports increased income
411.24 	after enrollment, premiums shall not be adjusted until
411.25 	eligibility renewal at the time the change in income is reported.
411.26 	(b) Children in families whose gross income is above 275
411.27 	percent of the federal poverty guidelines shall pay the maximum
411.28 	premium.
411.29 	The maximum premium is defined as a base charge for one,
411.30 	two, or three or more enrollees so that if all MinnesotaCare
411.31 	cases paid the maximum premium, the total revenue would equal
411.32 	the total cost of MinnesotaCare medical coverage and
411.33 	administration.  In this calculation, administrative costs shall
411.34 	be assumed to equal ten percent of the total.  The costs of
411.35 	medical coverage for pregnant women and children under age two
411.36 	and the enrollees in these groups shall be excluded from the
412.1 	total.  The maximum premium for two enrollees shall be twice the
412.2 	maximum premium for one, and the maximum premium for three or
412.3 	more enrollees shall be three times the maximum premium for one.
412.4 	(c) After calculating the percentage of premium each
412.5 	enrollee shall pay under paragraph (a), eight percent shall be
412.6 	added to the premium.
412.7 	
EFFECTIVE DATE. The amendment to paragraph (a) changing
412.8 	gross family or individual income to monthly gross family or
412.9 	individual income is effective August 1, 2007, or upon
412.10 	implementation of HealthMatch, whichever is later.  The
412.11 	amendment to paragraph (a) related to premium adjustments and
412.12 	changes of income and the amendment to paragraph (c) are
412.13 	effective September 1, 2005, or upon federal approval, whichever
412.14 	is later.  Prior to the implementation of HealthMatch, the
412.15 	commissioner shall implement this section to the fullest extent
412.16 	possible, including the use of manual processing.  Upon
412.17 	implementation of HealthMatch, the commissioner shall implement
412.18 	this section in a manner consistent with the procedures and
412.19 	requirements of HealthMatch.

412.20 	Sec. 75. Minnesota Statutes 2004, section 256L.15,
412.21 	subdivision 3, is amended to read:
412.22 		Subd. 3.Exceptions to sliding scale. An annual premium
412.23 	of $48 is required for all Children in families with income at
412.24 	or less than below 150 percent of the federal poverty guidelines
412.25 	pay a monthly premium of $4.
412.26 	
EFFECTIVE DATE. This section is effective August 1, 2007,
412.27 	or upon HealthMatch implementation, whichever is later.

412.28 	Sec. 76. Minnesota Statutes 2004, section 256L.15, is
412.29 	amended by adding a subdivision to read:
412.30 		Subd. 4.Exception for transitioned adults. County
412.31 	agencies shall pay premiums for single adults and households
412.32 	with no children formerly enrolled in general assistance medical
412.33 	care and enrolled in MinnesotaCare according to section 256D.03,
412.34 	subdivision 3, until six-month renewal.  The county agency has
412.35 	the option of continuing to pay premiums for these enrollees
412.36 	past the first six-month renewal period.
413.1 	
EFFECTIVE DATE. This section is effective September 1,
413.2 	2006.

413.3 	Sec. 77. Minnesota Statutes 2004, section 256L.17, is
413.4 	amended by adding a subdivision to read:
413.5 		Subd. 7.Exception for certain adults. Single adults and
413.6 	households with no children formerly enrolled in general
413.7 	assistance medical care and enrolled in MinnesotaCare according
413.8 	to section 256D.03, subdivision 3, are exempt from the
413.9 	requirements of this section until six-month renewal.
413.10 	
EFFECTIVE DATE. This section is effective September 1,
413.11 	2006.

413.12 	Sec. 78. Minnesota Statutes 2004, section 549.02, is
413.13 	amended by adding a subdivision to read:
413.14 		Subd. 3.Limitation. Notwithstanding subdivisions 1 and
413.15 	2, where the state agency is named or intervenes as a party to
413.16 	enforce the agency's rights under section 256B.056, the agency
413.17 	shall not be liable for costs to any prevailing defendant.
413.18 	
EFFECTIVE DATE. This section is effective August 1, 2005.

413.19 	Sec. 79. Minnesota Statutes 2004, section 549.04, is
413.20 	amended to read:
413.21 	549.04 DISBURSEMENTS; TAXATION AND ALLOWANCE.
413.22 		Subdivision 1.Generally. In every action in a district
413.23 	court, the prevailing party, including any public employee who
413.24 	prevails in an action for wrongfully denied or withheld
413.25 	employment benefits or rights, shall be allowed reasonable
413.26 	disbursements paid or incurred, including fees and mileage paid
413.27 	for service of process by the sheriff or by a private person.
413.28 		Subd. 2.Limitation. Notwithstanding subdivision 1,
413.29 	where the state agency is named or intervenes as a party to
413.30 	enforce the agency's rights under section 256B.056, the agency
413.31 	shall not be liable for disbursements to any prevailing
413.32 	defendant.
413.33 	
EFFECTIVE DATE. This section is effective August 1, 2005.

413.34 	Sec. 80. Laws 2003, First Special Session chapter 14,
413.35 	article 12, section 93, is amended to read:
413.36 	Sec. 93REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY
414.1 	CRITERIA AND POTENTIAL COST SAVINGS.
 414.2 	The commissioner of human services, in consultation with
414.3 	the commissioner of transportation and special transportation
414.4 	service providers, shall review eligibility criteria for medical
414.5 	assistance special transportation services and shall evaluate
414.6 	whether the level of special transportation services provided
414.7 	should be based on the degree of impairment of the client, as
414.8 	well as the medical diagnosis.  The commissioner shall also
414.9 	evaluate methods for reducing the cost of special transportation
414.10 	services, including, but not limited to:
414.11 	(1) requiring providers to maintain a daily log book
414.12 	confirming delivery of clients to medical facilities;
414.13 	(2) requiring providers to implement commercially available
414.14 	computer mapping programs to calculate mileage for purposes of
414.15 	reimbursement;
414.16 	(3) restricting special transportation service from being
414.17 	provided solely for trips to pharmacies;
414.18 	(4) modifying eligibility for special transportation;
414.19 	(5) expanding alternatives to the use of special
414.20 	transportation services;
414.21 	(6) improving the process of certifying persons as eligible
414.22 	for special transportation services; and
414.23 	(7) examining the feasibility and benefits of licensing
414.24 	special transportation providers.
414.25 	The commissioner shall present recommendations for changes
414.26 	in the eligibility criteria and potential cost-savings for
414.27 	special transportation services to the chairs and ranking
414.28 	minority members of the house and senate committees having
414.29 	jurisdiction over health and human services spending by January
414.30 	15, 2004.  The commissioner is prohibited from using a broker or
414.31 	coordinator to manage special transportation services until July
414.32 	1, 2005 2006, except for the purposes of checking for recipient
414.33 	eligibility, authorizing recipients for appropriate level of
414.34 	transportation, and monitoring provider compliance with
414.35 	Minnesota Statutes, section 256B.0625, subdivision 17. The
414.36 	commissioner shall not amend the initial contract to broker or
415.1 	manage nonemergency medical transportation to extend beyond two
415.2 	consecutive years.  The commissioner shall not enter into a
415.3 	broker or management contract for transportation services which
415.4 	denies a medical assistance recipient the free choice of health
415.5 	service provider, including a special transportation provider,
415.6 	as specified in Code of Federal Regulations, title 42, section
415.7 	431.51.This prohibition does not apply to the purchase or
415.8 	management of common carrier transportation.

415.9 	EFFECTIVE DATE. This section is effective the day
415.10 	following final enactment.

415.11 	Sec. 81. ADVISORY COMMITTEE ON NONEMERGENCY
415.12 	TRANSPORTATION SERVICES.
 415.13 	The commissioner of human services shall establish a
415.14 	seven-member advisory committee on medical assistance
415.15 	nonemergency transportation services.  The committee shall
415.16 	consist of:  a representative of the commissioner of human
415.17 	services, who shall serve as chair; two special transportation
415.18 	service providers, appointed by the trade associations
415.19 	representing special transportation service providers; one
415.20 	representative of nursing facilities; one representative of the
415.21 	disability community; and one house and one senate member,
415.22 	appointed respectively by the chairs of the house and senate
415.23 	committees with jurisdiction over medical assistance funding.
415.24 	The advisory committee shall monitor and evaluate the provision
415.25 	of medical assistance nonemergency medical transportation
415.26 	services, and present recommendations for any necessary changes
415.27 	to the commissioner.

415.28 	EFFECTIVE DATE. This section is effective the day
415.29 	following final enactment.

415.30 	Sec. 82. LIMITING COVERAGE OF HEALTH CARE SERVICES FOR
415.31 	MEDICAL ASSISTANCE, GENERAL ASSISTANCE MEDICAL CARE, AND
415.32 	MINNESOTACARE PROGRAMS.
 415.33 		Subdivision 1.Prior authorization of services. (a)
415.34 	Effective September 1, 2005, prior authorization is required for
415.35 	the services described in subdivision 2 for reimbursement under
415.36 	chapters 256B, 256D, and 256L.
416.1 	(b) Prior authorization shall be conducted under the
416.2 	direction of the medical director of the Department of Human
416.3 	Services in conjunction with a medical policy advisory council.
416.4 	To the extent available, the medical director shall use publicly
416.5 	available evidence-based guidelines developed by an independent,
416.6 	nonprofit organization or by the professional association of the
416.7 	specialty that typically provides the service or by a multistate
416.8 	Medicaid evidence-based practice center.  If the commissioner
416.9 	does not have a medical director and medical policy director in
416.10 	place, the commissioner shall contract prior authorization to a
416.11 	Minnesota-licensed utilization review organization or to another
416.12 	entity such as a peer review organization eligible to operate in
416.13 	Minnesota.
416.14 	(c) A prepaid health plan shall use prior authorization for
416.15 	the services described in subdivision 2 unless the prepaid
416.16 	health plan is otherwise using evidence-based practices to
416.17 	address these services.
416.18 		Subd. 2.Services requiring prior authorization. The
416.19 	following services require prior authorization:
416.20 	(1) elective outpatient high-technology imaging to include
416.21 	positive emission tomography (PET) scans, magnetic resonance
416.22 	imaging (MRI), computed tomography (CT), and nuclear cardiology;
416.23 	(2) spinal fusion, unless in an emergency situation related
416.24 	to trauma;
416.25 	(3) bariatric surgery;
416.26 	(4) cesarean section or insertion of tympanostomy tubes
416.27 	except in an emergency situation;
416.28 	(5) hysterectomy; and 
416.29 	(6) orthodontia.
416.30 		Subd. 3.Rate reduction. Effective for the services
416.31 	identified in subdivision 2, rendered on or after September 1,
416.32 	2005, the payment rate shall be reduced by ten percent from the
416.33 	rate in effect on June 30, 2005.  This subdivision expires July
416.34 	1, 2006, or upon the completion of the prior authorization
416.35 	system required under subdivision 1, whichever is earlier.
416.36 		Subd. 4.Appeals. (a) For review of an initial
417.1 	determination not to certify conducted under section 62M.06,
417.2 	subdivision 2 or 3, of a service that is subject to prior
417.3 	authorization under this section, the health care provider
417.4 	conducting the review must follow, when available, published
417.5 	evidence-based health care guidelines as established by a
417.6 	nonprofit Minnesota quality improvement organization, a
417.7 	nationally recognized guideline development organization, or by
417.8 	the professional association of the specialty that typically
417.9 	provides the service.
417.10 	(b) For appeals conducted under section 256.045,
417.11 	subdivision 3a, of a decision by a prepaid health plan to deny,
417.12 	reduce, or terminate a health care service that is subject to
417.13 	prior authorization under this section, the referee must base
417.14 	the decision on the application of the publicly available
417.15 	evidence-based health care guidelines referred to in subdivision
417.16 	1 or as established by the commissioner of human services
417.17 	provided that the guidelines meet the criteria set forth in
417.18 	section 62J.43, subdivision 2.
417.19 		Subd. 5.Expiration. This section expires July 1, 2007.
417.20 	
EFFECTIVE DATE. This section is effective the day
417.21 	following final enactment.

417.22 	Sec. 83. ORAL HEALTH CARE PILOT PROJECT.
 417.23 	The commissioner shall implement a two-year pilot project
417.24 	to provide services for state program recipients through a new
417.25 	oral health care delivery system.  The commissioner shall
417.26 	contract with a qualified entity or entities to administer the
417.27 	pilot project.

417.28 	EFFECTIVE DATE. This section is effective the day
417.29 	following final enactment.

417.30 	Sec. 84. SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
417.31 	CONTRACT.
 417.32 	Notwithstanding Minnesota Statutes, section 256B.692,
417.33 	subdivision 6, the commissioner of human services shall not
417.34 	reject a county-based purchasing health plan proposal that
417.35 	requires county-based purchasing on a sole-source or single-plan
417.36 	basis if the implementation of the sole-source or single-plan
418.1 	purchasing proposal does not limit an enrollee's provider choice
418.2 	or access to services.  The commissioner shall request federal
418.3 	approval, if necessary, to permit or maintain a sole-source or
418.4 	single-plan purchasing option even if choice is available in the
418.5 	area.

418.6 	EFFECTIVE DATE. This section is effective the day
418.7 	following final enactment.

418.8 	Sec. 85. PLANNING PROCESS FOR MANAGED CARE.
 418.9 	The commissioner of human services shall develop a planning
418.10 	process for the purposes of implementing at least one additional
418.11 	managed care arrangement to provide medical assistance services,
418.12 	excluding continuing care services, to recipients enrolled in
418.13 	the medical assistance fee-for-service program, effective
418.14 	January 1, 2007.  This planning process shall include an
418.15 	advisory committee composed of current fee-for-service
418.16 	consumers, consumer advocates, and providers, as well as
418.17 	representatives of health plans and other provider organizations
418.18 	qualified to provide basic health care services to persons with
418.19 	disabilities.  The commissioner shall seek any additional
418.20 	federal authority necessary to provide basic health care
418.21 	services through contracted managed care arrangements.

418.22 	EFFECTIVE DATE. This section is effective the day
418.23 	following final enactment.

418.24 	Sec. 86. DIRECTIVE TO SEEK FEDERAL MATCH FOR ALTERNATIVE
418.25 	CARE PROGRAM.
 418.26 	The commissioner of human services shall seek federal
418.27 	matching funds for the alternative care program during
418.28 	negotiations with the federal government over the repeal of
418.29 	certain intergovernmental transfers under Minnesota Statutes,
418.30 	section 256B.19, subdivision 1c, paragraph (d).  By December 15,
418.31 	2005, the commissioner shall report to the chairs of the house
418.32 	and senate finance committees and divisions with jurisdiction
418.33 	over funding for the Department of Human Services regarding the
418.34 	results of these negotiations.

418.35 	EFFECTIVE DATE. This section is effective the day
418.36 	following final enactment.

419.1 	Sec. 87. FEDERAL APPROVAL.
 419.2 	The commissioner of human services shall seek federal
419.3 	waivers and approvals necessary to allow the commissioner to
419.4 	charge medical assistance recipients with gross family incomes
419.5 	greater than 175 percent of the federal poverty guidelines
419.6 	sliding scale premiums, based on the sliding scale used for the
419.7 	MinnesotaCare program under Minnesota Statutes, section 256L.15.

419.8 	EFFECTIVE DATE. This section is effective the day
419.9 	following final enactment.

419.10 	Sec. 88. REPEALER.
 419.11 	(a) Minnesota Statutes 2004, section 256.955, is repealed
419.12 	effective January 1, 2006.
419.13 	(b) Minnesota Statutes 2004, section 256B.075, subdivision
419.14 	5, is repealed the day following final enactment.
419.15 	(c) Minnesota Statutes 2004, section 256L.04, subdivision
419.16 	11, MinnesotaCare outreach grants, is repealed effective August
419.17 	1, 2005.

419.18 	ARTICLE 9
419.19 	APPROPRIATIONS

419.20 	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 419.21 	The sums shown in the columns marked "APPROPRIATIONS" are
419.22 	appropriated from the general fund, or any other fund named, to
419.23 	the agencies and for the purposes specified in the sections of
419.24 	this article, to be available for the fiscal years indicated for
419.25 	each purpose.  The figures "2006" and "2007" where used in this
419.26 	article, mean that the appropriation or appropriations listed
419.27 	under them are available for the fiscal year ending June 30,
419.28 	2006, or June 30, 2007, respectively.  The first year is fiscal
419.29 	year 2006.  The second year is fiscal year 2007.  The biennium
419.30 	is fiscal years 2006 and 2007.
419.31 	SUMMARY BY FUND
419.32 	BIENNIAL
419.33 	                           2006          2007           TOTAL
419.34 	General            $4,093,090,000 $4,242,843,000 $8,335,933,000
419.35 	State Government
419.36 	Special Revenue        50,740,000     51,536,000    102,276,000
419.37 	Health Care
420.1 	Access                334,301,000    430,860,000    765,161,000
420.2 	Federal TANF          285,678,000    313,355,000    599,033,000
420.3 	Lottery Prize
420.4 	Fund                    1,456,000      1,456,000      2,912,000
420.5 	TOTAL              $4,765,265,000 $5,040,050,000 $9,805,315,000
420.6 	APPROPRIATIONS
420.7 	                                       Available for the Year
420.8 	                                           Ending June 30
420.9 	                                          2006         2007

420.10 	Sec. 2. COMMISSIONER OF
420.11 	HUMAN SERVICES
 420.12 		Subdivision 1.Total
420.13 	Appropriation                     $4,603,330,000 $4,875,483,000
420.14 	Summary by Fund
420.15 	General           3,993,634,000 4,141,557,000
420.16 	State Government
420.17 	Special Revenue         534,000       534,000
420.18 	Health Care
420.19 	Access              328,028,000   424,581,000
420.20 	Federal TANF        279,678,000   307,355,000
420.21 	Lottery Cash
420.22 	Flow                  1,456,000     1,456,000
420.23 	[RECEIPTS FOR SYSTEMS PROJECTS.]
420.24 	Appropriations and federal receipts for
420.25 	information system projects for MAXIS,
420.26 	PRISM, MMIS, AND SSIS must be deposited
420.27 	in the state system account authorized
420.28 	in Minnesota Statutes, section
420.29 	256.014.  Money appropriated for
420.30 	computer projects approved by the
420.31 	Minnesota Office of Technology, funded
420.32 	by the legislature, and approved by the
420.33 	commissioner of finance, may be
420.34 	transferred from one project to another
420.35 	and from development to operations as
420.36 	the commissioner of human services
420.37 	considers necessary.  Any unexpended
420.38 	balance in the appropriation for these
420.39 	projects does not cancel but is
420.40 	available for ongoing development and
420.41 	operations.
420.42 	[SYSTEMS CONTINUITY.] In the event of
420.43 	disruption of technical systems or
420.44 	computer operations, the commissioner
420.45 	may use available grant appropriations
420.46 	to ensure continuity of payments for
420.47 	maintaining the health, safety, and
420.48 	well-being of clients served by
420.49 	programs administered by the Department
420.50 	of Human Services.  Grant funds must be
420.51 	used in a manner consistent with the
420.52 	original intent of the appropriation.
420.53 	[NONFEDERAL SHARE TRANSFERS.] The
420.54 	nonfederal share of activities for
420.55 	which federal administrative
420.56 	reimbursement is appropriated to the
421.1 	commissioner may be transferred to the
421.2 	special revenue fund.
421.3 	[GIFTS.] Notwithstanding Minnesota
421.4 	Statutes, sections 16A.013 to 16A.016,
421.5 	the commissioner may accept, on behalf
421.6 	of the state, additional funding from
421.7 	sources other than state funds for the
421.8 	purpose of financing the cost of
421.9 	assistance program grants or nongrant
421.10 	administration.  All additional funding
421.11 	is appropriated to the commissioner for
421.12 	use as designated by the grantor of
421.13 	funding.
421.14 	[TANF FUNDS APPROPRIATED TO OTHER
421.15 	ENTITIES.] Any expenditures from the
421.16 	TANF block grant shall be expended
421.17 	according to the requirements and
421.18 	limitations of part A of title IV of
421.19 	the Social Security Act, as amended,
421.20 	and any other applicable federal
421.21 	requirement or limitation.  Prior to
421.22 	any expenditure of these funds, the
421.23 	commissioner shall ensure that funds
421.24 	are expended in compliance with the
421.25 	requirements and limitations of federal
421.26 	law and that any reporting requirements
421.27 	of federal law are met.  It shall be
421.28 	the responsibility of any entity to
421.29 	which these funds are appropriated to
421.30 	implement a memorandum of understanding
421.31 	with the commissioner that provides the
421.32 	necessary assurance of compliance prior
421.33 	to any expenditure of funds.  The
421.34 	commissioner shall receipt TANF funds
421.35 	appropriated to other state agencies
421.36 	and coordinate all related interagency
421.37 	accounting transactions necessary to
421.38 	implement these appropriations.
421.39 	Unexpended TANF funds appropriated to
421.40 	any state, local, or nonprofit entity
421.41 	cancel at the end of the state fiscal
421.42 	year unless appropriating language
421.43 	permits otherwise.
421.44 	[TANF MAINTENANCE OF EFFORT.] (a) In
421.45 	order to meet the basic maintenance of
421.46 	effort (MOE) requirements of the TANF
421.47 	block grant specified under Code of
421.48 	Federal Regulations, title 45, section
421.49 	263.1, the commissioner may only report
421.50 	nonfederal money expended for allowable
421.51 	activities listed in the following
421.52 	clauses as TANF/MOE expenditures:
421.53 	(1) MFIP cash, diversionary work
421.54 	program, and food assistance benefits
421.55 	under Minnesota Statutes, chapter 256J;
421.56 	(2) the child care assistance programs
421.57 	under Minnesota Statutes, sections
421.58 	119B.03 and 119B.05, and county child
421.59 	care administrative costs under
421.60 	Minnesota Statutes, section 119B.15;
421.61 	(3) state and county MFIP
421.62 	administrative costs under Minnesota
421.63 	Statutes, chapters 256J and 256K;
421.64 	(4) state, county, and tribal MFIP
422.1 	employment services under Minnesota
422.2 	Statutes, chapters 256J and 256K;
422.3 	(5) expenditures made on behalf of
422.4 	noncitizen MFIP recipients who qualify
422.5 	for the medical assistance without
422.6 	federal financial participation program
422.7 	under Minnesota Statutes, section
422.8 	256B.06, subdivision 4, paragraphs (d),
422.9 	(e), and (j); and
422.10 	(6) qualifying working family credit
422.11 	expenditures under Minnesota Statutes,
422.12 	section 290.0671.
422.13 	(b) The commissioner shall ensure that
422.14 	sufficient qualified nonfederal
422.15 	expenditures are made each year to meet
422.16 	the state's TANF/MOE requirements.  For
422.17 	the activities listed in paragraph (a),
422.18 	clauses (2) to (6), the commissioner
422.19 	may only report expenditures that are
422.20 	excluded from the definition of
422.21 	assistance under Code of Federal
422.22 	Regulations, title 45, section 260.31.
422.23 	(c) The commissioner shall ensure that
422.24 	the maintenance of effort used by the
422.25 	commissioner of finance for the
422.26 	February and November forecasts
422.27 	required under Minnesota Statutes,
422.28 	section 16A.103, contains expenditures
422.29 	under paragraph (a), clause (1), equal
422.30 	to at least 25 percent of the total
422.31 	required under Code of Federal
422.32 	Regulations, title 45, section 263.1.
422.33 	(d) Minnesota Statutes, section
422.34 	256.011, subdivision 3, which requires
422.35 	that federal grants or aids secured or
422.36 	obtained under that subdivision be used
422.37 	to reduce any direct appropriations
422.38 	provided by law, does not apply if the
422.39 	grants or aids are federal TANF funds.
422.40 	(e) Notwithstanding section 15,
422.41 	paragraph (a), clauses (1) to (6), and
422.42 	paragraphs (b) to (d), expire June 30,
422.43 	2009.
422.44 	[WORKING FAMILY CREDIT EXPENDITURES AS
422.45 	TANF/MOE.] The commissioner may claim
422.46 	as TANF maintenance of effort up to the
422.47 	following amounts of working family
422.48 	credit expenditures for the following
422.49 	fiscal years:
422.50 	(1) fiscal year 2006, $6,942,000; and
422.51 	(2) fiscal year 2007 and thereafter,
422.52 	$6,707,000.
422.53 	[INCREASE WORKING FAMILY CREDIT
422.54 	EXPENDITURES TO BE CLAIMED FOR
422.55 	TANF/MOE.] In addition to the amounts
422.56 	provided in this section, the
422.57 	commissioner may count the following
422.58 	amounts of working family credit
422.59 	expenditure as TANF/MOE:
422.60 	(1) fiscal year 2006, $52,610,000; and
423.1 	(2) fiscal year 2007, $52,655,000.
423.2 	[FOOD STAMPS EMPLOYMENT AND TRAINING
423.3 	FUNDS.] Notwithstanding Minnesota
423.4 	Statutes, sections 256J.626 and
423.5 	256D.051, subdivisions 1a, 6b, and 6c,
423.6 	federal food stamps employment and
423.7 	training funds received as
423.8 	reimbursement of Minnesota family
423.9 	investment program consolidated fund
423.10 	grant expenditures must be deposited in
423.11 	the general fund.  Consistent with the
423.12 	receipt of these federal funds, the
423.13 	commissioner may adjust the level of
423.14 	working family credit expenditures
423.15 	claimed as TANF maintenance of effort.
423.16 	Notwithstanding section 15, this
423.17 	provision expires June 30, 2009.
423.18 	[SPECIAL REVENUE FUND TRANSFER.]
423.19 	Notwithstanding any law to the
423.20 	contrary, excluding accounts authorized
423.21 	under Minnesota Statutes, section
423.22 	16A.1286, and Minnesota Statutes,
423.23 	chapter 254B, the commissioner shall
423.24 	transfer $1,139,000 of uncommitted
423.25 	special revenue fund balances to the
423.26 	general fund.  The actual transfers
423.27 	shall be identified within the standard
423.28 	information provided to the chairs of
423.29 	the legislative committees with
423.30 	jurisdiction over health and human
423.31 	services issues in December 2005.
423.32 	[CAPITATION RATE INCREASE.] Of the
423.33 	health care access fund appropriations
423.34 	to the University of Minnesota in the
423.35 	higher education omnibus appropriation
423.36 	bill, $2,157,000 in fiscal year 2006
423.37 	and $2,157,000 in fiscal year 2007 are
423.38 	to be used to increase the capitation
423.39 	payments under Minnesota Statutes,
423.40 	section 256B.69.  Notwithstanding
423.41 	section 15, this provision shall not
423.42 	expire.
423.43 		Subd. 2.Agency Management
423.44 	Summary by Fund
423.45 	General              46,899,000    46,782,000
423.46 	State Government
423.47 	Special Revenue         415,000       415,000
423.48 	Health Care Access    5,164,000     5,242,000
423.49 	Federal TANF            222,000       222,000
423.50 	The amounts that may be spent from the
423.51 	appropriation for each purpose are as
423.52 	follows:
423.53 	(a) Financial Operations
423.54 	General              10,473,000    10,473,000
423.55 	Health Care Access      848,000       879,000
423.56 	Federal TANF            122,000       122,000
424.1 	[ADMINISTRATIVE BASE ADJUSTMENT - WEB
424.2 	PAYMENT.] The health care access fund
424.3 	base is increased by $37,000 in fiscal
424.4 	year 2008 and $80,000 in fiscal year
424.5 	2009 for fees associated with web-based
424.6 	payment collections.
424.7 	[TRANSFER OF FUNDS.] Of the
424.8 	appropriation in Laws 2005, chapter
424.9 	156, article 1, section 11, subdivision
424.10 	2, $4,670,000 shall be transferred to
424.11 	the commissioner of human services for
424.12 	agency relocation.
424.13 	(b) Legal and
424.14 	Regulation Operations
424.15 	General               9,983,000     9,636,000
424.16 	State Government
424.17 	Special Revenue         415,000       415,000
424.18 	Health Care Access      319,000       319,000
424.19 	Federal TANF            100,000       100,000
424.20 	(c) Management Operations
424.21 	General               3,281,000     3,281,000
424.22 	Health Care Access       68,000        68,000
424.23 	(d) Information Technology
424.24 	Operations
424.25 	General              23,162,000    23,392,000
424.26 	Health Care Access    3,929,000     3,976,000
424.27 		Subd. 3.Revenue and Pass-Through Expenditures
424.28 	Summary by Fund
424.29 	Federal TANF         60,767,000    58,224,000
424.30 	[TANF TRANSFER TO FEDERAL CHILD CARE
424.31 	AND DEVELOPMENT FUND.] $6,692,000 in
424.32 	fiscal year 2006, $3,192,000 in fiscal
424.33 	year 2007, and $3,192,000 in fiscal
424.34 	year 2008 and each fiscal year
424.35 	thereafter is appropriated to the
424.36 	commissioner for the purposes of
424.37 	MFIP/Transition Year child care under
424.38 	Minnesota Statutes, section 119B.05.
424.39 	The commissioner shall authorize
424.40 	transfer of sufficient TANF funds to
424.41 	the federal child care and development
424.42 	fund to meet this appropriation and
424.43 	shall ensure that all transferred funds
424.44 	are expended according to the federal
424.45 	child care and development fund
424.46 	regulations.  Notwithstanding section
424.47 	15, this paragraph shall not expire.
424.48 		Subd. 4.Children and Economic
424.49 	Assistance Grants
424.50 	Summary by Fund
424.51 	General             386,449,000   395,589,000
425.1 	Federal TANF        218,223,000   248,457,000
425.2 	The amounts that may be spent from this
425.3 	appropriation for each purpose are as
425.4 	follows:
425.5 	(a) MFIP/DWP Grants
425.6 	General              35,640,000    31,902,000
425.7 	Federal TANF        114,232,000   117,093,000
425.8 	(b) Support Services Grants
425.9 	General               8,697,000     8,715,000
425.10 	Federal TANF        102,594,000   102,632,000
425.11 	(c) MFIP Child Care Assistance Grants
425.12 	General              55,034,000    33,555,000
425.13 	Federal TANF            -0-        27,335,000
425.14 	[MFIP CHILD CARE; TANF APPROPRIATION.]
425.15 	The federal TANF appropriation is a
425.16 	onetime appropriation.
425.17 	[TANF TRANSFER TO FEDERAL CHILD CARE
425.18 	AND DEVELOPMENT FUND.] $27,335,000 in
425.19 	fiscal year 2007 is appropriated to the
425.20 	commissioner for the purposes of
425.21 	MFIP/Transition Year child care under
425.22 	Minnesota Statutes, section 119B.05.
425.23 	The commissioner shall authorize
425.24 	transfer of sufficient TANF funds to
425.25 	the federal child care and development
425.26 	fund to meet this appropriation and
425.27 	shall ensure that all transferred funds
425.28 	are expended according to the federal
425.29 	child care and development fund
425.30 	regulations.
425.31 	(d) Basic Sliding Fee Child Care
425.32 	Assistance Grants
425.33 	General               7,503,000    28,570,000
425.34 	[CHILD CARE AND DEVELOPMENT FUND
425.35 	UNEXPENDED BALANCE.] In addition to the
425.36 	amount provided in this section, the
425.37 	commissioner shall expend $16,254,000
425.38 	in fiscal year 2006 and $2,085,000 in
425.39 	fiscal year 2007 from the federal child
425.40 	care and development fund unexpended
425.41 	balance for basic sliding fee child
425.42 	care under Minnesota Statutes, section
425.43 	119B.03.  The commissioner shall ensure
425.44 	that all child care and development
425.45 	funds are expended according to the
425.46 	federal child care and development fund
425.47 	regulations.
425.48 	[BASE ADJUSTMENT FOR FREEZE MAXIMUM
425.49 	RATES FOR CHILD CARE ASSISTANCE.] The
425.50 	general fund base is increased by
425.51 	$3,233,000 in fiscal year 2008 and
425.52 	$4,399,000 in fiscal year 2009 for
425.53 	basic sliding fee child care assistance.
425.54 	(e) Child Care Development Grants
426.1 	General               1,540,000     1,540,000
426.2 	(f) Child Support Enforcement Grants
426.3 	General               3,255,000     3,255,000
426.4 	(g) Children's Services Grants
426.5 	General              40,527,000    47,308,000
426.6 	[BASE ADJUSTMENT FOR ADOPTION
426.7 	ASSISTANCE GRANTS.] The general fund
426.8 	base is increased by $449,000 in fiscal
426.9 	year 2008 and $449,000 in fiscal year
426.10 	2009 for adoption assistance grants.
426.11 	[BASE ADJUSTMENT FOR RELATIVE CUSTODY
426.12 	ASSISTANCE GRANTS.] The general fund
426.13 	base is increased by $1,042,000 in
426.14 	fiscal year 2008 and $1,042,000 in
426.15 	fiscal year 2009 for relative custody
426.16 	assistance grants.
426.17 	[ADOPTION ASSISTANCE AND RELATIVE
426.18 	CUSTODY ASSISTANCE.] The commissioner
426.19 	may transfer unencumbered appropriation
426.20 	balances for adoption assistance and
426.21 	relative custody assistance between
426.22 	fiscal years and between programs.
426.23 	[PRIVATIZED ADOPTION GRANTS.] Federal
426.24 	reimbursement for privatized adoption
426.25 	grant and foster care recruitment grant
426.26 	expenditures is appropriated to the
426.27 	commissioner for adoption grants and
426.28 	foster care and adoption administrative
426.29 	purposes.
426.30 	[CHILDREN'S MENTAL HEALTH GRANTS BASE
426.31 	ADJUSTMENT.] The general fund base is
426.32 	increased by $44,000 in fiscal year
426.33 	2008 and fiscal year 2009 for costs
426.34 	associated with the long-term care
426.35 	provider cost-of-living adjustment.
426.36 	[AMERICAN INDIAN CHILD WELFARE PROJECT
426.37 	BASE ADJUSTMENT.] The general fund base
426.38 	is increased by $2,419,000 in fiscal
426.39 	year 2008 and $2,419,000 in fiscal year
426.40 	2009 for the American Indian child
426.41 	welfare project.
426.42 	(h) Children and Community
426.43 	Services Grants
426.44 	General              68,492,000    68,498,000
426.45 	[CHILDREN'S COMMUNITY SERVICE GRANTS
426.46 	BASE ADJUSTMENT.] The general fund base
426.47 	is increased by $3,000 in fiscal year
426.48 	2008 and fiscal year 2009 for costs
426.49 	associated with the long-term care
426.50 	provider cost-of-living adjustment.
426.51 	(i) General Assistance Grants
426.52 	General              30,823,000    31,157,000
426.53 	[GENERAL ASSISTANCE STANDARD.] The
426.54 	commissioner shall set the monthly
427.1 	standard of assistance for general
427.2 	assistance units consisting of an adult
427.3 	recipient who is childless and
427.4 	unmarried or living apart from parents
427.5 	or a legal guardian at $203.  The
427.6 	commissioner may reduce this amount
427.7 	according to Laws 1997, chapter 85,
427.8 	article 3, section 54.
427.9 	[EMERGENCY GENERAL ASSISTANCE.] The
427.10 	amount appropriated for emergency
427.11 	general assistance funds is limited to
427.12 	no more than $7,889,812 in fiscal year
427.13 	2006 and $7,889,812 in fiscal year
427.14 	2007.  Funds to counties shall be
427.15 	allocated by the commissioner using the
427.16 	allocation method specified in
427.17 	Minnesota Statutes, section 256D.06.
427.18 	(j) Minnesota Supplemental Aid Grants
427.19 	General              30,315,000    30,801,000
427.20 	[EMERGENCY MINNESOTA SUPPLEMENTAL AID
427.21 	FUNDS.] The amount appropriated for
427.22 	emergency Minnesota supplemental aid
427.23 	funds is limited to no more than
427.24 	$1,100,000 in fiscal year 2006 and
427.25 	$1,100,000 in fiscal year 2007.  Funds
427.26 	to counties shall be allocated by the
427.27 	commissioner using the allocation
427.28 	method specified in Minnesota Statutes,
427.29 	section 256D.46.
427.30 	(k) Group Residential Housing Grants
427.31 	General              87,989,000    94,033,000
427.32 	(l) Other Children and Economic
427.33 	Assistance Grants
427.34 	General              16,634,000    16,255,000
427.35 	Federal TANF          1,397,000     1,397,000
427.36 	[TRANSITIONAL HOUSING.] $3,238,000 in
427.37 	fiscal year 2006 and $3,238,000 in
427.38 	fiscal year 2007 are appropriated for
427.39 	transitional housing under Minnesota
427.40 	Statutes, section 119A.43.  Of this
427.41 	amount, $1,397,000 in fiscal year 2006
427.42 	and $1,397,000 in fiscal year 2007 are
427.43 	onetime appropriations from the federal
427.44 	TANF fund.  The general fund base for
427.45 	transitional housing shall be
427.46 	$2,988,000 each year for the fiscal
427.47 	2008-2009 biennium.
427.48 		Subd. 5.Children and Economic Assistance
427.49 	Management
427.50 	Summary by Fund
427.51 	General              42,559,000    42,603,000
427.52 	Health Care Access      261,000       261,000
427.53 	Federal TANF            466,000       452,000
427.54 	The amounts that may be spent from the
427.55 	appropriation for each purpose are as
428.1 	follows:
428.2 	(a) Children and Economic
428.3 	Assistance Administration
428.4 	General               7,838,000     7,832,000
428.5 	Federal TANF            452,000       452,000
428.6 	(b) Children and Economic
428.7 	Assistance Operations
428.8 	General              34,721,000    34,771,000
428.9 	Health Care Access      261,000       261,000
428.10 	Federal TANF             14,000       -0-
428.11 	[BASE REDUCTIONS.] (a) The general fund
428.12 	base is decreased by $50,000 in fiscal
428.13 	year 2008 and $50,000 in fiscal year
428.14 	2009.
428.15 	(b) The health care access fund base is
428.16 	decreased by $12,000 in fiscal year
428.17 	2008 and $12,000 in fiscal year 2009.
428.18 	[SPENDING AUTHORITY FOR FOOD STAMPS
428.19 	BONUS AWARDS.] In the event that
428.20 	Minnesota qualifies for the United
428.21 	States Department of Agriculture Food
428.22 	and Nutrition Services Food Stamp
428.23 	Program performance bonus awards
428.24 	beginning in federal fiscal year 2004,
428.25 	the funding is appropriated to the
428.26 	commissioner.  The commissioner shall
428.27 	retain 25 percent of the funding, with
428.28 	the other 75 percent divided among the
428.29 	counties according to a formula that
428.30 	takes into account each county's impact
428.31 	on state performance in the applicable
428.32 	bonus categories.
428.33 	[CHILD SUPPORT PAYMENT CENTER.]
428.34 	Payments to the commissioner from other
428.35 	governmental units, private
428.36 	enterprises, and individuals for
428.37 	services performed by the child support
428.38 	payment center must be deposited in the
428.39 	state systems account authorized under
428.40 	Minnesota Statutes, section 256.014.
428.41 	These payments are appropriated to the
428.42 	commissioner for the operation of the
428.43 	child support payment center or system,
428.44 	according to Minnesota Statutes,
428.45 	section 256.014.
428.46 	[CHILD SUPPORT COST RECOVERY FEES.] The
428.47 	commissioner shall transfer $34,000 of
428.48 	child support cost recovery fees
428.49 	collected in fiscal year 2006 and
428.50 	fiscal year 2007 to the PRISM special
428.51 	revenue account to offset PRISM system
428.52 	costs of maintaining the fee.
428.53 	[FINANCIAL INSTITUTION DATA MATCH AND
428.54 	PAYMENT OF FEES.] The commissioner is
428.55 	authorized to allocate up to $310,000
428.56 	each year in fiscal year 2006 and
428.57 	fiscal year 2007 from the PRISM special
428.58 	revenue account to make payments to
429.1 	financial institutions in exchange for
429.2 	performing data matches between account
429.3 	information held by financial
429.4 	institutions and the public authority's
429.5 	database of child support obligors as
429.6 	authorized by Minnesota Statutes,
429.7 	section 13B.06, subdivision 7.
429.8 		Subd. 6.Basic Health Care Grants
429.9 	Summary by Fund
429.10 	General           1,702,015,000 1,797,642,000
429.11 	Health Care Access  299,723,000   397,125,000
429.12 	[FULL FUNDING FOR DIAGNOSIS-RELATED
429.13 	GROUPS PAYMENT ADJUSTMENT.] In order to
429.14 	provide full funding for the
429.15 	diagnosis-related groups for hospitals
429.16 	located in Greater Minnesota under
429.17 	Minnesota Statutes, section 256.969,
429.18 	subdivision 26, the following increases
429.19 	are hereby appropriated:
429.20 	$722,000 in fiscal year 2006 and
429.21 	$1,076,000 in fiscal year 2007 for MA
429.22 	Basic Care-Families and Children;
429.23 	$903,000 in fiscal year 2006 and
429.24 	$1,345,000 in fiscal year 2007 for MA
429.25 	Basic Care-Elderly and Disabled; and
429.26 	$361,000 in fiscal year 2006 and
429.27 	$538,000 in fiscal year 2007 for
429.28 	General Assistance Medical Care.
429.29 	The amounts that may be spent from the
429.30 	appropriation for each purpose are as
429.31 	follows:
429.32 	(a) MinnesotaCare Grants
429.33 	Health Care Access  299,723,000   397,125,000
429.34 	[HEALTHMATCH DELAY.] Of this
429.35 	appropriation, $6,411,000 the first
429.36 	year and $96,305,000 the second year
429.37 	are for the MinnesotaCare program costs
429.38 	related to a 17-month delay in
429.39 	implementation of the HealthMatch
429.40 	program.
429.41 	[MINNESOTACARE FEDERAL RECEIPTS.]
429.42 	Receipts received as a result of
429.43 	federal participation pertaining to
429.44 	administrative costs of the Minnesota
429.45 	health care reform waiver shall be
429.46 	deposited as nondedicated revenue in
429.47 	the health care access fund.  Receipts
429.48 	received as a result of federal
429.49 	participation pertaining to grants
429.50 	shall be deposited in the federal fund
429.51 	and shall offset health care access
429.52 	funds for payments to providers.
429.53 	[MINNESOTACARE FUNDING.] The
429.54 	commissioner may expend money
429.55 	appropriated from the health care
429.56 	access fund for MinnesotaCare in either
429.57 	fiscal year of the biennium.
430.1 	(b) MA Basic Health Care -
430.2 	Families and Children
430.3 	General             608,938,000   697,432,000
430.4 	[HOSPITAL PAYMENT DELAY.] Payments from
430.5 	the Medicaid Management Information
430.6 	System that would otherwise have been
430.7 	made for inpatient hospital services
430.8 	for Minnesota health care program
430.9 	enrollees shall be delayed as follows:
430.10 	(1) for fiscal year 2008, the last
430.11 	payments shall be ratably reduced by a
430.12 	total of $12,000,000 and included in
430.13 	the first payments in fiscal year 2009;
430.14 	and
430.15 	(2) for fiscal year 2009, the last
430.16 	payments shall be ratably reduced by a
430.17 	total of $24,000,000 and included in
430.18 	the first payment of fiscal year 2010.
430.19 	The provisions of Minnesota Statutes,
430.20 	section 16A.124, shall not apply to
430.21 	these delayed payments.
430.22 	Notwithstanding section 15, this
430.23 	paragraph shall not expire.
430.24 	(c) MA Basic Health Care -
430.25 	Elderly and Disabled
430.26 	General             808,554,000   863,216,000
430.27 	(d) General Assistance Medical Care
430.28 	Grants
430.29 	General             277,244,000   236,935,000
430.30 	(e) Prescription Drug Program Grants
430.31 	General               4,313,000
430.32 	[PDP TO MEDICARE PART D TRANSITION.]
430.33 	The commissioner of human services,
430.34 	with the approval of the commissioner
430.35 	of finance, and after notification of
430.36 	the chair of the senate Health and
430.37 	Human Services Budget Division and the
430.38 	chair of the house Health Policy and
430.39 	Finance Committee, may transfer fiscal
430.40 	year 2006 appropriations between the
430.41 	medical assistance program and the
430.42 	prescription drug program.
430.43 	(f) Health Care Grants -
430.44 	Other Assistance
430.45 	General               2,967,000        59,000
430.46 		Subd. 7.Health Care Management
430.47 	Summary by Fund
430.48 	General              27,148,000    25,353,000
430.49 	Health Care Access   22,880,000    21,953,000
430.50 	The amounts that may be spent from the
430.51 	appropriation for each purpose are as
430.52 	follows:
431.1 	(a) Health Care Policy Administration
431.2 	General              10,405,000     9,158,000
431.3 	Health Care Access    7,564,000     6,885,000
431.4 	[ADMINISTRATIVE BASE ADJUSTMENT.] The
431.5 	health care access fund base is
431.6 	decreased by $1,486,000 in fiscal year
431.7 	2008 and $1,778,000 in fiscal year
431.8 	2009, for implementation of business
431.9 	process redesign in health care.  The
431.10 	general fund base is increased by
431.11 	$3,563,000 in fiscal year 2008 and
431.12 	$2,395,000 in fiscal year 2009.
431.13 	[MINNESOTA SENIOR HEALTH OPTIONS
431.14 	REIMBURSEMENT.] Federal administrative
431.15 	reimbursement resulting from the
431.16 	Minnesota senior health options project
431.17 	is appropriated to the commissioner for
431.18 	this activity.
431.19 	[UTILIZATION REVIEW.] Federal
431.20 	administrative reimbursement resulting
431.21 	from prior authorization and inpatient
431.22 	admission certification by a
431.23 	professional review organization shall
431.24 	be dedicated to the commissioner for
431.25 	these purposes.  A portion of these
431.26 	funds must be used for activities to
431.27 	decrease unnecessary pharmaceutical
431.28 	costs in medical assistance.
431.29 	[TICKET TO WORK.] Effective the day
431.30 	following final enactment, supplemental
431.31 	funding made available by the Centers
431.32 	for Medicare and Medicaid Services
431.33 	under the Ticket to Work Medicaid
431.34 	Infrastructure Grant to support
431.35 	outreach and education activities on
431.36 	Medicare Part D for persons receiving
431.37 	medical assistance for employed persons
431.38 	with disabilities is appropriated to
431.39 	the commissioner for required grant and
431.40 	administrative activities.
431.41 	[MEDICAL EDUCATION ASSIGNMENT.] The
431.42 	commissioner shall continue to seek
431.43 	approval from the Centers for Medicare
431.44 	and Medicaid Services to transfer to
431.45 	physician clinics 40 percent of the
431.46 	current medical education and research
431.47 	costs currently assigned to hospitals
431.48 	under Minnesota Statutes, section
431.49 	62J.692, subdivision 8.  The
431.50 	commissioner shall report to the house
431.51 	and senate chairs with funding
431.52 	authority over the Department of Human
431.53 	Services by January 15, 2006, regarding
431.54 	the results of this effort.
431.55 	(b) Health Care Operations
431.56 	General              16,743,000    16,195,000
431.57 	Health Care Access   15,316,000    15,068,000
431.58 	[BASE ADJUSTMENT.] The health care
431.59 	access fund base is increased by
431.60 	$1,508,000 in fiscal year 2008 and is
432.1 	decreased by $48,000 in fiscal year
432.2 	2009.
432.3 	[COUNTY ADMINISTRATIVE COST
432.4 	REIMBURSEMENT.] Of the general fund
432.5 	appropriation, $1,000,000 the first
432.6 	year is to the commissioner to be
432.7 	allocated to the counties for county
432.8 	costs associated with training county
432.9 	workers for enrolling eligible general
432.10 	assistance medical care clients into
432.11 	MinnesotaCare as required under
432.12 	Minnesota Statutes, sections 256D.03
432.13 	and 256L.05.  Funds appropriated for
432.14 	this purpose shall be distributed to
432.15 	counties by January 15, 2006, based on
432.16 	the average monthly number of general
432.17 	assistance medical care clients in the
432.18 	county during calendar year 2004.  This
432.19 	appropriation shall not become part of
432.20 	base level funding for the biennium
432.21 	beginning July 1, 2007.
432.22 		Subd. 8.Continuing Care Grants
432.23 	Summary by Fund
432.24 	General           1,549,939,000 1,618,201,000
432.25 	Lottery Prize         1,308,000     1,308,000
432.26 	The amounts that may be spent from the
432.27 	appropriation for each purpose are as
432.28 	follows:
432.29 	(a) Aging and Adult Services Grant
432.30 	General              13,954,000    13,960,000
432.31 	(b) Alternative Care Grants
432.32 	General              58,278,000    45,944,000
432.33 	[ALTERNATIVE CARE TRANSFER.] Any money
432.34 	allocated to the alternative care
432.35 	program that is not spent for the
432.36 	purposes indicated does not cancel but
432.37 	shall be transferred to the medical
432.38 	assistance account.
432.39 	[ALTERNATIVE CARE BASE.] Base level
432.40 	funding for alternative care grants is
432.41 	increased by $2,704,000 in fiscal year
432.42 	2008 and by $3,908,000 in fiscal year
432.43 	2009.
432.44 	[IMPLEMENTATION OF ALTERNATIVE CARE
432.45 	CHANGES.] Changes to Minnesota
432.46 	Statutes, section 256B.0913,
432.47 	subdivisions 2, 4, paragraph (a), 5,
432.48 	and 5a, are effective September 1,
432.49 	2005, for all persons found eligible
432.50 	for the alternative care program on and
432.51 	after September 1, 2005.  All persons
432.52 	who are alternative care clients as of
432.53 	August 31, 2005, must be subject to
432.54 	Minnesota Statutes, section 256B.0913,
432.55 	subdivisions 2, 4, paragraph (a), 5,
432.56 	and 5a, on the annual redetermination
432.57 	of program eligibility due after August
432.58 	31, 2005, but no later than January 1,
433.1 	2006.
433.2 	(c) Medical Assistance Grants -
433.3 	Long-term Care Facilities
433.4 	General             517,436,000   505,995,000
433.5 	[NURSING HOME MORATORIUM EXCEPTIONS.]
433.6 	During the first year, the commissioner
433.7 	of health may approve moratorium
433.8 	exception projects under Minnesota
433.9 	Statutes, section 144A.073, for which
433.10 	the full annualized state share of
433.11 	medical assistance costs does not
433.12 	exceed $1,500,000.  During the second
433.13 	year, the commissioner of health may
433.14 	approve moratorium exception projects
433.15 	under Minnesota Statutes, section
433.16 	144A.073, for which the full annualized
433.17 	state share of medical assistance costs
433.18 	does not exceed $1,500,000 less the
433.19 	amount approved during the first year.
433.20 	Priority shall be given to proposals
433.21 	that entail:  (1) complete building
433.22 	replacement in conjunction with
433.23 	reductions in the number of beds in a
433.24 	county, with greater weight given to
433.25 	projects in counties with a greater
433.26 	than average number of beds per 1,000
433.27 	elderly; (2) technology improvements;
433.28 	(3) improvements in life safety; (4)
433.29 	construction of nursing facilities that
433.30 	are part of senior services campuses;
433.31 	and (5) improvements in the work
433.32 	environment.
433.33 	(d) Medical Assistance Grants -
433.34 	Long-Term Care Waivers and
433.35 	Home Care Grants
433.36 	General             833,247,000   918,334,000
433.37 	[LIMITING GROWTH IN COMMUNITY
433.38 	ALTERNATIVES FOR DISABLED INDIVIDUALS
433.39 	WAIVER.] Notwithstanding Laws 2005,
433.40 	chapter 155, article 3, section 8, for
433.41 	each year of the biennium ending June
433.42 	30, 2007, the commissioner shall make
433.43 	available additional allocations for
433.44 	home and community-based services
433.45 	covered under Minnesota Statutes,
433.46 	section 256B.49, at a rate of 95 per
433.47 	month or 1,140 per year, plus any
433.48 	additional legislatively authorized
433.49 	growth.  Priorities for the allocation
433.50 	of funds shall be for individuals
433.51 	anticipated to be discharged from
433.52 	institutional settings or who are at
433.53 	imminent risk of a placement in an
433.54 	institutional setting.
433.55 	[LIMITING GROWTH IN TBI WAIVER.]
433.56 	Notwithstanding Laws 2005, chapter 155,
433.57 	article 3, section 8, for each year of
433.58 	the biennium ending June 30, 2007, the
433.59 	commissioner shall make available
433.60 	additional allocations for home and
433.61 	community-based services covered under
433.62 	Minnesota Statutes, section 256B.49, at
433.63 	a rate of 150 per year.  Priorities for
433.64 	the allocation of funds shall be for
434.1 	individuals anticipated to be
434.2 	discharged from institutional settings
434.3 	or who are at imminent risk of a
434.4 	placement in an institutional setting.
434.5 	[LIMITING GROWTH IN MR/RC WAIVER.]
434.6 	Notwithstanding Laws 2005, chapter 155,
434.7 	article 3, section 8, for each year of
434.8 	the biennium ending June 30, 2007, the
434.9 	commissioner shall limit the new
434.10 	diversion caseload growth in the MR/RC
434.11 	waiver to 50 additional allocations.
434.12 	Notwithstanding Minnesota Statutes,
434.13 	section 256B.0916, subdivision 5,
434.14 	paragraph (b), the available diversion
434.15 	allocations shall be awarded to support
434.16 	individuals whose health and safety
434.17 	needs result in an imminent risk of an
434.18 	institutional placement at any time
434.19 	during the fiscal year.
434.20 	(e) Mental Health Grants
434.21 	General              46,731,000    47,516,000
434.22 	Lottery Prize         1,308,000     1,308,000
434.23 	[MENTAL HEALTH GRANT BASE.] Base level
434.24 	funding for mental health grants is
434.25 	increased by $428,000 in fiscal year
434.26 	2008 and by $428,000 in fiscal year
434.27 	2009.
434.28 	(f) Deaf and Hard-of-Hearing
434.29 	Grants
434.30 	General               1,454,000     1,475,000
434.31 	[DEAF AND HARD-OF-HEARING BASE
434.32 	FUNDING.] Base level funding for the
434.33 	deaf and hard-of-hearing grants is
434.34 	increased by $5,000 in fiscal year 2008
434.35 	and $5,000 in fiscal year 2009.
434.36 	(g) Chemical Dependency
434.37 	Entitlement Grants
434.38 	General              63,183,000    68,744,000
434.39 	(h) Chemical Dependency Nonentitlement
434.40 	Grants
434.41 	General               1,055,000     1,055,000
434.42 	(i) Other Continuing Care Grants
434.43 	General              14,601,000    15,178,000
434.44 	[OTHER CONTINUING CARE GRANTS BASE
434.45 	FUNDING.] Base level funding for other
434.46 	continuing care grants is increased by
434.47 	$208,000 in fiscal year 2008 and
434.48 	$251,000 in fiscal year 2009.
434.49 		Subd. 9.Continuing Care Management
434.50 	Summary by Fund
434.51 	General              15,043,000    14,939,000
434.52 	State Government
435.1 	Special Revenue         119,000       119,000
435.2 	Lottery Prize           148,000       148,000
435.3 	[BASE ADJUSTMENT.] The general fund
435.4 	base is decreased by $341,000 for
435.5 	fiscal year 2008 and by $340,000 in
435.6 	fiscal year 2009.
435.7 	[QUALITY ASSURANCE COMMISSION.]
435.8 	$151,000 in fiscal year 2007 is
435.9 	appropriated from the general fund to
435.10 	the commissioner of human services for
435.11 	the Quality Assurance Commission under
435.12 	Minnesota Statutes, section 256B.0951.
435.13 	This funding is added to the base
435.14 	appropriation for the quality assurance
435.15 	commission program for the fiscal year
435.16 	beginning July 1, 2006.
435.17 	[TASK FORCE ON COLLABORATIVE SERVICES.]
435.18 	The commissioner, in collaboration with
435.19 	the commissioner of education, shall
435.20 	create a task force to discuss
435.21 	collaboration between schools and
435.22 	mental health providers to:  promote
435.23 	colocation and integrated services;
435.24 	identify barriers to collaboration;
435.25 	develop a model contract; and identify
435.26 	examples of successful collaboration.
435.27 	The task force shall also develop
435.28 	recommendations on how to pay for
435.29 	children's mental health screenings.
435.30 	The task force shall include
435.31 	representatives of school boards;
435.32 	administrative personnel; special
435.33 	education directors; counties; parent
435.34 	advocacy organizations; school social
435.35 	workers, counselors, nurses, and
435.36 	psychologists; community mental health
435.37 	professionals; health plans; and other
435.38 	interested parties.  The task force
435.39 	shall present a report to the chairs of
435.40 	the education and health policy
435.41 	committees by February 1, 2006.
435.42 		Subd. 10.State-Operated Services
435.43 	Summary by Fund
435.44 	General             223,581,000   200,448,000
435.45 	[BASE ADJUSTMENT.] The general fund
435.46 	base is decreased by $3,174,000 for
435.47 	fiscal year 2008 and by $6,472,000 in
435.48 	fiscal year 2009.
435.49 	[EVIDENCE-BASED PRACTICE FOR
435.50 	METHAMPHETAMINE TREATMENT.] Of the
435.51 	general fund appropriation, $300,000
435.52 	each year is to the commissioner of
435.53 	human services to support development
435.54 	of evidence-based practices for the
435.55 	treatment of methamphetamine abuse at
435.56 	the state-operated services chemical
435.57 	dependency program in Willmar.  These
435.58 	funds shall be used to support research
435.59 	on evidence-based practices for the
435.60 	treatment of methamphetamine abuse, to
435.61 	disseminate the results of the
435.62 	evidence-based practice research
436.1 	statewide, and to create training for
436.2 	addiction counselors specializing in
436.3 	the treatment of methamphetamine abuse.
436.4 	[TRANSFER AUTHORITY RELATED TO
436.5 	STATE-OPERATED SERVICES.] Money
436.6 	appropriated to finance state-operated
436.7 	services programs and administrative
436.8 	services may be transferred between
436.9 	fiscal years of the biennium with the
436.10 	approval of the commissioner of finance.
436.11 	[APPROPRIATION LIMITATION.] No part of
436.12 	the appropriation in this article to
436.13 	the commissioner for mental health
436.14 	treatment services at the regional
436.15 	treatment centers shall be used for the
436.16 	Minnesota sex offender program.
436.17 	[BASE ADJUSTMENT FOR STATE-OPERATED
436.18 	SERVICES UTILIZATION.] The general fund
436.19 	base is increased by $3,174,000 in
436.20 	fiscal year 2008 and by $6,472,000 in
436.21 	fiscal year 2009 for state-operated
436.22 	services forensic operations, with
436.23 	corresponding adjustments to
436.24 	nondedicated revenue estimates.

436.25 	Sec. 3. COMMISSIONER OF HEALTH
 436.26 		Subdivision 1.Total
436.27 	Appropriation                        113,331,000    115,553,000
436.28 	Summary by Fund
436.29 	General              64,738,000    66,568,000
436.30 	State Government
436.31 	Special Revenue      36,320,000    36,706,000
436.32 	Health Care Access    6,273,000     6,279,000
436.33 	Federal TANF          6,000,000     6,000,000
436.34 	[RENTAL COSTS, ADMINISTRATIVE
436.35 	REDUCTIONS, FEE INCREASES, AND REVENUE
436.36 	TRANSFER.] (a) Of this appropriation,
436.37 	$722,000 the first year and $2,583,000
436.38 	the second year are for rental costs in
436.39 	the new public health laboratory
436.40 	building.
436.41 	(b) The general fund appropriation in
436.42 	this section includes a departmentwide
436.43 	administrative reduction of $61,000 the
436.44 	first year and $62,000 the second
436.45 	year.  The commissioner shall ensure
436.46 	that any staff reductions made under
436.47 	this paragraph comply with Minnesota
436.48 	Statutes, section 43A.046.
436.49 	(c) $985,000 in fiscal year 2006 and
436.50 	$2,077,000 in fiscal year 2007 shall be
436.51 	transferred from the state government
436.52 	special revenue fund to the general
436.53 	fund.
436.54 	[TANF APPROPRIATIONS.] (a) $4,000,000
436.55 	of TANF funds is appropriated each year
436.56 	to the commissioner for home visiting
436.57 	and nutritional services listed under
437.1 	Minnesota Statutes, section 145.882,
437.2 	subdivision 7, clauses (6) and (7).
437.3 	Funding shall be distributed to
437.4 	community health boards based on
437.5 	Minnesota Statutes, section 145A.131,
437.6 	subdivision 1, and tribal governments
437.7 	based on Minnesota Statutes, section
437.8 	145A.14, subdivision 2, paragraph (b).
437.9 	(b) $2,000,000 of TANF funds is
437.10 	appropriated each year to the
437.11 	commissioner for decreasing racial and
437.12 	ethnic disparities in infant mortality
437.13 	rates under Minnesota Statutes, section
437.14 	145.928, subdivision 7.
437.15 	[TANF CARRYFORWARD.] Any unexpended
437.16 	balance of the TANF appropriation in
437.17 	the first year of the biennium does not
437.18 	cancel but is available for the second
437.19 	year.
437.20 		Subd. 2.Community and Family
437.21 	Health Improvement
437.22 	Summary by Fund
437.23 	General              40,413,000    40,382,000
437.24 	State Government
437.25 	Special Revenue         141,000       128,000
437.26 	Health Care Access    3,510,000     3,516,000
437.27 	Federal TANF          6,000,000     6,000,000
437.28 	[FAMILY PLANNING BASE REDUCTION.] Base
437.29 	level funding for the family planning
437.30 	special projects grant program is
437.31 	reduced by $1,877,000 each year of the
437.32 	biennium beginning July 1, 2007,
437.33 	provided that this reduction shall only
437.34 	take place upon full implementation of
437.35 	the family planning project section of
437.36 	the 1115 waiver.  Notwithstanding
437.37 	Minnesota Statutes, section 145.925,
437.38 	the commissioner shall give priority to
437.39 	community health care clinics providing
437.40 	family planning services that either
437.41 	serve a high number of women who do not
437.42 	qualify for medical assistance or are
437.43 	unable to participate in the medical
437.44 	assistance program as a medical
437.45 	assistance provider when allocating the
437.46 	remaining appropriations.
437.47 	Notwithstanding section 15, this
437.48 	paragraph shall not expire.
437.49 	[SHAKEN BABY VIDEO.] Of the state
437.50 	government special revenue fund
437.51 	appropriation, $13,000 in 2006 is
437.52 	appropriated to the commissioner of
437.53 	health to provide a video to hospitals
437.54 	on shaken baby syndrome.  The
437.55 	commissioner of health shall assess a
437.56 	fee to hospitals to cover the cost of
437.57 	the approved shaken baby video and the
437.58 	revenue received is to be deposited in
437.59 	the state government special revenue
437.60 	fund.
438.1 		Subd. 3.Policy Quality and
438.2 	Compliance
438.3 	Summary by Fund
438.4 	General               3,665,000     3,665,000
438.5 	State Government
438.6 	Special Revenue      11,528,000    11,428,000
438.7 	Health Care Access    2,763,000     2,763,000
438.8 	[BASE ADJUSTMENT.] The state government
438.9 	special revenue base is increased by
438.10 	$800,000 each year for fiscal years
438.11 	2008 and 2009.
438.12 	[STATEWIDE TRAUMA SYSTEM.] (a) Of the
438.13 	general fund appropriation, $382,000
438.14 	the first year and $352,000 the second
438.15 	year are for development of a statewide
438.16 	trauma system.
438.17 	(b) The commissioner shall increase
438.18 	hospital licensing fees a pro rata
438.19 	amount to increase fee revenue by
438.20 	$382,000 the first year and $352,000
438.21 	the second year.  This revenue shall be
438.22 	deposited in the general fund.
438.23 	[FAMILY PLANNING GRANTS.] Of the
438.24 	general fund appropriation, $500,000
438.25 	each year is to the commissioner for
438.26 	grants under Minnesota Statutes,
438.27 	section 145.925, to family planning
438.28 	clinics serving outstate Minnesota that
438.29 	demonstrate financial need.
438.30 		Subd. 4.Health Protection
438.31 	Summary by Fund
438.32 	General               9,068,000     9,068,000
438.33 	State Government
438.34 	Special Revenue      24,316,000    24,815,000
438.35 	[BASE ADJUSTMENT.] The state government
438.36 	special revenue base is increased by
438.37 	$935,000 each year for fiscal years
438.38 	2008 and 2009.
438.39 		Subd. 5.Minority and
438.40 	Multicultural Health
438.41 	Summary by Fund
438.42 	General               6,190,000     8,051,000
438.43 	State Government
438.44 	Special Revenue         335,000       335,000
438.45 		Subd. 6.Administrative
438.46 	Support Services
438.47 	Summary by Fund
438.48 	General               5,402,000     5,402,000

438.49 	Sec. 4. VETERANS NURSING HOMES BOARD
 439.1 	General              30,030,000    30,030,000
439.2 	[VETERANS HOMES SPECIAL REVENUE
439.3 	ACCOUNT.] The general fund
439.4 	appropriations made to the board may be
439.5 	transferred to a veterans homes special
439.6 	revenue account in the special revenue
439.7 	fund in the same manner as other
439.8 	receipts are deposited according to
439.9 	Minnesota Statutes, section 198.34, and
439.10 	are appropriated to the board for the
439.11 	operation of board facilities and
439.12 	programs.

439.13 	Sec. 5. HEALTH-RELATED BOARDS
 439.14 		Subdivision 1.State
439.15 	Government Special Revenue            13,340,000     13,750,000
439.16 	[NO SPENDING IN EXCESS OF REVENUES.]
439.17 	The commissioner of finance shall not
439.18 	permit the allotment, encumbrance, or
439.19 	expenditure of money appropriated in
439.20 	this section in excess of the
439.21 	anticipated biennial revenues or
439.22 	accumulated surplus revenues from fees
439.23 	collected by the boards.  Neither this
439.24 	provision nor Minnesota Statutes,
439.25 	section 214.06, applies to transfers
439.26 	from the general contingent account.
439.27 		Subd. 2.Board of Behavioral
439.28 	Health and Therapy                       673,000        673,000
439.29 		Subd. 3.Board of Chiropractic
439.30 	Examiners                                414,000        414,000
439.31 	[BOARD OF CHIROPRACTIC EXAMINERS
439.32 	APPROPRIATIONS INCREASE.] Of this
439.33 	appropriation, $30,000 each year is for
439.34 	the increased cost of board operations,
439.35 	excluding salary increases.
439.36 		Subd. 4.Board of Dentistry           1,038,000        888,000
439.37 	[BOARD OF DENTISTRY APPROPRIATIONS
439.38 	INCREASE.] Of this appropriation,
439.39 	$30,000 each year is for the increased
439.40 	cost of board meetings, board member
439.41 	compensation, and board operations,
439.42 	excluding salary increases.
439.43 	[ORAL HEALTH PILOT PROJECT.] Of this
439.44 	appropriation, $150,000 the first year
439.45 	is to be transferred to the
439.46 	commissioner of human services for an
439.47 	oral health care system pilot project.
439.48 		Subd. 5.Board of Dietetic and
439.49 	Nutrition Practice                       101,000        101,000
439.50 	The Board of Dietetic and Nutrition
439.51 	Practice may lower its fees by an
439.52 	amount not to exceed $36,000 in fiscal
439.53 	years 2006, 2007, 2008, and 2009.
439.54 		Subd. 6.Board of Marriage and
439.55 	Family Therapy                           127,000        131,000
439.56 	[BOARD OF MARRIAGE AND FAMILY THERAPY
439.57 	APPROPRIATIONS INCREASE.] Of this
440.1 	appropriation, $9,000 the first year
440.2 	and $13,000 the second year are to
440.3 	increase the executive director to 0.6
440.4 	full-time equivalent from 0.5 full-time
440.5 	equivalent, for an increase in
440.6 	technology costs related to the small
440.7 	boards' database system, and for added
440.8 	costs related to rule changes.
440.9 		Subd. 7.Board of Medical
440.10 	Practice                               3,729,000      3,769,000
440.11 	[BOARD OF MEDICAL PRACTICE
440.12 	APPROPRIATIONS INCREASE.] Of this
440.13 	appropriation, $125,000 the first year
440.14 	and $165,000 the second year are for
440.15 	the added costs of rent, legal and
440.16 	investigative services provided by the
440.17 	board, and services provided by the
440.18 	attorney general's office and the
440.19 	Office of Administrative Hearings for
440.20 	services on behalf of the board.
440.21 	[PHYSICIAN LOAN FORGIVENESS.] $200,000
440.22 	each year shall be transferred to the
440.23 	health professional education loan
440.24 	forgiveness program account for loan
440.25 	forgiveness for physician under
440.26 	Minnesota Statutes, section 144.1501.
440.27 	This appropriation shall become part of
440.28 	base level funding for the commissioner
440.29 	for the biennium beginning July 1,
440.30 	2007.  Notwithstanding section 15, this
440.31 	paragraph expires on June 30, 2009.
440.32 		Subd. 8.Board of Nursing             3,078,000      3,631,000
440.33 	[BASE ADJUSTMENT.] The base for the
440.34 	board of nursing is increased by
440.35 	$141,000 in fiscal year 2008 and by
440.36 	$216,000 in fiscal year 2009.
440.37 	[BOARD OF NURSING APPROPRIATIONS
440.38 	INCREASE.] Of this appropriation,
440.39 	$120,000 the first year and $126,000
440.40 	the second year are for the increased
440.41 	cost of board operations, excluding
440.42 	salary increases and $85,000 each year
440.43 	is to hire an advanced practice
440.44 	registered nurse.
440.45 	[TRANSFERS FROM SPECIAL REVENUE FUND.]
440.46 	Of this appropriation, the following
440.47 	transfers shall be made as directed
440.48 	from the state government special
440.49 	revenue fund:
440.50 	(a) $392,000 in fiscal year 2006,
440.51 	$864,000 in fiscal year 2007, $930,000
440.52 	in fiscal year 2008, and $930,000 in
440.53 	fiscal year 2009 shall be transferred
440.54 	to the general fund and is appropriated
440.55 	to the Department of Human Services to
440.56 	offset the state share of the medical
440.57 	assistance program costs of the
440.58 	long-term care and home and
440.59 	community-based care employee
440.60 	scholarship program and associated
440.61 	administrative costs.  At the end of
440.62 	each biennium, any funds not expended
440.63 	for the scholarship program and
441.1 	associated administrative costs shall
441.2 	be transferred to the state government
441.3 	special revenue fund.  Notwithstanding
441.4 	section 15, this paragraph expires June
441.5 	30, 2009.
441.6 	(b) $125,000 the first year and
441.7 	$200,000 the second year shall be
441.8 	transferred to the health professional
441.9 	education loan forgiveness program
441.10 	account for loan forgiveness for nurses
441.11 	under Minnesota Statutes, section
441.12 	144.1501.  This appropriation shall
441.13 	become part of base level funding for
441.14 	the commissioner for the biennium
441.15 	beginning July 1, 2007, but shall not
441.16 	be part of base level funding for the
441.17 	biennium beginning July 1, 2009.
441.18 	Notwithstanding section 15, this
441.19 	paragraph expires on June 30, 2009.
441.20 		Subd. 9.Board of Nursing
441.21 	Home Administrators                      616,000        619,000
441.22 	[ADMINISTRATIVE SERVICES UNIT.] Of this
441.23 	appropriation, $418,000 the first year
441.24 	and $421,000 the second year are for
441.25 	the health boards administrative
441.26 	services unit, of which $59,000 each
441.27 	year is for a rent increase for the
441.28 	health-related licensing boards.  The
441.29 	administrative services unit may
441.30 	receive and expend reimbursements for
441.31 	services performed for other agencies.
441.32 		Subd. 10.Board of Optometry             96,000         96,000
441.33 		Subd. 11.Board of Pharmacy           1,389,000      1,344,000
441.34 	[BOARD OF PHARMACY APPROPRIATIONS
441.35 	INCREASE.] Of this appropriation,
441.36 	$137,000 the first year and $92,000 the
441.37 	second year are for the increased cost
441.38 	of board operations, including
441.39 	retirement payouts and increased costs
441.40 	related to technology, but excluding
441.41 	salary increases.
441.42 	[RURAL PHARMACY PROGRAM.] Of this
441.43 	appropriation, $200,000 each year shall
441.44 	be transferred to the commissioner of
441.45 	health for the rural pharmacy planning
441.46 	and transition grant program under
441.47 	Minnesota Statutes, section 144.1476.
441.48 	Of this transferred amount, $20,000
441.49 	each year may be retained by the
441.50 	commissioner for related administrative
441.51 	costs.  This appropriation shall become
441.52 	part of base level funding for the
441.53 	commissioner for the biennium beginning
441.54 	July 1, 2007.  Notwithstanding section
441.55 	15, this paragraph expires on June 30,
441.56 	2009.
441.57 	[CANCER DRUG REPOSITORY PROGRAM.] Of
441.58 	this appropriation, $25,000 each year
441.59 	is for the cancer drug repository
441.60 	program under Minnesota Statutes,
441.61 	section 151.55.  This appropriation
441.62 	shall become part of base level funding
441.63 	for the board for the biennium
442.1 	beginning July 1, 2007, but shall not
442.2 	be part of the base for the biennium
442.3 	beginning July 1, 2009.
442.4 	Notwithstanding section 15, this
442.5 	paragraph expires June 30, 2009.
442.6 		Subd. 12.Board of Physical
442.7 	Therapy                                  201,000        207,000
442.8 	[BOARD OF PHYSICAL THERAPY
442.9 	APPROPRIATIONS INCREASE.] Of this
442.10 	appropriation, $4,000 the first year
442.11 	and $10,000 the second year are for the
442.12 	added costs of continued work on
442.13 	electronic access to the small boards'
442.14 	database and to provide flexible staff
442.15 	levels to assist in meeting peak
442.16 	demands related to the annual license
442.17 	renewal period and the handling of
442.18 	complex complaint and disciplinary
442.19 	cases.
442.20 		Subd. 13.Board of Podiatry              49,000         53,000
442.21 	[BOARD OF PODIATRY APPROPRIATIONS
442.22 	INCREASE.] Of this appropriation,
442.23 	$4,000 the first year and $8,000 the
442.24 	second year are for increased costs of
442.25 	rent, board member per diems, and other
442.26 	increases in board operations costs,
442.27 	excluding salary increases.
442.28 		Subd. 14.Board of Psychology           680,000        680,000
442.29 		Subd. 15.Board of Social
442.30 	Work                                     978,000        973,000
442.31 	[ADMINISTRATIVE MANAGEMENT.] Of this
442.32 	appropriation, $105,000 the first year
442.33 	and $100,000 the second year are to
442.34 	provide administrative management under
442.35 	Minnesota Statutes, section 148B.61,
442.36 	subdivision 4.  The following boards
442.37 	shall be assessed a prorated amount
442.38 	depending on the number of licensees
442.39 	under the board's regulatory authority
442.40 	providing mental health services within
442.41 	their scope of practice:  Board of
442.42 	Medical Practice, the Board of Nursing,
442.43 	the Board of Psychology, the Board of
442.44 	Social Work, the Board of Marriage and
442.45 	Family Therapy, and the Board of
442.46 	Behavioral Health and Therapy.
442.47 		Subd. 16.Board of Veterinary
442.48 	Medicine                                 171,000        171,000
442.49 	[BOARD OF VETERINARY MEDICINE
442.50 	APPROPRIATIONS INCREASE.] Of this
442.51 	appropriation, $8,000 each year is for
442.52 	the increased costs of a growing
442.53 	complaint caseload, rent, and other
442.54 	increased board operating costs,
442.55 	excluding salary increases.

442.56 	Sec. 6. EMERGENCY MEDICAL SERVICES BOARD
 442.57 	Total
442.58 	Appropriation                          3,027,000      3,027,000
442.59 	Summary by Fund
443.1 	General               2,481,000     2,481,000
443.2 	State Government
443.3 	Special Revenue         546,000       546,000
443.4 	[HEALTH PROFESSIONAL SERVICES
443.5 	ACTIVITY.] $546,000 each year from the
443.6 	state government special revenue fund
443.7 	is for the health professional services
443.8 	activity.  Of this amount, $50,000 each
443.9 	year is to hire an additional case
443.10 	manager and to continue employing a
443.11 	part-time student worker.

443.12 	Sec. 7. COUNCIL ON DISABILITY
 443.13 	General                                  500,000        500,000

443.14 	Sec. 8. OMBUDSMAN FOR MENTAL HEALTH
443.15 	AND MENTAL RETARDATION
 443.16 	General                                1,462,000      1,462,000

443.17 	Sec. 9. OMBUDSMAN FOR FAMILIES
 443.18 	General                                  245,000        245,000

443.19 	Sec. 10. Laws 2005, chapter 159, article 1, section 14, is
443.20 	amended to read:
443.21 	Sec. 14LAWS 2005, CHAPTER 14; EFFECTIVE DATE.
 443.22 	Laws 2005, chapter 14, section 1,takes effect August 1,
443.23 	2006, and Laws 2005, chapter 14, section 2, takes effect August
443.24 	1, 2005.

443.25 	Sec. 11. Laws 2003, First Special Session chapter 14,
443.26 	article 13C, section 2, subdivision 6, is amended to read:
443.27 		Subd. 6.Basic Health Care Grants
443.28 	Summary by Fund
443.29 	General           1,499,941,000 1,533,016,000
443.30 	Health Care Access  268,151,000   282,605,000
443.31 	[UPDATING FEDERAL POVERTY GUIDELINES.]
443.32 	Annual updates to the federal poverty
443.33 	guidelines are effective each July 1,
443.34 	following publication by the United
443.35 	States Department of Health and Human
443.36 	Services for health care programs under
443.37 	Minnesota Statutes, chapters 256, 256B,
443.38 	256D, and 256L.
443.39 	The amounts that may be spent from this
443.40 	appropriation for each purpose are as
443.41 	follows:
443.42 	(a) MinnesotaCare Grants
443.43 	Health Care Access 267,401,000   281,855,000
443.44 	[MINNESOTACARE FEDERAL RECEIPTS.]
443.45 	Receipts received as a result of
443.46 	federal participation pertaining to
444.1 	administrative costs of the Minnesota
444.2 	health care reform waiver shall be
444.3 	deposited as nondedicated revenue in
444.4 	the health care access fund.  Receipts
444.5 	received as a result of federal
444.6 	participation pertaining to grants
444.7 	shall be deposited in the federal fund
444.8 	and shall offset health care access
444.9 	funds for payments to providers.
444.10 	[MINNESOTACARE FUNDING.] The
444.11 	commissioner may expend money
444.12 	appropriated from the health care
444.13 	access fund for MinnesotaCare in either
444.14 	fiscal year of the biennium.
444.15 	(b) MA Basic Health Care Grants -
444.16 	Families and Children
444.17 	General             568,254,000   582,161,000
444.18 	[SERVICES TO PREGNANT WOMEN.] The
444.19 	commissioner shall use available
444.20 	federal money for the State-Children's
444.21 	Health Insurance Program for medical
444.22 	assistance services provided to
444.23 	pregnant women who are not otherwise
444.24 	eligible for federal financial
444.25 	participation beginning in fiscal year
444.26 	2003.  This federal money shall be
444.27 	deposited in the federal fund and shall
444.28 	offset general funds for payments to
444.29 	providers.  Notwithstanding section 14,
444.30 	this paragraph shall not expire.
444.31 	[MANAGED CARE RATE INCREASE.] (a)
444.32 	Effective January 1, 2004, the
444.33 	commissioner of human services shall
444.34 	increase the total payments to managed
444.35 	care plans under Minnesota Statutes,
444.36 	section 256B.69, by an amount equal to
444.37 	the cost increases to the managed care
444.38 	plans from by the elimination of: (1)
444.39 	the exemption from the taxes imposed
444.40 	under Minnesota Statutes, section
444.41 	297I.05, subdivision 5, for premiums
444.42 	paid by the state for medical
444.43 	assistance, general assistance medical
444.44 	care, and the MinnesotaCare program;
444.45 	and (2) the exemption of gross revenues
444.46 	subject to the taxes imposed under
444.47 	Minnesota Statutes, sections 295.50 to
444.48 	295.57, for payments paid by the state
444.49 	for services provided under medical
444.50 	assistance, general assistance medical
444.51 	care, and the MinnesotaCare program.
444.52 	Any increase based on clause (2) must
444.53 	be reflected in provider rates paid by
444.54 	the managed care plan unless the
444.55 	managed care plan is a staff model
444.56 	health plan company.
444.57 	(b) The commissioner of human services
444.58 	shall increase by two percent the
444.59 	fee-for-service payments under medical
444.60 	assistance, general assistance medical
444.61 	care, and the MinnesotaCare program for
444.62 	services subject to the hospital,
444.63 	surgical center, or health care
444.64 	provider taxes under Minnesota
444.65 	Statutes, sections 295.50 to 295.57,
445.1 	effective for services rendered on or
445.2 	after January 1, 2004.
445.3 	(c) The commissioner of finance shall
445.4 	transfer from the health care access
445.5 	fund to the general fund the following
445.6 	amounts in the fiscal years indicated:
445.7 	2004, $16,587,000; 2005, $46,322,000;
445.8 	2006, $49,413,000; and 2007,
445.9 	$52,659,000 $58,695,000; 2008,
445.10 	$28,631,000; and 2009, $66,713,000.
445.11 	(d) For fiscal years after 2007, the
445.12 	commissioner of finance shall transfer
445.13 	from the health care access fund to the
445.14 	general fund an amount equal to the
445.15 	revenue collected by the commissioner
445.16 	of revenue on the following:
445.17 	(1) gross revenues received by
445.18 	hospitals, surgical centers, and health
445.19 	care providers as payments for services
445.20 	provided under medical assistance,
445.21 	general assistance medical care, and
445.22 	the MinnesotaCare program, including
445.23 	payments received directly from the
445.24 	state or from a prepaid plan, under
445.25 	Minnesota Statutes, sections 295.50 to
445.26 	295.57; and
445.27 	(2) premiums paid by the state under
445.28 	medical assistance, general assistance
445.29 	medical care, and the MinnesotaCare
445.30 	program under Minnesota Statutes,
445.31 	section 297I.05, subdivision 5.
445.32 	The commissioner of finance shall
445.33 	monitor and adjust if necessary the
445.34 	amount transferred each fiscal year
445.35 	from the health care access fund to the
445.36 	general fund to ensure that the amount
445.37 	transferred equals the tax revenue
445.38 	collected for the items described in
445.39 	clauses (1) and (2) for that fiscal
445.40 	year.
445.41 	(e) Notwithstanding section 14, these
445.42 	provisions shall not expire.
445.43 	(c) MA Basic Health Care Grants - Elderly
445.44 	and Disabled
445.45 	General             695,421,000   741,605,000
445.46 	[DELAY MEDICAL ASSISTANCE
445.47 	FEE-FOR-SERVICE - ACUTE CARE.] The
445.48 	following payments in fiscal year 2005
445.49 	from the Medicaid Management
445.50 	Information System that would otherwise
445.51 	have been made to providers for medical
445.52 	assistance and general assistance
445.53 	medical care services shall be delayed
445.54 	and included in the first payment in
445.55 	fiscal year 2006:
445.56 	(1) for hospitals, the last two
445.57 	payments; and
445.58 	(2) for nonhospital providers, the last
445.59 	payment.
446.1 	This payment delay shall not include
446.2 	payments to skilled nursing facilities,
446.3 	intermediate care facilities for mental
446.4 	retardation, prepaid health plans, home
446.5 	health agencies, personal care nursing
446.6 	providers, and providers of only waiver
446.7 	services.  The provisions of Minnesota
446.8 	Statutes, section 16A.124, shall not
446.9 	apply to these delayed payments.
446.10 	Notwithstanding section 14, this
446.11 	provision shall not expire.
446.12 	[DEAF AND HARD-OF-HEARING SERVICES.]
446.13 	If, after making reasonable efforts,
446.14 	the service provider for mental health
446.15 	services to persons who are deaf or
446.16 	hearing impaired is not able to earn
446.17 	$227,000 through participation in
446.18 	medical assistance intensive
446.19 	rehabilitation services in fiscal year
446.20 	2005, the commissioner shall transfer
446.21 	$227,000 minus medical assistance
446.22 	earnings achieved by the grantee to
446.23 	deaf and hard-of-hearing grants to
446.24 	enable the provider to continue
446.25 	providing services to eligible persons.
446.26 	(d) General Assistance Medical Care
446.27 	Grants
446.28 	General             223,960,000   196,617,000
446.29 	(e) Health Care Grants - Other
446.30 	Assistance
446.31 	General               3,067,000     3,407,000
446.32 	Health Care Access      750,000       750,000
446.33 	[MINNESOTA PRESCRIPTION DRUG DEDICATED
446.34 	FUND.] Of the general fund
446.35 	appropriation, $284,000 in fiscal year
446.36 	2005 is appropriated to the
446.37 	commissioner for the prescription drug
446.38 	dedicated fund established under the
446.39 	prescription drug discount program.
446.40 	[DENTAL ACCESS GRANTS CARRYOVER
446.41 	AUTHORITY.] Any unspent portion of the
446.42 	appropriation from the health care
446.43 	access fund in fiscal years 2002 and
446.44 	2003 for dental access grants under
446.45 	Minnesota Statutes, section 256B.53,
446.46 	shall not cancel but shall be allowed
446.47 	to carry forward to be spent in the
446.48 	biennium beginning July 1, 2003, for
446.49 	these purposes.
446.50 	[STOP-LOSS FUND ACCOUNT.] The
446.51 	appropriation to the purchasing
446.52 	alliance stop-loss fund account
446.53 	established under Minnesota Statutes,
446.54 	section 256.956, subdivision 2, for
446.55 	fiscal years 2004 and 2005 shall only
446.56 	be available for claim reimbursements
446.57 	for qualifying enrollees who are
446.58 	members of purchasing alliances that
446.59 	meet the requirements described under
446.60 	Minnesota Statutes, section 256.956,
446.61 	subdivision 1, paragraph (f), clauses
446.62 	(1), (2), and (3).
447.1 	(f) Prescription Drug Program
447.2 	General               9,239,000     9,226,000
447.3 	[PRESCRIPTION DRUG ASSISTANCE PROGRAM.]
447.4 	Of the general fund appropriation,
447.5 	$702,000 in fiscal year 2004 and
447.6 	$887,000 in fiscal year 2005 are for
447.7 	the commissioner to establish and
447.8 	administer the prescription drug
447.9 	assistance program through the
447.10 	Minnesota board on aging.
447.11 	[REBATE REVENUE RECAPTURE.] Any funds
447.12 	received by the state from a drug
447.13 	manufacturer due to errors in the
447.14 	pharmaceutical pricing used by the
447.15 	manufacturer in determining the
447.16 	prescription drug rebate are
447.17 	appropriated to the commissioner to
447.18 	augment funding of the prescription
447.19 	drug program established in Minnesota
447.20 	Statutes, section 256.955.

447.21 	Sec. 12. TRANSFERS.
 447.22 		Subdivision 1.Grants. The commissioner of human
447.23 	services, with the approval of the commissioner of finance, and
447.24 	after notification of the chairs of the relevant senate budget
447.25 	division and house finance committee, may transfer unencumbered
447.26 	appropriation balances for the biennium ending June 30, 2007,
447.27 	within fiscal years among the MFIP, general assistance, general
447.28 	assistance medical care, medical assistance, MFIP child care
447.29 	assistance under Minnesota Statutes, section 119B.05, Minnesota
447.30 	supplemental aid, and group residential housing programs, and
447.31 	the entitlement portion of the chemical dependency consolidated
447.32 	treatment fund, and between fiscal years of the biennium.
447.33 		Subd. 2.Administration. Positions, salary money, and
447.34 	nonsalary administrative money may be transferred within the
447.35 	Departments of Human Services and Health and within the programs
447.36 	operated by the Veterans Nursing Homes Board as the
447.37 	commissioners and the board consider necessary, with the advance
447.38 	approval of the commissioner of finance.  The commissioner or
447.39 	the board shall inform the chairs of the relevant house and
447.40 	senate health committees quarterly about transfers made under
447.41 	this provision.
447.42 		Subd. 3.Prohibited transfers. Grant money shall not be
447.43 	transferred to operations within the Departments of Human
447.44 	Services and Health and within the programs operated by the
448.1 	Veterans Nursing Homes Board without the approval of the
448.2 	legislature.

448.3 	Sec. 13. SPECIAL REVENUE TRANSFER FOR CERTAIN PROGRAMS.
 448.4 	(a) The balance of indirect cost reimbursement attributable
448.5 	to federal grants transferred from the Department of Education
448.6 	to the Department of Human Services and available at the close
448.7 	of fiscal year 2005 shall be transferred to the general fund.
448.8 	(b) The balance of the child care child support recoveries
448.9 	in the special revenue account established under Minnesota
448.10 	Statutes, section 119B.074, and available at the close of fiscal
448.11 	year 2005, shall be transferred to the general fund.

448.12 	Sec. 14. INDIRECT COSTS NOT TO FUND PROGRAMS.
 448.13 	The commissioners of health and of human services shall not
448.14 	use indirect cost allocations to pay for the operational costs
448.15 	of any program for which they are responsible.

448.16 	Sec. 15. SUNSET OF UNCODIFIED LANGUAGE.
 448.17 	All uncodified language contained in this article expires
448.18 	on June 30, 2007, unless a different expiration date is explicit.

448.19 	Sec. 16. EFFECTIVE DATE; RELATIONSHIP TO OTHER
448.20 	APPROPRIATIONS.
 448.21 	Appropriations in this act are effective retroactively from
448.22 	July 1, 2005, and supersede and replace funding authorized by
448.23 	order of the Ramsey County District Court in Case No.
448.24 	C9-05-5928, as well as by Laws 2005, First Special Session
448.25 	chapter 2, which provided temporary funding through July 14,
448.26 	2005.  The other language in this article is effective August 1,
448.27 	2005.