1.1A bill for an act1.2relating to state government; making changes to health and human services 1.3programs; changing children and family provisions; modifying licensing 1.4provisions; amending health care law; modifying continuing care provisions; 1.5amending mental health provisions; changing Department of Health provisions; 1.6establishing a children's health security program; changing public health 1.7provisions; amending MinnesotaCare, medical assistance, and general assistance 1.8medical care; instituting health care reform; establishing the Minnesota 1.9Health Insurance Exchange; requiring Section 125 Plans; modifying health 1.10insurance provisions; regulating anatomical gifts; establishing family supportive 1.11services; providing rate increases for certain providers; changing health 1.12records information provisions; making technical changes; providing civil and 1.13criminal penalties; establishing task forces; requiring reports; making forecast 1.14adjustments; appropriating money for human services and health;amending 1.15Minnesota Statutes 2006, sections 13.3806, by adding a subdivision; 13.46, 1.16subdivision 2; 16A.10, by adding a subdivision; 16A.724, subdivision 2; 16B.61, 1.17by adding a subdivision; 16D.13, subdivision 3; 43A.316; 62A.65, subdivision 3; 1.1862E.141; 62H.02; 62J.04, subdivision 3; 62J.17, subdivisions 2, 4a, 7; 62J.41, 1.19subdivision 1; 62J.495; 62J.52, subdivisions 1, 2; 62J.60, subdivisions 2, 3; 1.2062J.692, subdivisions 1, 4, 7a, 8, 10; 62J.81, subdivision 1; 62J.82; 62L.12, 1.21subdivisions 2, 4; 62Q.165, subdivisions 1, 2; 62Q.80, subdivisions 3, 4, 13, 14, 1.22by adding a subdivision; 103I.101, subdivision 6; 103I.208, subdivisions 1, 2; 1.23103I.235, subdivision 1; 119B.05, subdivision 1; 119B.09, subdivisions 1, 7, by 1.24adding subdivisions; 119B.12; 119B.125, subdivision 2; 119B.13, subdivisions 1.251, 3a, 6, 7; 119B.21, subdivision 5; 144.05, by adding a subdivision; 144.123; 1.26144.125; 144.2215, subdivision 1; 144.3345; 144.565; 144.651, subdivision 1.2726; 144.672, subdivision 1; 144.698, subdivision 1; 144.699, by adding a 1.28subdivision; 144.9502, subdivision 3; 144.9504, subdivision 2; 144.9507, 1.29by adding a subdivision; 144.9512; 144A.071, subdivision 4c; 144E.101, 1.30subdivision 6; 144E.127; 144E.35, subdivision 1; 145A.17; 145C.05; 145C.07, 1.31by adding a subdivision; 148.235, by adding a subdivision; 151.37, subdivision 1.322; 152.11, by adding a subdivision; 156.001, by adding a subdivision; 156.02, 1.33subdivisions 1, 2; 156.04; 156.072, subdivision 2; 156.073; 156.12, subdivisions 1.342, 4, 6; 156.15, subdivision 2; 156.16, subdivisions 3, 10; 156.18, subdivisions 1.351, 2; 156.19; 157.16, subdivision 1; 179A.03, subdivision 7; 198.075; 245.462, 1.36subdivision 20; 245.465, by adding a subdivision; 245.4874; 245.50, subdivision 1.375; 245.98, subdivisions 2, 5; 245A.035; 245A.10, subdivision 2; 245A.16, 1.38subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04, subdivision 1; 1.39245C.05, subdivisions 1, 4, 5, 7, by adding subdivisions; 245C.08, subdivisions 2.11, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2; 245C.12; 2.2245C.16, subdivision 1; 245C.17, by adding subdivisions; 245C.21, by adding 2.3a subdivision; 245C.23, subdivision 2; 245C.24, subdivision 2; 246.54, 2.4subdivision 1; 252.27, subdivision 2a; 252.32, subdivision 3; 252.46, by adding 2.5a subdivision; 253B.185, subdivision 2; 254A.03, subdivision 3; 254A.16, 2.6subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivisions 1, 3; 254B.06, 2.7subdivision 3; 256.01, subdivisions 2, 2b, 4, 18, by adding subdivisions; 2.8256.015, subdivision 7; 256.017, subdivisions 1, 9; 256.0471, subdivision 1; 2.9256.476, subdivisions 1, 2, 3, 4, 5, 10; 256.969, subdivisions 3a, 9, by adding 2.10a subdivision; 256.974; 256.9741, subdivisions 1, 3; 256.9742, subdivisions 3, 2.114, 6; 256.9744, subdivision 1; 256.975, subdivision 7; 256.984, subdivision 1; 2.12256B.04, subdivision 14, by adding a subdivision; 256B.056, subdivisions 1a, 3, 2.135c, by adding a subdivision; 256B.057, subdivision 8; 256B.0621, subdivision 2.1411; 256B.0625, subdivisions 3f, 13c, 13d, 14, 17, 18a, 20, 23, 47, by adding 2.15subdivisions; 256B.0644; 256B.0911, subdivisions 3a, 3b, 4b, 4c, 6, 7, by 2.16adding subdivisions; 256B.0913, subdivisions 4, 5, 5a, 8, 9, 10, 11, 12, 13, 14; 2.17256B.0915; 256B.0917, subdivision 8; 256B.0919, subdivision 3; 256B.0943, 2.18subdivisions 6, 9, 11, 12; 256B.0945, subdivision 4; 256B.095; 256B.0951, 2.19subdivision 1; 256B.199; 256B.431, subdivisions 1, 2e, 3f, 17e; 256B.434, 2.20subdivision 4, by adding subdivisions; 256B.437, by adding a subdivision; 2.21256B.438, subdivision 3; 256B.439, subdivision 1; 256B.441, subdivisions 1, 2, 2.225, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions; 256B.49, 2.23subdivision 11, by adding a subdivision; 256B.5012, by adding a subdivision; 2.24256B.69, subdivisions 5g, 5h, 23, 28; 256B.75; 256B.76; 256B.763; 256D.03, 2.25subdivision 4; 256D.44, subdivisions 2, 5; 256E.35, subdivision 2; 256I.04, 2.26subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding a subdivision; 2.27256J.02, subdivisions 1, 4; 256J.021; 256J.08, subdivision 65; 256J.21, 2.28subdivision 2; 256J.24, subdivision 10; 256J.42, subdivision 1; 256J.425, 2.29subdivisions 3, 4; 256J.46, by adding a subdivision; 256J.49, subdivision 13; 2.30256J.521, subdivisions 1, 2, by adding a subdivision; 256J.53, subdivision 2.312; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4, 5, 6; 256J.751, 2.32subdivisions 2, 5; 256J.95, subdivisions 3, 13; 256K.45, by adding a subdivision; 2.33256L.01, subdivision 4; 256L.03, subdivisions 1, 5; 256L.035; 256L.04, 2.34subdivisions 1, 12; 256L.11, subdivision 7; 256L.12, subdivision 9a; 259.20, 2.35subdivision 2; 259.24, subdivision 3; 259.29, subdivision 1; 259.41; 259.53, 2.36subdivisions 1, 2; 259.57, subdivisions 1, 2; 259.67, subdivisions 4, 7; 259.75, 2.37subdivision 8; 260.012; 260.755, subdivisions 12, 20; 260.761, subdivision 2.387; 260.765, subdivision 5; 260.771, subdivisions 1, 2; 260B.157, subdivision 2.391; 260C.152, subdivision 5; 260C.163, subdivision 1; 260C.201, subdivision 2.4011; 260C.209; 260C.212, subdivisions 1, 2, 4, 9; 260C.317, subdivision 3; 2.41260C.331, subdivision 1; 270B.14, subdivision 1; 609.115, subdivision 9; 2.42626.556, subdivisions 2, 3, 10, 10a, 10c, 10f, by adding subdivisions; Laws 2000, 2.43chapter 340, section 19; Laws 2005, chapter 98, article 3, section 25; Laws 2005, 2.44First Special Session chapter 4, article 9, section 3, subdivision 2; Laws 2006, 2.45chapter 282, article 20, section 37; proposing coding for new law in Minnesota 2.46Statutes, chapters 16A; 62A; 62J; 62Q; 144; 145; 152; 156; 245A; 245C; 254A; 2.47256B; 256C; 256D; 256F; 256J; 260; 325E; proposing coding for new law as 2.48Minnesota Statutes, chapters 256N; 525A; repealing Minnesota Statutes 2006, 2.49sections 62J.052, subdivision 1; 62J.17, subdivisions 1, 5a, 6a, 8; 119B.08, 2.50subdivision 4; 144.335; 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 2.51252.275, subdivision 5; 254A.02, subdivisions 7, 9, 12, 14, 15, 16; 254A.085; 2.52254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 2.53254A.18; 256.969, subdivision 27; 256.9743; 256B.0913, subdivisions 5b, 5c, 2.545d, 5e, 5f, 5g, 5h; 256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.29; 2.55256J.37, subdivisions 3a, 3b; 256J.561, subdivision 1; 256J.62, subdivision 9; 2.56256J.626, subdivisions 7, 9; 256J.65; 525.921; 525.9211; 525.9212; 525.9213; 2.57525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 2.58525.9222; 525.9223; 525.9224; Laws 1997, chapter 8, section 1; Laws 2004, 3.1chapter 288, article 6, section 27; Minnesota Rules, parts 9503.0035, subpart 2; 3.29560.0102, subpart 2, item C; 9585.0030.3.3BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:3.4ARTICLE 13.5CHILDREN AND FAMILY3.6    Section 1. Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:3.7    Subd. 2. General. (a) Unless the data is summary data or a statute specifically 3.8provides a different classification, data on individuals collected, maintained, used, or 3.9disseminated by the welfare system is private data on individuals, and shall not be 3.10disclosed except:3.11    (1) according to section 
         13.05;3.12    (2) according to court order;3.13    (3) according to a statute specifically authorizing access to the private data;3.14    (4) to an agent of the welfare system, including a law enforcement person, attorney, 3.15or investigator acting for it in the investigation or prosecution of a criminal or civil 3.16proceeding relating to the administration of a program;3.17    (5) to personnel of the welfare system who require the data to verify an individual's 3.18identity; determine eligibility, amount of assistance, and the need to provide services to 3.19an individual or family across programs; evaluate the effectiveness of programs; and 3.20investigate suspected fraud;3.21    (6) to administer federal funds or programs;3.22    (7) between personnel of the welfare system working in the same program;3.23    (8) to the Department of Revenue to administer and evaluate tax refund or tax credit 3.24programs and to identify individuals who may benefit from these programs. The following 3.25information may be disclosed under this paragraph: an individual's and their dependent's 3.26names, dates of birth, Social Security numbers, income, addresses, and other data as 3.27required, upon request by the Department of Revenue. Disclosures by the commissioner 3.28of revenue to the commissioner of human services for the purposes described in this clause 3.29are governed by section 
         270B.14, subdivision 1. Tax refund or tax credit programs include, 3.30but are not limited to, the dependent care credit under section 
         290.067, the Minnesota 3.31working family credit under section 
         290.0671, the property tax refund and rental credit 3.32under section 
         290A.04, and the Minnesota education credit under section 
         290.0674;3.33    (9) between the Department of Human Services, the Department of Education, and 3.34the Department of Employment and Economic Development for the purpose of monitoring 3.35the eligibility of the data subject for unemployment benefits, for any employment or 4.1training program administered, supervised, or certified by that agency, for the purpose of 4.2administering any rehabilitation program or child care assistance program, whether alone 4.3or in conjunction with the welfare system, or to monitor and evaluate the Minnesota 4.4family investment program or the child care assistance program by exchanging data on 4.5recipients and former recipients of food support, cash assistance under chapter 256, 256D, 4.6256J, or 256K, child care assistance under chapter 119B, or medical programs under 4.7chapter 256B, 256D, or 256L;4.8    (10) to appropriate parties in connection with an emergency if knowledge of 4.9the information is necessary to protect the health or safety of the individual or other 4.10individuals or persons;4.11    (11) data maintained by residential programs as defined in section 
         245A.02 may 4.12be disclosed to the protection and advocacy system established in this state according 4.13to Part C of Public Law 98-527 to protect the legal and human rights of persons with 4.14developmental disabilities or other related conditions who live in residential facilities for 4.15these persons if the protection and advocacy system receives a complaint by or on behalf 4.16of that person and the person does not have a legal guardian or the state or a designee of 4.17the state is the legal guardian of the person;4.18    (12) to the county medical examiner or the county coroner for identifying or locating 4.19relatives or friends of a deceased person;4.20    (13) data on a child support obligor who makes payments to the public agency 4.21may be disclosed to the Minnesota Office of Higher Education to the extent necessary to 4.22determine eligibility under section 
         136A.121, subdivision 2, clause (5);4.23    (14) participant Social Security numbers and names collected by the telephone 4.24assistance program may be disclosed to the Department of Revenue to conduct an 4.25electronic data match with the property tax refund database to determine eligibility under 4.26section 
         237.70, subdivision 4a;4.27    (15) the current address of a Minnesota family investment program participant 4.28may be disclosed to law enforcement officers who provide the name of the participant 4.29and notify the agency that:4.30    (i) the participant:4.31    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after 4.32conviction, for a crime or attempt to commit a crime that is a felony under the laws of the 4.33jurisdiction from which the individual is fleeing; or4.34    (B) is violating a condition of probation or parole imposed under state or federal law;4.35    (ii) the location or apprehension of the felon is within the law enforcement officer's 4.36official duties; and5.1    (iii) the request is made in writing and in the proper exercise of those duties;5.2    (16) the current address of a recipient of general assistance or general assistance 5.3medical care may be disclosed to probation officers and corrections agents who are 5.4supervising the recipient and to law enforcement officers who are investigating the 5.5recipient in connection with a felony level offense;5.6    (17) information obtained from food support applicant or recipient households may 5.7be disclosed to local, state, or federal law enforcement officials, upon their written request, 5.8for the purpose of investigating an alleged violation of the Food Stamp Act, according 5.9to Code of Federal Regulations, title 7, section 272.1(c);5.10    (18) the address, Social Security number, and, if available, photograph of any 5.11member of a household receiving food support shall be made available, on request, to a 5.12local, state, or federal law enforcement officer if the officer furnishes the agency with the 5.13name of the member and notifies the agency that:5.14    (i) the member:5.15    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a 5.16crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;5.17    (B) is violating a condition of probation or parole imposed under state or federal 5.18law; or5.19    (C) has information that is necessary for the officer to conduct an official duty related 5.20to conduct described in subitem (A) or (B);5.21    (ii) locating or apprehending the member is within the officer's official duties; and5.22    (iii) the request is made in writing and in the proper exercise of the officer's official 5.23duty;5.24    (19) the current address of a recipient of Minnesota family investment program, 5.25general assistance, general assistance medical care, or food support may be disclosed to 5.26law enforcement officers who, in writing, provide the name of the recipient and notify the 5.27agency that the recipient is a person required to register under section 
         243.166, but is not 5.28residing at the address at which the recipient is registered under section 
         243.166;5.29    (20) certain information regarding child support obligors who are in arrears may be 5.30made public according to section 
         518A.74;5.31    (21) data on child support payments made by a child support obligor and data on 5.32the distribution of those payments excluding identifying information on obligees may be 5.33disclosed to all obligees to whom the obligor owes support, and data on the enforcement 5.34actions undertaken by the public authority, the status of those actions, and data on the 5.35income of the obligor or obligee may be disclosed to the other party;6.1    (22) data in the work reporting system may be disclosed under section 
         256.998, 6.2subdivision 7
         ;6.3    (23) to the Department of Education for the purpose of matching Department of 6.4Education student data with public assistance data to determine students eligible for free 6.5and reduced price meals, meal supplements, and free milk according to United States 6.6Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and 6.7state funds that are distributed based on income of the student's family; and to verify 6.8receipt of energy assistance for the telephone assistance plan;6.9    (24) the current address and telephone number of program recipients and emergency 6.10contacts may be released to the commissioner of health or a local board of health as 6.11defined in section 
         145A.02, subdivision 2, when the commissioner or local board of health 6.12has reason to believe that a program recipient is a disease case, carrier, suspect case, or at 6.13risk of illness, and the data are necessary to locate the person;6.14    (25) to other state agencies, statewide systems, and political subdivisions of this 6.15state, including the attorney general, and agencies of other states, interstate information 6.16networks, federal agencies, and other entities as required by federal regulation or law for 6.17the administration of the child support enforcement program;6.18    (26) to personnel of public assistance programs as defined in section 
         256.741, for 6.19access to the child support system database for the purpose of administration, including 6.20monitoring and evaluation of those public assistance programs;6.21    (27) to monitor and evaluate the Minnesota family investment program by 6.22exchanging data between the Departments of Human Services and Education, on 6.23recipients and former recipients of food support, cash assistance under chapter 256, 256D, 6.24256J, or 256K, child care assistance under chapter 119B, or medical programs under 6.25chapter 256B, 256D, or 256L;6.26    (28) to evaluate child support program performance and to identify and prevent 6.27fraud in the child support program by exchanging data between the Department of Human 6.28Services, Department of Revenue under section 
         270B.14, subdivision 1, paragraphs (a) 6.29and (b), without regard to the limitation of use in paragraph (c), Department of Health, 6.30Department of Employment and Economic Development, and other state agencies as is 6.31reasonably necessary to perform these functions; or6.32    (29) counties operating child care assistance programs under chapter 119B may 6.33disseminate data on program participants, applicants, and providers to the commissioner 6.34of education.7.1    (b) Information on persons who have been treated for drug or alcohol abuse may 7.2only be disclosed according to the requirements of Code of Federal Regulations, title 7.342, sections 2.1 to 
         2.67.7.4    (c) Data provided to law enforcement agencies under paragraph (a), clause (15), 7.5(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected 7.6nonpublic while the investigation is active. The data are private after the investigation 7.7becomes inactive under section 
         13.82, subdivision 5, paragraph (a) or (b).7.8    (d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but is 7.9not subject to the access provisions of subdivision 10, paragraph (b).7.10    For the purposes of this subdivision, a request will be deemed to be made in writing 7.11if made through a computer interface system.7.12    Sec. 2. Minnesota Statutes 2006, section 16D.13, subdivision 3, is amended to read:7.13    Subd. 3. Exclusion. A state agency may not charge interest under this section on 7.14overpayments of assistance benefits under the programs formerly codified in sections 7.15256.031
          to 
         256.0361, 
         256.72 to 
         256.87, and under chapters 119B, 256D, and 256I, or the 7.16federal food stamp program. Notwithstanding this prohibition, any debts that have been 7.17reduced to judgment under these programs are subject to the interest charges provided 7.18under section 
         549.09.7.19    Sec. 3. Minnesota Statutes 2006, section 119B.05, subdivision 1, is amended to read:7.20    Subdivision 1. Eligible participants. Families eligible for child care assistance 7.21under the MFIP child care program are:7.22    (1) MFIP participants who are employed or in job search and meet the requirements 7.23of section 
         119B.10; 7.24    (2) persons who are members of transition year families under section 
         119B.011, 7.25subdivision 20
         , and meet the requirements of section 
         119B.10; 7.26    (3) families who are participating in employment orientation or job search, or 7.27other employment or training activities that are included in an approved employability 7.28development plan under section sections 256J.09 and256J.95; 7.29    (4) MFIP families who are participating in work job search, job support, 7.30employment, or training activities as required in their employment plan, or in appeals, 7.31hearings, assessments, or orientations according to chapter 256J;7.32    (5) MFIP families who are participating in social services activities under chapter 7.33256J as required in their employment plan approved according to chapter 256J;8.1    (6) families who are participating in programs as required in tribal contracts under 8.2section 
         119B.02, subdivision 2, or 
         256.01, subdivision 2; and 8.3    (7) families who are participating in the transition year extension under section 8.4119B.011, subdivision 20a
         . 8.5    Sec. 4. Minnesota Statutes 2006, section 119B.09, subdivision 1, is amended to read:8.6    Subdivision 1. General Eligibility requirements for all applicants for child 8.7care assistance. (a) Child care services must be available to families who need child 8.8care to find or keep employment or to obtain the training or education necessary to find 8.9employment and who:8.10    (1) have household income less than or equal to 250 percent of the federal poverty 8.11guidelines, adjusted for family size, and meet the requirements of section 
         119B.05; 8.12receive MFIP assistance; and are participating in employment and training services under 8.13chapter 256J or 256K; or8.14    (2) have household income less than or equal to 175 percent of the federal poverty 8.15guidelines, adjusted for family size, at program entry and less than 250 percent of the 8.16federal poverty guidelines, adjusted for family size, at program exit.; or8.17    (3) have household income less than or equal to 250 percent of the federal poverty 8.18guidelines, adjusted for family size, and were a family whose child care assistance was 8.19terminated due to insufficient funds under Minnesota Rules, part 3400.0183.8.20    (b) Child care services must be made available as in-kind services.8.21    (c) All applicants for child care assistance and families currently receiving child care 8.22assistance must be assisted and required to cooperate in establishment of paternity and 8.23enforcement of child support obligations for all children in the family as a condition 8.24of program eligibility. For purposes of this section, a family is considered to meet the 8.25requirement for cooperation when the family complies with the requirements of section 8.26256.741
         .8.27EFFECTIVE DATE.This section is effective July 1, 2008.8.28    Sec. 5. Minnesota Statutes 2006, section 119B.09, subdivision 7, is amended to read:8.29    Subd. 7. Date of eligibility for assistance. (a) The date of eligibility for child 8.30care assistance under this chapter is the later of the date the application was signed; the 8.31beginning date of employment, education, or training; the date the infant is born for 8.32applicants to the at-home infant care program; or the date a determination has been made 8.33that the applicant is a participant in employment and training services under Minnesota 8.34Rules, part 3400.0080, subpart 2a, or chapter 256J.9.1    (b) Payment ceases for a family under the at-home infant child care program when a 9.2family has used a total of 12 months of assistance as specified under section 
         119B.035. 9.3Payment of child care assistance for employed persons on MFIP is effective the date of 9.4employment or the date of MFIP eligibility, whichever is later. Payment of child care 9.5assistance for MFIP or DWP participants in employment and training services is effective 9.6the date of commencement of the services or the date of MFIP or DWP eligibility, 9.7whichever is later. Payment of child care assistance for transition year child care must be 9.8made retroactive to the date of eligibility for transition year child care. 9.9    (c) Notwithstanding paragraph (b), payment of child care assistance for participants 9.10eligible under section 119B.05, may only be made retroactively for a maximum of six 9.11months from the date of application for child care assistance.9.12EFFECTIVE DATE.This section is effective July 1, 2008.9.13    Sec. 6. Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision 9.14to read:9.15    Subd. 11.Payment of other child care expenses.Payment by a source other 9.16than the family, of part or all of a family's child care expenses not payable under this 9.17chapter, does not affect the family's eligibility for child care assistance, and the amount 9.18paid is excluded from the family's income, if the funds are paid directly to the family's 9.19child care provider on behalf of the family. Child care providers who accept third-party 9.20payments must maintain family-specific documentation of payment source, amount, type 9.21of expenses, and time period covered by the payment.9.22    Sec. 7. Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision 9.23to read:9.24    Subd. 13.Sliding fee.Child care services to families must be made available on 9.25a sliding fee basis.9.26    (a) The commissioner shall convert eligibility requirements in section 119B.09 and 9.27parent fee schedules in 119B.12 to state median income, based on a family size of three, 9.28adjusted for family size,  Subd. 2(a) shall be implemented July 1, 2008. The commissioner 9.29shall report to the 2008 legislature with the necessary statutory changes to codify this 9.30conversion to state median income. 9.31    Sec. 8. Minnesota Statutes 2006, section 119B.12, is amended to read:9.32119B.12 SLIDING FEE SCALE.10.1    Subdivision 1. Fee schedule. In setting the sliding fee schedule, the commissioner 10.2shall exclude from the amount of income used to determine eligibility an amount for 10.3federal and state income and Social Security taxes attributable to that income level 10.4according to federal and state standardized tax tables. The commissioner shall base the 10.5parent fee on the ability of the family to pay for child care. The fee schedule must be 10.6designed to use any available tax credits.10.7    PARENT FEE SCHEDULE.   The parent fee schedule is as follows: 

10.810.9Income Range (as a percent of the federal poverty guidelines)Co-payment (as a percentage of adjusted gross income)10.10 0-74.99%$0/month10.1175.00-99.99%$5/month10.12100.00-104.99%2.61%10.13105.00-109.99%2.61%10.14110.00-114.99%2.61%10.15115.00-119.99%2.61%10.16120.00-124.99%2.91%10.17125.00-129.99%2.91%10.18130.00-134.99%2.91%10.19135.00-139.99%2.91%10.20140.00-144.99%3.21%10.21145.00-149.99%3.21%10.22150.00-154.99%3.21%10.23155.00-159.99%3.84%10.24160.00-164.99%3.84%10.25165.00-169.99%4.46%10.26170.00-174.99%4.76%10.27175.00-179.99%5.05%10.28180.00-184.99%5.65%10.29185.00-189.99%5.95%10.30190.00-194.99%6.24%10.31195.00-199.99%6.84%10.32200.00-204.99%7.58%10.33205.00-209.99%8.33%10.34210.00-214.99%9.20%10.35215.00-219.99%10.07%10.36220.00-224.99%10.94%10.37225.00-229.99%11.55%10.38230.00-234.99%12.16%10.39235.00-239.99%12.77%10.40240.00-244.99%13.38%10.41245.00-249.99%14.00%10.42250%ineligible

11.1    A family's monthly co-payment fee is the fixed percentage established for the 11.2income range multiplied by the highest possible income within that income range.11.3    Subd. 2. Parent fee. A family must be assessed a parent fee for each service period. 11.4A family's parent fee must be a fixed percentage of its annual gross income. Parent fees 11.5must apply to families eligible for child care assistance under sections 
         119B.03 and 11.6119B.05
         . Income must be as defined in section 
         119B.011, subdivision 15. The fixed 11.7percent is based on the relationship of the family's annual gross income to 100 percent 11.8of the annual federal poverty guidelines. Parent fees must begin at 75 percent of the 11.9poverty level. The minimum parent fees for families between 75 percent and 100 percent 11.10of poverty level must be $10 $5 per month. Parent fees must provide for graduated 11.11movement to full payment. Payment of part or all of a family's parent fee directly to the 11.12family's child care provider on behalf of the family by a source other than the family shall 11.13not affect the family's eligibility for child care assistance, and the amount paid shall be 11.14excluded from the family's income. Child care providers who accept third-party payments 11.15must maintain family specific documentation of payment source, amount, and time period 11.16covered by the payment.11.17EFFECTIVE DATE.(a) This section is effective July 1, 2007. 11.18    (b) Effective July 1, 2008, the parent fee scale for families with incomes greater than 11.19or equal to 100 percent of FPG shall be converted to state median income for a family size 11.20of three, adjusted for family size, as directed in section 119B.09, subdivision 2(a). 11.21    Sec. 9. Minnesota Statutes 2006, section 119B.125, subdivision 2, is amended to read:11.22    Subd. 2. Persons who cannot be authorized. (a) A person who meets any of the 11.23conditions under paragraphs (b) to (n) must not be authorized as a legal nonlicensed 11.24family child care provider. To determine whether any of the listed conditions exist, 11.25the county must request information about the provider from the Bureau of Criminal 11.26Apprehension, the juvenile courts, and social service agencies. When one of the listed 11.27entities does not maintain information on a statewide basis, the county must contact the 11.28entity in the county where the provider resides and any other county in which the provider 11.29previously resided in the past year. For purposes of this subdivision, a finding that a 11.30delinquency petition is proven in juvenile court must be considered a conviction in state 11.31district court. If a county has determined that a provider is able to be authorized in that 11.32county, and a family in another county later selects that provider, the provider is able to 11.33be authorized in the second county without undergoing a new background investigation 11.34unless one of the following conditions exists:11.35    (1) two years have passed since the first authorization;12.1    (2) another person age 13 or older has joined the provider's household since the 12.2last authorization;12.3    (3) a current household member has turned 13 since the last authorization; or12.4    (4) there is reason to believe that a household member has a factor that prevents 12.5authorization.12.6    (b) The person has been convicted of one of the following offenses or has admitted to 12.7committing or a preponderance of the evidence indicates that the person has committed an 12.8act that meets the definition of one of the following offenses: sections 
         609.185 to 
         609.195, 12.9murder in the first, second, or third degree; 
         609.2661 to 
         609.2663, murder of an unborn 12.10child in the first, second, or third degree; 
         609.322, solicitation, inducement, promotion 12.11of prostitution, or receiving profit from prostitution; 
         609.342 to 
         609.345, criminal sexual 12.12conduct in the first, second, third, or fourth degree; 
         609.352, solicitation of children to 12.13engage in sexual conduct; 
         609.365, incest; 
         609.377, felony malicious punishment of a 12.14child; 
         617.246, use of minors in sexual performance; 
         617.247, possession of pictorial 12.15representation of a minor; 
         609.2242 to 
         609.2243, felony domestic assault; a felony offense 12.16of spousal abuse; a felony offense of child abuse or neglect; a felony offense of a crime 12.17against children; or an attempt or conspiracy to commit any of these offenses as defined in 12.18Minnesota Statutes; or an offense in any other state or country where the elements are 12.19substantially similar to any of the offenses listed in this paragraph.12.20    (c) Less than 15 years have passed since the discharge of the sentence imposed for 12.21the offense and the person has received a felony conviction for one of the following 12.22offenses, or the person has admitted to committing or a preponderance of the evidence 12.23indicates that the person has committed an act that meets the definition of a felony 12.24conviction for one of the following offenses: sections 
         609.20 to 
         609.205, manslaughter in 12.25the first or second degree; 
         609.21, criminal vehicular homicide; 
         609.215, aiding suicide 12.26or aiding attempted suicide; 
         609.221 to 
         609.2231, assault in the first, second, third, or 12.27fourth degree; 
         609.224, repeat offenses of fifth degree assault; 
         609.228, great bodily 12.28harm caused by distribution of drugs; 
         609.2325, criminal abuse of a vulnerable adult; 12.29609.2335
         , financial exploitation of a vulnerable adult; 
         609.235, use of drugs to injure or 12.30facilitate a crime; 
         609.24, simple robbery; 
         617.241, repeat offenses of obscene materials 12.31and performances; 
         609.245, aggravated robbery; 
         609.25, kidnapping; 
         609.255, false 12.32imprisonment; 
         609.2664 to 
         609.2665, manslaughter of an unborn child in the first or 12.33second degree; 
         609.267 to 
         609.2672, assault of an unborn child in the first, second, or third 12.34degree; 
         609.268, injury or death of an unborn child in the commission of a crime; 
         609.27, 12.35coercion; 
         609.275, attempt to coerce; 
         609.324, subdivision 1, other prohibited acts, minor 12.36engaged in prostitution; 
         609.3451, repeat offenses of criminal sexual conduct in the fifth 13.1degree; 
         609.378, neglect or endangerment of a child; 
         609.52, theft; 
         609.521, possession of 13.2shoplifting gear; 
         609.561 to 
         609.563, arson in the first, second, or third degree; 
         609.582, 13.3burglary in the first, second, third, or fourth degree; 
         609.625, aggravated forgery; 
         609.63, 13.4forgery; 
         609.631, check forgery, offering a forged check; 
         609.635, obtaining signature 13.5by false pretenses; 
         609.66, dangerous weapon; 
         609.665, setting a spring gun; 
         609.67, 13.6unlawfully owning, possessing, or operating a machine gun; 
         609.687, adulteration; 
         609.71, 13.7riot; 
         609.713, terrorist threats; 
         609.749, harassment, stalking; 
         260C.301, termination of 13.8parental rights; 
         152.021 to 
         152.022 and 
         152.0262, controlled substance crime in the first 13.9or second degree; 
         152.023, subdivision 1, clause (3) or (4), or 
         152.023, subdivision 2, 13.10clause (4), controlled substance crime in third degree; 
         152.024, subdivision 1, clause 13.11(2), (3), or (4), controlled substance crime in fourth degree; 
         617.23, repeat offenses of 13.12indecent exposure; an attempt or conspiracy to commit any of these offenses as defined in 13.13Minnesota Statutes; or an offense in any other state or country where the elements are 13.14substantially similar to any of the offenses listed in this paragraph.13.15    (d) Less than ten years have passed since the discharge of the sentence imposed for 13.16the offense and the person has received a gross misdemeanor conviction for one of the 13.17following offenses or the person has admitted to committing or a preponderance of the 13.18evidence indicates that the person has committed an act that meets the definition of a gross 13.19misdemeanor conviction for one of the following offenses: sections 
         609.224, fifth degree 13.20assault; 
         609.2242 to 
         609.2243, domestic assault; 
         518B.01, subdivision 14, violation of 13.21an order for protection; 
         609.3451, fifth degree criminal sexual conduct; 
         609.746, repeat 13.22offenses of interference with privacy; 
         617.23, repeat offenses of indecent exposure; 13.23617.241
         , obscene materials and performances; 
         617.243, indecent literature, distribution; 13.24617.293
         , disseminating or displaying harmful material to minors; 
         609.71, riot; 
         609.66, 13.25dangerous weapons; 
         609.749, harassment, stalking; 
         609.224, subdivision 2, paragraph 13.26(c), fifth degree assault against a vulnerable adult by a caregiver; 
         609.23, mistreatment 13.27of persons confined; 
         609.231, mistreatment of residents or patients; 
         609.2325, criminal 13.28abuse of a vulnerable adult; 
         609.2335, financial exploitation of a vulnerable adult; 13.29609.233
         , criminal neglect of a vulnerable adult; 
         609.234, failure to report maltreatment of 13.30a vulnerable adult; 
         609.72, subdivision 3, disorderly conduct against a vulnerable adult; 13.31609.265
         , abduction; 
         609.378, neglect or endangerment of a child; 
         609.377, malicious 13.32punishment of a child; 
         609.324, subdivision 1a, other prohibited acts, minor engaged 13.33in prostitution; 
         609.33, disorderly house; 
         609.52, theft; 
         609.582, burglary in the first, 13.34second, third, or fourth degree; 
         609.631, check forgery, offering a forged check; 
         609.275, 13.35attempt to coerce; an attempt or conspiracy to commit any of these offenses as defined in 14.1Minnesota Statutes; or an offense in any other state or country where the elements are 14.2substantially similar to any of the offenses listed in this paragraph.14.3    (e) Less than seven years have passed since the discharge of the sentence imposed 14.4for the offense and the person has received a misdemeanor conviction for one of the 14.5following offenses or the person has admitted to committing or a preponderance of 14.6the evidence indicates that the person has committed an act that meets the definition 14.7of a misdemeanor conviction for one of the following offenses: sections 
         609.224, fifth 14.8degree assault; 
         609.2242, domestic assault; 
         518B.01, violation of an order for protection; 14.9609.3232
         , violation of an order for protection; 
         609.746, interference with privacy; 
         609.79, 14.10obscene or harassing telephone calls; 
         609.795, letter, telegram, or package opening, 14.11harassment; 
         617.23, indecent exposure; 
         609.2672, assault of an unborn child, third degree; 14.12617.293
         , dissemination and display of harmful materials to minors; 
         609.66, dangerous 14.13weapons; 
         609.665, spring guns; an attempt or conspiracy to commit any of these offenses 14.14as defined in Minnesota Statutes; or an offense in any other state or country where the 14.15elements are substantially similar to any of the offenses listed in this paragraph.14.16    (f) The person has been identified by the child protection agency in the county where 14.17the provider resides or a county where the provider has resided or by the statewide child 14.18protection database as a person found by a preponderance of evidence under section 14.19626.556
          to be responsible for physical or sexual abuse of a child within the last seven years.14.20    (g) The person has been identified by the adult protection agency in the county 14.21where the provider resides or a county where the provider has resided or by the statewide 14.22adult protection database as the person responsible for abuse or neglect of a vulnerable 14.23adult within the last seven years.14.24    (h) The person has refused to give written consent for disclosure of criminal history 14.25records.14.26    (i) The person has been denied a family child care license or has received a fine or a 14.27sanction as a licensed child care provider that has not been reversed on appeal.14.28    (j) The person has a family child care licensing disqualification that has not been 14.29set aside.14.30    (k) The person has admitted or a county has found that there is a preponderance of 14.31evidence that fraudulent information was given to the county for child care assistance 14.32application purposes or was used in submitting child care assistance bills for payment.14.33    (l) The person has been convicted of the crime of theft by wrongfully obtaining 14.34public assistance or has been found guilty of wrongfully obtaining public assistance by a 14.35federal court, state court, or an administrative hearing determination or waiver, through a 15.1disqualification consent agreement, as part of an approved diversion plan under section 15.2401.065, or a court-ordered stay with probationary or other conditions.15.3    (m) The person has a household member age 13 or older who has access to children 15.4during the hours that care is provided and who meets one of the conditions listed in 15.5paragraphs (b) to (l).15.6    (n) The person has a household member ages ten to 12 who has access to children 15.7during the hours that care is provided; information or circumstances exist which provide 15.8the county with articulable suspicion that further pertinent information may exist showing 15.9the household member meets one of the conditions listed in paragraphs (b) to (l); and the 15.10household member actually meets one of the conditions listed in paragraphs (b) to (l).15.11    Sec. 10. Minnesota Statutes 2006, section 119B.13, subdivision 1, is amended to read:15.12    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006 2007, the 15.13maximum rate paid for child care assistance in any county or multicounty region under the 15.14child care fund shall be the  rate for like-care arrangements in the county effective January15.15July 1, 2006, increased by six two percent.15.16    (b) Rate changes shall be implemented for services provided in September 200615.172007 unless a participant eligibility redetermination or a new provider agreement is 15.18completed between July 1, 2006 2007, and August 31, 2006 2007.15.19    As necessary, appropriate notice of adverse action must be made according to 15.20Minnesota Rules, part 
         3400.0185, subparts 3 and 4.15.21    New cases approved on or after  July 1, 2006 2007, shall have the maximum rates 15.22under paragraph (a), implemented immediately.15.23    (c) Not less than once every two years year, the commissioner shall survey rates 15.24charged by child care providers in Minnesota to determine the 75th percentile for 15.25like-care arrangements in counties. When the commissioner determines that, using the 15.26commissioner's established protocol, the number of providers responding to the survey is 15.27too small to determine the 75th percentile rate for like-care arrangements in a county or 15.28multicounty region, the commissioner may establish the 75th percentile maximum rate 15.29based on like-care arrangements in a county, region, or category that the commissioner 15.30deems to be similar.15.31    (d) A rate which includes a special needs rate paid under subdivision 3 or under 15.32a school readiness service agreement paid under section 30 may be in excess of the 15.33maximum rate allowed under this subdivision.15.34    (e) The department shall monitor the effect of this paragraph on provider rates. The 15.35county shall pay the provider's full charges for every child in care up to the maximum 16.1established. The commissioner shall determine the maximum rate for each type of care 16.2on an hourly, full-day, and weekly basis, including special needs and disability care. The 16.3half-day rates are effective beginning July 1, 2008.16.4    (f) When the provider charge is greater than the maximum provider rate allowed, 16.5the parent is responsible for payment of the difference in the rates in addition to any 16.6family co-payment fee.16.7    (g) All maximum provider rate changes shall be implemented on the Monday 16.8following the effective date of the maximum provider rate.16.9    Sec. 11. Minnesota Statutes 2006, section 119B.13, subdivision 3a, is amended to read:16.10    Subd. 3a. Provider rate differential for accreditation. A family child care 16.11provider or child care center shall be paid a 15 percent differential above the maximum 16.12rate established in subdivision 1, up to the actual provider rate, if the provider or center 16.13holds a current early childhood development credential or is accredited.  For a family 16.14child care provider, early childhood development credential and accreditation includes 16.15an individual who has earned a child development associate degree, a child development 16.16associate credential, a diploma in child development from a Minnesota state technical 16.17college, or a bachelor's or post baccalaureate degree in early childhood education from 16.18an accredited college or university, or who is accredited by the National Association for 16.19Family Child Care or the Competency Based Training and Assessment Program.  For a 16.20child care center, accreditation includes accreditation by the National Association for the 16.21Education of Young Children, the Council on Accreditation, the National Early Childhood 16.22Program Accreditation, the National School-Age Care Association, or the National Head 16.23Start Association Program of Excellence.  For Montessori programs, accreditation includes 16.24the American Montessori Society, Association of Montessori International-USA, or the 16.25National Center for Montessori Education.16.26    Sec. 12. Minnesota Statutes 2006, section 119B.13, subdivision 6, is amended to read:16.27    Subd. 6. Provider payments. (a) Counties or the state shall make vendor payments 16.28to the child care provider or pay the parent directly for eligible child care expenses.16.29    (b) If payments for child care assistance are made to providers, the provider shall 16.30bill the county for services provided within ten days of the end of the service period. If 16.31bills are submitted within ten days of the end of the service period, a county or the state 16.32shall issue payment to the provider of child care under the child care fund within 30 days 16.33of receiving a bill from the provider. Counties or the state may establish policies that 16.34make payments on a more frequent basis.17.1    (c) All billsIf a provider has received an authorization of care and has been issued a 17.2billing form for an eligible family, the bill must be submitted within 60 days of the last 17.3date of service on the bill. A county may pay a bill submitted more than 60 days after 17.4the last date of service if the provider shows good cause why the bill was not submitted 17.5within 60 days. Good cause must be defined in the county's child care fund plan under 17.6section 
         119B.08, subdivision 3, and the definition of good cause must include county 17.7error. A county may not pay any bill submitted more than a year after the last date of 17.8service on the bill. 17.9    (d) If a provider provided care for a time period without receiving an authorization 17.10of care and a billing form for an eligible family, payment of child care assistance may only 17.11be made retroactively for a maximum of six months from the date the provider is issued an 17.12authorization of care and a billing form.17.13    (d)(e) A county may stop payment issued to a provider or may refuse to pay a 17.14bill submitted by a provider if:17.15    (1) the provider admits to intentionally giving the county materially false information 17.16on the provider's billing forms; or17.17    (2) a county finds by a preponderance of the evidence that the provider intentionally 17.18gave the county materially false information on the provider's billing forms.17.19    (e)(f) A county's payment policies must be included in the county's child care plan 17.20under section 
         119B.08, subdivision 3. If payments are made by the state, in addition to 17.21being in compliance with this subdivision, the payments must be made in compliance 17.22with section 
         16A.124. 17.23    Sec. 13. Minnesota Statutes 2006, section 119B.13, subdivision 7, is amended to read:17.24    Subd. 7. Absent days. (a) Child care providers may not be reimbursed for more 17.25than 25 full-day absent days per child, excluding holidays, in a fiscal year, or for more 17.26than ten consecutive full-day absent days, unless the child has a documented medical 17.27condition that causes more frequent absences. Absences due to a documented medical 17.28condition of a parent or sibling who lives in the same residence as the child receiving 17.29child care assistance do not count against the 25-day absent day limit in a fiscal year. 17.30Documentation of medical conditions must be on the forms and submitted according to 17.31the timelines established by the commissioner. A public health nurse or school nurse 17.32may verify the illness in lieu of a medical practitioner. If a provider sends a child home 17.33early due to a medical reason including, but not limited to, fever or contagious illness, 17.34the child care center director or lead teacher may verify the illness in lieu of a medical 17.35practitioner. If a child attends for part of the time authorized to be in care in a day, but is 18.1absent for part of the time authorized to be in care in that same day, the absent time will be 18.2reimbursed but the time will not count toward the ten consecutive or 25 cumulative absent 18.3day limits. Children in families where at least one parent is under the age of 21, does not 18.4have a high school or general education development (GED) diploma, and is a student in a 18.5school district or another similar program that provides or arranges for child care, as well 18.6as parenting, social services, career and employment supports, and academic support to 18.7achieve high school graduation, may be exempt from the absent day limits upon request 18.8of the program and approval of the county. If a child attends part of an authorized day, 18.9payment to the provider must be for the full amount of care authorized for that day. Child 18.10care providers may only be reimbursed for absent days if the provider has a written policy 18.11for child absences and charges all other families in care for similar absences. 18.12    (b) Child care providers must be reimbursed for up to ten federal or state holidays 18.13or designated holidays per year when the provider charges all families for these days 18.14and the holiday or designated holiday falls on a day when the child is authorized to be 18.15in attendance. Parents may substitute other cultural or religious holidays for the ten 18.16recognized state and federal holidays. Holidays do not count toward the ten consecutive or 18.1725 cumulative absent day limits. 18.18    (c) A family or child care provider may not be assessed an overpayment for an 18.19absent day payment unless (1) there was an error in the amount of care authorized for the 18.20family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) 18.21the family or provider did not timely report a change as required under law.18.22    (d) The provider and family must receive notification of the number of absent days 18.23used upon initial provider authorization for a family and when the family has used 15 18.24cumulative absent days. Upon statewide implementation of the Minnesota Electronic 18.25Child Care System, the provider and family authorization for a family and ongoing 18.26notification of the number of absent days used as of the date of the notification.18.27    (e) A county may pay for more absent days than the statewide absent day policy 18.28established under this subdivision, if current market practice in the county justifies 18.29payment for those additional days. County policies for payment of absent days in excess 18.30of the statewide absent day policy and justification for these county policies must be 18.31included in the county's child care fund plan under section 119B.08, subdivision 3. This 18.32paragraph may be implemented by counties on or after July 1, 2008.18.33    Sec. 14. Minnesota Statutes 2006, section 119B.21, subdivision 5, is amended to read:19.1    Subd. 5. Child care services grants. (a) A child care resource and referral program 19.2designated under section 
         119B.19, subdivision 1a, may award child care services grants 19.3for: 19.4    (1) creating new licensed child care facilities and expanding existing facilities, 19.5including, but not limited to, supplies, equipment, facility renovation, and remodeling;19.6    (2) improving licensed child care facility programs;19.7    (3) staff training and development services including, but not limited to, in-service 19.8training, curriculum development, accreditation, certification, consulting, resource centers, 19.9and program and resource materials, supporting effective teacher-child interactions, 19.10child-focused teaching, and content-driven classroom instruction;19.11    (4) interim financing;19.12    (5) capacity building through the purchase of appropriate technology to create, 19.13enhance, and maintain business management systems;19.14    (6) emergency assistance for child care programs;19.15    (7) new programs or projects for the creation, expansion, or improvement of 19.16programs that serve ethnic immigrant and refugee communities; and19.17    (8) targeted recruitment initiatives to expand and build the capacity of the child 19.18care system and to improve the quality of care provided by legal nonlicensed child care 19.19providers.19.20    (b) A child care resource and referral program designated under section 
         119B.19, 19.21subdivision 1a
         , may award child care services grants to: 19.22    (1) licensed providers;19.23    (2) providers in the process of being licensed;19.24    (3) corporations or public agencies that develop or provide child care services;19.25    (4) school-age care programs; or19.26    (5) any combination of clauses (1) to (4).19.27Unlicensed providers are only eligible for grants under paragraph (a), clause (7).19.28    (c) A recipient of a child care services grant for facility improvements, interim 19.29financing, or staff training and development must provide a 25 percent local match.19.30    Sec. 15. Minnesota Statutes 2006, section 256.01, subdivision 2, is amended to read:19.31    Subd. 2. Specific powers. Subject to the provisions of section 
         241.021, subdivision 19.322
         , the commissioner of human services shall carry out the specific duties in paragraphs (a) 19.33through (cc):19.34    (a) Administer and supervise all forms of public assistance provided for by state law 19.35and other welfare activities or services as are vested in the commissioner. Administration 20.1and supervision of human services activities or services includes, but is not limited to, 20.2assuring timely and accurate distribution of benefits, completeness of service, and quality 20.3program management. In addition to administering and supervising human services 20.4activities vested by law in the department, the commissioner shall have the authority to:20.5    (1) require county agency participation in training and technical assistance programs 20.6to promote compliance with statutes, rules, federal laws, regulations, and policies 20.7governing human services;20.8    (2) monitor, on an ongoing basis, the performance of county agencies in the 20.9operation and administration of human services, enforce compliance with statutes, rules, 20.10federal laws, regulations, and policies governing welfare services and promote excellence 20.11of administration and program operation;20.12    (3) develop a quality control program or other monitoring program to review county 20.13performance and accuracy of benefit determinations;20.14    (4) require county agencies to make an adjustment to the public assistance benefits 20.15issued to any individual consistent with federal law and regulation and state law and rule 20.16and to issue or recover benefits as appropriate;20.17    (5) delay or deny payment of all or part of the state and federal share of benefits and 20.18administrative reimbursement according to the procedures set forth in section 
         256.017;20.19    (6) make contracts with and grants to public and private agencies and organizations, 20.20both profit and nonprofit, and individuals, using appropriated funds; and20.21    (7) enter into contractual agreements with federally recognized Indian tribes with 20.22a reservation in Minnesota to the extent necessary for the tribe to operate a federally 20.23approved family assistance program or any other program under the supervision of the 20.24commissioner. The commissioner shall consult with the affected county or counties in 20.25the contractual agreement negotiations, if the county or counties wish to be included, 20.26in order to avoid the duplication of county and tribal assistance program services. The 20.27commissioner may establish necessary accounts for the purposes of receiving and 20.28disbursing funds as necessary for the operation of the programs.20.29    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law, 20.30regulation, and policy necessary to county agency administration of the programs.20.31    (c) Administer and supervise all child welfare activities; promote the enforcement of 20.32laws protecting disabled, dependent, neglected and delinquent children, and children born 20.33to mothers who were not married to the children's fathers at the times of the conception 20.34nor at the births of the children; license and supervise child-caring and child-placing 20.35agencies and institutions; supervise the care of children in boarding and foster homes or 21.1in private institutions; and generally perform all functions relating to the field of child 21.2welfare now vested in the State Board of Control.21.3    (d) Administer and supervise all noninstitutional service to disabled persons, 21.4including those who are visually impaired, hearing impaired, or physically impaired 21.5or otherwise disabled. The commissioner may provide and contract for the care and 21.6treatment of qualified indigent children in facilities other than those located and available 21.7at state hospitals when it is not feasible to provide the service in state hospitals.21.8    (e) Assist and actively cooperate with other departments, agencies and institutions, 21.9local, state, and federal, by performing services in conformity with the purposes of Laws 21.101939, chapter 431.21.11    (f) Act as the agent of and cooperate with the federal government in matters of 21.12mutual concern relative to and in conformity with the provisions of Laws 1939, chapter 21.13431, including the administration of any federal funds granted to the state to aid in the 21.14performance of any functions of the commissioner as specified in Laws 1939, chapter 431, 21.15and including the promulgation of rules making uniformly available medical care benefits 21.16to all recipients of public assistance, at such times as the federal government increases its 21.17participation in assistance expenditures for medical care to recipients of public assistance, 21.18the cost thereof to be borne in the same proportion as are grants of aid to said recipients.21.19    (g) Establish and maintain any administrative units reasonably necessary for the 21.20performance of administrative functions common to all divisions of the department.21.21    (h) Act as designated guardian of both the estate and the person of all the wards of 21.22the state of Minnesota, whether by operation of law or by an order of court, without any 21.23further act or proceeding whatever, except as to persons committed as developmentally 21.24disabled. For children under the guardianship of the commissioner or a tribe in Minnesota 21.25recognized by the Secretary of the Interior whose interests would be best served by 21.26adoptive placement, the commissioner may contract with a licensed child-placing agency 21.27or a Minnesota tribal social services agency to provide adoption services. A contract 21.28with a licensed child-placing agency must be designed to supplement existing county 21.29efforts and may not replace existing county programs or tribal social services, unless the 21.30replacement is agreed to by the county board and the appropriate exclusive bargaining 21.31representative, tribal governing body, or the commissioner has evidence that child 21.32placements of the county continue to be substantially below that of other counties. Funds 21.33encumbered and obligated under an agreement for a specific child shall remain available 21.34until the terms of the agreement are fulfilled or the agreement is terminated.21.35    (i) Act as coordinating referral and informational center on requests for service for 21.36newly arrived immigrants coming to Minnesota.22.1    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no 22.2way be construed to be a limitation upon the general transfer of powers herein contained.22.3    (k) Establish county, regional, or statewide schedules of maximum fees and charges 22.4which may be paid by county agencies for medical, dental, surgical, hospital, nursing and 22.5nursing home care and medicine and medical supplies under all programs of medical 22.6care provided by the state and for congregate living care under the income maintenance 22.7programs.22.8    (l) Have the authority to conduct and administer experimental projects to test 22.9methods and procedures of administering assistance and services to recipients or potential 22.10recipients of public welfare. To carry out such experimental projects, it is further provided 22.11that the commissioner of human services is authorized to waive the enforcement of 22.12existing specific statutory program requirements, rules, and standards in one or more 22.13counties. The order establishing the waiver shall provide alternative methods and 22.14procedures of administration, shall not be in conflict with the basic purposes, coverage, or 22.15benefits provided by law, and in no event shall the duration of a project exceed four years. 22.16It is further provided that no order establishing an experimental project as authorized by 22.17the provisions of this section shall become effective until the following conditions have 22.18been met:22.19    (1) the secretary of health and human services of the United States has agreed, for 22.20the same project, to waive state plan requirements relative to statewide uniformity; and22.21    (2) a comprehensive plan, including estimated project costs, shall be approved by 22.22the Legislative Advisory Commission and filed with the commissioner of administration.22.23    (m) According to federal requirements, establish procedures to be followed by 22.24local welfare boards in creating citizen advisory committees, including procedures for 22.25selection of committee members.22.26    (n) Allocate federal fiscal disallowances or sanctions which are based on quality 22.27control error rates for the aid to families with dependent children program formerly 22.28codified in sections 
         256.72 to 
         256.87, medical assistance, or food stamp program in the 22.29following manner:22.30    (1) one-half of the total amount of the disallowance shall be borne by the county 22.31boards responsible for administering the programs. For the medical assistance and the 22.32AFDC program formerly codified in sections 
         256.72 to 
         256.87, disallowances shall be 22.33shared by each county board in the same proportion as that county's expenditures for the 22.34sanctioned program are to the total of all counties' expenditures for the AFDC program 22.35formerly codified in sections 
         256.72 to 
         256.87, and medical assistance programs. For the 22.36food stamp program, sanctions shall be shared by each county board, with 50 percent of 23.1the sanction being distributed to each county in the same proportion as that county's 23.2administrative costs for food stamps are to the total of all food stamp administrative costs 23.3for all counties, and 50 percent of the sanctions being distributed to each county in the 23.4same proportion as that county's value of food stamp benefits issued are to the total of 23.5all benefits issued for all counties. Each county shall pay its share of the disallowance 23.6to the state of Minnesota. When a county fails to pay the amount due hereunder, the 23.7commissioner may deduct the amount from reimbursement otherwise due the county, or 23.8the attorney general, upon the request of the commissioner, may institute civil action 23.9to recover the amount due; and23.10    (2) notwithstanding the provisions of clause (1), if the disallowance results from 23.11knowing noncompliance by one or more counties with a specific program instruction, and 23.12that knowing noncompliance is a matter of official county board record, the commissioner 23.13may require payment or recover from the county or counties, in the manner prescribed in 23.14clause (1), an amount equal to the portion of the total disallowance which resulted from the 23.15noncompliance, and may distribute the balance of the disallowance according to clause (1).23.16    (o) Develop and implement special projects that maximize reimbursements and 23.17result in the recovery of money to the state. For the purpose of recovering state money, 23.18the commissioner may enter into contracts with third parties. Any recoveries that result 23.19from projects or contracts entered into under this paragraph shall be deposited in the 23.20state treasury and credited to a special account until the balance in the account reaches 23.21$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be 23.22transferred and credited to the general fund. All money in the account is appropriated to 23.23the commissioner for the purposes of this paragraph.23.24    (p) Have the authority to make direct payments to facilities providing shelter 23.25to women and their children according to section 
         256D.05, subdivision 3. Upon 23.26the written request of a shelter facility that has been denied payments under section 23.27256D.05, subdivision 3
         , the commissioner shall review all relevant evidence and make 23.28a determination within 30 days of the request for review regarding issuance of direct 23.29payments to the shelter facility. Failure to act within 30 days shall be considered a 23.30determination not to issue direct payments.23.31    (q) Have the authority to establish and enforce the following county reporting 23.32requirements:23.33    (1) the commissioner shall establish fiscal and statistical reporting requirements 23.34necessary to account for the expenditure of funds allocated to counties for human 23.35services programs. When establishing financial and statistical reporting requirements, the 24.1commissioner shall evaluate all reports, in consultation with the counties, to determine if 24.2the reports can be simplified or the number of reports can be reduced;24.3    (2) the county board shall submit monthly or quarterly reports to the department 24.4as required by the commissioner. Monthly reports are due no later than 15 working days 24.5after the end of the month. Quarterly reports are due no later than 30 calendar days after 24.6the end of the quarter, unless the commissioner determines that the deadline must be 24.7shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines 24.8or risking a loss of federal funding. Only reports that are complete, legible, and in the 24.9required format shall be accepted by the commissioner;24.10    (3) if the required reports are not received by the deadlines established in clause (2), 24.11the commissioner may delay payments and withhold funds from the county board until 24.12the next reporting period. When the report is needed to account for the use of federal 24.13funds and the late report results in a reduction in federal funding, the commissioner shall 24.14withhold from the county boards with late reports an amount equal to the reduction in 24.15federal funding until full federal funding is received;24.16    (4) a county board that submits reports that are late, illegible, incomplete, or not 24.17in the required format for two out of three consecutive reporting periods is considered 24.18noncompliant. When a county board is found to be noncompliant, the commissioner 24.19shall notify the county board of the reason the county board is considered noncompliant 24.20and request that the county board develop a corrective action plan stating how the 24.21county board plans to correct the problem. The corrective action plan must be submitted 24.22to the commissioner within 45 days after the date the county board received notice 24.23of noncompliance;24.24    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year 24.25after the date the report was originally due. If the commissioner does not receive a report 24.26by the final deadline, the county board forfeits the funding associated with the report for 24.27that reporting period and the county board must repay any funds associated with the 24.28report received for that reporting period;24.29    (6) the commissioner may not delay payments, withhold funds, or require repayment 24.30under clause (3) or (5) if the county demonstrates that the commissioner failed to 24.31provide appropriate forms, guidelines, and technical assistance to enable the county to 24.32comply with the requirements. If the county board disagrees with an action taken by the 24.33commissioner under clause (3) or (5), the county board may appeal the action according 24.34to sections 
         14.57 to 
         14.69; and24.35    (7) counties subject to withholding of funds under clause (3) or forfeiture or 24.36repayment of funds under clause (5) shall not reduce or withhold benefits or services to 25.1clients to cover costs incurred due to actions taken by the commissioner under clause 25.2(3) or (5).25.3    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when 25.4federal fiscal disallowances or sanctions are based on a statewide random sample for 25.5the foster care program under title IV-E of the Social Security Act, United States Code, 25.6title 42, in direct proportion to each county's title IV-E foster care maintenance claim 25.7for that period.25.8    (s) Be responsible for ensuring the detection, prevention, investigation, and 25.9resolution of fraudulent activities or behavior by applicants, recipients, and other 25.10participants in the human services programs administered by the department.25.11    (t) Require county agencies to identify overpayments, establish claims, and utilize 25.12all available and cost-beneficial methodologies to collect and recover these overpayments 25.13in the human services programs administered by the department.25.14    (u) Have the authority to administer a drug rebate program for drugs purchased 25.15pursuant to the prescription drug program established under section 
         256.955 after the 25.16beneficiary's satisfaction of any deductible established in the program. The commissioner 25.17shall require a rebate agreement from all manufacturers of covered drugs as defined in 25.18section 
         256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on 25.19or after July 1, 2002, must include rebates for individuals covered under the prescription 25.20drug program who are under 65 years of age. For each drug, the amount of the rebate shall 25.21be equal to the rebate as defined for purposes of the federal rebate program in United 25.22States Code, title 42, section 1396r-8. The manufacturers must provide full payment 25.23within 30 days of receipt of the state invoice for the rebate within the terms and conditions 25.24used for the federal rebate program established pursuant to section 1927 of title XIX of 25.25the Social Security Act. The manufacturers must provide the commissioner with any 25.26information necessary to verify the rebate determined per drug. The rebate program shall 25.27utilize the terms and conditions used for the federal rebate program established pursuant to 25.28section 1927 of title XIX of the Social Security Act.25.29    (v) Have the authority to administer the federal drug rebate program for drugs 25.30purchased under the medical assistance program as allowed by section 1927 of title XIX 25.31of the Social Security Act and according to the terms and conditions of section 1927. 25.32Rebates shall be collected for all drugs that have been dispensed or administered in an 25.33outpatient setting and that are from manufacturers who have signed a rebate agreement 25.34with the United States Department of Health and Human Services.25.35    (w) Have the authority to administer a supplemental drug rebate program for drugs 25.36purchased under the medical assistance program. The commissioner may enter into 26.1supplemental rebate contracts with pharmaceutical manufacturers and may require prior 26.2authorization for drugs that are from manufacturers that have not signed a supplemental 26.3rebate contract. Prior authorization of drugs shall be subject to the provisions of section 26.4256B.0625, subdivision 13
         .26.5    (x) Operate the department's communication systems account established in Laws 26.61993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared 26.7communication costs necessary for the operation of the programs the commissioner 26.8supervises. A communications account may also be established for each regional 26.9treatment center which operates communications systems. Each account must be used 26.10to manage shared communication costs necessary for the operations of the programs the 26.11commissioner supervises. The commissioner may distribute the costs of operating and 26.12maintaining communication systems to participants in a manner that reflects actual usage. 26.13Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and 26.14other costs as determined by the commissioner. Nonprofit organizations and state, county, 26.15and local government agencies involved in the operation of programs the commissioner 26.16supervises may participate in the use of the department's communications technology and 26.17share in the cost of operation. The commissioner may accept on behalf of the state any 26.18gift, bequest, devise or personal property of any kind, or money tendered to the state for 26.19any lawful purpose pertaining to the communication activities of the department. Any 26.20money received for this purpose must be deposited in the department's communication 26.21systems accounts. Money collected by the commissioner for the use of communication 26.22systems must be deposited in the state communication systems account and is appropriated 26.23to the commissioner for purposes of this section.26.24    (y) Receive any federal matching money that is made available through the medical 26.25assistance program for the consumer satisfaction survey. Any federal money received for 26.26the survey is appropriated to the commissioner for this purpose. The commissioner may 26.27expend the federal money received for the consumer satisfaction survey in either year of 26.28the biennium.26.29    (z) Designate community information and referral call centers and incorporate 26.30cost reimbursement claims from the designated community information and referral 26.31call centers into the federal cost reimbursement claiming processes of the department 26.32according to federal law, rule, and regulations. Existing information and referral centers 26.33provided by Greater Twin Cities United Way or existing call centers for which Greater 26.34Twin Cities United Way has legal authority to represent, shall be included in these 26.35designations upon review by the commissioner and assurance that these services are 26.36accredited and in compliance with national standards. Any reimbursement is appropriated 27.1to the commissioner and all designated information and referral centers shall receive 27.2payments according to normal department schedules established by the commissioner 27.3upon final approval of allocation methodologies from the United States Department of 27.4Health and Human Services Division of Cost Allocation or other appropriate authorities.27.5    (aa) Develop recommended standards for foster care homes that address the 27.6components of specialized therapeutic services to be provided by foster care homes with 27.7those services.27.8    (bb) Authorize the method of payment to or from the department as part of the 27.9human services programs administered by the department. This authorization includes the 27.10receipt or disbursement of funds held by the department in a fiduciary capacity as part of 27.11the human services programs administered by the department.27.12    (cc) Have the authority to administer a drug rebate program for drugs purchased for 27.13persons eligible for general assistance medical care under section 
         256D.03, subdivision 3. 27.14For manufacturers that agree to participate in the general assistance medical care rebate 27.15program, the commissioner shall enter into a rebate agreement for covered drugs as 27.16defined in section 
         256B.0625, subdivisions 13 and 13d. For each drug, the amount of the 27.17rebate shall be equal to the rebate as defined for purposes of the federal rebate program in 27.18United States Code, title 42, section 1396r-8. The manufacturers must provide payment 27.19within the terms and conditions used for the federal rebate program established under 27.20section 1927 of title XIX of the Social Security Act. The rebate program shall utilize 27.21the terms and conditions used for the federal rebate program established under section 27.221927 of title XIX of the Social Security Act.27.23    Effective January 1, 2006, drug coverage under general assistance medical care shall 27.24be limited to those prescription drugs that:27.25    (1) are covered under the medical assistance program as described in section 27.26256B.0625, subdivisions 13 and 13d
         ; and27.27    (2) are provided by manufacturers that have fully executed general assistance 27.28medical care rebate agreements with the commissioner and comply with such agreements. 27.29Prescription drug coverage under general assistance medical care shall conform to 27.30coverage under the medical assistance program according to section 
         256B.0625, 27.31subdivisions 13 to 13g
         .27.32    The rebate revenues collected under the drug rebate program are deposited in the 27.33general fund.27.34    Sec. 16. Minnesota Statutes 2006, section 256.01, subdivision 4, is amended to read:27.35    Subd. 4. Duties as state agency.(a) The state agency shall:28.1    (1) supervise the administration of assistance to dependent children under Laws 28.21937, chapter 438, by the county agencies in an integrated program with other service for 28.3dependent children maintained under the direction of the state agency;28.4    (2) may subpoena witnesses and administer oaths, make rules, and take such action 28.5as may be necessary, or desirable for carrying out the provisions of Laws 1937, chapter 28.6438. All rules made by the state agency shall be binding on the counties and shall be 28.7complied with by the respective county agencies;28.8    (3)(2) establish adequate standards for personnel employed by the counties and the 28.9state agency in the administration of Laws 1937, chapter 438, and make the necessary 28.10rules to maintain such standards;28.11    (4)(3) prescribe the form of and print and supply to the county agencies blanks 28.12for applications, reports, affidavits, and such other forms as it may deem necessary and 28.13advisable;28.14    (5)(4) cooperate with the federal government and its public welfare agencies 28.15in any reasonable manner as may be necessary to qualify for federal aid for temporary 28.16assistance for needy families and in conformity with title I of Public Law 104-193, the 28.17Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and successor 28.18amendments, including the making of such reports and such forms and containing such 28.19information as the Federal Social Security Board may from time to time require, and 28.20comply with such provisions as such board may from time to time find necessary to assure 28.21the correctness and verification of such reports;28.22    (6) may cooperate with other state agencies in establishing reciprocal agreements in 28.23instances where a child receiving Minnesota family investment program assistance moves 28.24or contemplates moving into or out of the state, in order that such child may continue to 28.25receive supervised aid from the state moved from until the child shall have resided for 28.26one year in the state moved to;28.27    (7)(5) on or before October 1 in each even-numbered year make a biennial report 28.28to the governor concerning the activities of the agency;28.29    (8)(6) enter into agreements with other departments of the state as necessary to meet 28.30all requirements of the federal government; and28.31    (9)(7) cooperate with the commissioner of education to enforce the requirements 28.32for program integrity and fraud prevention for investigation for child care assistance 28.33under chapter 119B.28.34    (b) The state agency may:28.35    (1) subpoena witnesses and administer oaths, make rules, and take such action as 28.36may be necessary or desirable for carrying out the provisions of Laws 1937, chapter 438. 29.1All rules made by the state agency shall be binding on the counties and shall be complied 29.2with by the respective county agencies;29.3    (2) cooperate with other state agencies in establishing reciprocal agreements in 29.4instances where a child receiving Minnesota family investment program assistance moves 29.5or contemplates moving into or out of the state, in order that the child may continue 29.6to receive supervised aid from the state moved from until the child has resided for one 29.7year in the state moved to; and29.8    (3) administer oaths and affirmations, take depositions, certify to official acts, and 29.9issue subpoenas to compel the attendance of individuals and the production of documents 29.10and other personal property necessary in connection with the administration of programs 29.11administered by the Department of Human Services.29.12    (c) The fees for service of a subpoena in paragraph (b), clause (3), must be paid in 29.13the same manner as prescribed by law for a service of process issued by a district court. 29.14Witnesses must receive the same fees and mileage as in civil actions.29.15    (d) The subpoena in paragraph (b), clause (3), shall be enforceable through the 29.16district court in the district where the subpoena is issued.29.17    Sec. 17. Minnesota Statutes 2006, section 256.01, subdivision 18, is amended to read:29.18    Subd. 18. Immigration status verifications. (a) Notwithstanding any waiver of 29.19this requirement by the secretary of the United States Department of Health and Human 29.20Services, effective July 1, 2001, the commissioner shall utilize the Systematic Alien 29.21Verification for Entitlements (SAVE) program to conduct immigration status verifications:29.22    (1) as required under United States Code, title 8, section 1642;29.23    (2) for all applicants and recipients at recertification for food assistance benefits, 29.24whether under the federal food stamp program, the MFIP or work first program, or the 29.25Minnesota food assistance program;29.26    (3) for all applicants and recipients at recertification for general assistance medical 29.27care, except assistance for an emergency medical condition, for immunization with respect 29.28to an immunizable disease, or for testing and treatment of symptoms of a communicable 29.29disease; and29.30    (4) for all applicants and recipients at recertification for general assistance, 29.31Minnesota supplemental aid, MinnesotaCare, or group residential housing, when the 29.32benefits provided by these programs would fall under the definition of "federal public 29.33benefit" under United States Code, title 8, section 1642, if federal funds were used to 29.34pay for all or part of the benefits.30.1    (b) The commissioner shall comply with the reporting requirements under United 30.2States Code, title 42, section 611a, and any federal regulation or guidance adopted under 30.3that law.30.4    Sec. 18. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 30.5to read:30.6    Subd. 23.Administrative simplification; county cost study.(a) The commissioner 30.7shall establish and convene the first meeting of an advisory committee to identify ways 30.8to simplify and streamline human services laws and administrative requirements. The 30.9advisory committee shall select its chair from its membership at the first meeting.30.10    (b) The committee shall consist of three senators appointed by the senate Committee 30.11on Rules and Administration, three state representatives appointed by the speaker of the 30.12house of representatives, four department staff, and five county representatives appointed 30.13by the Association of Minnesota Counties after consultation with other relevant county 30.14organizations. 30.15    (c) The committee shall annually select up to two topics for review. The goals of 30.16the reviews are to discuss opportunities for administrative improvements and increased 30.17simplification and streamlining to improve consistency, efficiency, fairness, and to reduce 30.18the risk of recipient noncompliance. In reviewing the topics selected, consideration shall 30.19be given to:30.20    (1) current challenges in administrative complexity and service delivery and whether 30.21the sharing of responsibilities between the state and the county should be altered in any 30.22way, including transferring responsibilities from one entity to the other;30.23    (2) methods of reducing inconsistency with similar programs; and30.24    (3) the current funding mechanism, whether funding formulas should be adjusted for 30.25special demographic or geographic factors that influence program costs, differences in 30.26county property tax contributions and maintenance of effort obligations, and whether the 30.27mix of state and county obligations for financial support of this service should be changed.30.28    (d) The committee members shall assume responsibility for reporting progress to 30.29the appropriate leadership of the groups they represent. The commissioner, in partnership 30.30with the advisory committee, shall report to the legislative committees and divisions with 30.31jurisdiction over the Department of Human Services on the findings and recommendations 30.32of the advisory committee by December 15 of each year.30.33    (e) This section expires June 30, 2012.30.34    Sec. 19. Minnesota Statutes 2006, section 256.015, subdivision 7, is amended to read:31.1    Subd. 7. Cooperation required. Upon the request of the Department of Human 31.2Services, any state agency or third party payer shall cooperate with the department in 31.3furnishing information to help establish a third party liability. Upon the request of the 31.4Department of Human Services or county child support or human service agencies, any 31.5employer or third party payer shall cooperate in furnishing information about group health 31.6insurance plans or medical benefit plans available to its employees. For purposes of 31.7section 176.191, subdivision 4, the Department of Labor and Industry may allow the 31.8Department of Human Services and county agencies direct access and data matching on 31.9information relating to workers' compensation claims in order to determine whether the 31.10claimant has reported the fact of a pending claim and the amount paid to or on behalf of 31.11the claimant to the Department of Human Services. The Department of Human Services 31.12and county agencies shall limit its use of information gained from agencies, third party 31.13payers, and employers to purposes directly connected with the administration of its public 31.14assistance and child support programs. The provision of information by agencies, third 31.15party payers, and employers to the department under this subdivision is not a violation of 31.16any right of confidentiality or data privacy.31.17    Sec. 20. Minnesota Statutes 2006, section 256.017, subdivision 1, is amended to read:31.18    Subdivision 1. Authority and purpose. The commissioner shall administer a 31.19compliance system for the Minnesota family investment program, the food stamp or food 31.20support program, emergency assistance, general assistance, medical assistance, general 31.21assistance medical care, emergency general assistance, Minnesota supplemental assistance, 31.22preadmission screening, and alternative care grants, and the child care assistance program31.23under the powers and authorities named in section 
         256.01, subdivision 2. The purpose of 31.24the compliance system is to permit the commissioner to supervise the administration of 31.25public assistance programs and to enforce timely and accurate distribution of benefits, 31.26completeness of service and efficient and effective program management and operations, 31.27to increase uniformity and consistency in the administration and delivery of public 31.28assistance programs throughout the state, and to reduce the possibility of sanctions and 31.29fiscal disallowances for noncompliance with federal regulations and state statutes. 31.30    The commissioner shall utilize training, technical assistance, and monitoring 31.31activities, as specified in section 
         256.01, subdivision 2, to encourage county agency 31.32compliance with written policies and procedures. 31.33    Sec. 21. Minnesota Statutes 2006, section 256.017, subdivision 9, is amended to read:32.1    Subd. 9. Timing and disposition of penalty and case disallowance funds. Quality 32.2control case penalty and administrative penalty amounts shall be disallowed or withheld 32.3from the next regular reimbursement made to the county agency for state and federal 32.4benefit reimbursements and federal administrative reimbursements for all programs 32.5covered in this section, according to procedures established in statute, but shall not be 32.6imposed sooner than 30 calendar days from the date of written notice of such penalties. 32.7Except for penalties withheld under the child care assistance program, all penalties 32.8must be deposited in the county incentive fund provided in section 
         256.018. Penalties 32.9withheld under the child care assistance program shall be reallocated to counties using the 32.10allocation formula under section 119B.03, subdivision 5. All penalties must be imposed 32.11according to this provision until a decision is made regarding the status of a written 32.12exception. Penalties must be returned to county agencies when a review of a written 32.13exception results in a decision in their favor. 32.14    Sec. 22. Minnesota Statutes 2006, section 256.0471, subdivision 1, is amended to read:32.15    Subdivision 1. Qualifying overpayment. Any overpayment for assistance granted 32.16under chapter 119B, the MFIP program formerly codified under sections 
         256.031 to 32.17256.0361
         , and the AFDC program formerly codified under sections 
         256.72 to 
         256.871; 32.18chapters 256B, 256D, 256I, 256J, and 256K, and 256L; and the food stamp or food support 32.19program, except agency error claims, become a judgment by operation of law 90 days 32.20after the notice of overpayment is personally served upon the recipient in a manner that 32.21is sufficient under rule 4.03(a) of the Rules of Civil Procedure for district courts, or by 32.22certified mail, return receipt requested. This judgment shall be entitled to full faith and 32.23credit in this and any other state. 32.24    Sec. 23. Minnesota Statutes 2006, section 256.984, subdivision 1, is amended to read:32.25    Subdivision 1. Declaration. Every application for public assistance under this 32.26chapter or chapters 256B, 256D, 256J, and 256L; child care programs under chapter 119B; 32.27and food stamps or food support under chapter 393 shall be in writing or reduced to 32.28writing as prescribed by the state agency and shall contain the following declaration which 32.29shall be signed by the applicant:32.30"I declare under the penalties of perjury that this application has been examined 32.31by me and to the best of my knowledge is a true and correct statement of every 32.32material point. I understand that a person convicted of perjury may be sentenced 32.33to imprisonment of not more than five years or to payment of a fine of not more 32.34than $10,000, or both."33.1    Sec. 24. [256D.0516] EXPIRATION OF FOOD SUPPORT BENEFITS AND 33.2REPORTING REQUIREMENTS.33.3    Subdivision 1.Expiration of food support benefits.Food support benefits shall 33.4not be stored off line or expunged from a recipient's account unless the benefits have not 33.5been accessed for 12 months after the month they were issued.33.6    Subd. 2.Food support reporting requirements.The Department of Human 33.7Services shall implement simplified reporting as permitted under the Food Stamp Act of 33.81977, as amended, and the food stamp regulations in Code of Federal Regulations, title 33.97, part 273. Food support recipient households required to report periodically shall not 33.10be required to report more often than one time every six months. This provision shall 33.11not apply to households receiving food benefits under the Minnesota family investment 33.12program waiver.33.13EFFECTIVE DATE.Subdivision 1 is effective February 1, 2008, and subdivision 33.142 is effective May 1, 2008.33.15    Sec. 25. [256F.15] GRANT PROGRAM FOR CRISIS NURSERIES.33.16    Subdivision 1.Crisis nurseries.The commissioner of human services shall 33.17establish a grant program to assist private and public agencies and organizations to 33.18provide crisis nurseries to offer services and temporary care to families experiencing crisis 33.19situations including children who are at high risk of abuse and neglect, children who have 33.20been abused and neglected, and children who are in families receiving child protective 33.21services. This service shall be provided without a fee for a maximum of 30 days in any 33.22year. Crisis nurseries shall provide short-term case management, family support services, 33.23parent education, crisis intervention, referrals, and resources, as needed.33.24    (a) The crisis nurseries must provide a spectrum of services that may include, but 33.25are not limited to:33.26    (1) being available 24 hours a day, seven days a week;33.27    (2) providing services for children up to 72 hours at any one time;33.28    (3) providing short-term case management to bridge the gap between crisis and 33.29successful living;33.30    (4) making referrals for parents to counseling services and other community 33.31resources to help alleviate the underlying cause of the precipitating stress or crisis;33.32    (5) providing services without a fee for a maximum of 30 days in any year;33.33    (6) providing services to families with children from birth through 12 years of age, 33.34as services are available;34.1    (7) providing an immediate response to family needs and strengths with an initial 34.2assessment and intake interview, making referrals to appropriate agencies or programs, 34.3and providing temporary care of children, as needed;34.4    (8) maintaining the clients' confidentiality to the extent required by law, and also 34.5complying with statutory reporting requirements which may mandate a report to child 34.6protective services;34.7    (9) providing a volunteer component and support for volunteers;34.8    (10) providing preservice training and ongoing training to providers and volunteers;34.9    (11) evaluating the services provided by documenting use of services, the result of 34.10family referrals made to community resources, and how the services reduced the risk of 34.11maltreatment;34.12    (12) providing developmental assessments;34.13    (13) providing medical assessments as determined by using a risk screening tool;34.14    (14) providing parent education classes or programs that include parent-child 34.15interaction either on site or in collaboration with other community agencies; and34.16    (15) having a multidisciplinary advisory board which may include one or more 34.17parents who have used the crisis nursery services.34.18    (b) The crisis nurseries are encouraged to provide opportunities for parents to 34.19volunteer, if appropriate.34.20    (c) Parents shall retain custody of their children during placement in a crisis facility.34.21    Subd. 2.Fund distribution.In distributing funds, the commissioner shall give 34.22priority consideration to agencies and organizations with experience in working with 34.23abused or neglected children and their families, and with children at high risk of abuse and 34.24neglect and their families, and serve communities which demonstrate the greatest need 34.25for these services. Funds shall be distributed to crisis nurseries according to a formula 34.26developed by the commissioner in consultation with the Minnesota Crisis Nursery 34.27Association. The formula shall include funding for all existing crisis nursery programs 34.28that have been previously funded through the Department of Human Services and that 34.29meet program requirements as specified in subdivision 1, paragraph (a), and consideration 34.30of factors reflecting the need for services in each service area, including but not limited to 34.31the number of children 18 years of age and under living in the service area, the percent 34.32of children 18 years of age and under living in poverty in the service area, and factors 34.33reflecting the cost of providing services, including but not limited to the number of hours 34.34of service provided in the previous year.35.1    Sec. 26. Minnesota Statutes 2006, section 256J.01, is amended by adding a subdivision 35.2to read:35.3    Subd. 6.Legislative approval to move programs or activities.The commissioner 35.4shall not move programs or activities funded with MFIP or TANF maintenance of effort 35.5funds to other funding sources without legislative approval.35.6    Sec. 27. Minnesota Statutes 2006, section 256J.02, subdivision 1, is amended to read:35.7    Subdivision 1. Commissioner's authority to administer block grant funds. The 35.8commissioner of human services is authorized to receive, administer, and expend funds 35.9available under the TANF block grant authorized under title I of Public Law 104-193, the 35.10Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and under 35.11Public Law 109-171, the Deficit Reduction Act of 2005.35.12    Sec. 28. Minnesota Statutes 2006, section 256J.02, subdivision 4, is amended to read:35.13    Subd. 4. Authority to transfer. Subject to limitations of title I of Public Law 35.14104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, 35.15as amended, and under Public Law 109-171, the Deficit Reduction Act of 2005, the 35.16legislature may transfer money from the TANF block grant to the child care fund under 35.17chapter 119B, or the Title XX block grant.35.18    Sec. 29. Minnesota Statutes 2006, section 256J.021, is amended to read:35.19256J.021 SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.35.20    Families receiving assistance under this section must comply with all applicable 35.21requirements in this chapter.35.22    (a) Until October 1,  2006, the commissioner of human services must treat MFIP 35.23expenditures made to or on behalf of any minor child under section 256J.02, subdivision 35.242, clause (1), who is a resident of this state under section 256J.12, and who is part of a 35.25two-parent eligible household as expenditures under a separately funded state program 35.26and report those expenditures to the federal Department of Health and Human Services 35.27as separate state program expenditures under Code of Federal Regulations, title 45, 35.28section 263.5.35.29    (b) Beginning October 1, 2006, and each year thereafter, the commissioner of human 35.30services must treat MFIP expenditures made to or on behalf of any minor child under 35.31section 
         256J.02, subdivision 2, clause (1), who is a resident of this state under section 35.32256J.12, and who is part of a two-parent eligible household, as expenditures under a 35.33separately funded state program. These expenditures shall not count toward the state's 36.1maintenance of effort (MOE) requirements under the federal Temporary Assistance to 36.2Needy Families (TANF) program except if counting certain families would allow the 36.3commissioner to avoid a federal penalty. Families receiving assistance under this section 36.4must comply with all applicable requirements in this chapter.36.5    Sec. 30. Minnesota Statutes 2006, section 256J.08, subdivision 65, is amended to read:36.6    Subd. 65. Participant.(a) "Participant" means includes any of the following:36.7    (1) a person who is currently receiving cash assistance or the food portion available 36.8through MFIP. A person who fails to withdraw or access electronically any portion of the 36.9person's cash and food assistance payment by the end of the payment month, who makes a 36.10written request for closure before the first of a payment month and repays cash and food 36.11assistance electronically issued for that payment month within that payment month, or 36.12who returns any uncashed assistance check and food coupons and withdraws from the 36.13program is not a participant.;36.14    (2) a person who withdraws a cash or food assistance payment by electronic transfer 36.15or receives and cashes an MFIP assistance check or food coupons and is subsequently 36.16determined to be ineligible for assistance for that period of time is a participant, regardless 36.17whether that assistance is repaid. The term "participant" includes;36.18    (3) the caregiver relative and the minor child whose needs are included in the 36.19assistance payment.;36.20    (4) a person in an assistance unit who does not receive a cash and food assistance 36.21payment because the case has been suspended from MFIP is a participant.;36.22    (5) a person who receives cash payments under the diversionary work program 36.23under section 
         256J.95 is a participant.; and36.24    (6) a person who receives cash payments under the family stabilization services 36.25program under section 256J.575.36.26    (b) "Participant" does not include a person who fails to withdraw or access 36.27electronically any portion of the person's cash and food assistance payment by the end of 36.28the payment month, who makes a written request for closure before the first of a payment 36.29month and repays cash and food assistance electronically issued for that payment month 36.30within that payment month, or who returns any uncashed assistance check and food 36.31coupons and withdraws from the program.36.32EFFECTIVE DATE.This section is effective the day following final enactment.36.33    Sec. 31. Minnesota Statutes 2006, section 256J.21, subdivision 2, is amended to read:37.1    Subd. 2. Income exclusions. The following must be excluded in determining a 37.2family's available income:37.3    (1) payments for basic care, difficulty of care, and clothing allowances received for 37.4providing family foster care to children or adults under Minnesota Rules, parts 9555.5050 37.5to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used 37.6for care and maintenance of a third-party beneficiary who is not a household member;37.7    (2) reimbursements for employment training received through the Workforce 37.8Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;37.9    (3) reimbursement for out-of-pocket expenses incurred while performing volunteer 37.10services, jury duty, employment, or informal carpooling arrangements directly related to 37.11employment;37.12    (4) all educational assistance, except the county agency must count graduate student 37.13teaching assistantships, fellowships, and other similar paid work as earned income and, 37.14after allowing deductions for any unmet and necessary educational expenses, shall 37.15count scholarships or grants awarded to graduate students that do not require teaching 37.16or research as unearned income;37.17    (5) loans, regardless of purpose, from public or private lending institutions, 37.18governmental lending institutions, or governmental agencies;37.19    (6) loans from private individuals, regardless of purpose, provided an applicant or 37.20participant documents that the lender expects repayment;37.21    (7)(i) state income tax refunds; and37.22    (ii) federal income tax refunds;37.23    (8)(i) federal earned income credits;37.24    (ii) Minnesota working family credits;37.25    (iii) state homeowners and renters credits under chapter 290A; and37.26    (iv) federal or state tax rebates;37.27    (9) funds received for reimbursement, replacement, or rebate of personal or real 37.28property when these payments are made by public agencies, awarded by a court, solicited 37.29through public appeal, or made as a grant by a federal agency, state or local government, 37.30or disaster assistance organizations, subsequent to a presidential declaration of disaster;37.31    (10) the portion of an insurance settlement that is used to pay medical, funeral, and 37.32burial expenses, or to repair or replace insured property;37.33    (11) reimbursements for medical expenses that cannot be paid by medical assistance;37.34    (12) payments by a vocational rehabilitation program administered by the state 37.35under chapter 268A, except those payments that are for current living expenses;38.1    (13) in-kind income, including any payments directly made by a third party to a 38.2provider of goods and services;38.3    (14) assistance payments to correct underpayments, but only for the month in which 38.4the payment is received;38.5    (15) payments for short-term emergency needs under section 
         256J.626, subdivision 38.62
         ;38.7    (16) funeral and cemetery payments as provided by section 
         256.935;38.8    (17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in 38.9a calendar month;38.10    (18) any form of energy assistance payment made through Public Law 97-35, 38.11Low-Income Home Energy Assistance Act of 1981, payments made directly to energy 38.12providers by other public and private agencies, and any form of credit or rebate payment 38.13issued by energy providers;38.14    (19) Supplemental Security Income (SSI), including retroactive SSI payments and 38.15other income of an SSI recipient, except as described in section 
         256J.37, subdivision 3b;38.16    (20) Minnesota supplemental aid, including retroactive payments;38.17    (21) proceeds from the sale of real or personal property;38.18    (22) state adoption assistance payments under section 
         259.67, and up to an equal 38.19amount of county adoption assistance payments;38.20    (23) state-funded family subsidy program payments made under section 
         252.3238.21to help families care for children with developmental disabilities, consumer support 38.22grant funds under section 
         256.476, and resources and services for a disabled household 38.23member under one of the home and community-based waiver services programs under 38.24chapter 256B;38.25    (24) interest payments and dividends from property that is not excluded from and 38.26that does not exceed the asset limit;38.27    (25) rent rebates;38.28    (26) income earned by a minor caregiver, minor child through age 6, or a minor 38.29child who is at least a half-time student in an approved elementary or secondary education 38.30program;38.31    (27) income earned by a caregiver under age 20 who is at least a half-time student in 38.32an approved elementary or secondary education program;38.33    (28) MFIP child care payments under section 
         119B.05;38.34    (29) all other payments made through MFIP to support a caregiver's pursuit of 38.35greater economic stability;38.36    (30) income a participant receives related to shared living expenses;39.1    (31) reverse mortgages;39.2    (32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 39.342, chapter 13A, sections 1771 to 1790;39.4    (33) benefits provided by the women, infants, and children (WIC) nutrition program, 39.5United States Code, title 42, chapter 13A, section 1786;39.6    (34) benefits from the National School Lunch Act, United States Code, title 42, 39.7chapter 13, sections 1751 to 1769e;39.8    (35) relocation assistance for displaced persons under the Uniform Relocation 39.9Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title 39.1042, chapter 61, subchapter II, section 4636, or the National Housing Act, United States 39.11Code, title 12, chapter 13, sections 1701 to 1750jj;39.12    (36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 39.1312, part 2, sections 2271 to 2322;39.14    (37) war reparations payments to Japanese Americans and Aleuts under United 39.15States Code, title 50, sections 1989 to 1989d;39.16    (38) payments to veterans or their dependents as a result of legal settlements 39.17regarding Agent Orange or other chemical exposure under Public Law 101-239, section 39.1810405, paragraph (a)(2)(E);39.19    (39) income that is otherwise specifically excluded from MFIP consideration in 39.20federal law, state law, or federal regulation;39.21    (40) security and utility deposit refunds;39.22    (41) American Indian tribal land settlements excluded under Public Laws 98-123, 39.2398-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech 39.24Lake, and Mille Lacs reservations and payments to members of the White Earth Band, 39.25under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;39.26    (42) all income of the minor parent's parents and stepparents when determining the 39.27grant for the minor parent in households that include a minor parent living with parents or 39.28stepparents on MFIP with other children;39.29    (43) income of the minor parent's parents and stepparents equal to 200 percent of the 39.30federal poverty guideline for a family size not including the minor parent and the minor 39.31parent's child in households that include a minor parent living with parents or stepparents 39.32not on MFIP when determining the grant for the minor parent. The remainder of income is 39.33deemed as specified in section 
         256J.37, subdivision 1b;39.34    (44) payments made to children eligible for relative custody assistance under section 39.35257.85
         ;40.1    (45) vendor payments for goods and services made on behalf of a client unless the 40.2client has the option of receiving the payment in cash; and40.3    (46) the principal portion of a contract for deed payment.; and40.4    (47) cash payments to individuals enrolled for full-time service as a volunteer under 40.5AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps 40.6National, and AmeriCorps NCCC.40.7    Sec. 32. Minnesota Statutes 2006, section 256J.24, subdivision 10, is amended to read:40.8    Subd. 10. MFIP exit level. The commissioner shall adjust the MFIP earned income 40.9disregard to ensure that most participants do not lose eligibility for MFIP until their 40.10income reaches at least 115 140 percent of the federal poverty guidelines in effect in 40.11October of each fiscal year. The adjustment to the disregard shall be based on a household 40.12size of three, and the resulting earned income disregard percentage must be applied to all 40.13household sizes. The adjustment under this subdivision must be implemented at the same 40.14time as the October food stamp or food support cost-of-living adjustment is reflected in 40.15the food portion of MFIP transitional standard as required under subdivision 5a.40.16    Sec. 33. Minnesota Statutes 2006, section 256J.42, subdivision 1, is amended to read:40.17    Subdivision 1. Time limit. (a) Except as otherwise provided for in this section, an 40.18assistance unit in which any adult caregiver has received 60 months of cash assistance 40.19funded in whole or in part by the TANF block grant in this or any other state or 40.20United States territory, or from a tribal TANF program, MFIP, the AFDC program 40.21formerly codified in sections 
         256.72 to 
         256.87, or the family general assistance program 40.22formerly codified in sections 
         256D.01 to 
         256D.23, funded in whole or in part by state 40.23appropriations, is ineligible to receive MFIP. Any cash assistance funded with TANF 40.24dollars in this or any other state or United States territory, or from a tribal TANF program, 40.25or MFIP assistance funded in whole or in part by state appropriations, that was received 40.26by the unit on or after the date TANF was implemented, including any assistance received 40.27in states or United States territories of prior residence, counts toward the 60-month 40.28limitation. Months during which any cash assistance is received by an assistance unit 40.29with a mandatory member who is disqualified for wrongfully obtaining public assistance 40.30under section 256.98, subdivision 8, counts toward the time limit for the disqualified 40.31member. The 60-month limit applies to a minor caregiver except under subdivision 5. The 40.3260-month time period does not need to be consecutive months for this provision to apply. 41.1    (b) The months before July 1998 in which individuals received assistance as part of 41.2the field trials as an MFIP, MFIP-R, or MFIP or MFIP-R comparison group family are 41.3not included in the 60-month time limit.41.4EFFECTIVE DATE.This section is effective October 1, 2007.41.5    Sec. 34. Minnesota Statutes 2006, section 256J.425, subdivision 3, is amended to read:41.6    Subd. 3. Hard-to-employ participants. An assistance unit subject to the time 41.7limit in section 
         256J.42, subdivision 1, is eligible to receive months of assistance under 41.8a hardship extension if the participant who reached the time limit belongs to any of the 41.9following groups: 41.10    (1) a person who is diagnosed by a licensed physician, psychological practitioner, 41.11or other qualified professional, as developmentally disabled or mentally ill, and that 41.12condition prevents the person from obtaining or retaining unsubsidized employment;41.13    (2) a person who:41.14    (i) has been assessed by a vocational specialist or the county agency to be 41.15unemployable for purposes of this subdivision; or41.16    (ii) has an IQ below 80 who has been assessed by a vocational specialist or a county 41.17agency to be employable, but not at a level that makes the participant eligible for an 41.18extension under subdivision 4. The determination of IQ level must be made by a qualified 41.19professional. In the case of a non-English-speaking person: (A) the determination must 41.20be made by a qualified professional with experience conducting culturally appropriate 41.21assessments, whenever possible; (B) the county may accept reports that identify an 41.22IQ range as opposed to a specific score; (C) these reports must include a statement of 41.23confidence in the results;41.24    (3) a person who is determined by a qualified professional to be learning disabled, 41.25and the disability severely limits the person's ability to obtain, perform, or maintain 41.26suitable employment. For purposes of the initial approval of a learning disability 41.27extension, the determination must have been made or confirmed within the previous 12 41.28months. In the case of a non-English-speaking person: (i) the determination must be made 41.29by a qualified professional with experience conducting culturally appropriate assessments, 41.30whenever possible; and (ii) these reports must include a statement of confidence in the 41.31results. If a rehabilitation plan for a participant extended as learning disabled is developed 41.32or approved by the county agency, the plan must be incorporated into the employment 41.33plan. However, a rehabilitation plan does not replace the requirement to develop and 41.34comply with an employment plan under section 
         256J.521; or42.1    (4) a person who has been granted a family violence waiver, and who is complying 42.2with an employment plan under section 
         256J.521, subdivision 3; or42.3    (5) a participant under section 256J.561, subdivision 2, paragraph (d), who is 42.4complying with an employment plan tailored to recognize the special circumstances of 42.5the caregivers and family, including limitations due to illness or disability, and caregiving 42.6needs.42.7    Sec. 35. Minnesota Statutes 2006, section 256J.425, subdivision 4, is amended to read:42.8    Subd. 4. Employed participants. (a) An assistance unit subject to the time limit 42.9under section 
         256J.42, subdivision 1, is eligible to receive assistance under a hardship 42.10extension if the participant who reached the time limit belongs to: 42.11    (1) a one-parent assistance unit in which the participant is participating in work 42.12activities for at least 30 hours per week, of which an average of at least 25 hours per week 42.13every month are spent participating in employment;42.14    (2) a two-parent assistance unit in which the participants are participating in work 42.15activities for at least 55 hours per week, of which an average of at least 45 hours per week 42.16every month are spent participating in employment; or42.17    (3) an assistance unit in which a participant is participating in employment for fewer 42.18hours than those specified in clause (1) or (2), and the participant submits verification from 42.19a qualified professional, in a form acceptable to the commissioner, stating that the number 42.20of hours the participant may work is limited due to illness or disability, as long as the 42.21participant is participating in employment for at least the number of hours specified by the 42.22qualified professional. The participant must be following the treatment recommendations 42.23of the qualified professional providing the verification. The commissioner shall develop a 42.24form to be completed and signed by the qualified professional, documenting the diagnosis 42.25and any additional information necessary to document the functional limitations of the 42.26participant that limit work hours. If the participant is part of a two-parent assistance unit, 42.27the other parent must be treated as a one-parent assistance unit for purposes of meeting the 42.28work requirements under this subdivision.42.29    (b) For purposes of this section, employment means:42.30    (1) unsubsidized employment under section 256J.49, subdivision 13, clause (1); 42.31    (2) subsidized employment under section 256J.49, subdivision 13, clause (2); 42.32    (3) on-the-job training under section 256J.49, subdivision 13, clause (2); 42.33    (4) an apprenticeship under section 256J.49, subdivision 13, clause (1); 42.34    (5) supported work under section 256J.49, subdivision 13, clause (2); 42.35    (6) a combination of clauses (1) to (5); or43.1    (7) child care under section 256J.49, subdivision 13, clause (7), if it is in combination 43.2with paid employment.43.3    (c) If a participant is complying with a child protection plan under chapter 260C, 43.4the number of hours required under the child protection plan count toward the number 43.5of hours required under this subdivision.43.6    (d)(c) The county shall provide the opportunity for subsidized employment to 43.7participants needing that type of employment within available appropriations.43.8    (e)(d) To be eligible for a hardship extension for employed participants under this 43.9subdivision, a participant must be in compliance for at least ten out of the 12 months 43.10the participant received MFIP immediately preceding the participant's 61st month on 43.11assistance. If ten or fewer months of eligibility for TANF assistance remain at the time the 43.12participant from another state applies for assistance, the participant must be in compliance 43.13every month.43.14    (f)(e) The employment plan developed under section 
         256J.521, subdivision 2, for 43.15participants under this subdivision must contain at least the minimum number of hours 43.16specified in paragraph (a) for the purpose of meeting the requirements for an extension 43.17under this subdivision. The job counselor and the participant must sign the employment 43.18plan to indicate agreement between the job counselor and the participant on the contents 43.19of the plan. 43.20    (g)(f) Participants who fail to meet the requirements in paragraph (a), without 43.21good cause under section 
         256J.57, shall be sanctioned or permanently disqualified under 43.22subdivision 6. Good cause may only be granted for that portion of the month for which 43.23the good cause reason applies. Participants must meet all remaining requirements in the 43.24approved employment plan or be subject to sanction or permanent disqualification. 43.25    (h)(g) If the noncompliance with an employment plan is due to the involuntary loss 43.26of employment, the participant is exempt from the hourly employment requirement under 43.27this subdivision for one month. Participants must meet all remaining requirements in the 43.28approved employment plan or be subject to sanction or permanent disqualification. This 43.29exemption is available to each participant two times in a 12-month period.43.30    Sec. 36. Minnesota Statutes 2006, section 256J.46, is amended by adding a subdivision 43.31to read:43.32    Subd. 3.Restrictions on sanctions.A participant shall not be sanctioned for failure 43.33to meet the agreed upon hours in a participant's employment plan under section 256J.521, 43.34subdivision 2, when the participant:44.1    (1) fails to meet the agreed upon hours of participation in paid employment because 44.2the participant is not eligible for holiday pay and the participant's place of employment is 44.3closed for a holiday; or44.4    (2) is otherwise meeting or exceeding the federal TANF work participation rate 44.5hourly requirements.44.6    Sec. 37. Minnesota Statutes 2006, section 256J.49, subdivision 13, is amended to read:44.7    Subd. 13. Work activity. "Work activity" means any activity in a participant's 44.8approved employment plan that leads to employment. For purposes of the MFIP program, 44.9this includes activities that meet the definition of work activity under the participation 44.10requirements of TANF. Work activity includes:44.11    (1) unsubsidized employment, including work study and paid apprenticeships or 44.12internships;44.13    (2) subsidized private sector or public sector employment, including grant diversion 44.14as specified in section 
         256J.69, on-the-job training as specified in section 
         256J.66, 44.15the self-employment investment demonstration program (SEID) as specified in section 44.16256J.65
         , paid work experience, and supported work when a wage subsidy is provided; 44.17    (3) unpaid work experience, including community service, volunteer work, 44.18the community work experience program as specified in section 
         256J.67, unpaid 44.19apprenticeships or internships, and supported work when a wage subsidy is not provided. 44.20Unpaid work performed in return for cash assistance is prohibited and does not count 44.21as a work activity, unless the participant voluntarily agrees, in writing, to engage in 44.22unpaid work in return for cash assistance. The participant may terminate the unpaid 44.23work arrangement, in writing, at any time;44.24    (4) job search including job readiness assistance, job clubs, job placement, 44.25job-related counseling, and job retention services;44.26    (5) job readiness education, including English as a second language (ESL) or 44.27functional work literacy classes as limited by the provisions of section 
         256J.531, 44.28subdivision 2
         , general educational development (GED) course work, high school 44.29completion, and adult basic education as limited by the provisions of section 
         256J.531, 44.30subdivision 1
         ; 44.31    (6) job skills training directly related to employment, including education and 44.32training that can reasonably be expected to lead to employment, as limited by the 44.33provisions of section 
         256J.53; 44.34    (7) providing child care services to a participant who is working in a community 44.35service program;45.1    (8) activities included in the employment plan that is developed under section 45.2256J.521, subdivision 3
         ; and 45.3    (9) preemployment activities including chemical and mental health assessments, 45.4treatment, and services; learning disabilities services; child protective services; family 45.5stabilization services; or other programs designed to enhance employability.45.6    Sec. 38. Minnesota Statutes 2006, section 256J.521, subdivision 1, is amended to read:45.7    Subdivision 1. Assessments. (a) For purposes of MFIP employment services, 45.8assessment is a continuing process of gathering information related to employability 45.9for the purpose of identifying both participant's strengths and strategies for coping with 45.10issues that interfere with employment. The job counselor must use information from the 45.11assessment process to develop and update the employment plan under subdivision 2 or 3, 45.12as appropriate, and to determine whether the participant qualifies for a family violence 45.13waiver including an employment plan under subdivision 3, and to determine whether the 45.14participant should be referred to the family stabilization services program under section 45.15256J.575.45.16    (b) The scope of assessment must cover at least the following areas:45.17    (1) basic information about the participant's ability to obtain and retain employment, 45.18including: a review of the participant's education level; interests, skills, and abilities; prior 45.19employment or work experience; transferable work skills; child care and transportation 45.20needs;45.21    (2) identification of personal and family circumstances that impact the participant's 45.22ability to obtain and retain employment, including: any special needs of the children, the 45.23level of English proficiency, family violence issues, and any involvement with social 45.24services or the legal system;45.25    (3) the results of a mental and chemical health screening tool designed by the 45.26commissioner and results of the brief screening tool for special learning needs. Screening 45.27tools for mental and chemical health and special learning needs must be approved by the 45.28commissioner and may only be administered by job counselors or county staff trained in 45.29using such screening tools. The commissioner shall work with county agencies to develop 45.30protocols for referrals and follow-up actions after screens are administered to participants, 45.31including guidance on how employment plans may be modified based upon outcomes 45.32of certain screens. Participants must be told of the purpose of the screens and how the 45.33information will be used to assist the participant in identifying and overcoming barriers to 45.34employment. Screening for mental and chemical health and special learning needs must 45.35be completed by participants who are unable to find suitable employment after six weeks 46.1of job search under subdivision 2, paragraph (b), and participants who are determined to 46.2have barriers to employment under subdivision 2, paragraph (d). Failure to complete the 46.3screens will result in sanction under section 
         256J.46; and 46.4    (4) a comprehensive review of participation and progress for participants who have 46.5received MFIP assistance and have not worked in unsubsidized employment during the 46.6past 12 months. The purpose of the review is to determine the need for additional services 46.7and supports, including placement in subsidized employment or unpaid work experience 46.8under section 
         256J.49, subdivision 13, or referral to the family stabilization services 46.9program under section 256J.575. 46.10    (c) Information gathered during a caregiver's participation in the diversionary work 46.11program under section 
         256J.95 must be incorporated into the assessment process. 46.12    (d) The job counselor may require the participant to complete a professional chemical 46.13use assessment to be performed according to the rules adopted under section 
         254A.03, 46.14subdivision 3
         , including provisions in the administrative rules which recognize the cultural 46.15background of the participant, or a professional psychological assessment as a component 46.16of the assessment process, when the job counselor has a reasonable belief, based on 46.17objective evidence, that a participant's ability to obtain and retain suitable employment 46.18is impaired by a medical condition. The job counselor may assist the participant with 46.19arranging services, including child care assistance and transportation, necessary to meet 46.20needs identified by the assessment. Data gathered as part of a professional assessment 46.21must be classified and disclosed according to the provisions in section 
         13.46.46.22    Sec. 39. Minnesota Statutes 2006, section 256J.521, subdivision 2, is amended to read:46.23    Subd. 2. Employment plan; contents. (a) Based on the assessment under 46.24subdivision 1, the job counselor and the participant must develop an employment plan 46.25that includes participation in activities and hours that meet the requirements of section 46.26256J.55, subdivision 1
         . The purpose of the employment plan is to identify for each 46.27participant the most direct path to unsubsidized employment and any subsequent steps that 46.28support long-term economic stability. The employment plan should be developed using 46.29the highest level of activity appropriate for the participant. Activities must be chosen from 46.30clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of 46.31preference for activities, priority must be given for activities related to a family violence 46.32waiver when developing the employment plan. The employment plan must also list the 46.33specific steps the participant will take to obtain employment, including steps necessary 46.34for the participant to progress from one level of activity to another, and a timetable for 46.35completion of each step. Levels of activity include:47.1    (1) unsubsidized employment;47.2    (2) job search;47.3    (3) subsidized employment or unpaid work experience;47.4    (4) unsubsidized employment and job readiness education or job skills training;47.5    (5) unsubsidized employment or unpaid work experience and activities related to 47.6a family violence waiver or preemployment needs; and47.7    (6) activities related to a family violence waiver or preemployment needs.47.8    (b) Participants who are determined to possess sufficient skills such that the 47.9participant is likely to succeed in obtaining unsubsidized employment must job search at 47.10least 30 hours per week for up to six weeks and accept any offer of suitable employment. 47.11The remaining hours necessary to meet the requirements of section 
         256J.55, subdivision 47.121
         , may be met through participation in other work activities under section 
         256J.49, 47.13subdivision 13
         . The participant's employment plan must specify, at a minimum: (1) 47.14whether the job search is supervised or unsupervised; (2) support services that will 47.15be provided; and (3) how frequently the participant must report to the job counselor. 47.16Participants who are unable to find suitable employment after six weeks must meet 47.17with the job counselor to determine whether other activities in paragraph (a) should be 47.18incorporated into the employment plan. Job search activities which are continued after six 47.19weeks must be structured and supervised. 47.20    (c) Beginning July 1, 2004, activities and hourly requirements in the employment 47.21plan may be adjusted as necessary to accommodate the personal and family circumstances 47.22of participants identified under section 
         256J.561, subdivision 2, paragraph (d). Participants 47.23who no longer meet the provisions of section 
         256J.561, subdivision 2, paragraph (d), 47.24must meet with the job counselor within ten days of the determination to revise the 47.25employment plan. 47.26    (d) Participants who are determined to have barriers to obtaining or retaining 47.27employment that will not be overcome during six weeks of job search under paragraph (b) 47.28must work with the job counselor to develop an employment plan that addresses those 47.29barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6). 47.30The employment plan must include enough hours to meet the participation requirements 47.31in section 
         256J.55, subdivision 1, unless a compelling reason to require fewer hours 47.32is noted in the participant's file. 47.33    (e) The job counselor and the participant must sign the employment plan to indicate 47.34agreement on the contents.47.35    (f) Except as provided under paragraphs (g) and (h), failure to develop or comply 47.36with activities in the plan, or voluntarily quitting suitable employment without good 48.1cause, will result in the imposition of a sanction under section 
         256J.46. The job counselor 48.2is encouraged to allow participants who are participating in at least 20 hours of work 48.3activities to also participate in employment and training activities in order to meet the 48.4federal hourly participation rates.48.5    (g) When a participant fails to meet the agreed upon hours of participation in paid 48.6employment because the participant is not eligible for holiday pay and the participant's 48.7place of employment is closed for a holiday, the job counselor shall not impose a sanction 48.8or increase the hours of participation in any other activity, including paid employment, to 48.9offset the hours that were missed due to the holiday.48.10    (h) The job counselor shall not impose a sanction for failure to meet the agreed upon 48.11hours in a participant's employment plan under this subdivision when the participant 48.12is otherwise meeting or exceeding the federal TANF work participation rate hourly 48.13requirements.48.14    (f) (i) Employment plans must be reviewed at least every three months to determine 48.15whether activities and hourly requirements should be revised.48.16    Sec. 40. Minnesota Statutes 2006, section 256J.521, is amended by adding a 48.17subdivision to read:48.18    Subd. 7.Employment plan; nonmaintenance of effort; single caregivers.(a) 48.19When a single caregiver is moved to the nonmaintenance of effort state-funded program 48.20under section 256J.021, paragraphs (a) and (b), the single caregiver shall develop or revise 48.21the employment plan as specified in this subdivision with a job counselor or county. The 48.22plan must address issues interfering with employment, including physical and mental 48.23health, substance use, and social service issues of the caregiver and the caregiver's family. 48.24Job search and employment must also be included in the plan to the extent possible.48.25    (b) Counties must coordinate services by ensuring that all workers involved with 48.26the family communicate on a regular basis, and that expectations for the family across 48.27service areas lead to common goals.48.28    (c) Activities and hourly requirements in the employment plan may be adjusted as 48.29necessary to accommodate the personal and family circumstances of the participant. 48.30Participants who no longer meet the criteria for the nonmaintenance of effort state-funded 48.31program shall meet with the job counselor or county within ten days of the determination 48.32to revise the employment plan.48.33    Sec. 41. Minnesota Statutes 2006, section 256J.53, subdivision 2, is amended to read:49.1    Subd. 2. Approval of postsecondary education or training. (a) In order for a 49.2postsecondary education or training program to be an approved activity in an employment 49.3plan, the participant must be working in unsubsidized employment at least 20 hours per 49.4week.49.5    (b) Participants seeking approval of a postsecondary education or training plan 49.6must provide documentation that:49.7    (1) the employment goal can only be met with the additional education or training;49.8    (2) there are suitable employment opportunities that require the specific education or 49.9training in the area in which the participant resides or is willing to reside;49.10    (3) the education or training will result in significantly higher wages for the 49.11participant than the participant could earn without the education or training;49.12    (4) the participant can meet the requirements for admission into the program; and49.13    (5) there is a reasonable expectation that the participant will complete the training 49.14program based on such factors as the participant's MFIP assessment, previous education, 49.15training, and work history; current motivation; and changes in previous circumstances.49.16    (c) The hourly unsubsidized employment requirement does not apply for intensive 49.17education or training programs lasting 12 weeks or less when full-time attendance is 49.18required.49.19    (d)(b) Participants with an approved employment plan in place on July 1, 2003, 49.20which includes more than 12 months of postsecondary education or training shall be 49.21allowed to complete that plan provided that hourly requirements in section 
         256J.55, 49.22subdivision 1
         , and conditions specified in paragraph (b) (a), and subdivisions 3 and 5 are 49.23met. A participant whose case is subsequently closed for three months or less for reasons 49.24other than noncompliance with program requirements and who returns to MFIP shall 49.25be allowed to complete that plan provided that hourly requirements in section 
         256J.55, 49.26subdivision 1
         , and conditions specified in paragraph (b) (a) and subdivisions 3 and 5 are 49.27met.49.28    Sec. 42. Minnesota Statutes 2006, section 256J.55, subdivision 1, is amended to read:49.29    Subdivision 1. Participation requirements. (a) All caregivers must participate 49.30in employment services under sections 
         256J.515 to 
         256J.57 concurrent with receipt of 49.31MFIP assistance. 49.32    (b) Until July 1, 2004, participants who meet the requirements of section 
         256J.56 are 49.33exempt from participation requirements.50.1    (c) Participants under paragraph (a) must develop and comply with an employment 50.2plan under section 
         256J.521 or section 
         256J.54 in the case of a participant under the age of 50.320 who has not obtained a high school diploma or its equivalent.50.4    (d) With the exception of participants under the age of 20 who must meet the 50.5education requirements of section 
         256J.54, all participants must meet the hourly 50.6participation requirements of TANF or the hourly requirements listed in clauses (1) to 50.7(3), whichever is higher.50.8    (1) In single-parent families with no children under six years of age, the job 50.9counselor and the caregiver must develop an employment plan that includes 30 to 35 hours 50.10per week of work activities 130 hours per month of work activities.50.11    (2) In single-parent families with a child under six years of age, the job counselor 50.12and the caregiver must develop an employment plan that includes 20 to 35 hours per week 50.13of work activities 87 hours per month of work activities.50.14    (3) In two-parent families, the job counselor and the caregivers must develop 50.15employment plans which result in a combined total of at least 55 hours per week of work 50.16activities.50.17    (e) Failure to participate in employment services, including the requirement to 50.18develop and comply with an employment plan, including hourly requirements, without 50.19good cause under section 
         256J.57, shall result in the imposition of a sanction under section 50.20256J.46
         .50.21    Sec. 43. [256J.575] FAMILY STABILIZATION SERVICES.50.22    Subdivision 1.Purpose.(a) The family stabilization services serve families who are 50.23not making significant progress within the Minnesota family investment program (MFIP) 50.24due to a variety of barriers to employment.50.25    (b) The goal of the services is to stabilize and improve the lives of families at risk 50.26of long-term welfare dependency or family instability due to employment barriers such 50.27as physical disability, mental disability, age, or providing care for a disabled household 50.28member. These services promote and support families to achieve the greatest possible 50.29degree of self-sufficiency.50.30    Subd. 2.Definitions.The terms used in this section have the meanings given them 50.31in paragraphs (a) to (e).50.32    (a) "Family stabilization services" means the services established under this section.50.33    (b) "Case management" means the services provided by or through the county 50.34agency or through the employment services agency to participating families, including 51.1assessment, information, referrals, and assistance in the preparation and implementation 51.2of a family stabilization plan under subdivision 5.51.3    (c) "Family stabilization plan" means a plan developed by a case manager and 51.4the participant, which identifies the participant's most appropriate path to unsubsidized 51.5employment, family stability, and barrier reduction, taking into account the family's 51.6circumstances.51.7    (d) "Family stabilization services" means programs, activities, and services in this 51.8section that provide participants and their family members with assistance regarding, 51.9but not limited to:51.10    (1) obtaining and retaining unsubsidized employment;51.11    (2) family stability;51.12    (3) economic stability; and51.13    (4) barrier reduction.51.14    The goal of the services is to achieve the greatest degree of economic self-sufficiency 51.15and family well-being possible for the family under the circumstances.51.16    (e) "Case manager" means the county-designated staff person or employment 51.17services counselor.51.18    Subd. 3.Eligibility.(a) The following MFIP or diversionary work program (DWP) 51.19participants are eligible for the services under this section:51.20    (1) a participant identified under section 256J.561, subdivision 2, paragraph (d), who 51.21has or is eligible for an employment plan developed under section 256J.521, subdivision 51.222, paragraph (c);51.23    (2) a participant identified under section 256J.95, subdivision 12, paragraph (b), as 51.24unlikely to benefit from the DWP;51.25    (3) a participant who meets the requirements for or has been granted a hardship 51.26extension under section 256J.425, subdivision 2 or 3;51.27    (4) a participant who is applying for supplemental security income or Social Security 51.28disability insurance; 51.29    (5) a participant who is a noncitizen who has been in the United States for 12 or 51.30fewer months; and51.31    (6) a new MFIP participant, for the first 30 days the participant receives assistance or 51.32when the participant's employment plan is completed, whichever is sooner.51.33    (b) Families must meet all other eligibility requirements for MFIP established in 51.34this chapter. Families are eligible for financial assistance to the same extent as if they 51.35were participating in MFIP.52.1    (c) A participant under paragraph (a), clause (5), must be provided with English as a 52.2second language opportunities and skills training for up to 12 months. After 12 months, 52.3the case manager and participant must determine whether the participant should continue 52.4with English as a second language classes or skills training, or both, or if the participant 52.5should become an MFIP participant.52.6    Subd. 4.Universal participation.All caregivers must participate in family 52.7stabilization services as defined in subdivision 2.52.8    Subd. 5.Case management; family stabilization plans; coordinated services.(a) 52.9The county agency shall provide family stabilization services to families through a case 52.10management model. A case manager shall be assigned to each participating family within 52.1130 days after the family begins to receive financial assistance as a participant of the family 52.12stabilization services. The case manager, with the full involvement of the participant, shall 52.13recommend, and the county agency shall establish and modify as necessary, a family 52.14stabilization plan for each participating family. If a participant is already assigned to a 52.15county case manager or a county-designated case manager in social services, disability 52.16services, or housing services that case manager already assigned may be the case manager 52.17for purposes of these services.52.18    (b) The family stabilization plan must include:52.19    (1) each participant's plan for long-term self-sufficiency, including an employment 52.20goal where applicable;52.21    (2) an assessment of each participant's strengths and barriers, and any special 52.22circumstances of the participant's family that impact, or are likely to impact, the 52.23participant's progress towards the goals in the plan; and52.24    (3) an identification of the services, supports, education, training, and 52.25accommodations needed to reduce or overcome any barriers to enable the family to 52.26achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.52.27    (c) The case manager and the participant shall meet within 30 days of the family's 52.28referral to the case manager. The initial family stabilization plan must be completed within 52.2930 days of the first meeting with the case manager. The case manager shall establish a 52.30schedule for periodic review of the family stabilization plan that includes personal contact 52.31with the participant at least once per month. In addition, the case manager shall review 52.32and, if necessary, modify the plan under the following circumstances:52.33    (1) there is a lack of satisfactory progress in achieving the goals of the plan;52.34    (2) the participant has lost unsubsidized or subsidized employment;52.35    (3) a family member has failed or is unable to comply with a family stabilization 52.36plan requirement;53.1    (4) services, supports, or other activities required by the plan are unavailable;53.2    (5) changes to the plan are needed to promote the well-being of the children; or53.3    (6) the participant and case manager determine that the plan is no longer appropriate 53.4for any other reason.53.5    Subd. 6.Cooperation with services requirements.(a) To be eligible, a participant 53.6shall comply with paragraphs (b) to (e).53.7    (b) Participants shall engage in family stabilization plan services for the appropriate 53.8number of hours per week that the activities are scheduled and available, unless good 53.9cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate 53.10number of hours must be based on the participant's plan.53.11    (c) The case manager shall review the participant's progress toward the goals in the 53.12family stabilization plan every six months to determine whether conditions have changed, 53.13including whether revisions to the plan are needed.53.14    (d) When the participant has increased participation in work-related activities 53.15sufficient to meet the federal participation requirements of TANF, the county agency shall 53.16refer the participant to the MFIP program and assign the participant to a job counselor. 53.17The participant and the job counselor shall meet within 15 days of referral to the MFIP 53.18program to develop an employment plan under section 256J.521. No reapplication is 53.19necessary and financial assistance continues without interruption.53.20    (e) A participant's requirement to comply with any or all family stabilization plan 53.21requirements under this subdivision is excused when the case management services, 53.22training and educational services, and family support services identified in the participant's 53.23family stabilization plan are unavailable for reasons beyond the control of the participant, 53.24including when money appropriated is not sufficient to provide the services.53.25    Subd. 7.Sanctions.(a) The financial assistance grant of a participating family is 53.26reduced according to section 256J.46, if a participating adult fails without good cause to 53.27comply or continue to comply with the family stabilization plan requirements in this 53.28subdivision, unless compliance has been excused under subdivision 6, paragraph (e).53.29    (b) Given the purpose of the family stabilization services in this section and the 53.30nature of the underlying family circumstances that act as barriers to both employment and 53.31full compliance with program requirements, sanctions are appropriate only when it is clear 53.32that there is both the ability to comply and willful noncompliance by the participant, as 53.33confirmed by a behavioral health or medical professional.53.34    (c) Prior to the imposition of a sanction, the county agency shall review the 53.35participant's case to determine if the family stabilization plan is still appropriate and 54.1meet with the participant face-to-face. The participant may bring an advocate to the 54.2face-to-face meeting. 54.3    During the face-to-face meeting, the county agency must:54.4    (1) determine whether the continued noncompliance can be explained and mitigated 54.5by providing a needed family stabilization service, as defined in subdivision 2, paragraph 54.6(d);54.7    (2) determine whether the participant qualifies for a good cause exemption under 54.8section 256J.57, or if the sanction is for noncooperation with child support requirements, 54.9determine if the participant qualifies for a good cause exemption under section 256.741, 54.10subdivision 10;54.11    (3) determine whether activities in the family stabilization plan are appropriate 54.12based on the family's circumstances;54.13    (4) explain the consequences of continuing noncompliance;54.14    (5) identify other resources that may be available to the participant to meet the 54.15needs of the family; and54.16    (6) inform the participant of the right to appeal under section 256J.40.54.17    If the lack of an identified activity or service can explain the noncompliance, the 54.18county shall work with the participant to provide the identified activity.54.19    (d) If the participant fails to come to the face-to-face meeting, the case manager or a 54.20designee shall attempt at least one home visit. If a face-to-face meeting is not conducted, 54.21the county agency shall send the participant a written notice that includes the information 54.22under paragraph (c).54.23    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition 54.24of a sanction, the county agency shall provide a notice of intent to sanction under section 54.25256J.57, subdivision 2, and, when applicable, a notice of adverse action under section 54.26256J.31.54.27    (f) Section 256J.57 applies to this section except to the extent that it is modified 54.28by this subdivision.54.29    Subd. 8.Funding.(a) The commissioner of human services must treat MFIP 54.30expenditures made to or on behalf of any minor child under this section, who is part of a 54.31household that meets criteria in subdivision 3, as expenditures under a separately funded 54.32state program. These expenditures shall not count toward the state's maintenance of effort 54.33requirements under the federal TANF program.54.34    (b) A family is no longer part of a separately funded program under this section, if 54.35the caregiver no longer meets the criteria for family stabilization services in subdivision 55.13 or if it is determined at recertification that the caregiver is meeting the federal work 55.2participation rate, whichever occurs sooner.55.3    Sec. 44. Minnesota Statutes 2006, section 256J.626, subdivision 1, is amended to read:55.4    Subdivision 1. Consolidated fund. The consolidated fund is established to support 55.5counties and tribes in meeting their duties under this chapter. Counties and tribes must use 55.6funds from the consolidated fund to develop programs and services that are designed to 55.7improve participant outcomes as measured in section 
         256J.751, subdivision 2. Counties 55.8may use the funds for any allowable expenditures under subdivision 2, and to provide case 55.9management services to participants of the family stabilization services program. Tribes 55.10may use the funds for any allowable expenditures under subdivision 2, except those in 55.11subdivision 2, paragraph (a), clauses (1) and (6). 55.12    Sec. 45. Minnesota Statutes 2006, section 256J.626, subdivision 2, is amended to read:55.13    Subd. 2. Allowable expenditures. (a) The commissioner must restrict expenditures 55.14under the consolidated fund to benefits and services allowed under title IV-A of the federal 55.15Social Security Act. Allowable expenditures under the consolidated fund may include, but 55.16are not limited to:55.17    (1) short-term, nonrecurring shelter and utility needs that are excluded from the 55.18definition of assistance under Code of Federal Regulations, title 45, section 
         260.31, for 55.19families who meet the residency requirement in section 
         256J.12, subdivisions 1 and 1a. 55.20Payments under this subdivision are not considered TANF cash assistance and are not 55.21counted towards the 60-month time limit; 55.22    (2) transportation needed to obtain or retain employment or to participate in other 55.23approved work activities or activities under a family stabilization plan;55.24    (3) direct and administrative costs of staff to deliver employment services for 55.25MFIP or,  the diversionary work program, or the family stabilization services program; 55.26 to administer financial assistance,;  and to provide specialized services intended to assist 55.27hard-to-employ participants to transition to work or transition from the family stabilization 55.28services program to MFIP;55.29    (4) costs of education and training including functional work literacy and English as 55.30a second language;55.31    (5) cost of work supports including tools, clothing, boots, telephone service, and 55.32other work-related expenses;55.33    (6) county administrative expenses as defined in Code of Federal Regulations, title 55.3445, section 260(b);56.1    (7) services to parenting and pregnant teens;56.2    (8) supported work;56.3    (9) wage subsidies;56.4    (10) child care needed for MFIP or, the  diversionary work program, or the family 56.5stabilization services program  participants to participate in social services;56.6    (11) child care to ensure that families leaving MFIP or diversionary work program 56.7will continue to receive child care assistance from the time the family no longer qualifies 56.8for transition year child care until an opening occurs under the basic sliding fee child 56.9care program; and56.10    (12) services to help noncustodial parents who live in Minnesota and have minor 56.11children receiving MFIP or DWP assistance, but do not live in the same household as the 56.12child, obtain or retain employment; and56.13    (13) services to help families participating in the family stabilization services 56.14program achieve the greatest possible degree of self-sufficiency.56.15    (b) Administrative costs that are not matched with county funds as provided in 56.16subdivision 8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation 56.17under this section. The commissioner shall define administrative costs for purposes of 56.18this subdivision.56.19    (c) The commissioner may waive the cap on administrative costs for a county or tribe 56.20that elects to provide an approved supported employment, unpaid work, or community 56.21work experience program for a major segment of the county's or tribe's MFIP population. 56.22The county or tribe must apply for the waiver on forms provided by the commissioner. In 56.23no case shall total administrative costs exceed the TANF limits.56.24    Sec. 46. Minnesota Statutes 2006, section 256J.626, subdivision 3, is amended to read:56.25    Subd. 3. Eligibility for services. Families with a minor child, a pregnant woman, 56.26or a noncustodial parent of a minor child receiving assistance, with incomes below 200 56.27percent of the federal poverty guideline for a family of the applicable size, are eligible 56.28for services funded under the consolidated fund. Counties and tribes must give priority 56.29to families currently receiving MFIP or, the  diversionary work program, or the family 56.30stabilization services program, and families at risk of receiving MFIP or diversionary 56.31work program.56.32    Sec. 47. Minnesota Statutes 2006, section 256J.626, subdivision 4, is amended to read:56.33    Subd. 4. County and tribal biennial service agreements. (a) Effective January 1, 56.342004, and each two-year period thereafter, each county and tribe must have in place an 57.1approved biennial service agreement related to the services and programs in this chapter. 57.2In counties with a city of the first class with a population over 300,000, the county must 57.3consider a service agreement that includes a jointly developed plan for the delivery of 57.4employment services with the city. Counties may collaborate to develop multicounty, 57.5multitribal, or regional service agreements.57.6    (b) The service agreements will be completed in a form prescribed by the 57.7commissioner. The agreement must include:57.8    (1) a statement of the needs of the service population and strengths and resources 57.9in the community;57.10    (2) numerical goals for participant outcomes measures to be accomplished during 57.11the biennial period. The commissioner may identify outcomes from section 
         256J.751, 57.12subdivision 2
         , as core outcomes for all counties and tribes; 57.13    (3) strategies the county or tribe will pursue to achieve the outcome targets. 57.14Strategies must include specification of how funds under this section will be used and may 57.15include community partnerships that will be established or strengthened; and57.16    (4) strategies the county or tribe will pursue under the family stabilization services 57.17program; and 57.18    (5) other items prescribed by the commissioner in consultation with counties and 57.19tribes.57.20    (c) The commissioner shall provide each county and tribe with information needed 57.21to complete an agreement, including: (1) information on MFIP cases in the county or 57.22tribe; (2) comparisons with the rest of the state; (3) baseline performance on outcome 57.23measures; and (4) promising program practices.57.24    (d) The service agreement must be submitted to the commissioner by October 15, 57.252003, and October 15 of each second year thereafter. The county or tribe must allow 57.26a period of not less than 30 days prior to the submission of the agreement to solicit 57.27comments from the public on the contents of the agreement.57.28    (e) The commissioner must, within 60 days of receiving each county or tribal service 57.29agreement, inform the county or tribe if the service agreement is approved. If the service 57.30agreement is not approved, the commissioner must inform the county or tribe of any 57.31revisions needed prior to approval.57.32    (f) The service agreement in this subdivision supersedes the plan requirements 57.33of section 
         116L.88. 57.34    Sec. 48. Minnesota Statutes 2006, section 256J.626, subdivision 5, is amended to read:58.1    Subd. 5. Innovation projects. Beginning January 1, 2005, no more than $3,000,000 58.2of the funds annually appropriated to the commissioner for use in the consolidated 58.3fund shall be available to the commissioner for projects testing innovative approaches 58.4to improving outcomes for MFIP participants, family stabilization services program 58.5participants, and persons at risk of receiving MFIP as detailed in subdivision 3, and 58.6for providing incentives to counties and tribes that exceed performance. Projects shall 58.7be targeted to geographic areas with poor outcomes as specified in section 
         256J.751, 58.8subdivision 5
         , or to subgroups within the MFIP case load who are experiencing poor 58.9outcomes. For purposes of an incentive, a county or tribe exceeds performance if the 58.10county or tribe is above the top of the county's or tribe's annualized range of expected 58.11performance on the three-year self-support index under section 256J.751, subdivision 2, 58.12clause (7), and achieves a 50 percent TANF participation rate under section 256J.751, 58.13subdivision 2, clause (7), as averaged across the four quarterly measurements for the most 58.14recent year for which the measurements are available.58.15    Sec. 49. Minnesota Statutes 2006, section 256J.626, subdivision 6, is amended to read:58.16    Subd. 6. Base allocation to counties and tribes; definitions. (a) For purposes of 58.17this section, the following terms have the meanings given.58.18    (1) "2002 historic spending base" means the commissioner's determination of 58.19the sum of the reimbursement related to fiscal year 2002 of county or tribal agency 58.20expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings 58.21related to calendar year 2002 in the base program listed in clause (6), item (v), and the 58.22amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi), 58.23issued to or on behalf of persons residing in the county or tribal service delivery area.58.24    (2) "Adjusted caseload factor" means a factor weighted:58.25    (i) 47 percent on the MFIP cases in each county at four points in time in the most 58.26recent 12-month period for which data is available multiplied by the county's caseload 58.27difficulty factor; and58.28    (ii) 53 percent on the count of adults on MFIP in each county and tribe at four points 58.29in time in the most recent 12-month period for which data is available multiplied by the 58.30county or tribe's caseload difficulty factor.58.31    (3) "Caseload difficulty factor" means a factor determined by the commissioner for 58.32each county and tribe based upon the self-support index described in section 
         256J.751, 58.33subdivision 2
         , clause (7).58.34    (4) "Initial allocation" means the amount potentially available to each county or tribe 58.35based on the formula in paragraphs (b) through (h).59.1    (5) "Final allocation" means the amount available to each county or tribe based on 59.2the formula in paragraphs (b) through (h), after adjustment by subdivision 7.59.3    (6) "Base programs" means the:59.4    (i) MFIP employment and training services under Minnesota Statutes 2002, section 59.5256J.62, subdivision 1
         , in effect June 30, 2002;59.6    (ii) bilingual employment and training services to refugees under Minnesota Statutes 59.72002, section 
         256J.62, subdivision 6, in effect June 30, 2002;59.8    (iii) work literacy language programs under Minnesota Statutes 2002, section 59.9256J.62, subdivision 7
         , in effect June 30, 2002;59.10    (iv) supported work program authorized in Laws 2001, First Special Session chapter 59.119, article 17, section 2, in effect June 30, 2002;59.12    (v) administrative aid program under section 
         256J.76 in effect December 31, 2002; 59.13and59.14    (vi) emergency assistance program under Minnesota Statutes 2002, section 
         256J.48, 59.15in effect June 30, 2002.59.16    (b) The commissioner shall:59.17    (1) beginning July 1, 2003, determine the initial allocation of funds available under 59.18this section according to clause (2);59.19    (2) allocate all of the funds available for the period beginning July 1, 2003, and 59.20ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's 59.21share of the statewide 2002 historic spending base;59.22    (3) determine for calendar year 2005 the initial allocation of funds to be made 59.23available under this section in proportion to the county or tribe's initial allocation for the 59.24period of July 1, 2003, to December 31, 2004;59.25    (4) determine for calendar year 2006 the initial allocation of funds to be made 59.26available under this section based 90 percent on the proportion of the county or tribe's 59.27share of the statewide 2002 historic spending base and ten percent on the proportion of 59.28the county or tribe's share of the adjusted caseload factor;59.29    (5) determine for calendar year 2007 the initial allocation of funds to be made 59.30available under this section based 70 percent on the proportion of the county or tribe's 59.31share of the statewide 2002 historic spending base and 30 percent on the proportion of the 59.32county or tribe's share of the adjusted caseload factor; and59.33    (6) determine for calendar year 2008 and subsequent years the initial allocation of 59.34funds to be made available under this section based 50 percent on the proportion of the 59.35county or tribe's share of the statewide 2002 historic spending base and 50 percent on the 59.36proportion of the county or tribe's share of the adjusted caseload factor.60.1    (c) With the commencement of a new or expanded tribal TANF program or an 60.2agreement under section 
         256.01, subdivision 2, paragraph (g), in which some or all of 60.3the responsibilities of particular counties under this section are transferred to a tribe, 60.4the commissioner shall:60.5    (1) in the case where all responsibilities under this section are transferred to a tribal 60.6program, determine the percentage of the county's current caseload that is transferring to a 60.7tribal program and adjust the affected county's allocation accordingly; and60.8    (2) in the case where a portion of the responsibilities under this section are 60.9transferred to a tribal program, the commissioner shall consult with the affected county or 60.10counties to determine an appropriate adjustment to the allocation.60.11    (d) Effective January 1, 2005, counties and tribes will have their final allocations 60.12adjusted based on the performance provisions of subdivision 7.60.13    Sec. 50. Minnesota Statutes 2006, section 256J.751, subdivision 2, is amended to read:60.14    Subd. 2. Quarterly comparison report. The commissioner shall report quarterly to 60.15all counties on each county's performance on the following measures:60.16    (1) percent of MFIP caseload working in paid employment;60.17    (2) percent of MFIP caseload receiving only the food portion of assistance;60.18    (3) number of MFIP cases that have left assistance;60.19    (4) median placement wage rate;60.20    (5) caseload by months of TANF assistance;60.21    (6) percent of MFIP and diversionary work program (DWP) cases off cash assistance 60.22or working 30 or more hours per week at one-year, two-year, and three-year follow-up 60.23points from a baseline quarter. This measure is called the self-support index. The 60.24commissioner shall report quarterly an expected range of performance for each county, 60.25county grouping, and tribe on the self-support index. The expected range shall be derived 60.26by a statistical methodology developed by the commissioner in consultation with the 60.27counties and tribes. The statistical methodology shall control differences across counties 60.28in economic conditions and demographics of the MFIP and DWP case load; and60.29    (7) the MFIP TANF work participation rate, defined as the participation requirements 60.30specified in title 1 of Public Law 104-193 applied to all MFIP cases except child only 60.31cases under Public Law 109-171, the Deficit Reduction Act of 2005.60.32    Sec. 51. Minnesota Statutes 2006, section 256J.751, subdivision 5, is amended to read:60.33    Subd. 5. Failure to meet federal performance standards. (a) If sanctions occur 60.34for failure to meet the performance standards specified in title 1 of Public Law 104-193 61.1of the Personal Responsibility and Work Opportunity Act of 1996, and under Public 61.2Law 109-171, the Deficit Reduction Act of 2005, the state shall pay 88 percent of the 61.3sanction. The remaining 12 percent of the sanction will be paid by the counties. The 61.4county portion of the sanction will be distributed across all counties in proportion to each 61.5county's percentage of the MFIP average monthly caseload during the period for which 61.6the sanction was applied.61.7    (b) If a county fails to meet the performance standards specified in title 1 of Public 61.8Law 104-193 of the Personal Responsibility and Work Opportunity Act of 1996, and 61.9Public Law 109-171, the Deficit Reduction Act of 2005, for any year, the commissioner 61.10shall work with counties to organize a joint state-county technical assistance team to work 61.11with the county. The commissioner shall coordinate any technical assistance with other 61.12departments and agencies including the Departments of Employment and Economic 61.13Development and Education as necessary to achieve the purpose of this paragraph.61.14    (c) For state performance measures, a low-performing county is one that:61.15    (1) performs below the bottom of their expected range for the measure in subdivision 61.162, clause (7) (6), in an annualized measurement reported in October of each year; or61.17    (2) performs below 40 percent for the measure in subdivision 2, clause (8) (7), as 61.18averaged across the four quarterly measurements for the year, or the ten counties with the 61.19lowest rates if more than ten are below 40 percent.61.20    (d) Low-performing counties under paragraph (c) must engage in corrective action 61.21planning as defined by the commissioner. The commissioner may coordinate technical 61.22assistance as specified in paragraph (b) for low-performing counties under paragraph (c).61.23    Sec. 52. Minnesota Statutes 2006, section 256J.95, subdivision 3, is amended to read:61.24    Subd. 3. Eligibility for diversionary work program. (a) Except for the categories 61.25of family units listed below, all family units who apply for cash benefits and who 61.26meet MFIP eligibility as required in sections 
         256J.11 to 
         256J.15 are eligible and must 61.27participate in the diversionary work program. Family units that are not eligible for the 61.28diversionary work program include:61.29    (1) child only cases;61.30    (2) a single-parent family unit that includes a child under 12 weeks of age. A parent 61.31is eligible for this exception once in a parent's lifetime and is not eligible if the parent 61.32has already used the previously allowed child under age one exemption from MFIP 61.33employment services;61.34    (3) a minor parent without a high school diploma or its equivalent;62.1    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent 62.2who chooses to have an employment plan with an education option;62.3    (5) a caregiver age 60 or over;62.4    (6) family units with a caregiver who received DWP benefits in the 12 months prior 62.5to the month the family applied for DWP, except as provided in paragraph (c);62.6    (7) family units with a caregiver who received MFIP within the 12 months prior to 62.7the month the family unit applied for DWP;62.8    (8) a family unit with a caregiver who received 60 or more months of TANF 62.9assistance; and62.10    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to 62.11fraud.; and62.12    (10) refugees as defined in Code of Federal Regulations, title 45, chapter IV, section 62.13444.43, who arrived in the United States in the 12 months prior to the date of application 62.14for family cash assistance.62.15    (b) A two-parent family must participate in DWP unless both caregivers meet the 62.16criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit 62.17includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), or (9).62.18    (c) Once DWP eligibility is determined, the four months run consecutively. If a 62.19participant leaves the program for any reason and reapplies during the four-month period, 62.20the county must redetermine eligibility for DWP.62.21EFFECTIVE DATE.This section is effective the day following final enactment.62.22    Sec. 53. Minnesota Statutes 2006, section 256J.95, subdivision 13, is amended to read:62.23    Subd. 13. Immediate referral to employment services. Within one working day of 62.24determination that the applicant is eligible for the diversionary work program, but before 62.25benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to 62.26employment services. The referral to the DWP employment services must be in writing 62.27and must contain the following information:62.28    (1) notification that, as part of the application process, applicants are required to 62.29develop an employment plan or the DWP application will be denied;62.30    (2) the employment services provider name and phone number;62.31    (3) the date, time, and location of the scheduled employment services interview;62.32    (4) (3) the immediate availability of supportive services, including, but not limited 62.33to, child care, transportation, and other work-related aid; and63.1    (5) (4) the rights, responsibilities, and obligations of participants in the program, 63.2including, but not limited to, the grounds for good cause, the consequences of refusing or 63.3failing to participate fully with program requirements, and the appeal process.63.4    Sec. 54. Minnesota Statutes 2006, section 256K.45, is amended by adding a 63.5subdivision to read:63.6    Subd. 6.Funding.Any funds appropriated for this section may be expended 63.7on programs described under subdivisions 3 to 5, technical assistance, and capacity 63.8building. In addition, up to five percent of funds appropriated may be used for program 63.9administration and up to eight percent of funds appropriated may be used for the purpose 63.10of monitoring and evaluating runaway and homeless youth programs receiving funding 63.11under this section. Funding shall be directed to meet the greatest need, with a significant 63.12share of the funding focused on homeless youth providers in greater Minnesota.63.13    Sec. 55. Minnesota Statutes 2006, section 259.24, subdivision 3, is amended to read:63.14    Subd. 3. Child. When the child to be adopted is over 14 years of age, the child's 63.15written consent to adoption by a particular person is also shall be necessary. A child 63.16of any age who is under the guardianship of the commissioner and is legally available 63.17for adoption may not refuse or waive the commissioner's agent's exhaustive efforts to 63.18recruit, identify, and place the child in an adoptive home required under section 260C.317, 63.19subdivision 3, paragraph (b), or sign a document relieving county social services agencies 63.20of all recruitment efforts on the child's behalf.63.21    Sec. 56. Minnesota Statutes 2006, section 259.53, subdivision 1, is amended to read:63.22    Subdivision 1. Notice to commissioner; referral for postplacement assessment.63.23    (a) Upon the filing of a petition for adoption of a child who is:63.24    (1) under the guardianship of the commissioner or a licensed child-placing agency 63.25according to section 260C.201, subdivision 11, or 260C.317;63.26    (2) placed by the commissioner, commissioner's agent, or licensed child-placing 63.27agency after a consent to adopt according to section 259.24 or under an agreement 63.28conferring authority to place for adoption according to section 259.25; or63.29    (3) placed by preadoptive custody order for a direct adoptive placement ordered 63.30by the district court under section 259.47,63.31the court administrator shall immediately transmit a copy of the petition to the 63.32commissioner of human services.64.1    (b) The court shall immediately refer the petition to the agency specified below for 64.2completion of a postplacement assessment and report as required by subdivision 2.64.3    (1) If the child to be adopted has been committed to the guardianship of the 64.4commissioner or an agency under section 
         260C.317 or an agency has been given authority 64.5to place the child under section 
         259.25, the court shall refer the petition to that agency, 64.6unless another agency is supervising the placement, in which case the court shall refer the 64.7petition to the supervising agency. 64.8    (2) If the child to be adopted has been placed in the petitioner's home by a direct 64.9adoptive placement, the court shall refer the petition to the agency supervising the 64.10placement under section 
         259.47, subdivision 3, paragraph (a), clause (6). 64.11    (3) If the child is to be adopted by an individual who is related to the child as defined 64.12by section 
         245A.02, subdivision 13, and in all other instances not described in clause (1) 64.13or (2), the court shall refer the petition to the local social services agency of the county in 64.14which the prospective adoptive parent lives. 64.15    Sec. 57. Minnesota Statutes 2006, section 259.57, subdivision 1, is amended to read:64.16    Subdivision 1. Findings; orders. Upon the hearing,64.17    (a) if the court finds that it is in the best interests of the child that the petition 64.18be granted, a decree of adoption shall be made and recorded in the office of the court 64.19administrator, ordering that henceforth the child shall be the child of the petitioner. In the 64.20decree the court may change the name of the child if desired. After the decree is granted64.21for a child who is:64.22    (1) under the guardianship of the commissioner or a licensed child-placing agency 64.23according to section 260C.201, subdivision 11, or 260C.317;64.24    (2) placed by the commissioner, commissioner's agent, or licensed child-placing 64.25agency after a consent to adopt according to section 259.24 or under an agreement 64.26conferring authority to place for adoption according to section 259.25; or64.27    (3) adopted after a direct adoptive placement ordered by the district court under 64.28section 259.47,64.29the court administrator shall immediately mail a copy of the recorded decree to the 64.30commissioner of human services;64.31    (b) if the court is not satisfied that the proposed adoption is in the best interests 64.32of the child, the court shall deny the petition, and shall order the child returned to the 64.33custody of the person or agency legally vested with permanent custody or certify the 64.34case for appropriate action and disposition to the court having jurisdiction to determine 64.35the custody and guardianship of the child.65.1    Sec. 58. Minnesota Statutes 2006, section 259.67, subdivision 4, is amended to read:65.2    Subd. 4. Eligibility conditions. (a) The placing agency shall use the AFDC 65.3requirements as specified in federal law as of July 16, 1996, when determining the child's 65.4eligibility for adoption assistance under title IV-E of the Social Security Act. If the child 65.5does not qualify, the placing agency shall certify a child as eligible for state funded 65.6adoption assistance only if the following criteria are met:65.7    (1) Due to the child's characteristics or circumstances it would be difficult to provide 65.8the child an adoptive home without adoption assistance.65.9    (2)(i) A placement agency has made reasonable efforts to place the child for adoption 65.10without adoption assistance, but has been unsuccessful; or65.11    (ii) the child's licensed foster parents desire to adopt the child and it is determined by 65.12the placing agency that the adoption is in the best interest of the child.65.13    (3)(i) The child has been a ward of the commissioner, a Minnesota-licensed 65.14child-placing agency, or a tribal social service agency of Minnesota recognized by the 65.15Secretary of the Interior; or (ii) the child will be adopted according to tribal law without a 65.16termination of parental rights or relinquishment, provided that the tribe has documented 65.17the valid reason why the child cannot or should not be returned to the home of the child's 65.18parent. The placing agency shall not certify a child who remains under the jurisdiction 65.19of the sending agency pursuant to section 
         260.851, article 5, for state-funded adoption 65.20assistance when Minnesota is the receiving state.65.21    (b) For purposes of this subdivision, the characteristics or circumstances that may 65.22be considered in determining whether a child is a child with special needs under United 65.23States Code, title 42, chapter 7, subchapter IV, part E, or meets the requirements of 65.24paragraph (a), clause (1), are the following:65.25    (1) The child is a member of a sibling group to be placed as one unit in which at 65.26least one sibling is older than 15 months of age or is described in clause (2) or (3).65.27    (2) The child has documented physical, mental, emotional, or behavioral disabilities.65.28    (3) The child has a high risk of developing physical, mental, emotional, or behavioral 65.29disabilities.65.30    (4) The child is adopted according to tribal law without a termination of parental 65.31rights or relinquishment, provided that the tribe has documented the valid reason why the 65.32child cannot or should not be returned to the home of the child's parent.65.33    (4) The child is five years of age or older.65.34    (c) When a child's eligibility for adoption assistance is based upon the high risk of 65.35developing physical, mental, emotional, or behavioral disabilities, payments shall not be 66.1made under the adoption assistance agreement unless and until the potential disability 66.2manifests itself as documented by an appropriate health care professional.66.3    Sec. 59. Minnesota Statutes 2006, section 259.67, subdivision 7, is amended to read:66.4    Subd. 7. Reimbursement of costs. (a) Subject to rules of the commissioner, and 66.5the provisions of this subdivision a child-placing agency licensed in Minnesota or any 66.6other state, or local or tribal social services agency shall receive a reimbursement from the 66.7commissioner equal to 100 percent of the reasonable and appropriate cost of providing 66.8adoption services for a child certified as eligible for adoption assistance under subdivision 66.94. Such assistance. Adoption services under this subdivision may include adoptive family 66.10recruitment, counseling, and special training when needed. 66.11    (b) An eligible child must have a goal of adoption, which may include an adoption 66.12in accordance with tribal law, and meet one of the following criteria: 66.13    (1) is a ward of the commissioner of human services or a ward of tribal court 66.14pursuant to section 260.755, subdivision 20, who meets one of the criteria in subdivision 66.154, paragraph (b), clause (1), (2), or (3); or 66.16    (2) is under the guardianship of a Minnesota-licensed child-placing agency who 66.17meets one of the criteria in subdivision 4, paragraph (b), clause (1) or (2).66.18    (c) A child-placing agency licensed in Minnesota or any other state shall receive 66.19reimbursement for adoption services it purchases for or directly provides to an eligible 66.20child. Tribal social services shall receive reimbursement for adoption services it purchases 66.21for or directly provides to an eligible child. A local or tribal social services agency shall 66.22receive such reimbursement only for adoption services it purchases for an eligible child.66.23    (b) A child-placing agency licensed in Minnesota or any other state or local or tribal 66.24social services agency seeking reimbursement under this subdivision shall enter into66.25Before providing adoption services for which reimbursement will be sought under this 66.26subdivision, a reimbursement agreement, on the designated format, must be entered into66.27with the commissioner before providing adoption services for which reimbursement 66.28is sought. No reimbursement under this subdivision shall be made to an agency for 66.29services provided prior to entering a reimbursement agreement. Separate reimbursement 66.30agreements shall be made for each child and separate records shall be kept on each child 66.31for whom a reimbursement agreement is made. The commissioner of human services shall 66.32agree that the reimbursement costs are reasonable and appropriate. The commissioner 66.33may spend up to $16,000 for each purchase of service agreement. Only one agreement per 66.34child is allowed, unless an exception is granted by the commissioner. Funds encumbered 67.1and obligated under such an agreement for the child remain available until the terms of 67.2the agreement are fulfilled or the agreement is terminated.67.3    (c) When a local or tribal social services agency uses a purchase of service agreement 67.4to provide services reimbursable under a reimbursement agreement, The commissioner 67.5may shall make reimbursement payments directly to the agency providing the service if 67.6direct reimbursement is specified by the purchase of service agreement, and if the request 67.7for reimbursement is submitted by the local or tribal social services agency along with a 67.8verification that the service was provided.67.9    Sec. 60. Minnesota Statutes 2006, section 259.75, subdivision 8, is amended to read:67.10    Subd. 8. Reasons for deferral. Deferral of the listing of a child with the state 67.11adoption exchange shall be only for one or more of the following reasons:67.12    (a) the child is in an adoptive placement but is not legally adopted;67.13    (b) the child's foster parents or other individuals are now considering adoption;67.14    (c) diagnostic study or testing is required to clarify the child's problem and provide 67.15an adequate description; or67.16    (d) the child is currently in a hospital and continuing need for daily professional care 67.17will not permit placement in a family setting; or.67.18    (e) the child is 14 years of age or older and will not consent to an adoption plan.67.19Approval of a request to defer listing for any of the reasons specified in paragraph (b) or 67.20(c) shall be valid for a period not to exceed 90 days, with no subsequent deferrals for 67.21those reasons.67.22    Sec. 61. Minnesota Statutes 2006, section 260.012, is amended to read:67.23260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY 67.24REUNIFICATION; REASONABLE EFFORTS.67.25    (a) Once a child alleged to be in need of protection or services is under the court's 67.26jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate 67.27services, by the social services agency are made to prevent placement or to eliminate the 67.28need for removal and to reunite the child with the child's family at the earliest possible 67.29time, and when a child cannot be reunified with the parent or guardian from whom the67.30child was removed, the court must ensure that the responsible social services agency 67.31makes reasonable efforts to finalize an alternative permanent plan for the child as provided 67.32in paragraph (e). In determining reasonable efforts to be made with respect to a child and 67.33in making those reasonable efforts, the child's best interests, health, and safety must be of 67.34paramount concern. Reasonable efforts to prevent placement and for rehabilitation and 68.1reunification are always required except upon a determination by the court that a petition 68.2has been filed stating a prima facie case that:68.3    (1) the parent has subjected a child to egregious harm as defined in section 68.4260C.007, subdivision 14
         ;68.5    (2) the parental rights of the parent to another child have been terminated 68.6involuntarily;68.7    (3) the child is an abandoned infant under section 
         260C.301, subdivision 2, 68.8paragraph (a), clause (2);68.9    (4) the parent's custodial rights to another child have been involuntarily transferred 68.10to a relative under section 
         260C.201, subdivision 11, paragraph (e), clause (1), or a similar 68.11law of another jurisdiction; or68.12    (5) the provision of services or further services for the purpose of reunification is 68.13futile and therefore unreasonable under the circumstances.68.14    (b) When the court makes one of the prima facie determinations under paragraph (a), 68.15either permanency pleadings under section 
         260C.201, subdivision 11, or a termination 68.16of parental rights petition under sections 
         260C.141 and 
         260C.301 must be filed. A 68.17permanency hearing under section 
         260C.201, subdivision 11, must be held within 30 68.18days of this determination.68.19    (c) In the case of an Indian child, in proceedings under sections 
         260B.178 or 68.20260C.178
         , 
         260C.201, and 
         260C.301 the juvenile court must make findings and conclusions 68.21consistent with the Indian Child Welfare Act of 1978, United States Code, title 25, section 68.221901 et seq., as to the provision of active efforts. In cases governed by the Indian Child 68.23Welfare Act of 1978, United States Code, title 25, section 1901, the responsible social 68.24services agency must provide active efforts as required under United States Code, title 68.2525, section 1911(d).68.26    (d) "Reasonable efforts to prevent placement" means:68.27    (1) the agency has made reasonable efforts to prevent the placement of the child in 68.28foster care; or68.29    (2) given the particular circumstances of the child and family at the time of the 68.30child's removal, there are no services or efforts available which could allow the child to 68.31safely remain in the home.68.32    (e) "Reasonable efforts to finalize a permanent plan for the child" means due 68.33diligence by the responsible social services agency to:68.34    (1) reunify the child with the parent or guardian from whom the child was removed;69.1    (2) assess a noncustodial parent's ability to provide day-to-day care for the child and, 69.2where appropriate, provide services necessary to enable the noncustodial parent to safely 69.3provide the care, as required by section 
         260C.212, subdivision 4;69.4    (3) conduct a relative search as required under section 
         260C.212, subdivision 5; and69.5    (4) when the child cannot return to the parent or guardian from whom the child was 69.6removed, to plan for and finalize a safe and legally permanent alternative home for the 69.7child, and considers permanent alternative homes for the child inside or outside of the 69.8state, preferably through adoption or transfer of permanent legal and physical custody of 69.9the child.69.10    (f) Reasonable efforts are made upon the exercise of due diligence by the responsible 69.11social services agency to use culturally appropriate and available services to meet the 69.12needs of the child and the child's family. Services may include those provided by the 69.13responsible social services agency and other culturally appropriate services available in 69.14the community. At each stage of the proceedings where the court is required to review 69.15the appropriateness of the responsible social services agency's reasonable efforts as 69.16described in paragraphs (a), (d), and (e), the social services agency has the burden of 69.17demonstrating that:69.18    (1) it has made reasonable efforts to prevent placement of the child in foster care;69.19    (2) it has made reasonable efforts to eliminate the need for removal of the child from 69.20the child's home and to reunify the child with the child's family at the earliest possible time;69.21    (3) it has made reasonable efforts to finalize an alternative permanent home for 69.22the child, and considers permanent alternative homes for the child inside or outside of 69.23the state; or69.24    (4) reasonable efforts to prevent placement and to reunify the child with the parent 69.25or guardian are not required. The agency may meet this burden by stating facts in a sworn 69.26petition filed under section 
         260C.141, by filing an affidavit summarizing the agency's 69.27reasonable efforts or facts the agency believes demonstrate there is no need for reasonable 69.28efforts to reunify the parent and child, or through testimony or a certified report required 69.29under juvenile court rules.69.30    (g) Once the court determines that reasonable efforts for reunification are not 69.31required because the court has made one of the prima facie determinations under paragraph 69.32(a), the court may only require reasonable efforts for reunification after a hearing according 69.33to section 
         260C.163, where the court finds there is not clear and convincing evidence of 69.34the facts upon which the court based its prima facie determination. In this case when there 69.35is clear and convincing evidence that the child is in need of protection or services, the 69.36court may find the child in need of protection or services and order any of the dispositions 70.1available under section 
         260C.201, subdivision 1. Reunification of a surviving child with a 70.2parent is not required if the parent has been convicted of:70.3    (1) a violation of, or an attempt or conspiracy to commit a violation of, sections 70.4609.185
          to 
         609.20; 
         609.222, subdivision 2; or 
         609.223 in regard to another child of the 70.5parent;70.6    (2) a violation of section 
         609.222, subdivision 2; or 
         609.223, in regard to the 70.7surviving child; or70.8    (3) a violation of, or an attempt or conspiracy to commit a violation of, United States 70.9Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent.70.10    (h) The juvenile court, in proceedings under sections 
         260B.178 or 
         260C.178, 70.11260C.201
         , and 
         260C.301 shall make findings and conclusions as to the provision of 70.12reasonable efforts. When determining whether reasonable efforts have been made, the 70.13court shall consider whether services to the child and family were:70.14    (1) relevant to the safety and protection of the child;70.15    (2) adequate to meet the needs of the child and family;70.16    (3) culturally appropriate;70.17    (4) available and accessible;70.18    (5) consistent and timely; and70.19    (6) realistic under the circumstances.70.20    In the alternative, the court may determine that provision of services or further 70.21services for the purpose of rehabilitation is futile and therefore unreasonable under the 70.22circumstances or that reasonable efforts are not required as provided in paragraph (a).70.23    (i) This section does not prevent out-of-home placement for treatment of a child with 70.24a mental disability when the child's diagnostic assessment or individual treatment plan 70.25indicates that appropriate and necessary treatment cannot be effectively provided outside 70.26of a residential or inpatient treatment program.70.27    (j) If continuation of reasonable efforts to prevent placement or reunify the child 70.28with the parent or guardian from whom the child was removed is determined by the court 70.29to be inconsistent with the permanent plan for the child or upon the court making one of 70.30the prima facie determinations under paragraph (a), reasonable efforts must be made to 70.31place the child in a timely manner in a safe and permanent home and to complete whatever 70.32steps are necessary to legally finalize the permanent placement of the child.70.33    (k) Reasonable efforts to place a child for adoption or in another permanent 70.34placement may be made concurrently with reasonable efforts to prevent placement or to 70.35reunify the child with the parent or guardian from whom the child was removed. When 70.36the responsible social services agency decides to concurrently make reasonable efforts for 71.1both reunification and permanent placement away from the parent under paragraph (a), the 71.2agency shall disclose its decision and both plans for concurrent reasonable efforts to all 71.3parties and the court. When the agency discloses its decision to proceed on both plans for 71.4reunification and permanent placement away from the parent, the court's review of the 71.5agency's reasonable efforts shall include the agency's efforts under both plans.71.6    Sec. 62. Minnesota Statutes 2006, section 260.755, subdivision 12, is amended to read:71.7    Subd. 12. Indian tribe. "Indian tribe" means an Indian tribe, band, nation, or 71.8other organized group or community of Indians recognized as eligible for the services 71.9provided to Indians by the secretary because of their status as Indians, including any band71.10Native group under the Alaska Native Claims Settlement Act, United States Code, title 43, 71.11section 1602, and exercising tribal governmental powers.71.12    Sec. 63. Minnesota Statutes 2006, section 260.755, subdivision 20, is amended to read:71.13    Subd. 20. Tribal court. "Tribal court" means a court with federally recognized71.14jurisdiction over child custody proceedings and which is either a court of Indian offenses, 71.15or a court established and operated under the code or custom of an Indian tribe, or the71.16any other administrative body of a tribe which is vested with authority over child custody 71.17proceedings. Except as provided in section 
         260.771, subdivision 5, nothing in this chapter 71.18shall be construed as conferring jurisdiction on an Indian tribe. 71.19    Sec. 64. Minnesota Statutes 2006, section 260.761, subdivision 7, is amended to read:71.20    Subd. 7. Identification of extended family members. Any agency considering 71.21placement of an Indian child shall make reasonable active efforts to identify and locate 71.22extended family members.71.23    Sec. 65. Minnesota Statutes 2006, section 260.765, subdivision 5, is amended to read:71.24    Subd. 5. Identification of extended family members. Any agency considering 71.25placement of an Indian child shall make reasonable active efforts to identify and locate 71.26extended family members.71.27    Sec. 66. Minnesota Statutes 2006, section 260.771, subdivision 1, is amended to read:71.28    Subdivision 1. Indian tribe jurisdiction. An Indian tribe with a tribal court has 71.29exclusive jurisdiction over a child placement proceeding involving an Indian child who 71.30resides or is domiciled within the reservation of such the tribe at the commencement of 71.31the proceedings, except where jurisdiction is otherwise vested in the state by existing 72.1federal law. When an Indian child is in the legal custody of a person or agency pursuant 72.2to an order of a ward of the tribal court, the Indian tribe retains exclusive jurisdiction, 72.3notwithstanding the residence or domicile of the child.72.4    Sec. 67. Minnesota Statutes 2006, section 260.771, subdivision 2, is amended to read:72.5    Subd. 2. Court determination of tribal affiliation of child. In any child placement 72.6proceeding, the court shall establish whether an Indian child is involved and the identity 72.7of the Indian child's tribe. This chapter and the federal Indian Child Welfare Act are 72.8applicable without exception in any child custody proceeding, as defined in the federal act, 72.9involving an Indian child. This chapter applies to child custody proceedings involving 72.10an Indian child whether the child is in the physical or legal custody of an Indian parent, 72.11Indian custodian, Indian extended family member, or other person at the commencement 72.12of the proceedings. A court shall not determine the applicability of this chapter or the 72.13federal Indian Child Welfare Act to a child custody proceeding based upon whether an 72.14Indian child is part of an existing Indian family or based upon the level of contact a child 72.15has with the child's Indian tribe, reservation, society, or off-reservation community.72.16    Sec. 68. [260.852] PLACEMENT PROCEDURES.72.17    Subdivision 1.Home study.The state must have procedures for the orderly and 72.18timely interstate placement of children that are implemented in accordance with an 72.19interstate compact and that, within 60 days after the state receives from another state a 72.20request to conduct a study of a home environment for purposes of assessing the safety 72.21and suitability of placing a child in the home, the state shall, directly or by contract, 72.22conduct and complete a home study and return to the other state a report on the results of 72.23the study, which shall address the extent to which placement in the home would meet the 72.24needs of the child; except in the case of a home study begun before October 1, 2008, if the 72.25state fails to comply with conducting and completing the home study within the 60-day 72.26period and this is as a result of circumstances beyond the control of the state, the state has 72.2775 days to comply if the state documents the circumstances involved and certifies that 72.28completing the home study is in the best interests of the child. 72.29    This subdivision does not require the completion within the applicable period of 72.30the parts of the home study involving the education and training of the prospective foster 72.31or adoptive parents.72.32    Subd. 2.Effect of received report.The state shall treat any report described in 72.33subdivision 1 that is received from another state, an Indian tribe, or a private agency 72.34under contract with another state or Indian tribe as meeting any requirements imposed by 73.1the state for the completion of a home study before placing a child in the home, unless, 73.2within 14 days after receipt of the report, the state determines, based on grounds that 73.3are specific to the content of the report, that making a decision in reliance on the report 73.4would be contrary to the welfare of the child.73.5    Subd. 3.Resources.The state shall make effective use of cross-jurisdictional 73.6resources, including through contract for the purchase of services, and shall eliminate 73.7legal barriers to facilitate timely adoptive or permanent placements for waiting children. 73.8The state shall not impose any restriction on the use of private agencies for the purpose of 73.9conducting a home study to meet the 60-day requirement.73.10    Subd. 4.Incentive eligibility.Minnesota is an incentive-eligible state and must:73.11    (1) have an approved plan as required by the United States Secretary of Health 73.12and Human Services;73.13    (2) be in compliance with the data requirements of the United States Department of 73.14Health and Human Services; and73.15    (3) have data that verify that a home study is completed within 30 days.73.16    Subd. 5.Data requirements.The state shall provide to the United States Secretary 73.17of Health and Human Services a written report, covering the preceding fiscal year, that 73.18specifies:73.19    (1) the total number of interstate home studies requested by the state with respect 73.20to children in foster care under the responsibility of the state, and with respect to each 73.21study, the identity of the other state involved;73.22    (2) the total number of timely interstate home studies completed by the state with 73.23respect to children in foster care under the responsibility of other states and, with respect 73.24to each study, the identity of the other state involved; and73.25    (3) other information the United States Secretary of Health and Human Services 73.26requires in order to determine whether Minnesota is a home study incentive-eligible state.73.27    Subd. 6.Definitions.(a) The definitions in this subdivision apply to this section.73.28    (b) "Home study" means an evaluation of a home environment conducted in 73.29accordance with applicable requirements of the state in which the home is located, to 73.30determine whether a proposed placement of a child would meet the individual needs of the 73.31child, including the child's safety; permanency; health; well-being; and mental, emotional, 73.32and physical development.73.33    (c) "Interstate home study" means a home study conducted by a state at the request 73.34of another state to facilitate an adoptive or foster placement in the state of a child in foster 73.35care under the responsibility of the state.74.1    (d) "Timely interstate home study" means an interstate home study completed by a 74.2state if the state provides to the state that requested the study, within 30 days after receipt 74.3of the request, a report on the results of the study, except that there is no requirement 74.4for completion within the 30-day period of the parts of the home study involving the 74.5education and training of the prospective foster or adoptive parents.74.6    Subd. 7.Background study requirements for adoption and foster care.(a) 74.7Background study requirements for an adoption home study must be completed consistent 74.8with section 259.41, subdivisions 1, 2, and 3.74.9    (b) Background study requirements for a foster care license must be completed 74.10consistent with section 245C.08.74.11    Subd. 8.Home visits.If a child has been placed in foster care outside the state in 74.12which the home of the parents of the child is located, periodically, but at least every six 74.13months, a caseworker on the staff of the agency of the state in which the home of the 74.14parents of the child is located or the state in which the child has been placed, or a private 74.15agency under contract with either state, must visit the child in the home or institution and 74.16submit a report on each visit to the agency of the state in which the home of the parents of 74.17the child is located.74.18    Sec. 69. Minnesota Statutes 2006, section 260B.157, subdivision 1, is amended to read:74.19    Subdivision 1. Investigation. Upon request of the court the local social services 74.20agency or probation officer shall investigate the personal and family history and 74.21environment of any minor coming within the jurisdiction of the court under section 74.22260B.101
          and shall report its findings to the court. The court may order any minor coming 74.23within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or 74.24psychologist appointed by the court. 74.25    The court shall have order a chemical use assessment conducted when a child is 74.26(1) found to be delinquent for violating a provision of chapter 152, or for committing a 74.27felony-level violation of a provision of chapter 609 if the probation officer determines 74.28that alcohol or drug use was a contributing factor in the commission of the offense, or 74.29(2) alleged to be delinquent for violating a provision of chapter 152, if the child is being 74.30held in custody under a detention order. The assessor's qualifications and the assessment 74.31criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under 74.32chapter 254B are to be used to pay for the recommended treatment, the assessment and 74.33placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to 74.349530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall 74.35reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.75.1    The court shall have order a children's mental health screening conducted when 75.2a child is found to be delinquent. The screening shall be conducted with a screening 75.3instrument approved by the commissioner of human services and shall be conducted by a 75.4mental health practitioner as defined in section 
         245.4871, subdivision 26, or a probation 75.5officer who is trained in the use of the screening instrument. If the screening indicates 75.6a need for assessment, the local social services agency, in consultation with the child's 75.7family, shall have a diagnostic assessment conducted, including a functional assessment, 75.8as defined in section 
         245.4871. 75.9    With the consent of the commissioner of corrections and agreement of the county to 75.10pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction 75.11in an institution maintained by the commissioner for the detention, diagnosis, custody and 75.12treatment of persons adjudicated to be delinquent, in order that the condition of the minor 75.13be given due consideration in the disposition of the case. Any funds received under the 75.14provisions of this subdivision shall not cancel until the end of the fiscal year immediately 75.15following the fiscal year in which the funds were received. The funds are available for 75.16use by the commissioner of corrections during that period and are hereby appropriated 75.17annually to the commissioner of corrections as reimbursement of the costs of providing 75.18these services to the juvenile courts.75.19    Sec. 70. Minnesota Statutes 2006, section 260C.152, subdivision 5, is amended to read:75.20    Subd. 5. Notice to foster parents and preadoptive parents and relatives. The 75.21foster parents, if any, of a child and any preadoptive parent or relative providing care 75.22for the child must be provided notice of and an opportunity a right to be heard in any 75.23review or hearing to be held with respect to the child. Any other relative may also request, 75.24and must be granted, a notice and the opportunity to be heard under this section. This 75.25subdivision does not require that a foster parent, preadoptive parent, or relative providing 75.26care for the child be made a party to a review or hearing solely on the basis of the notice 75.27and opportunity right to be heard.75.28    Sec. 71. Minnesota Statutes 2006, section 260C.163, subdivision 1, is amended to read:75.29    Subdivision 1. General. (a) Except for hearings arising under section 
         260C.425, 75.30hearings on any matter shall be without a jury and may be conducted in an informal 75.31manner. In all adjudicatory proceedings involving a child alleged to be in need of 75.32protection or services, the court shall admit only evidence that would be admissible in a 75.33civil trial. To be proved at trial, allegations of a petition alleging a child to be in need of 75.34protection or services must be proved by clear and convincing evidence. 76.1    (b) Except for proceedings involving a child alleged to be in need of protection or 76.2services and petitions for the termination of parental rights, hearings may be continued or 76.3adjourned from time to time. In proceedings involving a child alleged to be in need of 76.4protection or services and petitions for the termination of parental rights, hearings may not 76.5be continued or adjourned for more than one week unless the court makes specific findings 76.6that the continuance or adjournment is in the best interests of the child. If a hearing is held 76.7on a petition involving physical or sexual abuse of a child who is alleged to be in need of 76.8protection or services or neglected and in foster care, the court shall file the decision with 76.9the court administrator as soon as possible but no later than 15 days after the matter is 76.10submitted to the court. When a continuance or adjournment is ordered in any proceeding, 76.11the court may make any interim orders as it deems in the best interests of the minor in 76.12accordance with the provisions of sections 
         260C.001 to 
         260C.421. 76.13    (c) Except as otherwise provided in this paragraph, the court shall exclude the 76.14general public from hearings under this chapter and shall admit only those persons who, in 76.15the discretion of the court, have a direct interest in the case or in the work of the court.76.16    (d) Adoption hearings shall be conducted in accordance with the provisions of 76.17laws relating to adoptions.76.18    (e) In any permanency hearing, including the transition of a child from foster care 76.19to independent living, the court shall ensure that any consult with the child is in an 76.20age-appropriate manner.76.21    Sec. 72. Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to 76.22read:76.23    Subd. 11. Review of court-ordered placements; permanent placement 76.24determination. (a) This subdivision and subdivision 11a do not apply in cases where 76.25the child is in placement due solely to the child's developmental disability or emotional 76.26disturbance, where legal custody has not been transferred to the responsible social services 76.27agency, and where the court finds compelling reasons under section 
         260C.007, subdivision 76.288
         , to continue the child in foster care past the time periods specified in this subdivision. 76.29Foster care placements of children due solely to their disability are governed by section 76.30260C.141, subdivision 2a
         . In all other cases where the child is in foster care or in the care 76.31of a noncustodial parent under subdivision 1, the court shall commence proceedings 76.32to determine the permanent status of a child not later than 12 months after the child is 76.33placed in foster care or in the care of a noncustodial parent. At the admit-deny hearing 76.34commencing such proceedings, the court shall determine whether there is a prima facie 76.35basis for finding that the agency made reasonable efforts, or in the case of an Indian 77.1child active efforts, required under section 
         260.012 and proceed according to the rules of 77.2juvenile court.77.3    For purposes of this subdivision, the date of the child's placement in foster care is 77.4the earlier of the first court-ordered placement or 60 days after the date on which the 77.5child has been voluntarily placed in foster care by the child's parent or guardian. For 77.6purposes of this subdivision, time spent by a child under the protective supervision of 77.7the responsible social services agency in the home of a noncustodial parent pursuant to 77.8an order under subdivision 1 counts towards the requirement of a permanency hearing 77.9under this subdivision or subdivision 11a. Time spent on a trial home visit does not count77.10counts towards the requirement of a permanency hearing under this subdivision orand a 77.11permanency review for a child under eight years of age under subdivision 11a.77.12    For purposes of this subdivision, 12 months is calculated as follows:77.13    (1) during the pendency of a petition alleging that a child is in need of protection 77.14or services, all time periods when a child is placed in foster care or in the home of a 77.15noncustodial parent are cumulated;77.16    (2) if a child has been placed in foster care within the previous five years under one 77.17or more previous petitions, the lengths of all prior time periods when the child was placed 77.18in foster care within the previous five years are cumulated. If a child under this clause 77.19has been in foster care for 12 months or more, the court, if it is in the best interests of the 77.20child and for compelling reasons, may extend the total time the child may continue out 77.21of the home under the current petition up to an additional six months before making a 77.22permanency determination.77.23    (b) Unless the responsible social services agency recommends return of the child 77.24to the custodial parent or parents, not later than 30 days prior to the admit-deny hearing 77.25required under paragraph (a) and the rules of juvenile court, the responsible social services 77.26agency shall file pleadings in juvenile court to establish the basis for the juvenile court to 77.27order permanent placement of the child, including a termination of parental rights petition, 77.28according to paragraph (d). Notice of the hearing and copies of the pleadings must be 77.29provided pursuant to section 
         260C.152.77.30    (c) The permanency proceedings shall be conducted in a timely fashion including 77.31that any trial required under section 
         260C.163 shall be commenced within 60 days of the 77.32admit-deny hearing required under paragraph (a). At the conclusion of the permanency 77.33proceedings, the court shall:77.34    (1) order the child returned to the care of the parent or guardian from whom the 77.35child was removed; or78.1    (2) order a permanent placement or termination of parental rights if permanent 78.2placement or termination of parental rights is in the child's best interests. The "best 78.3interests of the child" means all relevant factors to be considered and evaluated. Transfer 78.4of permanent legal and physical custody, termination of parental rights, or guardianship 78.5and legal custody to the commissioner through a consent to adopt are preferred 78.6permanency options for a child who cannot return home.78.7    (d) If the child is not returned to the home, the court must order one of the following 78.8dispositions:78.9    (1) permanent legal and physical custody to a relative in the best interests of the 78.10child according to the following conditions:78.11    (i) an order for transfer of permanent legal and physical custody to a relative shall 78.12only be made after the court has reviewed the suitability of the prospective legal and 78.13physical custodian;78.14    (ii) in transferring permanent legal and physical custody to a relative, the juvenile 78.15court shall follow the standards applicable under this chapter and chapter 260, and the 78.16procedures set out in the juvenile court rules;78.17    (iii) an order establishing permanent legal and physical custody under this 78.18subdivision must be filed with the family court;78.19    (iv) a transfer of legal and physical custody includes responsibility for the protection, 78.20education, care, and control of the child and decision making on behalf of the child;78.21    (v) the social services agency may bring a petition or motion naming a fit and 78.22willing relative as a proposed permanent legal and physical custodian. The commissioner 78.23of human services shall annually prepare for counties information that must be given to 78.24proposed custodians about their legal rights and obligations as custodians together with 78.25information on financial and medical benefits for which the child is eligible; and78.26    (vi) the juvenile court may maintain jurisdiction over the responsible social services 78.27agency, the parents or guardian of the child, the child, and the permanent legal and 78.28physical custodian for purposes of ensuring appropriate services are delivered to the child 78.29and permanent legal custodian or for the purpose of ensuring conditions ordered by the 78.30court related to the care and custody of the child are met;78.31    (2) termination of parental rights when the requirements of sections 
         260C.301 to 78.32260C.328
          are met or according to the following conditions:78.33    (i) order the social services agency to file a petition for termination of parental 78.34rights in which case all the requirements of sections 
         260C.301 to 
         260C.328 remain 78.35applicable; and79.1    (ii) an adoption completed subsequent to a determination under this subdivision may 79.2include an agreement for communication or contact under section 
         259.58;79.3    (3) long-term foster care according to the following conditions:79.4    (i) the court may order a child into long-term foster care only if it approves the 79.5responsible social service agency's compelling reasons that neither an award of permanent 79.6legal and physical custody to a relative, nor termination of parental rights is in the child's 79.7best interests;79.8    (ii) further, the court may only order long-term foster care for the child under this 79.9section if it finds the following:79.10    (A) the child has reached age 12 and the responsible social services agency has made 79.11reasonable efforts to locate and place the child with an adoptive family or with a fit and 79.12willing relative who will agree to a transfer of permanent legal and physical custody of 79.13the child, but such efforts have not proven successful; or79.14    (B) the child is a sibling of a child described in subitem (A) and the siblings have 79.15a significant positive relationship and are ordered into the same long-term foster care 79.16home; and79.17    (iii) at least annually, the responsible social services agency reconsiders its provision 79.18of services to the child and the child's placement in long-term foster care to ensure that:79.19    (A) long-term foster care continues to be the most appropriate legal arrangement 79.20for meeting the child's need for permanency and stability, including whether there is 79.21another permanent placement option under this chapter that would better serve the child's 79.22needs and best interests;79.23    (B) whenever possible, there is an identified long-term foster care family that is 79.24committed to being the foster family for the child as long as the child is a minor or under 79.25the jurisdiction of the court;79.26    (C) the child is receiving appropriate services or assistance to maintain or build 79.27connections with the child's family and community;79.28    (D) the child's physical and mental health needs are being appropriately provided 79.29for; and79.30    (E) the child's educational needs are being met;79.31    (4) foster care for a specified period of time according to the following conditions:79.32    (i) foster care for a specified period of time may be ordered only if:79.33    (A) the sole basis for an adjudication that the child is in need of protection or 79.34services is the child's behavior;79.35    (B) the court finds that foster care for a specified period of time is in the best 79.36interests of the child; and80.1    (C) the court approves the responsible social services agency's compelling reasons 80.2that neither an award of permanent legal and physical custody to a relative, nor termination 80.3of parental rights is in the child's best interests;80.4    (ii) the order does not specify that the child continue in foster care for any period 80.5exceeding one year; or80.6    (5) guardianship and legal custody to the commissioner of human services under 80.7the following procedures and conditions:80.8    (i) there is an identified prospective adoptive home agreed to by the responsible 80.9social services agency having legal custody of the child pursuant to court order under this 80.10section that has agreed to adopt the child and the court accepts the parent's voluntary 80.11consent to adopt under section 
         259.24, except that such consent executed by a parent under 80.12this item, following proper notice that consent given under this provision is irrevocable 80.13upon acceptance by the court, shall be irrevocable unless fraud is established and an order 80.14issues permitting revocation as stated in item (vii);80.15    (ii) if the court accepts a consent to adopt in lieu of ordering one of the other 80.16enumerated permanency dispositions, the court must review the matter at least every 90 80.17days. The review will address the reasonable efforts of the agency to achieve a finalized 80.18adoption;80.19    (iii) a consent to adopt under this clause vests all legal authority regarding the child, 80.20including guardianship and legal custody of the child, with the commissioner of human 80.21services as if the child were a state ward after termination of parental rights;80.22    (iv) the court must forward a copy of the consent to adopt, together with a certified 80.23copy of the order transferring guardianship and legal custody to the commissioner, to 80.24the commissioner;80.25    (v) if an adoption is not finalized by the identified prospective adoptive parent within 80.2612 months of the execution of the consent to adopt under this clause, the commissioner of 80.27human services or the commissioner's delegate shall pursue adoptive placement in another 80.28home unless the commissioner certifies that the failure to finalize is not due to either an 80.29action or a failure to act by the prospective adoptive parent;80.30    (vi) notwithstanding item (v), the commissioner of human services or the 80.31commissioner's designee must pursue adoptive placement in another home as soon as the 80.32commissioner or commissioner's designee determines that finalization of the adoption with 80.33the identified prospective adoptive parent is not possible, that the identified prospective 80.34adoptive parent is not willing to adopt the child, that the identified prospective adoptive 80.35parent is not cooperative in completing the steps necessary to finalize the adoption, or 80.36upon the commissioner's determination to withhold consent to the adoption.81.1    (vii) unless otherwise required by the Indian Child Welfare Act, United States Code, 81.2title 25, section 1913, a consent to adopt executed under this section, following proper 81.3notice that consent given under this provision is irrevocable upon acceptance by the court, 81.4shall be irrevocable upon acceptance by the court except upon order permitting revocation 81.5issued by the same court after written findings that consent was obtained by fraud.81.6    (e) In ordering a permanent placement of a child, the court must be governed by the 81.7best interests of the child, including a review of the relationship between the child and 81.8relatives and the child and other important persons with whom the child has resided or 81.9had significant contact. When the court has determined that permanent placement of the 81.10child away from the parent is necessary, the court shall consider permanent alternative 81.11homes that are available both inside and outside the state.81.12    (f) Once a permanent placement determination has been made and permanent 81.13placement has been established, further court reviews are necessary if:81.14    (1) the placement is long-term foster care or foster care for a specified period of time;81.15    (2) the court orders further hearings because it has retained jurisdiction of a transfer 81.16of permanent legal and physical custody matter;81.17    (3) an adoption has not yet been finalized; or81.18    (4) there is a disruption of the permanent or long-term placement.81.19    (g) Court reviews of an order for long-term foster care, whether under this section 81.20or section 
         260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and 81.21must review the child's out-of-home placement plan and the reasonable efforts of the 81.22agency to finalize the permanent plan for the child including the agency's efforts to:81.23    (1) ensure that long-term foster care continues to be the most appropriate legal 81.24arrangement for meeting the child's need for permanency and stability or, if not, to identify 81.25and attempt to finalize another permanent placement option under this chapter that would 81.26better serve the child's needs and best interests;81.27    (2) identify a specific long-term foster home for the child, if one has not already 81.28been identified;81.29    (3) support continued placement of the child in the identified home, if one has been 81.30identified;81.31    (4) ensure appropriate services are provided to address the physical health, mental 81.32health, and educational needs of the child during the period of long-term foster care and 81.33also ensure appropriate services or assistance to maintain relationships with appropriate 81.34family members and the child's community; and81.35    (5) plan for the child's independence upon the child's leaving long-term foster care 81.36living as required under section 
         260C.212, subdivision 1.82.1    (h) In the event it is necessary for a child that has been ordered into foster care for a 82.2specified period of time to be in foster care longer than one year after the permanency 82.3hearing held under this section, not later than 12 months after the time the child was 82.4ordered into foster care for a specified period of time, the matter must be returned to 82.5court for a review of the appropriateness of continuing the child in foster care and of the 82.6responsible social services agency's reasonable efforts to finalize a permanent plan for 82.7the child; if it is in the child's best interests to continue the order for foster care for a 82.8specified period of time past a total of 12 months, the court shall set objectives for the 82.9child's continuation in foster care, specify any further amount of time the child may be in 82.10foster care, and review the plan for the safe return of the child to the parent.82.11    (i) An order permanently placing a child out of the home of the parent or guardian 82.12must include the following detailed findings:82.13    (1) how the child's best interests are served by the order;82.14    (2) the nature and extent of the responsible social service agency's reasonable efforts, 82.15or, in the case of an Indian child, active efforts to reunify the child with the parent or 82.16guardian where reasonable efforts are required;82.17    (3) the parent's or parents' efforts and ability to use services to correct the conditions 82.18which led to the out-of-home placement; and82.19    (4) that the conditions which led to the out-of-home placement have not been 82.20corrected so that the child can safely return home.82.21    (j) An order for permanent legal and physical custody of a child may be modified 82.22under sections 
         518.18 and 
         518.185. The social services agency is a party to the proceeding 82.23and must receive notice. A parent may only seek modification of an order for long-term 82.24foster care upon motion and a showing by the parent of a substantial change in the parent's 82.25circumstances such that the parent could provide appropriate care for the child and that 82.26removal of the child from the child's permanent placement and the return to the parent's 82.27care would be in the best interest of the child. The responsible social services agency may 82.28ask the court to vacate an order for long-term foster care upon a prima facie showing 82.29that there is a factual basis for the court to order another permanency option under this 82.30chapter and that such an option is in the child's best interests. Upon a hearing where 82.31the court determines that there is a factual basis for vacating the order for long-term 82.32foster care and that another permanent order regarding the placement of the child is in 82.33the child's best interests, the court may vacate the order for long-term foster care and 82.34enter a different order for permanent placement that is in the child's best interests. The 82.35court shall not require further reasonable efforts to reunify the child with the parent or 82.36guardian as a basis for vacating the order for long-term foster care and ordering a different 83.1permanent placement in the child's best interests. The county attorney must file pleadings 83.2and give notice as required under the rules of juvenile court in order to modify an order for 83.3long-term foster care under this paragraph.83.4    (k) The court shall issue an order required under this section within 15 days of the 83.5close of the proceedings. The court may extend issuing the order an additional 15 days 83.6when necessary in the interests of justice and the best interests of the child.83.7    (l) This paragraph applies to proceedings required under this subdivision when 83.8the child is on a trial home visit:83.9    (1) if the child is on a trial home visit 12 months after the child was placed in 83.10foster care or in the care of a noncustodial parent as calculated in this subdivision, the 83.11responsible social services agency may file a report with the court regarding the child's and 83.12parent's progress on the trial home visit and its reasonable efforts to finalize the child's safe 83.13and permanent return to the care of the parent in lieu of filing the pleadings required under 83.14paragraph (b). The court shall make findings regarding reasonableness of the responsible 83.15social services efforts to finalize the child's return home as the permanent order in the best 83.16interests of the child. The court may continue the trial home visit to a total time not to 83.17exceed six months as provided in subdivision 1. If the court finds the responsible social 83.18services agency has not made reasonable efforts to finalize the child's return home as the 83.19permanent order in the best interests of the child, the court may order other or additional 83.20efforts to support the child remaining in the care of the parent; and83.21    (2) if a trial home visit ordered or continued at proceedings under this subdivision 83.22terminates, the court shall re-commence proceedings under this subdivision to determine 83.23the permanent status of the child not later than 30 days after the child is returned to foster 83.24care.83.25    Sec. 73. Minnesota Statutes 2006, section 260C.212, subdivision 1, is amended to read:83.26    Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan 83.27shall be prepared within 30 days after any child is placed in a residential facility by court 83.28order or by the voluntary release of the child by the parent or parents.83.29    For purposes of this section, a residential facility means any group home, family 83.30foster home or other publicly supported out-of-home residential facility, including any 83.31out-of-home residential facility under contract with the state, county or other political 83.32subdivision, or any agency thereof, to provide those services or foster care as defined in 83.33section 
         260C.007, subdivision 18.83.34    (b) An out-of-home placement plan means a written document which is prepared by 83.35the responsible social services agency jointly with the parent or parents or guardian of the 84.1child and in consultation with the child's guardian ad litem, the child's tribe, if the child is 84.2an Indian child, the child's foster parent or representative of the residential facility, and, 84.3where appropriate, the child. For a child in placement due solely or in part to the child's 84.4emotional disturbance, preparation of the out-of-home placement plan shall additionally 84.5include the child's mental health treatment provider. As appropriate, the plan shall be:84.6    (1) submitted to the court for approval under section 
         260C.178, subdivision 7;84.7    (2) ordered by the court, either as presented or modified after hearing, under section 84.8260C.178, subdivision 7
         , or 
         260C.201, subdivision 6; and84.9    (3) signed by the parent or parents or guardian of the child, the child's guardian ad 84.10litem, a representative of the child's tribe, the responsible social services agency, and, if 84.11possible, the child.84.12    (c) The out-of-home placement plan shall be explained to all persons involved in its 84.13implementation, including the child who has signed the plan, and shall set forth:84.14    (1) a description of the residential facility including how the out-of-home placement 84.15plan is designed to achieve a safe placement for the child in the least restrictive, most 84.16family-like, setting available which is in close proximity to the home of the parent or 84.17parents or guardian of the child when the case plan goal is reunification, and how the 84.18placement is consistent with the best interests and special needs of the child according to 84.19the factors under subdivision 2, paragraph (b);84.20    (2) the specific reasons for the placement of the child in a residential facility, and 84.21when reunification is the plan, a description of the problems or conditions in the home of 84.22the parent or parents which necessitated removal of the child from home and the changes 84.23the parent or parents must make in order for the child to safely return home;84.24    (3) a description of the services offered and provided to prevent removal of the child 84.25from the home and to reunify the family including:84.26    (i) the specific actions to be taken by the parent or parents of the child to eliminate 84.27or correct the problems or conditions identified in clause (2), and the time period during 84.28which the actions are to be taken; and84.29    (ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made 84.30to achieve a safe and stable home for the child including social and other supportive 84.31services to be provided or offered to the parent or parents or guardian of the child, the 84.32child, and the residential facility during the period the child is in the residential facility;84.33    (4) a description of any services or resources that were requested by the child or the 84.34child's parent, guardian, foster parent, or custodian since the date of the child's placement 84.35in the residential facility, and whether those services or resources were provided and if 84.36not, the basis for the denial of the services or resources;85.1    (5) the visitation plan for the parent or parents or guardian, other relatives as defined 85.2in section 
         260C.007, subdivision 27, and siblings of the child if the siblings are not placed 85.3together in the residential facility, and whether visitation is consistent with the best interest 85.4of the child, during the period the child is in the residential facility;85.5    (6) documentation of steps to finalize the adoption or legal guardianship of the child 85.6if the court has issued an order terminating the rights of both parents of the child or of 85.7the only known, living parent of the child, and. At a minimum, the documentation must 85.8include child-specific recruitment efforts such as relative search and the use of state, 85.9regional, and national adoption exchanges to facilitate orderly and timely placements in 85.10and outside of the state. A copy of this documentation shall be provided to the court in the 85.11review required under section 
         260C.317, subdivision 3, paragraph (b);85.12    (7) to the extent available and accessible, the health and educational records of the 85.13child including the most recent information available regarding:85.14    (i) the names and addresses of the child's health and educational providers;85.15    (ii) the child's grade level performance;85.16    (iii) the child's school record;85.17    (iv) assurances that the child's placement in foster care takes into account proximity 85.18to the school in which the child is enrolled at the time of placement;85.19    (v) a record of the child's immunizations;85.20    (vi) the child's known medical problems, including any known communicable 85.21diseases, as defined in section 
         144.4172, subdivision 2;85.22    (vii) the child's medications; and85.23    (viii) any other relevant health and education information;85.24    (8) an independent living plan for a child age 16 or older who is in placement as 85.25a result of a permanency disposition. The plan should include, but not be limited to, 85.26the following objectives:85.27    (i) educational, vocational, or employment planning;85.28    (ii) health care planning and medical coverage;85.29    (iii) transportation including, where appropriate, assisting the child in obtaining a 85.30driver's license;85.31    (iv) money management;85.32    (v) planning for housing;85.33    (vi) social and recreational skills; and85.34    (vii) establishing and maintaining connections with the child's family and 85.35community; and86.1    (9) for a child in placement due solely or in part to the child's emotional disturbance, 86.2diagnostic and assessment information, specific services relating to meeting the mental 86.3health care needs of the child, and treatment outcomes.86.4    (d) The parent or parents or guardian and the child each shall have the right to legal 86.5counsel in the preparation of the case plan and shall be informed of the right at the time 86.6of placement of the child. The child shall also have the right to a guardian ad litem. 86.7If unable to employ counsel from their own resources, the court shall appoint counsel 86.8upon the request of the parent or parents or the child or the child's legal guardian. The 86.9parent or parents may also receive assistance from any person or social services agency 86.10in preparation of the case plan.86.11    After the plan has been agreed upon by the parties involved or approved or ordered 86.12by the court, the foster parents shall be fully informed of the provisions of the case plan 86.13and shall be provided a copy of the plan.86.14    Upon discharge from foster care, the parent, adoptive parent, or permanent legal and 86.15physical custodian, as appropriate, and the child, if appropriate, must be provided with 86.16a current copy of the child's health and education record.86.17    Sec. 74. Minnesota Statutes 2006, section 260C.212, subdivision 4, is amended to read:86.18    Subd. 4. Responsible social service agency's duties for children in placement. (a) 86.19When a child is in placement, the responsible social services agency shall make diligent 86.20efforts to identify, locate, and, where appropriate, offer services to both parents of the child.86.21    (1) The responsible social services agency shall assess whether a noncustodial or 86.22nonadjudicated parent is willing and capable of providing for the day-to-day care of the 86.23child temporarily or permanently. An assessment under this clause may include, but 86.24is not limited to, obtaining information under section 
         260C.209. If after assessment, 86.25the responsible social services agency determines that a noncustodial or nonadjudicated 86.26parent is willing and capable of providing day-to-day care of the child, the responsible 86.27social services agency may seek authority from the custodial parent or the court to have 86.28that parent assume day-to-day care of the child. If a parent is not an adjudicated parent, 86.29the responsible social services agency shall require the nonadjudicated parent to cooperate 86.30with paternity establishment procedures as part of the case plan.86.31    (2) If, after assessment, the responsible social services agency determines that the 86.32child cannot be in the day-to-day care of either parent, the agency shall:86.33    (i) prepare an out-of-home placement plan addressing the conditions that each parent 86.34must meet before the child can be in that parent's day-to-day care; and87.1    (ii) provide a parent who is the subject of a background study under section 87.2260C.209
          15 days' notice that it intends to use the study to recommend against putting the 87.3child with that parent, as well as the notice provided in section 
         260C.209, subdivision 4, 87.4and the court shall afford the parent an opportunity to be heard concerning the study.87.5    The results of a background study of a noncustodial parent shall not be used by the 87.6agency to determine that the parent is incapable of providing day-to-day care of the child 87.7unless the agency reasonably believes that placement of the child into the home of that 87.8parent would endanger the child's health, safety, or welfare.87.9    (3) If, after the provision of services following an out-of-home placement plan under 87.10this section, the child cannot return to the care of the parent from whom the child was 87.11removed or who had legal custody at the time the child was placed in foster care, the 87.12agency may petition on behalf of a noncustodial parent to establish legal custody with 87.13that parent under section 
         260C.201, subdivision 11. If paternity has not already been 87.14established, it may be established in the same proceeding in the manner provided for 87.15under chapter 257.87.16    (4) The responsible social services agency may be relieved of the requirement to 87.17locate and offer services to both parents by the juvenile court upon a finding of good cause 87.18after the filing of a petition under section 
         260C.141.87.19    (b) The responsible social services agency shall give notice to the parent or parents 87.20or guardian of each child in a residential facility, other than a child in placement due 87.21solely to that child's developmental disability or emotional disturbance, of the following 87.22information:87.23    (1) that residential care of the child may result in termination of parental rights or an 87.24order permanently placing the child out of the custody of the parent, but only after notice 87.25and a hearing as required under chapter 260C and the juvenile court rules;87.26    (2) time limits on the length of placement and of reunification services, including 87.27the date on which the child is expected to be returned to and safely maintained in the 87.28home of the parent or parents or placed for adoption or otherwise permanently removed 87.29from the care of the parent by court order;87.30    (3) the nature of the services available to the parent;87.31    (4) the consequences to the parent and the child if the parent fails or is unable to use 87.32services to correct the circumstances that led to the child's placement;87.33    (5) the first consideration for placement with relatives;87.34    (6) the benefit to the child in getting the child out of residential care as soon as 87.35possible, preferably by returning the child home, but if that is not possible, through a 87.36permanent legal placement of the child away from the parent;88.1    (7) when safe for the child, the benefits to the child and the parent of maintaining 88.2visitation with the child as soon as possible in the course of the case and, in any event, 88.3according to the visitation plan under this section; and88.4    (8) the financial responsibilities and obligations, if any, of the parent or parents for 88.5the support of the child during the period the child is in the residential facility.88.6    (c) The responsible social services agency shall inform a parent considering 88.7voluntary placement of a child who is not developmentally disabled or emotionally 88.8disturbed of the following information:88.9    (1) the parent and the child each has a right to separate legal counsel before signing a 88.10voluntary placement agreement, but not to counsel appointed at public expense;88.11    (2) the parent is not required to agree to the voluntary placement, and a parent 88.12who enters a voluntary placement agreement may at any time request that the agency 88.13return the child. If the parent so requests, the child must be returned within 24 hours of 88.14the receipt of the request;88.15    (3) evidence gathered during the time the child is voluntarily placed may be used 88.16at a later time as the basis for a petition alleging that the child is in need of protection 88.17or services or as the basis for a petition seeking termination of parental rights or other 88.18permanent placement of the child away from the parent;88.19    (4) if the responsible social services agency files a petition alleging that the child is 88.20in need of protection or services or a petition seeking the termination of parental rights 88.21or other permanent placement of the child away from the parent, the parent would have 88.22the right to appointment of separate legal counsel and the child would have a right to the 88.23appointment of counsel and a guardian ad litem as provided by law, and that counsel will 88.24be appointed at public expense if they are unable to afford counsel; and88.25    (5) the timelines and procedures for review of voluntary placements under 88.26subdivision 3, and the effect the time spent in voluntary placement on the scheduling of a 88.27permanent placement determination hearing under section 
         260C.201, subdivision 11.88.28    (d) When an agency accepts a child for placement, the agency shall determine 88.29whether the child has had a physical examination by or under the direction of a licensed 88.30physician within the 12 months immediately preceding the date when the child came into 88.31the agency's care. If there is documentation that the child has had an examination within 88.32the last 12 months, the agency is responsible for seeing that the child has another physical 88.33examination within one year of the documented examination and annually in subsequent 88.34years. If the agency determines that the child has not had a physical examination within 88.35the 12 months immediately preceding placement, the agency shall ensure that the child 89.1has an examination within 30 days of coming into the agency's care and once a year 89.2in subsequent years.89.3    (e) If a child leaves foster care by reason of having attained the age of majority 89.4under state law, the child must be given at no cost a copy of the child's health and 89.5education report.89.6    Sec. 75. Minnesota Statutes 2006, section 260C.212, subdivision 9, is amended to read:89.7    Subd. 9. Review of certain child placements. (a) When a developmentally 89.8disabled child or emotionally disturbed child needs placement in a residential facility for 89.9the sole reason of accessing services or a level of skilled care that cannot be provided in 89.10the parent's home, the child must be placed pursuant to a voluntary placement agreement 89.11between the responsible social services agency and the child's parent. The voluntary 89.12placement agreement must give the responsible social services agency legal responsibility 89.13for the child's physical care, custody, and control, but must not transfer legal custody of 89.14the child to the agency. The voluntary placement agreement must be executed in a form 89.15developed and promulgated by the commissioner of human services. The responsible 89.16social services agency shall report to the commissioner the number of children who are the 89.17subject of a voluntary placement agreement under this subdivision and other information 89.18regarding these children as the commissioner may require.89.19    (b) If a developmentally disabled child or a child diagnosed as emotionally disturbed 89.20has been placed in a residential facility pursuant to a voluntary release by the child's parent 89.21or parents because of the child's disabling conditions or need for long-term residential 89.22treatment or supervision, the social services agency responsible for the placement shall 89.23report to the court and bring a petition for review of the child's foster care status as 89.24required in section 
         260C.141, subdivision 2a. 89.25    (b)(c) If a child is in placement due solely to the child's developmental disability or 89.26emotional disturbance, and the court finds compelling reasons not to proceed under section 89.27260C.201, subdivision 11
         , and custody of the child is not transferred to the responsible 89.28social services agency under section 
         260C.201, subdivision 1, paragraph (a), clause (2), 89.29and no petition is required by section 
         260C.201, subdivision 11. 89.30    (c)(d) Whenever a petition for review is brought pursuant to this subdivision, a 89.31guardian ad litem shall be appointed for the child.89.32    Sec. 76. Minnesota Statutes 2006, section 260C.317, subdivision 3, is amended to read:89.33    Subd. 3. Order; retention of jurisdiction. (a) A certified copy of the findings and 89.34the order terminating parental rights, and a summary of the court's information concerning 90.1the child shall be furnished by the court to the commissioner or the agency to which 90.2guardianship is transferred. The orders shall be on a document separate from the findings. 90.3The court shall furnish the individual to whom guardianship is transferred a copy of the 90.4order terminating parental rights.90.5    (b) The court shall retain jurisdiction in a case where adoption is the intended 90.6permanent placement disposition until the child's adoption is finalized, the child is 18 years 90.7of age, or the child is otherwise ordered discharged from the jurisdiction of the court. The 90.8guardian ad litem and counsel for the child shall continue on the case until an adoption 90.9decree is entered. A hearing must be held every 90 days following termination of parental 90.10rights for the court to review progress toward an adoptive placement and the specific 90.11recruitment efforts the agency has taken to find an adoptive family or other placement 90.12living arrangement for the child and to finalize the adoption or other permanency plan.90.13    (c) The responsible social services agency may make a determination of compelling 90.14reasons for a child to be in long-term foster care when the agency has made exhaustive 90.15efforts to recruit, identify, and place the child in an adoptive home, and the child continues 90.16in foster care for at least 24 months after the court has issued the order terminating 90.17parental rights. A child of any age who is under the guardianship of the commissioner of 90.18the Department of Human Services and is legally available for adoption may not refuse 90.19or waive the commissioner's agent's exhaustive efforts to recruit, identify, and place the 90.20child in an adoptive home required under paragraph (b) or sign a document relieving 90.21county social services agencies of all recruitment efforts on the child's behalf. Upon 90.22approving the agency's determination of compelling reasons, the court may order the 90.23child placed in long-term foster care. At least every 12 months thereafter as long as the 90.24child continues in out-of-home placement, the court shall conduct a permanency review 90.25hearing to determine the future status of the child using the review requirements of section 90.26260C.201, subdivision 11
         , paragraph (g).90.27    (d) The court shall retain jurisdiction through the child's minority in a case where 90.28long-term foster care is the permanent disposition whether under paragraph (c) or section 90.29260C.201, subdivision 11
         .90.30    Sec. 77. Minnesota Statutes 2006, section 260C.331, subdivision 1, is amended to read:90.31    Subdivision 1. Care, examination, or treatment. (a) Except where parental rights 90.32are terminated,90.33    (1) whenever legal custody of a child is transferred by the court to a responsible 90.34social services agency,91.1    (2) whenever legal custody is transferred to a person other than the responsible social 91.2services agency, but under the supervision of the responsible social services agency, or91.3    (3) whenever a child is given physical or mental examinations or treatment under 91.4order of the court, and no provision is otherwise made by law for payment for the care, 91.5examination, or treatment of the child, these costs are a charge upon the welfare funds of 91.6the county in which proceedings are held upon certification of the judge of juvenile court.91.7    (b) The court shall order, and the responsible social services agency shall require, 91.8the parents or custodian of a child, while the child is under the age of 18, to use the 91.9total income and resources attributable to the child for the period of care, examination, 91.10or treatment, except for clothing and personal needs allowance as provided in section 91.11256B.35
         , to reimburse the county for the cost of care, examination, or treatment. Income 91.12and resources attributable to the child include, but are not limited to, Social Security 91.13benefits, supplemental security income (SSI), veterans benefits, railroad retirement 91.14benefits and child support. When the child is over the age of 18, and continues to receive 91.15care, examination, or treatment, the court shall order, and the responsible social services 91.16agency shall require, reimbursement from the child for the cost of care, examination, or 91.17treatment from the income and resources attributable to the child less the clothing and 91.18personal needs allowance. Income does not include earnings from a child over the age of 91.1918 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c), 91.20clause (8), to transition from foster care.91.21    (c) If the income and resources attributable to the child are not enough to reimburse 91.22the county for the full cost of the care, examination, or treatment, the court shall inquire 91.23into the ability of the parents to support the child and, after giving the parents a reasonable 91.24opportunity to be heard, the court shall order, and the responsible social services agency 91.25shall require, the parents to contribute to the cost of care, examination, or treatment of 91.26the child. When determining the amount to be contributed by the parents, the court shall 91.27use a fee schedule based upon ability to pay that is established by the responsible social 91.28services agency and approved by the commissioner of human services. The income of 91.29a stepparent who has not adopted a child shall be excluded in calculating the parental 91.30contribution under this section.91.31    (d) The court shall order the amount of reimbursement attributable to the parents 91.32or custodian, or attributable to the child, or attributable to both sources, withheld under 91.33chapter 518A from the income of the parents or the custodian of the child. A parent or 91.34custodian who fails to pay without good reason may be proceeded against for contempt, or 91.35the court may inform the county attorney, who shall proceed to collect the unpaid sums, 91.36or both procedures may be used.92.1    (e) If the court orders a physical or mental examination for a child, the examination 92.2is a medically necessary service for purposes of determining whether the service is 92.3covered by a health insurance policy, health maintenance contract, or other health 92.4coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan 92.5requirements for medical necessity. Nothing in this paragraph changes or eliminates 92.6benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions, 92.7or other requirements in the policy, contract, or plan that relate to coverage of other 92.8medically necessary services.92.9    Sec. 78. Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:92.10    Subdivision 1. Disclosure to commissioner of human services. (a) On the request 92.11of the commissioner of human services, the commissioner shall disclose return information 92.12regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to 92.13the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).92.14    (b) Data that may be disclosed are limited to data relating to the identity, 92.15whereabouts, employment, income, and property of a person owing or alleged to be owing 92.16an obligation of child support.92.17    (c) The commissioner of human services may request data only for the purposes of 92.18carrying out the child support enforcement program and to assist in the location of parents 92.19who have, or appear to have, deserted their children. Data received may be used only 92.20as set forth in section 
         256.978. 92.21    (d) The commissioner shall provide the records and information necessary to 92.22administer the supplemental housing allowance to the commissioner of human services.92.23    (e) At the request of the commissioner of human services, the commissioner of 92.24revenue shall electronically match the Social Security numbers and names of participants 92.25in the telephone assistance plan operated under sections 
         237.69 to 
         237.711, with those of 92.26property tax refund filers, and determine whether each participant's household income is 92.27within the eligibility standards for the telephone assistance plan. 92.28    (f) The commissioner may provide records and information collected under sections 92.29295.50
          to 
         295.59 to the commissioner of human services for purposes of the Medicaid 92.30Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law 92.31102-234. Upon the written agreement by the United States Department of Health and 92.32Human Services to maintain the confidentiality of the data, the commissioner may provide 92.33records and information collected under sections 
         295.50 to 
         295.59 to the Centers for 92.34Medicare and Medicaid Services section of the United States Department of Health and 92.35Human Services for purposes of meeting federal reporting requirements. 93.1    (g) The commissioner may provide records and information to the commissioner of 93.2human services as necessary to administer the early refund of refundable tax credits.93.3    (h) The commissioner may disclose information to the commissioner of human 93.4services necessary to verify income for eligibility and premium payment under the 93.5MinnesotaCare program, under section 
         256L.05, subdivision 2. 93.6    (i) The commissioner may disclose information to the commissioner of human 93.7services necessary to verify whether applicants or recipients for the Minnesota family 93.8investment program, general assistance, food support, and Minnesota supplemental aid 93.9program, and child care assistance have claimed refundable tax credits under chapter 290 93.10and the property tax refund under chapter 290A, and the amounts of the credits.93.11    Sec. 79. Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to read:93.12    Subd. 2. Definitions. As used in this section, the following terms have the meanings 93.13given them unless the specific content indicates otherwise:93.14    (a) "Family assessment" means a comprehensive assessment of child safety, risk 93.15of subsequent child maltreatment, and family strengths and needs that is applied to a 93.16child maltreatment report that does not allege substantial child endangerment. Family 93.17assessment does not include a determination as to whether child maltreatment occurred 93.18but does determine the need for services to address the safety of family members and the 93.19risk of subsequent maltreatment.93.20    (b) "Investigation" means fact gathering related to the current safety of a child 93.21and the risk of subsequent maltreatment that determines whether child maltreatment 93.22occurred and whether child protective services are needed. An investigation must be used 93.23when reports involve substantial child endangerment, and for reports of maltreatment in 93.24facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to 93.25144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and 93.2613, and 124D.10; or in a nonlicensed personal care provider association as defined in 93.27sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.93.28    (c) "Substantial child endangerment" means a person responsible for a child's care, 93.29and in the case of sexual abuse includes a person who has a significant relationship to the 93.30child as defined in section 609.341, or a person in a position of authority as defined in 93.31section 609.341, who by act or omission commits or attempts to commit an act against a 93.32child under their care that constitutes any of the following:93.33    (1) egregious harm as defined in section 260C.007, subdivision 14;93.34    (2) sexual abuse as defined in paragraph (d);93.35    (3) abandonment under section 260C.301, subdivision 2;94.1    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the 94.2child's physical or mental health, including a growth delay, which may be referred to as 94.3failure to thrive, that has been diagnosed by a physician and is due to parental neglect;94.4    (5) murder in the first, second, or third degree under section 609.185, 609.19, or 94.5609.195;94.6    (6) manslaughter in the first or second degree under section 609.20 or 609.205;94.7    (7) assault in the first, second, or third degree under section 609.221, 609.222, or 94.8609.223;94.9    (8) solicitation, inducement, and promotion of prostitution under section 609.322;94.10    (9) criminal sexual conduct under sections 609.342 to 609.3451;94.11    (10) solicitation of children to engage in sexual conduct under section 609.352;94.12    (11) malicious punishment or neglect or endangerment of a child under section 94.13609.377 or 609.378;94.14    (12) use of a minor in sexual performance under section 617.246; or94.15    (13) parental behavior, status, or condition which mandates that the county attorney 94.16file a termination of parental rights petition under section 260C.301, subdivision 3, 94.17paragraph (a).94.18    (d) "Sexual abuse" means the subjection of a child by a person responsible for the 94.19child's care, by a person who has a significant relationship to the child, as defined in 94.20section 609.341, or by a person in a position of authority, as defined in section 609.341, 94.21subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual 94.22conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 94.23609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct 94.24in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual 94.25abuse also includes any act which involves a minor which constitutes a violation of 94.26prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes 94.27threatened sexual abuse.94.28    (e) "Person responsible for the child's care" means (1) an individual functioning 94.29within the family unit and having responsibilities for the care of the child such as a 94.30parent, guardian, or other person having similar care responsibilities, or (2) an individual 94.31functioning outside the family unit and having responsibilities for the care of the child 94.32such as a teacher, school administrator, other school employees or agents, or other lawful 94.33custodian of a child having either full-time or short-term care responsibilities including, 94.34but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, 94.35and coaching.94.36    (f) "Neglect" means:95.1    (1) failure by a person responsible for a child's care to supply a child with necessary 95.2food, clothing, shelter, health, medical, or other care required for the child's physical or 95.3mental health when reasonably able to do so;95.4    (2) failure to protect a child from conditions or actions that seriously endanger the 95.5child's physical or mental health when reasonably able to do so, including a growth delay, 95.6which may be referred to as a failure to thrive, that has been diagnosed by a physician and 95.7is due to parental neglect;95.8    (3) failure to provide for necessary supervision or child care arrangements 95.9appropriate for a child after considering factors as the child's age, mental ability, physical 95.10condition, length of absence, or environment, when the child is unable to care for the 95.11child's own basic needs or safety, or the basic needs or safety of another child in their care;95.12    (4) failure to ensure that the child is educated as defined in sections 120A.22 and 95.13260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 95.14child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;95.15    (5) nothing in this section shall be construed to mean that a child is neglected solely 95.16because the child's parent, guardian, or other person responsible for the child's care in 95.17good faith selects and depends upon spiritual means or prayer for treatment or care of 95.18disease or remedial care of the child in lieu of medical care; except that a parent, guardian, 95.19or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report 95.20if a lack of medical care may cause serious danger to the child's health. This section does 95.21not impose upon persons, not otherwise legally responsible for providing a child with 95.22necessary food, clothing, shelter, education, or medical care, a duty to provide that care;95.23    (6) prenatal exposure to a controlled substance, as defined in section 253B.02, 95.24subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal 95.25symptoms in the child at birth, results of a toxicology test performed on the mother at 95.26delivery or the child at birth, or medical effects or developmental delays during the child's 95.27first year of life that medically indicate prenatal exposure to a controlled substance;95.28    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);95.29    (8) chronic and severe use of alcohol or a controlled substance by a parent or 95.30person responsible for the care of the child that adversely affects the child's basic needs 95.31and safety; or95.32    (9) emotional harm from a pattern of behavior which contributes to impaired 95.33emotional functioning of the child which may be demonstrated by a substantial and 95.34observable effect in the child's behavior, emotional response, or cognition that is not 95.35within the normal range for the child's age and stage of development, with due regard to 95.36the child's culture.96.1    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury, 96.2inflicted by a person responsible for the child's care on a child other than by accidental 96.3means, or any physical or mental injury that cannot reasonably be explained by the child's 96.4history of injuries, or any aversive or deprivation procedures, or regulated interventions, 96.5that have not been authorized under section 121A.67 or 245.825. Abuse does not include 96.6reasonable and moderate physical discipline of a child administered by a parent or legal 96.7guardian which does not result in an injury. Abuse does not include the use of reasonable 96.8force by a teacher, principal, or school employee as allowed by section 121A.582. Actions 96.9which are not reasonable and moderate include, but are not limited to, any of the following 96.10that are done in anger or without regard to the safety of the child:96.11    (1) throwing, kicking, burning, biting, or cutting a child;96.12    (2) striking a child with a closed fist;96.13    (3) shaking a child under age three;96.14    (4) striking or other actions which result in any nonaccidental injury to a child 96.15under 18 months of age;96.16    (5) unreasonable interference with a child's breathing;96.17    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;96.18    (7) striking a child under age one on the face or head;96.19    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 96.20substances which were not prescribed for the child by a practitioner, in order to control or 96.21punish the child; or other substances that substantially affect the child's behavior, motor 96.22coordination, or judgment or that results in sickness or internal injury, or subjects the 96.23child to medical procedures that would be unnecessary if the child were not exposed 96.24to the substances;96.25    (9) unreasonable physical confinement or restraint not permitted under section 96.26609.379, including but not limited to tying, caging, or chaining; or96.27    (10) in a school facility or school zone, an act by a person responsible for the child's 96.28care that is a violation under section 121A.58.96.29    (h) "Report" means any report received by the local welfare agency, police 96.30department, county sheriff, or agency responsible for assessing or investigating 96.31maltreatment pursuant to this section.96.32    (i) "Facility" means: 96.33    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital, 96.34sanitarium, or other facility or institution required to be licensed under sections 144.50 to 96.35144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B; 97.1    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 97.2124D.10; or 97.3    (3) a nonlicensed personal care provider organization as defined in sections 256B.04, 97.4subdivision 16, and 256B.0625, subdivision 19a.97.5    (j) "Operator" means an operator or agency as defined in section 245A.02.97.6    (k) "Commissioner" means the commissioner of human services.97.7    (l) "Practice of social services," for the purposes of subdivision 3, includes but is 97.8not limited to employee assistance counseling and the provision of guardian ad litem and 97.9parenting time expeditor services.97.10    (m) "Mental injury" means an injury to the psychological capacity or emotional 97.11stability of a child as evidenced by an observable or substantial impairment in the child's 97.12ability to function within a normal range of performance and behavior with due regard to 97.13the child's culture.97.14    (n) "Threatened injury" means a statement, overt act, condition, or status that 97.15represents a substantial risk of physical or sexual abuse or mental injury. Threatened 97.16injury includes, but is not limited to, exposing a child to a person responsible for the 97.17child's care, as defined in paragraph (e), clause (1), who has:97.18    (1) subjected a child to, or failed to protect a child from, an overt act or condition 97.19that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a 97.20similar law of another jurisdiction;97.21    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause 97.22(4), or a similar law of another jurisdiction;97.23    (3) committed an act that has resulted in an involuntary termination of parental rights 97.24under section 260C.301, or a similar law of another jurisdiction; or97.25    (4) committed an act that has resulted in the involuntary transfer of permanent legal 97.26and physical custody of a child to a relative under section 260C.201, subdivision 11, 97.27paragraph (d), clause (1), or a similar law of another jurisdiction.97.28    (o) Persons who conduct assessments or investigations under this section shall take 97.29into account accepted child-rearing practices of the culture in which a child participates 97.30and accepted teacher discipline practices, which are not injurious to the child's health, 97.31welfare, and safety.97.32    Sec. 80. Minnesota Statutes 2006, section 626.556, subdivision 3, is amended to read:97.33    Subd. 3. Persons mandated to report. (a) A person who knows or has reason 97.34to believe a child is being neglected or physically or sexually abused, as defined in 97.35subdivision 2, or has been neglected or physically or sexually abused within the preceding 98.1three years, shall immediately report the information to the local welfare agency, agency 98.2responsible for assessing or investigating the report, police department, or the county 98.3sheriff if the person is:98.4    (1) a professional or professional's delegate who is engaged in the practice of 98.5the healing arts, social services, hospital administration, psychological or psychiatric 98.6treatment, child care, education, correctional supervision, probation and correctional 98.7services, or law enforcement; or98.8    (2) employed as a member of the clergy and received the information while 98.9engaged in ministerial duties, provided that a member of the clergy is not required by 98.10this subdivision to report information that is otherwise privileged under section 
         595.02, 98.11subdivision 1
         , paragraph (c).98.12    The police department or the county sheriff, upon receiving a report, shall 98.13immediately notify the local welfare agency or agency responsible for assessing or 98.14investigating the report, orally and in writing. The local welfare agency, or agency 98.15responsible for assessing or investigating the report, upon receiving a report, shall 98.16immediately notify the local police department or the county sheriff orally and in writing. 98.17The county sheriff and the head of every local welfare agency, agency responsible 98.18for assessing or investigating reports, and police department shall each designate a 98.19person within their agency, department, or office who is responsible for ensuring that 98.20the notification duties of this paragraph and paragraph (b) are carried out. Nothing in 98.21this subdivision shall be construed to require more than one report from any institution, 98.22facility, school, or agency.98.23    (b) Any person may voluntarily report to the local welfare agency, agency 98.24responsible for assessing or investigating the report, police department, or the county 98.25sheriff if the person knows, has reason to believe, or suspects a child is being or has been 98.26neglected or subjected to physical or sexual abuse. The police department or the county 98.27sheriff, upon receiving a report, shall immediately notify the local welfare agency or 98.28agency responsible for assessing or investigating the report, orally and in writing. The 98.29local welfare agency or agency responsible for assessing or investigating the report, upon 98.30receiving a report, shall immediately notify the local police department or the county 98.31sheriff orally and in writing.98.32    (c) A person mandated to report physical or sexual child abuse or neglect occurring 98.33within a licensed facility shall report the information to the agency responsible for 98.34licensing the facility under sections 
         144.50 to 
         144.58; 
         241.021; 
         245A.01 to 
         245A.16; or 98.35chapter 245B; or a nonlicensed personal care provider organization as defined in sections 98.36256B.04, subdivision 16
         ; and 
         256B.0625, subdivision 19. A health or corrections agency 99.1receiving a report may request the local welfare agency to provide assistance pursuant 99.2to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work 99.3within a school facility, upon receiving a complaint of alleged maltreatment, shall provide 99.4information about the circumstances of the alleged maltreatment to the commissioner of 99.5education. Section 
         13.03, subdivision 4, applies to data received by the commissioner of 99.6education from a licensing entity.99.7    (d) Any person mandated to report shall receive a summary of the disposition of 99.8any report made by that reporter, including whether the case has been opened for child 99.9protection or other services, or if a referral has been made to a community organization, 99.10unless release would be detrimental to the best interests of the child. Any person who is 99.11not mandated to report shall, upon request to the local welfare agency, receive a concise 99.12summary of the disposition of any report made by that reporter, unless release would be 99.13detrimental to the best interests of the child.99.14    (e) For purposes of this subdivision section, "immediately" means as soon as 99.15possible but in no event longer than 24 hours.99.16    Sec. 81. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision 99.17to read:99.18    Subd. 3e.Agency responsibility for assessing or investigating reports of sexual 99.19abuse.The local welfare agency is the agency responsible for investigating allegations 99.20of sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual 99.21functioning within the family unit as a person responsible for the child's care, or a person 99.22with a significant relationship to the child if that person resides in the child's household.99.23    Sec. 82. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision 99.24to read:99.25    Subd. 3f.Law enforcement agency responsibility for investigating 99.26maltreatment.The local law enforcement agency has responsibility for investigating any 99.27report of child maltreatment if a violation of a criminal statute is alleged. Law enforcement 99.28and the responsible agency must coordinate their investigations or assessments as required 99.29under subdivision 10.99.30    Sec. 83. Minnesota Statutes 2006, section 626.556, subdivision 10, is amended to read:99.31    Subd. 10. Duties of local welfare agency and local law enforcement agency upon 99.32receipt of a report. (a) Upon receipt of a report, the local welfare agency shall determine 100.1whether to conduct a family assessment or an investigation as appropriate to prevent or 100.2provide a remedy for child maltreatment. The local welfare agency:100.3    (1) shall conduct an investigation on reports involving substantial child 100.4endangerment;100.5    (2) shall begin an immediate investigation if, at any time when it is using a family 100.6assessment response, it determines that there is reason to believe that substantial child 100.7endangerment or a serious threat to the child's safety exists;100.8    (3) may conduct a family assessment for reports that do not allege substantial child 100.9endangerment. In determining that a family assessment is appropriate, the local welfare 100.10agency may consider issues of child safety, parental cooperation, and the need for an 100.11immediate response; and100.12    (4) may conduct a family assessment on a report that was initially screened and 100.13assigned for an investigation. In determining that a complete investigation is not required, 100.14the local welfare agency must document the reason for terminating the investigation and 100.15notify the local law enforcement agency if the local law enforcement agency is conducting 100.16a joint investigation.100.17    If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian, 100.18or individual functioning within the family unit as a person responsible for the child's 100.19care, or sexual abuse by a person with a significant relationship to the child when that 100.20person resides in the child's household or by a sibling, the local welfare agency shall 100.21immediately conduct a family assessment or investigation as identified in clauses (1) to 100.22(4). In conducting a family assessment or investigation, the local welfare agency shall 100.23gather information on the existence of substance abuse and domestic violence and offer 100.24services for purposes of preventing future child maltreatment, safeguarding and enhancing 100.25the welfare of the abused or neglected minor, and supporting and preserving family 100.26life whenever possible. If the report alleges a violation of a criminal statute involving 100.27sexual abuse, physical abuse, or neglect or endangerment, under section 
         609.378, the 100.28local law enforcement agency and local welfare agency shall coordinate the planning and 100.29execution of their respective investigation and assessment efforts to avoid a duplication of 100.30fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of 100.31the results of its investigation. In cases of alleged child maltreatment resulting in death, 100.32the local agency may rely on the fact-finding efforts of a law enforcement investigation 100.33to make a determination of whether or not maltreatment occurred. When necessary the 100.34local welfare agency shall seek authority to remove the child from the custody of a parent, 100.35guardian, or adult with whom the child is living. In performing any of these duties, the 100.36local welfare agency shall maintain appropriate records.101.1    If the family assessment or investigation indicates there is a potential for abuse of 101.2alcohol or other drugs by the parent, guardian, or person responsible for the child's care, 101.3the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota 101.4Rules, part 9530.6615. The local welfare agency shall report the determination of the 101.5chemical use assessment, and the recommendations and referrals for alcohol and other 101.6drug treatment services to the state authority on alcohol and drug abuse.101.7    (b) When a local agency receives a report or otherwise has information indicating 101.8that a child who is a client, as defined in section 
         245.91, has been the subject of physical 101.9abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section 101.10245.91
         , it shall, in addition to its other duties under this section, immediately inform the 101.11ombudsman established under sections 
         245.91 to 
         245.97. The commissioner of education 101.12shall inform the ombudsman established under sections 
         245.91 to 
         245.97 of reports 101.13regarding a child defined as a client in section 
         245.91 that maltreatment occurred at a 101.14school as defined in sections 
         120A.05, subdivisions 9, 11, and 13, and 
         124D.10.101.15    (c) Authority of the local welfare agency responsible for assessing or investigating 101.16the child abuse or neglect report, the agency responsible for assessing or investigating 101.17the report, and of the local law enforcement agency for investigating the alleged abuse or 101.18neglect includes, but is not limited to, authority to interview, without parental consent, 101.19the alleged victim and any other minors who currently reside with or who have resided 101.20with the alleged offender. The interview may take place at school or at any facility or 101.21other place where the alleged victim or other minors might be found or the child may be 101.22transported to, and the interview conducted at, a place appropriate for the interview of a 101.23child designated by the local welfare agency or law enforcement agency. The interview 101.24may take place outside the presence of the alleged offender or parent, legal custodian, 101.25guardian, or school official. For family assessments, it is the preferred practice to request 101.26a parent or guardian's permission to interview the child prior to conducting the child 101.27interview, unless doing so would compromise the safety assessment. Except as provided in 101.28this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible 101.29local welfare or law enforcement agency no later than the conclusion of the investigation 101.30or assessment that this interview has occurred. Notwithstanding rule 
         49.02 32 of the 101.31Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on 101.32an ex parte motion by the local welfare agency, order that, where reasonable cause exists, 101.33the agency withhold notification of this interview from the parent, legal custodian, or 101.34guardian. If the interview took place or is to take place on school property, the order shall 101.35specify that school officials may not disclose to the parent, legal custodian, or guardian the 101.36contents of the notification of intent to interview the child on school property, as provided 102.1under this paragraph, and any other related information regarding the interview that may 102.2be a part of the child's school record. A copy of the order shall be sent by the local welfare 102.3or law enforcement agency to the appropriate school official.102.4    (d) When the local welfare, local law enforcement agency, or the agency responsible 102.5for assessing or investigating a report of maltreatment determines that an interview should 102.6take place on school property, written notification of intent to interview the child on school 102.7property must be received by school officials prior to the interview. The notification 102.8shall include the name of the child to be interviewed, the purpose of the interview, and 102.9a reference to the statutory authority to conduct an interview on school property. For 102.10interviews conducted by the local welfare agency, the notification shall be signed by the 102.11chair of the local social services agency or the chair's designee. The notification shall be 102.12private data on individuals subject to the provisions of this paragraph. School officials 102.13may not disclose to the parent, legal custodian, or guardian the contents of the notification 102.14or any other related information regarding the interview until notified in writing by the 102.15local welfare or law enforcement agency that the investigation or assessment has been 102.16concluded, unless a school employee or agent is alleged to have maltreated the child. 102.17Until that time, the local welfare or law enforcement agency or the agency responsible 102.18for assessing or investigating a report of maltreatment shall be solely responsible for any 102.19disclosures regarding the nature of the assessment or investigation.102.20    Except where the alleged offender is believed to be a school official or employee, 102.21the time and place, and manner of the interview on school premises shall be within the 102.22discretion of school officials, but the local welfare or law enforcement agency shall have 102.23the exclusive authority to determine who may attend the interview. The conditions as to 102.24time, place, and manner of the interview set by the school officials shall be reasonable and 102.25the interview shall be conducted not more than 24 hours after the receipt of the notification 102.26unless another time is considered necessary by agreement between the school officials and 102.27the local welfare or law enforcement agency. Where the school fails to comply with the 102.28provisions of this paragraph, the juvenile court may order the school to comply. Every 102.29effort must be made to reduce the disruption of the educational program of the child, other 102.30students, or school staff when an interview is conducted on school premises.102.31    (e) Where the alleged offender or a person responsible for the care of the alleged 102.32victim or other minor prevents access to the victim or other minor by the local welfare 102.33agency, the juvenile court may order the parents, legal custodian, or guardian to produce 102.34the alleged victim or other minor for questioning by the local welfare agency or the local 102.35law enforcement agency outside the presence of the alleged offender or any person 102.36responsible for the child's care at reasonable places and times as specified by court order.103.1    (f) Before making an order under paragraph (e), the court shall issue an order to 103.2show cause, either upon its own motion or upon a verified petition, specifying the basis for 103.3the requested interviews and fixing the time and place of the hearing. The order to show 103.4cause shall be served personally and shall be heard in the same manner as provided in 103.5other cases in the juvenile court. The court shall consider the need for appointment of a 103.6guardian ad litem to protect the best interests of the child. If appointed, the guardian ad 103.7litem shall be present at the hearing on the order to show cause.103.8    (g) The commissioner of human services, the ombudsman for mental health and 103.9developmental disabilities, the local welfare agencies responsible for investigating reports, 103.10the commissioner of education, and the local law enforcement agencies have the right to 103.11enter facilities as defined in subdivision 2 and to inspect and copy the facility's records, 103.12including medical records, as part of the investigation. Notwithstanding the provisions of 103.13chapter 13, they also have the right to inform the facility under investigation that they are 103.14conducting an investigation, to disclose to the facility the names of the individuals under 103.15investigation for abusing or neglecting a child, and to provide the facility with a copy of 103.16the report and the investigative findings.103.17    (h) The local welfare agency responsible for conducting a family assessment or 103.18investigation shall collect available and relevant information to determine child safety, 103.19risk of subsequent child maltreatment, and family strengths and needs and share not public 103.20information with an Indian's tribal social services agency without violating any law of the 103.21state that may otherwise impose duties of confidentiality on the local welfare agency in 103.22order to implement the tribal state agreement. The local welfare agency or the agency 103.23responsible for investigating the report shall collect available and relevant information 103.24to ascertain whether maltreatment occurred and whether protective services are needed. 103.25Information collected includes, when relevant, information with regard to the person 103.26reporting the alleged maltreatment, including the nature of the reporter's relationship to the 103.27child and to the alleged offender, and the basis of the reporter's knowledge for the report; 103.28the child allegedly being maltreated; the alleged offender; the child's caretaker; and other 103.29collateral sources having relevant information related to the alleged maltreatment. The 103.30local welfare agency or the agency responsible for assessing or investigating the report 103.31may make a determination of no maltreatment early in an assessment, and close the case 103.32and retain immunity, if the collected information shows no basis for a full assessment or 103.33investigation.103.34    Information relevant to the assessment or investigation must be asked for, and 103.35may include:104.1    (1) the child's sex and age, prior reports of maltreatment, information relating 104.2to developmental functioning, credibility of the child's statement, and whether the 104.3information provided under this clause is consistent with other information collected 104.4during the course of the assessment or investigation;104.5    (2) the alleged offender's age, a record check for prior reports of maltreatment, and 104.6criminal charges and convictions. The local welfare agency or the agency responsible for 104.7assessing or investigating the report must provide the alleged offender with an opportunity 104.8to make a statement. The alleged offender may submit supporting documentation relevant 104.9to the assessment or investigation;104.10    (3) collateral source information regarding the alleged maltreatment and care of the 104.11child. Collateral information includes, when relevant: (i) a medical examination of the 104.12child; (ii) prior medical records relating to the alleged maltreatment or the care of the 104.13child maintained by any facility, clinic, or health care professional and an interview with 104.14the treating professionals; and (iii) interviews with the child's caretakers, including the 104.15child's parent, guardian, foster parent, child care provider, teachers, counselors, family 104.16members, relatives, and other persons who may have knowledge regarding the alleged 104.17maltreatment and the care of the child; and104.18    (4) information on the existence of domestic abuse and violence in the home of 104.19the child, and substance abuse.104.20    Nothing in this paragraph precludes the local welfare agency, the local law 104.21enforcement agency, or the agency responsible for assessing or investigating the report 104.22from collecting other relevant information necessary to conduct the assessment or 104.23investigation. Notwithstanding section 
         13.384 or 
         144.335, the local welfare agency has 104.24access to medical data and records for purposes of clause (3). Notwithstanding the data's 104.25classification in the possession of any other agency, data acquired by the local welfare 104.26agency or the agency responsible for assessing or investigating the report during the course 104.27of the assessment or investigation are private data on individuals and must be maintained 104.28in accordance with subdivision 11. Data of the commissioner of education collected 104.29or maintained during and for the purpose of an investigation of alleged maltreatment 104.30in a school are governed by this section, notwithstanding the data's classification as 104.31educational, licensing, or personnel data under chapter 13.104.32    In conducting an assessment or investigation involving a school facility as defined 104.33in subdivision 2, paragraph (i), the commissioner of education shall collect investigative 104.34reports and data that are relevant to a report of maltreatment and are from local law 104.35enforcement and the school facility.105.1    (i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face 105.2contact with the child reported to be maltreated and with the child's primary caregiver 105.3sufficient to complete a safety assessment and ensure the immediate safety of the child. 105.4The face-to-face contact with the child and primary caregiver shall occur immediately 105.5if substantial child endangerment is alleged and within five calendar days for all other 105.6reports. If the alleged offender was not already interviewed as the primary caregiver, the 105.7local welfare agency shall also conduct a face-to-face interview with the alleged offender 105.8in the early stages of the assessment or investigation. At the initial contact, the local child 105.9welfare agency or the agency responsible for assessing or investigating the report must 105.10inform the alleged offender of the complaints or allegations made against the individual in 105.11a manner consistent with laws protecting the rights of the person who made the report. 105.12The interview with the alleged offender may be postponed if it would jeopardize an active 105.13law enforcement investigation.105.14    (j) When conducting an investigation, the local welfare agency shall use a question 105.15and answer interviewing format with questioning as nondirective as possible to elicit 105.16spontaneous responses. For investigations only, the following interviewing methods and 105.17procedures must be used whenever possible when collecting information:105.18    (1) audio recordings of all interviews with witnesses and collateral sources; and105.19    (2) in cases of alleged sexual abuse, audio-video recordings of each interview with 105.20the alleged victim and child witnesses.105.21    (k) In conducting an assessment or investigation involving a school facility as 105.22defined in subdivision 2, paragraph (i), the commissioner of education shall collect 105.23available and relevant information and use the procedures in paragraphs (i), (k), and 105.24subdivision 3d, except that the requirement for face-to-face observation of the child 105.25and face-to-face interview of the alleged offender is to occur in the initial stages of the 105.26assessment or investigation provided that the commissioner may also base the assessment 105.27or investigation on investigative reports and data received from the school facility and 105.28local law enforcement, to the extent those investigations satisfy the requirements of 105.29paragraphs (i) and (k), and subdivision 3d.105.30    Sec. 84. Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to 105.31read:105.32    Subd. 10a. Abuse outside family unit Law enforcement agency responsibility 105.33for investigation; welfare agency reliance on law enforcement fact-finding; welfare 105.34agency offer of services.(a) If the report alleges neglect, physical abuse, or sexual abuse 105.35by a person who is not a parent, guardian, sibling, person responsible for the child's care 106.1functioning outside within the family unit, or a person who lives in the child's household 106.2and who has a significant relationship to the child, in a setting other than a facility as 106.3defined in subdivision 2, the local welfare agency shall immediately notify the appropriate 106.4law enforcement agency, which shall conduct an investigation of the alleged abuse or 106.5neglect if a violation of a criminal statute is alleged. 106.6    (b) The local agency may rely on the fact-finding efforts of the law enforcement 106.7investigation conducted under this subdivision to make a determination whether or not 106.8threatened harm or other maltreatment has occurred under subdivision 2 if an alleged 106.9offender has minor children or lives with minors.106.10    (c) The local welfare agency shall offer appropriate social services for the purpose of 106.11safeguarding and enhancing the welfare of the abused or neglected minor.106.12    Sec. 85. Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to 106.13read:106.14    Subd. 10c. Duties of local social service agency upon receipt of a report of 106.15medical neglect. If the report alleges medical neglect as defined in section 
         260C.007, 106.16subdivision 4 6, clause (5), the local welfare agency shall, in addition to its other duties 106.17under this section, immediately consult with designated hospital staff and with the parents 106.18of the infant to verify that appropriate nutrition, hydration, and medication are being 106.19provided; and shall immediately secure an independent medical review of the infant's 106.20medical charts and records and, if necessary, seek a court order for an independent medical 106.21examination of the infant. If the review or examination leads to a conclusion of medical 106.22neglect, the agency shall intervene on behalf of the infant by initiating legal proceedings 106.23under section 
         260C.141 and by filing an expedited motion to prevent the withholding 106.24of medically indicated treatment. 106.25    Sec. 86. Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to read:106.26    Subd. 10f. Notice of determinations. Within ten working days of the conclusion 106.27of a family assessment, the local welfare agency shall notify the parent or guardian of 106.28the child of the need for services to address child safety concerns or significant risk of 106.29subsequent child maltreatment. The local welfare agency and the family may also jointly 106.30agree that family support and family preservation services are needed. Within ten working 106.31days of the conclusion of an investigation, the local welfare agency or agency responsible 106.32for assessing or investigating the report shall notify the parent or guardian of the child, the 106.33person determined to be maltreating the child, and if applicable, the director of the facility, 106.34of the determination and a summary of the specific reasons for the determination. The 107.1notice must also include a certification that the information collection procedures under 107.2subdivision 10, paragraphs (h), (i), and (j), were followed and a notice of the right of a 107.3data subject to obtain access to other private data on the subject collected, created, or 107.4maintained under this section. In addition, the notice shall include the length of time that 107.5the records will be kept under subdivision 11c. The investigating agency shall notify the 107.6parent or guardian of the child who is the subject of the report, and any person or facility 107.7determined to have maltreated a child, of their appeal or review rights under this section 107.8or section 
         256.022. The notice must also state that a finding of maltreatment may result 107.9in denial of a license application or background study disqualification under chapter 107.10245C related to employment or services that are licensed by the Department of Human 107.11Services under chapter 245A, the Department of Health under chapter 144 or 144A, the 107.12Department of Corrections under section 241.021, and from providing services related to 107.13an unlicensed personal care provider organization under chapter 256B.107.14    Sec. 87. KINSHIP NAVIGATOR PROGRAM; DEMONSTRATION GRANT.107.15    (a) The commissioner of human services shall fund a two-year demonstration grant 107.16to be transferred to a nonprofit organization experienced in kinship advocacy and policy 107.17that has:107.18    (1) experience working with grandparents and relatives who are raising kinship 107.19children;107.20    (2) an established statewide outreach network;107.21    (3) established kinship support groups;107.22    (4) an intergenerational approach to programming; and107.23    (5) a board of directors consisting of 50 percent grandparents and relatives raising 107.24kinship children.107.25    (b) The purpose of the grant is to provide support to grandparents or relatives raising 107.26kinship children. One site must be in the metropolitan area, and the other in the Bemidji 107.27region. One-stop services may include, but are not limited to, legal services, education, 107.28information, family activities, support groups, mental health access, advocacy, mentors, 107.29and information related to foster care licensing. Funds may also be used for a media 107.30campaign to inform kinship families about available information and services, support 107.31sites, and other program development.107.32    Sec. 88. MFIP PILOT PROGRAM; WORKFORCE U.108.1    Subdivision 1.Establishment.A pilot program is established in Stearns and 108.2Benton Counties to expand the Workforce U program administered by the Stearns-Benton 108.3Employment and Training Council.108.4    Subd. 2.Evaluation.The Workforce U pilot program must be evaluated by a 108.5research and evaluation organization with experience evaluating welfare programs. The 108.6evaluation must include information on the total number of persons served, percentage 108.7of participants exiting the program, percentage of former participants reentering the 108.8program, average wages of program participants, and recommendations to the legislature 108.9for possible statewide implementation of the program. The evaluation must be presented 108.10to the legislature by February 15, 2011.108.11    Subd. 3.Expiration.The Workforce U pilot program expires on June 30, 2011.108.12    Sec. 89. LEECH LAKE YOUTH TREATMENT CENTER PROPOSAL.108.13    (a) The commissioner of human services shall provide a planning grant to address 108.14the unmet need for local, effective, culturally relevant alcohol and drug treatment for 108.15American Indian youth, and develop a plan for a family-based youth treatment center in 108.16the Leech Lake area. The planning grant must be provided to a volunteer board consisting 108.17of at least four members appointed by the commissioner, to include at least the following:108.18    (1) two members of the Leech Lake Tribal Council or their designees;108.19    (2) one member appointed by the Cass County Social Services administrator; and108.20    (3) one member appointed by the Cass Lake-Bena Public School superintendent.108.21    (b) The plan must include:108.22    (1) an interest, feasibility, and suitability of location study;108.23    (2) defining scope of programs and services to be offered;108.24    (3) defining site use limitations and restrictions, including physical and capacity;108.25    (4) defining facilities required for programs and services offered;108.26    (5) identifying partners, partnership roles, and partner resources;108.27    (6) developing proposed operating and maintenance budgets;108.28    (7) identifying funding sources;108.29    (8) developing a long-term funding plan; and108.30    (9) developing a formal steering committee, structure, and bylaws.108.31    (c) The plan is due to the legislative committees having jurisdiction over chemical 108.32health issues no later than September 2008 in order to provide the 12 months necessary to 108.33complete the plan.109.1    Sec. 90. MINNESOTA FOOD SUPPORT PROGRAM SIMPLIFIED 109.2APPLICATION.109.3    The Department of Human Services shall create a simplified application for the 109.4Minnesota food support program for persons over the age of 60 and persons with 109.5disabilities. The application must be no longer than three pages in length.109.6EFFECTIVE DATE.This section is effective January 1, 2008.109.7    Sec. 91. INSPECTION OF LEGAL UNLICENSED CHILD CARE PROVIDERS.109.8    The commissioner of human services, in consultation with the commissioners of 109.9health and education and the counties, shall develop and present recommendations to 109.10the legislature in January 2008 in order for each legally unlicensed child care provider 109.11receiving child care assistance funds to receive a onetime home visit to receive information 109.12on health and safety, and school readiness.109.13    Sec. 92. COMMISSIONER OF HUMAN SERVICES DUTIES; EARLY 109.14CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT 109.15TRAINING.109.16    Subdivision 1.Development and implementation of an early childhood and 109.17school-age professional development system.(a) The commissioner of human services, 109.18in cooperation with the commissioners of education and health, shall develop and phase-in 109.19the implementation of a professional development system for practitioners serving 109.20children in early childhood and school-age programs. The system shall provide training 109.21options and supports for practitioners to voluntarily choose, as they complete or exceed 109.22existing licensing requirements.109.23    The system must, at a minimum, include the following features:109.24    (1) a continuum of training content based on the early childhood and school-age 109.25care practitioner core competencies that translates knowledge into improved practice to 109.26support children's school success;109.27    (2) training strategies that provide direct feedback about practice to practitioners 109.28through ongoing consultation, mentoring, or coaching with special emphasis on early 109.29literacy and early mathematics;109.30    (3) an approval process for trainers;109.31    (4) a professional development registry for early childhood and school-age care 109.32practitioners that will provide tracking and recognition of practitioner training/career 109.33development progress;110.1    (5) a career lattice that includes a range of professional development and educational 110.2opportunities that provide appropriate coursework and degree pathways;110.3    (6) development of a plan with public higher education institutions for an articulated 110.4system of education, training, and professional development that includes credit for prior 110.5learning and development of equivalences to two- and four-year degrees;110.6    (7) incentives and supports for early childhood and school-age care practitioners 110.7to seek additional training and education, including TEACH, other scholarships, and 110.8career guidance; and110.9    (8) coordinated and accessible delivery of training to early childhood and school-age 110.10care practitioners.110.11    (b) By January 1, 2008, the commissioner, in consultation with the organizations 110.12named in subdivision 2 shall develop additional opportunities in order to qualify more 110.13licensed family child care providers under section 119B.13, subdivision 3a.110.14    (c) The commissioner of human services must evaluate the professional development 110.15system and make continuous improvements.110.16    (d) Beginning July 1, 2007, as appropriations permit, the commissioner shall 110.17phase-in the professional development system.110.18    Subd. 2.Two-hour early childhood training.By January 15, 2008, the 110.19commissioner of human services, with input from the Minnesota Licensed Family Child 110.20Care Association and the Minnesota Professional Development Council, shall identify 110.21trainings that qualify for the two-hour early childhood development training requirement 110.22for new child care practitioners under Minnesota Statutes, section 245A.14, subdivision 110.239a, paragraphs (a) and (b). For licensed family child care, the commissioner shall also 110.24seek the input of labor unions that serve licensed family child care providers, if the union 110.25has been recognized by a county to serve licensed family child care providers.110.26    Sec. 93. SCHOOL READINESS SERVICE AGREEMENTS.110.27    Subdivision 1.Overview.(a) Effective July 1, 2007, funds must be made available 110.28to allow the commissioner to pay higher rates to up to 50 child care providers who are 110.29deemed by the commissioner to meet the requirements of a school readiness service 110.30agreement (SRSA) provider and perform services that support school readiness for 110.31children and economic stability for parents.110.32    (b) A provider may be paid a rate above that currently allowed under Minnesota 110.33Statutes, section 119B.13, if:110.34    (1) the provider has entered into an SRSA with the commissioner; 111.1    (2) a family using that provider receives child care assistance under any provision in 111.2Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035; 111.3    (3) the family using that provider meets the criteria in this section; and 111.4    (4) funding is available under this section.111.5    Subd. 2.Provider eligibility.(a) To be considered for an SRSA, a provider shall 111.6apply to the commissioner. To be eligible to apply for an SRSA, a provider shall:111.7    (1) be eligible for child care assistance payments under Minnesota Statutes, chapter 111.8119B;111.9    (2) have at least 25 percent of the children enrolled with the provider subsidized 111.10through the child care assistance program;111.11    (3) provide full-time, full-year child care services; and 111.12    (4) serve at least one child who is subsidized through the child care assistance 111.13program and who is expected to enter kindergarten within the following 30 months.111.14    (b) The commissioner may waive the 25 percent requirement in paragraph (a), clause 111.15(2), if necessary to achieve geographic distribution of SRSA providers and diversity of 111.16types of care provided by SRSA providers.111.17    (c) An eligible provider who would like to enter into an SRSA with the commissioner 111.18shall submit an SRSA application. To determine whether to enter into an SRSA with a 111.19provider, the commissioner shall evaluate the following factors:111.20    (1) the qualifications of the provider and the provider's staff;111.21    (2) the provider's staff-child ratios;111.22    (3) the provider's curriculum;111.23    (4) the provider's current or planned parent education activities;111.24    (5) the provider's current or planned social service and employment linkages;111.25    (6) the provider's child development assessment plan;111.26    (7) the geographic distribution needed for SRSA providers;111.27    (8) the inclusion of a variety of child care delivery models; and 111.28    (9) other related factors determined by the commissioner.111.29    Subd. 3.Family and child eligibility.(a) A family eligible to choose an SRSA 111.30provider for their children shall:111.31    (1) be eligible to receive child care assistance under any provision in Minnesota 111.32Statutes, chapter 119B, except Minnesota Statutes, section 119B.035; 111.33    (2) be in an authorized activity for an average of at least 35 hours per week when 111.34initial eligibility is determined; and 111.35    (3) include a child who has not yet entered kindergarten.112.1    (b) A family who is determined to be eligible to choose an SRSA provider remains 112.2eligible to be paid at a higher rate through the SRSA provider when the following 112.3conditions exist:112.4    (1) the child attends child care with the SRSA provider a minimum of 25 hours per 112.5week, on average;112.6    (2) the family has a child who has not yet entered kindergarten; and 112.7    (3) the family maintains eligibility under Minnesota Statutes, chapter 119B, except 112.8Minnesota Statutes, section 119B.035.112.9    (c) For the 12 months after initial eligibility has been determined, a decrease in 112.10the family's authorized activities to an average of less than 35 hours per week does not 112.11result in ineligibility for the SRSA rate.112.12    (d) A family that moves between counties but continues to use the same SRSA 112.13provider shall continue to receive SRSA funding for the increased payments.112.14    Subd. 4.Requirements of providers.An SRSA must include assessment, 112.15evaluation, and reporting requirements that promote the goals of improved school 112.16readiness and movement toward appropriate child development milestones. A provider 112.17who enters into an SRSA shall comply with the assessment, evaluation, and reporting 112.18requirements in the SRSA.112.19    Subd. 5.Relationship to current law.(a) The following provisions in Minnesota 112.20Statutes, chapter 119B, must be waived or modified for families receiving services under 112.21this section.112.22    (b) Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a, 112.23maximum weekly rates under this section are 125 percent of the existing maximum 112.24weekly rate for like-care. Providers eligible for a differential rate under Minnesota 112.25Statutes, section 119B.13, subdivision 3a, remain eligible for the differential above the 112.26rate identified in this section. Only care for children who have not yet entered kindergarten 112.27may be paid at the maximum rate under this section. The provider's charge for service 112.28provided through an SRSA may not exceed the rate that the provider charges a private-pay 112.29family for like-care arrangements.112.30    (c) A family or child care provider may not be assessed an overpayment for care 112.31provided through an SRSA unless: 112.32    (1) there was an error in the amount of care authorized for the family; or 112.33    (2) the family or provider did not timely report a change as required under the law.112.34    (d) Care provided through an SRSA is authorized on a weekly basis.112.35    (e) Funds appropriated under this section to serve families eligible under Minnesota 112.36Statutes, section 119B.03, are not allocated through the basic sliding fee formula under 113.1Minnesota Statutes, section 119B.03. Funds appropriated under this section are used to 113.2offset increased costs when payments are made under SRSA's.113.3    (f) Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the 113.4maximum amount of child care assistance that may be authorized for a child receiving 113.5care through an SRSA in a two-week period is 160 hours per child.113.6    Subd. 6.Establishment of service agreements.(a) The commissioner shall 113.7approve SRSA's for up to 50 providers that represent diverse parts of the state and a 113.8variety of child care delivery models. Entering into a service agreement does not guarantee 113.9that a provider will receive payment at a higher rate for families receiving child care 113.10assistance. A family eligible under this section shall choose a provider participating in an 113.11SRSA in order for a higher rate to be paid. Payments through SRSA's are also limited by 113.12the availability of SRSA funds.113.13    (b) Nothing in this section shall be construed to limit parent choice as defined in 113.14Minnesota Statutes, section 119B.09, subdivision 5.113.15    (c) The commissioner may allow for startup time for some providers if failing to 113.16do so would limit geographic diversity of SRSA providers or a variety of child care 113.17delivery models.113.18    Sec. 94. FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.113.19    Subdivision 1.Establishment.A family, friend, and neighbor (FFN) grant program 113.20is established to promote children's early literacy, healthy development, and school 113.21readiness, and to foster community partnerships to promote children's school readiness. 113.22The commissioner shall attempt to ensure that grants are made in all areas of the state. The 113.23commissioner of human services shall make grants available to fund: community-based 113.24organizations, nonprofit organizations, and Indian tribes working with FFN caregivers 113.25under subdivision 2, paragraph (a); and community-based partnerships to implement early 113.26literacy programs under subdivision 2, paragraph (b).113.27    Subd. 2.Program components.(a)(1) Grants that the commissioner awards under 113.28this section must be used by community-based organizations, nonprofit organizations, and 113.29Indian tribes working with FFN caregivers in local communities, cultural communities, 113.30and Indian tribes to:113.31    (i) provide training, support, and resources to FFN caregivers in order to improve 113.32and promote children's health, safety, nutrition, and school readiness;113.33    (ii) connect FFN caregivers and children's families with appropriate community 113.34resources that support the families' health, mental health, economic, and developmental 113.35needs;114.1    (iii) connect FFN caregivers and children's families to early childhood screening 114.2programs and facilitate referrals where appropriate;114.3    (iv) provide FFN caregivers and children's families with information about early 114.4learning guidelines from the Departments of Human Services and Education;114.5    (v) provide FFN caregivers and children's families with information about becoming 114.6a licensed family child care provider; and114.7    (vi) provide FFN caregivers and children's families with information about early 114.8learning allowances and enrollment opportunities in high quality community-based 114.9child-care and preschool programs.114.10    (2) Grants that the commissioner awards under this paragraph also may be used for:114.11    (i) health and safety and early learning kits for FFN caregivers;114.12    (ii) play-and-learn groups with FFN caregivers;114.13    (iii) culturally appropriate early childhood training for FFN caregivers;114.14    (iv) transportation for FFN caregivers and children's families to school readiness and 114.15other early childhood training activities;114.16    (v) other activities that promote school readiness;114.17    (vi) data collection and evaluation;114.18    (vii) staff outreach and outreach activities;114.19    (viii) translation needs; or114.20    (ix) administrative costs that equal up to 12 percent of the recipient's grant award.114.21    (b) Grants that the commissioner awards under this section also must be used to fund 114.22partnerships among Minnesota public and regional library systems, community-based 114.23organizations, nonprofit organizations, and Indian tribes to implement early literacy 114.24programs in low-income communities, including tribal communities, to:114.25    (1) purchase and equip early childhood read-mobiles that provide FFN caregivers 114.26and children's families with books, training, and early literacy activities;114.27    (2) provide FFN caregivers and children's families with translations of early 114.28childhood books, training, and early literacy activities in native languages; or114.29    (3) provide FFN caregivers and children's families with early literacy activities in 114.30local libraries.114.31    Subd. 3.Grant awards.Interested entities eligible to receive a grant under 114.32this section may apply to the commissioner in the form and manner the commissioner 114.33determines. The commissioner shall awards grants to eligible entities consistent with 114.34the requirements of this section.114.35    Subd. 4.Evaluation.The commissioner, in consultation with early childhood 114.36care and education experts at the University of Minnesota, must evaluate the impact of 115.1the grants under subdivision 2 on children's school readiness and submit a written report 115.2to the human services and education finance and policy committees of the legislature by 115.3February 15, 2010.115.4EFFECTIVE DATE.This section is effective the day following final enactment.115.5    Sec. 95. CHILD CARE PROVIDER STUDY.115.6    The commissioner of human services is directed to study the implications of 115.7restricting the use of state subsidies in center-based child care to centers meeting state 115.8quality standards under Minnesota Statutes, section 124D.175, paragraph (c), and to 115.9publish the results no later than January 1, 2010. The study must include:115.10    (1) the likelihood of there being sufficient child care providers meeting the standards;115.11    (2) the cost to bring providers up to the standards and how this cost would be funded;115.12    (3) how the standards and the ratings would be communicated to both parents and 115.13the general public; and115.14    (4) a determination whether a similar system could be implemented for 115.15non-center-based care.115.16    Sec. 96. DIRECTION TO COMMISSIONER.115.17    (a) The commissioner of human services shall offer a request for proposals to 115.18identify a research and evaluation firm with experience working with:115.19    (1) homeless youth providers;115.20    (2) data; and115.21    (3) the topics of housing, homelessness, and a continuum of care for youth.115.22    (b) The research and evaluation firm identified under paragraph (a) shall monitor and 115.23evaluate the programs receiving funding under Minnesota Statutes, section 256K.45.115.24    Sec. 97. REVISOR'S INSTRUCTION.115.25    (a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d, 115.26as Minnesota Statutes, section 626.556, subdivision 3g.115.27    (b) The revisor shall change references to Minnesota Statutes, section 260.851, 115.28to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to 115.29section 260.853, article 4, wherever those references appear in Minnesota Statutes and 115.30Minnesota Rules.115.31    Sec. 98.  REPEALER.116.1(a) Minnesota Statutes 2006, sections 119B.08, subdivision 4; 256J.29; 256J.37, 116.2subdivisions 3a and 3b; and 256J.626, subdivisions 7 and 9, are repealed.116.3(b) Laws 1997, chapter 8, section 1, is repealed.116.4(c) Minnesota Rules, part 9560.0102, subpart 2, item C, is repealed.116.5ARTICLE 2116.6LICENSING116.7    Section 1. Minnesota Statutes 2006, section 245A.035, is amended to read:116.8245A.035 RELATIVE FOSTER CARE; UNLICENSED EMERGENCY 116.9LICENSE RELATIVE PLACEMENT.116.10    Subdivision 1. Grant of Emergency license placement. Notwithstanding section 116.11245A.03, subdivision 2a
         , or 
         245C.13, subdivision 2, a county agency may place a child 116.12for foster care with a relative who is not licensed to provide foster care, provided the 116.13requirements of subdivision 2 this section are met. As used in this section, the term 116.14"relative" has the meaning given it under section 
         260C.007, subdivision 27.116.15    Subd. 2. Cooperation with emergency licensing placement process. (a) A county 116.16agency that places a child with a relative who is not licensed to provide foster care must 116.17begin the process of securing an emergency license for the relative as soon as possible 116.18and must conduct the initial inspection required by subdivision 3, clause (1), whenever 116.19possible, prior to placing the child in the relative's home, but no later than three working 116.20days after placing the child in the home. A child placed in the home of a relative who is 116.21not licensed to provide foster care must be removed from that home if the relative fails 116.22to cooperate with the county agency in securing an emergency foster care license. The 116.23commissioner may issue an emergency foster care license to a relative with whom the 116.24county agency wishes to place or has placed a child for foster care, or to a relative with 116.25whom a child has been placed by court order.116.26    (b) If a child is to be placed in the home of a relative not licensed to provide foster 116.27care, either the placing agency or the county agency in the county in which the relative 116.28lives shall conduct the emergency licensing placement process as required in this section.116.29    Subd. 3. Requirements for emergency license placement. Before an emergency 116.30license placement may be issued made, the following requirements must be met:116.31    (1) the county agency must conduct an initial inspection of the premises where 116.32the foster care placement is to be provided made to ensure the health and safety of any 116.33child placed in the home. The county agency shall conduct the inspection using a form 116.34developed by the commissioner;117.1    (2) at the time of the inspection or placement, whichever is earlier, the county 117.2agency must provide the relative being considered for an emergency license shall receive117.3placement an application form for a child foster care license;117.4    (3) whenever possible, prior to placing the child in the relative's home, the relative 117.5being considered for an emergency license placement shall provide the information 117.6required by section 
         245C.05; and 117.7    (4) if the county determines, prior to the issuance of an emergency license117.8placement, that anyone requiring a background study may be prior to licensure of the 117.9home is disqualified under section 245C.14 and chapter 245C, and the disqualification 117.10is one which the commissioner cannot set aside, an emergency license shall placement 117.11must not be issued made.117.12    Subd. 4. Applicant study. When the county agency has received the information 117.13required by section 
         245C.05, the county agency shall begin an applicant study according to 117.14the procedures in chapter 245C. The commissioner may issue an emergency license upon 117.15recommendation of the county agency once the initial inspection has been successfully 117.16completed and the information necessary to begin the applicant background study has been 117.17provided. If the county agency does not recommend that the emergency license be granted, 117.18the agency shall notify the relative in writing that the agency is recommending denial to the 117.19commissioner; shall remove any child who has been placed in the home prior to licensure; 117.20and shall inform the relative in writing of the procedure to request review pursuant to 117.21subdivision 6. An emergency license shall be effective until a child foster care license is 117.22granted or denied, but shall in no case remain in effect more than 120 days from the date 117.23of placement submit the information to the commissioner according to section 245C.05.117.24    Subd. 5. Child foster care license application. (a) The relatives with whom the117.25emergency license holder placement has been made shall complete the child foster care 117.26license application and necessary paperwork within ten days of the placement. The county 117.27agency shall assist the emergency license holder applicant to complete the application. 117.28The granting of a child foster care license to a relative shall be under the procedures in this 117.29chapter and according to the standards set forth by foster care rule in Minnesota Rules, 117.30chapter 2960. In licensing a relative, the commissioner shall consider the importance of 117.31maintaining the child's relationship with relatives as an additional significant factor in 117.32determining whether to a background study disqualification should be set aside a licensing 117.33disqualifier under section 
         245C.22, or to grant a variance of licensing requirements should 117.34be granted under sections 245C.21 to 245C.27 section 245C.30.117.35    (b) When the county or private child-placing agency is processing an application 117.36for child foster care licensure of a relative as defined in section 
         260B.007, subdivision 118.112
         , or 
         260C.007, subdivision 27, the county agency or child-placing agency must explain 118.2the licensing process to the prospective licensee, including the background study process 118.3and the procedure for reconsideration of an initial disqualification for licensure. The 118.4county or private child-placing agency must also provide the prospective relative licensee 118.5with information regarding appropriate options for legal representation in the pertinent 118.6geographic area. If a relative is initially disqualified under section 
         245C.14, the county 118.7or child-placing agency commissioner must provide written notice of the reasons for the 118.8disqualification and the right to request a reconsideration by the commissioner as required 118.9under section 
         245C.17.118.10    (c) The commissioner shall maintain licensing data so that activities related to 118.11applications and licensing actions for relative foster care providers may be distinguished 118.12from other child foster care settings.118.13    Subd. 6.Denial of emergency license.If the commissioner denies an application 118.14for an emergency foster care license under this section, that denial must be in writing and 118.15must include reasons for the denial. Denial of an emergency license is not subject to 118.16appeal under chapter 14. The relative may request a review of the denial by submitting 118.17to the commissioner a written statement of the reasons an emergency license should be 118.18granted. The commissioner shall evaluate the request for review and determine whether 118.19to grant the emergency license. The commissioner's review shall be based on a review 118.20of the records submitted by the county agency and the relative. Within 15 working 118.21days of the receipt of the request for review, the commissioner shall notify the relative 118.22requesting review in written form whether the emergency license will be granted. The 118.23commissioner's review shall be based on a review of the records submitted by the county 118.24agency and the relative. A child shall not be placed or remain placed in the relative's home 118.25while the request for review is pending. Denial of an emergency license shall not preclude 118.26an individual from reapplying for an emergency license or from applying for a child foster 118.27care license. The decision of the commissioner is the final administrative agency action.118.28    Sec. 2. Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:118.29    Subd. 2. County fees for background studies and licensing inspections. (a) For 118.30purposes of family and group family child care licensing under this chapter, a county 118.31agency may charge a fee to an applicant or license holder to recover the actual cost of 118.32background studies, but in any case not to exceed $100 annually. A county agency may 118.33also charge alicense fee to an applicant or license holder to recover the actual cost of 118.34licensing inspections, but in any case not to exceed $150 annually$50 for a one-year 118.35license or $100 for a two-year license.119.1    (b) A county agency may charge a fee to a legal nonlicensed child care provider or 119.2applicant for authorization to recover the actual cost of background studies completed 119.3under section  
         119B.125, but in any case not to exceed $100 annually. 119.4    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):119.5    (1) in cases of financial hardship;119.6    (2)  if the county has a shortage of providers in the county's area;119.7    (3) for new providers; or119.8    (4) for providers who have attained at least 16 hours of training before seeking 119.9initial licensure.119.10    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on 119.11an installment basis for up to one year. If the provider is receiving child care assistance 119.12payments from the state, the provider may have the fees under paragraph (a) or (b) 119.13deducted from the child care assistance payments for up to one year and the state shall 119.14reimburse the county for the county fees collected in this manner.119.15EFFECTIVE DATE.This section is effective the day following final enactment.119.16    Sec. 3. Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:119.17    Subdivision 1. Delegation of authority to agencies. (a) County agencies and 119.18private agencies that have been designated or licensed by the commissioner to perform 119.19licensing functions and activities under section 
         245A.04andbackground studies for adult 119.20foster care, family adult day services, family child care, and child foster care under chapter 119.21245C,; to recommend denial of applicants under section 
         245A.05,; to issue correction 119.22orders, to issue variances, and recommend a conditional license under section 
         245A.06, or 119.23to recommend suspending or revoking a license or issuing a fine under section 
         245A.07, 119.24shall comply with rules and directives of the commissioner governing those functions and 119.25with this section. The following variances are excluded from the delegation of variance 119.26authority and may be issued only by the commissioner:119.27    (1) dual licensure of family child care and child foster care, dual licensure of child 119.28and adult foster care, and adult foster care and family child care;119.29    (2) adult foster care maximum capacity;119.30    (3) adult foster care minimum age requirement;119.31    (4) child foster care maximum age requirement;119.32    (5) variances regarding disqualified individuals except that county agencies may 119.33issue variances under section 
         245C.30 regarding disqualified individuals when the county 119.34is responsible for conducting a consolidated reconsideration according to sections 
         245C.25120.1and 
         245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination 120.2and a disqualification based on serious or recurring maltreatment; and120.3    (6) the required presence of a caregiver in the adult foster care residence during 120.4normal sleeping hours.120.5    (b) County agencies must report:120.6    (1) information about disqualification reconsiderations under sections 
         245C.25 and 120.7245C.27, subdivision 2
         , clauses paragraphs (a) and (b), and variances granted under 120.8paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by 120.9the commissioner; and.120.10    (2) for relative child foster care applicants and license holders, the number of 120.11relatives, as defined in section 260C.007, subdivision 27, and household members of 120.12relatives who are disqualified under section 245C.14; the disqualifying characteristics 120.13under section 245C.15; the number of these individuals who requested reconsideration 120.14under section 245C.21; the number of set-asides under section 245C.22; and variances 120.15under section 245C.30 issued. This information shall be reported to the commissioner 120.16annually by January 15 of each year in a format prescribed by the commissioner.120.17    (c) For family day care programs, the commissioner may authorize licensing reviews 120.18every two years after a licensee has had at least one annual review.120.19    (d) For family adult day services programs, the commissioner may authorize 120.20licensing reviews every two years after a licensee has had at least one annual review.120.21    (e) A license issued under this section may be issued for up to two years.120.22    (f) The commissioner shall work with counties to determine the cost and propose 120.23an ongoing funding allocation from the general fund to cover the cost to counties 120.24to implement an annual license review for licensed family child care providers. 120.25The commissioner shall solicit input from counties to determine the outcome. The 120.26commissioner shall report to the committees of the house of representatives and senate 120.27having jurisdiction over early childhood programs by January 15, 2008, as to the costs 120.28and the funding allocation recommended for future use.120.29EFFECTIVE DATE.This section is effective January 1, 2008.120.30    Sec. 4. Minnesota Statutes 2006, section 245A.16, subdivision 3, is amended to read:120.31    Subd. 3. Recommendations to the commissioner. The county or private agency 120.32shall not make recommendations to the commissioner regarding licensure without first 120.33conducting an inspection, and for adult foster care, family adult day services, family child 120.34care, and child foster care, a background study of the applicant, and evaluation pursuant to120.35under chapter 245C. The county or private agency must forward its recommendation to 121.1the commissioner regarding the appropriate licensing action within 20 working days of 121.2receipt of a completed application.121.3EFFECTIVE DATE.This section is effective January 1, 2008.121.4    Sec. 5. Minnesota Statutes 2006, section 245C.02, is amended by adding a subdivision 121.5to read:121.6    Subd. 14a.Private agency."Private agency" has the meaning given in section 121.7245A.02, subdivision 12.121.8    Sec. 6. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:121.9    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a 121.10background study of an individual required to be studied under section 
         245C.03, 121.11subdivision 1
         , at least upon application for initial license for all license types. 121.12    (b) The commissioner shall conduct a background study of an individual required to 121.13be studied under section 
         245C.03, subdivision 1, at reapplication for a license for family 121.14child care, child foster care, and adult foster care, and family adult day services. 121.15    (c) The commissioner is not required to conduct a study of an individual at the time 121.16of reapplication for a license if the individual's background study was completed by the 121.17commissioner of human services for an adult foster care license holder that is also:121.18    (1) registered under chapter 144D; or121.19    (2) licensed to provide home and community-based services to people with 121.20disabilities at the foster care location and the license holder does not reside in the foster 121.21care residence; and121.22    (3) the following conditions are met:121.23    (i) a study of the individual was conducted either at the time of initial licensure or 121.24when the individual became affiliated with the license holder;121.25    (ii) the individual has been continuously affiliated with the license holder since 121.26the last study was conducted; and121.27    (iii) the last study of the individual was conducted on or after October 1, 1995.121.28    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services 121.29shall conduct a study of an individual required to be studied under section 245C.03, at 121.30the time of reapplication for a child foster care license. The county or private agency 121.31shall collect and forward to the commissioner the information required under section 121.32245C.05, subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The 121.33background study conducted by the commissioner of human services under this paragraph 122.1must include a review of the information required under section 245C.08, subdivisions 122.21, paragraph (a), clauses (1) to (4), and 3.122.3    (e) The commissioner of human services shall conduct a background study of an 122.4individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) 122.5to (6), who is newly affiliated with a child foster care license holder. The county or 122.6private agency shall collect and forward to the commissioner the information required 122.7under section 245C.05, subdivisions 1 and 5. The background study conducted by the 122.8commissioner of human services under this paragraph must include a review of the 122.9information required under section 245C.08, subdivisions 1, paragraph (a), and 3.122.10    (f) Applicants for licensure, license holders, and other entities as provided in this 122.11chapter must submit completed background study forms to the commissioner before 122.12individuals specified in section 
         245C.03, subdivision 1, begin positions allowing direct 122.13contact in any licensed program. 122.14    (e) (g) For purposes of this section, a physician licensed under chapter 147 is 122.15considered to be continuously affiliated upon the license holder's receipt from the 122.16commissioner of health or human services of the physician's background study results.122.17    Sec. 7. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:122.18    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a 122.19background study of an individual required to be studied under section 
         245C.03, 122.20subdivision 1
         , at least upon application for initial license for all license types. 122.21    (b) The commissioner shall conduct a background study of an individual required 122.22to be studied under section 
         245C.03, subdivision 1, at reapplication for a license for 122.23family child care, child foster care, and adult foster care. 122.24    (c) The commissioner is not required to conduct a study of an individual at the time 122.25of reapplication for a license if the individual's background study was completed by the 122.26commissioner of human services for an adult foster care license holder that is also:122.27    (1) registered under chapter 144D; or122.28    (2) licensed to provide home and community-based services to people with 122.29disabilities at the foster care location and the license holder does not reside in the foster 122.30care residence; and122.31    (3) the following conditions are met:122.32    (i) a study of the individual was conducted either at the time of initial licensure or 122.33when the individual became affiliated with the license holder;122.34    (ii) the individual has been continuously affiliated with the license holder since 122.35the last study was conducted; and123.1    (iii) the last study of the individual was conducted on or after October 1, 1995.123.2    (d) From January 1, 2008, to December 31, 2009, the commissioner shall conduct 123.3a study of an individual required to be studied under section 245C.03, at the time of 123.4reapplication for a family child care license. The county shall collect and forward to the 123.5commissioner the information required under section 245C.05, subdivisions 1 and 5. The 123.6background study conducted by the commissioner under this paragraph must include a 123.7review of the information required under section 245C.08, subdivisions 1, paragraph 123.8(a), and 3.123.9    (e) The commissioner shall conduct a background study of an individual specified 123.10under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly 123.11affiliated with a family child care license holder. The county shall collect and forward 123.12to the commissioner the information required under section 245C.05, subdivisions 1 123.13and 5. The background study conducted by the commissioner under this paragraph 123.14must include a review of the information required under section 245C.08, subdivisions 123.151, paragraph (a), and 3.123.16    (f) Applicants for licensure, license holders, and other entities as provided in this 123.17chapter must submit completed background study forms to the commissioner before 123.18individuals specified in section 
         245C.03, subdivision 1, begin positions allowing direct 123.19contact in any licensed program. 123.20    (e)(g) For purposes of this section, a physician licensed under chapter 147 is 123.21considered to be continuously affiliated upon the license holder's receipt from the 123.22commissioner of health or human services of the physician's background study results.123.23EFFECTIVE DATE.This section is effective January 1, 2008.123.24    Sec. 8. Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:123.25    Subdivision 1. Individual studied. (a) The individual who is the subject of the 123.26background study must provide the applicant, license holder, or other entity under section 123.27245C.04
          with sufficient information to ensure an accurate study, including: 123.28    (1) the individual's first, middle, and last name and all other names by which the 123.29individual has been known;123.30    (2) home address, city, and state of residence;123.31    (3) zip code;123.32    (4) sex;123.33    (5) date of birth; and123.34    (6) Minnesota driver's license number or state identification number.124.1    (b) Every subject of a background study conducted or initiated by counties or private 124.2agencies under this chapter must also provide the home address, city, county, and state of 124.3residence for the past five years.124.4    (c) Every subject of a background study related to child foster care licensed through 124.5a private agency shall also provide the commissioner a signed consent for the release of 124.6any information received from national crime information databases to the private agency 124.7that initiated the background study.124.8    (d) The subject of a background study shall provide fingerprints as required in 124.9subdivision 5, paragraph (c).124.10    Sec. 9. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision 124.11to read:124.12    Subd. 2a.County or private agency.For background studies related to child foster 124.13care, county and private agencies must collect the information under subdivision 1 and 124.14forward it to the commissioner.124.15    Sec. 10. Minnesota Statutes 2006, section 245C.05, is amended by adding a 124.16subdivision to read:124.17    Subd. 2b.County agency.For background studies related to family child care, 124.18county agencies must collect the information under subdivision 1 and forward it to the 124.19commissioner.124.20EFFECTIVE DATE.This section is effective January 1, 2008.124.21    Sec. 11. Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to read:124.22    Subd. 4. Electronic transmission. For background studies conducted by the 124.23Department of Human Services, the commissioner shall implement a system for the 124.24electronic transmission of:124.25    (1) background study information to the commissioner; and124.26    (2) background study results to the license holder; and124.27    (3) background study results to county and private agencies for background studies 124.28conducted by the commissioner for family child care and child foster care.124.29EFFECTIVE DATE.This section is effective January 1, 2008.124.30    Sec. 12. Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to read:125.1    Subd. 5. Fingerprints. (a) Except as provided in paragraph (c), for any background 125.2study completed under this chapter, when the commissioner has reasonable cause to 125.3believe that further pertinent information may exist on the subject of the background 125.4study, the subject shall provide the commissioner with a set of classifiable fingerprints 125.5obtained from an authorized law enforcement agency.125.6    (b) For purposes of requiring fingerprints, the commissioner has reasonable cause 125.7when, but not limited to, the:125.8    (1) information from the Bureau of Criminal Apprehension indicates that the subject 125.9is a multistate offender;125.10    (2) information from the Bureau of Criminal Apprehension indicates that multistate 125.11offender status is undetermined; or125.12    (3) commissioner has received a report from the subject or a third party indicating 125.13that the subject has a criminal history in a jurisdiction other than Minnesota.125.14    (c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for 125.15background studies conducted by the commissioner for child foster care, the subject of the 125.16background study shall provide the commissioner with a set of classifiable fingerprints 125.17obtained from an authorized agency.125.18    Sec. 13. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:125.19    Subd. 7. Probation officer and corrections agent. (a) A probation officer or 125.20corrections agent shall notify the commissioner of an individual's conviction if the 125.21individual is:125.22    (1) affiliated with a program or facility regulated by the Department of Human 125.23Services or Department of Health, a facility serving children or youth licensed by the 125.24Department of Corrections, or any type of home care agency or provider of personal care 125.25assistance services; and125.26    (2) convicted of a crime constituting a disqualification under section 
         245C.14. 125.27    (b) For the purpose of this subdivision, "conviction" has the meaning given it 125.28in section 
         609.02, subdivision 5. 125.29    (c) The commissioner, in consultation with the commissioner of corrections, shall 125.30develop forms and information necessary to implement this subdivision and shall provide 125.31the forms and information to the commissioner of corrections for distribution to local 125.32probation officers and corrections agents.125.33    (d) The commissioner shall inform individuals subject to a background study that 125.34criminal convictions for disqualifying crimes will be reported to the commissioner by the 125.35corrections system.126.1    (e) A probation officer, corrections agent, or corrections agency is not civilly or 126.2criminally liable for disclosing or failing to disclose the information required by this 126.3subdivision.126.4    (f) Upon receipt of disqualifying information, the commissioner shall provide the 126.5notice required under section 
         245C.17, as appropriate, to agencies on record as having 126.6initiated a background study or making a request for documentation of the background 126.7study status of the individual. 126.8    (g) This subdivision does not apply to family child care and child foster care126.9programs.126.10    Sec. 14. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:126.11    Subd. 7. Probation officer and corrections agent. (a) A probation officer or 126.12corrections agent shall notify the commissioner of an individual's conviction if the 126.13individual is:126.14    (1) affiliated with a program or facility regulated by the Department of Human 126.15Services or Department of Health, a facility serving children or youth licensed by the 126.16Department of Corrections, or any type of home care agency or provider of personal care 126.17assistance services; and126.18    (2) convicted of a crime constituting a disqualification under section 
         245C.14. 126.19    (b) For the purpose of this subdivision, "conviction" has the meaning given it 126.20in section 
         609.02, subdivision 5. 126.21    (c) The commissioner, in consultation with the commissioner of corrections, shall 126.22develop forms and information necessary to implement this subdivision and shall provide 126.23the forms and information to the commissioner of corrections for distribution to local 126.24probation officers and corrections agents.126.25    (d) The commissioner shall inform individuals subject to a background study that 126.26criminal convictions for disqualifying crimes will be reported to the commissioner by the 126.27corrections system.126.28    (e) A probation officer, corrections agent, or corrections agency is not civilly or 126.29criminally liable for disclosing or failing to disclose the information required by this 126.30subdivision.126.31    (f) Upon receipt of disqualifying information, the commissioner shall provide the 126.32notice required under section 
         245C.17, as appropriate, to agencies on record as having 126.33initiated a background study or making a request for documentation of the background 126.34study status of the individual. 127.1    (g) This subdivision does not apply to family child care and child foster care 127.2programs.127.3EFFECTIVE DATE.This section is effective January 1, 2008.127.4    Sec. 15. Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to read:127.5    Subdivision 1. Background studies conducted by commissioner of human 127.6services. (a) For a background study conducted by the commissioner, the commissioner 127.7shall review:127.8    (1) information related to names of substantiated perpetrators of maltreatment of 127.9vulnerable adults that has been received by the commissioner as required under section 127.10626.557, subdivision 9c
         , paragraph (i);127.11    (2) the commissioner's records relating to the maltreatment of minors in licensed 127.12programs, and from county agency findings of maltreatment of minors as indicated 127.13through the social service information system;127.14    (3) information from juvenile courts as required in subdivision 4 for individuals 127.15listed in section 
         245C.03, subdivision 1, clauses (2), (5), and (6); and127.16    (4) information from the Bureau of Criminal Apprehension.; 127.17    (5) except as provided in clause (6), information from the national crime information 127.18system when the commissioner has reasonable cause as defined under section 245C.05, 127.19subdivision 5; and127.20    (6) for a background study related to a child foster care application for licensure, the 127.21commissioner shall also review:127.22    (i) information from the child abuse and neglect registry for any state in which the 127.23background study subject has resided in for the past five years; and127.24    (ii) information from national crime information databases.127.25    (b) Notwithstanding expungement by a court, the commissioner may consider 127.26information obtained under paragraph (a), clauses (3) and (4), unless the commissioner 127.27received notice of the petition for expungement and the court order for expungement is 127.28directed specifically to the commissioner.127.29    Sec. 16. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:127.30    Subd. 2. Background studies conducted by a county or private agency. (a) For 127.31a background study conducted by a county or private agency for child foster care, adult 127.32foster care, family adult day services, and family child care homes, the commissioner 127.33shall review:128.1    (1) information from the county agency's record of substantiated maltreatment 128.2of adults and the maltreatment of minors;128.3    (2) information from juvenile courts as required in subdivision 4 for individuals 128.4listed in section 
         245C.03, subdivision 1, clauses (2), (5), and (6);128.5    (3) information from the Bureau of Criminal Apprehension; and128.6    (4) arrest and investigative records maintained by the Bureau of Criminal 128.7Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the 128.8National Criminal Records Repository, and criminal records from other states.128.9    (b) If the individual has resided in the county for less than five years, the study shall 128.10include the records specified under paragraph (a) for the previous county or counties of 128.11residence for the past five years.128.12    (c) Notwithstanding expungement by a court, the county or private agency may 128.13consider information obtained under paragraph (a), clauses (3) and (4), unless the 128.14commissioner received notice of the petition for expungement and the court order for 128.15expungement is directed specifically to the commissioner.128.16    Sec. 17. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:128.17    Subd. 2. Background studies conducted by a county or private agency. (a) For a 128.18background study conducted by a county or private agency for child foster care, and adult 128.19foster care, and family child care homes, the commissioner shall review:128.20    (1) information from the county agency's record of substantiated maltreatment 128.21of adults and the maltreatment of minors;128.22    (2) information from juvenile courts as required in subdivision 4 for individuals 128.23listed in section 
         245C.03, subdivision 1, clauses (2), (5), and (6);128.24    (3) information from the Bureau of Criminal Apprehension; and128.25    (4) arrest and investigative records maintained by the Bureau of Criminal 128.26Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the 128.27National Criminal Records Repository, and criminal records from other states.128.28    (b) If the individual has resided in the county for less than five years, the study shall 128.29include the records specified under paragraph (a) for the previous county or counties of 128.30residence for the past five years.128.31    (c) Notwithstanding expungement by a court, the county or private agency may 128.32consider information obtained under paragraph (a), clauses (3) and (4), unless the 128.33commissioner received notice of the petition for expungement and the court order for 128.34expungement is directed specifically to the commissioner.128.35EFFECTIVE DATE.This section is effective January 1, 2008.129.1    Sec. 18. Minnesota Statutes 2006, section 245C.10, is amended by adding a 129.2subdivision to read:129.3    Subd. 4.Temporary personnel agencies, educational programs, and professional 129.4services agencies.The commissioner shall recover the cost of the background studies 129.5initiated by temporary personnel agencies, educational programs, and professional 129.6services agencies that initiate background studies under section 245C.03, subdivision 4, 129.7through a fee of no more than $20 per study charged to the agency. In fiscal years 2008 129.8and 2009, the fees collected under this subdivision are appropriated to the commissioner 129.9for the purpose of conducting background studies.129.10    Sec. 19. Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to read:129.11    Subdivision 1. Adult foster care; criminal conviction data. For individuals who 129.12are required to have background studies under section 
         245C.03, subdivisions 1 and 2, and 129.13who have been continuously affiliated with a an adult foster care provider that is licensed 129.14in more than one county, criminal conviction data may be shared among those counties in 129.15which the adult foster care programs are licensed. A county agency's receipt of criminal 129.16conviction data from another county agency shall meet the criminal data background 129.17study requirements of this chapter. 129.18    Sec. 20. Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to read:129.19    Subd. 2. Jointly licensed programs. A county agency may accept a background 129.20study completed by the commissioner under this chapter in place of the background study 129.21required under section 
         245A.16, subdivision 3, in programs with joint licensure as home 129.22and community-based services and adult foster care for people with developmental 129.23disabilities when the license holder does not reside in the adult foster care residence and 129.24the subject of the study has been continuously affiliated with the license holder since the 129.25date of the commissioner's study. 129.26    Sec. 21. Minnesota Statutes 2006, section 245C.12, is amended to read:129.27245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.129.28    (a) For the purposes of background studies completed by tribal organizations 129.29performing licensing activities otherwise required of the commissioner under this chapter, 129.30after obtaining consent from the background study subject, tribal licensing agencies shall 129.31have access to criminal history data in the same manner as county licensing agencies and 129.32private licensing agencies under this chapter.130.1    (b) Tribal organizations may contract with the commissioner to obtain background 130.2study data on individuals under tribal jurisdiction related to adoptions according to 130.3section 245C.34. Tribal organizations may also contract with the commissioner to obtain 130.4background study data on individuals under tribal jurisdiction related to child foster care 130.5according to section 245C.34.130.6    Sec. 22. Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:130.7    Subdivision 1. Determining immediate risk of harm. (a) If the commissioner 130.8determines that the individual studied has a disqualifying characteristic, the commissioner 130.9shall review the information immediately available and make a determination as to the 130.10subject's immediate risk of harm to persons served by the program where the individual 130.11studied will have direct contact.130.12    (b) The commissioner shall consider all relevant information available, including the 130.13following factors in determining the immediate risk of harm:130.14    (1) the recency of the disqualifying characteristic;130.15    (2) the recency of discharge from probation for the crimes;130.16    (3) the number of disqualifying characteristics;130.17    (4) the intrusiveness or violence of the disqualifying characteristic;130.18    (5) the vulnerability of the victim involved in the disqualifying characteristic;130.19    (6) the similarity of the victim to the persons served by the program where the 130.20individual studied will have direct contact; and130.21    (7) whether the individual has a disqualification from a previous background study 130.22that has not been set aside.130.23    (c) This section does not apply when the subject of a background study is regulated 130.24by a health-related licensing board as defined in chapter 214, and the subject is determined 130.25to be responsible for substantiated maltreatment under section 
         626.556 or 
         626.557. 130.26    (d) This section does not apply to a background study related to an initial application 130.27for a child foster care license.130.28    (e) If the commissioner has reason to believe, based on arrest information or an 130.29active maltreatment investigation, that an individual poses an imminent risk of harm to 130.30persons receiving services, the commissioner may order that the person be continuously 130.31supervised or immediately removed pending the conclusion of the maltreatment 130.32investigation or criminal proceedings.130.33    Sec. 23. Minnesota Statutes 2006, section 245C.17, is amended by adding a 130.34subdivision to read:131.1    Subd. 5.Notice to county or private agency.For studies on individuals related to a 131.2license to provide child foster care, the commissioner shall also provide a notice of the 131.3background study results to the county or private agency that initiated the background 131.4study.131.5    Sec. 24. Minnesota Statutes 2006, section 245C.17, is amended by adding a 131.6subdivision to read:131.7    Subd. 5a.Notice to county agency.For studies on individuals related to a license to 131.8provide family child care, the commissioner shall also provide a notice of the background 131.9study results to the county or private agency that initiated the background study.131.10EFFECTIVE DATE.This section is effective January 1, 2008.131.11    Sec. 25. Minnesota Statutes 2006, section 245C.21, is amended by adding a 131.12subdivision to read:131.13    Subd. 1a.Submission of reconsideration request to county or private agency.131.14    (a) For disqualifications related to studies conducted by county agencies, and for 131.15disqualifications related to studies conducted by the commissioner for child foster care, 131.16the individual shall submit the request for reconsideration to the county or private agency 131.17that initiated the background study.131.18    (b) A reconsideration request shall be submitted within the time frames specified in 131.19subdivision 2.131.20    (c) The county or private agency shall forward the individual's request for 131.21reconsideration and provide the commissioner with a recommendation whether to set aside 131.22the individual's disqualification.131.23    Sec. 26. Minnesota Statutes 2006, section 245C.21, is amended by adding a 131.24subdivision to read:131.25    Subd. 1a.Submission of reconsideration request to county agency.(a) For 131.26disqualifications related to studies conducted by county agencies, and for disqualifications 131.27related to studies conducted by the commissioner for family child care, the individual shall 131.28submit the request for reconsideration to the county that initiated the background study.131.29    (b) A reconsideration request shall be submitted within the time frames specified in 131.30subdivision 2.131.31    (c) The county agency shall forward the individual's request for reconsideration and 131.32provide the commissioner with a recommendation whether to set aside the individual's 131.33disqualification.132.1EFFECTIVE DATE.This section is effective January 1, 2008.132.2    Sec. 27. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:132.3    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The 132.4commissioner shall notify the license holder of the disqualification and order the license 132.5holder to immediately remove the individual from any position allowing direct contact 132.6with persons receiving services from the license holder if:132.7    (1) the individual studied does not submit a timely request for reconsideration 132.8under section 
         245C.21;132.9    (2) the individual submits a timely request for reconsideration, but the commissioner 132.10does not set aside the disqualification for that license holder under section 
         245C.22;132.11    (3) an individual who has a right to request a hearing under sections 
         245C.27 and 132.12256.045
         , or 
         245C.28 and chapter 14 for a disqualification that has not been set aside, does 132.13not request a hearing within the specified time; or132.14    (4) an individual submitted a timely request for a hearing under sections 
         245C.27132.15and 
         256.045, or 
         245C.28 and chapter 14, but the commissioner does not set aside the 132.16disqualification under section 
         245A.08, subdivision 5, or 
         256.045.132.17    (b) If the commissioner does not set aside the disqualification under section 
         245C.22, 132.18and the license holder was previously ordered under section 
         245C.17 to immediately 132.19remove the disqualified individual from direct contact with persons receiving services or 132.20to ensure that the individual is under continuous, direct supervision when providing direct 132.21contact services, the order remains in effect pending the outcome of a hearing under 132.22sections 
         245C.27 and 
         256.045, or 
         245C.28 and chapter 14.132.23    (c) For background studies related to child foster care, the commissioner shall 132.24also notify the county or private agency that initiated the study of the results of the 132.25reconsideration.132.26    Sec. 28. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:132.27    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The 132.28commissioner shall notify the license holder of the disqualification and order the license 132.29holder to immediately remove the individual from any position allowing direct contact 132.30with persons receiving services from the license holder if:132.31    (1) the individual studied does not submit a timely request for reconsideration 132.32under section 
         245C.21; 132.33    (2) the individual submits a timely request for reconsideration, but the commissioner 132.34does not set aside the disqualification for that license holder under section 
         245C.22; 133.1    (3) an individual who has a right to request a hearing under sections 
         245C.27 and 133.2256.045
         , or 
         245C.28 and chapter 14 for a disqualification that has not been set aside, does 133.3not request a hearing within the specified time; or 133.4    (4) an individual submitted a timely request for a hearing under sections 
         245C.27133.5and 
         256.045, or 
         245C.28 and chapter 14, but the commissioner does not set aside the 133.6disqualification under section 
         245A.08, subdivision 5, or 
         256.045. 133.7    (b) If the commissioner does not set aside the disqualification under section 
         245C.22, 133.8and the license holder was previously ordered under section 
         245C.17 to immediately 133.9remove the disqualified individual from direct contact with persons receiving services or 133.10to ensure that the individual is under continuous, direct supervision when providing direct 133.11contact services, the order remains in effect pending the outcome of a hearing under 133.12sections 
         245C.27 and 
         256.045, or 
         245C.28 and chapter 14. 133.13    (c) For background studies related to family child care, the commissioner shall also 133.14notify the county that initiated the study of the results of the reconsideration.133.15EFFECTIVE DATE.This section is effective January 1, 2008.133.16    Sec. 29. Minnesota Statutes 2006, section 245C.24, subdivision 2, is amended to read:133.17    Subd. 2. Permanent bar to set aside a disqualification. (a) Except as provided in 133.18paragraph (b), the commissioner may not set aside the disqualification of any individual 133.19disqualified pursuant to this chapter, in connection with a license to provide family child 133.20care for children, foster care for children in the provider's home, or foster care or day care 133.21services for adults in the provider's home regardless of how much time has passed, if the 133.22individual was disqualified for a crime or conduct listed in section 
         245C.15, subdivision 1.133.23    (b) For an individual in the chemical dependency field who was disqualified for a 133.24crime or conduct listed under section 
         245C.15, subdivision 1, and whose disqualification 133.25was set aside prior to July 1, 2005, the commissioner must consider granting a variance 133.26pursuant to section 
         245C.30 for the license holder for a program dealing primarily with 133.27adults. A request for reconsideration evaluated under this paragraph must include a 133.28letter of recommendation from the license holder that was subject to the prior set-aside 133.29decision addressing the individual's quality of care to children or vulnerable adults and the 133.30circumstances of the individual's departure from that service.133.31    Sec. 30. [245C.33] ADOPTION BACKGROUND STUDY REQUIREMENTS.133.32    Subdivision 1.Background studies conducted by commissioner.Before 133.33placement of a child for purposes of adoption, the commissioner shall conduct a 134.1background study on individuals listed in section 259.41, subdivision 3, for county 134.2agencies and private agencies licensed to place children for adoption.134.3    Subd. 2.Information and data provided to county or private agency.The 134.4subject of the background study shall provide the following information to the county 134.5or private agency:134.6    (1) the information specified in section 245C.05;134.7    (2) a set of classifiable fingerprints obtained from an authorized agency; and134.8    (3) for studies initiated by a private agency, a signed consent for the release of 134.9information received from national crime information databases to the private agency.134.10    Subd. 3.Information and data provided to commissioner.The county or private 134.11agency shall forward the data collected under subdivision 2 to the commissioner.134.12    Subd. 4.Information commissioner reviews.(a) The commissioner shall review 134.13the following information regarding the background study subject:134.14    (1) the information under section 245C.08, subdivisions 1, 3, and 4;134.15    (2) information from the child abuse and neglect registry for any state in which the 134.16subject has resided for the past five years; and134.17    (3) information from national crime information databases.134.18    (b) The commissioner shall provide any information collected under this subdivision 134.19to the county or private agency that initiated the background study. The commissioner 134.20shall indicate if the information collected shows that the subject of the background study 134.21has a conviction listed in United States Code, title 42, section 671(a)(20)(A).134.22    Sec. 31. [245C.34] ADOPTION AND CHILD FOSTER CARE BACKGROUND 134.23STUDIES; TRIBAL ORGANIZATIONS.134.24    Subdivision 1.Background studies may be conducted by commissioner.(a) 134.25Tribal organizations may contract with the commissioner under section 245C.12 to obtain 134.26background study data on individuals under tribal jurisdiction related to adoptions.134.27    (b) Tribal organizations may contract with the commissioner under section 245C.12 134.28to obtain background study data on individuals under tribal jurisdiction related to child 134.29foster care.134.30    (c) Background studies initiated by tribal organizations under paragraphs (a) and (b) 134.31must be conducted as provided in subdivisions 2 and 3.134.32    Subd. 2.Information and data provided to tribal organization.The background 134.33study subject must provide the following information to the tribal organization:134.34    (1) for background studies related to adoptions, the information under section 134.35245C.05;135.1    (2) for background studies related to child foster care, the information under section 135.2245C.05;135.3    (3) a set of classifiable fingerprints obtained from an authorized agency; and135.4    (4) a signed consent for the release of information received from national crime 135.5information databases to the tribal organization.135.6    Subd. 3.Information and data provided to commissioner.The tribal organization 135.7shall forward the data collected under subdivision 2 to the commissioner.135.8    Subd. 4.Information commissioner reviews.(a) The commissioner shall review 135.9the following information regarding the background study subject:135.10    (1) the information under section 245C.08, subdivisions 1, 3, and 4;135.11    (2) information from the child abuse and neglect registry for any state in which the 135.12subject has resided for the past five years; and135.13    (3) information from national crime information databases.135.14    (b) The commissioner shall provide any information collected under this subdivision 135.15to the tribal organization that initiated the background study. The commissioner shall 135.16indicate if the information collected shows that the subject of the background study has a 135.17conviction listed in United States Code, title 42, section 671(a)(20)(A).135.18    Sec. 32. Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:135.19    Subd. 2. Other applicable law.(a) Portions of chapters 245A, 245C, 257, 260, and 135.20317A may also affect the adoption of a particular child. 135.21    (b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter 135.2221, sections 1901-1923, may also apply in the adoption of an Indian child, and may 135.23preempt specific provisions of this chapter.135.24    (c) Consistent with section 245C.33 and Public Law 109-248, a completed 135.25background study is required before the approval of any foster or adoptive placement in 135.26a related or an unrelated home.135.27    Sec. 33. Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:135.28    Subdivision 1. Best interests of the child. (a) The policy of the state of Minnesota 135.29is to ensure that the best interests of the child are met by requiring individualized 135.30determination of the needs of the child and of how the adoptive placement will serve the 135.31needs of the child.135.32    (b) Among the factors the agency shall consider in determining the needs of the child 135.33are those specified under section 
         260C.193, subdivision 3, paragraph (b).136.1    (c) Except for emergency placements provided for in section 245A.035, a completed 136.2background study is required under section 245C.33 before the approval of an adoptive 136.3placement in a home.136.4    Sec. 34. Minnesota Statutes 2006, section 259.41, is amended to read:136.5259.41 ADOPTION STUDY.136.6    Subdivision 1. Study required before placement; certain relatives excepted. (a) 136.7An approved adoption study; completed background study, as required under section 136.8245C.33; and written report must be completed before the child is placed in a prospective 136.9adoptive home under this chapter, except as allowed by section 
         259.47, subdivision 6. 136.10In an agency placement, the report must be filed with the court at the time the adoption 136.11petition is filed. In a direct adoptive placement, the report must be filed with the court in 136.12support of a motion for temporary preadoptive custody under section 
         259.47, subdivision 136.133
         , or, if the study and report are complete, in support of an emergency order under section 136.14259.47, subdivision 6
         . The study and report shall be completed by a licensed child-placing 136.15agency and must be thorough and comprehensive. The study and report shall be paid for 136.16by the prospective adoptive parent, except as otherwise required under section 
         259.67136.17or 
         259.73. 136.18    (b) A placement for adoption with an individual who is related to the child, as 136.19defined by section 
         245A.02, subdivision 13, is not subject to this section except as required 136.20by section sections 245C.33 and259.53, subdivision 2, paragraph (c). 136.21    (c) In the case of a licensed foster parent seeking to adopt a child who is in the foster 136.22parent's care, any portions of the foster care licensing process that duplicate requirements 136.23of the home study may be submitted in satisfaction of the relevant requirements of this 136.24section.136.25    Subd. 2. Form of study. (a) The adoption study must include at least one in-home 136.26visit with the prospective adoptive parent. At a minimum, the study must include136.27document the following information about the prospective adoptive parent:136.28    (1) a background check study as required by subdivision 3 and section 245C.33, 136.29and including:136.30    (i) an evaluation assessment of the data and information provided by section 136.31245C.33, subdivision 4, to determine if the prospective adoptive parent and any other 136.32person over the age of 13 living in the home has a felony conviction consistent with 136.33subdivision 3 and section 471(a)(2) of the Social Security Act; and137.1    (ii) an assessment of the effect of a any conviction or finding of substantiated 137.2maltreatment on the ability to capacity of the prospective adoptive parent to safely care 137.3for and parent a child;137.4    (2) a medical and social history and assessment of current health;137.5    (3) an assessment of potential parenting skills;137.6    (4) an assessment of ability to provide adequate financial support for a child; and137.7    (5) an assessment of the level of knowledge and awareness of adoption issues 137.8including, where appropriate, matters relating to interracial, cross-cultural, and special 137.9needs adoptions.137.10    (b) The adoption study is the basis for completion of a written report. The report 137.11must be in a format specified by the commissioner and must contain recommendations 137.12regarding the suitability of the subject of the study to be an adoptive parent.137.13    Subd. 3. Background check; affidavit of history study. (a) At the time an adoption 137.14study is commenced, each prospective adoptive parent must:137.15    (1) authorize access by the agency to any private data needed to complete the study;137.16    (2) provide all addresses at which the prospective adoptive parent and anyone in the 137.17household over the age of 13 has resided in the previous five years; and137.18    (3) disclose any names used previously other than the name used at the time of 137.19the study.137.20    (b) When the requirements of paragraph (a) have been met, the agency shall 137.21immediately begin initiate a background check, study under section 245C.33 to be 137.22completed by the commissioner on each person over the age of 13 living in the home, 137.23consisting, at a minimum, of the following:. As required under section 245C.33 and Public 137.24Law 109-248, a completed background study is required before the approval of any foster 137.25or adoptive placement in a related or an unrelated home. The required background study 137.26must be completed as part of the home study.137.27    (1) a check of criminal conviction data with the Bureau of Criminal Apprehension 137.28and local law enforcement authorities;137.29    (2) a check for data on substantiated maltreatment of a child or vulnerable adult 137.30and domestic violence data with local law enforcement and social services agencies and 137.31district courts; and137.32    (3) for those persons under the age of 25, a check of juvenile court records.137.33    Notwithstanding the provisions of section 260B.171 or 260C.171, the Bureau of 137.34Criminal Apprehension, local law enforcement and social services agencies, district courts, 137.35and juvenile courts shall release the requested information to the agency completing 137.36the adoption study.138.1    (c) When paragraph (b) requires checking the data or records of local law 138.2enforcement and social services agencies and district and juvenile courts, the agency 138.3shall check with the law enforcement and social services agencies and courts whose 138.4jurisdictions cover the addresses under paragraph (a), clause (2). In the event that the 138.5agency is unable to complete any of the record checks required by paragraph (b), the 138.6agency shall document the fact and the agency's efforts to obtain the information.138.7    (d) For a study completed under this section, when the agency has reasonable 138.8cause to believe that further information may exist on the prospective adoptive parent or 138.9household member over the age of 13 that may relate to the health, safety, or welfare of 138.10the child, the prospective adoptive parent or household member over the age of 13 shall 138.11provide the agency with a set of classifiable fingerprints obtained from an authorized law 138.12enforcement agency and the agency may obtain criminal history data from the National 138.13Criminal Records Repository by submitting fingerprints to the Bureau of Criminal 138.14Apprehension. The agency has reasonable cause when, but not limited to, the:138.15    (1) information from the Bureau of Criminal Apprehension indicates that the 138.16prospective adoptive parent or household member over the age of 13 is a multistate 138.17offender;138.18    (2) information from the Bureau of Criminal Apprehension indicates that multistate 138.19offender status is undetermined;138.20    (3) the agency has received a report from the prospective adoptive parent or 138.21household member over the age of 13 or a third party indicating that the prospective 138.22adoptive parent or household member over the age of 13 has a criminal history in a 138.23jurisdiction other than Minnesota; or138.24    (4) the prospective adoptive parent or household member over the age of 13 is or has 138.25been a resident of a state other than Minnesota in the prior five years.138.26    (e) At any time prior to completion of the background check required under 138.27paragraph (b), a prospective adoptive parent may submit to the agency conducting the 138.28study a sworn affidavit stating whether they or any person residing in the household have 138.29been convicted of a crime. The affidavit shall also state whether the adoptive parent or any 138.30other person residing in the household is the subject of an open investigation of, or have 138.31been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment 138.32within the past ten years. A complete description of the crime, open investigation, or 138.33substantiated abuse, and a complete description of any sentence, treatment, or disposition 138.34must be included. The affidavit must contain an acknowledgment that if, at any time 138.35before the adoption is final, a court receives evidence leading to a conclusion that a 138.36prospective adoptive parent knowingly gave false information in the affidavit, it shall be 139.1determined that the adoption of the child by the prospective adoptive parent is not in the 139.2best interests of the child.139.3    (f) For the purposes of subdivision 1 and section 259.47, subdivisions 3 and 6, an 139.4adoption study is complete for placement, even though the background checks required by 139.5paragraph (b) have not been completed, if each prospective adoptive parent has completed 139.6the affidavit allowed by paragraph (e) and the other requirements of this section have been 139.7met. The background checks required by paragraph (b) must be completed before an 139.8adoption petition is filed. If an adoption study has been submitted to the court under section 139.9259.47, subdivision 3 or 6, before the background checks required by paragraph (b) were 139.10complete, an updated adoption study report which includes the results of the background 139.11check must be filed with the adoption petition. In the event that an agency is unable to 139.12complete any of the records checks required by paragraph (b), the agency shall submit with 139.13the petition to adopt an affidavit documenting the agency's efforts to complete the checks.139.14    (c) A home study under paragraph (b) used to consider placement of any child 139.15on whose behalf Title IV-E adoption assistance payments are to be made must not be 139.16approved if a background study reveals a felony conviction at any time for:139.17    (1) child abuse or neglect;139.18    (2) spousal abuse;139.19    (3) a crime against children, including child pornography; or139.20    (4) a crime involving violence, including rape, sexual assault, or homicide, but not 139.21including other physical assault or battery.139.22    (d) A home study under paragraph (b) used to consider placement of any child 139.23on whose behalf Title IV-E adoption assistance payments are to be made must not be 139.24approved if a background study reveals a felony conviction within the past five years for:139.25    (1) physical assault or battery; or139.26    (2) a drug-related offense.139.27    Subd. 4. Updates to adoption study; period of validity. An agency may update 139.28an adoption study and report as needed, regardless of when the original study and report 139.29or most recent update was completed. An update must be in a format specified by the 139.30commissioner and must verify the continuing accuracy of the elements of the original 139.31report and document any changes to elements of the original report. An update to a study 139.32and report not originally completed under this section must ensure that the study and 139.33report, as updated, meet the requirements of this section. An adoption study is valid if the 139.34report has been completed or updated within the previous 12 months.139.35    Sec. 35. Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:140.1    Subd. 2. Adoption agencies; postplacement assessment and report. (a) The 140.2agency to which the petition has been referred under subdivision 1 shall conduct a 140.3postplacement assessment and file a report with the court within 90 days of receipt 140.4of a copy of the adoption petition. The agency shall send a copy of the report to the 140.5commissioner at the time it files the report with the court. The assessment and report 140.6must evaluate the environment and antecedents of the child to be adopted, the home of 140.7the petitioners, whether placement with the petitioners meets the needs of the child as 140.8described in section 
         259.57, subdivision 2. The report must include a recommendation to 140.9the court as to whether the petition should or should not be granted. 140.10    In making evaluations and recommendations, the postplacement assessment and 140.11report must, at a minimum, address the following:140.12    (1) the level of adaptation by the prospective adoptive parents to parenting the child;140.13    (2) the health and well-being of the child in the prospective adoptive parents' home;140.14    (3) the level of incorporation by the child into the prospective adoptive parents' 140.15home, extended family, and community; and140.16    (4) the level of inclusion of the child's previous history into the prospective adoptive 140.17home, such as cultural or ethnic practices, or contact with former foster parents or 140.18biological relatives.140.19    (b) A postplacement adoption report is valid for 12 months following its date 140.20of completion.140.21    (c) If the petitioner is an individual who is related to the child, as defined by section 140.22245A.02, subdivision 13, the agency, as part of its postplacement assessment and report 140.23under paragraph (a), shall conduct a background check meeting the requirements of 140.24section 259.41, subdivision 3, paragraph (b). The prospective adoptive parent shall 140.25cooperate in the completion of the background check by supplying the information and 140.26authorizations described in section 259.41, subdivision 3, paragraph (a).140.27    (d) (c) If the report recommends that the court not grant the petition to adopt the 140.28child, the provisions of this paragraph apply. Unless the assessment and report were 140.29completed by the local social services agency, the agency completing the report, at the 140.30time it files the report with the court under paragraph (a), must provide a copy of the report 140.31to the local social services agency in the county where the prospective adoptive parent 140.32lives. The agency or local social services agency may recommend that the court dismiss 140.33the petition. If the local social services agency determines that continued placement in the 140.34home endangers the child's physical or emotional health, the agency shall seek a court 140.35order to remove the child from the home.141.1    (e) (d) If, through no fault of the petitioner, the agency to whom the petition was 141.2referred under subdivision 1, paragraph (b), fails to complete the assessment and file the 141.3report within 90 days of the date it received a copy of the adoption petition, the court may 141.4hear the petition upon giving the agency and the local social services agency, if different, 141.5five days' notice by mail of the time and place of the hearing.141.6    Sec. 36. Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:141.7    Subd. 2. Protection of child's best interests. (a) The policy of the state of 141.8Minnesota is to ensure that the best interests of children are met by requiring an 141.9individualized determination of the needs of the child and how the adoptive placement 141.10will serve the needs of the child.141.11    (b) Among the factors the court shall consider in determining the needs of the child 141.12are those specified under section 
         260C.193, subdivision 3, paragraph (b). Consistent with 141.13section 245C.33 and Public Law 109-248, a complete background study is required before 141.14the approval of an adoptive placement in a home. 141.15    (c) In reviewing adoptive placement and in determining appropriate adoption, 141.16the court shall consider placement, consistent with the child's best interests and in the 141.17following order, with (1) a relative or relatives of the child, or (2) an important friend with 141.18whom the child has resided or had significant contact. Placement of a child cannot be 141.19delayed or denied based on race, color, or national origin of the adoptive parent or the 141.20child. Whenever possible, siblings should be placed together unless it is determined 141.21not to be in the best interests of a sibling.141.22    (d) If the child's birth parent or parents explicitly request that relatives and important 141.23friends not be considered, the court shall honor that request consistent with the best 141.24interests of the child.141.25    If the child's birth parent or parents express a preference for placing the child in an 141.26adoptive home of the same or a similar religious background to that of the birth parent 141.27or parents, the court shall place the child with a family that also meets the birth parent's 141.28religious preference. Only if no family is available as described in clause (a) or (b) 141.29may the court give preference to a family described in clause (c) that meets the parent's 141.30religious preference.141.31    (e) This subdivision does not affect the Indian Child Welfare Act, United States 141.32Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation 141.33Act, sections 
         260.751 to 
         260.835.142.1    Sec. 37. Minnesota Statutes 2006, section 260C.209, is amended to read:142.2260C.209 BACKGROUND CHECKS.142.3    Subdivision 1. Subjects. The responsible social services agency must conduct142.4initiate a background check study to be completed by the commissioner under this section 142.5of chapter 245C on the following individuals:142.6    (1) a noncustodial parent or nonadjudicated parent who is being assessed for 142.7purposes of providing day-to-day care of a child temporarily or permanently under section 142.8260C.212, subdivision 4
         , and any member of the parent's household who is over the age of 142.913 when there is a reasonable cause to believe that the parent or household member over 142.10age 13 has a criminal history or a history of maltreatment of a child or vulnerable adult 142.11which would endanger the child's health, safety, or welfare;142.12    (2) an individual whose suitability for relative placement under section 
         260C.212, 142.13subdivision 5
         , is being determined and any member of the relative's household who is 142.14over the age of 13 when:142.15    (i) the relative must be licensed for foster care; or142.16    (ii) the agency must conduct a background study is required under section 
         259.53, 142.17subdivision 2
         ; or142.18    (iii) the agency or the commissioner has reasonable cause to believe the relative 142.19or household member over the age of 13 has a criminal history which would not make 142.20transfer of permanent legal and physical custody to the relative under section 
         260C.201, 142.21subdivision 11
         , in the child's best interest; and142.22    (3) a parent, following an out-of-home placement, when the responsible social 142.23services agency has reasonable cause to believe that the parent has been convicted of a 142.24crime directly related to the parent's capacity to maintain the child's health, safety, or 142.25welfare or the parent is the subject of an open investigation of, or has been the subject 142.26of a substantiated allegation of, child or vulnerable-adult maltreatment within the past 142.27ten years.142.28"Reasonable cause" means that the agency has received information or a report from the 142.29subject or a third person that creates an articulable suspicion that the individual has a 142.30history that may pose a risk to the health, safety, or welfare of the child. The information 142.31or report must be specific to the potential subject of the background check and shall not 142.32be based on the race, religion, ethnic background, age, class, or lifestyle of the potential 142.33subject.142.34    Subd. 2. General procedures. (a) When conducting initiating a background check 142.35under subdivision 1, the agency may shall require the individual being assessed to provide 142.36sufficient information to ensure an accurate assessment under this section, including:143.1    (1) the individual's first, middle, and last name and all other names by which the 143.2individual has been known;143.3    (2) home address, zip code, city, county, and state of residence for the past ten five143.4years;143.5    (3) sex;143.6    (4) date of birth; and143.7    (5) driver's license number or state identification number.143.8    (b) When notified by the commissioner or the responsible social services agency that 143.9it is conducting an assessment under this section, the Bureau of Criminal Apprehension, 143.10commissioners of health and human services, law enforcement, and county agencies must 143.11provide the commissioner or the responsible social services agency or county attorney 143.12with the following information on the individual being assessed: criminal history data, 143.13reports about the maltreatment of adults substantiated under section 
         626.557, and reports 143.14of maltreatment of minors substantiated under section 
         626.556.143.15    Subd. 3. Multistate information.(a) For any assessment every background study143.16completed under this section, if the responsible social services agency has reasonable 143.17cause to believe that the individual is a multistate offender, the individual must the subject 143.18of the background study shall provide the responsible social services agency or the 143.19county attorney with a set of classifiable fingerprints obtained from an authorized law 143.20enforcement agency. The responsible social services agency or county attorney may shall 143.21provide the fingerprints to the commissioner, and the commissioner shall obtain criminal 143.22history data from the National Criminal Records Repository by submitting the fingerprints 143.23to the Bureau of Criminal Apprehension.143.24    (b) For purposes of this subdivision, the responsible social services agency has 143.25reasonable cause when, but not limited to:143.26    (1) information from the Bureau of Criminal Apprehension indicates that the 143.27individual is a multistate offender;143.28    (2) information from the Bureau of Criminal Apprehension indicates that multistate 143.29offender status is undetermined;143.30    (3) the social services agency has received a report from the individual or a third 143.31party indicating that the individual has a criminal history in a jurisdiction other than 143.32Minnesota; or143.33    (4) the individual is or has been a resident of a state other than Minnesota at any 143.34time during the prior ten years.143.35    Subd. 4. Notice upon receipt. The responsible social services agency commissioner143.36must provide the subject of the background study with the results of the study as required144.1under this section within 15 business days of receipt or at least 15 days prior to the hearing 144.2at which the results will be presented, whichever comes first. The subject may provide 144.3written information to the agency that the results are incorrect and may provide additional 144.4or clarifying information to the agency and to the court through a party to the proceeding. 144.5This provision does not apply to any background study conducted under chapters 245A 144.6and chapter 245C.144.7    Sec. 38. Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to read:144.8    Subd. 2. Placement decisions based on best interest of the child. (a) The policy 144.9of the state of Minnesota is to ensure that the child's best interests are met by requiring an 144.10individualized determination of the needs of the child and of how the selected placement 144.11will serve the needs of the child being placed. The authorized child-placing agency shall 144.12place a child, released by court order or by voluntary release by the parent or parents, in 144.13a family foster home selected by considering placement with relatives and important 144.14friends in the following order:144.15    (1) with an individual who is related to the child by blood, marriage, or adoption; or144.16    (2) with an individual who is an important friend with whom the child has resided or 144.17had significant contact.144.18    (b) Among the factors the agency shall consider in determining the needs of the 144.19child are the following:144.20    (1) the child's current functioning and behaviors;144.21    (2) the medical, educational, and developmental needs of the child;144.22    (3) the child's history and past experience;144.23    (4) the child's religious and cultural needs;144.24    (5) the child's connection with a community, school, and church;144.25    (6) the child's interests and talents;144.26    (7) the child's relationship to current caretakers, parents, siblings, and relatives; and144.27    (8) the reasonable preference of the child, if the court, or the child-placing agency 144.28in the case of a voluntary placement, deems the child to be of sufficient age to express 144.29preferences.144.30    (c) Placement of a child cannot be delayed or denied based on race, color, or national 144.31origin of the foster parent or the child.144.32    (d) Siblings should be placed together for foster care and adoption at the earliest 144.33possible time unless it is determined not to be in the best interests of a sibling or unless it 144.34is not possible after appropriate efforts by the responsible social services agency.145.1    (e) Except for emergency placement as provided for in section 245A.035, a 145.2completed background study is required under section 245C.08 before the approval of a 145.3foster placement in a related or unrelated home.145.4ARTICLE 3145.5HEALTH CARE145.6    Section 1. Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to 145.7read:145.8    Subd. 2. Transfers. (a) Notwithstanding section 
         295.581, to the extent available 145.9resources in the health care access fund exceed expenditures in that fund, effective with 145.10the biennium beginning July 1, 2007,the commissioner shall transfer funds from the 145.11health care access fund to the general fund to offset the costs of MinnesotaCare enrollees 145.12shifting to medical assistance due to the implementation of an automated eligibility 145.13determination system. The medical assistance costs shall be identified and updated in the 145.14November and February forecasts.145.15    (b) In addition to the amounts in paragraph (a), the commissioner of finance shall 145.16transfer the excess funds from the health care access fund to the general fund on June 145.1730 of each year, provided that the amount transferred in any fiscal biennium shall not 145.18exceed $96,000,000. For the biennium ending June 30, 2011, the transfer shall not exceed 145.19$48,000,000.145.20    (b)(c) For fiscal years 2006 to 2009, MinnesotaCare shall be a forecasted program, 145.21and, if necessary, the commissioner shall reduce these transfers from the health care access 145.22fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, 145.23transfer sufficient funds from the general fund to the health care access fund to meet 145.24annual MinnesotaCare expenditures.145.25    Sec. 2. Minnesota Statutes 2006, section 256.969, subdivision 3a, is amended to read:145.26    Subd. 3a. Payments. (a) Acute care hospital billings under the medical 145.27assistance program must not be submitted until the recipient is discharged. However, 145.28the commissioner shall establish monthly interim payments for inpatient hospitals that 145.29have individual patient lengths of stay over 30 days regardless of diagnostic category. 145.30Except as provided in section 
         256.9693, medical assistance reimbursement for treatment 145.31of mental illness shall be reimbursed based on diagnostic classifications. Individual 145.32hospital payments established under this section and sections 
         256.9685, 
         256.9686, and 145.33256.9695
         , in addition to third party and recipient liability, for discharges occurring during 145.34the rate year shall not exceed, in aggregate, the charges for the medical assistance covered 146.1inpatient services paid for the same period of time to the hospital. This payment limitation 146.2shall be calculated separately for medical assistance and general assistance medical 146.3care services. The limitation on general assistance medical care shall be effective for 146.4admissions occurring on or after July 1, 1991. Services that have rates established under 146.5subdivision 11 or 12, must be limited separately from other services. After consulting with 146.6the affected hospitals, the commissioner may consider related hospitals one entity and 146.7may merge the payment rates while maintaining separate provider numbers. The operating 146.8and property base rates per admission or per day shall be derived from the best Medicare 146.9and claims data available when rates are established. The commissioner shall determine 146.10the best Medicare and claims data, taking into consideration variables of recency of the 146.11data, audit disposition, settlement status, and the ability to set rates in a timely manner. 146.12The commissioner shall notify hospitals of payment rates by December 1 of the year 146.13preceding the rate year. The rate setting data must reflect the admissions data used to 146.14establish relative values. Base year changes from 1981 to the base year established for the 146.15rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited 146.16to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 146.171. The commissioner may adjust base year cost, relative value, and case mix index data 146.18to exclude the costs of services that have been discontinued by the October 1 of the year 146.19preceding the rate year or that are paid separately from inpatient services. Inpatient stays 146.20that encompass portions of two or more rate years shall have payments established based 146.21on payment rates in effect at the time of admission unless the date of admission preceded 146.22the rate year in effect by six months or more. In this case, operating payment rates for 146.23services rendered during the rate year in effect and established based on the date of 146.24admission shall be adjusted to the rate year in effect by the hospital cost index.146.25    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total 146.26payment, before third-party liability and spenddown, made to hospitals for inpatient 146.27services is reduced by .5 percent from the current statutory rates.146.28    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 146.29admissions occurring on or after July 1, 2003, made to hospitals for inpatient services 146.30before third-party liability and spenddown, is reduced five percent from the current 146.31statutory rates. Mental health services within diagnosis related groups 424 to 432, and146.32facilities defined under subdivision 16, and, effective for admissions occurring on or after 146.33July 1, 2007, a long-term hospital as designated by the Medicare program that is located in 146.34a city of the first class as defined in section 410.01, are excluded from this paragraph.146.35    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for 146.36fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for 147.1inpatient services before third-party liability and spenddown, is reduced 6.0 percent from 147.2the current statutory rates. Mental health services within diagnosis related groups 424 to 147.3432 and, facilities defined under subdivision 16, and, effective for admissions occurring 147.4on or after July 1, 2007, a long-term hospital as designated by the Medicare program 147.5that is located in a city of the first class as defined in section 410.01, are excluded from 147.6this paragraph. Notwithstanding section 
         256.9686, subdivision 7, for purposes of this 147.7paragraph, medical assistance does not include general assistance medical care. Payments 147.8made to managed care plans shall be reduced for services provided on or after January 147.91, 2006, to reflect this reduction.147.10    Sec. 3. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:147.11    Subd. 9. Disproportionate numbers of low-income patients served. (a) For 147.12admissions occurring on or after October 1, 1992, through December 31, 1992, the 147.13medical assistance disproportionate population adjustment shall comply with federal law 147.14and shall be paid to a hospital, excluding regional treatment centers and facilities of the 147.15federal Indian Health Service, with a medical assistance inpatient utilization rate in excess 147.16of the arithmetic mean. The adjustment must be determined as follows:147.17    (1) for a hospital with a medical assistance inpatient utilization rate above the 147.18arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 147.19federal Indian Health Service but less than or equal to one standard deviation above the 147.20mean, the adjustment must be determined by multiplying the total of the operating and 147.21property payment rates by the difference between the hospital's actual medical assistance 147.22inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 147.23treatment centers and facilities of the federal Indian Health Service; and147.24    (2) for a hospital with a medical assistance inpatient utilization rate above one 147.25standard deviation above the mean, the adjustment must be determined by multiplying 147.26the adjustment that would be determined under clause (1) for that hospital by 1.1. If 147.27federal matching funds are not available for all adjustments under this subdivision, the 147.28commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for 147.29federal match. The commissioner may establish a separate disproportionate population 147.30operating payment rate adjustment under the general assistance medical care program. 147.31For purposes of this subdivision medical assistance does not include general assistance 147.32medical care. The commissioner shall report annually on the number of hospitals likely to 147.33receive the adjustment authorized by this paragraph. The commissioner shall specifically 147.34report on the adjustments received by public hospitals and public hospital corporations 147.35located in cities of the first class.148.1    (b) For admissions occurring on or after July 1, 1993, the medical assistance 148.2disproportionate population adjustment shall comply with federal law and shall be paid to 148.3a hospital, excluding regional treatment centers and facilities of the federal Indian Health 148.4Service, with a medical assistance inpatient utilization rate in excess of the arithmetic 148.5mean. The adjustment must be determined as follows:148.6    (1) for a hospital with a medical assistance inpatient utilization rate above the 148.7arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 148.8federal Indian Health Service but less than or equal to one standard deviation above the 148.9mean, the adjustment must be determined by multiplying the total of the operating and 148.10property payment rates by the difference between the hospital's actual medical assistance 148.11inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 148.12treatment centers and facilities of the federal Indian Health Service;148.13    (2) for a hospital with a medical assistance inpatient utilization rate above one 148.14standard deviation above the mean, the adjustment must be determined by multiplying 148.15the adjustment that would be determined under clause (1) for that hospital by 1.1. The 148.16commissioner may establish a separate disproportionate population operating payment 148.17rate adjustment under the general assistance medical care program. For purposes of this 148.18subdivision, medical assistance does not include general assistance medical care. The 148.19commissioner shall report annually on the number of hospitals likely to receive the 148.20adjustment authorized by this paragraph. The commissioner shall specifically report on 148.21the adjustments received by public hospitals and public hospital corporations located 148.22in cities of the first class;148.23    (3) for a hospital that had medical assistance fee-for-service payment volume during 148.24calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service 148.25payment volume, a medical assistance disproportionate population adjustment shall be 148.26paid in addition to any other disproportionate payment due under this subdivision as 148.27follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995. 148.28For a hospital that had medical assistance fee-for-service payment volume during calendar 148.29year 1991 in excess of eight percent of total medical assistance fee-for-service payment 148.30volume and was the primary hospital affiliated with the University of Minnesota, a 148.31medical assistance disproportionate population adjustment shall be paid in addition to any 148.32other disproportionate payment due under this subdivision as follows: $505,000 due on 148.33the 15th of each month after noon, beginning July 15, 1995; and148.34    (4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be 148.35reduced to zero.149.1    (c) The commissioner shall adjust rates paid to a health maintenance organization 149.2under contract with the commissioner to reflect rate increases provided in paragraph (b), 149.3clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those 149.4rates to reflect payments provided in clause (3).149.5    (d) If federal matching funds are not available for all adjustments under paragraph 149.6(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a 149.7pro rata basis so that all adjustments under paragraph (b) qualify for federal match.149.8    (e) For purposes of this subdivision, medical assistance does not include general 149.9assistance medical care.149.10    (f) For hospital services occurring on or after July 1, 2005, to June 30, 2007, general 149.11assistance medical care expenditures for fee-for-service inpatient and outpatient hospital 149.12services made by the department and by prepaid health plans participating in general 149.13assistance medical careeffective July 1, 2007, payments under section 256B.199 shall be 149.14considered Medicaid disproportionate share hospital payments, except as limited below:149.15by clauses (1) to (5);149.16    (1) only the portion of Minnesota's disproportionate share hospital allotment under 149.17section 1923(f) of the Social Security Act that is not spent on the disproportionate 149.18population adjustments in paragraph (b), clauses (1) and (2), may be used for general 149.19assistance medical care expenditures;149.20    (2) only those general assistance medical care expenditures made to hospitals that 149.21qualify for disproportionate share payments under section 1923 of the Social Security Act 149.22and the Medicaid state plan may be considered disproportionate share hospital payments;149.23    (3) only those general assistance medical care expenditures made to an individual 149.24hospital that would not cause the hospital to exceed its individual hospital limits under 149.25section 1923 of the Social Security Act may be considered; and149.26    (4) general assistance medical care expenditures may be considered only to the 149.27extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.149.28All hospitals and prepaid health plans participating in general assistance medical care 149.29must provide any necessary expenditure, cost, and revenue information required by 149.30the commissioner as necessary for purposes of obtaining federal Medicaid matching 149.31funds for general assistance medical care expenditures. Medicaid disproportionate share 149.32payments; and149.33    (5) expenditures under general assistance medical care shall be used to the fullest 149.34extent before payments under section 256B.199.150.1    (g) Upon federal approval of the related state plan amendment, paragraph (f) is 150.2effective retroactively from July 1, 2005, or the earliest effective date approved by the 150.3Centers for Medicare and Medicaid Services.150.4    Sec. 4. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision 150.5to read:150.6    Subd. 28.Long-term hospital payment adjustment.For admissions occurring on 150.7or after July 1, 2009, the commissioner shall increase the medical assistance payments 150.8to a long-term hospital with a medical assistance inpatient utilization rate of 17.95 150.9percent of total patient days as of the base year in effect on July 1, 2005, by an amount 150.10equal to 13 percent of the total of the operating and property payment rates. Payments 150.11made to managed care plans shall not reflect this payment increase. For purposes of 150.12this subdivision, medical assistance does not include general assistance medical care. 150.13Payments to a hospital under this subdivision shall be reduced by the amount of any 150.14payments made under subdivision 27.150.15    Sec. 5. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:150.16    Subd. 14. Competitive bidding. (a) When determined to be effective, economical, 150.17and feasible, the commissioner may utilize volume purchase through competitive bidding 150.18and negotiation under the provisions of chapter 16C, to provide items under the medical 150.19assistance program including but not limited to the following:150.20    (1) eyeglasses;150.21    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency 150.22situation on a short-term basis, until the vendor can obtain the necessary supply from 150.23the contract dealer;150.24    (3) hearing aids and supplies; and150.25    (4) durable medical equipment, including but not limited to:150.26    (i) hospital beds;150.27    (ii) commodes;150.28    (iii) glide-about chairs;150.29    (iv) patient lift apparatus;150.30    (v) wheelchairs and accessories;150.31    (vi) oxygen administration equipment;150.32    (vii) respiratory therapy equipment;150.33    (viii) electronic diagnostic, therapeutic and life support systems;151.1    (5) specialnonemergency transportation services level of need determinations, 151.2disbursement of public transportation passes and tokens, and volunteer and recipient 151.3mileage and parking reimbursements; and151.4    (6) drugs.151.5    (b) Rate changes under this chapter and chapters 256D and 256L do not affect 151.6contract payments under this subdivision unless specifically identified.151.7    Sec. 6. Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision 151.8to read:151.9    Subd. 14a.Level of need determination.Nonemergency medical transportation 151.10level of need determinations must be performed by a physician, a registered nurse working 151.11under direct supervision of a physician, a physician's assistant, a nurse practitioner, a 151.12licensed practical nurse, or a discharge planner. Nonemergency medical transportation 151.13level of need determinations must not be performed more than semiannually on any 151.14individual, unless the individual's circumstances have sufficiently changed so as to 151.15require a new level of need determination. Individuals residing in licensed nursing 151.16facilities and individuals requiring stretcher transportation are exempt from a level of need 151.17determination and are eligible for special transportation services until the individual no 151.18longer resides in a licensed nursing facility or no longer requires stretcher transportation.151.19    Sec. 7. Minnesota Statutes 2006, section 256B.056, is amended by adding a 151.20subdivision to read:151.21    Subd. 1d.Treatment of certain monetary gifts.The commissioner shall disregard 151.22as income any portion of a monetary gift received by an applicant or enrollee that is 151.23designated to purchase a prosthetic device not covered by insurance, other third-party 151.24payers, or medical assistance.151.25    Sec. 8. Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to 151.26read:151.27    Subd. 3f. Circumcision for newborns.Newborn Circumcision is not covered, 151.28unless the procedure is medically necessary or required because of a well-established 151.29religious practice.151.30    Sec. 9. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 151.31subdivision to read:152.1    Subd. 8d.Chiropractic services.Medical assistance covers the following 152.2medically necessary chiropractic services: one initial or progress exam per year, manual 152.3manipulation of the spine, and x-rays.152.4EFFECTIVE DATE.This section is effective July 1, 2007.152.5    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to 152.6read:152.7    Subd. 13c. Formulary committee. The commissioner, after receiving 152.8recommendations from professional medical associations and professional pharmacy 152.9associations, and consumer groups shall designate a Formulary Committee to carry 152.10out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be 152.11comprised of four licensed physicians actively engaged in the practice of medicine in 152.12Minnesota one of whom must be actively engaged in the treatment of persons with mental 152.13illness; at least three licensed pharmacists actively engaged in the practice of pharmacy 152.14in Minnesota; and one consumer representative; the remainder to be made up of health 152.15care professionals who are licensed in their field and have recognized knowledge in the 152.16clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs. 152.17Members of the Formulary Committee shall not be employed by the Department of 152.18Human Services, but the committee shall be staffed by an employee of the department 152.19who shall serve as an ex officio, nonvoting member of the board committee. The 152.20department's medical director shall also serve as an ex officio, nonvoting member for the 152.21committee. Committee members shall serve three-year terms and may be reappointed 152.22by the commissioner. The Formulary Committee shall meet at least quarterly. The 152.23commissioner may require more frequent Formulary Committee meetings as needed. An 152.24honorarium of $100 per meeting and reimbursement for mileage shall be paid to each 152.25committee member in attendance.152.26    Sec. 11. Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to 152.27read:152.28    Subd. 13d. Drug formulary.(a) The commissioner shall establish a drug 152.29formulary. Its establishment and publication shall not be subject to the requirements of the 152.30Administrative Procedure Act, but the Formulary Committee shall review and comment 152.31on the formulary contents.152.32    (b) The formulary shall not include:152.33    (1) drugs or products for which there is no federal funding;152.34    (2) over-the-counter drugs, except as provided in subdivision 13;153.1    (3) drugs used for weight loss, except that medically necessary lipase inhibitors may 153.2be covered for a recipient with type II diabetes;153.3    (4) drugs when used for the treatment of impotence or erectile dysfunction;153.4    (5) drugs for which medical value has not been established; and153.5    (6) drugs from manufacturers who have not signed a rebate agreement with the 153.6Department of Health and Human Services pursuant to section 1927 of title XIX of the 153.7Social Security Act.153.8    (c) If a single-source drug used by at least two percent of the fee-for-service 153.9medical assistance recipients is removed from the formulary due to the failure of the 153.10manufacturer to sign a rebate agreement with the Department of Health and Human 153.11Services, the commissioner shall notify prescribing practitioners within 30 days of 153.12receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a 153.13rebate agreement was not signed.153.14EFFECTIVE DATE.This section is effective the day following final enactment.153.15    Sec. 12. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 153.16subdivision to read:153.17    Subd. 13i.Medicare Part D.Notwithstanding subdivision 13, paragraph (d), for 153.18recipients who are enrolled in a Medicare Part D prescription drug plan or Medicare 153.19Advantage special needs plan, medical assistance covers co-payments which the recipient 153.20is responsible for under a Medicare Part D prescription drug plan or Medicare Advantage 153.21special needs plan, once the recipient has paid $12 per month in prescription drug 153.22co-payments, and according to the requirements of the plan.153.23    Sec. 13. Minnesota Statutes 2006, section 256B.0625, subdivision 17, is amended to 153.24read:153.25    Subd. 17. Transportation costs. (a) Medical assistance covers transportation costs 153.26incurred solely for obtaining emergency medical care or transportation costs incurred 153.27by eligible persons in obtaining emergency or nonemergency medical care when paid 153.28directly to an ambulance company, common carrier, or other recognized providers of 153.29transportation services.153.30    (b) Medical assistance covers special transportation, as defined in Minnesota Rules, 153.31part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that 153.32would prohibit the recipient from safely accessing and using a bus, taxi, other commercial 153.33transportation, or private automobile.154.1The commissioner may use an order by the recipient's attending physician to certify that 154.2the recipient requires special transportation services. Special transportation includes 154.3driver-assisted service to eligible individuals. Driver-assisted service includes passenger 154.4pickup at and return to the individual's residence or place of business, assistance with 154.5admittance of the individual to the medical facility, and assistance in passenger securement 154.6or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers 154.7must obtain written documentation from the health care service provider who is serving 154.8the recipient being transported, identifying the time that the recipient arrived. Special 154.9transportation providers may not bill for separate base rates for the continuation of a trip 154.10beyond the original destination. Special transportation providers must take recipients 154.11to the nearest appropriate health care provider, using the most direct quickest route 154.12available as determined by a commercially available mileage software program approved 154.13by the commissioner. The maximum medical assistance reimbursement rates for special 154.14transportation services are:154.15    (1) $17 for the base rate and $1.35 $1.43 per mile for services to eligible persons 154.16who need a wheelchair-accessible van;154.17    (2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who 154.18do not need a wheelchair-accessible van; and154.19    (3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for 154.20services to eligible persons who need a stretcher-accessible vehicle.154.21    Sec. 14. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to 154.22read:154.23    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 154.24meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 154.25$6.50 for lunch, or $8 for dinner.154.26    (b) Medical assistance reimbursement for lodging for persons traveling to receive 154.27medical care may not exceed $50 per day unless prior authorized by the local agency.154.28    (c) Medical assistance direct mileage reimbursement to thean eligible person or the154.29an eligible person's driver may not exceed 20 cents per mile friend, neighbor, or relative 154.30that is providing direct transportation to a covered service shall be at 15 cents below the 154.31current Internal Revenue Service mileage reimbursement for business purposes.154.32    (d) Medical assistance covers oral language interpreter services when provided by 154.33an enrolled health care provider during the course of providing a direct, person-to-person 154.34covered health care service to an enrolled recipient with limited English proficiency.155.1    Sec. 15. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 155.2subdivision to read:155.3    Subd. 49.Community health worker.(a) Medical assistance covers the care 155.4coordination and patient education services provided by a community health worker if 155.5the community health worker has: 155.6    (1) received a certificate from the Minnesota State Colleges and Universities System 155.7approved community health worker curriculum; or155.8    (2) at least five years of supervised experience with an enrolled physician or 155.9advanced practice registered nurse.155.10Community health workers eligible for payment under clause (2) must complete the 155.11certification program by January 1, 2010, to continue to be eligible for payment.155.12    (b) Community health workers must work under the supervision of a medical 155.13assistance enrolled physician or advanced practice registered nurse.155.14    Sec. 16. Minnesota Statutes 2006, section 256B.0644, is amended to read:155.15256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 155.16PROGRAMS.155.17    (a) A vendor of medical care, as defined in section 
         256B.02, subdivision 7, and a 155.18health maintenance organization, as defined in chapter 62D, must participate as a provider 155.19or contractor in the medical assistance program, general assistance medical care program, 155.20and MinnesotaCare as a condition of participating as a provider in health insurance plans 155.21and programs or contractor for state employees established under section 
         43A.18, the 155.22public employees insurance program under section 
         43A.316, for health insurance plans 155.23offered to local statutory or home rule charter city, county, and school district employees, 155.24the workers' compensation system under section 
         176.135, and insurance plans provided 155.25through the Minnesota Comprehensive Health Association under sections 
         62E.01 to 155.2662E.19
         . The limitations on insurance plans offered to local government employees shall 155.27not be applicable in geographic areas where provider participation is limited by managed 155.28care contracts with the Department of Human Services. 155.29    (b) For providers other than health maintenance organizations, participation in the 155.30medical assistance program means that:155.31     (1) the provider accepts new medical assistance, general assistance medical care, 155.32and MinnesotaCare patients or;155.33    (2) for providers other than dental service providers, at least 20 percent of the 155.34provider's patients are covered by medical assistance, general assistance medical care, and 155.35MinnesotaCare as their primary source of coverage, or; or156.1    (3) for dental service providers, at least ten percent of the provider's patients are 156.2covered by medical assistance, general assistance medical care, and MinnesotaCare as 156.3their primary source of coverage, or the provider accepts new medical assistance and 156.4MinnesotaCare patients who are children with special health care needs. For purposes 156.5of this section, "children with special health care needs" means children up to age 18 156.6who: (i) require health and related services beyond that required by children generally; 156.7and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 156.8condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 156.9cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 156.10neurological diseases; visual impairment or deafness; Down syndrome and other genetic 156.11disorders; autism; fetal alcohol syndrome; and other conditions designated by the 156.12commissioner after consultation with representatives of pediatric dental providers and 156.13consumers. 156.14    (c) Patients seen on a volunteer basis by the provider at a location other than the 156.15provider's usual place of practice may be considered in meeting this the participation 156.16requirement in this section. The commissioner shall establish participation requirements 156.17for health maintenance organizations. The commissioner shall provide lists of 156.18participating medical assistance providers on a quarterly basis to the commissioner of 156.19employee relations, the commissioner of labor and industry, and the commissioner of 156.20commerce. Each of the commissioners shall develop and implement procedures to exclude 156.21as participating providers in the program or programs under their jurisdiction those 156.22providers who do not participate in the medical assistance program. The commissioner 156.23of employee relations shall implement this section through contracts with participating 156.24health and dental carriers. 156.25    Sec. 17. [256B.0751] CARE COORDINATION FOR CHILDREN WITH 156.26HIGH-COST MEDICAL CONDITIONS.156.27    Subdivision 1.Care coordination required.(a) The commissioner of human 156.28services shall contract with the U special kids program to provide care coordination, 156.29beginning October 1, 2007, for medical assistance enrollees who are children with 156.30high-cost medical conditions, and to perform the other duties specified in this section.156.31    (b) For purposes of this section, "care coordination" means collaboration with 156.32primary care physicians and specialists to manage care, development of medical 156.33management plans for recurrent acute illnesses, oversight and coordination of all aspects 156.34of care in partnership with families, organization of medical information into a summary 156.35of critical information, coordination and appropriate sequencing of tests and multiple 157.1appointments, information and assistance with accessing resources, and telephone triage 157.2for acute illnesses or problems.157.3    Subd. 2.Referrals.The commissioner shall develop a mechanism to refer 157.4children to the U special kids program for care coordination. Beginning October 1, 2007, 157.5and subject to the limits on total program enrollment specified in subdivision 3, the 157.6commissioner shall refer to the U special kids program children who:157.7    (1) incur medical expenses that exceed the qualifying level specified in subdivision 3;157.8    (2) have medical conditions that involve four or more major systems; require 157.9multiple specialists; require use of technology such as G-tube, trach, central line, or 157.10oxygen; and require multiple medications;157.11    (3) do not have a medical case manager for cancer, organ transplantation, epilepsy, 157.12or bone marrow replacement; and157.13    (4) voluntarily agree to participate in the program.157.14    Subd. 3.Qualifying level of medical expenses.(a) For the period October 1, 2007, 157.15through September 30, 2008, the commissioner shall refer children for care coordination 157.16under this section if they incurred medical expenses of $500,000 or more during the 157.17fiscal year ending June 30, 2007.157.18    (b) For the period October 1, 2008, through September 30, 2009, the commissioner 157.19shall refer children for care coordination under this section if they incurred medical 157.20expenses of $400,000 or more during the fiscal year ending June 30, 2008.157.21    (c) For the period October 1, 2009, through September 30, 2010, the commissioner 157.22shall refer children for care coordination under this section if they incurred medical 157.23expenses of $300,000 or more during the fiscal year ending June 30, 2009.157.24    (d) Beginning October 1, 2010, the commissioner shall refer children for care 157.25coordination under this section if they incurred medical expenses of $250,000 or more 157.26during the previous fiscal year.157.27    (e) The commissioner shall limit referrals to the extent necessary to ensure that 157.28total enrollment in the U special kids program does not exceed 100 children for the 157.29period October 1, 2007, through September 30, 2008, and does not exceed 150 children 157.30beginning October 1, 2008.157.31    Subd. 4.Case management.Beginning October 1, 2007, the U special kids 157.32program shall coordinate all nonmedical case management services provided to children 157.33who are required to receive care coordination under this section. The program may 157.34require all nonmedical case managers, including, but not limited to, county case managers 157.35and case managers for children served under a home and community-based waiver, 157.36to submit care plans for approval, and to document client compliance with the care 158.1plans. The U special kids program, beginning October 1, 2008, may employ or contract 158.2with nonmedical case managers to provide all nonmedical case management services to 158.3children required to receive care coordination under this section. The commissioner shall 158.4reimburse the U special kids program for case management services through the medical 158.5assistance program.158.6    Subd. 5.Statewide availability of care coordination.The U special kids program 158.7may contract with other entities to provide care coordination services as defined in 158.8subdivision 1, in order to ensure the availability of these services in all regions of the state.158.9    Subd. 6.Advance practice nurse telephone triage system.The U special kids 158.10program shall establish and operate an advance practice nurse telephone triage system that 158.11is available statewide, 24 hours a day, seven days per week. The system must provide 158.12advance practice nurses with access to a Web-based information system to appropriately 158.13triage medical problems, manage care, and reduce unnecessary hospitalizations.158.14    Subd. 7.Monitoring and evaluation.The commissioner shall monitor program 158.15outcomes and evaluate the extent to which referrals to the U special kids program have 158.16improved the quality and coordination of care and provided financial savings to the 158.17medical assistance program. The U special kids program shall submit to the commissioner, 158.18in the form and manner specified by the commissioner, all data and information necessary 158.19to monitor program outcomes and evaluate the program. The commissioner shall present a 158.20preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the 158.21legislature by January 15, 2010.158.22EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal 158.23approval, whichever is later.158.24    Sec. 18. [256B.0752] CARE COORDINATION FOR CHILDREN WITH 158.25HIGH-COST MENTAL HEALTH CONDITIONS.158.26    Subdivision 1.Care coordination required.(a) The commissioner of human 158.27services shall contract with the U special kids program to provide care coordination, 158.28beginning October 1, 2007, for medical assistance enrollees who are children with 158.29high-cost mental health conditions and behavioral problems, and to perform the other 158.30duties specified in this section.158.31    (b) For purposes of this section, "care coordination" means: collaboration with 158.32primary care physicians and specialists to manage care; development of mental health 158.33management plans for recurrent mental health issues; oversight and coordination of all 158.34aspects of care in partnership with families; organization of medical, treatment, and 158.35therapy information into a summary of critical information; coordination and appropriate 159.1sequencing of evaluations and multiple appointments; information and assistance with 159.2accessing resources; and telephone triage for behavior or other problems.159.3    Subd. 2.Referrals.The commissioner shall develop a mechanism to refer children 159.4to the program for care coordination. Beginning October 1, 2007, and subject to the limits 159.5on total program enrollment specified in subdivision 3, the commissioner shall refer to 159.6the U special kids program children who:159.7    (1) incur mental health expenses that exceed the qualifying level specified in 159.8subdivision 3;159.9    (2) are currently receiving or at risk of needing inpatient mental health treatment, 159.10foster home care, or both; and159.11    (3) voluntarily agree to participate in the program.159.12    Subd. 3.Qualifying level of medical expenses.(a) Beginning October 1, 2007, the 159.13commissioner shall refer children for care coordination under this section if they incurred 159.14medical and mental health expenses of $250,000 or more in the previous fiscal year.159.15    (b) The commissioner shall limit referrals to the extent necessary to ensure that total 159.16enrollment in the U special kids program does not exceed 25 children for the period 159.17October 1, 2007, through September 30, 2008; does not exceed 75 children for the 159.18period October 1, 2008, through September 30, 2009; and does not exceed 125 children 159.19beginning October 1, 2009.159.20    Subd. 4.Case management.The U special kids program, beginning October 1, 159.212007, shall coordinate all nonmedical case management services provided to children who 159.22are required to receive care coordination under this section. The program may require all 159.23nonmedical case managers, including but not limited to county case managers and case 159.24managers for children served under a home and community-based waiver, to submit care 159.25plans for approval, and to document client compliance with the care plans. The U special 159.26kids program, beginning October 1, 2008, may employ or contract with nonmedical case 159.27managers to provide all nonmedical case management services to children required to 159.28receive care coordination under this section. The commissioner shall reimburse the 159.29U special kids program for case management services through the medical assistance 159.30program.159.31    Subd. 5.Statewide availability of care coordination.The program may contract 159.32with other entities to provide care coordination services as defined in subdivision 1, in 159.33order to ensure the availability of these services in all regions of the state.159.34    Subd. 6.Monitoring and evaluation.The commissioner shall monitor program 159.35outcomes and shall evaluate the extent to which referrals to the U special kids program 159.36have improved the quality and coordination of care and provided financial savings to the 160.1medical assistance program. The U special kids program shall submit to the commissioner, 160.2in the form and manner specified by the commissioner, all data and information necessary 160.3to monitor program outcomes and evaluate the program. The commissioner shall present a 160.4preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the 160.5legislature by January 15, 2010.160.6EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal 160.7approval, whichever is later. The commissioner shall notify the Office of the Revisor of 160.8Statutes when federal approval is obtained.160.9    Sec. 19. [256B.194] FEDERAL PAYMENTS.160.10    Subdivision 1.Payments at actual cost.If the Centers for Medicare & Medicaid 160.11Services (CMS) promulgates a final rule consistent with its stated intent in the proposed 160.12rule published at 72 Federal Register, No. 11, January 18, 2007, regarding limiting 160.13payments to units of government, and notwithstanding Minnesota Statutes or Minnesota 160.14Rules to the contrary, for providers that are units of government, the commissioner may 160.15limit medical assistance and MinnesotaCare payments to a provider's actual cost of 160.16providing services, in accordance with the CMS final rule. If a final rule is promulgated, 160.17the commissioner may also require medical assistance and MinnesotaCare providers to 160.18provide any information necessary to determine Medicaid-related costs, and require the 160.19cooperation of providers in any audit or review necessary to ensure payments are limited 160.20to cost. This section does not apply to providers who are exempt from the provisions of 160.21the CMS final rule.160.22    Subd. 2.Loss of federal financial participation.For all transfers, certified 160.23expenditures, and medical assistance payments listed below, if the commissioner 160.24determines that federal financial participation is no longer available for the medical 160.25assistance payments listed, then related obligations for the nonfederal share of payments 160.26and the medical assistance payments shall terminate. The commissioner shall notify all 160.27affected parties of the loss of federal financial participation, and the resulting payments 160.28and obligations that are terminated. If the commissioner determines that federal financial 160.29participation is no longer available for any medical assistance payments or contributions 160.30to the nonfederal share of medical assistance payments that have already been made, the 160.31commissioner may collect the medical assistance payments from providers and return 160.32contributions of the nonfederal share to its source. The transfers, certified expenditures, 160.33and medical assistance payments subject to this section are those specified in: sections 160.3462J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d; 160.35256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses 161.1(2), (3), and (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws 161.22005, First Special Session chapter 4, article 9, section 2, subdivision 1.161.3    Sec. 20. Minnesota Statutes 2006, section 256B.199, is amended to read:161.4256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.161.5    (a) Hennepin County,and Hennepin County Medical Center, Ramsey County, 161.6Regions Hospital, the University of Minnesota, and Fairview-University Medical Center161.7shall report quarterly to the commissioner beginning June 1, 2007, payments made during 161.8the second previous quarter that may qualify for reimbursement under federal law.161.9    (b) Based on these reports, the commissioner shall apply for federal matching funds. 161.10These funds are appropriated to the commissioner for the payments under section 256.969, 161.11subdivision 27 to Hennepin County Medical Center.161.12    (c) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform 161.13the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share 161.14hospital payment money expected to be available in the current federal fiscal year.161.15    (d) This section sunsets on June 30, 2009. The commissioner shall report to 161.16the legislature by December 15, 2008, with recommendations for maximizing federal 161.17disproportionate share hospital payments after June 30, 2009.161.18    Sec. 21. Minnesota Statutes 2006, section 256B.75, is amended to read:161.19256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.161.20    (a) For outpatient hospital facility fee payments for services rendered on or after 161.21October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted 161.22charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those 161.23services for which there is a federal maximum allowable payment. Effective for services 161.24rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital 161.25facility fees and emergency room facility fees shall be increased by eight percent over the 161.26rates in effect on December 31, 1999, except for those services for which there is a federal 161.27maximum allowable payment. Services for which there is a federal maximum allowable 161.28payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum 161.29allowable payment. Total aggregate payment for outpatient hospital facility fee services 161.30shall not exceed the Medicare upper limit. If it is determined that a provision of this 161.31section conflicts with existing or future requirements of the United States government with 161.32respect to federal financial participation in medical assistance, the federal requirements 161.33prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to 162.1avoid reduced federal financial participation resulting from rates that are in excess of 162.2the Medicare upper limitations.162.3    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and 162.4ambulatory surgery hospital facility fee services for critical access hospitals designated 162.5under section 
         144.1483, clause (10), shall be paid on a cost-based payment system that 162.6is based on the cost-finding methods and allowable costs of the Medicare program. All 162.7hospital outpatient services provided by any hospital exclusively devoted to the care of 162.8pediatric patients under age 21 that is located in a Minnesota metropolitan statistical area 162.9must be paid for using the methodology established for critical access hospitals at a rate 162.10equal to fee-for-service rates plus 46 percent, as limited by allowable costs.162.11    (c) Effective for services provided on or after July 1, 2003, rates that are based 162.12on the Medicare outpatient prospective payment system shall be replaced by a budget 162.13neutral prospective payment system that is derived using medical assistance data. The 162.14commissioner shall provide a proposal to the 2003 legislature to define and implement 162.15this provision.162.16    (d) For fee-for-service services provided on or after July 1, 2002, the total payment, 162.17before third-party liability and spenddown, made to hospitals for outpatient hospital 162.18facility services is reduced by .5 percent from the current statutory rate.162.19    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 162.20services provided on or after July 1, 2003, made to hospitals for outpatient hospital 162.21facility services before third-party liability and spenddown, is reduced five percent from 162.22the current statutory rates. Facilities defined under section 
         256.969, subdivision 16, are 162.23excluded from this paragraph.162.24EFFECTIVE DATE.This section is effective July 1, 2007, and applies to services 162.25provided on or after that date.162.26    Sec. 22. Minnesota Statutes 2006, section 256B.76, is amended to read:162.27256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.162.28    (a) Effective for services rendered on or after October 1, 1992, the commissioner 162.29shall make payments for physician services as follows:162.30    (1) payment for level one Centers for Medicare and Medicaid Services' common 162.31procedural coding system codes titled "office and other outpatient services," "preventive 162.32medicine new and established patient," "delivery, antepartum, and postpartum care," 162.33"critical care," cesarean delivery and pharmacologic management provided to psychiatric 162.34patients, and level three codes for enhanced services for prenatal high risk, shall be paid 163.1at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 163.230, 1992. If the rate on any procedure code within these categories is different than the 163.3rate that would have been paid under the methodology in section 
         256B.74, subdivision 2, 163.4then the larger rate shall be paid; 163.5    (2) payments for all other services shall be paid at the lower of (i) submitted charges, 163.6or (ii) 15.4 percent above the rate in effect on June 30, 1992;163.7    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 163.8percentile of 1989, less the percent in aggregate necessary to equal the above increases 163.9except that payment rates for home health agency services shall be the rates in effect 163.10on September 30, 1992;163.11    (4) effective for services rendered on or after January 1, 2000, payment rates for 163.12physician and professional services shall be increased by three percent over the rates in 163.13effect on December 31, 1999, except for home health agency and family planning agency 163.14services; and163.15    (5) the increases in clause (4) shall be implemented January 1, 2000, for managed 163.16care.163.17    (b) Effective for services rendered on or after October 1, 1992, the commissioner 163.18shall make payments for dental services as follows:163.19    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 163.20percent above the rate in effect on June 30, 1992;163.21    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th 163.22percentile of 1989, less the percent in aggregate necessary to equal the above increases;163.23    (3) effective for services rendered on or after January 1, 2000, payment rates for 163.24dental services shall be increased by three percent over the rates in effect on December 163.2531, 1999;163.26    (4) the commissioner shall award grants to community clinics or other nonprofit 163.27community organizations, political subdivisions, professional associations, or other 163.28organizations that demonstrate the ability to provide dental services effectively to public 163.29program recipients. Grants may be used to fund the costs related to coordinating access for 163.30recipients, developing and implementing patient care criteria, upgrading or establishing 163.31new facilities, acquiring furnishings or equipment, recruiting new providers, or other 163.32development costs that will improve access to dental care in a region. In awarding grants, 163.33the commissioner shall give priority to applicants that plan to serve areas of the state in 163.34which the number of dental providers is not currently sufficient to meet the needs of 163.35recipients of public programs or uninsured individuals. The commissioner shall consider 163.36the following in awarding the grants:164.1    (i) potential to successfully increase access to an underserved population;164.2    (ii) the ability to raise matching funds;164.3    (iii) the long-term viability of the project to improve access beyond the period 164.4of initial funding;164.5    (iv) the efficiency in the use of the funding; and164.6    (v) the experience of the proposers in providing services to the target population.164.7    The commissioner shall monitor the grants and may terminate a grant if the grantee 164.8does not increase dental access for public program recipients. The commissioner shall 164.9consider grants for the following:164.10    (i) implementation of new programs or continued expansion of current access 164.11programs that have demonstrated success in providing dental services in underserved 164.12areas;164.13    (ii) a pilot program for utilizing hygienists outside of a traditional dental office to 164.14provide dental hygiene services; and164.15    (iii) a program that organizes a network of volunteer dentists, establishes a system to 164.16refer eligible individuals to volunteer dentists, and through that network provides donated 164.17dental care services to public program recipients or uninsured individuals;164.18    (5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 164.19shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;164.20    (6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, 164.21for managed care; and164.22    (7) effective for services provided on or after January 1, 2002, payment for 164.23diagnostic examinations and dental x-rays provided to children under age 21 shall be the 164.24lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.164.25    (c) Effective for dental services rendered on or after January 1, 2002, the 164.26commissioner may, within the limits of available appropriation, increase reimbursements 164.27to dentists and dental clinics deemed by the commissioner to be critical access dental 164.28providers. Reimbursement to a critical access dental provider may be increased by not 164.29more than 50 percent above the reimbursement rate that would otherwise be paid to the 164.30provider. Payments toFor dental services rendered after June 30, 2007, the commissioner 164.31shall increase reimbursement by 33 percent above the reimbursement rate that would 164.32otherwise be paid to the provider. The commissioner shall pay the health plan companies 164.33shall be adjustedin amounts sufficient to reflect increased reimbursements to critical 164.34access dental providers as approved by the commissioner. In determining which dentists 164.35and dental clinics shall be deemed critical access dental providers, the commissioner 164.36shall review:165.1    (1) the utilization rate in the service area in which the dentist or dental clinic operates 165.2for dental services to patients covered by medical assistance, general assistance medical 165.3care, or MinnesotaCare as their primary source of coverage;165.4    (2) the level of services provided by the dentist or dental clinic to patients covered 165.5by medical assistance, general assistance medical care, or MinnesotaCare as their primary 165.6source of coverage; and165.7    (3) whether the level of services provided by the dentist or dental clinic is critical to 165.8maintaining adequate levels of patient access within the service area.165.9In the absence of a critical access dental provider in a service area, the commissioner may 165.10designate a dentist or dental clinic as a critical access dental provider if the dentist or 165.11dental clinic is willing to provide care to patients covered by medical assistance, general 165.12assistance medical care, or MinnesotaCare at a level which significantly increases access 165.13to dental care in the service area.165.14    The commissioner shall annually establish a reimbursement schedule for critical 165.15access dental providers and provider-specific limits on total reimbursement received 165.16under the reimbursement schedule, and shall notify each critical access dental provider 165.17of the schedule and limit.165.18    (d) An entity that operates both a Medicare certified comprehensive outpatient 165.19rehabilitation facility and a facility which was certified prior to January 1, 1993, that is 165.20licensed under Minnesota Rules, parts 
         9570.2000 to 
         9570.3600, and for whom at least 33 165.21percent of the clients receiving rehabilitation services in the most recent calendar year are 165.22medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation 165.23services at rates that are 38 percent greater than the maximum reimbursement rate 165.24allowed under paragraph (a), clause (2), when those services are (1) provided within the 165.25comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing 165.26facilities owned by the entity.165.27    (e) Effective for services rendered on or after January 1, 2007, the commissioner 165.28shall make payments for physician and professional services based on the Medicare 165.29relative value units (RVU's). This change shall be budget neutral and the cost of 165.30implementing RVU's will be incorporated in the established conversion factor.165.31    Sec. 23. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:165.32    Subd. 4. General assistance medical care; services. (a)(i) For a person who is 165.33eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical 165.34care covers, except as provided in paragraph (c):165.35    (1) inpatient hospital services;166.1    (2) outpatient hospital services;166.2    (3) services provided by Medicare certified rehabilitation agencies;166.3    (4) prescription drugs and other products recommended through the process 166.4established in section 
         256B.0625, subdivision 13;166.5    (5) equipment necessary to administer insulin and diagnostic supplies and equipment 166.6for diabetics to monitor blood sugar level;166.7    (6) eyeglasses and eye examinations provided by a physician or optometrist;166.8    (7) hearing aids;166.9    (8) prosthetic devices;166.10    (9) laboratory and X-ray services;166.11    (10) physician's services;166.12    (11) medical transportation except special transportation;166.13    (12) chiropractic services as covered under the medical assistance program;166.14    (13) podiatric services;166.15    (14) dental services as covered under the medical assistance program;166.16    (15) outpatient services provided by a mental health center or clinic that is under 166.17contract with the county board and is established under section 
         245.62;166.18    (16) day treatment services for mental illness provided under contract with the 166.19county board;166.20    (17) prescribed medications for persons who have been diagnosed as mentally ill as 166.21necessary to prevent more restrictive institutionalization;166.22    (18) psychological services, medical supplies and equipment, and Medicare 166.23premiums, coinsurance and deductible payments;166.24    (19) medical equipment not specifically listed in this paragraph when the use of 166.25the equipment will prevent the need for costlier services that are reimbursable under 166.26this subdivision;166.27    (20) services performed by a certified pediatric nurse practitioner, a certified family 166.28nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological 166.29nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse 166.30practitioner in independent practice, if (1) the service is otherwise covered under this 166.31chapter as a physician service, (2) the service provided on an inpatient basis is not included 166.32as part of the cost for inpatient services included in the operating payment rate, and (3) the 166.33service is within the scope of practice of the nurse practitioner's license as a registered 166.34nurse, as defined in section 
         148.171;166.35    (21) services of a certified public health nurse or a registered nurse practicing in 166.36a public health nursing clinic that is a department of, or that operates under the direct 167.1authority of, a unit of government, if the service is within the scope of practice of the 167.2public health nurse's license as a registered nurse, as defined in section 
         148.171;167.3    (22) telemedicine consultations, to the extent they are covered under section 167.4256B.0625, subdivision 3b
         ; and167.5    (23) mental health telemedicine and psychiatric consultation as covered under 167.6section 
         256B.0625, subdivisions 46 and 48.;167.7    (24) care coordination and patient education services provided by a community 167.8health worker according to section 256B.0625, subdivision 49; and167.9    (25) regardless of the number of employees that an enrolled health care provider 167.10may have, sign language interpreter services when provided by an enrolled health care 167.11provider during the course of providing a direct, person-to-person covered health care 167.12service to an enrolled recipient who has a hearing loss and uses interpreting services.167.13    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3, 167.14paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited 167.15to inpatient hospital services, including physician services provided during the inpatient 167.16hospital stay. A $1,000 deductible is required for each inpatient hospitalization.167.17    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this 167.18subdivision.167.19    (c) In order to contain costs, the commissioner of human services shall select 167.20vendors of medical care who can provide the most economical care consistent with high 167.21medical standards and shall where possible contract with organizations on a prepaid 167.22capitation basis to provide these services. The commissioner shall consider proposals by 167.23counties and vendors for prepaid health plans, competitive bidding programs, block grants, 167.24or other vendor payment mechanisms designed to provide services in an economical 167.25manner or to control utilization, with safeguards to ensure that necessary services are 167.26provided. Before implementing prepaid programs in counties with a county operated or 167.27affiliated public teaching hospital or a hospital or clinic operated by the University of 167.28Minnesota, the commissioner shall consider the risks the prepaid program creates for the 167.29hospital and allow the county or hospital the opportunity to participate in the program in a 167.30manner that reflects the risk of adverse selection and the nature of the patients served by 167.31the hospital, provided the terms of participation in the program are competitive with the 167.32terms of other participants considering the nature of the population served. Payment for 167.33services provided pursuant to this subdivision shall be as provided to medical assistance 167.34vendors of these services under sections 
         256B.02, subdivision 8, and 
         256B.0625. For 167.35payments made during fiscal year 1990 and later years, the commissioner shall consult 168.1with an independent actuary in establishing prepayment rates, but shall retain final control 168.2over the rate methodology.168.3    (d) Effective January 1, 2008, drug coverage under general assistance medical care 168.4is limited to prescription drugs that:168.5    (i) are covered under the medical assistance program as described in section 168.6256B.0625, subdivisions 13 and 13d; and168.7    (ii) are provided by manufacturers that have fully executed general assistance 168.8medical care rebate agreements with the commissioner and comply with the agreements. 168.9Prescription drug coverage under general assistance medical care must conform to 168.10coverage under the medical assistance program according to section 256B.0625, 168.11subdivisions 13 to 13g.168.12    (d) (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following 168.13co-payments for services provided on or after October 1, 2003:168.14    (1) $25 for eyeglasses;168.15    (2) $25 for nonemergency visits to a hospital-based emergency room;168.16    (3) $3 per brand-name drug prescription and $1 per generic drug prescription, 168.17subject to a $12 per month maximum for prescription drug co-payments. No co-payments 168.18shall apply to antipsychotic drugs when used for the treatment of mental illness; and168.19    (4) 50 percent coinsurance on restorative dental services.168.20    (e) (f) Co-payments shall be limited to one per day per provider for nonpreventive 168.21visits, eyeglasses, and nonemergency visits to a hospital-based emergency room. 168.22Recipients of general assistance medical care are responsible for all co-payments in this 168.23subdivision. The general assistance medical care reimbursement to the provider shall be 168.24reduced by the amount of the co-payment, except that reimbursement for prescription 168.25drugs shall not be reduced once a recipient has reached the $12 per month maximum for 168.26prescription drug co-payments. The provider collects the co-payment from the recipient. 168.27Providers may not deny services to recipients who are unable to pay the co-payment, 168.28except as provided in paragraph (f).168.29    (f) (g) If it is the routine business practice of a provider to refuse service to an 168.30individual with uncollected debt, the provider may include uncollected co-payments 168.31under this section. A provider must give advance notice to a recipient with uncollected 168.32debt before services can be denied.168.33    (g) (h) Any county may, from its own resources, provide medical payments for 168.34which state payments are not made.168.35    (h) (i) Chemical dependency services that are reimbursed under chapter 254B must 168.36not be reimbursed under general assistance medical care.169.1    (i) (j) The maximum payment for new vendors enrolled in the general assistance 169.2medical care program after the base year shall be determined from the average usual and 169.3customary charge of the same vendor type enrolled in the base year.169.4    (j) (k) The conditions of payment for services under this subdivision are the same 169.5as the conditions specified in rules adopted under chapter 256B governing the medical 169.6assistance program, unless otherwise provided by statute or rule.169.7    (k) (l) Inpatient and outpatient payments shall be reduced by five percent, effective 169.8July 1, 2003. This reduction is in addition to the five percent reduction effective July 1, 169.92003, and incorporated by reference in paragraph (i).169.10    (l) (m) Payments for all other health services except inpatient, outpatient, and 169.11pharmacy services shall be reduced by five percent, effective July 1, 2003.169.12    (m) (n) Payments to managed care plans shall be reduced by five percent for services 169.13provided on or after October 1, 2003.169.14    (n) (o) A hospital receiving a reduced payment as a result of this section may apply 169.15the unpaid balance toward satisfaction of the hospital's bad debts.169.16    (o) (p) Fee-for-service payments for nonpreventive visits shall be reduced by $3 169.17for services provided on or after January 1, 2006. For purposes of this subdivision, a 169.18visit means an episode of service which is required because of a recipient's symptoms, 169.19diagnosis, or established illness, and which is delivered in an ambulatory setting by 169.20a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse, 169.21audiologist, optician, or optometrist.169.22    (p) (q) Payments to managed care plans shall not be increased as a result of the 169.23removal of the $3 nonpreventive visit co-payment effective January 1, 2006.169.24    Sec. 24. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:169.25    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 169.26and (c), the MinnesotaCare benefit plan shall include the following co-payments and 169.27coinsurance requirements for all enrollees:169.28    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 169.29subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 169.30$3,000 per family;169.31    (2) $3 per prescription for adult enrollees;169.32    (3) $25 for eyeglasses for adult enrollees;169.33    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 169.34episode of service which is required because of a recipient's symptoms, diagnosis, or 169.35established illness, and which is delivered in an ambulatory setting by a physician or 170.1physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 170.2audiologist, optician, or optometrist; and170.3    (5) $6 for nonemergency visits to a hospital-based emergency room.170.4    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 170.5children under the age of 21 in households with family income equal to or less than 175 170.6percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 170.7parents and relative caretakers of children under the age of 21 in households with family 170.8income greater than 175 percent of the federal poverty guidelines for inpatient hospital 170.9admissions occurring on or after January 1, 2001.170.10    (c) Paragraph (a), clauses (1) to (4), dodoes not apply to pregnant women and 170.11children under the age of 21.170.12    (d) Adult enrollees with family gross income that exceeds 175 percent of the 170.13federal poverty guidelines and who are not pregnant shall be financially responsible for 170.14the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient 170.15hospital benefit limit.170.16    (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 170.17or changes from one prepaid health plan to another during a calendar year, any charges 170.18submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 170.19expenses incurred by the enrollee for inpatient services, that were submitted or incurred 170.20prior to enrollment, or prior to the change in health plans, shall be disregarded.170.21    Sec. 25. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:170.22    Subdivision 1. Families with children. (a) Families with children with family 170.23income equal to or less than 275 percent of the federal poverty guidelines for the 170.24applicable family size shall be eligible for MinnesotaCare according to this section. All 170.25other provisions of sections 
         256L.01 to 
         256L.18, including the insurance-related barriers 170.26to enrollment under section 
         256L.07, shall apply unless otherwise specified. 170.27    (b) Parents who enroll in the MinnesotaCare program must also enroll their children, 170.28if the children are eligible. Children may be enrolled separately without enrollment by 170.29parents. However, if one parent in the household enrolls, both parents must enroll, unless 170.30other insurance is available. If one child from a family is enrolled, all children must 170.31be enrolled, unless other insurance is available. If one spouse in a household enrolls, 170.32the other spouse in the household must also enroll, unless other insurance is available. 170.33Families cannot choose to enroll only certain uninsured members.171.1    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies 171.2to the MinnesotaCare program. These persons are no longer counted in the parental 171.3household and may apply as a separate household.171.4    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents 171.5are not eligible for MinnesotaCare if their gross income exceeds $50,000 $25,000 for the 171.6six-month period of eligibility.171.7    Sec. 26. Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:171.8    Subd. 12. Persons in detention. Beginning January 1, 1999, an applicant residing 171.9in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee 171.10residing in a correctional or detention facility is not eligible at renewal of eligibility under 171.11section 
         256L.05, subdivision 3b 3a.171.12    Sec. 27. Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:171.13    Subd. 7. Critical access dental providers. Effective for dental services provided 171.14to MinnesotaCare enrollees on or afterbetween January 1, 2007, and June 30, 2007, the 171.15commissioner shall increase payment rates to dentists and dental clinics deemed by the 171.16commissioner to be critical access providers under section 
         256B.76, paragraph (c), by 50 171.17percent above the payment rate that would otherwise be paid to the provider. Effective 171.18for dental services provided to MinnesotaCare enrollees on or after July 1, 2007, the 171.19commissioner shall increase payment rates to dentists and dental clinics deemed by the 171.20commissioner to be critical access providers under section 256B.76, paragraph (c), by 171.2133 percent above the payment rate that would otherwise be paid to the provider. The 171.22commissioner shall adjust the rates paid on or after January 1, 2007, topay the prepaid 171.23health plans under contract with the commissioner amounts sufficient to reflect this rate 171.24increase. The prepaid health plan must pass this rate increase to providers who have 171.25been identified by the commissioner as critical access dental providers under section 171.26256B.76
         , paragraph (c).171.27    Sec. 28. HENNEPIN COUNTY PILOT PROJECT.171.28    The commissioner of human services shall support a pilot project in Hennepin 171.29County to demonstrate the effectiveness of alternative strategies to redetermine eligibility 171.30for certain recipient populations in the medical assistance program. The target populations 171.31for the demonstration are persons who are eligible based upon disability or age, who have 171.32chronic medical conditions, and who are expected to experience minimal change in income 171.33or assets from month to month. The commissioner and the county shall analyze the issues 172.1and strategies employed and the outcomes to determine reasonable efforts to streamline 172.2eligibility statewide. The duration of the pilot project shall be no more than two years. 172.3The commissioner shall apply for any federal waivers needed to implement this section.172.4    Sec. 29. COUNTY-BASED PURCHASING STUDY.172.5    The commissioner of health shall study county-based purchasing initiatives 172.6established under Minnesota Statutes, section 256B.692, and compare these initiatives 172.7to managed care plans serving medical assistance, general assistance medical care, and 172.8MinnesotaCare enrollees. The study must:172.9    (1) provide a history and description of county-based purchasing initiatives, 172.10including state and federal requirements and any federal waivers Minnesota counties have 172.11applied for or received;172.12    (2) provide a history and description of managed care plan participation in the 172.13prepaid medical assistance, prepaid general assistance medical care, and prepaid 172.14Minnesota programs, and the provision by managed care plans of third-party administrator 172.15services for county-based purchasing initiatives;172.16    (3) provide relevant data, including limitations on data, data that was requested but 172.17not received, and explanations for why requested data was not received;172.18    (4) provide recommendations for further data collection and research;172.19    (5) summarize successes and challenges of the two service delivery methods;172.20    (6) provide recommendations for possible expansion of county-based purchasing 172.21in rural and urban settings; and172.22    (7) identify and describe features of county-based purchasing and managed care 172.23plans serving medical assistance, general assistance medical care, and MinnesotaCare 172.24enrollees, to provide a comparison of cost, quality, access, and community health 172.25improvement that includes, but is not limited to:172.26    (i) descriptions of how health care and social services are integrated and coordinated 172.27for persons with complex care needs, including persons with high-risk pregnancies, 172.28adolescents, persons who are disabled, persons who are elderly, and persons with chronic 172.29health care and social needs;172.30    (ii) use of monetary grants and surpluses to:172.31    (A) increase provider reimbursement, including dental care reimbursement, in order 172.32to improve health care access; and172.33    (B) improve community health beyond the requirements of the public health care 172.34programs, such as the funding of public education, research, and community initiatives to 172.35enhance utilization of preventive services, social services, or mental health care;173.1    (iii) administrative costs, including billing and collection of unpaid fees, co-pays or 173.2other charges, and top five management salaries;173.3    (iv) reporting requirements of contracts with the Department of Human Services;173.4    (v) public access to all information about management and administration, including 173.5but not limited to provider contracts and reimbursement, models of care management and 173.6coordination, utilization review, contracts with consultants and other vendors, handling of 173.7monetary grants and surpluses, and health outcomes data;173.8    (vi) provider reimbursement by clinical practice area;173.9    (vii) populations served, described by age, disability, income, race, language, 173.10occupation, and other demographic characteristics;173.11    (viii) utilization of community-based prevention interventions, including but not 173.12limited to public health nursing visits to new parents, use of nurse-managed interventions 173.13to reduce cardiac hospitalizations, and the use of medical homes for chronic disease 173.14management;173.15    (ix) utilization of cancer screening;173.16    (x) utilization of interpreter services;173.17    (xi) immunization rates for children age five and under;173.18    (xii) hospitalization rates for conditions related to diabetes, asthma, or cardiac 173.19illnesses;173.20    (xiii) rates of rehospitalization within a month of hospital discharge;173.21    (xiv) coordination with county agencies to increase enrollment;173.22    (xv) number of new program enrollees and the rate of enrollment, including the 173.23percentage of eligible persons who become enrollees;173.24    (xvi) enrollee satisfaction with their care; and173.25    (xvii) number of enrollees who do not receive care.173.26    Managed care plans, county-based purchasing initiatives, health care providers, 173.27counties, and the commissioner of human services shall, upon request, provide data to 173.28the commissioner of health that is necessary to complete the study. The commissioner of 173.29health shall submit the study to the legislature by December 31, 2007.173.30    Sec. 30. GRANT FOR TOLL-FREE HEALTH CARE ACCESS NUMBER.173.31    The commissioner of human services shall award a grant to the Neighborhood 173.32Health Care Network to pay the costs of maintaining and staffing a toll-free telephone 173.33number to provide callers with information on health coverage options, eligibility for 173.34MinnesotaCare and other health care programs, and health care providers that offer free or 173.35reduced-cost health care services.174.1    Sec. 31. IMPLEMENTATION OF PHARMACY DISPENSING FEE INCREASE.174.2    The commissioner, after consulting with the Pharmacy Payment Reform Advisory 174.3Committee established under Laws 2006, chapter 282, article 16, section 15, may 174.4proportionally increase or decrease the dispensing fee for multiple-source generic drugs 174.5under Minnesota Statutes, section 256B.0625, subdivision 13e, paragraph (a), to reflect 174.6the actual amount of reductions in program cost for ingredient reimbursement savings 174.7obtained.174.8EFFECTIVE DATE.This section is effective upon implementation of changes to 174.9the federal upper reimbursement limit under title VI, chapter IV of the federal Deficit 174.10Reduction Act of 2005, United States Code, title 42, section 1396r-8(e)(5).174.11    Sec. 32. REPEALER.174.12Minnesota Statutes 2006, section 256.969, subdivision 27, is repealed effective 174.13July 1, 2007.174.14ARTICLE 4174.15CONTINUING CARE174.16    Section 1. Minnesota Statutes 2006, section 144A.071, subdivision 4c, is amended to 174.17read:174.18    Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The 174.19commissioner of health, in coordination with the commissioner of human services, may 174.20approve the renovation, replacement, upgrading, or relocation of a nursing home or 174.21boarding care home, under the following conditions:174.22    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be 174.23constructed on the site of a new city-owned hospital to replace an existing 85-bed facility 174.24attached to a hospital that is also being replaced. The threshold allowed for this project 174.25under section 
         144A.073 shall be the maximum amount available to pay the additional 174.26medical assistance costs of the new facility; 174.27    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St. 174.28Louis County, provided that the 29 beds must be transferred from active or layaway status 174.29at an existing facility in St. Louis County that had 235 beds on April 1, 2003.174.30The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment 174.31rate at that facility shall not be adjusted as a result of this transfer. The operating payment 174.32rate of the facility adding beds after completion of this project shall be the same as it was 175.1on the day prior to the day the beds are licensed and certified. This project shall not 175.2proceed unless it is approved and financed under the provisions of section 
         144A.073;  175.3    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of 175.4the new beds are transferred from a 45-bed facility in Austin under common ownership 175.5that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea 175.6under common ownership; (ii) the commissioner of human services is authorized by the 175.72004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) 175.8money is available from planned closures of facilities under common ownership to make 175.9implementation of this clause budget-neutral to the state. The bed capacity of the Albert 175.10Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the 175.11new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's 175.12disease or related dementias; and175.13    (4) to license and certify up to 80 beds transferred from an existing state-owned 175.14nursing facility in Cass County to a new facility located on the grounds of the 175.15Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be 175.16determined based on the interim and settle-up payment provisions of Minnesota Rules, 175.17part 
         9549.0057, and the reimbursement provisions of section 
         256B.431. The property 175.18payment rate for the first three years of operation shall be $35 per day. For subsequent 175.19years, the property payment rate of $35 per day shall be adjusted for inflation as provided 175.20in section 
         256B.434, subdivision 4, paragraph (c), as long as the facility has a contract 175.21under section 
         256B.434.; and175.22    (5) to license and certify 180 beds transferred from an existing facility in 175.23Minneapolis to a new facility in Robbinsdale; provided that the beds are transferred from a 175.24219-bed facility under common ownership that shall be closed following the transfer. The 175.25operating payment rate of the new facility after completion of this project shall be adjusted 175.26upward by $35 per day and the property payment rate shall be $34.049 per day.175.27    (b) Projects approved under this subdivision shall be treated in a manner equivalent 175.28to projects approved under subdivision 4a.175.29EFFECTIVE DATE.This section is effective the day following final enactment.175.30    Sec. 2. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:175.31    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor 175.32child, including a child determined eligible for medical assistance without consideration of 175.33parental income, must contribute to the cost of services used by making monthly payments 175.34on a sliding scale based on income, unless the child is married or has been married, 175.35parental rights have been terminated, or the child's adoption is subsidized according to 176.1section 
         259.67 or through title IV-E of the Social Security Act. The parental contribution 176.2is a partial or full payment for medical services provided for diagnostic, therapeutic, 176.3curing, treating, mitigating, rehabilitation, and maintenance and personal care services as 176.4defined in United States Code, title 26, section 213, needed by the child with a chronic 176.5illness or disability.176.6    (b) For households with adjusted gross income equal to or greater than 100 percent 176.7of federal poverty guidelines, the parental contribution shall be computed by applying the 176.8following schedule of rates to the adjusted gross income of the natural or adoptive parents:176.9    (1) if the adjusted gross income is equal to or greater than 100 percent of federal 176.10poverty guidelines and less than 175 percent of federal poverty guidelines, the parental 176.11contribution is $4 per month;176.12    (2) if the adjusted gross income is equal to or greater than 175 percent of federal 176.13poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, 176.14the parental contribution shall be determined using a sliding fee scale established by the 176.15commissioner of human services which begins at one percent of adjusted gross income 176.16at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted 176.17gross income for those with adjusted gross income up to 545 percent of federal poverty 176.18guidelines;176.19    (3) if the adjusted gross income is greater than 545 percent of federal poverty 176.20guidelines and less than 675 percent of federal poverty guidelines, the parental 176.21contribution shall be 7.5 percent of adjusted gross income;176.22    (4) if the adjusted gross income is equal to or greater than 675 percent of federal 176.23poverty guidelines and less than 975 percent of federal poverty guidelines, the parental 176.24contribution shall be determined using a sliding fee scale established by the commissioner 176.25of human services which begins at 7.5 percent of adjusted gross income at 675 percent of 176.26federal poverty guidelines and increases to ten percent of adjusted gross income for those 176.27with adjusted gross income up to 975 percent of federal poverty guidelines; and176.28    (5) if the adjusted gross income is equal to or greater than 975 percent of federal 176.29poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross 176.30income.176.31    If the child lives with the parent, the annual adjusted gross income parental 176.32contribution is reduced by $2,400 prior to calculating the parental contribution$100 176.33per month. If the child resides in an institution specified in section 
         256B.35, the parent 176.34is responsible for the personal needs allowance specified under that section in addition 176.35to the parental contribution determined under this section. The parental contribution is 177.1reduced by any amount required to be paid directly to the child pursuant to a court order, 177.2but only if actually paid.177.3    (c) The household size to be used in determining the amount of contribution under 177.4paragraph (b) includes natural and adoptive parents and their dependents, including the 177.5child receiving services. Adjustments in the contribution amount due to annual changes 177.6in the federal poverty guidelines shall be implemented on the first day of July following 177.7publication of the changes.177.8    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the 177.9natural or adoptive parents determined according to the previous year's federal tax form, 177.10except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 177.11have been used to purchase a home shall not be counted as income.177.12    (e) The contribution shall be explained in writing to the parents at the time eligibility 177.13for services is being determined. The contribution shall be made on a monthly basis 177.14effective with the first month in which the child receives services. Annually upon 177.15redetermination or at termination of eligibility, if the contribution exceeded the cost of 177.16services provided, the local agency or the state shall reimburse that excess amount to 177.17the parents, either by direct reimbursement if the parent is no longer required to pay 177.18a contribution, or by a reduction in or waiver of parental fees until the excess amount 177.19is exhausted.177.20    (f) The monthly contribution amount must be reviewed at least every 12 months; 177.21when there is a change in household size; and when there is a loss of or gain in income 177.22from one month to another in excess of ten percent. The local agency shall mail a written 177.23notice 30 days in advance of the effective date of a change in the contribution amount. 177.24A decrease in the contribution amount is effective in the month that the parent verifies a 177.25reduction in income or change in household size.177.26    (g) Parents of a minor child who do not live with each other shall each pay the 177.27contribution required under paragraph (a). An amount equal to the annual court-ordered 177.28child support payment actually paid on behalf of the child receiving services shall be 177.29deducted from the adjusted gross income of the parent making the payment prior to 177.30calculating the parental contribution under paragraph (b).177.31    (h) The contribution under paragraph (b) shall be increased by an additional five 177.32percent if the local agency determines that insurance coverage is available but not 177.33obtained for the child. For purposes of this section, "available" means the insurance is a 177.34benefit of employment for a family member at an annual cost of no more than five percent 177.35of the family's annual income. For purposes of this section, "insurance" means health 178.1and accident insurance coverage, enrollment in a nonprofit health service plan, health 178.2maintenance organization, self-insured plan, or preferred provider organization.178.3    Parents who have more than one child receiving services shall not be required 178.4to pay more than the amount for the child with the highest expenditures. There shall 178.5be no resource contribution from the parents. The parent shall not be required to pay 178.6a contribution in excess of the cost of the services provided to the child, not counting 178.7payments made to school districts for education-related services. Notice of an increase in 178.8fee payment must be given at least 30 days before the increased fee is due.178.9    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, 178.10in the 12 months prior to July 1:178.11    (1) the parent applied for insurance for the child;178.12    (2) the insurer denied insurance;178.13    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted 178.14a complaint or appeal, in writing, to the commissioner of health or the commissioner of 178.15commerce, or litigated the complaint or appeal; and178.16    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.178.17    For purposes of this section, "insurance" has the meaning given in paragraph (h).178.18    A parent who has requested a reduction in the contribution amount under this 178.19paragraph shall submit proof in the form and manner prescribed by the commissioner or 178.20county agency, including, but not limited to, the insurer's denial of insurance, the written 178.21letter or complaint of the parents, court documents, and the written response of the insurer 178.22approving insurance. The determinations of the commissioner or county agency under this 178.23paragraph are not rules subject to chapter 14.178.24    Sec. 3. Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:178.25    Subd. 3. Amount of support grant; use. Support grant amounts shall be 178.26determined by the county social service agency. Services and items purchased with a 178.27support grant must:178.28    (1) be over and above the normal costs of caring for the dependent if the dependent 178.29did not have a disability;178.30    (2) be directly attributable to the dependent's disabling condition; and178.31    (3) enable the family to delay or prevent the out-of-home placement of the dependent.178.32    The design and delivery of services and items purchased under this section must 178.33suit the dependent's chronological age and be provided in the least restrictive environment 178.34possible, consistent with the needs identified in the individual service plan.179.1    Items and services purchased with support grants must be those for which there 179.2are no other public or private funds available to the family. Fees assessed to parents 179.3for health or human services that are funded by federal, state, or county dollars are not 179.4reimbursable through this program.179.5    In approving or denying applications, the county shall consider the following factors:179.6    (1) the extent and areas of the functional limitations of the disabled child;179.7    (2) the degree of need in the home environment for additional support; and179.8    (3) the potential effectiveness of the grant to maintain and support the person in 179.9the family environment.179.10    The maximum monthly grant amount shall be $250 per eligible dependent, or 179.11$3,000 per eligible dependent per state fiscal year, within the limits of available funds and 179.12as adjusted by any legislatively authorized cost of living adjustment. The county social 179.13service agency may consider the dependent's supplemental security income in determining 179.14the amount of the support grant.179.15    Any adjustments to their monthly grant amount must be based on the needs of the 179.16family and funding availability.179.17    Sec. 4. Minnesota Statutes 2006, section 252.46, is amended by adding a subdivision 179.18to read:179.19    Subd. 22.Provider rate increase; St. Louis County.A day training and 179.20habilitation provider in St. Louis County licensed to provide services to up to 80 179.21individuals shall receive a per diem rate increase that does not exceed 95 percent of the 179.22greater of 125 percent of the current statewide median or 125 percent of the regional 179.23average per diem rate, whichever is higher.179.24    Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 179.25to read:179.26    Subd. 24.Disability linkage line.The commissioner shall establish the disability 179.27linkage line, a statewide consumer information, referral, and assistance system for people 179.28with disabilities and chronic illnesses that: 179.29    (1) provides information about state and federal eligibility requirements, benefits, 179.30and service options; 179.31    (2) makes referrals to appropriate support entities; 179.32    (3) delivers information and assistance based on national and state standards; 179.33    (4) assists people to make well-informed decisions; and 179.34    (5) supports the timely resolution of service access and benefit issues.180.1    Sec. 6. Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:180.2    Subdivision 1. Purpose and goals. The commissioner of human services shall 180.3establish a consumer support grant program for individuals with functional limitations and 180.4their families who wish to purchase and secure their own supports. The commissioner and 180.5local agencies shall jointly develop an implementation plan which must include a way to 180.6resolve the issues related to county liability. The program shall:180.7    (1) make support grants available to individuals or families as an effective alternative 180.8to the developmental disability family support program, personal care attendant services, 180.9home health aide services, and private duty nursing services;180.10    (2) provide consumers more control, flexibility, and responsibility over their services 180.11and supports;180.12    (3) promote local program management and decision making; and180.13    (4) encourage the use of informal and typical community supports.180.14    Sec. 7. Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:180.15    Subd. 2. Definitions. For purposes of this section, the following terms have the 180.16meanings given them:180.17    (a) "County board" means the county board of commissioners for the county of 180.18financial responsibility as defined in section 
         256G.02, subdivision 4, or its designated 180.19representative. When a human services board has been established under sections 
         402.01180.20to 
         402.10, it shall be considered the county board for the purposes of this section. 180.21    (b) "Family" means the person's birth parents, adoptive parents or stepparents, 180.22siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece, 180.23nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is 180.24at least 18 years of age.180.25    (c) "Functional limitations" means the long-term inability to perform an activity or 180.26task in one or more areas of major life activity, including self-care, understanding and use 180.27of language, learning, mobility, self-direction, and capacity for independent living. For the 180.28purpose of this section, the inability to perform an activity or task results from a mental, 180.29emotional, psychological, sensory, or physical disability, condition, or illness.180.30    (d) "Informed choice" means a voluntary decision made by the person or,180.31the person's legal representative, or other authorized representative after becoming 180.32familiarized with the alternatives to:180.33    (1) select a preferred alternative from a number of feasible alternatives;180.34    (2) select an alternative which may be developed in the future; and180.35    (3) refuse any or all alternatives.181.1    (e) "Local agency" means the local agency authorized by the county board or, 181.2for counties not participating in the consumer grant program by July 1, 2002, the 181.3commissioner, to carry out the provisions of this section.181.4    (f) "Person" or "persons" means a person or persons meeting the eligibility criteria in 181.5subdivision 3.181.6    (g) "Authorized representative" means an individual designated by the person or 181.7their legal representative to act on their behalf. This individual may be a family member, 181.8guardian, representative payee, or other individual designated by the person or their legal 181.9representative, if any, to assist in purchasing and arranging for supports. For the purposes 181.10of this section, an authorized representative is at least 18 years of age.181.11    (h) "Screening" means the screening of a person's service needs under sections 181.12256B.0911
          and 
         256B.092. 181.13    (i) "Supports" means services, care, aids, environmental modifications, or assistance 181.14purchased by the person or the person's family, the person's legal representative, or other 181.15authorized representative. Examples of supports include respite care, assistance with daily 181.16living, and assistive technology. For the purpose of this section, notwithstanding the 181.17provisions of section 
         144A.43, supports purchased under the consumer support program 181.18are not considered home care services. 181.19    (j) "Program of origination" means the program the individual transferred from 181.20when approved for the consumer support grant program.181.21    Sec. 8. Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:181.22    Subd. 3. Eligibility to apply for grants. (a) A person is eligible to apply for a 181.23consumer support grant if the person meets all of the following criteria:181.24    (1) the person is eligible for and has been approved to receive services under 181.25medical assistance as determined under sections 
         256B.055 and 
         256B.056 or the person 181.26has been approved to receive a grant under the developmental disability family support 181.27program under section 
         252.32; 181.28    (2) the person is able to direct and purchase the person's own care and supports, or 181.29the person has a family member, legal representative, or other authorized representative 181.30who can purchase and arrange supports on the person's behalf;181.31    (3) the person has functional limitations, requires ongoing supports to live in the 181.32community, and is at risk of or would continue institutionalization without such supports; 181.33and182.1    (4) the person will live in a home. For the purpose of this section, "home" means the 182.2person's own home or home of a person's family member. These homes are natural home 182.3settings and are not licensed by the Department of Health or Human Services.182.4    (b) Persons may not concurrently receive a consumer support grant if they are:182.5    (1) receiving personal care attendant and home health aide services, or private duty 182.6nursing under section 
         256B.0625; a developmental disability family support grant; or 182.7alternative care services under section 
         256B.0913; or 182.8    (2) residing in an institutional or congregate care setting.182.9    (c) A person or person's family receiving a consumer support grant shall not be 182.10charged a fee or premium by a local agency for participating in the program.182.11    (d) Individuals receiving home and community-based waivers under United States 182.12Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except 182.13for individuals receiving consumer support grants before July 1, 2003, as long as other 182.14eligibility criteria are met.182.15    (e) The commissioner shall establish a budgeted appropriation each fiscal year 182.16for the consumer support grant program. The number of individuals participating in 182.17the program will be adjusted so the total amount allocated to counties does not exceed 182.18the amount of the budgeted appropriation. The budgeted appropriation will be adjusted 182.19annually to accommodate changes in demand for the consumer support grants.182.20    Sec. 9. Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:182.21    Subd. 4. Support grants; criteria and limitations. (a) A county board may 182.22choose to participate in the consumer support grant program. If a county has not chosen 182.23to participate by July 1, 2002, the commissioner shall contract with another county or 182.24other entity to provide access to residents of the nonparticipating county who choose 182.25the consumer support grant option. The commissioner shall notify the county board 182.26in a county that has declined to participate of the commissioner's intent to enter into 182.27a contract with another county or other entity at least 30 days in advance of entering 182.28into the contract. The local agency shall establish written procedures and criteria to 182.29determine the amount and use of support grants. These procedures must include, at least, 182.30the availability of respite care, assistance with daily living, and adaptive aids. The local 182.31agency may establish monthly or annual maximum amounts for grants and procedures 182.32where exceptional resources may be required to meet the health and safety needs of the 182.33person on a time-limited basis, however, the total amount awarded to each individual may 182.34not exceed the limits established in subdivision 11.183.1    (b) Support grants to a person or a person's family, a person's legal representative, 183.2or other authorized representative will be provided through a monthly subsidy payment 183.3and be in the form of cash, voucher, or direct county payment to vendor. Support grant 183.4amounts must be determined by the local agency. Each service and item purchased with a 183.5support grant must meet all of the following criteria:183.6    (1) it must be over and above the normal cost of caring for the person if the person 183.7did not have functional limitations;183.8    (2) it must be directly attributable to the person's functional limitations;183.9    (3) it must enable the person or the person's family, a person's legal representative, 183.10or other authorized representative to delay or prevent out-of-home placement of the 183.11person; and183.12    (4) it must be consistent with the needs identified in the service agreement, when 183.13applicable.183.14    (c) Items and services purchased with support grants must be those for which there 183.15are no other public or private funds available to the person or the person's family, a person's 183.16legal representative, or other authorized representative. Fees assessed to the person or the 183.17person's family for health and human services are not reimbursable through the grant.183.18    (d) In approving or denying applications, the local agency shall consider the 183.19following factors:183.20    (1) the extent and areas of the person's functional limitations;183.21    (2) the degree of need in the home environment for additional support; and183.22    (3) the potential effectiveness of the grant to maintain and support the person in the 183.23family environment or the person's own home.183.24    (e) At the time of application to the program or screening for other services, 183.25the person or the person's family, a person's legal representative, or other authorized 183.26representative shall be provided sufficient information to ensure an informed choice 183.27of alternatives by the person, the person's legal representative, or other authorized 183.28representative, if any, or the person's family. The application shall be made to the local 183.29agency and shall specify the needs of the person and family, the form and amount of 183.30grant requested, the items and services to be reimbursed, and evidence of eligibility for 183.31medical assistance.183.32    (f) Upon approval of an application by the local agency and agreement on a support 183.33plan for the person or person's family, the local agency shall make grants to the person or 183.34the person's family. The grant shall be in an amount for the direct costs of the services or 183.35supports outlined in the service agreement.184.1    (g) Reimbursable costs shall not include costs for resources already available, such as 184.2special education classes, day training and habilitation, case management, other services to 184.3which the person is entitled, medical costs covered by insurance or other health programs, 184.4or other resources usually available at no cost to the person or the person's family.184.5    (h) The state of Minnesota, the county boards participating in the consumer 184.6support grant program, or the agencies acting on behalf of the county boards in the 184.7implementation and administration of the consumer support grant program shall not be 184.8liable for damages, injuries, or liabilities sustained through the purchase of support by 184.9the individual, the individual's family, or the authorized representative under this section 184.10with funds received through the consumer support grant program. Liabilities include but 184.11are not limited to: workers' compensation liability, the Federal Insurance Contributions 184.12Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section, 184.13participating county boards and agencies acting on behalf of county boards are exempt 184.14from the provisions of section 
         268.04.184.15    Sec. 10. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:184.16    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of 184.17transferring persons to the consumer support grant program from the developmental 184.18disability family support program and personal care assistant services, home health 184.19aide services, or private duty nursing services, the amount of funds transferred by the 184.20commissioner between the developmental disability family support program account, the 184.21medical assistance account, or the consumer support grant account shall be based on each 184.22county's participation in transferring persons to the consumer support grant program 184.23from those programs and services.184.24    (b) At the beginning of each fiscal year, county allocations for consumer support 184.25grants shall be based on:184.26    (1) the number of persons to whom the county board expects to provide consumer 184.27supports grants;184.28    (2) their eligibility for current program and services;184.29    (3) the amount of nonfederal dollars allowed under subdivision 11; and184.30    (4) projected dates when persons will start receiving grants. County allocations shall 184.31be adjusted periodically by the commissioner based on the actual transfer of persons or 184.32service openings, and the nonfederal dollars associated with those persons or service 184.33openings, to the consumer support grant program.185.1    (c) The amount of funds transferred by the commissioner from the medical 185.2assistance account for an individual may be changed if it is determined by the county or its 185.3agent that the individual's need for support has changed.185.4    (d) The authority to utilize funds transferred to the consumer support grant account 185.5for the purposes of implementing and administering the consumer support grant program 185.6will not be limited or constrained by the spending authority provided to the program 185.7of origination.185.8    (e) The commissioner may use up to five percent of each county's allocation, as 185.9adjusted, for payments for administrative expenses, to be paid as a proportionate addition 185.10to reported direct service expenditures.185.11    (f) The county allocation for each individual or individual's family cannot exceed 185.12the amount allowed under subdivision 11.185.13    (g) The commissioner may recover, suspend, or withhold payments if the county 185.14board, local agency, or grantee does not comply with the requirements of this section.185.15    (h) Grant funds unexpended by consumers shall return to the state once a year. The 185.16annual return of unexpended grant funds shall occur in the quarter following the end of 185.17the state fiscal year.185.18    Sec. 11. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:185.19    Subd. 10. Consumer responsibilities. Persons receiving grants under this section 185.20shall:185.21    (1) spend the grant money in a manner consistent with their agreement with the 185.22local agency;185.23    (2) notify the local agency of any necessary changes in the grant or the items on 185.24which it is spent;185.25    (3) notify the local agency of any decision made by the person, the a person's legal 185.26representative, or the person's family or other authorized representative that would change 185.27their eligibility for consumer support grants;185.28    (4) arrange and pay for supports; and185.29    (5) inform the local agency of areas where they have experienced difficulty securing 185.30or maintaining supports.185.31    Sec. 12. Minnesota Statutes 2006, section 256.974, is amended to read:185.32256.974 OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS185.33LONG-TERM CARE; LOCAL PROGRAMS.186.1    The ombudsman for older Minnesotans long-term care serves in the classified service 186.2under section 
         256.01, subdivision 7, in an office within the Minnesota Board on Aging that 186.3incorporates the long-term care ombudsman program required by the Older Americans 186.4Act, Public Law 100-75 as amended, United States Code, title 42, section 3027(a)(12)186.5(9) and 3058g (a), and established within the Minnesota Board on Aging. The Minnesota 186.6Board on Aging may make grants to and designate local programs for the provision of 186.7ombudsman services to clients in county or multicounty areas. The local program may not 186.8be an agency engaged in the provision of nursing home care, hospital care, or home care 186.9services either directly or by contract, or have the responsibility for planning, coordinating, 186.10funding, or administering nursing home care, hospital care, or home care services.186.11    Sec. 13. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:186.12    Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing 186.13home licensed under sections 
         144A.02 to 
         144A.10or; a boarding care home licensed 186.14under sections 
         144.50 to 
         144.56; or a licensed or registered residential setting which 186.15provides or arranges for the provision of home care services. 186.16    Sec. 14. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:186.17    Subd. 3. Client. "Client" means an individual who requests, or on whose behalf a 186.18request is made for, ombudsman services and is (a) a resident of a long-term care facility 186.19or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or 186.20denial of inpatient or outpatient services, or (c) an individual reserving, receiving, or 186.21requesting a home care service.186.22    Sec. 15. Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:186.23    Subd. 3. Posting. Every long-term care facility and acute care facility shall post in a 186.24conspicuous place the address and telephone number of the office. A home care service 186.25provider shall provide all recipients, including those in elderly housing with services 186.26under chapter 144D, with the address and telephone number of the office. Counties shall 186.27provide clients receiving a consumer support grant or a service allowancelong-term care 186.28consultation services under section 256B.0911 or home and community-based services 186.29through a state or federally funded program with the name, address, and telephone number 186.30of the office. The posting or notice is subject to approval by the ombudsman.186.31    Sec. 16. Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:187.1    Subd. 4. Access to long-term care and acute care facilities and clients. The 187.2ombudsman or designee may:187.3    (1) enter any long-term care facility without notice at any time;187.4    (2) enter any acute care facility without notice during normal business hours;187.5    (3) enter any acute care facility without notice at any time to interview a patient or 187.6observe services being provided to the patient as part of an investigation of a matter that is 187.7within the scope of the ombudsman's authority, but only if the ombudsman's or designee's 187.8presence does not intrude upon the privacy of another patient or interfere with routine 187.9hospital services provided to any patient in the facility;187.10    (4) communicate privately and without restriction with any client in accordance 187.11with section 144.651, as long as the ombudsman has the client's consent for such 187.12communication; 187.13    (5) inspect records of a long-term care facility, home care service provider, or acute 187.14care facility that pertain to the care of the client according to sectionssection 144.335and 187.15144.651; and 187.16    (6) with the consent of a client or client's legal guardian, the ombudsman or 187.17designated staff shall have access to review records pertaining to the care of the client 187.18according to sectionssection 144.335and 144.651. If a client cannot consent and has no 187.19legal guardian, access to the records is authorized by this section. 187.20    A person who denies access to the ombudsman or designee in violation of this 187.21subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a 187.22misdemeanor.187.23    Sec. 17. Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:187.24    Subd. 6. Prohibition against discrimination or retaliation. (a) No entity shall take 187.25discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a 187.26patient, resident, or guardian or family member of a patient, resident, or guardian for filing 187.27in good faith a complaint with or providing information to the ombudsman or designee 187.28including volunteers. A person who violates this subdivision or who aids, abets, invites, 187.29compels, or coerces another to do so is guilty of a misdemeanor.187.30    (b) There shall be a rebuttable presumption that any adverse action, as defined below, 187.31within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose 187.32of this clause, the term "adverse action" refers to action taken by the entity involved in a 187.33report against the person making the report or the person with respect to whom the report 187.34was made because of the report, and includes, but is not limited to:187.35    (1) discharge or transfer from a facility;188.1    (2) termination of service;188.2    (3) restriction or prohibition of access to the facility or its residents;188.3    (4) discharge from or termination of employment;188.4    (5) demotion or reduction in remuneration for services; and188.5    (6) any restriction of rights set forth in section 
         144.651or,144A.44, or 144A.751. 188.6    Sec. 18. Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:188.7    Subdivision 1. Classification. Except as provided in this section, data maintained 188.8by the office under sections 
         256.974 to 
         256.9744 are private data on individuals or 188.9nonpublic data as defined in section 
         13.02, subdivision 9 or 12, and must be maintained 188.10in accordance with the requirements of Public Law 100-75 the Older Americans Act, as 188.11amended, United States Code, title 42, section 3027(a)(12)(D) 3058g(d).188.12    Sec. 19. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:188.13    Subd. 7. Consumer information and assistance; senior linkage. (a) The 188.14Minnesota Board on Aging shall operate a statewide information and assistance service 188.15to aid older Minnesotans and their families in making informed choices about long-term 188.16care options and health care benefits. Language services to persons with limited English 188.17language skills may be made available. The service, known as Senior LinkAge Line, must 188.18be available during business hours through a statewide toll-free number and must also 188.19be available through the Internet.188.20    (b) The service must assist older adults, caregivers, and providers in accessing 188.21information about choices in long-term care services that are purchased through private 188.22providers or available through public options. The service must:188.23    (1) develop a comprehensive database that includes detailed listings in both 188.24consumer- and provider-oriented formats;188.25    (2) make the database accessible on the Internet and through other telecommunication 188.26and media-related tools;188.27    (3) link callers to interactive long-term care screening tools and make these tools 188.28available through the Internet by integrating the tools with the database;188.29    (4) develop community education materials with a focus on planning for long-term 188.30care and evaluating independent living, housing, and service options;188.31    (5) conduct an outreach campaign to assist older adults and their caregivers in 188.32finding information on the Internet and through other means of communication;188.33    (6) implement a messaging system for overflow callers and respond to these callers 188.34by the next business day;189.1    (7) link callers with county human services and other providers to receive more 189.2in-depth assistance and consultation related to long-term care options; and189.3    (8) link callers with quality profiles for nursing facilities and other providers 189.4developed by the commissioner of health.; and189.5    (9) incorporate information about housing with services and consumer rights 189.6within the MinnesotaHelp.info network long-term care database to facilitate consumer 189.7comparison of services and costs among housing with services establishments and with 189.8other in-home services and to support financial self-sufficiency as long as possible. 189.9Housing with services establishments and their arranged home care providers shall provide 189.10information to the commissioner of human services that is consistent with information 189.11required by the commissioner of health under section 144G.06, the Uniform Consumer 189.12Information Guide. The commissioner of human services shall provide the data to the 189.13Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term 189.14care database.189.15    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness 189.16of the statewide information and assistance, and submit this evaluation to the legislature 189.17by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps 189.18in service delivery, continuity in information between the service and identified linkages, 189.19and potential use of private funding to enhance the service.189.20EFFECTIVE DATE.This section is effective the day following final enactment.189.21    Sec. 20. Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to 189.22read:189.23    Subd. 1a. Income and assets generally. Unless specifically required by state law or 189.24rule or federal law or regulation, the methodologies used in counting income and assets 189.25to determine eligibility for medical assistance for persons whose eligibility category is 189.26based on blindness, disability, or age of 65 or more years, the methodologies for the 189.27supplemental security income program shall be used, except as provided under subdivision 189.283, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be 189.29counted as income for purposes of this subdivision until July 1 of each year. Effective 189.30upon federal approval, for children eligible under section 
         256B.055, subdivision 12, or 189.31for home and community-based waiver services whose eligibility for medical assistance 189.32is determined without regard to parental income, child support payments, including any 189.33payments made by an obligor in satisfaction of or in addition to a temporary or permanent 189.34order for child support, and Social Security payments are not counted as income. For 189.35families and children, which includes all other eligibility categories, the methodologies 190.1under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal 190.2Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public 190.3Law 104-193, shall be used, except that effective October 1, 2003, the earned income 190.4disregards and deductions are limited to those in subdivision 1c. For these purposes, a 190.5"methodology" does not include an asset or income standard, or accounting method, 190.6or method of determining effective dates.190.7    Sec. 21. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:190.8    Subd. 3. Asset limitations for aged, blind, or disabled individuals and families.190.9    To be eligible for medical assistance, a person whose eligibility is based on blindness, 190.10disability, or age of 65 or more years must not individually own more than $3,000 $6,000190.11in assets, or if a member of a household with two family members, husband and wife, or 190.12parent and child, the household must not own more than $6,000 $12,000 in assets, plus 190.13$200 $400 for each additional legal dependent. In addition to these maximum amounts, 190.14an eligible individual or family may accrue interest on these amounts, but they must be 190.15reduced to the maximum at the time of an eligibility redetermination. The accumulation 190.16of the clothing and personal needs allowance according to section 
         256B.35 must also be 190.17reduced to the maximum at the time of the eligibility redetermination. The value of assets 190.18that are not considered in determining eligibility for medical assistance is the value of 190.19those assets excluded under the supplemental security income program for aged, blind, 190.20and disabled persons, with the following exceptions: 190.21    (a) Household goods and personal effects are not considered.190.22    (b) Capital and operating assets of a trade or business that the local agency 190.23determines are necessary to the person's ability to earn an income are not considered.190.24    (c) Motor vehicles are excluded to the same extent excluded by the supplemental 190.25security income program.190.26    (d) Assets designated as burial expenses are excluded to the same extent excluded by 190.27the supplemental security income program. Burial expenses funded by annuity contracts 190.28or life insurance policies must irrevocably designate the individual's estate as contingent 190.29beneficiary to the extent proceeds are not used for payment of selected burial expenses.190.30    (e) Effective upon federal approval, for a person who no longer qualifies as an 190.31employed person with a disability due to loss of earnings, assets allowed while eligible 190.32for medical assistance under section 
         256B.057, subdivision 9, are not considered for 12 190.33months, beginning with the first month of ineligibility as an employed person with a 190.34disability, to the extent that the person's total assets remain within the allowed limits of 190.35section 
         256B.057, subdivision 9, paragraph (b). 191.1    (f) When a person enrolled in medical assistance under section 256B.057, 191.2subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive 191.3months before the person's 65th birthday, the assets owned by the person and the person's 191.4spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph 191.5(b), when determining eligibility for medical assistance under section 256B.055, 191.6subdivision 7. The income of a spouse of a person enrolled in medical assistance under 191.7section 256B.057, subdivision 9, during each of the 24 consecutive months before the 191.8person's 65th birthday must be disregarded when determining eligibility for medical 191.9assistance under section 256B.055, subdivision 7, when the person reaches age 65. This 191.10paragraph does not apply at the time the person or the person's spouse requests medical 191.11assistance payment for long-term care services.191.12EFFECTIVE DATE.This section is effective July 1, 2007, except that the increase 191.13in the asset standard for persons whose eligibility for medical assistance is based on 191.14blindness, disability, or age of 65 or more years is effective July 1, 2008.191.15    Sec. 22. Minnesota Statutes 2006, section 256B.056, subdivision 5c, is amended to 191.16read:191.17    Subd. 5c. Excess income standard. (a) The excess income standard for families 191.18with children is the standard specified in subdivision 4.191.19    (b) The excess income standard for a person whose eligibility is based on blindness, 191.20disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the 191.21family size. Effective July 1, 2002, the excess income standard for this paragraph shall 191.22equal 75 percent of the federal poverty guidelines. Effective July 1, 2007, the excess 191.23income standard for this paragraph shall equal 85 percent of the federal poverty guidelines. 191.24The excess income standard for this paragraph shall be increased by five percentage points 191.25on July 1 of each of the next three years, so that the excess income standard shall equal 191.26100 percent of the federal poverty guidelines effective July 1, 2010.191.27EFFECTIVE DATE.This section is effective July 1, 2007.191.28    Sec. 23. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to 191.29read:191.30    Subd. 11. Data use agreement; Notice of relocation assistance. The commissioner 191.31shall execute a data use agreement with the Centers for Medicare and Medicaid Services 191.32to obtain the long-term care minimum data set data to assist residents of nursing facilities 191.33who have establish a process with the Centers for Independent Living that allows a person 192.1residing in a Minnesota nursing facility to receive needed information, consultation, and 192.2assistance from one of the centers about the available community support options that may 192.3enable the person to relocate to the community, if the person: (1) is under the age of 65, 192.4(2) has indicated a desire to live in the community. The commissioner shall in turn enter 192.5into agreements with the Centers for Independent Living to provide information about 192.6assistance for persons who want to move to the community. The commissioner shall work 192.7with the Centers for Independent Living on both the content of the information to be 192.8provided and privacy protections for the individual residents, and (3) has signed a release 192.9of information authorized by the person or the person's appointed legal representative. 192.10The process established under this subdivision shall be coordinated with the long-term 192.11care consultation service activities established in section 256B.0911.192.12    Sec. 24. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to 192.13read:192.14    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for 192.15meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, 192.16$6.50 for lunch, or $8 for dinner.192.17    (b) Medical assistance reimbursement for lodging for persons traveling to receive 192.18medical care may not exceed $50 per day unless prior authorized by the local agency.192.19    (c) Medical assistance direct mileage reimbursement to the eligible person or the 192.20eligible person's driver may not exceed 20 cents per mile.192.21    (d) Regardless of the number of employees that an enrolled health care provider 192.22may have, medical assistance covers sign and oral language interpreter services when 192.23provided by an enrolled health care provider during the course of providing a direct, 192.24person-to-person covered health care service to an enrolled recipient with limited English 192.25proficiency or who has a hearing loss and uses interpreting services.192.26    Sec. 25. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 192.27subdivision to read:192.28    Subd. 49.Self-directed supports option.Upon federal approval, medical 192.29assistance covers the self-directed supports option as defined under section 256B.0657 and 192.30section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.192.31EFFECTIVE DATE.This section is effective upon federal approval of the state 192.32Medicaid plan amendment. The commissioner of human services shall inform the Office 192.33of the Revisor of Statutes when approval is obtained.193.1    Sec. 26. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.193.2    Subdivision 1.Definition."Self-directed supports option" means personal 193.3assistance, supports, items, and related services purchased under an approved budget 193.4plan and budget by a recipient.193.5    Subd. 2.Eligibility.(a) The self-directed supports option is available to a person 193.6who:193.7    (1) is a recipient of medical assistance as determined under sections 256B.055, 193.8256B.056, and 256B.057, subdivision 9;193.9    (2) is eligible for personal care assistant services under section 256B.0655;193.10    (3) lives in the person's own apartment or home, which is not owned, operated, or 193.11controlled by a provider of services not related by blood or marriage;193.12    (4) has the ability to hire, fire, supervise, establish staff compensation for, and 193.13manage the individuals providing services, and to choose and obtain items, related 193.14services, and supports as described in the participant's plan. If the recipient is not able to 193.15carry out these functions but has a legal guardian or parent to carry them out, the guardian 193.16or parent may fulfill these functions on behalf of the recipient; and193.17    (5) has not been excluded or disenrolled by the commissioner.193.18    (b) The commissioner may disenroll or exclude recipients, including guardians and 193.19parents, under the following circumstances:193.20    (1) recipients who have been restricted by the Primary Care Utilization Review 193.21Committee may be excluded for a specified time period; and 193.22    (2) recipients who exit the self-directed supports option during the recipient's 193.23service plan year shall not access the self-directed supports option for the remainder 193.24of that service plan year.193.25    Subd. 3.Eligibility for other services.Selection of the self-directed supports 193.26option by a recipient shall not restrict access to other medically necessary care and 193.27services furnished under the state plan medical assistance benefit, including home care 193.28targeted case management, except that a person receiving home and community-based 193.29waiver services, a family support grant or a consumer support grant is not eligible for 193.30funding under the self-directed supports option.193.31    Subd. 4.Assessment requirements.(a) The self-directed supports option 193.32assessment must meet the following requirements:193.33    (1) it shall be conducted by the county public health nurse or a certified public 193.34health nurse under contract with the county;193.35    (2) it shall be conducted face-to-face in the recipient's home initially, and at least 193.36annually thereafter; when there is a significant change in the recipient's condition; and 194.1when there is a change in the need for personal care assistant services. A recipient who is 194.2residing in a facility may be assessed for the self-directed support option for the purpose 194.3of returning to the community using this option; and 194.4    (3) it shall be completed using the format established by the commissioner.194.5    (b) The results of the assessment and recommendations shall be communicated to 194.6the commissioner and the recipient by the county public health nurse or certified public 194.7health nurse under contract with the county.194.8    Subd. 5.Self-directed supports option plan requirements.(a) The plan for the 194.9self-directed supports option must meet the following requirements:194.10    (1) the plan must be completed using a person-centered process that:194.11    (i) builds upon the recipient's capacity to engage in activities that promote 194.12community life;194.13    (ii) respects the recipient's preferences, choices, and abilities;194.14    (iii) involves families, friends, and professionals in the planning or delivery of 194.15services or supports as desired or required by the recipient; and 194.16    (iv) addresses the need for personal care assistant services identified in the recipient's 194.17self-directed supports option assessment;194.18    (2) the plan shall be developed by the recipient or by the guardian of an adult 194.19recipient or by a parent or guardian of a minor child, with the assistance of an enrolled 194.20medical assistance home care targeted case manager provider who meets the requirements 194.21established for using a person-centered planning process and shall be reviewed at least 194.22annually upon reassessment or when there is a significant change in the recipient's 194.23condition; and 194.24    (3) the plan must include the total budget amount available divided into monthly 194.25amounts that cover the number of months of personal care assistant services authorization 194.26included in the budget. The amount used each month may vary, but additional funds shall 194.27not be provided above the annual personal care assistant services authorized amount 194.28unless a change in condition is documented.194.29    (b) The commissioner shall:194.30    (1) establish the format and criteria for the plan as well as the requirements for 194.31providers who assist with plan development;194.32    (2) review the assessment and plan and, within 30 days after receiving the 194.33assessment and plan, make a decision on approval of the plan;194.34    (3) notify the recipient, parent, or guardian of approval or denial of the plan and 194.35provide notice of the right to appeal under section 256.045; and 194.36    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.195.1    Subd. 6.Services covered.(a) Services covered under the self-directed supports 195.2option include:195.3    (1) personal care assistant services under section 256B.0655; and 195.4    (2) items, related services, and supports, including assistive technology, that increase 195.5independence or substitute for human assistance to the extent expenditures would 195.6otherwise be used for human assistance.195.7    (b) Items, supports, and related services purchased under this option shall not be 195.8considered home care services for the purposes of section 144A.43.195.9    Subd. 7.Noncovered services.Services or supports that are not eligible for 195.10payment under the self-directed supports option include:195.11    (1) services, goods, or supports that do not benefit the recipient;195.12    (2) any fees incurred by the recipient, such as Minnesota health care program fees 195.13and co-pays, legal fees, or costs related to advocate agencies;195.14    (3) insurance, except for insurance costs related to employee coverage or fiscal 195.15support entity payments;195.16    (4) room and board and personal items that are not related to the disability, except 195.17that medically prescribed specialized diet items may be covered if they reduce the need for 195.18human assistance;195.19    (5) home modifications that add square footage;195.20    (6) home modifications for a residence other than the primary residence of the 195.21recipient, or in the event of a minor with parents not living together, the primary residences 195.22of the parents;195.23    (7) expenses for travel, lodging, or meals related to training the recipient, the parent 195.24or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or 195.25unpaid caregivers that exceed $500 in a 12-month period;195.26    (8) experimental treatment;195.27    (9) any service or item covered by other medical assistance state plan services, 195.28including prescription and over-the-counter medications, compounds, and solutions and 195.29related fees, including premiums and co-payments;195.30    (10) membership dues or costs, except when the service is necessary and appropriate 195.31to treat a physical condition or to improve or maintain the recipient's physical condition. 195.32The condition must be identified in the recipient's plan of care and monitored by a 195.33Minnesota health care program enrolled physician;195.34    (11) vacation expenses other than the cost of direct services;195.35    (12) vehicle maintenance or modifications not related to the disability;195.36    (13) tickets and related costs to attend sporting or other recreational events; and196.1    (14) costs related to Internet access, except when necessary for operation of assistive 196.2technology, to increase independence, or to substitute for human assistance.196.3    Subd. 8.Self-directed budget requirements.The budget for the provision of the 196.4self-directed service option shall be equal to the greater of either:196.5    (1) the annual amount of personal care assistant services under section 256B.0655 196.6that the recipient has used in the most recent 12-month period; or 196.7    (2) the amount determined using the consumer support grant methodology under 196.8section 256.476, subdivision 11, except that the budget amount shall include the federal 196.9and nonfederal share of the average service costs.196.10    Subd. 9.Quality assurance and risk management.(a) The commissioner 196.11shall establish quality assurance and risk management measures for use in developing 196.12and implementing self-directed plans and budgets that (1) recognize the roles and 196.13responsibilities involved in obtaining services in a self-directed manner, and (2) assure 196.14the appropriateness of such plans and budgets based upon a recipient's resources and 196.15capabilities. These measures must include (i) background studies, and (ii) backup and 196.16emergency plans, including disaster planning.196.17    (b) The commissioner shall provide ongoing technical assistance and resource and 196.18educational materials for families and recipients selecting the self-directed option.196.19    (c) Performance assessments measures, such as of a recipient's satisfaction with the 196.20services and supports, and ongoing monitoring of health and well-being shall be identified 196.21in consultation with the stakeholder group.196.22    Subd. 10.Fiscal support entity.(a) Each recipient shall choose a fiscal support 196.23entity provider certified by the commissioner to make payments for services, items, 196.24supports, and administrative costs related to managing a self-directed service plan 196.25authorized for payment in the approved plan and budget. Recipients shall also choose 196.26the payroll, agency with choice, or the fiscal conduit model of financial and service 196.27management.196.28    (b) The fiscal support entity:196.29    (1) may not limit or restrict the recipient's choice of service or support providers, 196.30including use of the payroll, agency with choice, or fiscal conduit model of financial 196.31and service management; 196.32    (2) must have a written agreement with the recipient or the recipient's representative 196.33that identifies the duties and responsibilities to be performed and the specific related 196.34charges; 197.1    (3) must provide the recipient and the home care targeted case manager with a 197.2monthly written summary of the self-directed supports option services that were billed, 197.3including charges from the fiscal support entity;197.4    (4) must be knowledgeable of and comply with Internal Revenue Service 197.5requirements necessary to process employer and employee deductions, provide appropriate 197.6and timely submission of employer tax liabilities, and maintain documentation to support 197.7medical assistance claims; 197.8    (5) must have current and adequate liability insurance and bonding and sufficient 197.9cash flow and have on staff or under contract a certified public accountant or an individual 197.10with a baccalaureate degree in accounting; and 197.11    (6) must maintain records to track all self-directed supports option services 197.12expenditures, including time records of persons paid to provide supports and receipts for 197.13any goods purchased. The records must be maintained for a minimum of five years from 197.14the claim date and be available for audit or review upon request. Claims submitted by 197.15the fiscal support entity must correspond with services, amounts, and time periods as 197.16authorized in the recipient's self-directed supports option plan.197.17    (c) The commissioner shall have authority to:197.18    (1) set or negotiate rates with fiscal support entities;197.19    (2) limit the number of fiscal support entities;197.20    (3) identify a process to certify and recertify fiscal support entities and assure fiscal 197.21support entities are available to recipients throughout the state; and 197.22    (4) establish a uniform format and protocol to be used by eligible fiscal support 197.23entities.197.24    Subd. 11.Stakeholder consultation.The commissioner shall consult with a 197.25statewide consumer-directed services stakeholder group, including representatives of 197.26all types of consumer-directed service users, advocacy organizations, counties, and 197.27consumer-directed service providers. The commissioner shall seek recommendations 197.28from this stakeholder group in developing:197.29    (1) the self-directed plan format;197.30    (2) requirements and guidelines for the person-centered plan assessment and 197.31planning process;197.32    (3) implementation of the option and the quality assurance and risk management 197.33techniques; and 197.34    (4) standards and requirements, including rates for the personal support plan 197.35development provider and the fiscal support entity; policies; training; and implementation. 197.36The stakeholder group shall provide recommendations on the repeal of the personal care 198.1assistant choice option, transition issues, and whether the consumer support grant program 198.2under section 256.476 should be modified. The stakeholder group shall meet at least 198.3three times each year to provide advice on policy, implementation, and other aspects of 198.4consumer and self-directed services.198.5EFFECTIVE DATE.Subdivisions 1 to 10 are effective upon federal approval of 198.6the state Medicaid plan amendment. The commissioner of human services shall inform 198.7the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11 198.8is effective July 1, 2007.198.9    Sec. 27. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to 198.10read:198.11    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, 198.12services planning, or other assistance intended to support community-based living, 198.13including persons who need assessment in order to determine waiver or alternative care 198.14program eligibility, must be visited by a long-term care consultation team within ten 198.15working days after the date on which an assessment was requested or recommended. 198.16Assessments must be conducted according to paragraphs (b) to (g) (i).198.17    (b) The county may utilize a team of either the social worker or public health nurse, 198.18or both, to conduct the assessment in a face-to-face interview. The consultation team 198.19members must confer regarding the most appropriate care for each individual screened or 198.20assessed.198.21    (c) The long-term care consultation team must assess the health and social needs of 198.22the person, using an assessment form provided by the commissioner.198.23    (d) The team must conduct the assessment in a face-to-face interview with the 198.24person being assessed and the person's legal representative, if applicable.198.25    (e) The team must provide the person, or the person's legal representative, with 198.26written recommendations for facility- or community-based services. The team must 198.27document that the most cost-effective alternatives available were offered to the individual. 198.28For purposes of this requirement, "cost-effective alternatives" means community services 198.29and living arrangements that cost the same as or less than nursing facility care.198.30    (f) If the person chooses to use community-based services, the team must provide 198.31the person or the person's legal representative with a written community support plan, 198.32regardless of whether the individual is eligible for Minnesota health care programs. 198.33The person may request assistance in developing a community support plan without 198.34participating in a complete assessment.199.1    (g) The person has the right to make the final decision between nursing facility 199.2placement and community placement after the screening team's recommendation, except 199.3as provided in subdivision 4a, paragraph (c).199.4    (h) The team must give the person receiving assessment or support planning, or 199.5the person's legal representative, materials, and forms supplied by the commissioner 199.6containing the following information:199.7    (1) the need for and purpose of preadmission screening and assessment if the person 199.8selects nursing facility placement;199.9    (2) the role of the long-term care consultation assessment and support planning in 199.10waiver and alternative care program eligibility determination;199.11    (2) (3) information about Minnesota health care programs;199.12    (3) (4) the person's freedom to accept or reject the recommendations of the team;199.13    (4) (5) the person's right to confidentiality under the Minnesota Government Data 199.14Practices Act, chapter 13; and199.15    (6) the long-term care consultant's decision regarding the person's need for nursing 199.16facility level of care;199.17    (5) (7) the person's right to appeal the decision regarding the need for nursing facility 199.18level of care or the county's final decisions regarding public programs eligibility according 199.19to section 
         256.045, subdivision 3. 199.20    (i) Face-to-face assessment completed as part of eligibility determination for 199.21the alternative care, elderly waiver, community alternatives for disabled individuals, 199.22community alternative care, and traumatic brain injury waiver programs under sections 199.23256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more 199.24than 60 calendar days after the date of assessment. The effective eligibility start date 199.25for these programs can never be prior to the date of assessment. If an assessment was 199.26completed more than 60 days before the effective waiver or alternative care program 199.27eligibility start date, assessment and support plan information must be updated in a 199.28face-to-face visit and documented in the department's Medicaid Management Information 199.29System (MMIS). The effective date of program eligibility in this case cannot be prior to 199.30the date the updated assessment is completed.199.31    Sec. 28. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to 199.32read:199.33    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall 199.34provide assistance to persons residing in a nursing facility, hospital, regional treatment 199.35center, or intermediate care facility for persons with developmental disabilities who 200.1request or are referred for assistance. Transition assistance must include assessment, 200.2community support plan development, referrals to Minnesota health care programs, 200.3and referrals to programs that provide assistance with housing. Transition assistance 200.4must also include information about the Centers for Independent Living and about other 200.5organizations that can provide assistance with relocation efforts, and information about 200.6contacting these organizations to obtain their assistance and support. 200.7    (b) The county shall develop transition processes with institutional social workers 200.8and discharge planners to ensure that:200.9    (1) persons admitted to facilities receive information about transition assistance 200.10that is available;200.11    (2) the assessment is completed for persons within ten working days of the date of 200.12request or recommendation for assessment; and200.13    (3) there is a plan for transition and follow-up for the individual's return to the 200.14community. The plan must require notification of other local agencies when a person 200.15who may require assistance is screened by one county for admission to a facility located 200.16in another county.200.17    (c) If a person who is eligible for a Minnesota health care program is admitted to a 200.18nursing facility, the nursing facility must include a consultation team member or the case 200.19manager in the discharge planning process.200.20    Sec. 29. Minnesota Statutes 2006, section 256B.0911, is amended by adding a 200.21subdivision to read:200.22    Subd. 3c.Transition to housing with services.(a) Transitional consultation shall 200.23be offered to all prospective residents 65 years of age or older regardless of income, assets, 200.24or funding sources before housing with services establishments offering or providing 200.25assisted living execute a lease or contract with the prospective resident. The purpose of 200.26transitional long-term care consultation is to support persons with current or anticipated 200.27long-term care needs in making informed choices among options that include the most 200.28cost-effective and least restrictive settings, and to delay spenddown to eligibility for 200.29publicly funded programs by connecting people to alternative services in their homes 200.30before transition to housing with services.200.31    (b) Transitional consultation services are provided as determined by the 200.32commissioner of human services in partnership with county long-term care consultation 200.33units, and the Area Agencies on Aging, and are a combination of telephone-based 200.34and in-person assistance provided under models developed by the commissioner. The 200.35consultation is to be performed in a manner which provides objective and complete 201.1information. Transitional consultation must be provided within five working days of the 201.2request of the prospective resident as follows:201.3    (1) the consultation must be provided by a qualified professional as determined by 201.4the commissioner;201.5    (2) the consultation must include a review of the prospective resident's reasons for 201.6considering assisted living, the prospective resident's personal goals, a discussion of the 201.7prospective resident's immediate and projected long-term care needs, and alternative 201.8community services or assisted living settings that may meet the prospective resident's 201.9needs; and201.10    (3) the prospective resident will be informed of the availability of long-term care 201.11consultation services described in subdivision 3a that are available at no charge to the 201.12prospective resident to assist the prospective resident in assessment and planning to 201.13meet the prospective resident's long-term care needs. Regardless of the consultation, 201.14prospective residents maintain the right to choose housing with services or assisted living, 201.15if that is their choice.201.16EFFECTIVE DATE.This section is effective October 1, 2008.201.17    Sec. 30. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to 201.18read:201.19    Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the 201.20federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are 201.21limited to:201.22    (1) a person who, having entered an acute care facility from a certified nursing 201.23facility, is returning to a certified nursing facility;201.24    (2) a person transferring from one certified nursing facility in Minnesota to another 201.25certified nursing facility in Minnesota; and201.26    (3) a person, 21 years of age or older, who satisfies the following criteria, as specified 201.27in Code of Federal Regulations, title 42, section 483.106(b)(2):201.28    (i) the person is admitted to a nursing facility directly from a hospital after receiving 201.29acute inpatient care at the hospital;201.30    (ii) the person requires nursing facility services for the same condition for which 201.31care was provided in the hospital; and201.32    (iii) the attending physician has certified before the nursing facility admission that 201.33the person is likely to receive less than 30 days of nursing facility services.201.34    (b) Persons who are exempt from preadmission screening for purposes of level of 201.35care determination include:202.1    (1) persons described in paragraph (a);202.2    (2) an individual who has a contractual right to have nursing facility care paid for 202.3indefinitely by the veterans' administration;202.4    (3) an individual enrolled in a demonstration project under section 
         256B.69, 202.5subdivision 8
         , at the time of application to a nursing facility; and202.6    (4) an individual currently being served under the alternative care program or under 202.7a home and community-based services waiver authorized under section 1915(c) of the 202.8federal Social Security Act; and.202.9    (5) individuals admitted to a certified nursing facility for a short-term stay, which 202.10is expected to be 14 days or less in duration based upon a physician's certification, and 202.11who have been assessed and approved for nursing facility admission within the previous 202.12six months. This exemption applies only if the consultation team member determines at 202.13the time of the initial assessment of the six-month period that it is appropriate to use the 202.14nursing facility for short-term stays and that there is an adequate plan of care for return to 202.15the home or community-based setting. If a stay exceeds 14 days, the individual must be 202.16referred no later than the first county working day following the 14th resident day for a 202.17screening, which must be completed within five working days of the referral. The payment 202.18limitations in subdivision 7 apply to an individual found at screening to not meet the level 202.19of care criteria for admission to a certified nursing facility.202.20    (c) Persons admitted to a Medicaid-certified nursing facility from the community 202.21on an emergency basis as described in paragraph (d) or from an acute care facility on a 202.22nonworking day must be screened the first working day after admission.202.23    (d) Emergency admission to a nursing facility prior to screening is permitted when 202.24all of the following conditions are met:202.25    (1) a person is admitted from the community to a certified nursing or certified 202.26boarding care facility during county nonworking hours;202.27    (2) a physician has determined that delaying admission until preadmission screening 202.28is completed would adversely affect the person's health and safety;202.29    (3) there is a recent precipitating event that precludes the client from living safely in 202.30the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's 202.31inability to continue to provide care;202.32    (4) the attending physician has authorized the emergency placement and has 202.33documented the reason that the emergency placement is recommended; and202.34    (5) the county is contacted on the first working day following the emergency 202.35admission.203.1Transfer of a patient from an acute care hospital to a nursing facility is not considered 203.2an emergency except for a person who has received hospital services in the following 203.3situations: hospital admission for observation, care in an emergency room without hospital 203.4admission, or following hospital 24-hour bed care.203.5    (e) A nursing facility must provide a written notice to persons who satisfy the criteria 203.6in paragraph (a), clause (3),information to all persons admitted regarding the person's 203.7right to request and receive long-term care consultation services as defined in subdivision 203.81a. The noticeinformation must be provided prior to the person's discharge from the 203.9facility and in a format specified by the commissioner.203.10    Sec. 31. Minnesota Statutes 2006, section 256B.0911, subdivision 4c, is amended to 203.11read:203.12    Subd. 4c. Screening requirements. (a) A person may be screened for nursing 203.13facility admission by telephone or in a face-to-face screening interview. Consultation team 203.14members shall identify each individual's needs using the following categories:203.15    (1) the person needs no face-to-face screening interview to determine the need 203.16for nursing facility level of care based on information obtained from other health care 203.17professionals;203.18    (2) the person needs an immediate face-to-face screening interview to determine the 203.19need for nursing facility level of care and complete activities required under subdivision 203.204a; or203.21    (3) the person may be exempt from screening requirements as outlined in subdivision 203.224b, but will need transitional assistance after admission or in-person follow-along after 203.23a return home.203.24    (b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing 203.25facility must be screened prior to admission.203.26    (c) The long-term care consultation team shall recommend a case mix classification 203.27for persons admitted to a certified nursing facility when sufficient information is received 203.28to make that classification. The nursing facility is authorized to conduct all case mix 203.29assessments for persons who have been screened prior to admission for whom the county 203.30did not recommend a case mix classification. The nursing facility is authorized to conduct 203.31all case mix assessments for persons admitted to the facility prior to a preadmission 203.32screening. The county retains the responsibility of distributing appropriate case mix 203.33forms to the nursing facility.203.34    (d) (c) The county screening or intake activity must include processes to identify 203.35persons who may require transition assistance as described in subdivision 3b.204.1    Sec. 32. Minnesota Statutes 2006, section 256B.0911, subdivision 6, is amended to 204.2read:204.3    Subd. 6. Payment for long-term care consultation services. (a) The total payment 204.4for each county must be paid monthly by certified nursing facilities in the county. The 204.5monthly amount to be paid by each nursing facility for each fiscal year must be determined 204.6by dividing the county's annual allocation for long-term care consultation services by 12 204.7to determine the monthly payment and allocating the monthly payment to each nursing 204.8facility based on the number of licensed beds in the nursing facility. Payments to counties 204.9in which there is no certified nursing facility must be made by increasing the payment 204.10rate of the two facilities located nearest to the county seat.204.11    (b) The commissioner shall include the total annual payment determined under 204.12paragraph (a) for each nursing facility reimbursed under section 
         256B.431 or 
         256B.434204.13according to section 
         256B.431, subdivision 2b, paragraph (g), or 256B.435.204.14    (c) In the event of the layaway, delicensure and decertification, or removal from 204.15layaway of 25 percent or more of the beds in a facility, the commissioner may adjust 204.16the per diem payment amount in paragraph (b) and may adjust the monthly payment 204.17amount in paragraph (a). The effective date of an adjustment made under this paragraph 204.18shall be on or after the first day of the month following the effective date of the layaway, 204.19delicensure and decertification, or removal from layaway.204.20    (d) Payments for long-term care consultation services are available to the county 204.21or counties to cover staff salaries and expenses to provide the services described in 204.22subdivision 1a. The county shall employ, or contract with other agencies to employ, within 204.23the limits of available funding, sufficient personnel to provide long-term care consultation 204.24services while meeting the state's long-term care outcomes and objectives as defined in 204.25section 
         256B.0917, subdivision 1. The county shall be accountable for meeting local 204.26objectives as approved by the commissioner in the biennial home and community-based 204.27services quality assurance plan on a form provided by the commissioner.204.28    (e) Notwithstanding section 
         256B.0641, overpayments attributable to payment of the 204.29screening costs under the medical assistance program may not be recovered from a facility.204.30    (f) The commissioner of human services shall amend the Minnesota medical 204.31assistance plan to include reimbursement for the local consultation teams.204.32    (g) The county may bill, as case management services, assessments, support 204.33planning, and follow-along provided to persons determined to be eligible for case 204.34management under Minnesota health care programs. No individual or family member 204.35shall be charged for an initial assessment or initial support plan development provided 204.36under subdivision 3a or 3b.205.1    Sec. 33. Minnesota Statutes 2006, section 256B.0911, is amended by adding a 205.2subdivision to read:205.3    Subd. 6a.Withholding.If any provider obligated to pay the long-term care 205.4consultation amount as described in subdivision 6 is more than two months delinquent in 205.5the timely payment of the monthly installment, the commissioner may withhold payments, 205.6penalties, and interest in accordance with the methods outlined in section 256.9657, 205.7subdivision 7a. Any amount withheld under this provision must be returned to the county 205.8to whom the delinquent payments were due.205.9    Sec. 34. Minnesota Statutes 2006, section 256B.0911, subdivision 7, is amended to 205.10read:205.11    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance 205.12reimbursement for nursing facilities shall be authorized for a medical assistance recipient 205.13only if a preadmission screening has been conducted prior to admission or the county has 205.14authorized an exemption. Medical assistance reimbursement for nursing facilities shall 205.15not be provided for any recipient who the local screener has determined does not meet the 205.16level of care criteria for nursing facility placement or, if indicated, has not had a level II 205.17OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of 205.181987 completed unless an admission for a recipient with mental illness is approved by the 205.19local mental health authority or an admission for a recipient with developmental disability 205.20is approved by the state developmental disability authority.205.21    (b) The nursing facility must not bill a person who is not a medical assistance 205.22recipient for resident days that preceded the date of completion of screening activities as 205.23required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed 205.24resident days in the nursing facility resident day totals reported to the commissioner.205.25    (c) The commissioner shall make a request to the Centers for Medicare and Medicaid 205.26Services for a waiver allowing team approval of Medicaid payments for certified nursing 205.27facility care. An individual has a choice and makes the final decision between nursing 205.28facility placement and community placement after the screening team's recommendation, 205.29except as provided in subdivision 4a, paragraph (c).205.30    Sec. 35. Minnesota Statutes 2006, section 256B.0913, subdivision 4, is amended to 205.31read:205.32    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.205.33    (a) Funding for services under the alternative care program is available to persons who 205.34meet the following criteria:206.1    (1) the person has been determined by a community assessment under section 206.2256B.0911
          to be a person who would require the level of care provided in a nursing 206.3facility, but for the provision of services under the alternative care program;206.4    (2) the person is age 65 or older;206.5    (3) the person would be eligible for medical assistance within 135 days of admission 206.6to a nursing facility;206.7    (4) the person is not ineligible for the payment of long-term care services by the206.8medical assistance program due to an asset transfer penalty under section 256B.0595 or 206.9equity interest in the home exceeding $500,000 as stated in section 256B.056;206.10    (5) the person needs long-term care services that are not funded through other state 206.11or federal funding;206.12    (6) the monthly cost of the alternative care services funded by the program for 206.13this person does not exceed 75 percent of the monthly limit described under section 206.14256B.0915, subdivision 3a
         . This monthly limit does not prohibit the alternative care client 206.15from payment for additional services, but in no case may the cost of additional services 206.16purchased under this section exceed the difference between the client's monthly service 206.17limit defined under section 
         256B.0915, subdivision 3, and the alternative care program 206.18monthly service limit defined in this paragraph. If medical care-related supplies and 206.19equipment or environmental modifications and adaptations are or will be purchased for 206.20an alternative care services recipient, the costs may be prorated on a monthly basis for 206.21up to 12 consecutive months beginning with the month of purchase. If the monthly cost 206.22of a recipient's other alternative care services exceeds the monthly limit established in 206.23this paragraph, the annual cost of the alternative care services shall be determined. In this 206.24event, the annual cost of alternative care services shall not exceed 12 times the monthly 206.25limit described in this paragraph; and206.26    (7) the person is making timely payments of the assessed monthly fee.206.27A person is ineligible if payment of the fee is over 60 days past due, unless the person 206.28agrees to:206.29    (i) the appointment of a representative payee;206.30    (ii) automatic payment from a financial account;206.31    (iii) the establishment of greater family involvement in the financial management of 206.32payments; or206.33    (iv) another method acceptable to the county lead agency to ensure prompt fee 206.34payments.206.35    The county shall lead agency may extend the client's eligibility as necessary while 206.36making arrangements to facilitate payment of past-due amounts and future premium 207.1payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall 207.2not be reinstated for a period of 30 days.207.3    (b) Alternative care funding under this subdivision is not available for a person 207.4who is a medical assistance recipient or who would be eligible for medical assistance 207.5without a spenddown or waiver obligation. A person whose initial application for medical 207.6assistance and the elderly waiver program is being processed may be served under the 207.7alternative care program for a period up to 60 days. If the individual is found to be eligible 207.8for medical assistance, medical assistance must be billed for services payable under the 207.9federally approved elderly waiver plan and delivered from the date the individual was 207.10found eligible for the federally approved elderly waiver plan. Notwithstanding this 207.11provision, alternative care funds may not be used to pay for any service the cost of which: 207.12(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; 207.13or (iii) is used to pay a medical assistance income spenddown for a person who is eligible 207.14to participate in the federally approved elderly waiver program under the special income 207.15standard provision.207.16    (c) Alternative care funding is not available for a person who resides in a licensed 207.17nursing home, certified boarding care home, hospital, or intermediate care facility, except 207.18for case management services which are provided in support of the discharge planning 207.19process for a nursing home resident or certified boarding care home resident to assist with 207.20a relocation process to a community-based setting.207.21    (d) Alternative care funding is not available for a person whose income is greater 207.22than the maintenance needs allowance under section 
         256B.0915, subdivision 1d, but equal 207.23to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal207.24year for which alternative care eligibility is determined, who would be eligible for the 207.25elderly waiver with a waiver obligation.207.26    Sec. 36. Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to 207.27read:207.28    Subd. 5. Services covered under alternative care. Alternative care funding may 207.29be used for payment of costs of:207.30    (1) adult day care;207.31    (2) home health aide;207.32    (3) homemaker services;207.33    (4) personal care;207.34    (5) case management;207.35    (6) respite care;208.1    (7) care-related supplies and equipment;208.2    (8) meals delivered to the home;208.3    (9) nonmedical transportation;208.4    (10) nursing services;208.5    (11) chore services;208.6    (12) companion services;208.7    (13) nutrition services;208.8    (14) training for direct informal caregivers;208.9    (15) telehome care to provide services in their own homes in conjunction with 208.10in-home visits;208.11    (16) discretionary services, for which counties may make payment from their 208.12alternative care program allocation or services not otherwise defined in this section 208.13or section 256B.0625, following approval by the commissioner consumer-directed 208.14community services under the alternative care programs which are available statewide and 208.15limited to the average monthly expenditures representative of all alternative care program 208.16participants for the same case mix resident class assigned in the most recent fiscal year for 208.17which complete expenditure data is available;208.18    (17) environmental modifications and adaptations; and208.19    (18) direct cash payments for which counties may make payment from their 208.20alternative care program allocation to clients for the purpose of purchasing services, 208.21following approval by the commissioner, and subject to the provisions of subdivision 5h, 208.22until approval and implementation of consumer-directed services through the federally 208.23approved elderly waiver plan. Upon implementation, consumer-directed services under 208.24the alternative care program are available statewide and limited to the average monthly 208.25expenditures representative of all alternative care program participants for the same case 208.26mix resident class assigned in the most recent fiscal year for which complete expenditure 208.27data is available discretionary services, for which lead agencies may make payment from 208.28their alternative care program allocation for services not otherwise defined in this section 208.29or section 256B.0625, following approval by the commissioner.208.30    Total annual payments for discretionary services and direct cash payments, until 208.31the federally approved consumer-directed service option is implemented statewide, for 208.32all clients within a county may served by a lead agency must not exceed 25 percent of 208.33that county's lead agency's annual alternative care program base allocation. Thereafter, 208.34discretionary services are limited to 25 percent of the county's annual alternative care 208.35program base allocation.209.1    Sec. 37. Minnesota Statutes 2006, section 256B.0913, subdivision 5a, is amended to 209.2read:209.3    Subd. 5a. Services; service definitions; service standards. (a) Unless specified in 209.4statute, the services, service definitions, and standards for alternative care services shall 209.5be the same as the services, service definitions, and standards specified in the federally 209.6approved elderly waiver plan, except foralternative care does not cover transitional 209.7support services, assisted living services, adult foster care services, and residential care 209.8services and benefits defined under section 256B.0625 that meet primary and acute 209.9health care needs.209.10    (b) The county lead agency must ensure that the funds are not used to supplant 209.11or supplement services available through other public assistance or services programs., 209.12including supplementation of client co-pays, deductibles, premiums, or other cost-sharing 209.13arrangements for health-related benefits and services or entitlement programs and services 209.14that are available to the person, but in which they have elected not to enroll. For a provider 209.15of supplies and equipment when the monthly cost of the supplies and equipment is less 209.16than $250, persons or agencies must be employed by or under a contract with the county209.17lead agency or the public health nursing agency of the local board of health in order to 209.18receive funding under the alternative care program. Supplies and equipment may be 209.19purchased from a vendor not certified to participate in the Medicaid program if the cost for 209.20the item is less than that of a Medicaid vendor.209.21    (c) Personal care services must meet the service standards defined in the federally 209.22approved elderly waiver plan, except that a county lead agency may contract with a 209.23client's relative who meets the relative hardship waiver requirements or a relative who 209.24meets the criteria and is also the responsible party under an individual service plan that 209.25ensures the client's health and safety and supervision of the personal care services by a 209.26qualified professional as defined in section 
         256B.0625, subdivision 19c. Relative hardship 209.27is established by the county lead agency when the client's care causes a relative caregiver 209.28to do any of the following: resign from a paying job, reduce work hours resulting in lost 209.29wages, obtain a leave of absence resulting in lost wages, incur substantial client-related 209.30expenses, provide services to address authorized, unstaffed direct care time, or meet 209.31special needs of the client unmet in the formal service plan.209.32    Sec. 38. Minnesota Statutes 2006, section 256B.0913, subdivision 8, is amended to 209.33read:209.34    Subd. 8. Requirements for individual care plan. (a) The case manager shall 209.35implement the plan of care for each alternative care client and ensure that a client's 210.1service needs and eligibility are reassessed at least every 12 months. The plan shall 210.2include any services prescribed by the individual's attending physician as necessary to 210.3allow the individual to remain in a community setting. In developing the individual's care 210.4plan, the case manager should include the use of volunteers from families and neighbors, 210.5religious organizations, social clubs, and civic and service organizations to support the 210.6formal home care services. The county lead agency shall be held harmless for damages or 210.7injuries sustained through the use of volunteers under this subdivision including workers' 210.8compensation liability. The county of service case manager shall provide documentation 210.9in each individual's plan of care and, if requested, to the commissioner that the most 210.10cost-effective alternatives available have been offered to the individual and that the 210.11individual was free to choose among available qualified providers, both public and private, 210.12including qualified case management or service coordination providers other than those 210.13employed by any county; however, the county or tribe maintains responsibility for prior 210.14authorizing services in accordance with statutory and administrative requirements. The 210.15case manager must give the individual a ten-day written notice of any denial, termination, 210.16or reduction of alternative care services.210.17    (b) The county of service or tribe must provide access to and arrange for case 210.18management services, including assuring implementation of the plan. "County of service" 210.19has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11. The county of 210.20service must notify the county of financial responsibility of the approved care plan and 210.21the amount of encumbered funds.210.22    Sec. 39. Minnesota Statutes 2006, section 256B.0913, subdivision 9, is amended to 210.23read:210.24    Subd. 9. Contracting provisions for providers. Alternative care funds paid to 210.25service providers are subject to audit by the commissioner for fiscal and utilization control.210.26    The lead agency must select providers for contracts or agreements using the 210.27following criteria and other criteria established by the county lead agency:210.28    (1) the need for the particular services offered by the provider;210.29    (2) the population to be served, including the number of clients, the length of time 210.30services will be provided, and the medical condition of clients;210.31    (3) the geographic area to be served;210.32    (4) quality assurance methods, including appropriate licensure, certification, or 210.33standards, and supervision of employees when needed;210.34    (5) rates for each service and unit of service exclusive of county lead agency210.35administrative costs;211.1    (6) evaluation of services previously delivered by the provider; and211.2    (7) contract or agreement conditions, including billing requirements, cancellation, 211.3and indemnification.211.4    The county lead agency must evaluate its own agency services under the criteria 211.5established for other providers.211.6    Sec. 40. Minnesota Statutes 2006, section 256B.0913, subdivision 10, is amended to 211.7read:211.8    Subd. 10. Allocation formula. (a) The alternative care appropriation for fiscal 211.9years 1992 and beyond shall cover only alternative care eligible clients. By July 1 15 of 211.10each year, the commissioner shall allocate to county agencies the state funds available for 211.11alternative care for persons eligible under subdivision 2.211.12    (b) The adjusted base for each county lead agency is the county's lead agency's211.13current fiscal year base allocation plus any targeted funds approved during the current 211.14fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each 211.15county lead agency, the determination of alternative care program expenditures shall be 211.16based on payments for services rendered from April 1 through March 31 in the base year, 211.17to the extent that claims have been submitted and paid by June 1 of that year.211.18    (c) If the alternative care program expenditures as defined in paragraph (b) are 95 211.19percent or more of the county's lead agency's adjusted base allocation, the allocation for 211.20the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that 211.21inflation is included in the state budget.211.22    (d) If the alternative care program expenditures as defined in paragraph (b) are less 211.23than 95 percent of the county's lead agency's adjusted base allocation, the allocation 211.24for the next fiscal year is the adjusted base allocation less the amount of unspent funds 211.25below the 95 percent level.211.26    (e) If the annual legislative appropriation for the alternative care program is 211.27inadequate to fund the combined county lead agency allocations for a biennium, the 211.28commissioner shall distribute to each county lead agency the entire annual appropriation 211.29as that county's lead agency's percentage of the computed base as calculated in paragraphs 211.30(c) and (d).211.31    (f) On agreement between the commissioner and the lead agency, the commissioner 211.32may have discretion to reallocate alternative care base allocations distributed to lead 211.33agencies in which the base amount exceeds program expenditures.212.1    Sec. 41. Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to 212.2read:212.3    Subd. 11. Targeted funding. (a) The purpose of targeted funding is to make 212.4additional money available to counties lead agencies with the greatest need. Targeted 212.5funds are not intended to be distributed equitably among all counties lead agencies, but 212.6rather, allocated to those with long-term care strategies that meet state goals.212.7    (b) The funds available for targeted funding shall be the total appropriation for each 212.8fiscal year minus county lead agency allocations determined under subdivision 10 as 212.9adjusted for any inflation increases provided in appropriations for the biennium.212.10    (c) The commissioner shall allocate targeted funds to counties lead agencies that 212.11demonstrate to the satisfaction of the commissioner that they have developed feasible 212.12plans to increase alternative care spending. In making targeted funding allocations, the 212.13commissioner shall use the following priorities:212.14    (1) counties lead agencies that received a lower allocation in fiscal year 1991 than in 212.15fiscal year 1990. Counties remain in this priority until they have been restored to their 212.16fiscal year 1990 level plus inflation;212.17    (2) counties lead agencies that sustain a base allocation reduction for failure to spend 212.1895 percent of the allocation if they demonstrate that the base reduction should be restored;212.19    (3) counties lead agencies that propose projects to divert community residents from 212.20nursing home placement or convert nursing home residents to community living; and212.21    (4) counties lead agencies that can otherwise justify program growth by 212.22demonstrating the existence of waiting lists, demographically justified needs, or other 212.23unmet needs.212.24    (d) Counties Lead agencies that would receive targeted funds according to 212.25paragraph (c) must demonstrate to the commissioner's satisfaction that the funds 212.26would be appropriately spent by showing how the funds would be used to further the 212.27state's alternative care goals as described in subdivision 1, and that the county has the 212.28administrative and service delivery capability to use them.212.29    (e) The commissioner shall request applications make applications available for 212.30targeted funds by November 1 of each year. The counties lead agencies selected for 212.31targeted funds shall be notified of the amount of their additional funding. Targeted funds 212.32allocated to a county lead agency in one year shall be treated as part of the county's lead 212.33agency's base allocation for that year in determining allocations for subsequent years. No 212.34reallocations between counties lead agencies shall be made.213.1    Sec. 42. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to 213.2read:213.3    Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients 213.4to help pay for the cost of participating in the program. The amount of the fee for the 213.5alternative care client shall be determined as follows:213.6    (1) when the alternative care client's income less recurring and predictable medical 213.7expenses is less than 100 percent of the federal poverty guideline effective on July 1 of 213.8the state fiscal year in which the fee is being computed, and total assets are less than 213.9$10,000, the fee is zero;213.10    (2) when the alternative care client's income less recurring and predictable medical 213.11expenses is equal to or greater than 100 percent but less than 150 percent of the federal 213.12poverty guideline effective on July 1 of the state fiscal year in which the fee is being 213.13computed, and total assets are less than $10,000, the fee is five percent of the cost of 213.14alternative care services;213.15    (3) when the alternative care client's income less recurring and predictable medical 213.16expenses is equal to or greater than 150 percent but less than 200 percent of the federal 213.17poverty guidelines effective on July 1 of the state fiscal year in which the fee is being 213.18computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative 213.19care services;213.20    (4) when the alternative care client's income less recurring and predictable medical 213.21expenses is equal to or greater than 200 percent of the federal poverty guidelines effective 213.22on July 1 of the state fiscal year in which the fee is being computed and assets are less than 213.23$10,000, the fee is 30 percent of the cost of alternative care services; and213.24    (5) when the alternative care client's assets are equal to or greater than $10,000, the 213.25fee is 30 percent of the cost of alternative care services.213.26    For married persons, total assets are defined as the total marital assets less the 213.27estimated community spouse asset allowance, under section 
         256B.059, if applicable. For 213.28married persons, total income is defined as the client's income less the monthly spousal 213.29allotment, under section 
         256B.058. 213.30    All alternative care services shall be included in the estimated costs for the purpose 213.31of determining the fee.213.32    Fees are due and payable each month alternative care services are received unless the 213.33actual cost of the services is less than the fee, in which case the fee is the lesser amount.213.34    (b) The fee shall be waived by the commissioner when:213.35    (1) a person who is residing in a nursing facility is receiving case management only;214.1    (2) a married couple is requesting an asset assessment under the spousal 214.2impoverishment provisions;214.3    (3) a person is found eligible for alternative care, but is not yet receiving alternative 214.4care services including case management services; or214.5    (4) a person has chosen to participate in a consumer-directed service plan for which 214.6the cost is no greater than the total cost of the person's alternative care service plan less 214.7the monthly fee amount that would otherwise be assessed.214.8    (c) The county agency must record in the state's receivable system the client's 214.9assessed fee amount or the reason the fee has been waived. The commissioner will bill 214.10and collect the fee from the client. Money collected must be deposited in the general fund 214.11and is appropriated to the commissioner for the alternative care program. The client must 214.12supply the county lead agency with the client's Social Security number at the time of 214.13application. The county lead agency shall supply the commissioner with the client's Social 214.14Security number and other information the commissioner requires to collect the fee from 214.15the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in 214.16chapter 270A and other methods available to the commissioner. The commissioner may 214.17require counties lead agencies to inform clients of the collection procedures that may be 214.18used by the state if a fee is not paid. This paragraph does not apply to alternative care 214.19pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 214.20133, if a county operating under the pilot project reports the following dollar amounts 214.21to the commissioner quarterly:214.22    (1) total fees billed to clients;214.23    (2) total collections of fees billed; and214.24    (3) balance of fees owed by clients.214.25If a county lead agency does not adhere to these reporting requirements, the commissioner 214.26may terminate the billing, collecting, and remitting portions of the pilot project and require 214.27the county lead agency involved to operate under the procedures set forth in this paragraph.214.28    Sec. 43. Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to 214.29read:214.30    Subd. 13. County Lead agency biennial plan. The county lead agency biennial 214.31plan for long-term care consultation services under section 
         256B.0911, the alternative 214.32care program under this section, and waivers for the elderly under section 
         256B.0915, 214.33shall be submitted by the lead agency as the home and community-based services quality 214.34assurance plan on a form provided by the commissioner.215.1    Sec. 44. Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to 215.2read:215.3    Subd. 14. Provider requirements, payment, and rate adjustments. (a) Unless 215.4otherwise specified in statute, providers must be enrolled as Minnesota health care 215.5program providers and abide by the requirements for provider participation according to 215.6Minnesota Rules, part 9505.0195.215.7    (b) Payment for provided alternative care services as approved by the client's 215.8case manager shall occur through the invoice processing procedures of the department's 215.9Medicaid Management Information System (MMIS). To receive payment, the county lead 215.10agency or vendor must submit invoices within 12 months following the date of service. 215.11The county lead agency and its vendors under contract shall not be reimbursed for services 215.12which exceed the county allocation.215.13    (c) The county lead agency shall negotiate individual rates with vendors and may 215.14authorize service payment for actual costs up to the county's current approved rate. 215.15Notwithstanding any other rule or statutory provision to the contrary, the commissioner 215.16shall not be authorized to increase rates by an annual inflation factor, unless so authorized 215.17by the legislature. To improve access to community services and eliminate payment 215.18disparities between the alternative care program and the elderly waiver program, the 215.19commissioner shall establish statewide maximum service rate limits and eliminate 215.20county-specific service rate limits.215.21    (1) Effective July 1, 2001, for service rate limits, except those in subdivision 5, 215.22paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative 215.23care statewide maximum rate or the elderly waiver statewide maximum rate.215.24    (2) Counties Lead agencies may negotiate individual service rates with vendors for 215.25actual costs up to the statewide maximum service rate limit.215.26    Sec. 45. Minnesota Statutes 2006, section 256B.0915, is amended to read:215.27256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.215.28    Subdivision 1. Authority. The commissioner is authorized to apply for a home 215.29and community-based services waiver for the elderly, authorized under section 1915(c) 215.30of the Social Security Act, in order to obtain federal financial participation to expand 215.31the availability of services for persons who are eligible for medical assistance. The 215.32commissioner may apply for additional waivers or pursue other federal financial 215.33participation which is advantageous to the state for funding home care services for the 215.34frail elderly who are eligible for medical assistance. The provision of waivered services 216.1to elderly and disabled medical assistance recipients must comply with the criteria for 216.2service definitions and provider standards approved in the waiver.216.3    Subd. 1a. Elderly waiver case management services. (a) Elderly case management 216.4services under the home and community-based services waiver for elderly individuals are 216.5available from providers meeting qualification requirements and the standards specified 216.6in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case 216.7management services.216.8    Case management services assist individuals who receive waiver services in gaining 216.9access to needed waiver and other state plan services, as well as needed medical, social, 216.10educational, and other services regardless of the funding source for the services to which 216.11access is gained.216.12    A case aide shall provide assistance to the case manager in carrying out 216.13administrative activities of the case management function. The case aide may not assume 216.14responsibilities that require professional judgment including assessments, reassessments, 216.15and care plan development. The case manager is responsible for providing oversight of 216.16the case aide.216.17    Case managers shall be responsible for ongoing monitoring of the provision of 216.18services included in the individual's plan of care. Case managers shall initiate and oversee 216.19the process of assessment and reassessment of the individual's care and review plan of 216.20care at intervals specified in the federally approved waiver plan.216.21    (b) The county of service or tribe must provide access to and arrange for case 216.22management services. County of service has the meaning given it in Minnesota Rules, 216.23part 9505.0015, subpart 11.216.24    Subd. 1b. Provider qualifications and standards. The commissioner must 216.25enroll qualified providers of elderly case management services under the home 216.26and community-based waiver for the elderly under section 1915(c) of the Social 216.27Security Act. The enrollment process shall ensure the provider's ability to meet the 216.28qualification requirements and standards in this subdivision and other federal and state 216.29requirements of this service. An elderly case management provider is an enrolled medical 216.30assistance provider who is determined by the commissioner to have all of the following 216.31characteristics:216.32    (1) the demonstrated capacity and experience to provide the components of 216.33case management to coordinate and link community resources needed by the eligible 216.34population;217.1    (2) administrative capacity and experience in serving the target population for 217.2whom it will provide services and in ensuring quality of services under state and federal 217.3requirements;217.4    (3) a financial management system that provides accurate documentation of services 217.5and costs under state and federal requirements;217.6    (4) the capacity to document and maintain individual case records under state and 217.7federal requirements; and217.8    (5) the countylead agency may allow a case manager employed by the countylead 217.9agency to delegate certain aspects of the case management activity to another individual 217.10employed by the countylead agency provided there is oversight of the individual by 217.11the case manager. The case manager may not delegate those aspects which require 217.12professional judgment including assessments, reassessments, and care plan development.217.13Lead agencies include counties, health plans, and federally recognized tribes who 217.14authorize services under this section.217.15    Subd. 1c.Case management activities under the state plan.The commissioner 217.16shall seek an amendment to the home and community-based services waiver for the 217.17elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner 217.18is unable to secure the approval of the secretary of health and human services for the 217.19requested waiver amendment by December 31, 1993, the commissioner shall amend 217.20the medical assistance state plan to provide that case management provided under the 217.21home and community-based services waiver for the elderly is performed by counties 217.22as an administrative function for the proper and effective administration of the state 217.23medical assistance plan. The state shall reimburse counties for the nonfederal share of 217.24costs for case management performed as an administrative function under the home and 217.25community-based services waiver for the elderly.217.26    Subd. 1d. Posteligibility treatment of income and resources for elderly waiver.217.27    Notwithstanding the provisions of section 
         256B.056, the commissioner shall make the 217.28following amendment to the medical assistance elderly waiver program effective July 1, 217.291999, or upon federal approval, whichever is later. 217.30    A recipient's maintenance needs will be an amount equal to the Minnesota 217.31supplemental aid equivalent rate as defined in section 
         256I.03, subdivision 5, plus the 217.32medical assistance personal needs allowance as defined in section 
         256B.35, subdivision 217.331
         , paragraph (a), when applying posteligibility treatment of income rules to the gross 217.34income of elderly waiver recipients, except for individuals whose income is in excess of 217.35the special income standard according to Code of Federal Regulations, title 42, section 217.36435.236
         . Recipient maintenance needs shall be adjusted under this provision each July 1. 218.1    Subd. 2. Spousal impoverishment policies. The commissioner shall seek to amend 218.2the federal waiver and the medical assistance state plan to allowapply:218.3    (1) the spousal impoverishment criteria as authorized under United States Code, title 218.442, section 1396r-5, and as implemented in sections 
         256B.0575, 
         256B.058, and 
         256B.059, 218.5except that the amendment shall seek to add to;218.6    (2)  the personal needs allowance permitted in section 
         256B.0575,; and218.7    (3) an amount equivalent to the group residential housing rate as set by section 218.8256I.03, subdivision 5
         , and according to the approved federal waiver and medical 218.9assistance state plan. 218.10    Subd. 3. Limits of cases. The number of medical assistance waiver recipients that 218.11a countylead agency may serve must be allocated according to the number of medical 218.12assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be 218.13served with the approval of the commissioner.218.14    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of waivered 218.15services to an individual elderly waiver client shall be the weighted average monthly 218.16nursing facility rate of the case mix resident class to which the elderly waiver client would 218.17be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's 218.18maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first 218.19day of the state fiscal year in which the resident assessment system as described in section 218.20256B.437
          for nursing home rate determination is implemented. Effective on the first day 218.21of the state fiscal year in which the resident assessment system as described in section 218.22256B.437
          for nursing home rate determination is implemented and the first day of each 218.23subsequent state fiscal year, the monthly limit for the cost of waivered services to an 218.24individual elderly waiver client shall be the rate of the case mix resident class to which the 218.25waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 218.26in effect on the last day of the previous state fiscal year, adjusted by the greater of any 218.27legislatively adopted home and community-based services percentage rate increase or the 218.28average statewide percentage increase in nursing facility payment rates. 218.29    (b) If extended medical supplies and equipment or environmental modifications are 218.30or will be purchased for an elderly waiver client, the costs may be prorated for up to 218.3112 consecutive months beginning with the month of purchase. If the monthly cost of a 218.32recipient's waivered services exceeds the monthly limit established in paragraph (a), the 218.33annual cost of all waivered services shall be determined. In this event, the annual cost of 218.34all waivered services shall not exceed 12 times the monthly limit of waivered services as 218.35described in paragraph (a).219.1    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing 219.2facility. (a) For a person who is a nursing facility resident at the time of requesting a 219.3determination of eligibility for elderly waivered services, a monthly conversion limit for 219.4the cost of elderly waivered services may be requested. The monthly conversion limit for 219.5the cost of elderly waiver services shall be the resident class assigned under Minnesota 219.6Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where 219.7the resident currently resides until July 1 of the state fiscal year in which the resident 219.8assessment system as described in section 
         256B.437 for nursing home rate determination 219.9is implemented. Effective on July 1 of the state fiscal year in which the resident 219.10assessment system as described in section 
         256B.437 for nursing home rate determination 219.11is implemented, the monthly conversion limit for the cost of elderly waiver services 219.12shall be the per diem nursing facility rate as determined by the resident assessment 219.13system as described in section 
         256B.437 for that resident in the nursing facility where 219.14the resident currently resides multiplied by 365 and divided by 12, less the recipient's 219.15maintenance needs allowance as described in subdivision 1d. The initially approved 219.16conversion rate may be adjusted by the greater of any subsequent legislatively adopted 219.17home and community-based services percentage rate increase or the average statewide 219.18percentage increase in nursing facility payment rates. The limit under this subdivision 219.19only applies to persons discharged from a nursing facility after a minimum 30-day stay 219.20and found eligible for waivered services on or after July 1, 1997. For conversions from the 219.21nursing home to the elderly waiver with consumer directed community support services, 219.22the conversion rate limit is equal to the nursing facility rate reduced by a percentage equal 219.23to the percentage difference between the consumer directed services budget limit that 219.24would be assigned according to the federally approved waiver plan and the corresponding 219.25community case mix cap, but not to exceed 50 percent.219.26    (b) The following costs must be included in determining the total monthly costs 219.27for the waiver client:219.28    (1) cost of all waivered services, including extended medical supplies and equipment 219.29and environmental modifications and adaptations; and219.30    (2) cost of skilled nursing, home health aide, and personal care services reimbursable 219.31by medical assistance.219.32    Subd. 3c. Service approval and contracting provisions. (a) Medical assistance 219.33funding for skilled nursing services, private duty nursing, home health aide, and personal 219.34care services for waiver recipients must be approved by the case manager and included in 219.35the individual care plan.220.1    (b) A countylead agency is not required to contract with a provider of supplies and 220.2equipment if the monthly cost of the supplies and equipment is less than $250.220.3    Subd. 3d. Adult foster care rate. The adult foster care rate shall be considered 220.4a difficulty of care payment and shall not include room and board. The adult foster 220.5care service rate shall be negotiated between the countylead agency and the foster care 220.6provider. The elderly waiver payment for the foster care service in combination with 220.7the payment for all other elderly waiver services, including case management, must not 220.8exceed the limit specified in subdivision 3a, paragraph (a).220.9    Subd. 3e. Assisted livingCustomized living service rate. (a) Payment for assisted 220.10living servicecustomize living services shall be a monthly rate negotiated and authorized 220.11by the county agency based on an individualized service plan for each resident and may 220.12not cover direct rent or food costs. lead agency within the parameters established by 220.13the commissioner. The payment agreement must delineate the services that have been 220.14customized for each recipient and specify the amount of each service to be provided. The 220.15lead agency shall ensure that there is a documented need for all services authorized. 220.16Customized living services must not include rent or raw food costs. The negotiated 220.17payment rate must be based on services to be provided. Negotiated rates must not exceed 220.18payment rates for comparable elderly waiver or medical assistance services and must 220.19reflect economies of scale.220.20    (b) The individualized monthly negotiated payment for assisted livingcustomized 220.21living services as described in section 256B.0913, subdivisions 5d to 5f, and residential 220.22care services as described in section 256B.0913, subdivision 5c, shall not exceed the 220.23nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit 220.24is being calculated, of the greater of either the statewide or any of the geographic 220.25groups' weighted average monthly nursing facility rate of the case mix resident class 220.26to which the elderly waiver eligible client would be assigned under Minnesota Rules, 220.27parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in 220.28subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident 220.29assessment system as described in section 
         256B.437 for nursing home rate determination 220.30is implemented. Effective on July 1 of the state fiscal year in which the resident 220.31assessment system as described in section 
         256B.437 for nursing home rate determination 220.32is implemented and July 1 of each subsequent state fiscal year, the individualized monthly 220.33negotiated payment for the services described in this clause shall not exceed the limit 220.34described in this clause which was in effect on June 30 of the previous state fiscal year 220.35and which has been adjusted by the greater of any legislatively adopted home and 221.1community-based services cost-of-living percentage increase or any legislatively adopted 221.2statewide percent rate increase for nursing facilities. 221.3    (c) The individualized monthly negotiated payment for assisted Customized living 221.4services described in section 144A.4605 and are delivered by a provider licensed by the 221.5Department of Health as a class A or class F home care provider or an assisted living 221.6home care provider and provided in a building that is registered as a housing with services 221.7establishment under chapter 144D and that provides 24-hour supervision in combination 221.8with the payment for other elderly waiver services, including case management, must not 221.9exceed the limit specified in subdivision 3a. 221.10    Subd. 3f. Individual service rates; expenditure forecasts. (a) The countylead 221.11agency shall negotiate individual service rates with vendors and may authorize payment 221.12for actual costs up to the county'slead agency's current approved rate. Persons or agencies 221.13must be employed by or under a contract with the countylead agency or the public health 221.14nursing agency of the local board of health in order to receive funding under the elderly 221.15waiver program, except as a provider of supplies and equipment when the monthly cost of 221.16the supplies and equipment is less than $250.221.17    (b) Reimbursement for the medical assistance recipients under the approved waiver 221.18shall be made from the medical assistance account through the invoice processing 221.19procedures of the department's Medicaid Management Information System (MMIS), 221.20only with the approval of the client's case manager. The budget for the state share of the 221.21Medicaid expenditures shall be forecasted with the medical assistance budget, and shall 221.22be consistent with the approved waiver.221.23    Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access 221.24to community services and eliminate payment disparities between the alternative care 221.25program and the elderly waiver, the commissioner shall establish statewide maximum 221.26service rate limits and eliminate county-specificlead agency-specific service rate limits.221.27    (b) Effective July 1, 2001, for service rate limits, except those described or defined in 221.28subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative 221.29care statewide maximum rate or the elderly waiver statewide maximum rate.221.30    (c) CountiesLead agencies may negotiate individual service rates with vendors for 221.31actual costs up to the statewide maximum service rate limit.221.32    Subd. 3h.Service rate limits; 24-hour customized living services.The payment 221.33rates for 24-hour customized living services is a monthly rate negotiated and authorized by 221.34the lead agency within the parameters established by the commissioner of human services. 221.35The payment agreement must delineate the services that have been customized for each 221.36recipient and specify the amount of each service to be provided. The lead agency shall 222.1ensure that there is a documented need for all services authorized. The lead agency shall 222.2not authorize 24-hour customized living services unless there is a documented need for 222.324-hour supervision. For purposes of this section, "24-hour supervision" means that the 222.4recipient requires assistance due to needs related to one or more of the following:222.5    (1) intermittent assistance with toileting or transferring;222.6    (2) cognitive or behavioral issues;222.7    (3) a medical condition that requires clinical monitoring; or222.8    (4) other conditions or needs as defined by the commissioner of human services. 222.9The lead agency shall ensure that the frequency and mode of supervision of the recipient 222.10and the qualifications of staff providing supervision are described and meet the needs 222.11of the recipient. Customized living services must not include rent or raw food costs. 222.12The negotiated payment rate for 24-hour customized living services must be based on 222.13services to be provided. Negotiated rates must not exceed payment rates for comparable 222.14elderly waiver or medical assistance services and must reflect economies of scale. The 222.15individually negotiated 24-hour customized living payments, in combination with the 222.16payment for other elderly waiver services, including case management, must not exceed 222.17the recipient's community budget cap specified in subdivision 3a.222.18    Subd. 4. Termination notice. The case manager must give the individual a ten-day 222.19written notice of any denial, reduction, or termination of waivered services.222.20    Subd. 5. Assessments and reassessments for waiver clients. Each client shall 222.21receive an initial assessment of strengths, informal supports, and need for services in 222.22accordance with section 
         256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 222.23client served under the elderly waiver must be conducted at least every 12 months and 222.24at other times when the case manager determines that there has been significant change 222.25in the client's functioning. This may include instances where the client is discharged 222.26from the hospital. 222.27    Subd. 6. Implementation of care plan. Each elderly waiver client shall be provided 222.28a copy of a written care plan that meets the requirements outlined in section 
         256B.0913, 222.29subdivision 8
         . The care plan must be implemented by the county administering waivered 222.30servicesof service when it is different than the county of financial responsibility. The 222.31county of service administering waivered services must notify the county of financial 222.32responsibility of the approved care plan.222.33    Subd. 7. Prepaid elderly waiver services. An individual for whom a prepaid health 222.34plan is liable for nursing home services or elderly waiver services according to section 222.35256B.69, subdivision 6a
         , is not eligible to also receive county-administered elderly waiver 222.36services under this section. 223.1    Subd. 8. Services and supports. (a) Services and supports shall meet the 223.2requirements set out in United States Code, title 42, section 1396n.223.3    (b) Services and supports shall promote consumer choice and be arranged and 223.4provided consistent with individualized, written care plans.223.5    (c) The state of Minnesota, county, managed care organization, or tribal government 223.6under contract to administer the elderly waiver shall not be liable for damages, injuries, 223.7or liabilities sustained through the purchase of direct supports or goods by the person, 223.8the person's family, or the authorized representatives with funds received through 223.9consumer-directed community support services under the federally approved waiver plan. 223.10Liabilities include, but are not limited to, workers' compensation liability, the Federal 223.11Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).223.12    Subd. 9. Tribal management of elderly waiver. Notwithstanding contrary 223.13provisions of this section, or those in other state laws or rules, the commissioner may 223.14develop a model for tribal management of the elderly waiver program and implement this 223.15model through a contract between the state and any of the state's federally recognized tribal 223.16governments. The model shall include the provision of tribal waiver case management, 223.17assessment for personal care assistance, and administrative requirements otherwise carried 223.18out by countieslead agencies but shall not include tribal financial eligibility determination 223.19for medical assistance.223.20EFFECTIVE DATE.Subdivision 3h is effective the day following final enactment.223.21    Sec. 46. Minnesota Statutes 2006, section 256B.0917, subdivision 8, is amended to 223.22read:223.23    Subd. 8. Living-at-home/block nurse program grant. (a) The organization 223.24awarded the contract under subdivision 7, shall develop and administer a grant program 223.25to establish or expand up to 3351 community-based organizations that will implement 223.26living-at-home/block nurse programs that are designed to enable senior citizens to live as 223.27independently as possible in their homes and in their communities. At least one-half of 223.28the programs must be in counties outside the seven-county metropolitan area. Nonprofit 223.29organizations and units of local government are eligible to apply for grants to establish 223.30the community organizations that will implement living-at-home/block nurse programs. 223.31In awarding grants, the organization awarded the contract under subdivision 7 shall give 223.32preference to nonprofit organizations and units of local government from communities 223.33that:223.34    (1) have high nursing home occupancy rates;223.35    (2) have a shortage of health care professionals;224.1    (3) are located in counties adjacent to, or are located in, counties with existing 224.2living-at-home/block nurse programs; and224.3    (4) meet other criteria established by LAH/BN, Inc., in consultation with the 224.4commissioner.224.5    (b) Grant applicants must also meet the following criteria:224.6    (1) the local community demonstrates a readiness to establish a community model 224.7of care, including the formation of a board of directors, advisory committee, or similar 224.8group, of which at least two-thirds is comprised of community citizens interested in 224.9community-based care for older persons;224.10    (2) the program has sponsorship by a credible, representative organization within 224.11the community;224.12    (3) the program has defined specific geographic boundaries and defined its 224.13organization, staffing and coordination/delivery of services;224.14    (4) the program demonstrates a team approach to coordination and care, ensuring 224.15that the older adult participants, their families, the formal and informal providers are all 224.16part of the effort to plan and provide services; and224.17    (5) the program provides assurances that all community resources and funding will 224.18be coordinated and that other funding sources will be maximized, including a person's 224.19own resources.224.20    (c) Grant applicants must provide a minimum of five percent of total estimated 224.21development costs from local community funding. Grants shall be awarded for four-year 224.22periods, and the base amount shall not exceed $80,000 $100,000 per applicant for the grant 224.23period. The organization under contract may increase the grant amount for applicants from 224.24communities that have socioeconomic characteristics that indicate a higher level of need 224.25for assistance. Subject to the availability of funding, grants and grant renewals awarded or 224.26entered into on or after July 1, 1997, shall be renewed by LAH/BN, Inc. every four years, 224.27unless LAH/BN, Inc. determines that the grant recipient has not satisfactorily operated the 224.28living-at-home/block nurse program in compliance with the requirements of paragraphs 224.29(b) and (d). Grants provided to living-at-home/block nurse programs under this paragraph 224.30may be used for both program development and the delivery of services.224.31    (d) Each living-at-home/block nurse program shall be designed by representatives of 224.32the communities being served to ensure that the program addresses the specific needs of 224.33the community residents. The programs must be designed to:224.34    (1) incorporate the basic community, organizational, and service delivery principles 224.35of the living-at-home/block nurse program model;225.1    (2) provide senior citizens with registered nurse directed assessment, provision and 225.2coordination of health and personal care services on a sliding fee basis as an alternative 225.3to expensive nursing home care;225.4    (3) provide information, support services, homemaking services, counseling, and 225.5training for the client and family caregivers;225.6    (4) encourage the development and use of respite care, caregiver support, and 225.7in-home support programs, such as adult foster care and in-home adult day care;225.8    (5) encourage neighborhood residents and local organizations to collaborate in 225.9meeting the needs of senior citizens in their communities;225.10    (6) recruit, train, and direct the use of volunteers to provide informal services and 225.11other appropriate support to senior citizens and their caregivers; and225.12    (7) provide coordination and management of formal and informal services to senior 225.13citizens and their families using less expensive alternatives.225.14    Sec. 47. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to 225.15read:225.16    Subd. 3. County certification of persons providing adult foster care to related 225.17persons. A person exempt from licensure under section 
         245A.03, subdivision 2, who 225.18provides adult foster care to a related individual age 65 and older, and who meets the 225.19requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the 225.20county to provide adult foster care. A person certified by the county to provide adult foster 225.21care may be reimbursed for services provided and eligible for funding under sections 225.22256B.0913 and section256B.0915, if the relative would suffer a financial hardship as 225.23a result of providing care. For purposes of this subdivision, financial hardship refers 225.24to a situation in which a relative incurs a substantial reduction in income as a result of 225.25resigning from a full-time job or taking a leave of absence without pay from a full-time 225.26job to care for the client. 225.27    Sec. 48. Minnesota Statutes 2006, section 256B.095, is amended to read:225.28256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.225.29    (a) Effective July 1, 1998, a quality assurance system for persons with developmental 225.30disabilities, which includes an alternative quality assurance licensing system for programs, 225.31is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, 225.32Steele, Wabasha, and Winona Counties for the purpose of improving the quality of 225.33services provided to persons with developmental disabilities. A county, at its option, may 225.34choose to have all programs for persons with developmental disabilities located within 226.1the county licensed under chapter 245A using standards determined under the alternative 226.2quality assurance licensing system or may continue regulation of these programs under 226.3the licensing system operated by the commissioner. The project expires on June 30, 226.420092014.226.5    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to 226.6participate in the quality assurance system established under paragraph (a). The 226.7commission established under section 
         256B.0951 may, at its option, allow additional 226.8counties to participate in the system.226.9    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) 226.10may establish a quality assurance system under this section. A new system established 226.11under this section shall have the same rights and duties as the system established 226.12under paragraph (a). A new system shall be governed by a commission under section 226.13256B.0951
         . The commissioner shall appoint the initial commission members based 226.14on recommendations from advocates, families, service providers, and counties in the 226.15geographic area included in the new system. Counties that choose to participate in a 226.16new system shall have the duties assigned under section 
         256B.0952. The new system 226.17shall establish a quality assurance process under section 
         256B.0953. The provisions of 226.18section 
         256B.0954 shall apply to a new system established under this paragraph. The 226.19commissioner shall delegate authority to a new system established under this paragraph 226.20according to section 
         256B.0955.226.21    (d) Effective July 1, 2007, the quality assurance system may be expanded to include 226.22programs for persons with disabilities and older adults.226.23    Sec. 49. Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to 226.24read:226.25    Subdivision 1. Membership. The Quality Assurance Commission is established. 226.26The commission consists of at least 14 but not more than 21 members as follows: at 226.27least three but not more than five members representing advocacy organizations; at 226.28least three but not more than five members representing consumers, families, and their 226.29legal representatives; at least three but not more than five members representing service 226.30providers; at least three but not more than five members representing counties; and the 226.31commissioner of human services or the commissioner's designee. The first commission 226.32shall establish membership guidelines for the transition and recruitment of membership for 226.33the commission's ongoing existence. Members of the commission who do not receive a 226.34salary or wages from an employer for time spent on commission duties may receive a per 226.35diem payment when performing commission duties and functions. All members may be 227.1reimbursed for expenses related to commission activities. Notwithstanding the provisions 227.2of section 
         15.059, subdivision 5, the commission expires on June 30, 20092014.227.3    Sec. 50. [256B.096] QUALITY MANAGEMENT; ASSURANCE; AND 227.4IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY 227.5SERVICES.227.6    Subdivision 1.Scope.In order to improve the quality of services provided to 227.7Minnesotans with disabilities and to meet the requirements of the federally approved home 227.8and community-based waivers under section 1915c of the Social Security Act, a statewide 227.9quality assurance and improvement system for Minnesotans receiving disability services 227.10shall be developed. The disability services included are the home and community-based 227.11services waiver programs for persons with developmental disabilities under section 227.12256B.092, subdivision 4, and persons with disabilities under section 256B.49.227.13    Subd. 2.Stakeholder advisory group.The commissioner shall consult with a 227.14stakeholder advisory group on the development and implementation of the state quality 227.15management, assurance, and improvement system, including representatives from: 227.16disability service recipients, disability service providers, disability advocacy groups, 227.17county human service agencies, and state agency staff from the Departments of Human 227.18Services and Health and ombudsman for mental health and developmental disabilities on 227.19the development of a statewide quality assurance and improvement system.227.20    Subd. 3.Annual survey of service recipients.The commissioner, in consultation 227.21with the stakeholder advisory group, shall develop and conduct an annual independent 227.22random statewide survey of between five and ten percent of service recipients to determine 227.23the effectiveness and quality of disability services. The survey shall be consistent with 227.24the system performance expectations of the Centers for Medicare and Medicaid Services 227.25quality management requirements and framework. The survey shall analyze whether 227.26desired outcomes have been achieved for persons with different demographic, diagnostic, 227.27health, and functional needs and receiving different types of services, in different settings, 227.28with different costs. The survey shall be field tested during 2008 and implemented by 227.29February 1, 2009. Annual statewide and regional reports of the results shall be published 227.30for use by regions, counties, and providers to plan and measure the impact of quality 227.31improvement activities.227.32    Subd. 4.Improvements for incident reporting, investigation, analysis, and 227.33follow-up.In consultation with the stakeholder advisory group, the commissioner shall 227.34identify the information, data sources, and technology needed to improve the system 227.35of incident reporting, including:228.1    (1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and228.2    (2) investigation, analysis, and follow-up for disability services.228.3    The commissioner must ensure that the federal home and community-based waiver 228.4requirements are met and that incidents that may have jeopardized safety; health; or 228.5violated service-related assurances, civil and human rights, and other protections designed 228.6to prevent abuse, neglect, and exploitation are reviewed, investigated, and acted upon 228.7in a timely manner.228.8    Subd. 5.Biennial report.The commissioner shall provide a biennial report to the 228.9chairs of the legislative committees with jurisdiction over health and human services 228.10policy and funding beginning January 15, 2009, on the development and activities of the 228.11quality management, assurance, and improvement system designed to meet the federal 228.12requirements under the home and community-based services waiver programs for persons 228.13with disabilities. By January 15, 2008, the commissioner shall provide a preliminary 228.14report on the priorities for meeting the federal requirements, progress on the annual 228.15survey, recommendations for improvements in the incident reporting system, and a plan 228.16for incorporating the quality assurance efforts under section 256B.095 and other regional 228.17efforts into the statewide system.228.18    Sec. 51. Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:228.19    Subdivision 1. In general. The commissioner shall determine prospective 228.20payment rates for resident care costs. For rates established on or after July 1, 1985, the 228.21commissioner shall develop procedures for determining operating cost payment rates that 228.22take into account the mix of resident needs, geographic location, and other factors as 228.23determined by the commissioner. The commissioner shall consider whether the fact that a 228.24facility is attached to a hospital or has an average length of stay of 180 days or less should 228.25be taken into account in determining rates. The commissioner shall consider the use of the 228.26standard metropolitan statistical areas when developing groups by geographic location. 228.27The commissioner shall provide notice to each nursing facility on or before May 1 August 228.2815 of the rates effective for the following rate year except that if legislation is pending on 228.29May 1 August 15 that may affect rates for nursing facilities, the commissioner shall set the 228.30rates after the legislation is enacted and provide notice to each facility as soon as possible.228.31    Compensation for top management personnel shall continue to be categorized as a 228.32general and administrative cost and is subject to any limits imposed on that cost category.228.33    Sec. 52. Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to 228.34read:229.1    Subd. 2e. Contracts for services for ventilator-dependent persons.(a) 229.2The commissioner may negotiate with a nursing facility eligible to receive medical 229.3assistance payments to provide services to a ventilator-dependent person identified by the 229.4commissioner according to criteria developed by the commissioner, including:229.5    (1) nursing facility care has been recommended for the person by a preadmission 229.6screening team;229.7    (2) the person has been hospitalized and no longer requires inpatient acute care 229.8hospital services; and229.9    (3) the commissioner has determined that necessary services for the person cannot 229.10be provided under existing nursing facility rates.229.11    The commissioner may negotiate an adjustment to the operating cost payment 229.12rate for a nursing facility with a resident who is ventilator-dependent, for that resident. 229.13The negotiated adjustment must reflect only the actual additional cost of meeting the 229.14specialized care needs of a ventilator-dependent person identified by the commissioner 229.15for whom necessary services cannot be provided under existing nursing facility rates and 229.16which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or 229.179505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before 229.18July 1, 2001, and have their payment rate under this subdivision negotiated after July 1, 229.192001, the negotiated payment rate must not exceed 200 percent of the highest multiple 229.20bedroom payment rate for the facility, as initially established by the commissioner for the 229.21rate year for case mix classification K; or, upon implementation of the RUG's-based case 229.22mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a 229.23nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300 229.24percent of the facility's multiple bedroom payment rate for case mix classification K; or, 229.25upon implementation of the RUG's-based case mix system, 300 percent of the highest 229.26RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private 229.27paying residents under the provisions of section   
         256B.48, subdivision 1. 229.28    (b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to 229.29care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever 229.30is later, the operating payment rates for residents determined eligible under paragraph (a) 229.31of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds 229.32and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300 229.33percent of the facility's highest RUG rate.229.34    Sec. 53. Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to 229.35read:230.1    Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the 230.2rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571 230.3per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom. 230.4For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a 230.5single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060, 230.6subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per 230.7bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060, 230.8subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per 230.9bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060, 230.10subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of the 230.11Census: Composite fixed-weighted price index as published in the C30 Report, Value 230.12of New Construction Put in Place Economic Analysis: Price Indexes for Private Fixed 230.13Investments in Structures; Special Care. 230.14    (b)  Rental factor. For the rate year beginning July 1, 1988, the commissioner shall 230.15increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8, 230.16item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing 230.17nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation 230.18services used by the state's contracted appraisers. For rate years beginning on or after July 230.191, 1989, the rental factor is the amount determined under this paragraph for the rate year 230.20beginning July 1, 1988. 230.21    (c)  Occupancy factor. For rate years beginning on or after July 1, 1988, in order 230.22to determine property-related payment rates under Minnesota Rules, part 9549.0060, 230.23for all nursing facilities except those whose average length of stay in a skilled level of 230.24care within a nursing facility is 180 days or less, the commissioner shall use 95 percent 230.25of capacity days. For a nursing facility whose average length of stay in a skilled level of 230.26care within a nursing facility is 180 days or less, the commissioner shall use the greater of 230.27resident days or 80 percent of capacity days but in no event shall the divisor exceed 95 230.28percent of capacity days. 230.29    (d)  Equipment allowance. For rate years beginning on July 1, 1988, and July 1, 230.301989, the commissioner shall add ten cents per resident per day to each nursing facility's 230.31property-related payment rate. The ten-cent property-related payment rate increase is not 230.32cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the 230.33commissioner shall increase each nursing facility's equipment allowance as established 230.34in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For 230.35rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be 230.36adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E. 231.1For the rate period beginning October 1, 1992, the equipment allowance for each nursing 231.2facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the 231.3allowance must be adjusted annually for inflation. 231.4    (e)  Post chapter 199 related-organization debts and interest expense. For rate 231.5years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item 231.6E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983, 231.7provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010 231.8to 9510.0480, the debt is subject to repayment through annual principal payments, and 231.9the nursing facility demonstrates to the commissioner's satisfaction that the interest rate 231.10on the debt was less than market interest rates for similar arm's-length transactions at 231.11the time the debt was incurred. If the debt was incurred due to a sale between family 231.12members, the nursing facility must also demonstrate that the seller no longer participates 231.13in the management or operation of the nursing facility. Debts meeting the conditions of 231.14this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010 231.15to 9549.0080. 231.16    (f)  Building capital allowance for nursing facilities with operating leases. For 231.17rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs 231.18incurred for the nursing facility's buildings shall receive its building capital allowance 231.19computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating 231.20lease provides that the lessee's rent is adjusted to recognize improvements made by the 231.21lessor and related debt, the costs for capital improvements and related debt shall be allowed 231.22in the computation of the lessee's building capital allowance, provided that reimbursement 231.23for these costs under an operating lease shall not exceed the rate otherwise paid. 231.24    Sec. 54. Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to 231.25read:231.26    Subd. 17e. Replacement-costs-new per bed limit effective July 1, 2001.231.27    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2), 231.28for a total replacement, as defined in paragraph (f) subdivision 17d, authorized under 231.29section   
         144A.071 or   
         144A.073 after July 1, 1999, or any building project that is a 231.30relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, the 231.31replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed 231.32rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating 231.33the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part 231.349549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be 231.35adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000. 232.1    Sec. 55. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:232.2    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which 232.3have their payment rates determined under this section rather than section 
         256B.431, the 232.4commissioner shall establish a rate under this subdivision. The nursing facility must enter 232.5into a written contract with the commissioner.232.6    (b) A nursing facility's case mix payment rate for the first rate year of a facility's 232.7contract under this section is the payment rate the facility would have received under 232.8section 
         256B.431.232.9    (c) A nursing facility's case mix payment rates for the second and subsequent years 232.10of a facility's contract under this section are the previous rate year's contract payment 232.11rates plus an inflation adjustment and, for facilities reimbursed under this section or 232.12section 
         256B.431, an adjustment to include the cost of any increase in Health Department 232.13licensing fees for the facility taking effect on or after July 1, 2001. The index for the 232.14inflation adjustment must be based on the change in the Consumer Price Index-all items 232.15(United States City average) (CPI-U) forecasted by the commissioner of finance's national 232.16economic consultant, as forecasted in the fourth quarter of the calendar year preceding 232.17the rate year. The inflation adjustment must be based on the 12-month period from the 232.18midpoint of the previous rate year to the midpoint of the rate year for which the rate 232.19is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 232.201, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 232.212007, and July 1, 2008, July 1, 2009, and July 1, 2010, this paragraph shall apply only 232.22to the property-related payment rate, except that adjustments to include the cost of any 232.23increase in Health Department licensing fees taking effect on or after July 1, 2001, shall 232.24be provided. Beginning in 2005, adjustment to the property payment rate under this 232.25section and section 
         256B.431 shall be effective on October 1. In determining the amount 232.26of the property-related payment rate adjustment under this paragraph, the commissioner 232.27shall determine the proportion of the facility's rates that are property-related based on the 232.28facility's most recent cost report. 232.29    (d) The commissioner shall develop additional incentive-based payments of up to 232.30five percent above a facility's operating payment rate for achieving outcomes specified 232.31in a contract. The commissioner may solicit contract amendments and implement those 232.32which, on a competitive basis, best meet the state's policy objectives. The commissioner 232.33shall limit the amount of any incentive payment and the number of contract amendments 232.34under this paragraph to operate the incentive payments within funds appropriated for this 232.35purpose. The contract amendments may specify various levels of payment for various 232.36levels of performance. Incentive payments to facilities under this paragraph may be in the 233.1form of time-limited rate adjustments or onetime supplemental payments. In establishing 233.2the specified outcomes and related criteria, the commissioner shall consider the following 233.3state policy objectives:233.4    (1) successful diversion or discharge of residents to the residents' prior home or other 233.5community-based alternatives;233.6    (2) adoption of new technology to improve quality or efficiency; 233.7    (3) improved quality as measured in the Nursing Home Report Card; 233.8    (4) reduced acute care costs; and233.9    (5) any additional outcomes proposed by a nursing facility that the commissioner 233.10finds desirable.233.11    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that 233.12take action to come into compliance with existing or pending requirements of the life 233.13safety code provisions or other federal regulations governing sprinkler systems shall 233.14receive reimbursement for the costs associated with compliance if all of the following 233.15conditions are met:233.16    (1) the expenses associated with compliance occurred on or after January 1, 2005, 233.17and before December 31, 2008;233.18    (2) the costs were not otherwise reimbursed under section 144A.071, 144A.073, 233.19or 256B.434, subdivision 4f; and233.20    (3) the total allowable costs reported under this paragraph are less than the minimum 233.21threshold established under section 256B.431, subdivisions 15, paragraph (e), and 16.233.22The commissioner shall use funds appropriated for this purpose to provide to qualifying 233.23nursing facilities a rate adjustment beginning October 1, 2007, and ending September 233.2430, 2008. Nursing facilities that have expended funds or anticipate the need to expend 233.25funds to satisfy the most recent life safety code requirements by (1) installing a sprinkler 233.26system or (2) replacing all or portions of an existing sprinkler system may submit to the 233.27commissioner by June 30, 2007, on a form provided by the commissioner the actual 233.28costs of a completed project or the estimated costs, based on a project bid, of a planned 233.29project. The commissioner shall calculate a rate adjustment equal to the allowable 233.30costs of the project divided by the resident days reported for the report year ending 233.31September 30, 2006. If the costs from all projects exceed the appropriation for this 233.32purpose, the commissioner shall allocate the funds appropriated on a pro rata basis to the 233.33qualifying facilities by reducing the rate adjustment determined for each facility by an 233.34equal percentage. If the rate adjustments under this subdivision are reduced to fit the 233.35appropriation, facilities may include the portion of the costs that are not reimbursed by 233.36the rate adjustment as part of a project that meets the requirements of subdivision 4f. 234.1If the commissioner determines that there are any unexpended funds for the purposes 234.2of this paragraph, the commissioner may allocate the remainder of the funds to the 234.3qualifying facilities on a pro rata basis for other physical plant changes required by the 234.4nursing facility in order to meet the most recent life safety code compliance standards. 234.5Facilities that used estimated costs when requesting the rate adjustment shall report to 234.6the commissioner by January 31, 2009, on the use of these funds on a form provided by 234.7the commissioner. If the nursing facility fails to provide the report, the commissioner 234.8shall recoup the funds appropriated to the facility for this purpose. If the facility reports 234.9expenditures allowable under this subdivision that are less than the amount received in the 234.10facility's annualized rate adjustment, the commissioner shall recoup the difference.234.11    Sec. 56. Minnesota Statutes 2006, section 256B.434, is amended by adding a 234.12subdivision to read:234.13    Subd. 4i.Nursing facility rate increase effective October 1, 2007; Hennepin 234.14County.For the rate year beginning October 1, 2007, the commissioner shall provide to 234.15a nursing facility in Hennepin County licensed for 268 beds as of February 1, 2007, an 234.16increase in the property payment rate of $6.52 per resident per day. The increase under 234.17this subdivision must be added following the determination under this chapter of the 234.18payment rate for the rate year beginning October 1, 2007, and must be included in the 234.19facility's total payment rate for purposes of determining future rates under this section or 234.20any other section.234.21    Sec. 57. Minnesota Statutes 2006, section 256B.434, is amended by adding a 234.22subdivision to read:234.23    Subd. 4j.Rate increase for facilities in Chisago County.Effective October 234.241, 2007, operating payment rates of all nursing facilities in Chisago County that are 234.25reimbursed under this section or section 256B.441 shall be increased to be equal, for 234.26a RUG's rate with a weight of 1.00, to the geographic group III median rate for the 234.27same RUG's weight. The percentage of the operating payment rate for each facility to 234.28be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in that 234.29facility's September 30, 2007, operating payment rate. This subdivision applies only if it 234.30results in a rate increase. Increases provided by this subdivision shall be added to the rate 234.31determined under any new reimbursement system established under section 256B.441.234.32    Sec. 58. Minnesota Statutes 2006, section 256B.434, is amended by adding a 234.33subdivision to read:235.1    Subd. 4k.Nursing facility rate increase effective January 1, 2008; Hennepin 235.2County.Effective January 1, 2008, a nursing facility in Hennepin County licensed for 235.3137 beds as of February 1, 2007, shall receive an increase of $2.81 in each case mix 235.4payment rate to offset property tax payments due as a result of the facility's conversion 235.5from nonprofit to for-profit status. The increase under this subdivision must be added 235.6following the determination under this chapter of the payment rate for the rate year 235.7beginning October 1, 2007, and must be included in the facility's total payment rate for the 235.8purposes of determining future rates under this section or any other section.235.9    Sec. 59. Minnesota Statutes 2006, section 256B.434, is amended by adding a 235.10subdivision to read:235.11    Subd. 4l.Property rate adjustment; Kanabec County.The commissioner 235.12shall allow a property rate adjustment for a facility located in Kanabec County that 235.13was approved for a moratorium exception project in 2001, but experienced a delay and 235.14additional costs associated with the project, and completed the project in 2005. The 235.15property payment rate for the rate years beginning October 1, 2007, and ending September 235.1630, 2009, must be $22.73 per resident day. For subsequent years, the property rate of 235.17$22.73 per resident day shall be adjusted as provided in subdivision 4, paragraph (c), as 235.18long as the facility has a contract under this section.235.19    Sec. 60. Minnesota Statutes 2006, section 256B.434, is amended by adding a 235.20subdivision to read:235.21    Subd. 4m.Rate increase for facilities in Rice County.Effective July 1, 2007, 235.22operating payment rates of nursing facilities in Rice County located within two miles 235.23of Scott County or Dakota County that are reimbursed under this section or section 235.24256B.441 must be increased to be equal, for a RUG's rate with a weight of 1.00, to the 235.25geographic group III median rate for the same RUG's weight. The percentage of the 235.26operating payment rate for each facility to be case-mix adjusted must be equal to the 235.27percentage that is case-mix adjusted in that facility's June 30, 2006, operating payment 235.28rate. This subdivision applies only if it results in a rate increase.235.29    Sec. 61. Minnesota Statutes 2006, section 256B.434, is amended by adding a 235.30subdivision to read:235.31    Subd. 4n.Facility rate increase.Forthe rate year beginning October 1, 2007, a 235.32nursing facility in Faribault County licensed for 50 beds as of April 19, 2006, shall receive 235.33a rate increase of $2.64 in each case mix payment rate to offset property tax payments 236.1due as a result of the facility's conversion from nonprofit to for-profit status. The increase 236.2under this subdivision shall be added to the payment rates in effect for the facility on 236.3September 30, 2007, and shall be included in the facility's total payment rates for the 236.4purposes of determining future rates under this section or any other section.236.5    Sec. 62. Minnesota Statutes 2006, section 256B.434, is amended by adding a 236.6subdivision to read:236.7    Subd. 19.Nursing facility rate increases beginning October 1, 2007, and 236.8October 1, 2008.(a) For the rate year beginning October 1, 2007, the commissioner 236.9shall make available to each nursing facility reimbursed under this section operating 236.10payment rate adjustments equal to three percent of the operating payment rates in effect 236.11on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner 236.12shall make available to each nursing facility reimbursed under this section operating 236.13payment rate adjustments equal to three percent of the operating payment rates in effect 236.14on September 30, 2008.236.15    (b) Seventy-five percent of the money resulting from the rate adjustments under 236.16paragraph (a) must be used for increases in compensation-related costs of eligible 236.17employees. 236.18    (c) For purposes of this subdivision, eligible employees includes all persons directly 236.19employed by the nursing facility on or after the effective date of the rate adjustments, 236.20except:236.21    (1) persons employed in the central office of a corporation that has an ownership 236.22interest in the nursing facility or exercises control over the nursing facility; and 236.23    (2) persons paid by the nursing facility under a management contract.236.24    (d) The commissioner shall allow as compensation-related costs all costs for:236.25    (1) wages and salaries;236.26    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' 236.27compensation;236.28    (3) the employer's share of health and dental insurance, life insurance, disability 236.29insurance, long-term care insurance, uniform allowance, and pensions; and236.30    (4) other benefits provided, subject to the approval of the commissioner.236.31    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the 236.32requirements in paragraph (b) shall be provided to nursing facilities effective October 236.331 of each year.236.34    (f) Nursing facilities may apply for the portion of the rate adjustments under 236.35paragraph (a) that is subject to the requirements in paragraph (b). The application 237.1must be submitted to the commissioner within six months of the effective date of the 237.2rate adjustments, and the nursing facility must provide additional information required 237.3by the commissioner within nine months of the effective date of the rate adjustments. 237.4The commissioner must respond to all applications within three weeks of receipt. 237.5The commissioner may waive the deadlines in this paragraph under extraordinary 237.6circumstances, to be determined at the sole discretion of the commissioner. The 237.7application must contain:237.8    (1) an estimate of the amounts of money that must be used as specified in paragraph 237.9(b);237.10    (2) a detailed distribution plan specifying the allowable compensation-related 237.11increases the nursing facility will implement to use the funds available in clause (1);237.12    (3) a description of how the nursing facility will notify eligible employees of 237.13the contents of the approved application, which must provide for giving each eligible 237.14employee a copy of the approved application, excluding the information required in clause 237.15(1), or posting a copy of the approved application, excluding the information required in 237.16clause (1), for a period of at least six weeks in an area of the nursing facility to which all 237.17eligible employees have access; and237.18    (4) instructions for employees who believe they have not received the 237.19compensation-related increases specified in clause (2), as approved by the commissioner, 237.20and which must include a mailing address, e-mail address, and the telephone number 237.21that may be used by the employee to contact the commissioner or the commissioner's 237.22representative.237.23    (g) The commissioner shall ensure that cost increases in distribution plans under 237.24paragraph (f), clause (2), that may be included in approved applications, comply with 237.25requirements in clauses (1) to (4):237.26    (1) costs to be incurred during the applicable rate year resulting from wage and 237.27salary increases implemented prior to the first day of the nursing facility's payroll period 237.28that includes October 1 of each year shall be allowed if they were not used in a prior 237.29year's application;237.30    (2) a portion of the costs resulting from tenure-related wage or salary increases may 237.31be considered to be allowable compensation-related increases, in accordance with existing 237.32formulas that the commissioner shall provide;237.33    (3) the annualized amount of increases in costs for the employer's share of health 237.34and dental insurance, life insurance, disability insurance, and workers' compensation shall 237.35be allowable compensation-related increases if they are effective on or after April 1 of 238.1the year in which the rate adjustments are effective and prior to April 1 of the following 238.2year; and 238.3    (4) for nursing facilities in which employees are represented by an exclusive 238.4bargaining representative, an agreement negotiated and agreed to by the employer and 238.5the exclusive bargaining representative constitutes the plan. The commissioner shall not 238.6review and shall not require changes to the portions of the plan covered by collective 238.7bargaining agreements. A negotiated agreement may constitute the plan only if the 238.8agreement is finalized after the date of enactment of all increases for the rate year and 238.9signed by both parties prior to submission to the commissioner.238.10    (h) The commissioner shall review applications received under paragraph (f) and 238.11shall provide the portion of the rate adjustments under paragraph (b) if the requirements of 238.12this subdivision have been met. The rate adjustments shall be effective October 1 of each 238.13year. Notwithstanding paragraph (a), if the approved application distributes less money 238.14than is available, the amount of the rate adjustment shall be reduced so that the amount of 238.15money made available is equal to the amount to be distributed.238.16    Sec. 63. Minnesota Statutes 2006, section 256B.434, is amended by adding a 238.17subdivision to read:238.18    Subd. 20.Payment of Public Employees Retirement Association costs.Nursing 238.19facilities that participate in the Public Employees Retirement Association (PERA) shall 238.20have the component of their payment rate associated with the costs of PERA determined 238.21for each rate year. Effective for rate years beginning on and after October 1, 2007, the 238.22commissioner shall determine the portion of the payment rate in effect on September 30 238.23each year and shall subtract that amount from the payment rate to be effective on the 238.24following October 1. The portion that shall be deemed to be included in the September 30, 238.252007, rate that is associated with PERA costs shall be the allowed costs in the facility's 238.26base for determining rates under this section, divided by the resident days reported for that 238.27year. The commissioner shall add to the payment rate to be effective on October 1 each 238.28year an amount equal to the reported costs associated with PERA, for the year ended on 238.29the most recent September 30 for which data is available, divided by total resident days 238.30for that year, as reported by the facility and audited under section 256B.441.238.31    Sec. 64. Minnesota Statutes 2006, section 256B.437, is amended by adding a 238.32subdivision to read:238.33    Subd. 11.Big Stone County rate adjustment. Notwithstanding the time period 238.34specified in subdivision 3, the commissioner shall approve a planned closure rate 239.1adjustment in Big Stone County for an eight-bed facility in Clinton for reassignment to a 239.250-bed facility in Graceville. The adjustment shall be calculated according to subdivisions 239.33 and 6.239.4    Sec. 65. Minnesota Statutes 2006, section 256B.438, subdivision 3, is amended to read:239.5    Subd. 3. Case mix indices. (a) The commissioner of human services shall assign a 239.6case mix index to each resident class based on the Centers for Medicare and Medicaid 239.7Services staff time measurement study and adjusted for Minnesota-specific wage indices. 239.8The case mix indices assigned to each resident class shall be published in the Minnesota 239.9State Register at least 120 days prior to the implementation of the 34 group, RUG-III 239.10resident classification system.239.11    (b) An index maximization approach shall be used to classify residents.239.12    (c) After implementation of the revised case mix system, the commissioner of 239.13human services may annually rebase case mix indices and base rates using more current 239.14data on average wage rates and staff time measurement studies. This rebasing shall be 239.15calculated under subdivision 7, paragraph (b). The commissioner shall publish in the 239.16Minnesota State Register adjusted case mix indices at least 45 days prior to the effective 239.17date of the adjusted case mix indices.239.18    Sec. 66. Minnesota Statutes 2006, section 256B.439, subdivision 1, is amended to read:239.19    Subdivision 1. Development and implementation of quality profiles. (a) The 239.20commissioner of human services, in cooperation with the commissioner of health, shall 239.21develop and implement a quality profile system for nursing facilities and, beginning not 239.22later than July 1, 2004, other providers of long-term care services, except when the quality 239.23profile system would duplicate requirements under section 
         256B.5011, 
         256B.5012, or 239.24256B.5013
         . Beginning July 1, 2008, the commissioners shall include quality profiles of 239.25nursing homes that are not medical assistance certified in the Minnesota Nursing Home 239.26Report Card. The nonmedical assistance certified nursing homes may provide to the 239.27commissioners information necessary to conduct consumer satisfaction surveys and to 239.28determine other quality measures. The system must be developed and implemented to the 239.29extent possible without the collection of significant amounts of new data. To the extent 239.30possible, the system must incorporate or be coordinated with information on quality 239.31maintained by area agencies on aging, long-term care trade associations, and other entities. 239.32The system must be designed to provide information on quality to: 239.33    (1) consumers and their families to facilitate informed choices of service providers;240.1    (2) providers to enable them to measure the results of their quality improvement 240.2efforts and compare quality achievements with other service providers; and240.3    (3) public and private purchasers of long-term care services to enable them to 240.4purchase high-quality care.240.5    (b) The system must be developed in consultation with the long-term care task force, 240.6area agencies on aging, and representatives of consumers, providers, and labor unions. 240.7Within the limits of available appropriations, the commissioners may employ consultants 240.8to assist with this project.240.9    Sec. 67. Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:240.10    Subdivision 1. Rate determination Rebasing of nursing facility operating cost 240.11payment rates. (a) The commissioner shall establish a value-based nursing facility 240.12reimbursement system which will provide facility-specific, prospective rates for nursing 240.13facilities participating in the medical assistance program. The rates shall be determined 240.14using an annual statistical and cost report filed by each nursing facility. The total payment 240.15rate shall be composed of four rate components: direct care services, support services, 240.16external fixed, and property-related rate components. The payment rate shall be derived 240.17from statistical measures of actual costs incurred in facility operation of nursing facilities. 240.18From this cost basis, the components of the total payment rate shall be adjusted for quality 240.19of services provided, recognition of staffing levels, geographic variation in labor costs, and 240.20resident acuity. The commissioner shall rebase nursing facility operating cost payment 240.21rates to align payments to facilities with the cost of providing care. The rebased operating 240.22cost payment rates shall be calculated using the statistical and cost report filed by each 240.23nursing facility for the report period ending one year prior to the rate year.240.24    (b) Rates shall be rebased annually. The new operating cost payment rates based on 240.25this section shall take effect beginning with the rate year beginning October 1, 2009, and 240.26shall be phased in over three rate years through October 1, 2011.240.27    (c) Operating cost payment rates shall be rebased on October 1, 2012, and every 240.28two years after that date.240.29    (d) Operating cost payment rates for rate years in which rebasing does not occur 240.30shall be increased by the Global Insight SNF Market Basket inflation factor from the 240.31midpoint of the previous rate year to the midpoint of the next rate year.240.32    (e) Each cost reporting year shall begin on October 1 and end on the following 240.33September 30. Beginning in 2006, a statistical and cost report shall be filed by each 240.34nursing facility by January 15. Notice of rates shall be distributed by August 15 and the 240.35rates shall go into effect on October 1 for one year.241.1    (c) The commissioner shall begin to phase in the new reimbursement system 241.2beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.241.3    Sec. 68. Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:241.4    Subd. 2. Definitions. For purposes of this section, the terms in subdivisions 3 to 241.542 42a  have the meanings given unless otherwise provided for in this section.241.6    Sec. 69. Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:241.7    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for 241.8administering the overall activities of the nursing home. These costs include salaries and 241.9wages of the administrator, assistant administrator, business office employees, security 241.10guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases 241.11related to business office functions, licenses, and permits except as provided in the 241.12external fixed costs category, employee recognition, travel including meals and lodging, 241.13training, voice and data communication or transmission, office supplies, liability insurance 241.14and other forms of insurance not designated to other areas, personnel recruitment, legal 241.15services, accounting services, management or business consultants, data processing, 241.16information technology, Web site, central or home office costs, business meetings and 241.17seminars, postage, fees for professional organizations, subscriptions, security services, 241.18advertising, board of director's fees, working capital interest expense, and bad debts and 241.19bad debt collection fees.241.20    Sec. 70. Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:241.21    Subd. 6. Allowed costs. "Allowed costs" means the amounts reported by the facility 241.22which are necessary for the operation of the facility and the care of residents and which 241.23are reviewed by the department for accuracy, reasonableness, and compliance with this 241.24section and generally accepted accounting principles. All references to costs in this section 241.25shall be assumed to refer to allowed costs.241.26    Sec. 71. Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to 241.27read:241.28    Subd. 10. Dietary costs. "Dietary costs" means the costs for the salaries and wages 241.29of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees 241.30assigned to the kitchen and dining room, and associated fringe benefits and payroll 241.31taxes. Dietary costs also includes the salaries or fees of dietary consultants, direct costs 241.32of raw food (both normal and special diet food), dietary supplies, and food preparation 242.1and serving. Also included are special dietary supplements used for tube feeding or oral 242.2feeding, such as elemental high nitrogen diet, even if written as a prescription item by a 242.3physician.242.4    Sec. 72. Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to 242.5read:242.6    Subd. 11. Direct care costs category."Direct care costs category" "Direct care 242.7costs" means costs for nursing services, activities, and social services the wages of nursing 242.8administration, staff education, direct care registered nurses, licensed practical nurses, 242.9certified nursing assistants, trained medication aides, and associated fringe benefits and 242.10payroll taxes; services from a supplemental nursing services agency; supplies that are 242.11stocked at nursing stations or on the floor and distributed or used individually, including, 242.12but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice 242.13bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas, 242.14enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products, 242.15thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic 242.16agents, drugs that are not paid for on a separate fee schedule by the medical assistance 242.17program or any other payer, and technology related to the provision of nursing care to 242.18residents, such as electronic charting systems.242.19    Sec. 73. Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to 242.20read:242.21    Subd. 13. External fixed costs category."External fixed costs category" "External 242.22fixed costs"  means costs related to the nursing home surcharge under section 
         256.9657, 242.23subdivision 1
         ; licensure fees under section 
         144.122; long-term care consultation fees 242.24under section 
         256B.0911, subdivision 6; family advisory council fee under section 242.25 144A.33
         ; scholarships under section 
         256B.431, subdivision 36; planned closure rate 242.26adjustments under section 256B.436 or256B.437; or single bed room incentives under 242.27section 256B.431, subdivision 42; property taxes and property insurance; and PERA.242.28    Sec. 74. Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to 242.29read:242.30    Subd. 14. Facility average case mix index. "Facility average case mix index" or 242.31"CMI" means a numerical value score that describes the relative resource use for all 242.32residents within the groups under the resource utilization group (RUG-III) classification 242.33system prescribed by the commissioner based on an assessment of each resident. The 243.1facility average CMI shall be computed as the standardized days divided by total days for 243.2all residents in the facility. The RUG's weights used in this section shall be as follows 243.3for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB 243.41.109; RAA 0.957; SSC 1.453; SSB 1.254; SSA 1.047; CC2 1.292; CC1 1.200; CB2 243.51.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676; 243.6BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023; 243.7PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1 243.80.651; and DDF 1.000243.9    Sec. 75. Minnesota Statutes 2006, section 256B.441, is amended by adding a 243.10subdivision to read:243.11    Subd. 14a.Facility type groups.Facilities shall be classified into two groups, 243.12called "facility type groups," which shall consist of:243.13    (1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota 243.14Rules, parts 9570.2000 to 9570.3400; and 243.15    (2) freestanding: all other facilities.243.16    Sec. 76. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to 243.17read:243.18    Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group 243.19life, health, dental, workers' compensation, and other employee insurances and pension, 243.20profit-sharing, and retirement plans for which the employer pays all or a portion of the 243.21costs and that are available to at least all employees who work at least 20 hours per week.243.22    Sec. 77. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to 243.23read:243.24    Subd. 20. Housekeeping costs. "Housekeeping costs" means the costs for the 243.25salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning 243.26employees and associated fringe benefits and payroll taxes. It also includes the cost of 243.27housekeeping supplies, including, but not limited to,  cleaning and lavatory supplies and 243.28contract services.243.29    Sec. 78. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to 243.30read:243.31    Subd. 24. Maintenance and plant operations costs. "Maintenance and plant 243.32operations costs" means the costs for the salaries and wages of the maintenance supervisor, 244.1engineers, heating-plant employees, and other maintenance employees and associated 244.2fringe benefits and payroll taxes. It also includes direct costs for maintenance and 244.3operation of the building and grounds, including, but not limited to,  fuel, electricity, 244.4medical waste and garbage removal, water, sewer, supplies, tools, and repairs.244.5    Sec. 79. Minnesota Statutes 2006, section 256B.441, is amended by adding a 244.6subdivision to read:244.7    Subd. 28a.Other direct care costs."Other direct care costs" means the costs 244.8for the salaries and wages and associated fringe benefits and payroll taxes of mental 244.9health workers, religious personnel, and other direct care employees not specified in 244.10the definition of direct care costs. 244.11    Sec. 80. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to 244.12read:244.13    Subd. 30. Peer groups. Facilities shall be classified into three groups, called "peer 244.14groups," which by county. The groups  shall consist of:244.15    (1) C&NC/Short Stay/R80 - facilities that have three or more admissions per bed 244.16per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000 244.17to 9570.3600 group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota, 244.18Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott, 244.19Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;244.20    (2) boarding care homes - facilities that have more than 50 percent of their beds 244.21licensed as boarding care homes group two: facilities in Aitkin, Beltrami, Blue Earth, 244.22Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, 244.23Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, 244.24Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, 244.25Watonwan, or Wilkin County; and244.26    (3) standard - all other facilities group three: facilities in all other counties.244.27    Sec. 81. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to 244.28read:244.29    Subd. 31. Prior rate-setting method system operating cost payment rate."Prior 244.30rate-setting method" "Prior system operating cost payment rate"  means the operating cost 244.31payment rate determination process in effect prior to October 1, 2006 on September 30, 244.322009, under Minnesota Rules and Minnesota Statutes, not including planned closure rate 245.1adjustments under section 256B.436 or 256B.437, or single bed room incentives under 245.2section 256B.431, subdivision 42.245.3    Sec. 82. Minnesota Statutes 2006, section 256B.441, is amended by adding a 245.4subdivision to read:245.5    Subd. 33a.Raw food costs."Raw food costs" means the cost of food provided to 245.6nursing facility residents. Also included are special dietary supplements used for tube 245.7feeding or oral feeding, such as elemental high nitrogen diet.245.8    Sec. 83. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to 245.9read:245.10    Subd. 34. Related organization. "Related organization" means a person that 245.11furnishes goods or services to a nursing facility and that is a close relative of a nursing 245.12facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility, 245.13or an affiliate of a close relative of an affiliate of a nursing facility. As used in this 245.14subdivision, paragraphs (a) to (d) apply:245.15    (a) "Affiliate" means a person that directly, or indirectly through one or more 245.16intermediaries, controls or is controlled by, or is under common control with another 245.17person.245.18    (b) "Person" means an individual, a corporation, a partnership, an association, a 245.19trust, an unincorporated organization, or a government or political subdivision.245.20    (c) "Close relative of an affiliate of a nursing facility" means an individual whose 245.21relationship by blood, marriage, or adoption to an individual who is an affiliate of a 245.22nursing facility is no more remote than first cousin.245.23    (d) "Control" including the terms "controlling," "controlled by," and "under common 245.24control with" means the possession, direct or indirect, of the power to direct or cause the 245.25direction of the management, operations, or policies of a person, whether through the 245.26ownership of voting securities, by contract, or otherwise, or to influence in any manner 245.27other than through an arms length, legal transaction.245.28    Sec. 84. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to 245.29read:245.30    Subd. 38. Social services costs. "Social services costs" means the costs for the 245.31salaries and wages of the supervisor and other social work employees, associated fringe 245.32benefits and payroll taxes, supplies, services, and consultants. This category includes the 245.33cost of those employees who manage and process admission to the nursing facility.246.1    Sec. 85. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.2subdivision to read:246.3    Subd. 42a.Therapy costs."Therapy costs" means any costs related to medical 246.4assistance therapy services provided to residents that are not billed separately from the 246.5daily operating rate.246.6    Sec. 86. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.7subdivision to read:246.8    Subd. 48.Calculation of operating per diems.The direct care per diem for 246.9each facility shall be the facility's direct care costs divided by its standardized days. 246.10The other care-related per diem shall be the sum of the facility's activities costs, other 246.11direct care costs, raw food costs, therapy costs, and social services costs, divided by the 246.12facility's resident days. The other operating per diem shall be the sum of the facility's 246.13administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance 246.14and plant operations costs divided by the facility's resident days.246.15    Sec. 87. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.16subdivision to read:246.17    Subd. 49.Determination of total care-related per diem.The total care-related 246.18per diem for each facility shall be the sum of the direct care per diem and the other 246.19care-related per diem.246.20    Sec. 88. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.21subdivision to read:246.22    Subd. 50.Determination of total care-related limit.The limit on the total 246.23care-related per diem shall be determined for each peer group and facility type group 246.24combination. A facility's total care-related per diems shall be limited to 120 percent of the 246.25median for the facility's peer and facility type group. The facility-specific direct care costs 246.26used in making this comparison and in the calculation of the median shall be based on a 246.27RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per 246.28diem reduced to the limit. If a reduction of the total care-related per diem is necessary 246.29because of this limit, the reduction shall be made proportionally to both the direct care per 246.30diem and the other care-related per diem.246.31    Sec. 89. Minnesota Statutes 2006, section 256B.441, is amended by adding a 246.32subdivision to read:247.1    Subd. 51.Determination of other operating limit.The limit on the other operating 247.2per diem shall be determined for each peer group. A facility's other operating per diem 247.3shall be limited to 105 percent of the median for its peer group. A facility that is above 247.4that limit shall have its other operating per diem reduced to the limit.247.5    Sec. 90. Minnesota Statutes 2006, section 256B.441, is amended by adding a 247.6subdivision to read:247.7    Subd. 52.Determination of efficiency incentive.Each facility shall be eligible 247.8for an efficiency incentive based on its other operating per diem. A facility with an other 247.9operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency 247.10incentive. All other facilities shall receive an incentive calculated as 50 percent times the 247.11difference between the facility's other operating per diem and its other operating per diem 247.12limit, up to a maximum incentive of $3.247.13    Sec. 91. Minnesota Statutes 2006, section 256B.441, is amended by adding a 247.14subdivision to read:247.15    Subd. 53.Calculation of payment rate for external fixed costs.The commissioner 247.16shall calculate a payment rate for external fixed costs.247.17    (a) For a facility licensed as a nursing home, the portion related to section 256.9657 247.18shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care 247.19home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the 247.20result of its number of nursing home beds divided by its total number of licensed beds.247.21    (b) The portion related to the licensure fee under section 144.122, paragraph (d), 247.22shall be the amount of the fee divided by actual resident days.247.23    (c) The portion related to scholarships shall be determined under section 256B.431, 247.24subdivision 36.247.25    (d) The portion related to long-term care consultation shall be determined according 247.26to section 256B.0911, subdivision 6.247.27    (e) The portion related to development and education of resident and family advisory 247.28councils under section 144A.33 shall be $5 divided by 365.247.29    (f) The portion related to planned closure rate adjustments shall be as determined 247.30under sections 256B.436 and 256B.437, subdivision 6.247.31    (g) The portions related to property insurance, real estate taxes, special assessments, 247.32and payments made in lieu of real estate taxes directly identified or allocated to the nursing 247.33facility shall be the actual amounts divided by actual resident days.248.1    (h) The portion related to the Public Employees Retirement Association shall be 248.2actual costs divided by resident days.248.3    (i) The single bed room incentives shall be as determined under section 256B.431, 248.4subdivision 42.248.5    (j) The payment rate for external fixed costs shall be the sum of the amounts in 248.6paragraphs (a) to (i).248.7    Sec. 92. Minnesota Statutes 2006, section 256B.441, is amended by adding a 248.8subdivision to read:248.9    Subd. 54.Adjustment of per diem for inflation.The total care-related per diem 248.10and other operating per diem calculated under this section shall be adjusted for inflation to 248.11adjust for the delay between the reporting year and the rate year. The total care-related 248.12payment rate and other operating payment rate shall be calculated as the per diem 248.13increased by the Global Insight Consumer Price Index urban inflation factor for the period 248.14from the midpoint of the reporting year to the midpoint of the rate year. 248.15    Sec. 93. Minnesota Statutes 2006, section 256B.441, is amended by adding a 248.16subdivision to read:248.17    Subd. 55.Determination of total payment rates.In rate years when rates are 248.18rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total 248.19care-related payment rate, other operating payment rate, efficiency incentive, external 248.20fixed cost rate, and the property rate determined under section 256B.434. To determine 248.21a total payment rate for each RUG's level, the total care-related payment rate shall be 248.22divided into the direct care payment rate and the other care-related payment rate, and the 248.23direct care payment rate multiplied by the RUG's weight for each RUG's level using the 248.24weights in subdivision 14.248.25    Sec. 94. Minnesota Statutes 2006, section 256B.441, is amended by adding a 248.26subdivision to read:248.27    Subd. 56.Phase-in of rebased operating cost payment rates.For the rate years 248.28beginning October 1, 2009, October 1, 2010, and October 1, 2011, the operating cost 248.29payment rate calculated under this section shall be phased in by blending it with the 248.30operating cost payment rate determined under section 256B.434. For the rate year 248.31beginning October 1, 2009, the operating cost payment rate for each facility shall be 248.3225 percent of the operating cost payment rate from this section, and 75 percent of the 248.33operating cost payment rate from section 256B.434. For the rate year beginning October 1, 249.12010, the operating cost payment rate for each facility shall be 35 percent of the operating 249.2cost payment rate from this section, and 65 percent of the operating cost payment rate 249.3from section 256B.434. For the rate year beginning October 1, 2011, the operating cost 249.4payment rate for each facility shall be the operating cost payment rate determined under 249.5this section. The blending of operating cost payment rates under this section shall be 249.6performed separately for each RUG's class.249.7    Sec. 95. Minnesota Statutes 2006, section 256B.441, is amended by adding a 249.8subdivision to read:249.9    Subd. 57.Adjustment for inflation during phase-in of rebased operating cost 249.10payment rates.During the phase-in of operating cost payment rates under subdivision 249.1156, both the operating costs per diem under this section and the operating cost payment 249.12rate under section 256B.434 shall be adjusted for inflation. The adjustment for each year 249.13for the operating cost per diems shall be the Global Insight Consumer Price Index urban 249.14inflation factor from the midpoint of the reporting year to the midpoint of the current rate 249.15year. The adjustment for each year for the operating cost payment rate under section 249.16256B.434 shall be the Global Insight Consumer Price Index urban inflation factor from the 249.17midpoint of the October 1, 2007, rate year to the midpoint of the current rate year.249.18    Sec. 96. Minnesota Statutes 2006, section 256B.441, is amended by adding a 249.19subdivision to read:249.20    Subd. 58.Hold harmless.For the rate years beginning October 1, 2009, October 1, 249.212010, and October 1, 2011, no nursing facility shall receive an operating cost payment 249.22rate less than its operating cost payment rate under section 256B.434. The comparison 249.23of operating cost payment rates under this section shall be made for each of the RUG's 249.24classes separately, and the operating cost payment rates under section 256B.434 used 249.25under this section shall not include the inflation increases described in subdivision 57.249.26    Sec. 97. Minnesota Statutes 2006, section 256B.441, is amended by adding a 249.27subdivision to read:249.28    Subd. 59.Appeals.Nursing facilities may appeal, as defined under section 256B.50, 249.29the determination of a payment rate established under this chapter.249.30    Sec. 98. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:249.31    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and 249.32community-based service waivers, as authorized under section 1915(c) of the Social 250.1Security Act to serve persons under the age of 65 who are determined to require the level 250.2of care provided in a nursing home and persons who require the level of care provided in a 250.3hospital. The commissioner shall apply for the home and community-based waivers in 250.4order to:250.5    (i) promote the support of persons with disabilities in the most integrated settings;250.6    (ii) expand the availability of services for persons who are eligible for medical 250.7assistance;250.8    (iii) promote cost-effective options to institutional care; and250.9    (iv) obtain federal financial participation.250.10    (b) The provision of waivered services to medical assistance recipients with 250.11disabilities shall comply with the requirements outlined in the federally approved 250.12applications for home and community-based services and subsequent amendments, 250.13including provision of services according to a service plan designed to meet the needs of 250.14the individual. For purposes of this section, the approved home and community-based 250.15application is considered the necessary federal requirement.250.16    (c) The commissioner shall provide interested persons serving on agency advisory 250.17committees and, task forces, the Centers for Independent Living, and others upon who250.18request, with to be on a list to receive, notice of, and an opportunity to comment on, 250.19at least 30 days before any effective dates, (1) any substantive changes to the state's 250.20disability services program manual, or (2) changes or amendments to the federally 250.21approved applications for home and community-based waivers, prior to their submission 250.22to the federal Centers for Medicare and Medicaid Services.250.23    (d) The commissioner shall seek approval, as authorized under section 1915(c) of 250.24the Social Security Act, to allow medical assistance eligibility under this section for 250.25children under age 21 without deeming of parental income or assets.250.26    (e) The commissioner shall seek approval, as authorized under section 1915(c) of 250.27the Social Act, to allow medical assistance eligibility under this section for individuals 250.28under age 65 without deeming the spouse's income or assets.250.29    Sec. 99. Minnesota Statutes 2006, section 256B.49, is amended by adding a 250.30subdivision to read:250.31    Subd. 16a.Medical assistance reimbursement.(a) The commissioner shall 250.32seek federal approval for medical assistance reimbursement of independent living skills 250.33services, foster care waiver service, supported employment, prevocational service, 250.34structured day service, and adult day care under the home and community-based waiver 251.1for persons with a traumatic brain injury, the community alternatives for disabled 251.2individuals waivers, and the community alternative care waivers.251.3    (b) Medical reimbursement shall be made only when the provider demonstrates 251.4evidence of its capacity to meet basic health, safety, and protection standards through 251.5one of the methods in paragraphs (c) to (e).251.6    (c) The provider is licensed to provide services under chapter 245B and agrees to 251.7apply these standards to services funded through the traumatic brain injury, community 251.8alternatives for disabled, or community alternative care home and community-based 251.9waivers.251.10    (d) The local agency contracting for the services certifies on a form provided by the 251.11commissioner that the provider has the capacity to meet the individual needs as identified 251.12in each person's individual service plan. When certifying that the service provider meets 251.13the necessary provider qualifications, the local agency shall verify that the provider has 251.14policies and procedures governing the following:251.15    (1) protection of the consumer's rights and privacy;251.16    (2) risk assessment and planning;251.17    (3) record keeping and reporting of incidents and emergencies with documentation 251.18of corrective action if needed;251.19    (4) service outcomes, regular reviews of progress, and periodic reports;251.20    (5) complaint and grievance procedures;251.21    (6) service termination or suspension;251.22    (7) necessary training and supervision of direct care staff that includes:251.23    (i) documentation in personnel files of 20 hours of orientation training in providing 251.24training related to service provision;251.25    (ii) training in recognizing the symptoms and effects of certain disabilities, health 251.26conditions, and positive behavioral supports and interventions; and 251.27    (iii) a minimum of five hours of related training annually; and 251.28    (8) when applicable, the local agency shall verify that the provider has policies and 251.29procedures in place governing the following:251.30    (i) safe medication administration;251.31    (ii) proper handling of consumer funds; and 251.32    (iii) behavioral interventions that are in compliance with prohibitions and standards 251.33developed by the commissioner to meet federal requirements regarding the use of 251.34restraints and restrictive interventions.252.1    (e) For foster care waiver services or independent living skills services, the local 252.2agency contracting for the services certifies on a form provided by the commissioner that 252.3the provider meets the following:252.4    (1) the provider of foster care waiver services is licensed to provide adult foster 252.5care under Minnesota Rules, parts 9555.5105 to 9555.6265, or child foster care under 252.6Minnesota Rules, parts 2960.3000 to 2960.3230;252.7    (2) the provider of independent living skills services also provides licensed foster 252.8care services and agrees to apply the foster care standards under Minnesota Rules, parts 252.99555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225, subpart 252.108; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080, subparts 10 252.11and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for the provision of those 252.12services; and252.13    (3) the provider has policies and procedures applying to the provision of foster 252.14care waiver services or independent living skills services that govern (i) behavioral 252.15interventions that are in compliance with prohibitions and standards developed by the 252.16commissioner to meet federal requirements regarding the use of restraints and restrictive 252.17interventions and (ii) documentation of service needs and outcomes, regular reviews 252.18of progress, and periodic reports.252.19    (f) The local agency shall review each provider's continued compliance with 252.20the basic health, safety, and protection standards on a regular basis. For the review 252.21of paragraph (e), the local agency shall coordinate the review with the county review 252.22of foster care licensure.252.23EFFECTIVE DATE.This section is effective the day following final enactment.252.24    Sec. 100. Minnesota Statutes 2006, section 256B.5012, is amended by adding a 252.25subdivision to read:252.26    Subd. 7.ICF/MR rate increases October 1, 2007, and October 1, 2008.(a) For 252.27the rate periods beginning October 1, 2007, and October 1, 2008, the commissioner shall 252.28make available to each facility reimbursed under this section an adjustment to the total 252.29operating payment rate of three percent.252.30    (b) Seventy-five percent of the money resulting from the rate adjustment under 252.31paragraph (a) must be used to increase wages and benefits and pay associated costs for 252.32employees, except for administrative and central office employees. Seventy-five percent 252.33of the money received by a facility as a result of the rate adjustment provided in paragraph 252.34(a) must be used only for wage, benefit, and staff increases implemented on or after 252.35the effective date of the rate increase each year, and must not be used for increases 253.1implemented prior to that date. The wage adjustment eligible employees may receive may 253.2vary based on merit, seniority, or other factors determined by the provider.253.3    (c) For each facility, the commissioner shall make available an adjustment, based 253.4on occupied beds, using the percentage specified in paragraph (a) multiplied by the total 253.5payment rate, including variable rate but excluding the property-related payment rate, in 253.6effect on the preceding day. The total payment rate must include the adjustment provided 253.7in section 256B.501, subdivision 12.253.8    (d) A facility whose payment rates are governed by closure agreements, receivership 253.9agreements, or Minnesota Rules, part 9553.0075, is not eligible for an adjustment 253.10otherwise granted under this subdivision.253.11    (e) A facility may apply for the portion of the payment rate adjustment provided 253.12under paragraph (a) for employee wages and benefits and associated costs. The application 253.13must be made to the commissioner and contain a plan by which the facility will distribute 253.14the funds according to paragraph (b). For facilities in which the employees are represented 253.15by an exclusive bargaining representative, an agreement negotiated and agreed to by 253.16the employer and the exclusive bargaining representative constitutes the plan. The 253.17commissioner shall not review, and shall not require changes, to the portion or portions 253.18of the plan covered by collective bargaining agreements. A negotiated agreement may 253.19constitute the plan only if the agreement is finalized after the date of enactment of all rate 253.20increases for the rate year. The commissioner shall review the plan to ensure that the 253.21payment rate adjustment per diem is used as provided in this subdivision. To be eligible, a 253.22facility must submit its plan by March 31, 2008, and December 31, 2008, respectively. 253.23If a facility's plan is effective for its employees after the first day of the applicable rate 253.24period that the funds are available, the payment rate adjustment per diem is effective 253.25the same date as its plan.253.26    (f) A copy of the approved distribution plan must be made available to all employees 253.27by giving each employee a copy or by posting it in an area of the facility to which all 253.28employees have access. If an employee does not receive the wage and benefit adjustment 253.29described in the facility's approved plan and is unable to resolve the problem with the 253.30facility's management or through the employee's union representative, the employee 253.31may contact the commissioner at an address or telephone number provided by the 253.32commissioner and included in the approved plan.253.33    Sec. 101. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to 253.34read:254.1    Subd. 23. Alternative services; elderly and disabled persons. (a) The 254.2commissioner may implement demonstration projects to create alternative integrated 254.3delivery systems for acute and long-term care services to elderly persons and persons 254.4with disabilities as defined in section 
         256B.77, subdivision 7a, that provide increased 254.5coordination, improve access to quality services, and mitigate future cost increases. 254.6The commissioner may seek federal authority to combine Medicare and Medicaid 254.7capitation payments for the purpose of such demonstrations and may contract with 254.8Medicare-approved special needs plans to provide Medicaid services. Medicare funds and 254.9services shall be administered according to the terms and conditions of the federal contract 254.10and demonstration provisions. For the purpose of administering medical assistance funds, 254.11demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions 254.12of Minnesota Rules, parts 
         9500.1450 to 
         9500.1464, apply to these demonstrations, 254.13with the exceptions of parts 
         9500.1452, subpart 2, item B; and 
         9500.1457, subpart 1, 254.14items B and C, which do not apply to persons enrolling in demonstrations under this 254.15section. An initial open enrollment period may be provided. Persons who disenroll from 254.16demonstrations under this subdivision remain subject to Minnesota Rules, parts 
         9500.1450254.17to 
         9500.1464. When a person is enrolled in a health plan under these demonstrations and 254.18the health plan's participation is subsequently terminated for any reason, the person shall 254.19be provided an opportunity to select a new health plan and shall have the right to change 254.20health plans within the first 60 days of enrollment in the second health plan. Persons 254.21required to participate in health plans under this section who fail to make a choice of 254.22health plan shall not be randomly assigned to health plans under these demonstrations. 254.23Notwithstanding section 
         256L.12, subdivision 5, and Minnesota Rules, part 
         9505.5220, 254.24subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision, 254.25the commissioner may contract with managed care organizations, including counties, to 254.26serve only elderly persons eligible for medical assistance, elderly and disabled persons, or 254.27disabled persons only. For persons with a primary diagnosis of developmental disability, 254.28serious and persistent mental illness, or serious emotional disturbance, the commissioner 254.29must ensure that the county authority has approved the demonstration and contracting 254.30design. Enrollment in these projects for persons with disabilities shall be voluntary. The 254.31commissioner shall not implement any demonstration project under this subdivision for 254.32persons with a primary diagnosis of developmental disabilities, serious and persistent 254.33mental illness, or serious emotional disturbance, without approval of the county board of 254.34the county in which the demonstration is being implemented.254.35    (b) Notwithstanding chapter 245B, sections 
         252.40 to 
         252.46, 
         256B.092, 
         256B.501254.36to 
         256B.5015, and Minnesota Rules, parts 
         9525.0004 to 
         9525.0036, 
         9525.1200 to 255.19525.1330
         , 
         9525.1580, and 
         9525.1800 to 
         9525.1930, the commissioner may implement 255.2under this section projects for persons with developmental disabilities. The commissioner 255.3may capitate payments for ICF/MR services, waivered services for developmental 255.4disabilities, including case management services, day training and habilitation and 255.5alternative active treatment services, and other services as approved by the state and by 255.6the federal government. Case management and active treatment must be individualized 255.7and developed in accordance with a person-centered plan. Costs under these projects may 255.8not exceed costs that would have been incurred under fee-for-service. Beginning July 1, 255.92003, and until twofour years after the pilot project implementation date, subcontractor 255.10participation in the long-term care developmental disability pilot is limited to a nonprofit 255.11long-term care system providing ICF/MR services, home and community-based waiver 255.12services, and in-home services to no more than 120 consumers with developmental 255.13disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the 255.14legislature prior to expansion of the developmental disability pilot project. This paragraph 255.15expires twofour years after the implementation date of the pilot project.255.16    (c) Before implementation of a demonstration project for disabled persons, the 255.17commissioner must provide information to appropriate committees of the house of 255.18representatives and senate and must involve representatives of affected disability groups 255.19in the design of the demonstration projects.255.20    (d) A nursing facility reimbursed under the alternative reimbursement methodology 255.21in section 
         256B.434 may, in collaboration with a hospital, clinic, or other health care entity 255.22provide services under paragraph (a). The commissioner shall amend the state plan and 255.23seek any federal waivers necessary to implement this paragraph.255.24    (e) The commissioner, in consultation with the commissioners of commerce and 255.25health, may approve and implement programs for all-inclusive care for the elderly (PACE) 255.26according to federal laws and regulations governing that program and state laws or rules 255.27applicable to participating providers. The process for approval of these programs shall 255.28begin only after the commissioner receives grant money in an amount sufficient to cover 255.29the state share of the administrative and actuarial costs to implement the programs during 255.30state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an 255.31account in the special revenue fund and are appropriated to the commissioner to be used 255.32solely for the purpose of PACE administrative and actuarial costs. A PACE provider is 255.33not required to be licensed or certified as a health plan company as defined in section 255.3462Q.01, subdivision 4
         . Persons age 55 and older who have been screened by the county 255.35and found to be eligible for services under the elderly waiver or community alternatives 255.36for disabled individuals or who are already eligible for Medicaid but meet level of 256.1care criteria for receipt of waiver services may choose to enroll in the PACE program. 256.2Medicare and Medicaid services will be provided according to this subdivision and 256.3federal Medicare and Medicaid requirements governing PACE providers and programs. 256.4PACE enrollees will receive Medicaid home and community-based services through the 256.5PACE provider as an alternative to services for which they would otherwise be eligible 256.6through home and community-based waiver programs and Medicaid State Plan Services. 256.7The commissioner shall establish Medicaid rates for PACE providers that do not exceed 256.8costs that would have been incurred under fee-for-service or other relevant managed care 256.9programs operated by the state.256.10    (f) The commissioner shall seek federal approval to expand the Minnesota disability 256.11health options (MnDHO) program established under this subdivision in stages, first to 256.12regional population centers outside the seven-county metro area and then to all areas 256.13of the state. Until January 1, 2008July 1, 2009, expansion for MnDHO projects that 256.14include home and community-based services is limited to the two projects and service 256.15areas in effect on March 1, 2006.  Enrollment in integrated MnDHO programs that 256.16include home and community-based services shall remain voluntary. Costs for home 256.17and community-based services included under MnDHO must not exceed costs that 256.18would have been incurred under the fee-for-service program. In developing program 256.19specifications for expansion of integrated programs, the commissioner shall involve and 256.20consult the state-level stakeholder group established in subdivision 28, paragraph (d), 256.21including consultation on whether and how to include home and community-based waiver 256.22programs. Plans for further expansion of MnDHO projects shall be presented to the chairs 256.23of the house and senate committees with jurisdiction over health and human services 256.24policy and finance by February 1, 2007.256.25    (g) Notwithstanding section 
         256B.0261, health plans providing services under this 256.26section are responsible for home care targeted case management and relocation targeted 256.27case management. Services must be provided according to the terms of the waivers and 256.28contracts approved by the federal government.256.29    Sec. 102. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to 256.30read:256.31    Subd. 28. Medicare special needs plans; medical assistance basic health care.256.32    (a) The commissioner may contract with qualified Medicare-approved special needs 256.33plans to provide medical assistance basic health care services to persons with disabilities, 256.34including those with developmental disabilities. Basic health care services include:257.1    (1) those services covered by the medical assistance state plan except for ICF/MR 257.2services, home and community-based waiver services, case management for persons with 257.3developmental disabilities under section 
         256B.0625, subdivision 20a, and personal care 257.4and certain home care services defined by the commissioner in consultation with the 257.5stakeholder group established under paragraph (d); and257.6    (2) basic health care services may also include risk for up to 100 days of nursing 257.7facility services for persons who reside in a noninstitutional setting and home health 257.8services related to rehabilitation as defined by the commissioner after consultation with 257.9the stakeholder group.257.10    The commissioner may exclude other medical assistance services from the basic 257.11health care benefit set. Enrollees in these plans can access any excluded services on the 257.12same basis as other medical assistance recipients who have not enrolled.257.13    Unless a person is otherwise required to enroll in managed care, enrollment in these 257.14plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic 257.15enrollment with an option to opt out is not voluntary enrollment. 257.16    (b) Beginning January 1, 2007, the commissioner may contract with qualified 257.17Medicare special needs plans to provide basic health care services under medical 257.18assistance to persons who are dually eligible for both Medicare and Medicaid and those 257.19Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare. 257.20The commissioner shall consult with the stakeholder group under paragraph (d) (e) in 257.21developing program specifications for these services. The commissioner shall report to 257.22the chairs of the house and senate committees with jurisdiction over health and human 257.23services policy and finance by February 1, 2007, on implementation of these programs and 257.24the need for increased funding for the ombudsman for managed care and other consumer 257.25assistance and protections needed due to enrollment in managed care of persons with 257.26disabilities. Payment for Medicaid services provided under this subdivision for the months 257.27of May and June will be made no earlier than July 1 of the same calendar year.257.28    (c) Beginning January 1, 2008, the commissioner may expand contracting under this 257.29subdivision to all persons with disabilities not otherwise required to enroll in managed 257.30care.257.31    (d) By February 1, 2009, the commissioner shall report to the chairs of the house and 257.32senate committees with jurisdiction over health and human services policy and finance on 257.33the initial results of implementation of contracts with qualified Medicare special needs 257.34plans to provide basic health care services under medical assistance to persons who are 257.35dually eligible for both Medicare and Medicaid. This report shall include an overall 257.36assessment of the impact on quality of care including actual costs and benefits.258.1    (e) The commissioner shall establish a state-level stakeholder group to provide 258.2advice on managed care programs for persons with disabilities, including both MnDHO 258.3and contracts with special needs plans that provide basic health care services as described 258.4in paragraphs (a) and (b). The stakeholder group shall include representatives of the 258.5counties and labor organizations representing county social service workers, members, 258.6consumer advocates, and providers, and provide advice on program expansions under this 258.7subdivision and subdivision 23, including:258.8    (1) implementation efforts; 258.9    (2) consumer protections; and258.10    (3) program specifications such as quality assurance measures, data collection and 258.11reporting, and evaluation of costs, quality, and results.; and258.12    (4) county safety net protections for persons with disabilities.258.13    (e) (f) Each plan under contract to provide medical assistance basic health care 258.14services shall establish a local or regional stakeholder group, including representatives 258.15of the counties covered by the plan and labor organizations representing county social 258.16service workers, members, consumer advocates, and current providers, for advice on 258.17issues that arise in the local or regional area.258.18    Sec. 103. [256C.261] SERVICES FOR DEAF-BLIND PERSONS.258.19     (a) The commissioner of human services shall combine the existing biennial base 258.20level funding for deaf-blind services into a single grant program. At least 35 percent 258.21of the total funding is awarded for services and other supports to deaf-blind children 258.22and their families and at least 25 percent is awarded for services and other supports to 258.23deaf-blind adults.258.24    The commissioner shall award grants for the purposes of: 258.25    (1) providing services and supports to individuals who are deaf-blind; and 258.26    (2) developing and providing training to counties and the network of senior citizen 258.27service providers. The purpose of the training grants is to teach counties how to use 258.28existing programs that capture federal financial participation to meet the needs of eligible 258.29deaf-blind persons and to build capacity of senior service programs to meet the needs of 258.30seniors with a dual sensory hearing and vision loss.258.31    (b) The commissioner may make grants:258.32    (1) for services and training provided by organizations; and258.33    (2) to develop and administer consumer-directed services.258.34    (c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant 258.35under paragraph (a).259.1    (d) Deaf-blind service providers are not required to, but may, provide intervenor 259.2services as part of the service package provided with grant funds under this section.259.3    Sec. 104. Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:259.4    Subd. 2. Standard of assistance for persons eligible for medical assistance 259.5waivers or at risk of placement in a group residential housing facility. The state 259.6standard of assistance for a person (1) who is eligible for a medical assistance home 259.7and community-based services waiver or a person, (2) who has been determined by the 259.8local agency to meet the plan requirements for placement in a group residential housing 259.9facility under section 
         256I.04, subdivision 1a, or (3) who is eligible for a shelter needy 259.10payment under subdivision 5, paragraph (f), is the standard established in subdivision 3, 259.11paragraph (a) or (b).259.12    Sec. 105. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:259.13    Subd. 5. Special needs. In addition to the state standards of assistance established in 259.14subdivisions 1 to 4, payments are allowed for the following special needs of recipients of 259.15Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 259.16center, or a group residential housing facility.259.17    (a) The county agency shall pay a monthly allowance for medically prescribed 259.18diets if the cost of those additional dietary needs cannot be met through some other 259.19maintenance benefit. The need for special diets or dietary items must be prescribed by 259.20a licensed physician. Costs for special diets shall be determined as percentages of the 259.21allotment for a one-person household under the thrifty food plan as defined by the United 259.22States Department of Agriculture. The types of diets and the percentages of the thrifty 259.23food plan that are covered are as follows:259.24    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;259.25    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent 259.26of thrifty food plan;259.27    (3) controlled protein diet, less than 40 grams and requires special products, 125 259.28percent of thrifty food plan;259.29    (4) low cholesterol diet, 25 percent of thrifty food plan;259.30    (5) high residue diet, 20 percent of thrifty food plan;259.31    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;259.32    (7) gluten-free diet, 25 percent of thrifty food plan;259.33    (8) lactose-free diet, 25 percent of thrifty food plan;259.34    (9) antidumping diet, 15 percent of thrifty food plan;260.1    (10) hypoglycemic diet, 15 percent of thrifty food plan; or260.2    (11) ketogenic diet, 25 percent of thrifty food plan.260.3    (b) Payment for nonrecurring special needs must be allowed for necessary home 260.4repairs or necessary repairs or replacement of household furniture and appliances using 260.5the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, 260.6as long as other funding sources are not available.260.7    (c) A fee for guardian or conservator service is allowed at a reasonable rate 260.8negotiated by the county or approved by the court. This rate shall not exceed five percent 260.9of the assistance unit's gross monthly income up to a maximum of $100 per month. If the 260.10guardian or conservator is a member of the county agency staff, no fee is allowed.260.11    (d) The county agency shall continue to pay a monthly allowance of $68 for 260.12restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 260.131990, and who eats two or more meals in a restaurant daily. The allowance must continue 260.14until the person has not received Minnesota supplemental aid for one full calendar month 260.15or until the person's living arrangement changes and the person no longer meets the criteria 260.16for the restaurant meal allowance, whichever occurs first.260.17    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less, 260.18is allowed for representative payee services provided by an agency that meets the 260.19requirements under SSI regulations to charge a fee for representative payee services. This 260.20special need is available to all recipients of Minnesota supplemental aid regardless of 260.21their living arrangement.260.22    (f) Notwithstanding the language in this subdivision, an amount equal to the 260.23maximum allotment authorized by the federal Food Stamp Program for a single individual 260.24which is in effect on the first day of January July of the previous each year will be added to 260.25the standards of assistance established in subdivisions 1 to 4 for individuals adults under 260.26the age of 65 who qualify as shelter needy and are: (1) relocating from an institution, or 260.27an adult mental health residential treatment program under section 
         256B.0622, and who 260.28are shelter needy; (2) self-directed supports option participants defined under section 260.29256B.0657 if enacted in the 2007 legislative session; or (3) home and community-based 260.30waiver recipients living in their own rented, leased, or owned apartment or home not 260.31owned, operated, or controlled by a provider of service not related by blood or marriage. 260.32Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy 260.33benefit under subdivision 5, paragraph (f), is considered a household of one. An eligible 260.34individual who receives this benefit prior to age 65 may continue to receive the benefit 260.35after the age of 65.261.1    (g)(1) Persons eligible for shelter needy funding under paragraph (f), who are not 261.2receiving medial assistance home and community-based waiver services, are eligible for 261.3a state-funded transitional supports allowance under section 256B.49, subdivision 16, 261.4paragraph (e), to establish their own residence not owned, operated, or controlled by a 261.5provider of service not related by blood or marriage.261.6    (2) "Shelter needy" means that the assistance unit incurs monthly shelter costs that 261.7exceed 40 percent of the assistance unit's gross income before the application of this 261.8special needs standard. "Gross income" for the purposes of this section is the applicant's or 261.9recipient's income as defined in section 
         256D.35, subdivision 10, or the standard specified 261.10in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or 261.11state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be 261.12considered shelter needy for purposes of this paragraph.261.13    Sec. 106. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:261.14    Subd. 3. Moratorium on the development of group residential housing beds. (a) 261.15County agencies shall not enter into agreements for new group residential housing beds 261.16with total rates in excess of the MSA equivalent rate except: (1) for group residential 261.17housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 261.18provided the facility is needed to meet the census reduction targets for persons with 261.19developmental disabilities at regional treatment centers; (2) to ensure compliance with 261.20the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements 261.21for inappropriately placed persons with developmental disabilities or mental illness; 261.22(3) up to 80 beds in a single, specialized facility located in Hennepin County that will 261.23provide housing for chronic inebriates who are repetitive users of detoxification centers 261.24and are refused placement in emergency shelters because of their state of intoxication, 261.25and planning for the specialized facility must have been initiated before July 1, 1991, in 261.26anticipation of receiving a grant from the Housing Finance Agency under section 
         462A.05, 261.27subdivision 20a
         , paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for 261.28up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County 261.29for homeless adults with a mental illness, a history of substance abuse, or human 261.30immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this 261.31section, "homeless adult" means a person who is living on the street or in a shelter or 261.32discharged from a regional treatment center, community hospital, or residential treatment 261.33program and has no appropriate housing available and lacks the resources and support 261.34necessary to access appropriate housing. At least 70 percent of the supportive housing 261.35units must serve homeless adults with mental illness, substance abuse problems, or human 262.1immunodeficiency virus or acquired immunodeficiency syndrome who are about to be 262.2or, within the previous six months, has been discharged from a regional treatment center, 262.3or a state-contracted psychiatric bed in a community hospital, or a residential mental 262.4health or chemical dependency treatment program. If a person meets the requirements of 262.5subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group 262.6residential housing rate for that person is limited to the supplementary rate under section 262.7256I.05, subdivision 1a
         , and is determined by subtracting the amount of the person's 262.8countable income that exceeds the MSA equivalent rate from the group residential housing 262.9supplementary rate. A resident in a demonstration project site who no longer participates 262.10in the demonstration program shall retain eligibility for a group residential housing 262.11payment in an amount determined under section 
         256I.06, subdivision 8, using the MSA 262.12equivalent rate. Service funding under section 
         256I.05, subdivision 1a, will end June 30, 262.131997, if federal matching funds are available and the services can be provided through a 262.14managed care entity. If federal matching funds are not available, then service funding will 262.15continue under section 
         256I.05, subdivision 1a; or (6) (5) for group residential housing 262.16beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which 262.17are used exclusively for recipients receiving home and community-based waiver services 262.18under sections 
         256B.0915, 
         256B.092, subdivision 5, 
         256B.093, and 
         256B.49, and who 262.19resided in a nursing facility for the six months immediately prior to the month of entry 262.20into the group residential housing setting. The group residential housing rate for these 262.21beds must be set so that the monthly group residential housing payment for an individual 262.22occupying the bed when combined with the nonfederal share of services delivered under 262.23the waiver for that person does not exceed the nonfederal share of the monthly medical 262.24assistance payment made for the person to the nursing facility in which the person resided 262.25prior to entry into the group residential housing establishment. The rate may not exceed 262.26the MSA equivalent rate plus $426.37 for any case.; or (6) for an additional two beds, 262.27resulting in a total of 32 beds, for a facility located in Hennepin County providing services 262.28for recovering and chemically dependent men that has had a group residential housing 262.29contract with the county and has been licensed as a board and lodge facility with special 262.30services since 1980; (7) for a group residential housing provider located in Stearns County 262.31that operates a 40-bed facility, that received financing through the Minnesota Housing 262.32Finance Agency Ending Long-Term Homelessness Initiative and serves chemically 262.33dependent clientele, providing 24-hour-a-day supervision; (8) for a group residential 262.34housing provider located in Crow Wing County that serves a chemically dependent 262.35clientele, providing 24-hour-a-day supervision and limiting a resident's maximum length 262.36of stay to 13 months out of a consecutive 24-month period; (9) for a 60-bed facility in 263.1St. Louis County which opened in January 2006 that will serve chemically dependent 263.2persons operated by a group residential housing provider that currently operates a 304-bed 263.3facility in Minneapolis; and (10) for a group residential housing provider that operates two 263.4ten-bed facilities, one located in Hennepin County and one located in Ramsey County, 263.5which provide community support and serve the mental health needs of individuals who 263.6have chronically lived unsheltered, providing 24-hour-a-day supervision.263.7    (b) A county agency may enter into a group residential housing agreement for beds 263.8with rates in excess of the MSA equivalent rate in addition to those currently covered 263.9under a group residential housing agreement if the additional beds are only a replacement 263.10of beds with rates in excess of the MSA equivalent rate which have been made available 263.11due to closure of a setting, a change of licensure or certification which removes the beds 263.12from group residential housing payment, or as a result of the downsizing of a group 263.13residential housing setting. The transfer of available beds from one county to another can 263.14only occur by the agreement of both counties.263.15    Sec. 107. Minnesota Statutes 2006, section 256I.05, is amended by adding a 263.16subdivision to read:263.17    Subd. 1h.Supplementary rate for certain facilities serving chemically 263.18dependent males.Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a 263.19county agency shall negotiate a supplementary rate in addition to the rate specified in 263.20subdivision 1, not to exceed $737.87 per month, including any legislatively authorized 263.21inflationary adjustments, for a group residential housing provider that:263.22    (1) is located in Ramsey County and has had a group residential housing contract 263.23with the county since 1982 and has been licensed as a board and lodge facility with special 263.24services since 1979; and263.25    (2) serves recovering and chemically dependent males, providing 24-hour-a-day 263.26supervision.263.27    Sec. 108. Minnesota Statutes 2006, section 256I.05, is amended by adding a 263.28subdivision to read:263.29    Subd. 1i.Supplementary rate for certain facilities; Hennepin County.263.30    Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate 263.31a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 263.32per month, including any legislatively authorized inflationary adjustments, for a facility 263.33located in Hennepin County with a capacity of up to 48 beds that has been licensed since 264.11978 as a board and lodging facility and that until August 1, 2007, operated as a licensed 264.2chemical dependency treatment program.264.3EFFECTIVE DATE.This section is effective the day following final enactment.264.4    Sec. 109. Minnesota Statutes 2006, section 256I.05, is amended by adding a 264.5subdivision to read:264.6    Subd. 1j.Supplementary rate for certain facilities; St. Louis County.(a) 264.7Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a 264.8county agency shall negotiate a supplementary rate in addition to the rate specified in 264.9subdivision 1, not to exceed $700 per month, including any legislatively authorized 264.10inflationary adjustments, for a 60-bed facility in St. Louis County which opened in 264.11January 2006 that will serve chemically dependent persons operated by a group residential 264.12housing provider that currently operates a 304-bed facility in Minneapolis.264.13    (b) The supplementary rate in paragraph (a) applies to the 48 beds which do not 264.14already receive a supplementary rate.264.15    Sec. 110. Minnesota Statutes 2006, section 256I.05, is amended by adding a 264.16subdivision to read:264.17    Subd. 1k.Supplementary rate for certain facilities; Crow Wing County.264.18    Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a 264.19county agency shall negotiate a supplementary rate in addition to the rate specified in 264.20subdivision 1, not to exceed $700 per month, including any legislatively authorized 264.21inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve 264.22chemically dependent persons operated by a group residential housing provider that 264.23currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which 264.24opened in January of 2006.264.25    Sec. 111. Minnesota Statutes 2006, section 256I.05, is amended by adding a 264.26subdivision to read:264.27    Subd. 1l.Supplementary rate for certain facilities; Stearns County.264.28    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 264.29shall negotiate a supplementary service rate in addition to the rate specified in subdivision 264.301, not to exceed $700 per month, including any legislatively authorized inflationary 264.31adjustments, for a group residential housing provider located in Stearns County that 264.32operates a 40-bed facility, that received financing through the Minnesota Housing Finance 265.1Agency Ending Long-Term Homelessness Initiative and serves chemically dependent 265.2clientele, providing 24-hour-a-day supervision.265.3    Sec. 112. Minnesota Statutes 2006, section 256I.05, is amended by adding a 265.4subdivision to read:265.5    Subd. 1m.Supplementary rate for certain facilities; St. Louis County.265.6    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 265.7shall negotiate a supplementary service rate in addition to the rate specified in subdivision 265.81, not to exceed $700 per month, including any legislatively authorized inflationary 265.9adjustments, for a group residential housing provider located in St. Louis County that 265.10operates a 30-bed facility, that received financing through the Minnesota Housing Finance 265.11Agency Ending Long-Term Homelessness Initiative and serves chemically dependent 265.12clientele, providing 24-hour-a-day supervision. 265.13    Sec. 113. Minnesota Statutes 2006, section 256I.05, is amended by adding a 265.14subdivision to read:265.15    Subd. 1n.Supplemental rate for certain facilities; Hennepin and Ramsey 265.16Counties.Notwithstanding the provisions of this section, beginning July 1, 2007, a county 265.17agency shall negotiate a supplemental service rate in addition to the rate specified in 265.18subdivision 1, not to exceed $715.78 per month, including any legislatively authorized 265.19inflationary adjustments, for a group residential housing provider that operates two 265.20ten-bed facilities, one located in Hennepin County and one located in Ramsey County, 265.21which provide community support and serve the mental health needs of individuals who 265.22have chronically lived unsheltered, providing 24-hour-a-day supervision.265.23    Sec. 114. Laws 2000, chapter 340, section 19, is amended to read:265.24    Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.265.25    (a) Expenditures for housing with services and adult foster care shall be excluded 265.26when determining average monthly expenditures per client for alternative care pilot 265.27projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.265.28    (b) Alternative care pilot projects shall not expire on June 30, 2001, but shall 265.29continue until June 30, 2005 2007.265.30EFFECTIVE DATE.This section is effective retroactively from June 29, 2005, for 265.31activities related to discontinuing pilot projects under this section.265.32    Sec. 115. Laws 2006, chapter 282, article 20, section 37, is amended to read:266.1    Sec. 37. REPAYMENT DELAY.266.2    A county that overspent its allowed amounts in calendar year 2004 or 2005 under 266.3the waivered services program for persons with developmental disabilities shall not be 266.4required to pay back the amount of overspending until May 31, 2007.266.5EFFECTIVE DATE.This section is effective the day following final enactment.266.6    Sec. 116. LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.266.7    (a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon the 266.8recommendation of a county agency, the commissioner of human services shall grant a 266.9license with any necessary variances to a nonresidential program for youth which provides 266.10services to youth with disabilities under age 21 during nonschool hours established 266.11to ensure health and safety, prevent out-of-home placement, and increase community 266.12inclusion of youth with disabilities. The nonresidential youth program is subject to the 266.13conditions of any variances granted and with consumer rights under Minnesota Statutes, 266.14section 245B.04, consumer protection standards under Minnesota Statutes, section 266.15245B.05, service standards under Minnesota Statutes, section 245B.06, management 266.16standards under Minnesota Statutes, section 245B.07, and fire marshal inspections under 266.17Minnesota Statutes, section 245A.151, until the commissioner develops other licensure 266.18requirements for this type of program.266.19    (b) By February 1, 2008, the commissioner shall recommend amendments to 266.20licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of 266.21appropriate services for school-age youth with disabilities under age 21 who need 266.22supervision and services to develop skills necessary to maintain personal safety and 266.23increase their independence, productivity, and participation in their communities during 266.24nonschool hours. As part of developing the recommendations, the commissioner shall 266.25survey county agencies to determine how the needs of youth with disabilities under age 21 266.26who require supervision and support services are being met and the funding sources used. 266.27The recommendations must be provided to the house and senate chairs of the committees 266.28with jurisdiction over licensing of programs for youth with disabilities.266.29    Sec. 117. INDEPENDENT LIVING.266.30    An individual who has lived in one of the facilities under Minnesota Statutes, 266.31section 256I.05, subdivision 1n, who is being transitioned to independent living as 266.32part of the program plan continues to be eligible for group residential housing and the 266.33supplemental service rate negotiated with the county under Minnesota Statutes, section 266.34256I.05, subdivision 1n.267.1    Sec. 118. ASSISTIVE TECHNOLOGY STUDY AND REPORT.267.2    Subdivision 1.Study.(a) During the biennium ending June 30, 2009, the Council 267.3on Disability shall facilitate a statewide study of the assistive technology needs of 267.4people with disabling conditions, and seniors. As part of the study, the council shall 267.5identify community-based service providers, state agencies, and other entities involved in 267.6providing assistive technology supports. The study shall also examine the creation of an 267.7assistive technology pretax savings account to allow disabled persons to set aside pretax 267.8and unearned income to purchase assistive technology devices, equipment, and services.267.9    (b) The council shall provide oversight and direction to the Minnesota Regions 267.10Assistive Technology Collaborative during the biennium ending June 30, 2009.267.11    Subd. 2.Report.The council shall present to the chairs of the house and senate 267.12committees having jurisdiction over human services, by January 1, 2009, a report of the 267.13findings of the study, including proposed legislation creating a statewide comprehensive 267.14plan to meet the assistive technology needs of people with disabling conditions and 267.15seniors. The statewide plan must include steps to coordinate and streamline assistive 267.16technology services and the creation of an assistive technology pretax savings account.267.17    Sec. 119. COMMUNITY SERVICES PROVIDER RATE INCREASES.267.18    (a) The commissioner of human services shall increase allocations, reimbursement 267.19rates, or rate limits, as applicable, by three percent for the rate period beginning October 1, 267.202007, and the rate period beginning October 1, 2008, effective for services rendered on 267.21or after those dates.267.22    (b) The three percent annual rate increase described in this section must be provided 267.23to:267.24    (1) home and community-based waivered services for persons with developmental 267.25disabilities or related conditions under Minnesota Statutes, section 256B.501;267.26    (2) home and community-based waivered services for the elderly under Minnesota 267.27Statutes, section 256B.0915;267.28    (3) waivered services under community alternatives for disabled individuals under 267.29Minnesota Statutes, section 256B.49;267.30    (4) community alternative care waivered services under Minnesota Statutes, section 267.31256B.49;267.32    (5) traumatic brain injury waivered services under Minnesota Statutes, section 267.33256B.49;267.34    (6) nursing services and home health services under Minnesota Statutes, section 267.35256B.0625, subdivision 6a;268.1    (7) personal care services and nursing supervision of personal care services under 268.2Minnesota Statutes, section 256B.0625, subdivision 19a;268.3    (8) private duty nursing services under Minnesota Statutes, section 256B.0625, 268.4subdivision 7;268.5    (9) day training and habilitation services for adults with developmental disabilities 268.6or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the 268.7additional cost of rate adjustments on day training and habilitation service, provided as a 268.8social service under Minnesota Statutes, section 256M.60;268.9    (10) alternative care services under Minnesota Statutes, section 256B.0913;268.10    (11) adult residential program grants under Minnesota Statutes, section 245.73;268.11    (12) adult and children's mental health grants under Minnesota Rules, parts 268.129535.1700 to 9535.1760;268.13    (13) the group residential housing supplementary service rate under Minnesota 268.14Statutes, section 256I.05, subdivision 1a;268.15    (14) adult mental health integrated fund grants under Minnesota Statutes, section 268.16245.4661;268.17    (15) semi-independent living services (SILS) under Minnesota Statutes, section 268.18252.275, including SILS funding under county social services grants formerly funded 268.19under Minnesota Statutes, chapter 256I;268.20    (16) community support services for deaf and hard-of-hearing adults with mental 268.21illness who use or wish to use sign language as their primary means of communication 268.22under Minnesota Statutes, section 256.01, subdivision 2;268.23    (17) living skills training programs for persons with intractable epilepsy who need 268.24assistance in the transition to independent living under Laws 1988, chapter 689;268.25    (18) physical therapy services under Minnesota Statutes, sections 256B.0625, 268.26subdivision 8, and 256D.03, subdivision 4;268.27    (19) occupational therapy services under Minnesota Statutes, sections 256B.0625, 268.28subdivision 8a, and 256D.03, subdivision 4;268.29    (20) speech-language therapy services under Minnesota Statutes, section 256D.03, 268.30subdivision 4, and Minnesota Rules, part 9505.0390; 268.31    (21) respiratory therapy services under Minnesota Statutes, section 256D.03, 268.32subdivision 4, and Minnesota Rules, part 9505.0295;268.33    (22) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, 268.34and 256B.0928;269.1    (23) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233; 269.2256C.25; Laws 1985, chapter 9, article 1; and Laws 1997, First Special Session chapter 269.35, section 20;269.4    (24) children's therapeutic services and supports under Minnesota Statutes, section 269.5256B.0943;269.6    (25) tier I chemical health services under Minnesota Statutes, chapter 254B;269.7    (26) consumer support grants under Minnesota Statutes, section 256.476;269.8    (27) family support grants under Minnesota Statutes, section 252.32;269.9    (28) case management services to persons with HIV or AIDS under Minnesota 269.10Statutes, section 256.01, subdivision 19; and269.11    (29) adult rehabilitative mental health services under Minnesota Statutes, section 269.12256B.0623.269.13    (c) Providers that receive a rate increase under this section shall use 75 percent of 269.14the additional revenue to increase wages and benefits and pay associated costs for all 269.15employees, except for management fees, the administrator, and central office staff.269.16    (d) For public employees, the increase for wages and benefits for certain staff is 269.17available and pay rates must be increased only to the extent that they comply with laws 269.18governing public employees' collective bargaining. Money received by a provider for pay 269.19increases under this section may be used only for increases implemented on or after the 269.20first day of the rate period in which the increase is available and must not be used for 269.21increases implemented prior to that date.269.22    (e) A copy of the provider's plan for complying with paragraph (c) must be made 269.23available to all employees by giving each employee a copy or by posting a copy in an area 269.24of the provider's operation to which all employees have access. If an employee does not 269.25receive the adjustment, if any, described in the plan and is unable to resolve the problem 269.26with the provider, the employee may contact the employee's union representative. If the 269.27employee is not covered by a collective bargaining agreement, the employee may contact 269.28the commissioner at a telephone number provided by the commissioner and included in 269.29the provider's plan. 269.30    (f) The commissioner and each county agency shall take steps necessary to 269.31implement the increases required by this section on the dates specified, and the increases 269.32must be effective on the dates specified, regardless of the client's service authorization date 269.33and notwithstanding the terms of any provider contract, service agreement, or schedule 269.34that limits when a county may increase payment rates.269.35    Sec. 120. DENTAL ACCESS FOR PERSONS WITH DISABILITIES.270.1    The commissioner of human services shall study access to dental services for 270.2persons with disabilities, and shall present recommendations for improving access to 270.3dental services to the legislature by January 15, 2008. The study must examine physical 270.4and geographic access, the willingness of dentists to serve persons with disabilities 270.5enrolled in state health care programs, reimbursement rates for dental service providers, 270.6and other factors identified by the commissioner.270.7    Sec. 121. COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.270.8    By October 1, 2007, the commissioner shall seek federal approval to allow persons 270.9who have been eligible for medical assistance for employed persons with disabilities 270.10(MA-EPD) under Minnesota Statutes, section 256B.057, subdivision 9, for each of the 24 270.11consecutive months prior to becoming age 65 to continue using the MA-EPD eligibility 270.12rules as long as they qualify.270.13    Sec. 122. MINNESOTA RULES.270.14    The Department of Administration shall publish adopted rules in the State Register 270.15making the terminology changes specified in section 92 in Minnesota Rules. Upon 270.16publication in the State Register, the terminology changes for Minnesota Rules are 270.17adopted without further administrative action.270.18    Sec. 123. REVISOR'S INSTRUCTION.270.19    The revisor of statutes shall change the terms in column A to the terms in column B 270.20wherever they appear in Minnesota Statutes:

270.21Column AColumn B270.22270.23270.24270.25270.26"Office of Ombudsman for Older Minnesotans" and "Office of the Ombudsman for Older Minnesotans""Office of Ombudsman for Long-Term Care"270.27270.28"ombudsman for older Minnesotans""ombudsman for long-term care"

270.29    Sec. 124. REPEALER.270.30Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261; 270.31252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h; 270.32and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.271.1ARTICLE 5271.2MENTAL HEALTH271.3    Section 1. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to 271.4read:271.5    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the 271.6brain or a clinically significant disorder of thought, mood, perception, orientation, 271.7memory, or behavior that is listed in the clinical manual of the International Classification 271.8of Diseases (ICD-9-CM), current edition, code range 290.0 to 
         302.99 or 306.0 to 316.0 271.9or the corresponding code in the American Psychiatric Association's Diagnostic and 271.10Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and 271.11that seriously limits a person's capacity to function in primary aspects of daily living such 271.12as personal relations, living arrangements, work, and recreation. 271.13    (b) An "adult with acute mental illness" means an adult who has a mental illness that 271.14is serious enough to require prompt intervention.271.15    (c) For purposes of case management and community support services, a "person 271.16with serious and persistent mental illness" means an adult who has a mental illness and 271.17meets at least one of the following criteria:271.18    (1) the adult has undergone two or more episodes of inpatient care for a mental 271.19illness within the preceding 24 months;271.20    (2) the adult has experienced a continuous psychiatric hospitalization or residential 271.21treatment exceeding six months' duration within the preceding 12 months;271.22    (3) the adult has been treated by a crisis team two or more times within the preceding 271.2324 months;271.24    (4) the adult:271.25    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline 271.26personality disorder;271.27    (ii) indicates a significant impairment in functioning; and271.28    (iii) has a written opinion from a mental health professional, in the last three years, 271.29stating that the adult is reasonably likely to have future episodes requiring inpatient or 271.30residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 271.31management or community support services are provided;271.32    (4) (5) the adult has, in the last three years, been committed by a court as a person 271.33who is mentally ill under chapter 253B, or the adult's commitment has been stayed or 271.34continued; or272.1    (5) (6) the adult (i) was eligible under clauses (1) to (4) (5), but the specified time 272.2period has expired or the adult was eligible as a child under section 
         245.4871, subdivision 272.36
         ; and (ii) has a written opinion from a mental health professional, in the last three years, 272.4stating that the adult is reasonably likely to have future episodes requiring inpatient or 272.5residential treatment, of a frequency described in clause (1) or (2), unless ongoing case 272.6management or community support services are provided. 272.7    Sec. 2. Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision 272.8to read:272.9    Subd. 3.Responsibility not duplicated.For individuals who have health care 272.10coverage, the county board is not responsible for providing mental health services which 272.11are within the limits of the individual's health care coverage.272.12    Sec. 3. Minnesota Statutes 2006, section 245.4874, is amended to read:272.13245.4874 DUTIES OF COUNTY BOARD.272.14    Subdivision 1.Duties of the county board. (a) The county board must:272.15    (1) develop a system of affordable and locally available children's mental health 272.16services according to sections 
         245.487 to 
         245.4887;272.17    (2) establish a mechanism providing for interagency coordination as specified in 272.18section 
         245.4875, subdivision 6;272.19    (3) consider the assessment of unmet needs in the county as reported by the local 272.20children's mental health advisory council under section 
         245.4875, subdivision 5, paragraph 272.21(b), clause (3). The county shall provide, upon request of the local children's mental health 272.22advisory council, readily available data to assist in the determination of unmet needs;272.23    (4) assure that parents and providers in the county receive information about how to 272.24gain access to services provided according to sections 
         245.487 to 
         245.4887;272.25    (5) coordinate the delivery of children's mental health services with services 272.26provided by social services, education, corrections, health, and vocational agencies to 272.27improve the availability of mental health services to children and the cost-effectiveness of 272.28their delivery;272.29    (6) assure that mental health services delivered according to sections 
         245.487272.30to 
         245.4887 are delivered expeditiously and are appropriate to the child's diagnostic 272.31assessment and individual treatment plan;272.32    (7) provide the community with information about predictors and symptoms of 272.33emotional disturbances and how to access children's mental health services according to 272.34sections 
         245.4877 and 
         245.4878;273.1    (8) provide for case management services to each child with severe emotional 273.2disturbance according to sections 
         245.486; 
         245.4871, subdivisions 3 and 4; and 
         245.4881, 273.3subdivisions 1, 3, and 5
         ;273.4    (9) provide for screening of each child under section 
         245.4885 upon admission 273.5to a residential treatment facility, acute care hospital inpatient treatment, or informal 273.6admission to a regional treatment center;273.7    (10) prudently administer grants and purchase-of-service contracts that the county 273.8board determines are necessary to fulfill its responsibilities under sections 
         245.487 to 273.9245.4887
         ;273.10    (11) assure that mental health professionals, mental health practitioners, and case 273.11managers employed by or under contract to the county to provide mental health services 273.12are qualified under section 
         245.4871;273.13    (12) assure that children's mental health services are coordinated with adult mental 273.14health services specified in sections 
         245.461 to 
         245.486 so that a continuum of mental 273.15health services is available to serve persons with mental illness, regardless of the person's 273.16age;273.17    (13) assure that culturally informed mental health consultants are used as necessary 273.18to assist the county board in assessing and providing appropriate treatment for children of 273.19cultural or racial minority heritage; and273.20    (14) consistent with section 
         245.486, arrange for or provide a children's mental 273.21health screening to a child receiving child protective services or a child in out-of-home 273.22placement, a child for whom parental rights have been terminated, a child found to be 273.23delinquent, and a child found to have committed a juvenile petty offense for the third or 273.24subsequent time, unless a screening has been performed within the previous 180 days, or 273.25the child is currently under the care of a mental health professional. The court or county 273.26agency must notify a parent or guardian whose parental rights have not been terminated of 273.27the potential mental health screening and the option to prevent the screening by notifying 273.28the court or county agency in writing. The screening shall be conducted with a screening 273.29instrument approved by the commissioner of human services according to criteria that 273.30are updated and issued annually to ensure that approved screening instruments are valid 273.31and useful for child welfare and juvenile justice populations, and shall be conducted 273.32by a mental health practitioner as defined in section 
         245.4871, subdivision 26, or a 273.33probation officer or local social services agency staff person who is trained in the use of 273.34the screening instrument. Training in the use of the instrument shall include training in the 273.35administration of the instrument, the interpretation of its validity given the child's current 273.36circumstances, the state and federal data practices laws and confidentiality standards, the 274.1parental consent requirement, and providing respect for families and cultural values. 274.2If the screen indicates a need for assessment, the child's family, or if the family lacks 274.3mental health insurance, the local social services agency, in consultation with the child's 274.4family, shall have conducted a diagnostic assessment, including a functional assessment, 274.5as defined in section 
         245.4871. The administration of the screening shall safeguard the 274.6privacy of children receiving the screening and their families and shall comply with the 274.7Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance 274.8Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be 274.9considered private data and the commissioner shall not collect individual screening results.274.10    (b) When the county board refers clients to providers of children's therapeutic 274.11services and supports under section 
         256B.0943, the county board must clearly identify 274.12the desired services components not covered under section 
         256B.0943 and identify the 274.13reimbursement source for those requested services, the method of payment, and the 274.14payment rate to the provider.274.15    Subd. 2.Responsibility not duplicated.For individuals who have health care 274.16coverage, the county board is not responsible for providing mental health services which 274.17are within the limits of the individual's health care coverage.274.18    Sec. 4. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:274.19    Subd. 5. Special contracts; bordering states. (a) An individual who is detained, 274.20committed, or placed on an involuntary basis under chapter 253B may be confined or 274.21treated in a bordering state pursuant to a contract under this section. An individual who is 274.22detained, committed, or placed on an involuntary basis under the civil law of a bordering 274.23state may be confined or treated in Minnesota pursuant to a contract under this section. A 274.24peace or health officer who is acting under the authority of the sending state may transport 274.25an individual to a receiving agency that provides services pursuant to a contract under 274.26this section and may transport the individual back to the sending state under the laws 274.27of the sending state. Court orders valid under the law of the sending state are granted 274.28recognition and reciprocity in the receiving state for individuals covered by a contract 274.29under this section to the extent that the court orders relate to confinement for treatment 274.30or care of mental illness or chemical dependency. Such treatment or care may address 274.31other conditions that may be co-occurring with the mental illness or chemical dependency. 274.32These court orders are not subject to legal challenge in the courts of the receiving state. 274.33Individuals who are detained, committed, or placed under the law of a sending state and 274.34who are transferred to a receiving state under this section continue to be in the legal 274.35custody of the authority responsible for them under the law of the sending state. Except 275.1in emergencies, those individuals may not be transferred, removed, or furloughed from 275.2a receiving agency without the specific approval of the authority responsible for them 275.3under the law of the sending state.275.4    (b) While in the receiving state pursuant to a contract under this section, an 275.5individual shall be subject to the sending state's laws and rules relating to length of 275.6confinement, reexaminations, and extensions of confinement. No individual may be sent 275.7to another state pursuant to a contract under this section until the receiving state has 275.8enacted a law recognizing the validity and applicability of this section.275.9    (c) If an individual receiving services pursuant to a contract under this section leaves 275.10the receiving agency without permission and the individual is subject to involuntary 275.11confinement under the law of the sending state, the receiving agency shall use all 275.12reasonable means to return the individual to the receiving agency. The receiving agency 275.13shall immediately report the absence to the sending agency. The receiving state has the 275.14primary responsibility for, and the authority to direct, the return of these individuals 275.15within its borders and is liable for the cost of the action to the extent that it would be 275.16liable for costs of its own resident.275.17    (d) Responsibility for payment for the cost of care remains with the sending agency.275.18    (e) This subdivision also applies to county contracts under subdivision 2 which 275.19include emergency care and treatment provided to a county resident in a bordering state.275.20    (f) If a Minnesota resident is admitted to a facility in a bordering state under this 275.21chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or 275.22an advance practice registered nurse certified in mental health, who is licensed in the 275.23bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092, 275.24253B.12, and 253B.17 subject to the same requirements and limitations in section 275.25253B.02, subdivision 7.275.26    Sec. 5. Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:275.27    Subd. 2. Program. The commissioner of human services shall establish a program 275.28for the treatment of compulsive gamblers. The commissioner may contract with an 275.29entity with expertise regarding the treatment of compulsive gambling to operate the 275.30program. The program may include the establishment of a statewide toll-free number, 275.31resource library, public education programs; regional in-service training programs and 275.32conferences for health care professionals, educators, treatment providers, employee 275.33assistance programs, and criminal justice representatives; and the establishment of 275.34certification standards for programs and service providers. The commissioner may enter 275.35into agreements with other entities and may employ or contract with consultants to 276.1facilitate the provision of these services or the training of individuals to qualify them to 276.2provide these services. The program may also include inpatient and outpatient treatment 276.3and rehabilitation services and for residents in a temporary or permanent residential 276.4setting for mental health or chemical dependency, and individuals in jails or correctional 276.5facilities. The program may also include research studies. The research studies must 276.6include baseline and prevalence studies for adolescents and adults to identify those at the 276.7highest risk. The program must be approved by the commissioner before it is established.276.8    Sec. 6. Minnesota Statutes 2006, section 245.98, subdivision 5, is amended to read:276.9    Subd. 5. Standards. The commissioner shall create standards for treatment and 276.10provider qualifications for the treatment component of the compulsive gambling program.276.11The commissioner, in coordination with the commissioner of corrections, shall create 276.12standards for the assessment and treatment of compulsive gamblers in programs operated 276.13by the commissioner of corrections.276.14    Sec. 7. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.276.15    Prior to placement of a child in a foster care home, the child foster care provider, if 276.16required to be licensed, must complete two hours of training that addresses the causes, 276.17symptoms, and key warning signs of mental health disorders; cultural considerations; and 276.18effective approaches for dealing with a child's behaviors. At least one hour of the annual 276.1912-hour training requirement for foster parents must be on children's mental health issues 276.20and treatment. Training curriculum shall be approved by the commissioner of human 276.21services.276.22    Sec. 8. Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:276.23    Subdivision 1. County portion for cost of care. Except for chemical dependency 276.24services provided under sections 
         254B.01 to 
         254B.09, the client's county shall pay to the 276.25state of Minnesota a portion of the cost of care provided in a regional treatment center 276.26or a state nursing facility to a client legally settled in that county. A county's payment 276.27shall be made from the county's own sources of revenue and payments shall be paid as 276.28follows: payments to the state from the county shall equal 20 percent a percentage of the 276.29cost of care, as determined by the commissioner, for each day, or the portion thereof, that 276.30the client spends at a regional treatment center or a state nursing facility. according to 276.31the following schedule for each admission:276.32    (1) for the first 30 days: 20 percent until January 1, 2008, ten percent from January 276.331, 2008, to June 30, 2009, and zero percent thereafter;277.1    (2) 20 percent for days 31 to 60; and277.2    (3) for any days over 60: 20 percent until January 1, 2008, 30 percent from January 277.31, 2008, to June 30, 2009, 40 percent from July 1, 2009, to June 30, 2010, and 50 percent 277.4thereafter.277.5 If payments received by the state under sections 
         246.50 to 
         246.53 exceed 80 percent the 277.6noncounty portion of the cost of care, the county shall be responsible for paying the state 277.7only the remaining amount. The county shall not be entitled to reimbursement from 277.8the client, the client's estate, or from the client's relatives, except as provided in section 277.9246.53
         . No such payments shall be made for any client who was last committed prior to 277.10July 1, 1947.277.11    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to 277.12read:277.13    Subd. 20. Mental health case management. (a) To the extent authorized by rule 277.14of the state agency, medical assistance covers case management services to persons with 277.15serious and persistent mental illness and children with severe emotional disturbance. 277.16Services provided under this section must meet the relevant standards in sections 
         245.461277.17to 
         245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota 277.18Rules, parts 
         9520.0900 to 
         9520.0926, and 
         9505.0322, excluding subpart 10. 277.19    (b) Entities meeting program standards set out in rules governing family community 277.20support services as defined in section 
         245.4871, subdivision 17, are eligible for medical 277.21assistance reimbursement for case management services for children with severe 277.22emotional disturbance when these services meet the program standards in Minnesota 277.23Rules, parts 
         9520.0900 to 
         9520.0926 and 
         9505.0322, excluding subparts 6 and 10. 277.24    (c) Medical assistance and MinnesotaCare payment for mental health case 277.25management shall be made on a monthly basis. In order to receive payment for an eligible 277.26child, the provider must document at least a face-to-face contact with the child, the child's 277.27parents, or the child's legal representative. To receive payment for an eligible adult, the 277.28provider must document:277.29    (1) at least a face-to-face contact with the adult or the adult's legal representative; or277.30    (2) at least a telephone contact with the adult or the adult's legal representative and 277.31document a face-to-face contact with the adult or the adult's legal representative within 277.32the preceding two months.277.33    (d) Payment for mental health case management provided by county or state staff 277.34shall be based on the monthly rate methodology under section 
         256B.094, subdivision 6, 278.1paragraph (b), with separate rates calculated for child welfare and mental health, and 278.2within mental health, separate rates for children and adults. 278.3    (e) Payment for mental health case management provided by Indian health services 278.4or by agencies operated by Indian tribes may be made according to this section or other 278.5relevant federally approved rate setting methodology.278.6    (f) Payment for mental health case management provided by vendors who contract 278.7with a county or Indian tribe shall be based on a monthly rate negotiated by the host county 278.8or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 278.9service to other payers. If the service is provided by a team of contracted vendors, the 278.10county or tribe may negotiate a team rate with a vendor who is a member of the team. The 278.11team shall determine how to distribute the rate among its members. No reimbursement 278.12received by contracted vendors shall be returned to the county or tribe, except to reimburse 278.13the county or tribe for advance funding provided by the county or tribe to the vendor.278.14    (g) If the service is provided by a team which includes contracted vendors, tribal 278.15staff, and county or state staff, the costs for county or state staff participation in the team 278.16shall be included in the rate for county-provided services. In this case, the contracted 278.17vendor, the tribal agency, and the county may each receive separate payment for services 278.18provided by each entity in the same month. In order to prevent duplication of services, 278.19each entity must document, in the recipient's file, the need for team case management and 278.20a description of the roles of the team members.278.21    (h) The commissioner shall calculate the nonfederal share of actual medical 278.22assistance and general assistance medical care payments for each county, based on the 278.23higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999, 278.24and transfer one-half of the result from medical assistance and general assistance medical 278.25care to each county's mental health grants under section 
         256E.12 for calendar year 1999. 278.26The annualized minimum amount added to each county's mental health grant shall be 278.27$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce 278.28the statewide growth factor in order to fund these minimums. The annualized total amount 278.29transferred shall become part of the base for future mental health grants for each county. 278.30    (i) Notwithstanding section 
         256B.19, subdivision 1, the nonfederal share of costs 278.31for mental health case management shall be provided by the recipient's county of 278.32responsibility, as defined in sections 
         256G.01 to 
         256G.12, from sources other than federal 278.33funds or funds used to match other federal funds. If the service is provided by a tribal 278.34agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this 278.35service is paid by the state without a federal share through fee-for-service, 50 percent of 278.36the cost shall be provided by the recipient's county of responsibility.279.1    (j) Notwithstanding any administrative rule to the contrary, prepaid medical 279.2assistance, general assistance medical care, and MinnesotaCare include mental health case 279.3management. When the service is provided through prepaid capitation, the nonfederal 279.4share is paid by the state and the county pays no share.279.5    (j)(k) The commissioner may suspend, reduce, or terminate the reimbursement to a 279.6provider that does not meet the reporting or other requirements of this section. The county 279.7of responsibility, as defined in sections 
         256G.01 to 
         256G.12, or, if applicable, the tribal 279.8agency, is responsible for any federal disallowances. The county or tribe may share this 279.9responsibility with its contracted vendors. 279.10    (k)(l) The commissioner shall set aside a portion of the federal funds earned for 279.11county expenditures under this section to repay the special revenue maximization account 279.12under section 
         256.01, subdivision 2, clause (15). The repayment is limited to: 279.13    (1) the costs of developing and implementing this section; and279.14    (2) programming the information systems.279.15    (l)(m) Payments to counties and tribal agencies for case management expenditures 279.16under this section shall only be made from federal earnings from services provided 279.17under this section. When this service is paid by the state without a federal share through 279.18fee-for-service, 50 percent of the cost shall be provided by the state. Payments to 279.19county-contracted vendors shall include both the federal earnings, the state share, and the 279.20county share.279.21    (m)(n) Notwithstanding section 
         256B.041, county payments for the cost of mental 279.22health case management services provided by county or state staff shall not be made 279.23to the commissioner of finance. For the purposes of mental health case management 279.24services provided by county or state staff under this section, the centralized disbursement 279.25of payments to counties under section 
         256B.041 consists only of federal earnings from 279.26services provided under this section. 279.27    (n)(o) Case management services under this subdivision do not include therapy, 279.28treatment, legal, or outreach services.279.29    (o)(p) If the recipient is a resident of a nursing facility, intermediate care facility, 279.30or hospital, and the recipient's institutional care is paid by medical assistance, payment 279.31for case management services under this subdivision is limited to the last 180 days of 279.32the recipient's residency in that facility and may not exceed more than six months in a 279.33calendar year.279.34    (p)(q) Payment for case management services under this subdivision shall not 279.35duplicate payments made under other program authorities for the same purpose.280.1    (q)(r) By July 1, 2000, the commissioner shall evaluate the effectiveness of the 280.2changes required by this section, including changes in number of persons receiving 280.3mental health case management, changes in hours of service per person, and changes in 280.4caseload size.280.5    (r)(s) For each calendar year beginning with the calendar year 2001, the annualized 280.6amount of state funds for each county determined under paragraph (h) shall be adjusted by 280.7the county's percentage change in the average number of clients per month who received 280.8case management under this section during the fiscal year that ended six months prior to 280.9the calendar year in question, in comparison to the prior fiscal year.280.10    (s)(t) For counties receiving the minimum allocation of $3,000 or $5,000 described 280.11in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county 280.12receives the higher of the following amounts:280.13    (1) a continuation of the minimum allocation in paragraph (h); or280.14    (2) an amount based on that county's average number of clients per month who 280.15received case management under this section during the fiscal year that ended six months 280.16prior to the calendar year in question, times the average statewide grant per person per 280.17month for counties not receiving the minimum allocation.280.18    (t)(u) The adjustments in paragraphs (s) and (t) shall be calculated separately for 280.19children and adults.280.20EFFECTIVE DATE.This section is effective January 1, 2009, except the 280.21amendment to paragraph (i) is effective January 1, 2008.280.22    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to 280.23read:280.24    Subd. 47. Treatment foster care services. Effective July 1, 2006 2009, and subject 280.25to federal approval, medical assistance covers treatment foster care services according to 280.26section 
         256B.0946.280.27    Sec. 11. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to 280.28read:280.29    Subd. 4. Payment rates. (a) Notwithstanding sections 
         256B.19 and 
         256B.041, 280.30payments to counties for residential services provided by a residential facility shall only 280.31be made of federal earnings for services provided under this section, and the nonfederal 280.32share of costs for services provided under this section shall be paid by the county from 280.33sources other than federal funds or funds used to match other federal funds. Payment to 280.34counties for services provided according to this section shall be a proportion of the per 281.1day contract rate that relates to rehabilitative mental health services and shall not include 281.2payment for costs or services that are billed to the IV-E program as room and board. 281.3    (b) Per diem rates paid to providers under this section by prepaid plans shall be the 281.4proportion of the per-day contract rate that relates to rehabilitative mental health services 281.5and shall not include payment for group foster care costs or services that are billed to the 281.6county of financial responsibility.281.7    (c) The commissioner shall set aside a portion not to exceed five percent of the 281.8federal funds earned for county expenditures under this section to cover the state costs of 281.9administering this section. Any unexpended funds from the set-aside shall be distributed 281.10to the counties in proportion to their earnings under this section.281.11EFFECTIVE DATE.This section is effective January 1, 2009.281.12    Sec. 12. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:281.13    Subd. 5g. Payment for covered services. For services rendered on or after January 281.141, 2003, the total payment made to managed care plans for providing covered services 281.15under the medical assistance and general assistance medical care programs is reduced by 281.16.5 percent from their current statutory rates. This provision excludes payments for nursing 281.17home services, home and community-based waivers, and payments to demonstration 281.18projects for persons with disabilities, and mental health services added as covered benefits 281.19after December 31, 2007.281.20    Sec. 13. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:281.21    Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g, 281.22the total payment made to managed care plans under the medical assistance program is 281.23reduced 1.0 percent for services provided on or after October 1, 2003, and an additional 281.241.0 percent for services provided on or after January 1, 2004. This provision excludes 281.25payments for nursing home services, home and community-based waivers, and payments 281.26to demonstration projects for persons with disabilities, and mental health services added as 281.27covered benefits after December 1, 2007.281.28    Sec. 14. Minnesota Statutes 2006, section 256B.763, is amended to read:281.29256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.281.30    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007, 281.31payment rates shall be increased by 23.7 percent over the rates in effect on January 1, 281.322006, for:282.1    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;282.2    (2) community mental health centers under section 
         256B.0625, subdivision 5; and282.3    (3) mental health clinics and centers certified under Minnesota Rules, parts 282.49520.0750
          to 
         9520.0870, or hospital outpatient psychiatric departments that are designated 282.5as essential community providers under section 
         62Q.19.282.6    (b) This increase applies to group skills training when provided as a component of 282.7children's therapeutic services and support, psychotherapy, medication management, 282.8evaluation and management, diagnostic assessment, explanation of findings, psychological 282.9testing, neuropsychological services, direction of behavioral aides, and inpatient 282.10consultation.282.11    (c) This increase does not apply to rates that are governed by section 
         256B.0625, 282.12subdivision 30, or 
         256B.761, paragraph (b), other cost-based rates, rates that are 282.13negotiated with the county, rates that are established by the federal government, or rates 282.14that increased between January 1, 2004, and January 1, 2005.282.15    (d) The commissioner shall adjust rates paid to prepaid health plans under contract 282.16with the commissioner to reflect the rate increases provided in paragraph (a). The prepaid 282.17health plan must pass this rate increase to the providers identified in paragraph (a)282.18paragraphs (a), (e), and (f). The prepaid plan must pass this rate increase to the providers 282.19identified in paragraphs (a), (e), and (f).282.20    (e) For MinnesotaCare only, payment rates shall be increased by 23.7 percent over 282.21the rates in effect on December 31, 2007, for:282.22    (1) medication education services provided on or after January 1, 2008, by adult 282.23rehabilitative mental health services providers certified under section 256B.0623; and282.24    (2) mental health behavioral aide services provided on or after January 1, 2008, by 282.25children's therapeutic services and support providers certified under section 256B.0943.282.26    (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by 282.27children's therapeutic services and support providers certified under section 256B.0943 282.28and not already included in paragraph (a), payment rates for MinnesotaCare shall be 282.29increased by 23.7 percent over the rates in effect on December 31, 2007.282.30    Sec. 15. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:282.31    Subdivision 1. Covered health services. For individuals under section 
         256L.04, 282.32subdivision 7
         , with income no greater than 75 percent of the federal poverty guidelines 282.33or for families with children under section 
         256L.04, subdivision 1, all subdivisions of 282.34this section apply. "Covered health services" means the health services reimbursed 282.35under chapter 256B, with the exception of inpatient hospital services, special education 283.1services, private duty nursing services, adult dental care services other than services 283.2covered under section 
         256B.0625, subdivision 9, orthodontic services, nonemergency 283.3medical transportation services, personal care assistant and case management services, 283.4nursing home or intermediate care facilities services, inpatient mental health services, 283.5and chemical dependency services. Outpatient mental health services covered under the 283.6MinnesotaCare program are limited to diagnostic assessments, psychological testing, 283.7explanation of findings, mental health telemedicine, psychiatric consultation, medication 283.8management by a physician, day treatment, partial hospitalization, and individual, family, 283.9and group psychotherapy.283.10    "Covered health services" also includes intensive mental health outpatient treatment 283.11for dialectical behavioral therapy for adults.283.12    No public funds shall be used for coverage of abortion under MinnesotaCare 283.13except where the life of the female would be endangered or substantial and irreversible 283.14impairment of a major bodily function would result if the fetus were carried to term; or 283.15where the pregnancy is the result of rape or incest.283.16    Covered health services shall be expanded as provided in this section.283.17EFFECTIVE DATE.This section is effective January 1, 2008, except coverage for 283.18mental health case management is effective January 1, 2009.283.19    Sec. 16. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:283.20    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b) 283.21and (c), the MinnesotaCare benefit plan shall include the following co-payments and 283.22coinsurance requirements for all enrollees:283.23    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, 283.24subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and 283.25$3,000 per family;283.26    (2) $3 per prescription for adult enrollees;283.27    (3) $25 for eyeglasses for adult enrollees;283.28    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 283.29episode of service which is required because of a recipient's symptoms, diagnosis, or 283.30established illness, and which is delivered in an ambulatory setting by a physician or 283.31physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 283.32audiologist, optician, or optometrist; and283.33    (5) $6 for nonemergency visits to a hospital-based emergency room.283.34    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of 283.35children under the age of 21 in households with family income equal to or less than 175 284.1percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to 284.2parents and relative caretakers of children under the age of 21 in households with family 284.3income greater than 175 percent of the federal poverty guidelines for inpatient hospital 284.4admissions occurring on or after January 1, 2001.284.5    (c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children 284.6under the age of 21.284.7    (d) Paragraph (a), clause (4), does not apply to mental health services.284.8    (e) Adult enrollees with family gross income that exceeds 175 percent of the 284.9federal poverty guidelines and who are not pregnant shall be financially responsible for 284.10the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient 284.11hospital benefit limit.284.12    (e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, 284.13or changes from one prepaid health plan to another during a calendar year, any charges 284.14submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket 284.15expenses incurred by the enrollee for inpatient services, that were submitted or incurred 284.16prior to enrollment, or prior to the change in health plans, shall be disregarded.284.17    Sec. 17. Minnesota Statutes 2006, section 256L.035, is amended to read:284.18256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE 284.19ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.284.20    (a) "Covered health services" for individuals under section 
         256L.04, subdivision 284.217
         , with income above 75 percent, but not exceeding 175 percent, of the federal poverty 284.22guideline means:284.23    (1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and 284.24subject to an annual limitation of $10,000;284.25    (2) physician services provided during an inpatient stay; and284.26    (3) physician services not provided during an inpatient stay; outpatient hospital 284.27services; freestanding ambulatory surgical center services; chiropractic services; lab and 284.28diagnostic services; diabetic supplies and equipment; mental health services as covered 284.29under chapter 256B; and prescription drugs; subject to the following co-payments:284.30    (i) $50 co-pay per emergency room visit;284.31    (ii) $3 co-pay per prescription drug; and284.32    (iii) $5 co-pay per nonpreventive visit; except this co-pay does not apply to mental 284.33health services or community mental health services.284.34The services covered under this section may be provided by a physician, physician 284.35ancillary, chiropractor, psychologist, or licensed independent clinical social worker, or 285.1other mental health providers covered under chapter 256B if the services are within the 285.2scope of practice of that health care professional.285.3    For purposes of this section, "a visit" means an episode of service which is required 285.4because of a recipient's symptoms, diagnosis, or established illness, and which is delivered 285.5in an ambulatory setting by any health care provider identified in this paragraph.285.6    Enrollees are responsible for all co-payments in this section.285.7    (b) Reimbursement to the providers shall be reduced by the amount of the 285.8co-payment, except that reimbursement for prescription drugs shall not be reduced once a 285.9recipient has reached the $20 per month maximum for prescription drug co-payments. 285.10The provider collects the co-payment from the recipient. Providers may not deny services 285.11to recipients who are unable to pay the co-payment, except as provided in paragraph (c).285.12    (c) If it is the routine business practice of a provider to refuse service to an individual 285.13with uncollected debt, the provider may include uncollected co-payments under this 285.14section. A provider must give advance notice to a recipient with uncollected debt before 285.15services can be denied.285.16EFFECTIVE DATE.This section is effective January 1, 2008, except coverage 285.17for mental health case management under paragraph (a), clause (3), is effective January 285.181, 2009.285.19    Sec. 18. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:285.20    Subd. 9a. Rate setting; ratable reduction. For services rendered on or after 285.21October 1, 2003, the total payment made to managed care plans under the MinnesotaCare 285.22program is reduced 1.0 percent. This provision excludes payments for mental health 285.23services added as covered benefits after December 31, 2007.285.24    Sec. 19. Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:285.25    Subd. 9. Compulsive gambling assessment required. (a) If a person is convicted 285.26of theft under section 
         609.52, embezzlement of public funds under section 
         609.54, or 285.27forgery under section 
         609.625, 
         609.63, or 
         609.631, the probation officer shall determine in 285.28the report prepared under subdivision 1 whether or not compulsive gambling contributed 285.29to the commission of the offense. If so, the report shall contain the results of a compulsive 285.30gambling assessment conducted in accordance with this subdivision. The probation officer 285.31shall make an appointment for the offender to undergo the assessment if so indicated. 285.32    (b) The compulsive gambling assessment report must include a recommended level 285.33of treatment for the offender if the assessor concludes that the offender is in need of 285.34compulsive gambling treatment. The assessment must be conducted by an assessor 286.1qualified under section 
         245.98, subdivision 2a, to perform these assessments or to 286.2provide compulsive gambling treatment. An assessor providing a compulsive gambling 286.3assessment may not have any direct or shared financial interest or referral relationship 286.4resulting in shared financial gain with a treatment provider. If an independent assessor is 286.5not available, the probation officer may use the services of an assessor with a financial 286.6interest or referral relationship as authorized under rules adopted by the commissioner 286.7of human services under section 
         245.98, subdivision 2a. 286.8    (c) The commissioner of human services shall reimburse the assessor for the 286.9costs associated with a compulsive gambling assessment at a rate established by the 286.10commissioner up to a maximum of $100 for each assessment. To the extent practicable, the 286.11commissioner shall standardize reimbursement rates for assessments. The commissioner 286.12shall reimburse these costs after receiving written verification from the probation officer 286.13that the assessment was performed and found acceptable.286.14    (d) The commissioner shall make a report to the legislature by January 15, 2008, 286.15regarding the transfer of funds to counties for state registered nurses employed in 286.16community mental health pilot projects as part of the assertive community treatment 286.17teams under section 245.4661. The report shall address the impact of the nursing shortage 286.18on replacing these positions, continuity of patient care if these positions cannot be filled, 286.19and ways to maintain state registered nurses in these positions until the nurse retires or 286.20leaves employment. No funds for state registered nurse positions may be transferred 286.21before the report date.286.22    Sec. 20. CASE MANAGEMENT; BEST PRACTICES.286.23    The commissioner of human services, in consultation with consumers, families, 286.24counties, and other interested stakeholders, will develop recommendations for changes in 286.25the adult mental health act related to case management, consistent with evidence-based 286.26and best practices.286.27    Sec. 21. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.286.28    Subdivision 1.Pilot project authorized; purpose.A two-year Regional Children's 286.29Mental Health Initiative pilot project is established to improve children's mental health 286.30service coordination, communication, and processes in Blue Earth, Brown, Faribault, 286.31Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The 286.32purpose of the Regional Children's Mental Health Initiative will be to plan and develop 286.33new programs and services related to children's mental health in south central Minnesota.287.1    Subd. 2.Goals.To accomplish its purpose, the Regional Children's Mental Health 287.2Initiative shall have the following goals:287.3    (1) work to streamline delivery and regional access to services;287.4    (2) share strategies and resources for the management of out-of-home placements;287.5    (3) establish standard protocols and operating procedures for functions that are 287.6performed across all counties;287.7    (4) share information to improve resource allocation and service delivery across 287.8counties;287.9    (5) evaluate outcomes of various treatment alternatives;287.10    (6) create a network for and provide support to service delivery groups;287.11    (7) establish a regional process to match children in need of out-of-home placement 287.12with foster homes that can meet their needs; and287.13    (8) recruit and retain foster homes.287.14    Subd. 3.Director's Council.The Director's Council shall govern the operations of 287.15the Regional Children's Mental Health Initiative. Members of the Director's Council shall 287.16represent each of the 11 counties participating in the pilot project.287.17    Subd. 4.Regional Children's Mental Health Initiative Team.The members 287.18of the Regional Children's Mental Health Initiative Team shall conduct planning and 287.19development of new and modified children's mental health programs and services in the 287.20region. Members of the team shall reflect the cultural, demographic, and geographic 287.21diversity of the region and shall be composed of representatives from each of the 287.22following:287.23    (1) the medical community;287.24    (2) human services;287.25    (3) corrections;287.26    (4) education;287.27    (5) mental health providers and vendors;287.28    (6) advocacy organizations;287.29    (7) parents; and287.30    (8) children and youth.287.31    Subd. 5.Authority.The regional children's mental health initiative shall have the 287.32authority to develop and implement the following programs:287.33    (1) Flexible funding payments. This program will make funds available to respond to 287.34the unique and unpredictable needs of children with mental health issues such as the need 287.35for prescription drugs, transportation, clothing, and assessments not otherwise available.288.1    (2) Transition to self-sufficiency. This program will help youths between the ages of 288.214 and 21 establish professional relationships, find jobs, build financial foundations, and 288.3learn to fulfill their roles as productive citizens.288.4    (3) Crisis response. This program will establish public and private partnerships 288.5to offer a range of options to meet the needs of children in crisis. Methods to meet 288.6these needs may include accessible local services, holistic assessments, urgent care and 288.7stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.288.8    (4) Integrated services for complex conditions. This program will design, develop, 288.9and implement packages of integrated services to meet the needs of children with specific, 288.10complex conditions.288.11    Subd. 6.Evaluation and report.The regional children's mental health initiative 288.12shall develop a method for evaluating the effectiveness of this pilot project focusing on 288.13identifiable goals and outcomes. An interim report on the pilot project's effectiveness 288.14shall be submitted to the house and senate finance committees having jurisdiction over 288.15mental health, the commissioner of human services, and the Minnesota Association of 288.16County Social Service Administrators no later than December 31, 2008. A final report 288.17is due no later than December 31, 2009.288.18    Sec. 22. TRAUMA-FOCUSED EVIDENCE-BASED PRACTICES TO 288.19CHILDREN.288.20    Organizations that are certified to provide children's therapeutic services and 288.21supports under Minnesota Statutes, section 256B.0943, are eligible to apply for a grant. 288.22Grants are to be used to provide trauma-focused evidence-based practices to children 288.23who are living in a battered women's shelter, homeless shelter, transitional housing, or 288.24supported housing. Children served must have been exposed to or witnessed domestic 288.25violence, have been exposed to or witnessed community violence, or be a refugee. Priority 288.26shall be given to organizations that demonstrate collaboration with battered women's 288.27shelters, homeless shelters, or providers of transitional housing or supported housing. The 288.28commissioner shall specify which constitutes evidence-based practice. Organizations shall 288.29use all available funding streams.288.30    Sec. 23. DUAL DIAGNOSIS; DEMONSTRATION PROJECT.288.31    (a) The commissioner of human services shall fund demonstration projects for high 288.32risk adults with serious mental illness and co-occurring substance abuse problems. The 288.33projects must include, but not be limited to, the following:289.1    (1) housing services, including rent or housing subsidies, housing with clinical 289.2staff, or housing support;289.3    (2) assertive outreach services; and289.4    (3) intensive direct therapeutic, rehabilitative, and care management services 289.5oriented to harm reduction.289.6    (b) The commissioner shall work with providers to ensure proper licensure or 289.7certification to meet medical assistance or third-party payor reimbursement requirements.289.8    Sec. 24. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S 289.9MENTAL HEALTH PILOT PROJECT.289.10    Subdivision 1.Pilot project authorized.The commissioner of human services 289.11shall fund a three-year pilot project to measure the effect of children's identified mental 289.12health needs, including social and emotional needs, on Minnesota family investment 289.13program (MFIP) participants' ability to obtain and retain employment. The project shall 289.14also measure the effect on work activity of MFIP participants' needs to address their 289.15children's identified mental health needs.289.16    Subd. 2.Provider and agency proposals.(a) Interested MFIP providers and 289.17agencies shall: 289.18    (1) submit proposals defining how they will identify participants whose children 289.19have mental health needs that hinder the employment process; 289.20    (2) connect families with appropriate developmental, social, and emotional 289.21screenings and services; and 289.22    (3) incorporate those services into the participant's employment plan.289.23Each proposal under this paragraph must include an evaluation component.289.24    (b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP 289.25participants of the following: 289.26    (1) the availability of developmental, social, and emotional screening tools for 289.27children and youth; 289.28    (2) the purpose of the screenings; 289.29    (3) how the information will be used to assist the participants in identifying and 289.30addressing potential barriers to employment; and 289.31    (4) that their employment plan may be modified based on the screening results.289.32    Subd. 3.Program components.(a) MFIP providers shall obtain the participant's 289.33written consent for participation in the pilot project, including consent for developmental, 289.34social, and emotional screening.290.1    (b) MFIP providers shall coordinate with county social service agencies and health 290.2plans to assist recipients in arranging referrals indicated by the screening results.290.3    (c) Tools used for developmental, social, and emotional screenings shall be approved 290.4by the commissioner of human services.290.5    Subd. 4.Program evaluation.The commissioner of human services shall conduct 290.6an evaluation of the pilot project to determine:290.7    (1) the number of participants who took part in the screening;290.8    (2) the number of children who were screened and what screening tools were used;290.9    (3) the number of children who were identified in the screening who needed referral 290.10or follow-up services;290.11    (4) the number of children who received services, what agency provided the services, 290.12and what type of services were provided;290.13    (5) the number of employment plans that were adjusted to include the activities 290.14recommended in the screenings;290.15    (6) the changes in work participation rates;290.16    (7) the changes in earned income;290.17    (8) the changes in sanction rates; and290.18    (9) the participants' report of program effectiveness.290.19    Subd. 5.Work activity.Participant involvement in screenings and subsequent 290.20referral and follow-up services shall count as work activity under Minnesota Statutes, 290.21section 256J.49, subdivision 13.290.22    Sec. 25. SOCIAL AND ECONOMIC COSTS OF GAMBLING.290.23    Subdivision 1.Report.The commissioner of human services, in consultation with 290.24the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed 290.25vendors, shall prepare a report that provides a process and funding mechanism to study the 290.26issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate 290.27of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall 290.28include in the report potential financial commitments made by stakeholders and others in 290.29order to fund the study. The report is due to the legislative committees having jurisdiction 290.30over compulsive gambling issues by December 1, 2007. 290.31    Subd. 2.Issues to be addressed.The study must address:290.32    (1) state, local, and tribal government policies and practices in Minnesota to legalize 290.33or prohibit gambling;290.34    (2) the relationship between gambling and crime in Minnesota, including: (i) the 290.35relationship between gambling and overall crime rates; (ii) the relationship between 291.1gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child 291.2neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement 291.3and regulation practices that are intended to address the relationship between gambling 291.4and levels of crime;291.5    (3) the relationship between expanded gambling and increased rates of problem 291.6gambling in Minnesota, including the impact of pathological or problem gambling on 291.7individuals, families, businesses, social institutions, and the economy;291.8    (4) the social impact of gambling on individuals, families, businesses, and social 291.9institutions in Minnesota, including an analysis of the relationship between gambling and 291.10depression, abuse, divorce, homelessness, suicide, and bankruptcy;291.11    (5) the economic impact of gambling on state, local, and tribal economies in 291.12Minnesota; and291.13    (6) any other issues deemed necessary in assessing the social and economic impact 291.14of gambling in Minnesota.291.15    Subd. 3.Quantification of social and economic impact.The study shall quantify 291.16the social and economic impact on both (1) state, local, and tribal governments in 291.17Minnesota, and (2) Minnesota's communities and social institutions, including individuals, 291.18families, and businesses within those communities and institutions.291.19    Sec. 26.  REPEALER.291.20Minnesota Rules, part 9585.0030, is repealed.291.21ARTICLE 6291.22DEPARTMENT OF HEALTH291.23    Section 1. Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:291.24    Subd. 2. Definitions. For purposes of this section, the terms defined in this 291.25subdivision have the meanings given.291.26    (a) "Access" means the financial, temporal, and geographic availability of health 291.27care to individuals who need it.291.28    (b)(a) "Capital expenditure" means an expenditure which, under generally accepted 291.29accounting principles, is not properly chargeable as an expense of operation and 291.30maintenance.291.31    (c) "Cost" means the amount paid by consumers or third party payers for health 291.32care services or products.291.33    (d) "Date of the major spending commitment" means the date the provider formally 291.34obligated itself to the major spending commitment. The obligation may be incurred 292.1by entering into a contract, making a down payment, issuing bonds or entering a loan 292.2agreement to provide financing for the major spending commitment, or taking some other 292.3formal, tangible action evidencing the provider's intention to make the major spending 292.4commitment.292.5    (e)(b) "Health care service" means:292.6    (1) a service or item that would be covered by the medical assistance program 292.7under chapter 256B if provided in accordance with medical assistance requirements to an 292.8eligible medical assistance recipient; and292.9    (2) a service or item that would be covered by medical assistance except that it is 292.10characterized as experimental, cosmetic, or voluntary.292.11    "Health care service" does not include retail, over-the-counter sales of 292.12nonprescription drugs and other retail sales of health-related products that are not generally 292.13paid for by medical assistance and other third-party coverage.292.14    (f)(c) "Major spending commitment" means an expenditure in excess of $1,000,000 292.15for:292.16    (1) acquisition of a unit of medical equipment;292.17    (2) a capital expenditure for a single project for the purposes of providing health 292.18care services, other than for the acquisition of medical equipment;292.19    (3) offering a new specialized service not offered before;292.20    (4) planning for an activity that would qualify as a major spending commitment 292.21under this paragraph; or292.22    (5) a project involving a combination of two or more of the activities in clauses 292.23(1) to (4).292.24    The cost of acquisition of medical equipment, and the amount of a capital 292.25expenditure, is the total cost to the provider regardless of whether the cost is distributed 292.26over time through a lease arrangement or other financing or payment mechanism.292.27    (g)(d) "Medical equipment" means fixed and movable equipment that is used by 292.28a provider in the provision of a health care service. "Medical equipment" includes, but 292.29is not limited to, the following:292.30    (1) an extracorporeal shock wave lithotripter;292.31    (2) a computerized axial tomography (CAT) scanner;292.32    (3) a magnetic resonance imaging (MRI) unit;292.33    (4) a positron emission tomography (PET) scanner; and292.34    (5) emergency and nonemergency medical transportation equipment and vehicles.293.1    (h)(e) "New specialized service" means a specialized health care procedure or 293.2treatment regimen offered by a provider that was not previously offered by the provider, 293.3including, but not limited to:293.4    (1) cardiac catheterization services involving high-risk patients as defined in the 293.5Guidelines for Coronary Angiography established by the American Heart Association 293.6and the American College of Cardiology;293.7    (2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or 293.8any other service for transplantation of any other organ;293.9    (3) megavoltage radiation therapy;293.10    (4) open heart surgery;293.11    (5) neonatal intensive care services; and293.12    (6) any new medical technology for which premarket approval has been granted by 293.13the United States Food and Drug Administration, excluding implantable and wearable 293.14devices.293.15    (f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic, 293.16obstetrics, mental health, chemical dependency, and emergency services.293.17    Sec. 2. Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:293.18    Subd. 4a. Expenditure reporting.(a) A provider making a major spending 293.19commitment after April 1, 1992, shall submit notification of the expenditure to the 293.20commissioner and provide the commissioner with any relevant background information.293.21    (b) Notification must include a report, submitted within 60 days after the date of the 293.22major spending commitment, using terms conforming to the definitions in section 62J.03293.23and this section. Each report is subject to retrospective review and must contain: 293.24    (1) a detailed description of the major spending commitment, including the specific 293.25dollar amount of each expenditure, and its purpose;293.26    (2) the date of the major spending commitment;293.27    (3) a statement of the expected impact that the major spending commitment will 293.28have on charges by the provider to patients and third party payers;293.29    (4) a statement of the expected impact on the clinical effectiveness or quality of care 293.30received by the patients that the provider expects to serve;293.31    (5) a statement of the extent to which equivalent services or technology are already 293.32available to the provider's actual and potential patient population;293.33    (6) a statement of the distance from which the nearest equivalent services or 293.34technology are already available to the provider's actual and potential population;293.35    (7) a statement describing the pursuit of any lawful collaborative arrangements; and294.1    (8) a statement of assurance that the provider will not use, purchase, or perform 294.2health care technologies and procedures that are not clinically effective and cost-effective, 294.3unless the technology is used for experimental or research purposes to determine whether 294.4a technology or procedure is clinically effective and cost-effective.294.5    The provider may submit any additional information that it deems relevant.294.6    (c) The commissioner may request additional information from a provider for the 294.7purpose of review of a report submitted by that provider, and may consider relevant 294.8information from other sources. A provider shall provide any information requested by 294.9the commissioner within the time period stated in the request, or within 30 days after the 294.10date of the request if the request does not state a time.294.11    (d) If the provider fails to submit a complete and timely expenditure report, including 294.12any additional information requested by the commissioner, the commissioner may make 294.13the provider's subsequent major spending commitments subject to the procedures of 294.14prospective review and approval under subdivision 6a.294.15    Each hospital, outpatient surgical center, diagnostic imaging center, and physician 294.16clinic shall report annually to the commissioner on all major spending commitments, 294.17in the form and manner specified by the commissioner. The report shall include the 294.18following information:294.19    (a) a description of major spending commitments made during the previous year, 294.20including the total dollar amount of major spending commitments and purpose of the 294.21expenditures;294.22    (b) the cost of land acquisition, construction of new facilities, and renovation of 294.23existing facilities;294.24    (c) the cost of purchased or leased medical equipment, by type of equipment;294.25    (d) expenditures by type for specialty care and new specialized services;294.26    (e) information on the amount and types of added capacity for diagnostic imaging 294.27services, outpatient surgical services, and new specialized services; and294.28    (f) information on investments in electronic medical records systems.294.29For hospitals and outpatient surgical centers, this information shall be included in reports 294.30to the commissioner that are required under section 144.698. For diagnostic imaging 294.31centers, this information shall be included in reports to the commissioner that are required 294.32under section 144.565. For physician clinics, this information shall be included in reports 294.33to the commissioner that are required under section 62J.41. For all other health care 294.34providers that are subject to this reporting requirement, reports must be submitted to the 294.35commissioner by March 1 each year for the preceding calendar year.295.1    Sec. 3. Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:295.2    Subd. 7. Exceptions. (a) The retrospective review process as described in 295.3subdivision 5a and the prospective review and approval process as described in subdivision 295.46a reporting requirement in subdivision 4adodoes not apply to:295.5    (1) a major spending commitment to replace existing equipment with comparable 295.6equipment used for direct patient care, upgrades of equipment beyond the current model, 295.7or comparable model must be reported;295.8    (2) (1) a major spending commitment made by a research and teaching institution 295.9for purposes of conducting medical education, medical research supported or sponsored 295.10by a medical school, or by a federal or foundation grant or clinical trials;295.11    (3) a major spending commitment to repair, remodel, or replace existing buildings or 295.12fixtures if, in the judgment of the commissioner, the project does not involve a substantial 295.13expansion of service capacity or a substantial change in the nature of health care services 295.14provided;295.15    (4) (2) a major spending commitment for building maintenance including heating, 295.16water, electricity, and other maintenance-related expenditures; and295.17    (5) (3) a major spending commitment for activities, not directly related to the 295.18delivery of patient care services, including food service, laundry, housekeeping, and 295.19other service-related activities; and.295.20    (6) a major spending commitment for computer equipment or data systems not 295.21directly related to the delivery of patient care services, including computer equipment or 295.22data systems related to medical record automation.295.23    (b) In addition to the exceptions listed in paragraph (a), the prospective review and 295.24approval process described in subdivision 6a reporting requirement in subdivision 4a does 295.25not apply to mergers, acquisitions, and other changes in ownership or control that, in the 295.26judgment of the commissioner, do not involve a substantial expansion of service capacity 295.27or a substantial change in the nature of health care services provided.295.28    Sec. 4. Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:295.29    Subdivision 1. Cost containment data to be collected from providers. The 295.30commissioner shall require health care providers to collect and provide both patient 295.31specific information and descriptive and financial aggregate data on:295.32    (1) the total number of patients served;295.33    (2) the total number of patients served by state of residence and Minnesota county;295.34    (3) the site or sites where the health care provider provides services;296.1    (4) the number of individuals employed, by type of employee, by the health care 296.2provider;296.3    (5) the services and their costs for which no payment was received;296.4    (6) total revenue by type of payer or by groups of payers, including but not limited 296.5to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service 296.6plan corporations, commercial insurers, health maintenance organizations, and individual 296.7patients;296.8    (7) revenue from research activities;296.9    (8) revenue from educational activities;296.10    (9) revenue from out-of-pocket payments by patients;296.11    (10) revenue from donations; and296.12    (11) a report on health care capital expenditures during the previous year, as required 296.13by section 62J.17; and296.14    (11) (12) any other data required by the commissioner, including data in 296.15unaggregated form, for the purposes of developing spending estimates, setting spending 296.16limits, monitoring actual spending, and monitoring costs.296.17The commissioner may, by rule, modify the data submission categories listed above if the 296.18commissioner determines that this will reduce the reporting burden on providers without 296.19having a significant negative effect on necessary data collection efforts.296.20    Sec. 5. Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:296.21    Subdivision 1. Uniform billing form CMS 1450. (a) On and after January 1, 296.221996, all institutional inpatient hospital services, ancillary services, institutionally owned 296.23or operated outpatient services rendered by providers in Minnesota, and institutional 296.24or noninstitutional home health services that are not being billed using an equivalent 296.25electronic billing format, must be billed using the uniform billing form CMS 1450, except 296.26as provided in subdivision 5.296.27    (b) The instructions and definitions for the use of the uniform billing form CMS 296.281450 shall be in accordance with the uniform billing form manual specified by the 296.29commissioner. In promulgating these instructions, the commissioner may utilize the 296.30manual developed by the National Uniform Billing Committee, as adopted and finalized 296.31by the Minnesota Uniform Billing Committee.296.32    (c) Services to be billed using the uniform billing form CMS 1450 include: 296.33institutional inpatient hospital services and distinct units in the hospital such as psychiatric 296.34unit services, physical therapy unit services, swing bed (SNF) services, inpatient state 296.35psychiatric hospital services, inpatient skilled nursing facility services, home health 297.1services (Medicare part A), and hospice services; ancillary services, where benefits are 297.2exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals, 297.3skilled nursing facilities, and home health (Medicare part B); institutional owned or 297.4operated outpatient services such as waivered services, hospital outpatient services, 297.5including ambulatory surgical center services, hospital referred laboratory services, 297.6hospital-based ambulance services, and other hospital outpatient services, skilled nursing 297.7facilities, home health, freestanding renal dialysis centers, comprehensive outpatient 297.8rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health 297.9clinics, and community mental health centers; home health services such as home health 297.10intravenous therapy providers, waivered services, personal care attendants, and hospice; 297.11and any other health care provider certified by the Medicare program to use this form.297.12    (d) On and after January 1, 1996, a mother and newborn child must be billed 297.13separately, and must not be combined on one claim form.297.14    (e) Services provided by Medicare Critical Access Hospitals electing Method 297.15II billing will be allowed an exception to this provision to allow the inclusion of the 297.16professional fees on the CMS 1450.297.17    Sec. 6. Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:297.18    Subd. 2. Uniform billing form CMS 1500. (a) On and after January 1, 1996, all 297.19noninstitutional health care services rendered by providers in Minnesota except dental 297.20or pharmacy providers, that are not currently being billed using an equivalent electronic 297.21billing format, must be billed using the health insurance claim form CMS 1500, except as 297.22provided in subdivision 5.297.23    (b) The instructions and definitions for the use of the uniform billing form CMS 297.241500 shall be in accordance with the manual developed by the Administrative Uniformity 297.25Committee entitled standards for the use of the CMS 1500 form, dated February 1994, 297.26as further defined by the commissioner.297.27    (c) Services to be billed using the uniform billing form CMS 1500 include physician 297.28services and supplies, durable medical equipment, noninstitutional ambulance services, 297.29independent ancillary services including occupational therapy, physical therapy, speech 297.30therapy and audiology, home infusion therapy, podiatry services, optometry services, 297.31mental health licensed professional services, substance abuse licensed professional 297.32services, nursing practitioner professional services, certified registered nurse anesthetists, 297.33chiropractors, physician assistants, laboratories, medical suppliers, and other health care 297.34providers such as day activity centers and freestanding ambulatory surgical centers.298.1    (d) Services provided by Medicare Critical Access Hospitals electing Method 298.2II billing will be allowed an exception to this provision to allow the inclusion of the 298.3professional fees on the CMS 1450.298.4    Sec. 7. Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:298.5    Subd. 2. General characteristics. (a) The Minnesota uniform health care 298.6identification card must be a preprinted card constructed of plastic, paper, or any other 298.7medium that conforms with ANSI and ISO 7810 physical characteristics standards. The 298.8card dimensions must also conform to ANSI and ISO 7810 physical characteristics 298.9standard. The use of a signature panel is optional. The uniform prescription drug 298.10information contained on the card must conform with the format adopted by the NCPDP 298.11and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of 298.12the fields required to submit a claim in conformance with the most recent pharmacy 298.13identification card implementation guide produced by the NCPDP. All information 298.14required to submit a prescription drug claim, exclusive of information provided on a 298.15prescription that is required by law, must be included on the card in a clear, readable, and 298.16understandable manner. If a health benefit plan requires a conditional or situational field, 298.17as defined by the NCPDP, the conditional or situational field must conform to the most 298.18recent pharmacy information card implementation guide produced by the NCPDP.298.19    (b) The Minnesota uniform health care identification card must have an essential 298.20information window on the front side with the following data elements: card issuer name, 298.21electronic transaction routing information, card issuer identification number, cardholder 298.22(insured) identification number, and cardholder (insured) identification name. No optional 298.23data may be interspersed between these data elements. 298.24    (c) Standardized labels are required next to human readable data elements and 298.25must come before the human data elements.298.26    Sec. 8. Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:298.27    Subd. 3. Human readable data elements. (a) The following are the minimum 298.28human readable data elements that must be present on the front side of the Minnesota 298.29uniform health care identification card:298.30    (1) card issuer name or logo, which is the name or logo that identifies the card issuer. 298.31The card issuer name or logo may be located at the top of the card. No standard label 298.32is required for this data element;298.33    (2) complete electronic transaction routing information including, at a minimum, 298.34the international identification number. The standardized label of this data element 299.1is "RxBIN." Processor control numbers and group numbers are required if needed to 299.2electronically process a prescription drug claim. The standardized label for the process 299.3control numbers data element is "RxPCN" and the standardized label for the group 299.4numbers data element is "RxGrp," except that if the group number data element is a 299.5universal element to be used by all health care providers, the standardized label may be 299.6"Grp." To conserve vertical space on the card, the international identification number and 299.7the processor control number may be printed on the same line;299.8     (3) cardholder (insured) identification number, which is the unique identification 299.9number of the individual card holder established and defined under this section. The 299.10standardized label for the data element is "ID";299.11    (4) cardholder (insured) identification name, which is the name of the individual 299.12card holder. The identification name must be formatted as follows: first name, space, 299.13optional middle initial, space, last name, optional space and name suffix. The standardized 299.14label for this data element is "Name";299.15    (5) care type, which is the description of the group purchaser's plan product under 299.16which the beneficiary is covered. The description shall include the health plan company 299.17name and the plan or product name. The standardized label for this data element is 299.18"Care Type";299.19    (6) service type, which is the description of coverage provided such as hospital, 299.20dental, vision, prescription, or mental health. The standard label for this data element 299.21is "Svc Type"; and299.22    (7) provider/clinic name, which is the name of the primary care clinic the card 299.23holder is assigned to by the health plan company. The standard label for this field is 299.24"PCP." This information is mandatory only if the health plan company assigns a specific 299.25primary care provider to the card holder.299.26    (b) The following human readable data elements shall be present on the back side 299.27of the Minnesota uniform health care identification card. These elements must be left 299.28justified, and no optional data elements may be interspersed between them:299.29    (1) claims submission names and addresses, which are the names and addresses of 299.30the entity or entities to which claims should be submitted. If different destinations are 299.31required for different types of claims, this must be labeled;299.32    (2) telephone numbers and names that pharmacies and other health care providers 299.33may call for assistance. These telephone numbers and names are required on the back 299.34side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies 299.35or other providers with assistance or with the telephone numbers and names of contacts 299.36for assistance; and300.1    (3) telephone numbers and names; which are the telephone numbers and names of the 300.2following contacts with a standardized label describing the service function as applicable:300.3    (i) eligibility and benefit information;300.4    (ii) utilization review;300.5    (iii) precertification; or300.6    (iv) customer services.300.7    (c) The following human readable data elements are mandatory on the back 300.8side of the Minnesota uniform health care identification card for health maintenance 300.9organizations:300.10    (1) emergency care authorization telephone number or instruction on how to receive 300.11authorization for emergency care. There is no standard label required for this information; 300.12and300.13    (2) one of the following:300.14    (i) telephone number to call to appeal to or file a complaint with the commissioner of 300.15health; or300.16    (ii) for persons enrolled under section 
         256B.69, 
         256D.03, or 
         256L.12, the telephone 300.17number to call to file a complaint with the ombudsperson designated by the commissioner 300.18of human services under section 
         256B.69 and the address to appeal to the commissioner of 300.19human services. There is no standard label required for this information. 300.20    (d) All human readable data elements not required under paragraphs (a) to (c) are 300.21optional and may be used at the issuer's discretion.300.22    Sec. 9. Minnesota Statutes 2006, section 62Q.80, is amended by adding a subdivision 300.23to read:300.24    Subd. 1a.Demonstration project.The commissioner of health shall award a 300.25demonstration project grant to a community-based health care initiative to develop and 300.26operate a community-based health care coverage program to operate within Carlton, 300.27Cook, Lake, and St. Louis Counties. The demonstration project shall extend for five years 300.28and must comply with all the requirements of this section.300.29    Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:300.30    Subd. 3. Approval.  (a) Prior to the operation of a community-based health care 300.31coverage program, a community-based health initiative shall submit to the commissioner 300.32of health for approval the community-based health care coverage program developed by 300.33the initiative. The commissioner shall only approve a program that has been awarded 300.34a community access program grant from the United States Department of Health and 301.1Human Services. The commissioner shall ensure that the program meets the federal grant 301.2requirements and any requirements described in this section and is actuarially sound based 301.3on a review of appropriate records and methods utilized by the community-based health 301.4initiative in establishing premium rates for the community-based health care coverage 301.5program. 301.6    (b) Prior to approval, the commissioner shall also ensure that:301.7    (1) the benefits offered comply with subdivision 8 and that there are adequate 301.8numbers of health care providers participating in the community-based health network to 301.9deliver the benefits offered under the program;301.10    (2) the activities of the program are limited to activities that are exempt under this 301.11section or otherwise from regulation by the commissioner of commerce;301.12    (3) the complaint resolution process meets the requirements of subdivision 10; and 301.13    (4) the data privacy policies and procedures comply with state and federal law.301.14    Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:301.15    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval 301.16by the commissioner of health a community-based health care coverage program. The 301.17operational structure established by the initiative shall include, but is not limited to: 301.18    (1) establishing a process for enrolling eligible individuals and their dependents; 301.19    (2) collecting and coordinating premiums from enrollees and employers of enrollees;301.20    (3) providing payment to participating providers; 301.21    (4) establishing a benefit set according to subdivision 8 and establishing premium 301.22rates and cost-sharing requirements; 301.23    (5) creating incentives to encourage primary care and wellness services; and 301.24    (6) initiating disease management services, as appropriate. 301.25    (b) The payments collected under paragraph (a), clause (2), may be used to capture 301.26available federal funds.301.27    Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:301.28    Subd. 13. Report.  (a) The initiative shall submit quarterly status reports to the 301.29commissioner of health on January 15, April 15, July 15, and October 15 of each year, 301.30with the first report due January 15, 2007 2008. The status report shall include:301.31    (1) the financial status of the program, including the premium rates, cost per member 301.32per month, claims paid out, premiums received, and administrative expenses; 301.33    (2) a description of the health care benefits offered and the services utilized; 302.1    (3) the number of employers participating, the number of employees and dependents 302.2covered under the program, and the number of health care providers participating; 302.3    (4) a description of the health outcomes to be achieved by the program and a status 302.4report on the performance measurements to be used and collected; and 302.5    (5) any other information requested by the commissioner of health or commerce or 302.6the legislature. 302.7    (b) The initiative shall contract with an independent entity to conduct an evaluation 302.8of the program to be submitted to the commissioners of health and commerce and the 302.9legislature by January 15, 2009 2010. The evaluation shall include:302.10    (1) an analysis of the health outcomes established by the initiative and the 302.11performance measurements to determine whether the outcomes are being achieved;302.12    (2) an analysis of the financial status of the program, including the claims to 302.13premiums loss ratio and utilization and cost experience; 302.14    (3) the demographics of the enrollees, including their age, gender, family income, 302.15and the number of dependents; 302.16    (4) the number of employers and employees who have been denied access to the 302.17program and the basis for the denial; 302.18    (5) specific analysis on enrollees who have aggregate medical claims totaling over 302.19$5,000 per year, including data on the enrollee's main diagnosis and whether all the 302.20medical claims were covered by the program; 302.21    (6) number of enrollees referred to state public assistance programs; 302.22    (7) a comparison of employer-subsidized health coverage provided in a comparable 302.23geographic area to the designated community-based geographic area served by the 302.24program, including, to the extent available: 302.25    (i) the difference in the number of employers with 50 or fewer employees offering 302.26employer-subsidized health coverage; 302.27    (ii) the difference in uncompensated care being provided in each area; and302.28    (iii) a comparison of health care outcomes and measurements established by the 302.29initiative; and 302.30    (8) any other information requested by the commissioner of health or commerce.302.31    Sec. 13. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:302.32    Subd. 14. Sunset. This section expires December 31, 2011 2012.302.33    Sec. 14. [144.291] MINNESOTA HEALTH RECORDS ACT.303.1    Subdivision 1.Short title.Sections 144.291 to 144.298 may be cited as the 303.2Minnesota Health Records Act.303.3    Subd. 2.Definitions.For the purposes of sections 144.291 to 144.298, the following 303.4terms have the meanings given.303.5    (a) Affiliate. "Affiliate" has the meaning given in section 144.6521, subdivision 3, 303.6paragraph (b).303.7    (b) Group purchaser. "Group purchaser" has the meaning given in section 62J.03, 303.8subdivision 6.303.9    (c) Health record. "Health record" means any information, whether oral or recorded 303.10in any form or medium, that relates to the past, present, or future physical or mental health 303.11or condition of a patient; the provision of health care to a patient; or the past, present, or 303.12future payment for the provision of health care to a patient.303.13    (d) Identifying information. "Identifying information" means the patient's name, 303.14address, date of birth, gender, parent's or guardian's name regardless of the age of the 303.15patient, and other nonclinical data which can be used to uniquely identify a patient.303.16    (e) Individually identifiable form. "Individually identifiable form" means a form in 303.17which the patient is or can be identified as the subject of the health records.303.18    (f) Medical emergency. "Medical emergency" means medically necessary care 303.19which is immediately needed to preserve life, prevent serious impairment to bodily 303.20functions, organs, or parts, or prevent placing the physical or mental health of the patient 303.21in serious jeopardy.303.22    (g) Patient. "Patient" means a natural person who has received health care services 303.23from a provider for treatment or examination of a medical, psychiatric, or mental 303.24condition, the surviving spouse and parents of a deceased patient, or a person the patient 303.25appoints in writing as a representative, including a health care agent acting according to 303.26chapter 145C, unless the authority of the agent has been limited by the principal in the 303.27principal's health care directive. Except for minors who have received health care services 303.28under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or 303.29guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.303.30    (h) Provider. "Provider" means: 303.31    (1) any person who furnishes health care services and is regulated to furnish the 303.32services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A, 303.33151, 153, or 153A; 303.34    (2) a home care provider licensed under section 144A.46; 303.35    (3) a health care facility licensed under this chapter or chapter 144A; 303.36    (4) a physician assistant registered under chapter 147A; and 304.1    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to 304.2148B.71.304.3    (i) Record locator service. "Record locator service" means an electronic index of 304.4patient identifying information that directs providers in a health information exchange to 304.5the location of patient health records held by providers and group purchasers.304.6    (j) Related health care entity. "Related health care entity" means an affiliate of 304.7the provider releasing the health records.304.8    Sec. 15. [144.292] PATIENT RIGHTS.304.9    Subdivision 1.Scope.Patients have the rights specified in this section regarding the 304.10treatment the patient receives and the patient's health record.304.11    Subd. 2.Patient access.Upon request, a provider shall supply to a patient complete 304.12and current information possessed by that provider concerning any diagnosis, treatment, 304.13and prognosis of the patient in terms and language the patient can reasonably be expected 304.14to understand.304.15    Subd. 3.Additional patient rights.A patient's right specified in this section and 304.16sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and 304.17144.652 and any other provision of law relating to the access of a patient to the patient's 304.18health records.304.19    Subd. 4.Notice of rights; information on release.A provider shall provide to 304.20patients, in a clear and conspicuous manner, a written notice concerning practices and 304.21rights with respect to access to health records. The notice must include an explanation of:304.22    (1) disclosures of health records that may be made without the written consent of the 304.23patient, including the type of records and to whom the records may be disclosed; and304.24    (2) the right of the patient to have access to and obtain copies of the patient's health 304.25records and other information about the patient that is maintained by the provider.304.26    The notice requirements of this subdivision are satisfied if the notice is included with 304.27the notice and copy of the patient and resident bill of rights under section 144.652 or if it 304.28is displayed prominently in the provider's place of business. The commissioner of health 304.29shall develop the notice required in this subdivision and publish it in the State Register.304.30    Subd. 5.Copies of health records to patients.Except as provided in section 304.31144.296, upon a patient's written request, a provider, at a reasonable cost to the patient, 304.32shall promptly furnish to the patient:304.33    (1) copies of the patient's health record, including but not limited to laboratory 304.34reports, x-rays, prescriptions, and other technical information used in assessing the 304.35patient's health conditions; or305.1    (2) the pertinent portion of the record relating to a condition specified by the patient.305.2    With the consent of the patient, the provider may instead furnish only a summary 305.3of the record. The provider may exclude from the health record written speculations 305.4about the patient's health condition, except that all information necessary for the patient's 305.5informed consent must be provided.305.6    Subd. 6.Cost.(a) When a patient requests a copy of the patient's record for 305.7purposes of reviewing current medical care, the provider must not charge a fee.305.8    (b) When a provider or its representative makes copies of patient records upon a 305.9patient's request under this section, the provider or its representative may charge the 305.10patient or the patient's representative no more than 75 cents per page, plus $10 for time 305.11spent retrieving and copying the records, unless other law or a rule or contract provide for 305.12a lower maximum charge. This limitation does not apply to x-rays. The provider may 305.13charge a patient no more than the actual cost of reproducing x-rays, plus no more than 305.14$10 for the time spent retrieving and copying the x-rays.305.15    (c) The respective maximum charges of 75 cents per page and $10 for time provided 305.16in this subdivision are in effect for calendar year 1992 and may be adjusted annually each 305.17calendar year as provided in this subdivision. The permissible maximum charges shall 305.18change each year by an amount that reflects the change, as compared to the previous year, 305.19in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U), 305.20published by the Department of Labor.305.21    (d) A provider or its representative must not charge a fee to provide copies of records 305.22requested by a patient or the patient's authorized representative if the request for copies 305.23of records is for purposes of appealing a denial of Social Security disability income or 305.24Social Security disability benefits under title II or title XVI of the Social Security Act. For 305.25the purpose of further appeals, a patient may receive no more than two medical record 305.26updates without charge, but only for medical record information previously not provided. 305.27For purposes of this paragraph, a patient's authorized representative does not include units 305.28of state government engaged in the adjudication of Social Security disability claims.305.29    Subd. 7.Withholding health records from patient.(a) If a provider reasonably 305.30determines that the information is detrimental to the physical or mental health of the 305.31patient, or is likely to cause the patient to inflict self harm, or to harm another, the provider 305.32may withhold the information from the patient and may supply the information to an 305.33appropriate third party or to another provider. The other provider or third party may 305.34release the information to the patient.306.1    (b) A provider shall release information upon written request unless, prior to the 306.2request, a provider has designated and described a specific basis for withholding the 306.3information as authorized by paragraph (a).306.4    Sec. 16. [144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.306.5    Subdivision 1.Release or disclosure of health records.Health records can be 306.6released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.306.7    Subd. 2.Patient consent to release of records.A provider, or a person who 306.8receives health records from a provider, may not release a patient's health records to a 306.9person without:306.10    (1) a signed and dated consent from the patient or the patient's legally authorized 306.11representative authorizing the release;306.12    (2) specific authorization in law; or306.13    (3) a representation from a provider that the provider holds a consent from the 306.14patient.306.15    Subd. 3.Release from one provider to another.A patient's health record, 306.16including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical 306.17information used in assessing the patient's condition, or the pertinent portion of the record 306.18relating to a specific condition, or a summary of the record, shall promptly be furnished to 306.19another provider upon the written request of the patient. The written request shall specify 306.20the name of the provider to whom the health record is to be furnished. The provider who 306.21furnishes the health record or summary may retain a copy of the materials furnished. The 306.22patient shall be responsible for the reasonable costs of furnishing the information.306.23    Subd. 4.Duration of consent.Except as provided in this section, a consent is 306.24valid for one year or for a lesser period specified in the consent or for a different period 306.25provided by law.306.26    Subd. 5.Exceptions to consent requirement.This section does not prohibit the 306.27release of health records:306.28    (1) for a medical emergency when the provider is unable to obtain the patient's 306.29consent due to the patient's condition or the nature of the medical emergency;306.30    (2) to other providers within related health care entities when necessary for the 306.31current treatment of the patient; or306.32    (3) to a health care facility licensed by this chapter, chapter 144A, or to the same 306.33types of health care facilities licensed by this chapter and chapter 144A that are licensed 306.34in another state when a patient:306.35    (i) is returning to the health care facility and unable to provide consent; or307.1    (ii) who resides in the health care facility, has services provided by an outside 307.2resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable 307.3to provide consent.307.4    Subd. 6.Consent does not expire.Notwithstanding subdivision 4, if a patient 307.5explicitly gives informed consent to the release of health records for the purposes and 307.6restrictions in clauses (1) and (2), the consent does not expire after one year for:307.7    (1) the release of health records to a provider who is being advised or consulted with 307.8in connection with the releasing provider's current treatment of the patient;307.9    (2) the release of health records to an accident and health insurer, health service plan 307.10corporation, health maintenance organization, or third-party administrator for purposes of 307.11payment of claims, fraud investigation, or quality of care review and studies, provided that:307.12    (i) the use or release of the records complies with sections 72A.49 to 72A.505;307.13    (ii) further use or release of the records in individually identifiable form to a person 307.14other than the patient without the patient's consent is prohibited; and307.15    (iii) the recipient establishes adequate safeguards to protect the records from 307.16unauthorized disclosure, including a procedure for removal or destruction of information 307.17that identifies the patient.307.18    Subd. 7.Exception to consent.Subdivision 2 does not apply to the release of health 307.19records to the commissioner of health or the Health Data Institute under chapter 62J, 307.20provided that the commissioner encrypts the patient identifier upon receipt of the data.307.21    Subd. 8.Record locator service.(a) A provider or group purchaser may send 307.22patient identifying information and information about the location of the patient's health 307.23records to a record locator service without consent from the patient. Except in the case of 307.24a medical emergency, a provider participating in a health information exchange using a 307.25record locator service cannot access patient identifying information and information 307.26about the location of the patient's health records until the patient has provided consent. 307.27The Minnesota Department of Health may not access the record locator service or receive 307.28data from the record locator service. Only a provider may access patient identifying 307.29information in a record locator service. The consent does not expire and may be revoked 307.30by the patient at any time by providing written notice of the revocation to the provider.307.31    (b) A health information exchange maintaining a record locator service or an entity 307.32maintaining a record locator service for a health information exchange must maintain an 307.33audit log of providers accessing information in a record locator service that minimally 307.34contains information on: 307.35    (1) the identity of the provider accessing the information; 307.36    (2) the identity of the patient whose information was accessed by the provider; and 308.1    (3) the date the information was accessed. 308.2    (c) No group purchaser may in any way require a provider to participate in any 308.3record locator service as a condition of payment or participation.308.4    (d) A record locator service must provide a mechanism for patients to opt out of 308.5including their identifying information and information about the location of their health 308.6records in a record locator service. At a minimum, any consent form that permits a 308.7provider to access a record locator service must include a check-box option that allows a 308.8patient to completely opt out of the record locator service which shall be clearly displayed 308.9to the patient. A provider participating in a health information exchange with a record 308.10locator service who receives a patient's request to completely opt out of the record locator 308.11service or to not have a specific provider contact in the record locator service shall be 308.12responsible for removing the patient's information from the record locator service.308.13    Subd. 9.Documentation of release.(a) In cases where a provider releases health 308.14records without patient consent as authorized by law, the release must be documented in 308.15the patient's health record. In the case of a release under section 144.294, subdivision 2, the 308.16documentation must include the date and circumstances under which the release was made, 308.17the person or agency to whom the release was made, and the records that were released.308.18    (b) When a health record is released using a representation from a provider that 308.19holds a consent from the patient, the releasing provider shall document: 308.20    (1) the provider requesting the health records; 308.21    (2) the identity of the patient;308.22    (3) the health records requested; and 308.23    (4) the date the health records were requested.308.24    Sec. 17. [144.294] RECORDS RELATING TO MENTAL HEALTH.308.25    Subdivision 1.Provider inquiry.Upon the written request of a spouse, parent, 308.26child, or sibling of a patient being evaluated for or diagnosed with mental illness, a 308.27provider shall inquire of a patient whether the patient wishes to authorize a specific 308.28individual to receive information regarding the patient's current and proposed course of 308.29treatment. If the patient so authorizes, the provider shall communicate to the designated 308.30individual the patient's current and proposed course of treatment. Section 144.293, 308.31subdivisions 2 and 4, apply to consents given under this subdivision.308.32    Subd. 2.Disclosure to law enforcement agency.Notwithstanding section 144.293, 308.33subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental 308.34health to a law enforcement agency if the law enforcement agency provides the name 308.35of the patient and communicates that the:309.1    (1) patient is currently involved in an emergency interaction with the law 309.2enforcement agency; and309.3    (2) disclosure of the records is necessary to protect the health or safety of the patient 309.4or of another person. 309.5    The scope of disclosure under this subdivision is limited to the minimum necessary 309.6for law enforcement to respond to the emergency. A law enforcement agency that obtains 309.7health records under this subdivision shall maintain a record of the requestor, the provider 309.8of the information, and the patient's name. Health records obtained by a law enforcement 309.9agency under this subdivision are private data on individuals as defined in section 13.02, 309.10subdivision 12, and must not be used by law enforcement for any other purpose.309.11    Subd. 3.Records release for family and caretaker; mental health care.(a) 309.12Notwithstanding section 144.293, a provider providing mental health care and treatment 309.13may disclose health record information described in paragraph (b) about a patient to a 309.14family member of the patient or other person who requests the information if:309.15    (1) the request for information is in writing;309.16    (2) the family member or other person lives with, provides care for, or is directly 309.17involved in monitoring the treatment of the patient;309.18    (3) the involvement under clause (2) is verified by the patient's mental health care 309.19provider, the patient's attending physician, or a person other than the person requesting the 309.20information, and is documented in the patient's medical record;309.21    (4) before the disclosure, the patient is informed in writing of the request, the name 309.22of the person requesting the information, the reason for the request, and the specific 309.23information being requested;309.24    (5) the patient agrees to the disclosure, does not object to the disclosure, or is 309.25unable to consent or object, and the patient's decision or inability to make a decision is 309.26documented in the patient's medical record; and309.27    (6) the disclosure is necessary to assist in the provision of care or monitoring of the 309.28patient's treatment. 309.29    (b) The information disclosed under this paragraph is limited to diagnosis, admission 309.30to or discharge from treatment, the name and dosage of the medications prescribed, side 309.31effects of the medication, consequences of failure of the patient to take the prescribed 309.32medication, and a summary of the discharge plan. 309.33    (c) If a provider reasonably determines that providing information under this 309.34subdivision would be detrimental to the physical or mental health of the patient or is 309.35likely to cause the patient to inflict self harm or to harm another, the provider must not 309.36disclose the information. 310.1    (d) This subdivision does not apply to disclosures for a medical emergency or 310.2to family members as authorized or required under subdivision 1 or section 144.293, 310.3subdivision 5, clause (1).310.4    Sec. 18. [144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL 310.5RESEARCH.310.6    Subdivision 1.Methods of release.(a) Notwithstanding section 144.293, 310.7subdivisions 2 and 4, health records may be released to an external researcher solely for 310.8purposes of medical or scientific research only as follows:310.9    (1) health records generated before January 1, 1997, may be released if the patient 310.10has not objected or does not elect to object after that date;310.11    (2) for health records generated on or after January 1, 1997, the provider must:310.12    (i) disclose in writing to patients currently being treated by the provider that health 310.13records, regardless of when generated, may be released and that the patient may object, in 310.14which case the records will not be released; and310.15    (ii) use reasonable efforts to obtain the patient's written general authorization that 310.16describes the release of records in item (i), which does not expire but may be revoked or 310.17limited in writing at any time by the patient or the patient's authorized representative; 310.18    (3) the provider must advise the patient of the rights specified in clause (4); and310.19    (4) the provider must, at the request of the patient, provide information on how the 310.20patient may contact an external researcher to whom the health record was released and 310.21the date it was released.310.22    (b) Authorization may be established if an authorization is mailed at least two 310.23times to the patient's last known address with a postage prepaid return envelope and a 310.24conspicuous notice that the patient's medical records may be released if the patient does 310.25not object, and at least 60 days have expired since the second notice was sent.310.26    Subd. 2.Duties of researcher.In making a release for research purposes, the 310.27provider shall make a reasonable effort to determine that:310.28    (1) the use or disclosure does not violate any limitations under which the record 310.29was collected;310.30    (2) the use or disclosure in individually identifiable form is necessary to accomplish 310.31the research or statistical purpose for which the use or disclosure is to be made;310.32    (3) the recipient has established and maintains adequate safeguards to protect the 310.33records from unauthorized disclosure, including a procedure for removal or destruction of 310.34information that identifies the patient; and311.1    (4) further use or release of the records in individually identifiable form to a person 311.2other than the patient without the patient's consent is prohibited.311.3    Sec. 19. [144.296] COPIES OF VIDEOTAPES.311.4    A provider may not release a copy of a videotape of a child victim or alleged victim 311.5of physical or sexual abuse without a court order under section 13.03, subdivision 6, or 311.6as provided in section 611A.90. This section does not limit the right of a patient to view 311.7the videotape.311.8    Sec. 20. [144.297] INDEPENDENT MEDICAL EXAMINATION.311.9    This section applies to the subject and provider of an independent medical 311.10examination requested by or paid for by a third party. Notwithstanding section 144.293, a 311.11provider may release health records created as part of an independent medical examination 311.12to the third party who requested or paid for the examination.311.13    Sec. 21. [144.298] PENALTIES.311.14    Subdivision 1.Licensing action.A violation of sections 144.291 to 144.298 may 311.15be grounds for disciplinary action against a provider by the appropriate licensing board 311.16or agency.311.17    Subd. 2.Allocation of liability.In adjudicating a dispute involving the disclosure 311.18of patient health records, a court shall use the criteria in this subdivision in determining 311.19how liability will be allocated.311.20    (a) When requesting health records using consent, a person warrants that the consent:311.21    (1) contains no information known to the person to be false; and311.22    (2) accurately states the patient's desire to have health records disclosed or that there 311.23is specific authorization in law.311.24    (b) When requesting health records using consent or the representation authorized in 311.25section 144.293, subdivision 2, a provider warrants that the request:311.26    (1) contains no information known to the provider to be false;311.27    (2) accurately states the patient's desire to have health records disclosed or that 311.28there is specific authorization in law; and311.29    (3) does not exceed any limits imposed by the patient in the consent.311.30    (c) When disclosing health records, a person releasing health records warrants that 311.31the person:311.32    (1) has complied with the requirements of this section regarding disclosure of 311.33health records;312.1    (2) knows of no information related to the request that is false; and312.2    (3) has complied with the limits set by the patient in the consent or as described 312.3in the representation of consent.312.4    (d) A court of this state presumes that:312.5    (1) a request made by a person that complies with the provisions of this section is 312.6valid and represents the wishes of the patient;312.7    (2) the information listed in a consent or representation of consent is accurate;312.8    (3) the recipient of a consent or representation of consent has no knowledge or 312.9notice that the person making the request breached a duty to the patient or does not 312.10rightfully have a consent;312.11    (4) the signature on the consent or representation of consent is not forged;312.12    (5) the consent or representation of consent was not obtained under false pretenses; 312.13and312.14    (6) the consent or representation of consent was not altered without the patient's 312.15permission.312.16    (e) No person or provider may disclaim or contractually limit the application of this 312.17section, or obtain indemnity for its effects, if the disclaimer, limitation, or indemnity 312.18restricts liability for misrepresentation against persons reasonably relying on the consent, 312.19representation of consent, or disclosure.312.20    (f) A court of this state shall give effect to liability allocations between the parties 312.21provided by contract that does not allocate liability to the detriment of the patient and the 312.22allocation is consistent with the requirements of sections 144.291 to 144.298.312.23    (g) A patient is eligible to receive compensatory damages plus costs and reasonable 312.24attorney fees if there is a negligent or intentional violation of sections 144.293 to 144.295.312.25    Subd. 3.Liability for a record locator service.A patient is eligible to receive 312.26compensatory damages plus costs and reasonable attorney fees if a health information 312.27exchange maintaining a record locator service, or an entity maintaining a record locator 312.28service for a health information exchange, negligently or intentionally violates the 312.29provisions of section 144.293, subdivision 8.312.30    Sec. 22. Minnesota Statutes 2006, section 144.3345, is amended to read:312.31144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD 312.32GRANTS.312.33    Subdivision 1. Definitions. The following definitions are used for the purposes 312.34of this section.313.1    (a) "Eligible community e-health collaborative" means an existing or newly 313.2established collaborative to support the adoption and use of interoperable electronic 313.3health records. A collaborative must consist of at least three two or more eligible health 313.4care entities in at least two of the categories listed in paragraph (b) and have a focus on 313.5interconnecting the members of the collaborative for secure and interoperable exchange of 313.6health care information.313.7    (b) "Eligible health care entity" means one of the following:313.8    (1) community clinics, as defined under section 
         145.9268; 313.9    (2) hospitals eligible for rural hospital capital improvement grants, as defined 313.10in section 
         144.148;313.11    (3) physician clinics located in a community with a population of less than 50,000 313.12according to United States Census Bureau statistics and outside the seven-county 313.13metropolitan area; 313.14    (4) nursing facilities licensed under sections 
         144A.01 to 
         144A.27; 313.15    (5) community health boards or boards of health as established under chapter 145A; 313.16    (6) nonprofit entities with a purpose to provide health information exchange 313.17coordination governed by a representative, multi-stakeholder board of directors; and313.18    (7) other providers of health or health care services approved by the commissioner 313.19for which interoperable electronic health record capability would improve quality of 313.20care, patient safety, or community health.313.21    Subd. 2. Grants authorized. The commissioner of health shall award grants to:313.22    (a) eligible community e-health collaborative projects to improve the implementation 313.23and use of interoperable electronic health records including but not limited to the 313.24following projects:313.25    (1) collaborative efforts to host and support fully functional interoperable electronic 313.26health records in multiple care settings; 313.27    (2) electronic medication history and electronic patient registration medical history313.28information; 313.29    (3) electronic personal health records for persons with chronic diseases and for 313.30prevention services; 313.31    (4) rural and underserved community models for electronic prescribing; and313.32    (5) enabling modernize local public health information systems to rapidly and 313.33electronically exchange information needed to participate in community e-health 313.34collaboratives or for public health emergency preparedness and response.; and313.35    (6) implement regional or community-based health information exchange 313.36organizations;314.1    (b) community clinics, as defined under section 145.9268, to implement and use 314.2interoperable electronic health records, including but not limited to the following projects:314.3    (1) efforts to plan for and implement fully functional, standards-based interoperable 314.4electronic health records; and314.5    (2) purchases and implementation of computer hardware, software, and technology 314.6to fully implement interoperable electronic health records;314.7    (c) regional or community-based health information exchange organizations to 314.8connect and facilitate the exchange of health information between eligible health care 314.9entities, including but not limited to the development, testing, and implementation of:314.10    (1) data exchange standards, including data, vocabulary, and messaging standards, 314.11for the exchange of health information, provided that such standards are consistent with 314.12state and national standards;314.13    (2) security standards necessary to ensure the confidentiality and integrity of health 314.14records;314.15    (3) computer interfaces and mechanisms for standardizing health information 314.16exchanged between eligible health care entities;314.17    (4) a record locator service for identifying the location of patient health records; or314.18    (5) interfaces and mechanisms for implementing patient consent requirements; and314.19    (d) community health boards and boards of health as established under chapter 314.20145A to modernize local public health information systems to be standards-based and 314.21interoperable with other electronic health records and information systems, or for 314.22enhanced public health emergency preparedness and response.314.23    Grant funds may not be used for construction of health care or other buildings or 314.24facilities.314.25    Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible 314.26community e-health collaborative, community clinic, regional or community-based health 314.27information exchange, or community health boards and boards of health must submit an 314.28application to the commissioner of health by the deadline established by the commissioner. 314.29A grant may be awarded upon the signing of a grant contract. In awarding grants, the 314.30commissioner shall give preference to projects benefiting providers located in rural and 314.31underserved areas of Minnesota which the commissioner has determined have an unmet 314.32need for the development and funding of electronic health records. Applicants may apply 314.33for and the commissioner may award grants for one-year, two-year, or three-year periods.314.34    (b) An application must be on a form and contain information as specified by the 314.35commissioner but at a minimum must contain:314.36    (1) a description of the purpose or project for which grant funds will be used; 315.1    (2) a description of the problem or problems the grant funds will be used to address, 315.2including an assessment of the likelihood of the project occurring absent grant funding; 315.3    (3) a description of achievable objectives, a workplan, budget, budget narrative, a 315.4project communications plan, a timeline for implementation and completion of processes 315.5or projects enabled by the grant, and an assessment of privacy and security issues and a 315.6proposed approach to address these issues;315.7    (4) a description of the health care entities and other groups participating in the 315.8project, including identification of the lead entity responsible for applying for and 315.9receiving grant funds; 315.10    (5) a plan for how patients and consumers will be involved in development of 315.11policies and procedures related to the access to and interchange of information; 315.12    (6) evidence of consensus and commitment among the health care entities and others 315.13who developed the proposal and are responsible for its implementation; and315.14    (7) a plan for documenting and evaluating results of the grant. ; and315.15    (8) a plan for use of data exchange standards, including data and vocabulary.315.16    (c) The commissioner shall review each application to determine whether the 315.17application is complete and whether the applicant and the project are eligible for a 315.18grant. In evaluating applications, the commissioner shall take into consideration factors, 315.19including but not limited to, the following:315.20    (1) the degree to which the proposal interconnects the various providers of care with 315.21other health care entities in the applicant's geographic community; 315.22    (2) the degree to which the project provides for the interoperability of electronic 315.23health records or related health information technology between the members of the 315.24collaborative, and presence and scope of a description of how the project intends to 315.25interconnect with other providers not part of the project into the future;315.26    (3) the degree to which the project addresses current unmet needs pertaining 315.27to interoperable electronic health records in a geographic area of Minnesota and the 315.28likelihood that the needs would not be met absent grant funds; 315.29    (4) the applicant's thoroughness and clarity in describing the project, how the project 315.30will improve patient safety, quality of care, and consumer empowerment, and the role of 315.31the various collaborative members;315.32    (5) the recommendations of the Health Information and Technology Infrastructure 315.33Advisory Committee; and315.34    (6) other factors that the commissioner deems relevant.316.1    (d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall 316.2be required to provide $1 in the form of cash or in-kind staff or services for each $3 316.3provided under the grant program.316.4    (e) Grants shall not exceed $900,000 per grant. The commissioner has discretion 316.5over the size and number of grants awarded.316.6    Subd. 4. Evaluation and report. The commissioner of health shall evaluate the 316.7overall effectiveness of the grant program. The commissioner shall collect progress 316.8and expenditure reports to evaluate the grant program from the eligible community 316.9collaboratives receiving grants.316.10    Sec. 23. Minnesota Statutes 2006, section 144.565, is amended to read:316.11144.565 DIAGNOSTIC IMAGING FACILITIES.316.12    Subdivision 1. Utilization and services data; economic and financial interests.316.13    The commissioner shall require diagnostic imaging facilities and providers of diagnostic 316.14imaging services in Minnesota to annually report by March 1 each year for the preceding 316.15fiscal year to the commissioner, in the form and manner specified by the commissioner:316.16    (1) utilization data for each health plan company and each public program, 316.17including workers' compensation, as follows: of diagnostic imaging services as defined 316.18in subdivision 4, paragraph (b);316.19    (i) the number of computerized tomography (CT) procedures performed;316.20    (ii) the number of magnetic resonance imaging (MRI) procedures performed; and316.21    (iii) the number of positron emission tomography (PET) procedures performed; and316.22    (2) the names of all physicians with any financial or economic interest and all other 316.23individuals with a ten percent or greater financial or economic interest in the facility.;316.24    (3) the location where procedures were performed;316.25    (4) the number of units of each type of fixed, portable, and mobile scanner used at 316.26each location;316.27    (5) the average number of hours per month each mobile scanner was operated at 316.28each location;316.29    (6) the number of hours per month each scanner was leased, if applicable;316.30    (7) the total number of diagnostic imaging procedures billed for by the provider at 316.31each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph 316.32(b); and316.33    (8) a report on major health care capital expenditures during the previous year, as 316.34required by section 62J.17.317.1    Subd. 2. Commissioner's right to inspect records. If the report is not filed or 317.2the commissioner of health has reason to believe the report is incomplete or false, the 317.3commissioner shall have the right to inspect diagnostic imaging facility books, audits, 317.4and records.317.5    Subd. 3. Separate reports.For a diagnostic imaging facility that is not attached 317.6or not contiguous to a hospital or a hospital affiliate, the commissioner shall require 317.7the information in subdivision 1 be reported separately for each detached diagnostic 317.8imaging facility as part of the report required under section 144.702. If any entity owns 317.9more than one diagnostic imaging facility, that entity must report by individual facility. 317.10Reports must include only services that were billed by the provider of diagnostic imaging 317.11services submitting the report. If a diagnostic imaging facility leases capacity, technical 317.12services, or professional services to one or more other providers of diagnostic imaging 317.13services, each provider must submit a separate annual report to the commissioner for all 317.14diagnostic imaging services that it provided and billed. The owner of the leased capacity 317.15must provide a report listing the names and addresses of providers to whom the diagnostic 317.16imaging services and equipment were leased.317.17    Subd. 4. Definitions. For purposes of this section, the following terms have the 317.18meanings given:317.19    (a) "Diagnostic imaging facility" means a health care facility that providesis not 317.20a hospital or location licensed as a hospital which offers diagnostic imaging services 317.21through the use of ionizing radiation or other imaging technique including, but not limited 317.22to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a 317.23freestanding or mobile basis in Minnesota, regardless of whether the equipment used 317.24to provide the service is owned or leased. For the purposes of this section, diagnostic 317.25imaging facility includes, but is not limited to, facilities such as a physician's office, clinic, 317.26mobile transport vehicle, outpatient imaging center, or surgical center.317.27    (b) "Diagnostic imaging service" means the use of ionizing radiation or other 317.28imaging technique on a human patient including, but not limited to, magnetic resonance 317.29imaging (MRI) or computerized tomography (CT), positron emission tomography (PET), 317.30or single photon emission computerized tomography (SPECT) scans using fixed, portable, 317.31or mobile equipment.317.32    (b)(c) "Financial or economic interest" means a direct or indirect:317.33    (1) equity or debt security issued by an entity, including, but not limited to, shares of 317.34stock in a corporation, membership in a limited liability company, beneficial interest in 317.35a trust, units or other interests in a partnership, bonds, debentures, notes or other equity 317.36interests or debt instruments, or any contractual arrangements;318.1    (2) membership, proprietary interest, or co-ownership with an individual, group, or 318.2organization to which patients, clients, or customers are referred to; or318.3    (3) employer-employee or independent contractor relationship, including, but not 318.4limited to, those that may occur in a limited partnership, profit-sharing arrangement, or 318.5other similar arrangement with any facility to which patients are referred, including any 318.6compensation between a facility and a health care provider, the group practice of which 318.7the provider is a member or employee or a related party with respect to any of them.318.8    (c)(d) "Freestanding Fixed equipment" means a stationary diagnostic imaging 318.9facility that is not located within a: machine installed in a permanent location.318.10    (1) hospital;318.11    (2) location licensed as a hospital; or318.12    (3) physician's office or clinic where the professional practice of medicine by 318.13licensed physicians is the primary purpose and not the provision of ancillary services 318.14such as diagnostic imaging.318.15    (d)(e) "Mobile equipment" means a diagnostic imaging facility that is transported to 318.16various sites not including movement within a hospital or a physician's office or clinic318.17machine in a self-contained transport vehicle designed to be brought to a temporary offsite 318.18location to perform diagnostic imaging services.318.19    (f) "Portable equipment" means a diagnostic imaging machine designed to be 318.20temporarily transported within a permanent location to perform diagnostic imaging 318.21services.318.22    (g) "Provider of diagnostic imaging services" means a diagnostic imaging facility 318.23or an entity that offers and bills for diagnostic imaging services at a facility owned or 318.24leased by the entity.318.25    Subd. 5.Reports open to public inspection.All reports filed pursuant to this 318.26section shall be open to public inspection.318.27    Sec. 24. [144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS 318.28CONTROL PROGRAMS.318.29    In order to improve the prevention of hospital-associated bloodstream infections due 318.30to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall establish 318.31an MRSA control program that meets Minnesota Department of Health best practices 318.32standards as published January 15, 2008, including considerations of: 318.33    (1) identification of all MRSA-colonized patients in all intensive care units, and 318.34other at-risk patients identified by the hospital, through active surveillance testing; 319.1    (2) isolation of identified MRSA-colonized or MRSA-infected patients in an 319.2appropriate manner; 319.3    (3) monitoring and strict enforcement of hand hygiene requirements; and 319.4    (4) maintenance of records.319.5    Sec. 25. Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:319.6    Subd. 26. Right to associate.(a) Residents may meet with and receive visitors 319.7and participate in activities of commercial, religious, political, as defined in section 319.8203B.11
          and community groups without interference at their discretion if the activities 319.9do not infringe on the right to privacy of other residents or are not programmatically 319.10contraindicated. This includes:319.11    (1) the right to join with other individuals within and outside the facility to work for 319.12improvements in long-term care;319.13    (2) the right to visitation by an individual the patient has appointed as the patient's 319.14health care agent under chapter 145C;319.15    (3) the right to visitation and health care decision making by an individual designated 319.16by the patient under paragraph (c).319.17    (b) Upon admission to a facility where federal law prohibits unauthorized disclosure 319.18of patient or resident identifying information to callers and visitors, the patient or 319.19resident, or the legal guardian or conservator of the patient or resident, shall be given the 319.20opportunity to authorize disclosure of the patient's or resident's presence in the facility 319.21to callers and visitors who may seek to communicate with the patient or resident. To the 319.22extent possible, the legal guardian or conservator of a patient or resident shall consider the 319.23opinions of the patient or resident regarding the disclosure of the patient's or resident's 319.24presence in the facility. 319.25    (c) Upon admission to a facility, the patient or resident, or the legal guardian 319.26or conservator of the patient or resident, must be given the opportunity to designate 319.27a person who is not related who will have the status of the patient's next of kin with 319.28respect to visitation and making a health care decision. A designation must be included 319.29in the patient's health record. With respect to making a health care decision, a health 319.30care directive or appointment of a health care agent under chapter 145C prevails over a 319.31designation made under this paragraph. The unrelated person may also be identified as 319.32such by the patient or by the patient's family.319.33    Sec. 26. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.320.1    Subdivision 1.Definitions.For purposes of this section, "federally qualified health 320.2center" means an entity that is receiving a grant under United States Code, title 42, 320.3section 254b, or, based on the recommendation of the Health Resources and Services 320.4Administration within the Public Health Service, is determined by the secretary to meet 320.5the requirements for receiving such a grant.320.6    Subd. 2.Allocation of subsidies.The commissioner of health shall distribute 320.7subsidies to federally qualified health centers operating in Minnesota to continue, expand, 320.8and improve federally qualified health center services to low-income populations. The 320.9commissioner shall distribute the funds appropriated under this section to federally 320.10qualified health centers operating in Minnesota as of January 1, 2007. The amount of 320.11each subsidy shall be in proportion to each federally qualified health center's amount of 320.12discounts granted to patients during calendar year 2006 as reported on the federal Uniform 320.13Data System report in conformance with the Bureau of Primary Health Care Program 320.14Expectations Policy Information Notice 98-23, except that each eligible federally qualified 320.15health center shall receive at least two percent but no more than 30 percent of the total 320.16amount of money available under this section.320.17    Sec. 27. Minnesota Statutes 2006, section 145C.05, is amended to read:320.18145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.320.19    Subdivision 1. Content. A health care directive executed pursuant to this chapter 320.20may, but need not, be in the form contained in section 
         145C.16. 320.21    Subd. 2. Provisions that may be included. (a) A health care directive may include 320.22provisions consistent with this chapter, including, but not limited to:320.23    (1) the designation of one or more alternate health care agents to act if the named 320.24health care agent is not reasonably available to serve;320.25    (2) directions to joint health care agents regarding the process or standards by which 320.26the health care agents are to reach a health care decision for the principal, and a statement 320.27whether joint health care agents may act independently of one another;320.28    (3) limitations, if any, on the right of the health care agent or any alternate health 320.29care agents to receive, review, obtain copies of, and consent to the disclosure of the 320.30principal's medical records or to visit the principal when the principal is a patient in a 320.31health care facility;320.32    (4) limitations, if any, on the nomination of the health care agent as guardian for 320.33purposes of sections 
         524.5-202, 
         524.5-211, 
         524.5-302, and 
         524.5-303; 321.1    (5) a document of gift for the purpose of making an anatomical gift, as set forth in 321.2sections 
         525.921 to 
         525.9224, or an amendment to, revocation of, or refusal to make 321.3an anatomical gift; 321.4    (6) a declaration regarding intrusive mental health treatment under section 
         253B.03, 321.5subdivision 6d
         , or a statement that the health care agent is authorized to give consent for 321.6the principal under section 
         253B.04, subdivision 1a; 321.7    (7) a funeral directive as provided in section 
         149A.80, subdivision 2; 321.8    (8) limitations, if any, to the effect of dissolution or annulment of marriage or 321.9termination of domestic partnership on the appointment of a health care agent under 321.10section 
         145C.09, subdivision 2; 321.11    (9) specific reasons why a principal wants a health care provider or an employee 321.12of a health care provider attending the principal to be eligible to act as the principal's 321.13health care agent;321.14    (10) health care instructions by a woman of child bearing age regarding how she 321.15would like her pregnancy, if any, to affect health care decisions made on her behalf; and321.16    (11) health care instructions regarding artificially administered nutrition or hydration.321.17    (b) A health care directive may include a statement of the circumstances under 321.18which the directive becomes effective other than upon the judgment of the principal's 321.19attending physician in the following situations:321.20    (1) a principal who in good faith generally selects and depends upon spiritual means 321.21or prayer for the treatment or care of disease or remedial care and does not have an 321.22attending physician, may include a statement appointing an individual who may determine 321.23the principal's decision-making capacity; and321.24    (2) a principal who in good faith does not generally select a physician or a health 321.25care facility for the principal's health care needs may include a statement appointing an 321.26individual who may determine the principal's decision-making capacity, provided that if 321.27the need to determine the principal's capacity arises when the principal is receiving care 321.28under the direction of an attending physician in a health care facility, the determination 321.29must be made by an attending physician after consultation with the appointed individual.321.30    If a person appointed under clause (1) or (2) is not reasonably available and the 321.31principal is receiving care under the direction of an attending physician in a health care 321.32facility, an attending physician shall determine the principal's decision-making capacity.321.33    (c) A health care directive may authorize a health care agent to make health care 321.34decisions for a principal even though the principal retains decision-making capacity.322.1    Sec. 28. Minnesota Statutes 2006, section 145C.07, is amended by adding a 322.2subdivision to read:322.3    Subd. 5.Visitation.A health care agent may visit the principal when the 322.4principal is a patient in a health care facility regardless of whether the principal retains 322.5decision-making capacity, unless:322.6    (1) the principal has otherwise specified in the health care directive;322.7    (2) a principal who retains decision-making capacity indicates otherwise; or322.8    (3) a health care provider reasonably determines that the principal must be isolated 322.9from all visitors or that the presence of the health care agent would endanger the health or 322.10safety of the principal, other patients, or the facility in which the care is being provided.322.11    Sec. 29. Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:322.12    Subdivision 1. License required annually. A license is required annually for every 322.13person, firm, or corporation engaged in the business of conducting a food and beverage 322.14service establishment, hotel, motel, lodging establishment, or resort. Any person wishing 322.15to operate a place of business licensed in this section shall first make application, pay the 322.16required fee specified in this section, and receive approval for operation, including plan 322.17review approval. Seasonal and temporary food stands and special event food stands are 322.18not required to submit plans. Nonprofit organizations operating a special event food 322.19stand with multiple locations at an annual one-day event shall be issued only one license. 322.20Application shall be made on forms provided by the commissioner and shall require 322.21the applicant to state the full name and address of the owner of the building, structure, 322.22or enclosure, the lessee and manager of the food and beverage service establishment, 322.23hotel, motel, lodging establishment, or resort; the name under which the business is to 322.24be conducted; and any other information as may be required by the commissioner to 322.25complete the application for license.322.26    Sec. 30. HEALTH PROMOTION PROGRAM.322.27    The State Community Health Services Advisory Committee established in 322.28Minnesota Statutes, section 145A.10, subdivision 10, shall develop a plan to fund and 322.29implement an ongoing comprehensive health promotion program that can effect change 322.30more effectively and at lower cost at a community level rather than through individual 322.31counseling and change promotion. The program shall use proven public health strategies 322.32to promote healthy lifestyles and behaviors in order to establish a sustainable, long-term 322.33approach to reducing preventable disability, chronic health conditions, and disease. The 322.34focus shall be on community based initiatives that address childhood and adult obesity, 323.1tobacco and substance abuse, improved activity levels among senior citizens, and other 323.2lifestyle issues that impact health and healthcare costs. Because of its population health 323.3focus, funding shall be related to the size of the population to be served. The plan shall be 323.4completed by September 15, 2007, and shared with the Legislative Health Care Access 323.5Commission.323.6    Sec. 31. INJUNCTIVE RELIEF REPORT.323.7    The commissioner of health shall present to the 2008 legislature, by December 15, 323.82007, recommendations to fund the cost of bringing actions for injunctive relief under 323.9Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).323.10    Sec. 32. DIAGNOSTIC IMAGING SERVICES ADVISORY COMMITTEE; 323.11ESTABLISHMENT.323.12    (a) The commissioner of health shall establish a Diagnostic Imaging Services 323.13Advisory Committee to perform the following duties:323.14    (1) gather and analyze data to understand the factors driving utilization of diagnostic 323.15imaging services, including computed tomography (CT), magnetic resonance imaging 323.16(MRI), positron emission tomography (PET), magnetic resonance angiography (MRA), 323.17and nuclear cardiology, in the state relative to evidence-based guidelines; and323.18    (2) develop recommendations, based on the data collected, on how to improve 323.19the delivery of evidence-based diagnostic imaging services. In developing these 323.20recommendations, the advisory committee shall consider the impacts on patient care, 323.21premium costs, and administrative simplicity.323.22    (b) The members of the Diagnostic Imaging Services Advisory Committee shall 323.23include the commissioners of health and human services or the commissioners' designees 323.24and the following:323.25    (1) three physicians representing speciality and geographic diversity, appointed by 323.26the Minnesota Medical Association;323.27    (2) two hospital representatives, one from a metropolitan hospital and one from a 323.28rural hospital, appointed by the Minnesota Hospital Association;323.29    (3) three health plan company representatives appointed by the Minnesota Council 323.30of Health Plans;323.31    (4) two representatives appointed by the Institute for Clinical System Improvement; 323.32and323.33    (5) one clinic manager appointed by the Minnesota Medical Group Management 323.34Association.324.1    (c) The Diagnostic Imaging Services Advisory Committee shall convene no later 324.2than September 1, 2007. The commissioner shall report back to the legislature no later 324.3than January 15, 2008. The advisory committee is governed under Minnesota Statutes, 324.4section 15.059, except that members shall not receive a per diem and may only be 324.5reimbursed for expenses.324.6    (d) A strategy to improve the delivery of evidence-based diagnostic imaging services 324.7may be developed by health plans. The commissioner of health shall report the agreement 324.8to the chairs of the senate and house health care committees immediately.324.9EFFECTIVE DATE.This section is effective July 1, 2007.324.10    Sec. 33. HEARING AID DISPENSER FEES.324.11    Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section 324.12153A.17, may not be increased until after the Department of Health provides a report to 324.13the legislature regarding the need and reasons for fee increases.324.14    Sec. 34. REVISOR'S INSTRUCTION.324.15    In Minnesota Statutes and Minnesota Rules, the revisor shall change the references 324.16in column A with the references in column B.

324.17Column AColumn B324.18section 144.335sections 144.291 to 144.298324.19section 144.335, subdivision 1section 144.291, subdivision 2324.20324.21section 144.335, subdivision 1, paragraph (b)section 144.291, subdivision 2, paragraph (h)324.22324.23section 144.335, subdivision 2, paragraphs (a) and (b)section 144.292, subdivisions 2 and 5324.24section 144.335, subdivision 2section 144.292324.25section 144.335, subdivision 3asection 144.294, subdivision 2324.26324.27section 144.335, subdivision 3a, paragraph (d)section 144.295324.28324.29section 144.335, subdivision 3a, paragraph (f)section 144.294324.30section 144.335, subdivision 3bsection 144.293, subdivision 7

324.31    Sec. 35.  REPEALER.324.32(a) Minnesota Statutes 2006, section 144.335, is repealed.324.33(b) Minnesota Statutes 2006, section 62J.17, subdivisions 1, 5a, 6a, and 8, are 324.34repealed, effective the day following final enactment.325.1ARTICLE 7325.2MISCELLANEOUS325.3    Section 1. Minnesota Statutes 2006, section 16A.10, is amended by adding a 325.4subdivision to read:325.5    Subd. 2a.Base budget detail.Within one week of the release of the budget forecasts 325.6required in section 16A.102 in November of an even-numbered year and February of an 325.7odd-numbered year, the commissioner, after consulting with the commissioners of human 325.8services and health, must provide to the legislature information at the program, budget 325.9activity and management activity level for the base level budget of the Department of 325.10Human Services and the Department of Health for the next biennium. The information 325.11must be organized in a manner that explains how base level budget appropriations are 325.12projected to be spent. Within one week of the release of the budget forecasts required in 325.13section 16A.102 in November of an even-numbered year, the commissioner must also 325.14provide the legislature with the information submitted by the commissioners of human 325.15services and health under subdivision 2, clauses (3) and (4).325.16    Sec. 2. Minnesota Statutes 2006, section 43A.316, is amended to read:325.1743A.316 PUBLIC EMPLOYEES INSURANCE PROGRAM.325.18    Subdivision 1. Intent. The legislature finds that the creation of a statewide program 325.19to provide public employees and other eligible persons with life insurance and hospital, 325.20medical, and dental benefit coverage through provider organizations would result in a 325.21greater utilization more efficient use of government resources and would advance the 325.22health and welfare of the citizens of the state.325.23    Subd. 2. Definitions. For the purpose of this section, the terms defined in this 325.24subdivision have the meaning given them.325.25    (a)  Commissioner. "Commissioner" means the commissioner of employee relations. 325.26    (b)  Employee. "Employee" means: 325.27    (1) a person who is a public employee within the definition of section 
         179A.03, 325.28subdivision 14
         , who is insurance eligible and is employed by an eligible employer; 325.29    (2) an elected public official of an eligible employer who is insurance eligible;325.30    (3) a person employed by a labor organization or employee association certified as 325.31an exclusive representative of employees of an eligible employer or by another public 325.32employer approved by the commissioner, so long as the plan meets the requirements of a 325.33governmental plan under United States Code, title 29, section 1002(32); or325.34    (4) a person employed by a county or municipal hospital.326.1    (c)  Eligible employer. "Eligible employer" means: 326.2    (1) a public employer within the definition of section 
         179A.03, subdivision 15, that 326.3is a town, county, city, school district as defined in section 
         120A.05, service cooperative 326.4as defined in section 
         123A.21, intermediate district as defined in section 
         136D.01, 326.5Cooperative Center for Vocational Education as defined in section 
         123A.22, regional 326.6management information center as defined in section 
         123A.23, or an education unit 326.7organized under the joint powers action, section 
         471.59; or 326.8    (2) an exclusive representative of employees, as defined in paragraph (b);326.9    (3) a county or municipal hospital; or326.10    (4) another public employer approved by the commissioner; or326.11    (5) a nursing home as defined in section 144A.01, subdivision 5, located in this state.326.12    (d)  Exclusive representative. "Exclusive representative" means an exclusive 326.13representative as defined in section 
         179A.03, subdivision 8. 326.14    (e)  Labor-Management Committee. "Labor-Management Committee" means the 326.15committee established by subdivision 4. 326.16    (f)  Program. "Program" means the statewide public employees insurance program 326.17created by subdivision 3. 326.18    Subd. 3. Public employee insurance program. The commissioner shall be the 326.19administrator of the public employee insurance program and may determine its funding 326.20arrangements. The commissioner may contract with a qualified entity to perform the 326.21administrative functions. The commissioner shall model the program after the plan 326.22established in section 
         43A.18, subdivision 2, but may modify adopt variations from that 326.23plan, in consultation with the Labor-Management Committee. The variations may include 326.24different deductibles, coinsurance, co-pays, or other enrollee cost-sharing provisions.326.25    Subd. 4. Labor-Management Committee.(a) The Labor-Management Committee 326.26consists of ten members appointed by the commissioner. The Labor-Management 326.27Committee must comprise five members who represent employees, including at least 326.28one retired employee, and five members who represent eligible employers. Committee 326.29members are eligible for expense reimbursement in the same manner and amount as 326.30authorized by the commissioner's plan adopted under section 
         43A.18, subdivision 2. The 326.31commissioner shall consult with the labor-management committee in major decisions 326.32that affect the program. The committee shall study issues and make recommendations 326.33relating to the insurance program including, but not limited to, flexible benefits, utilization 326.34review, quality assessment, and cost efficiency. The committee continues to exist while 326.35the program remains in operation. 327.1    (b) The five members of the Labor-Management Committee who represent 327.2employees must be chosen by the commissioner from among persons nominated as 327.3provided in this paragraph. Exclusive representatives of employees of counties, cities, 327.4school districts, and nursing homes are entitled to nominate two candidates for the 327.5Labor-Management Committee from each of those four categories, and the commissioner 327.6shall appoint one of those two nominees from each category. The commissioner shall 327.7choose the fifth employee to represent retired employees.327.8    (c) The five members of the Labor-Management Committee who represent employers 327.9must be chosen by the commissioner from among persons nominated as provided in 327.10this paragraph. The Association of Minnesota Counties, Minnesota League of Cities, 327.11Minnesota School Boards Association, and the Minnesota Association of Nursing Homes 327.12are each entitled to nominate two candidates for the committee, and the commissioner 327.13shall appoint one of those from each group. The commissioner shall select the fifth 327.14employer member from an employer participating in the program and not represented 327.15by the other four employer members, if any, or if that is not reasonably possible, the 327.16commissioner may appoint any other person as the fifth employer representative.327.17    Subd. 5. Public employee participation. (a) Participation in the program is subject 327.18to the conditions in this subdivision.327.19    (b) Each exclusive representative for an eligible employer determines whether the 327.20employees it represents will participate in the program. The exclusive representative shall 327.21give the employer notice of intent to participate at least 30 60 days before the expiration 327.22date of the collective bargaining agreement preceding the collective bargaining agreement 327.23that covers the date of entry into the program. Either all or none of the employees 327.24represented by an exclusive representative must participate. The exclusive representative 327.25and the eligible employer shall give notice to the commissioner of the determination to 327.26participate in the program at least 30 60 days before entry into the program. Entry into the 327.27program is governed by a schedule established by the commissioner.327.28    (c) Employees not represented by exclusive representatives may become members 327.29of the program upon a determination of an eligible employer to include these employees 327.30in the program. Either all or none of the employer's unrepresented employees must 327.31participate. The eligible employer shall give at least 30 60 days' notice to the commissioner 327.32before entering the program. Entry into the program is governed by a schedule established 327.33by the commissioner.327.34    (d) Participation in the program is for a two-year three-year term. Participation is 327.35automatically renewed for an additional two-year three-year term unless the exclusive 327.36representative, or the employer for unrepresented employees, gives the commissioner 328.1notice of withdrawal at least 30 60 days before expiration of the participation period. A 328.2group that withdraws must wait two years before rejoining, except with the approval of 328.3the commissioner. An exclusive representative, or employer for unrepresented employees, 328.4may also withdraw if premiums increase 50 percent by more than 20 percent in excess of 328.5the Consumer Price Index for all urban consumers or more from one insurance year to 328.6the next.328.7    (e) The exclusive representative shall give the employer notice of intent to withdraw 328.8to the commissioner at least 30 60 days before the expiration date of a collective 328.9bargaining agreement that includes the date on which the term of participation expires.328.10    (f) Each participating eligible employer shall notify the commissioner of the names 328.11of individuals who will be participating within two weeks of after the commissioner 328.12receiving receives notice of the parties' intent to participate. The employer shall also 328.13submit other information as required by the commissioner for administration of the 328.14program.328.15    (g) An employer that withdraws from the program under circumstances that do not 328.16permit withdrawal under this subdivision is liable to the board for premiums payable by 328.17the employer until the time that the employer is eligible to withdraw, and the employer 328.18shall pay those premiums voluntarily and no later than their due date. If the premiums are 328.19not paid voluntarily, the board has authority to and shall collect these premiums under any 328.20method permitted by law for a governmental or nongovernmental creditor of the employer.328.21    Subd. 6. Coverage. (a) By January 1, 1989, The commissioner shall announce the 328.22benefits of the program. The program shall include employee hospital, medical, dental, 328.23and life insurance for employees and hospital and medical benefits for dependents. Health 328.24maintenance organization options and other delivery system options may be provided if 328.25they are available, cost-effective, and capable of servicing the number of people covered 328.26in the program. Participation in optional coverages may be provided by collective 328.27bargaining agreements. For employees not represented by an exclusive representative, the 328.28employer may offer the optional coverages to eligible employees and their dependents 328.29provided in the program. Health coverage must include at least the benefits required of a 328.30health plan company regulated under chapter 62A, 62C, or 62D.328.31    (b) The commissioner, with the assistance of the Labor-Management Committee, 328.32shall periodically assess whether it is financially feasible for the program to offer or to 328.33continue an individual retiree program that has competitive premium rates and benefits. 328.34If the commissioner determines it to be feasible to offer an individual retiree program, 328.35the commissioner shall announce the applicable benefits, premium rates, and terms of 328.36participation. Eligibility to participate in the individual retiree program is governed by 329.1subdivision 8, but applies to retirees of eligible employers that do not participate in the 329.2program and to those retirees' dependents and surviving spouses.329.3    Subd. 6a. Chiropractic services Choice of type of provider. All benefits provided 329.4by the program or a successor program relating to expenses incurred for medical treatment 329.5or services of a physician health care provider must also include chiropractic treatment 329.6and services of a chiropractor any other type of licensed, certified, or registered health care 329.7provider to the extent that the chiropractic services and treatment are within the scope of 329.8chiropractic licensure the provider's licensure, certification, or registration.329.9    This subdivision is intended to provide equal access to benefits for program members 329.10who choose to obtain treatment for illness or injury from a doctor of chiropractic, as long 329.11as the treatment falls within the chiropractor's scope of practice. This subdivision is not 329.12intended to change or add to the benefits provided for in the program.329.13    Subd. 7. Premiums.(a) The proportion of premium paid by the employer and 329.14employee is subject to collective bargaining or personnel policies. If, at the beginning of 329.15the coverage period, no collective bargaining agreement has been finalized, the increased 329.16dollar costs, if any, from the previous year is the sole responsibility of the individual 329.17participant until a collective bargaining agreement states otherwise. Premiums, including 329.18an administration fee, shall be established by the commissioner. The commissioner may 329.19decide to rate specific employers separately for premium purposes, if the commissioner 329.20determines that doing so is in the best interests of the program. Each employer shall pay 329.21monthly the amounts due for employee benefits including the amounts under subdivision 329.228 to the commissioner no later than the dates established by the commissioner. If an 329.23employer fails to make the payments as required, the commissioner may shall cancel 329.24program benefits and pursue other civil remedies, as provided in subdivision 5, paragraph 329.25(d).329.26    (b) The premium charged for an employer's first month in the program must be 329.27three times the regular monthly premium charged to that employer, to help establish 329.28and maintain the program's financial resources. The extra two months premium must 329.29be refunded to the employer if the employer leaves the program, if the refund would 329.30not reduce the program's reserves below the level determined to be appropriate by the 329.31commissioner.329.32    Subd. 8. Continuation of coverage. (a) A former employee of an employer 329.33participating in the program who is receiving a public pension disability benefit or an 329.34annuity or has met the age and service requirements necessary to receive an annuity under 329.35chapter 353, 353C, 354, 354A, 356, 422A, 423, 423A, or 424, and the former employee's 329.36dependents, are eligible to participate in the program. This participation is at the person's 330.1expense unless a collective bargaining agreement or personnel policy provides otherwise. 330.2Premiums for these participants must be established by the commissioner.330.3    The commissioner may provide policy exclusions for preexisting conditions 330.4only when there is a break in coverage between a participant's coverage under the 330.5employment-based group insurance program and the participant's coverage under this 330.6section. An employer shall notify an employee of the option to participate under this 330.7paragraph no later than the effective date of retirement. The retired employee or the 330.8employer of a participating group on behalf of a current or retired employee shall notify 330.9the commissioner within 30 days of the effective date of retirement of intent to participate 330.10in the program according to the rules established by the commissioner.330.11    (b) The spouse of a deceased employee or former employee may purchase the 330.12benefits provided at premiums established by the commissioner if the spouse was a 330.13dependent under the employee's or former employee's coverage under this section at the 330.14time of the death. The spouse remains eligible to participate in the program as long as 330.15the group that included the deceased employee or former employee participates in the 330.16program. Coverage under this clause must be coordinated with relevant insurance benefits 330.17provided through the federally sponsored Medicare program.330.18    (c) The program benefits must continue in the event of strike permitted by section 330.19179A.18
         , if the exclusive representative chooses to have coverage continue and the 330.20employee pays the total monthly premiums when due. 330.21    (d) A participant who discontinues coverage may not reenroll.330.22    (d) Persons participating under these paragraphs this subdivision shall make 330.23appropriate premium payments in the time and manner established by the commissioner.330.24They are not subject to the payment of the extra payments required under subdivision 7, 330.25paragraph (b).330.26    Subd. 9. Insurance trust fund. The insurance trust fund in the state treasury 330.27consists of deposits of the premiums received from employers participating in the 330.28program and transfers before July 1, 1994, from the excess contributions holding account 330.29established by section 
         353.65, subdivision 7. All money in the fund is appropriated to 330.30the commissioner to pay insurance premiums, approved claims, refunds, administrative 330.31costs, and other related service costs. Premiums paid by employers to the fund are exempt 330.32from the taxes imposed by chapter 297I. The commissioner shall reserve an amount of 330.33money to cover the estimated costs of claims incurred but unpaid. The State Board of 330.34Investment shall invest the money according to section 
         11A.24. Investment income and 330.35losses attributable to the fund must be credited to the fund. 331.1    Subd. 10. Exemption. The public employee insurance program and, where 331.2applicable, the employers participating in it are exempt from chapters 60A, 62A, 62C, 331.362D, 62E, and 62H, section 
         471.617, subdivisions 2 and 3, and the bidding requirements 331.4of section 
         471.6161, except as otherwise provided in subdivision 6, paragraph (a). 331.5    Subd. 11.Reinsurance.The commissioner may, on behalf of the program, 331.6participate in an insured or self-insured reinsurance pool.331.7    Sec. 3. Minnesota Statutes 2006, section 62H.02, is amended to read:331.862H.02 REQUIRED PROVISIONS.331.9    (a) A joint self-insurance plan must include aggregate excess stop-loss coverage and 331.10individual excess stop-loss coverage provided by an insurance company licensed by the 331.11state of Minnesota. 331.12    (b) Aggregate excess stop-loss coverage must include provisions to cover incurred, 331.13unpaid claim liability in the event of plan termination. In addition,331.14    (c) The plan of self-insurance must have participating employers fund an amount at 331.15least equal to the point at which the excess or stop-loss insurer has contracted to assume 331.16100 percent of additional liability. 331.17    (d) A joint self-insurance plan must submit its proposed excess or stop-loss insurance 331.18contract to the commissioner of commerce at least 30 days prior to the proposed plan's 331.19effective date and at least 30 days subsequent to any renewal date. The commissioner shall 331.20review the contract to determine if they meet the standards established by sections 
         62H.01331.21to 
         62H.08 and respond within a 30-day period. 331.22    (e) Any excess or stop-loss insurance plan must contain a provision that the excess 331.23or stop-loss insurer will give the plan and the commissioner of commerce a minimum of 331.24180 days' notice of termination or nonrenewal. If the plan fails to secure replacement 331.25coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the 331.26commissioner shall issue an order providing for the orderly termination of the plan. 331.27    (f) The commissioner may waive the requirements of this section and of any rule 331.28relating to the requirements of this section, if the commissioner determines that a joint 331.29self-insurance plan has established alternative arrangements that fully fund the plan's 331.30liability or incurred but unpaid claims. The commissioner may not waive the requirement 331.31that a joint self-insurance plan have excess stop-loss coverage. 331.32EFFECTIVE DATE.This section is effective the day following final enactment.331.33    Sec. 4. [62Q.40] LANGUAGE INTERPRETER SERVICES.332.1    (a) A health plan must cover sign language interpreter services provided to deaf and 332.2hard-of-hearing enrollees and language interpreter services provided to enrollees with 332.3limited English proficiency in order to facilitate the provision of health care services by a 332.4provider. For purposes of this section, "provider" has the meaning given in section 62J.03, 332.5subdivision 8, and includes a health care provider facility; and "health plan" includes 332.6coverage excluded under section 62A.011, subdivision 3, clauses (6), (7), (9), and (10). 332.7Interpreter services may be provided in person, by telephone, facsimile, video or audio 332.8streaming, or by video conference. In accordance with paragraphs (b) and (c), a health 332.9plan company shall reimburse either the party providing interpreter services directly 332.10for the costs of language interpreter services provided to the enrollee or the provider 332.11arranging for the provision of interpreter services. Providers that employ or contract 332.12with interpreters may bill and shall be reimbursed directly by health plan companies for 332.13such services in accordance with paragraph (b). A health plan company shall provide to 332.14enrollees, upon request, the policies and procedures for addressing the needs of deaf and 332.15hard-of-hearing enrollees and enrollees with limited English proficiency. All parties 332.16providing interpreter services must disclose their methods for ensuring competency upon 332.17request of any health plan company, provider, or consumer.332.18    (b) A health plan company shall pay for interpreter services as required in paragraph 332.19(a) by establishing a network of interpreter service providers and requiring use of its own 332.20network of interpreter services providers. The health plan company shall consider, as part 332.21of its interpreter service provider network, entering into an agreement with a provider for 332.22use of an interpreter service provider employed by or under contract with the provider if:332.23    (1) the provider accepts as reimbursement for services rendered by the provider's 332.24employed or contracted interpreter service provider the lesser of either the health plan 332.25company's reimbursement rate for its in-network interpreter service providers or the 332.26provider's fee for services rendered by the provider's interpreter service provider; and332.27    (2) the interpreter service provider meets the published quality standards of the 332.28health plan company.332.29    (c) If a health plan company's or a provider's employed or contracted interpreter 332.30service provider is unavailable to provide interpreter services, the health plan company 332.31shall reimburse the interpreter service provider at the lesser of the health plan company's 332.32median reimbursement rate for its in-network interpreter service providers or the 332.33interpreter service provider's fee. An interpreter service provider not employed or under 332.34contract with a health plan company or provider who fails to meet the quality standards 332.35of a health plan company or as required by law, shall be ineligible for reimbursement 332.36under this section.333.1    (d) If the health plan company pays the interpreter service provider directly, it has no 333.2obligation to pay the provider under this section.333.3    (e) Nothing in this section requires a health plan company to establish a network 333.4of interpreter service providers.333.5EFFECTIVE DATE.This section is effective July 1, 2008, and applies to plans 333.6issued or renewed to provide coverage to Minnesota residents on or after that date unless 333.7the legislature enacts alternative funding sources based on the recommendations of the 333.8commissioner.333.9    Sec. 5. Minnesota Statutes 2006, section 144.05, is amended by adding a subdivision 333.10to read:333.11    Subd. 5.Base budget detail.The commissioner shall provide the commissioner 333.12of finance with the information necessary to provide base budget detail to the legislature 333.13under section 16A.10, subdivision 2a.333.14    Sec. 6. Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision 333.15to read:333.16    Subd. 11.Dispensing by protocol.A registered nurse in a family planning agency 333.17as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives 333.18prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant 333.19to a dispensing protocol established by the agency's medical director or under the direction 333.20of a physician. The dispensing protocol must address the requirements of sections 151.01, 333.21subdivision 30, and 151.212, subdivision 1.333.22    Sec. 7. Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:333.23    Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of 333.24professional practice only, may prescribe, administer, and dispense a legend drug, and may 333.25cause the same to be administered by a nurse, a physician assistant, or medical student or 333.26resident under the practitioner's direction and supervision, and may cause a person who 333.27is an appropriately certified, registered, or licensed health care professional to prescribe, 333.28dispense, and administer the same within the expressed legal scope of the person's practice 333.29as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug, 333.30without reference to a specific patient, by directing a nurse, pursuant to section 
         148.235, 333.31subdivisions 8 and 9
         , physician assistant, or medical student or resident to adhere to 333.32a particular practice guideline or protocol when treating patients whose condition falls 333.33within such guideline or protocol, and when such guideline or protocol specifies the 334.1circumstances under which the legend drug is to be prescribed and administered. An 334.2individual who verbally, electronically, or otherwise transmits a written, oral, or electronic 334.3order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug. 334.4This paragraph applies to a physician assistant only if the physician assistant meets the 334.5requirements of section 
         147A.18. 334.6    (b) A licensed practitioner that dispenses for profit a legend drug that is to be 334.7administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must 334.8file with the practitioner's licensing board a statement indicating that the practitioner 334.9dispenses legend drugs for profit, the general circumstances under which the practitioner 334.10dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to 334.11dispense legend drugs for profit after July 31, 1990, unless the statement has been filed 334.12with the appropriate licensing board. For purposes of this paragraph, "profit" means (1) 334.13any amount received by the practitioner in excess of the acquisition cost of a legend drug 334.14for legend drugs that are purchased in prepackaged form, or (2) any amount received 334.15by the practitioner in excess of the acquisition cost of a legend drug plus the cost of 334.16making the drug available if the legend drug requires compounding, packaging, or other 334.17treatment. The statement filed under this paragraph is public data under section 
         13.03. 334.18This paragraph does not apply to a licensed doctor of veterinary medicine or a registered 334.19pharmacist. Any person other than a licensed practitioner with the authority to prescribe, 334.20dispense, and administer a legend drug under paragraph (a) shall not dispense for profit. 334.21To dispense for profit does not include dispensing by a community health clinic when the 334.22profit from dispensing is used to meet operating expenses. 334.23    (c) A prescription or drug order for a legend drug is not valid unless it is issued 334.24for a legitimate medical purpose arising from a prescriber-patient relationship that 334.25includes a documented patient evaluation adequate to establish diagnoses and identify 334.26underlying conditions and contraindications to the treatment. Treatment, including issuing 334.27a prescription or drug order, based solely on an online questionnaire does not constitute a 334.28legitimate medical purpose.334.29    Sec. 8. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to 334.30read:334.31    Subd. 2d.Identification requirement for schedule II or III controlled substance.334.32    No person may dispense a controlled substance included in schedule II or III without 334.33requiring the person purchasing the controlled substance, who need not be the person for 334.34whom the controlled substance prescription is written, to present valid photographic 335.1identification, unless the person purchasing the controlled substance, or if applicable the 335.2person for whom the controlled substance prescription is written, is known to the dispenser.335.3    Sec. 9. [152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES 335.4PRESCRIPTION ELECTRONIC REPORTING SYSTEM.335.5    Subdivision 1.Definitions.For purposes of this section, the terms defined in this 335.6subdivision have the meanings given.335.7    (a) "Board" means the Minnesota State Board of Pharmacy established under 335.8chapter 151.335.9    (b) "Controlled substances" means those substances listed in section 152.02, 335.10subdivisions 3 and 4, and those substances defined by the board pursuant to section 335.11152.02, subdivisions 8 and 12.335.12    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision 335.1330. Dispensing does not include the direct administering of a controlled substance to a 335.14patient by a licensed health care professional.335.15    (d) "Dispenser" means a person authorized by law to dispense a controlled substance, 335.16pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy 335.17that distributes controlled substances for inpatient hospital care.335.18    (e) "Prescriber" means a licensed health care professional who is authorized to 335.19prescribe a controlled substance under section 152.12, subdivision 1.335.20    (f) "Prescription" has the meaning given in section 151.01, subdivision 16.335.21    Subd. 2.Prescription electronic reporting system.(a) By January 1, 2009, 335.22or upon enactment of legislation that implements the recommendations of the Board 335.23of Pharmacy under subdivision 3, paragraph (c), whichever is later, the board shall 335.24establish an electronic system for reporting the information required under subdivision 335.254 for all controlled substances dispensed within the state. Data for controlled substance 335.26prescriptions that are dispensed in a quantity small enough to provide treatment to a 335.27patient for a period of 48 hours or less need not be reported.335.28    (b) The board may contract with a vendor for the purpose of obtaining technical 335.29assistance in the design, implementation, and maintenance of the electronic reporting 335.30system. The vendor's role shall be limited to providing technical support to the board 335.31concerning the software, databases, and computer systems required to interface with the 335.32existing systems currently used by pharmacies to dispense prescriptions and transmit 335.33prescription data to other third parties.335.34    (c) The board may issue a waiver to a dispenser that is unable to submit dispensing 335.35information by electronic means. The waiver may permit the dispenser to submit 336.1dispensing information by paper form or other means, provided all information required 336.2by subdivision 4 is submitted in this alternative format.336.3    Subd. 3.Prescription Electronic Reporting Advisory Committee.(a) The 336.4board shall convene an advisory committee. The committee must include at least one 336.5representative of:336.6    (1) the Department of Health;336.7    (2) the Department of Human Services;336.8    (3) each health-related licensing board that licenses prescribers;336.9    (4) a professional medical association, which may include an association of pain 336.10management and chemical dependency specialists;336.11    (5) a professional pharmacy association; 336.12    (6) a consumer privacy or security advocate; and 336.13    (7) a consumer or patient rights organization.336.14    (b) The advisory committee shall advise the board on the development and operation 336.15of the electronic reporting system, including, but not limited to:336.16    (1) technical standards for electronic prescription drug reporting;336.17    (2) proper analysis and interpretation of prescription monitoring data; and336.18    (3) an evaluation process for the program.336.19    (c) The Board of Pharmacy, after consultation with the advisory committee, shall 336.20present recommendations and draft legislation on the issues addressed by the advisory 336.21committee under paragraph (b), to the legislature by December 15, 2007.336.22    Subd. 4.Reporting requirements and notice.(a) Each dispenser must submit the 336.23following data to the board or its designated vendor, subject to the notice required under 336.24paragraph (d):336.25    (1) prescriber DEA number;336.26    (2) dispenser DEA number;336.27    (3) name of the patient for whom the prescription was written;336.28    (4) date of birth of the patient for whom the prescription was written;336.29    (5) date the prescription was written;336.30    (6) date the prescription was filled;336.31    (7) NDC code for drug dispensed; and336.32    (8) quantity of controlled substance dispensed.336.33    (b) The dispenser must submit the required information according to the format and 336.34protocols specified in the "ASAP Telecommunications Format for Controlled Substances," 336.35May 1995 edition, published by the American Society for Automation in Pharmacy, which 336.36is hereby adopted by reference, by a procedure established by the board.337.1    (c) A dispenser is not required to submit this data for those controlled substance 337.2prescriptions dispensed for:337.3    (1) individuals residing in licensed skilled nursing or intermediate care facilities;337.4    (2) individuals receiving assisted living services under chapter 144G or through a 337.5medical assistance home and community-based waiver;337.6    (3) individuals receiving medication intravenously;337.7    (4) individuals receiving hospice and other palliative or end-of-life care; and337.8    (5) individuals receiving services from a home care provider regulated under chapter 337.9144A.337.10    (d) A dispenser must not submit data under this subdivision unless a conspicuous 337.11notice of the reporting requirements of this section is given to the patient for whom the 337.12prescription was written.337.13    Subd. 5.Use of data by board.(a) The board shall develop and maintain a database 337.14of the data reported under subdivision 4. The board shall maintain data that could identify 337.15an individual prescriber or dispenser in encrypted form. The database may be used by 337.16permissible users identified under subdivision 6 for the identification of:337.17    (1) individuals receiving prescriptions for controlled substances from prescribers 337.18who subsequently obtain controlled substances from dispensers in quantities or with a 337.19frequency inconsistent with generally recognized standards of dosage for those controlled 337.20substances; and 337.21    (2) individuals presenting forged or otherwise false or altered prescriptions for 337.22controlled substances to dispensers. 337.23    (b) No permissible user identified under subdivision 6 may access the database 337.24for the sole purpose of identifying prescribers of controlled substances for unusual or 337.25excessive prescribing patterns without a valid search warrant or court order.337.26    (c) No personnel of a state or federal occupational licensing board or agency may 337.27access the database for the purpose of obtaining information to be used to initiate or 337.28substantiate a disciplinary action against a prescriber.337.29    (d) Data reported under subdivision 4 shall be retained by the board in the database 337.30for a six-month period, and shall be removed from the database six months from the 337.31date the data was received.337.32    Subd. 6.Access to reporting system data.(a) Except as indicated in this 337.33subdivision, the data submitted to the board under subdivision 4 is private data on 337.34individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.337.35    (b) Except as specified in subdivision 5, the following persons shall be considered 337.36permissible users and may access the data submitted under subdivision 4 in the same or 338.1similar manner, and for the same or similar purposes, as those persons who are authorized 338.2to access similar private data on individuals under federal and state law:338.3    (1) a prescriber, to the extent the information relates specifically to a current patient 338.4of the prescriber, to whom the practitioner is prescribing or considering prescribing any 338.5controlled substance;338.6    (2) a dispenser to the extent the information relates specifically to a current patient to 338.7whom that dispenser is dispensing or considering dispensing any controlled substance;338.8    (3) an individual who is the recipient of a controlled substance prescription for 338.9which data was submitted under subdivision 4;338.10    (4) personnel of the board specifically assigned to conduct a bona fide investigation 338.11of a specific board licensee;338.12    (5) personnel of the board engaged in the collection of controlled substance 338.13prescription information as part of the assigned duties and responsibilities under this 338.14section;338.15    (6) authorized personnel of a vendor under contract with the board who are engaged 338.16in the design, implementation, and maintenance of the electronic reporting system as part 338.17of the assigned duties and responsibilities of their employment, provided that access to data 338.18is limited to the minimum amount necessary to test and maintain the system databases;338.19    (7) federal, state, and local law enforcement authorities engaged in a bona fide 338.20investigation of a specific person; and338.21    (8) personnel of the medical assistance program assigned to use the data collected 338.22under this section to identify recipients whose usage of controlled substances may warrant 338.23restriction to a single primary care physician, a single outpatient pharmacy, or a single 338.24hospital.338.25    (c) Any permissible user identified in paragraph (b), who directly accesses 338.26the data electronically, shall implement and maintain a comprehensive information 338.27security program that contains administrative, technical, and physical safeguards that 338.28are appropriate to the user's size and complexity, and the sensitivity of the personal 338.29information obtained. The permissible user shall identify reasonably foreseeable internal 338.30and external risks to the security, confidentiality, and integrity of personal information 338.31that could result in the unauthorized disclosure, misuse, or other compromise of the 338.32information and assess the sufficiency of any safeguards in place to control the risks.338.33    (d) The board shall not release data submitted under this section unless it is provided 338.34with evidence, satisfactory to the board, that the person requesting the information is 338.35entitled to receive the data. Access to the data by law enforcement authorities must be 338.36accompanied by a valid search warrant.339.1    (e) The board shall not release the name of a prescriber without the written consent 339.2of the prescriber or a valid search warrant or court order. The board shall provide a 339.3mechanism for a prescriber to submit to the board a signed consent authorizing the release 339.4of the prescriber's name when data containing the prescriber's name is requested.339.5    (f) The board shall maintain a log of all persons who access the data and shall ensure 339.6that any permissible user complies with paragraph (c) prior to attaining direct access to 339.7the data.339.8    Subd. 7.Disciplinary action.(a) A dispenser who knowingly fails to submit data to 339.9the board as required under this section is subject to disciplinary action by the appropriate 339.10health-related licensing board.339.11    (b) A prescriber or dispenser authorized to access the data who knowingly discloses 339.12the data in violation of state or federal laws relating to the privacy of health care data 339.13shall be subject to disciplinary action by the appropriate health-related licensing board, 339.14and appropriate civil penalties.339.15    Subd. 8.Evaluation and reporting.(a) The board shall evaluate the prescription 339.16electronic reporting system to determine if the system is cost-effective and whether it is 339.17negatively impacting appropriate prescribing practices of controlled substances. The 339.18board may contract with a vendor to design and conduct the evaluation.339.19    (b) The board shall submit the evaluation of the system to the legislature by January 339.2015, 2010.339.21    Subd. 9.Immunity from liability; no requirement to obtain information.(a) A 339.22pharmacist, prescriber, or other dispenser making a report to the program in good faith 339.23under this section is immune from any civil, criminal, or administrative liability, which 339.24might otherwise be incurred or imposed as a result of the report, or on the basis that the 339.25pharmacist or prescriber did or did not seek or obtain or use information from the program.339.26    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser 339.27to obtain information about a patient from the program, and the pharmacist, prescriber, 339.28or other dispenser, if acting in good faith, is immune from any civil, criminal, or 339.29administrative liability that might otherwise be incurred or imposed for requesting, 339.30receiving, or using information from the program.339.31EFFECTIVE DATE.This section is effective July 1, 2007, or upon receiving 339.32sufficient nonstate funds to implement the prescription electronic reporting program, 339.33whichever is later. In the event that nonstate funds are not secured by the Board of 339.34Pharmacy to adequately fund the implementation of the prescription electronic reporting 339.35program, the board is not required to implement this section without a subsequent 339.36appropriation from the legislature.340.1    Sec. 10. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to read:340.2    Subd. 7. Essential employee. "Essential employee" means firefighters, peace 340.3officers subject to licensure under sections 
         626.84 to 
         626.863, 911 system and police and 340.4fire department public safety dispatchers, guards at correctional facilities, confidential 340.5employees, supervisory employees, assistant county attorneys, assistant city attorneys, 340.6principals, and assistant principals. However, for state employees, "essential employee" 340.7means all employees, except for nonprofessional employees employed by the Department 340.8of Human Services in mental health facilities for the treatment of psychopathic 340.9personalities, sexual predators, and the criminally insane, in law enforcement, public 340.10safety radio communications operators, health care professionals, correctional guards, 340.11professional engineering, and supervisory collective bargaining units, irrespective of 340.12severance, and no other employees. For University of Minnesota employees, "essential 340.13employee" means all employees in law enforcement, nursing professional and supervisory 340.14units, irrespective of severance, and no other employees. "Firefighters" means salaried 340.15employees of a fire department whose duties include, directly or indirectly, controlling, 340.16extinguishing, preventing, detecting, or investigating fires. Employees for whom the state 340.17court administrator is the negotiating employer are not essential employees. For Hennepin 340.18Healthcare System, Inc. employees, "essential employees" means all employees.340.19EFFECTIVE DATE.This section is effective the day following final enactment.340.20    Sec. 11. Minnesota Statutes 2006, section 245.4874, is amended to read:340.21245.4874 DUTIES OF COUNTY BOARD.340.22    (a) The county board must:340.23    (1) develop a system of affordable and locally available children's mental health 340.24services according to sections 
         245.487 to 
         245.4887;340.25    (2) establish a mechanism providing for interagency coordination as specified in 340.26section 
         245.4875, subdivision 6;340.27    (3) consider the assessment of unmet needs in the county as reported by the local 340.28children's mental health advisory council under section 
         245.4875, subdivision 5, paragraph 340.29(b), clause (3). The county shall provide, upon request of the local children's mental health 340.30advisory council, readily available data to assist in the determination of unmet needs;340.31    (4) assure that parents and providers in the county receive information about how to 340.32gain access to services provided according to sections 
         245.487 to 
         245.4887;340.33    (5) coordinate the delivery of children's mental health services with services 340.34provided by social services, education, corrections, health, and vocational agencies to 341.1improve the availability of mental health services to children and the cost-effectiveness of 341.2their delivery;341.3    (6) assure that mental health services delivered according to sections 
         245.487341.4to 
         245.4887 are delivered expeditiously and are appropriate to the child's diagnostic 341.5assessment and individual treatment plan;341.6    (7) provide the community with information about predictors and symptoms of 341.7emotional disturbances and how to access children's mental health services according to 341.8sections 
         245.4877 and 
         245.4878;341.9    (8) provide for case management services to each child with severe emotional 341.10disturbance according to sections 
         245.486; 
         245.4871, subdivisions 3 and 4; and 
         245.4881, 341.11subdivisions 1, 3, and 5
         ;341.12    (9) provide for screening of each child under section 
         245.4885 upon admission 341.13to a residential treatment facility, acute care hospital inpatient treatment, or informal 341.14admission to a regional treatment center;341.15    (10) prudently administer grants and purchase-of-service contracts that the county 341.16board determines are necessary to fulfill its responsibilities under sections 
         245.487 to 341.17245.4887
         ;341.18    (11) assure that mental health professionals, mental health practitioners, and case 341.19managers employed by or under contract to the county to provide mental health services 341.20are qualified under section 
         245.4871;341.21    (12) assure that children's mental health services are coordinated with adult mental 341.22health services specified in sections 
         245.461 to 
         245.486 so that a continuum of mental 341.23health services is available to serve persons with mental illness, regardless of the person's 341.24age;341.25    (13) assure that culturally informed mental health consultants are used as necessary 341.26to assist the county board in assessing and providing appropriate treatment for children of 341.27cultural or racial minority heritage; and341.28    (14) consistent with section 
         245.486, arrange for or provide a children's mental 341.29health screening to a child receiving child protective services or a child in out-of-home 341.30placement, a child for whom parental rights have been terminated, a child found to be 341.31delinquent, and a child found to have committed a juvenile petty offense for the third 341.32or subsequent time, unless a screening or diagnostic assessment has been performed 341.33within the previous 180 days, or the child is currently under the care of a mental health 341.34professional. The court or county agency must notify a parent or guardian whose 341.35parental rights have not been terminated of the potential mental health screening and the 341.36option to prevent the screening by notifying the court or county agency in writing. The 342.1screening shall be conducted with a screening instrument approved by the commissioner 342.2of human services according to criteria that are updated and issued annually to ensure 342.3that approved screening instruments are valid and useful for child welfare and juvenile 342.4justice populations, and shall be conducted by a mental health practitioner as defined in 342.5section 
         245.4871, subdivision 26, or a probation officer or local social services agency 342.6staff person who is trained in the use of the screening instrument. Training in the use of the 342.7instrument shall include training in the administration of the instrument, the interpretation 342.8of its validity given the child's current circumstances, the state and federal data practices 342.9laws and confidentiality standards, the parental consent requirement, and providing respect 342.10for families and cultural values. If the screen indicates a need for assessment, the child's 342.11family, or if the family lacks mental health insurance, the local social services agency, 342.12in consultation with the child's family, shall have conducted a diagnostic assessment, 342.13including a functional assessment, as defined in section 
         245.4871. The administration of 342.14the screening shall safeguard the privacy of children receiving the screening and their 342.15families and shall comply with the Minnesota Government Data Practices Act, chapter 342.1613, and the federal Health Insurance Portability and Accountability Act of 1996, Public 342.17Law 104-191. Screening results shall be considered private data and the commissioner 342.18shall not collect individual screening results.342.19    (b) When the county board refers clients to providers of children's therapeutic 342.20services and supports under section 
         256B.0943, the county board must clearly identify 342.21the desired services components not covered under section 
         256B.0943 and identify the 342.22reimbursement source for those requested services, the method of payment, and the 342.23payment rate to the provider.342.24    Sec. 12. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:342.25    Subd. 2. Transfer to correctional facility. (a) If a person has been committed 342.26under this section and later is committed to the custody of the commissioner of corrections 342.27for any reason, including but not limited to, being sentenced for a crime or revocation of 342.28the person's supervised release or conditional release under section 
         244.05, 609.108, 342.29subdivision 6, or 
         609.109, subdivision 7, the person shall be transferred to a facility 342.30designated by the commissioner of corrections without regard to the procedures provided 342.31in section 
         253B.18. 342.32    (b) If a person is committed under this section after a commitment to the 342.33commissioner of corrections, the person shall first serve the sentence in a facility 342.34designated by the commissioner of corrections. After the person has served the sentence, 343.1the person shall be transferred to a treatment program designated by the commissioner 343.2of human services.343.3    Sec. 13. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:343.4    Subd. 3. Rules for chemical dependency care. The commissioner of human 343.5services shall establish by rule criteria to be used in determining the appropriate level 343.6of chemical dependency care, whether outpatient, inpatient or short-term treatment 343.7programs, for each recipient of public assistance seeking treatment for alcohol or other 343.8drug dependency and abuse problems. The criteria shall address, at least, the family 343.9relationship, past treatment history, medical or physical problems, arrest record, and 343.10employment situation.343.11    Sec. 14. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:343.12    Subd. 2. Program and service guidelines. (a) The commissioner shall provide 343.13program and service guidelines and technical assistance to the county boards in carrying 343.14out services authorized under sections section254A.08, 254A.12, 254A.14, and their 343.15responsibilities under chapter 256E. 343.16    (b) The commissioner shall recommend to the governor means of improving 343.17the efficiency and effectiveness of comprehensive program services in the state and 343.18maximizing the use of nongovernmental funds for providing comprehensive programs.343.19    Sec. 15. [254A.20] CHEMICAL USE ASSESSMENTS; FINANCIAL CONFLICT 343.20OF INTEREST.343.21    (a) Except as provided in paragraph (b), an assessor conducting a chemical use 343.22assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any 343.23direct or shared financial interest or referral relationship resulting in shared financial 343.24interest or referral relationship resulting in shared financial gain with a treatment provider. 343.25    (b) A county may contract with an assessor having a conflict described in paragraph 343.26(a) if the county documents that: 343.27    (1) the assessor is employed by a culturally specific service provider or a service 343.28provider with a program designed to treat individuals of a specific age, sex, or sexual 343.29preference; 343.30    (2) the county does not employ a sufficient number of qualified assessors and the 343.31only qualified assessors available in the county have a direct or shared financial interest or 343.32a referral relationship resulting in shared financial gain with a treatment provider; or 344.1    (3) the county social service agency has an existing relationship with an assessor 344.2or service provider and elects to enter into a contract with that assessor to provide both 344.3assessment and treatment under circumstances specified in the county's contract, provided 344.4the county retains responsibility for making placement decisions.344.5EFFECTIVE DATE.This section is effective the day following final enactment.344.6    Sec. 16. Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:344.7    Subdivision 1. Chemical dependency treatment allocation. The chemical 344.8dependency funds appropriated for allocation shall be placed in a special revenue account. 344.9The commissioner shall annually transfer funds from the chemical dependency fund to pay 344.10for operation of the drug and alcohol abuse normative evaluation system and to pay for all 344.11costs incurred by adding two positions for licensing of chemical dependency treatment 344.12and rehabilitation programs located in hospitals for which funds are not otherwise 344.13appropriated. For each year of the biennium ending June 30, 1999, the commissioner shall 344.14allocate funds to the American Indian chemical dependency tribal account for treatment 344.15of American Indians by eligible vendors under section 254B.05, equal to the amount 344.16allocated in fiscal year 1997. Six percent of the remaining money must be reserved for 344.17tribal allocation under section 254B.09, subdivisions 4 and 5. The commissioner shall 344.18annually divide the money available in the chemical dependency fund that is not held 344.19in reserve by counties from a previous allocation, or allocated to the American Indian 344.20chemical dependency tribal account. Six percent of the remaining money must be 344.21reserved for the nonreservation American Indian chemical dependency allocation for 344.22treatment of American Indians by eligible vendors under section 
         254B.05, subdivision 344.231
         . The remainder of the money must be allocated among the counties according to the 344.24following formula, using state demographer data and other data sources determined by 344.25the commissioner: 344.26    (a) For purposes of this formula, American Indians and children under age 14 are 344.27subtracted from the population of each county to determine the restricted population.344.28    (b) The amount of chemical dependency fund expenditures for entitled persons for 344.29services not covered by prepaid plans governed by section 
         256B.69 in the previous year is 344.30divided by the amount of chemical dependency fund expenditures for entitled persons for 344.31all services to determine the proportion of exempt service expenditures for each county. 344.32    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt 344.33service expenditures to determine the adjusted prepaid plan months of eligibility for 344.34each county.345.1    (d) The adjusted prepaid plan months of eligibility is added to the number of 345.2restricted population fee for service months of eligibility for the Minnesota family 345.3investment program, general assistance, and medical assistance and divided by the county 345.4restricted population to determine county per capita months of covered service eligibility.345.5    (e) The number of adjusted prepaid plan months of eligibility for the state is added 345.6to the number of fee for service months of eligibility for the Minnesota family investment 345.7program, general assistance, and medical assistance for the state restricted population and 345.8divided by the state restricted population to determine state per capita months of covered 345.9service eligibility.345.10    (f) The county per capita months of covered service eligibility is divided by the 345.11state per capita months of covered service eligibility to determine the county welfare 345.12caseload factor.345.13    (g) The median married couple income for the most recent three-year period 345.14available for the state is divided by the median married couple income for the same period 345.15for each county to determine the income factor for each county.345.16    (h) The county restricted population is multiplied by the sum of the county welfare 345.17caseload factor and the county income factor to determine the adjusted population.345.18    (i) $15,000 shall be allocated to each county.345.19    (j) The remaining funds shall be allocated proportional to the county adjusted 345.20population.345.21    Sec. 17. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:345.22    Subd. 5. Administrative adjustment. The commissioner may make payments to 345.23local agencies from money allocated under this section to support administrative activities 345.24under sections 
         254B.03 and 
         254B.04. The administrative payment must not exceed 345.25five percent of the first $50,000, four percent of the next $50,000, and three percent of 345.26the remaining payments for services from the allocation. Twenty-five percent of the 345.27administrative allowance shall be advanced at the beginning of each quarter, based on 345.28the payments for services made in the most recent quarter for which data is available. 345.29Adjustment of any overestimate or underestimate based on actual expenditures shall be 345.30made by the state agency by adjusting the administrative allowance for any succeeding 345.31quarter.345.32    Sec. 18. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:345.33    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical 345.34dependency services to persons residing within its jurisdiction who meet criteria 346.1established by the commissioner for placement in a chemical dependency residential or 346.2nonresidential treatment service. Chemical dependency money must be administered 346.3by the local agencies according to law and rules adopted by the commissioner under 346.4sections 
         14.001 to 
         14.69. 346.5    (b) In order to contain costs, the county board shall, with the approval of the 346.6commissioner of human services, select eligible vendors of chemical dependency services 346.7who can provide economical and appropriate treatment. Unless the local agency is a social 346.8services department directly administered by a county or human services board, the local 346.9agency shall not be an eligible vendor under section 
         254B.05. The commissioner may 346.10approve proposals from county boards to provide services in an economical manner or to 346.11control utilization, with safeguards to ensure that necessary services are provided. If a 346.12county implements a demonstration or experimental medical services funding plan, the 346.13commissioner shall transfer the money as appropriate. If a county selects a vendor located 346.14in another state, the county shall ensure that the vendor is in compliance with the rules 346.15governing licensure of programs located in the state. 346.16    (c) The calendar year 2002 rate for vendors may not increase more than three 346.17percent above the rate approved in effect on January 1, 2001. The calendar year 2003 346.18rate for vendors may not increase more than three percent above the rate in effect on 346.19January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in 346.20effect on January 1, 2003.346.21    (d) (c) A culturally specific vendor that provides assessments under a variance under 346.22Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to 346.23persons not covered by the variance.346.24    Sec. 19. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:346.25    Subd. 3. Local agencies to pay state for county share.Local agencies shall submit 346.26invoices to the state on forms supplied by the commissioner and according to procedures 346.27established by the commissioner. Local agencies shall pay the state for the county share 346.28of the invoiced services authorized by the local agency. Payments shall be made at the 346.29beginning of each month for services provided in the previous month. The commissioner 346.30shall bill the county monthly for services, based on the most recent month for which 346.31expenditure information is available. Adjustment of any overestimate or underestimate 346.32based on actual expenditures shall be made by the state agency by adjusting the estimate 346.33for any succeeding month.346.34    Sec. 20. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:347.1    Subd. 3. Payment; denial. The commissioner shall pay eligible vendors for 347.2placements made by local agencies under section 
         254B.03, subdivision 1, and placements 347.3by tribal designated agencies according to section 
         254B.09. The commissioner may 347.4reduce or deny payment of the state share when services are not provided according to the 347.5placement criteria established by the commissioner. The commissioner may pay for all or 347.6a portion of improper county chemical dependency placements and bill the county for the 347.7entire payment made when the placement did not comply with criteria established by the 347.8commissioner. The commissioner may make payments to vendors and charge the county 347.9100 percent of the payments if documentation of a county approved placement is received 347.10more than 30 working days, exclusive of weekends and holidays, after the date services 347.11began; or if the county approved invoice is received by the commissioner more than 120 347.12days after the last date of service provided. The commissioner shall not pay vendors until 347.13private insurance company claims have been settled. 347.14    Sec. 21. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision 347.15to read:347.16    Subd. 25.Base budget detail.The commissioner shall provide the commissioner 347.17of finance with the information necessary to provide base budget detail to the legislature 347.18under section 16A.10, subdivision 2a.347.19    Sec. 22. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to 347.20read:347.21    Subd. 23. Day treatment services. Medical assistance covers day treatment 347.22services as specified in sections 
         245.462, subdivision 8, and 
         245.4871, subdivision 10, that 347.23are provided under contract with the county board. Notwithstanding Minnesota Rules, 347.24part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day 347.25treatment for adults according to section 
         256B.0625, subdivision 25. Notwithstanding 347.26Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance 347.27covers day treatment services for children as specified under section 
         256B.0943. 347.28    Sec. 23. [256B.0636] PRESCRIBING OF CONTROLLED SUBSTANCES; 347.29ABUSE PREVENTION.347.30    The commissioner shall develop and implement a plan to:347.31    (1) monitor the prescribing of controlled substances listed in section 152.02, 347.32subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under 348.1section 152.02, subdivisions 8 and 12, by enrolled providers and providers under contract 348.2with participating managed care plans;348.3    (2) require enrolled providers and providers under contract with participating 348.4managed care plans to report information related to potential patient abuse of the 348.5controlled substances to the commissioner, and the Board of Pharmacy; and348.6    (3) provide education to Minnesota health care program enrollees on the proper use 348.7of controlled substances.348.8    Sec. 24. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to 348.9read:348.10    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be 348.11an eligible provider entity under this section, a provider entity must have a clinical 348.12infrastructure that utilizes diagnostic assessment, an individualized treatment plan, 348.13service delivery, and individual treatment plan review that are culturally competent, 348.14child-centered, and family-driven to achieve maximum benefit for the client. The provider 348.15entity must review and update the clinical policies and procedures every three years and 348.16must distribute the policies and procedures to staff initially and upon each subsequent 348.17update.348.18    (b) The clinical infrastructure written policies and procedures must include policies 348.19and procedures for:348.20    (1) providing or obtaining a client's diagnostic assessment that identifies acute and 348.21chronic clinical disorders, co-occurring medical conditions, sources of psychological and 348.22environmental problems, and a functional assessment. The functional assessment must 348.23clearly summarize the client's individual strengths and needs;348.24    (2) developing an individual treatment plan that is:348.25    (i) based on the information in the client's diagnostic assessment;348.26    (ii) developed no later than the end of the first psychotherapy session after the 348.27completion of the client's diagnostic assessment by the mental health professional who 348.28provides the client's psychotherapy;348.29    (iii) developed through a child-centered, family-driven planning process that 348.30identifies service needs and individualized, planned, and culturally appropriate 348.31interventions that contain specific treatment goals and objectives for the client and the 348.32client's family or foster family;348.33    (iv) reviewed at least once every 90 days and revised, if necessary; and348.34    (v) signed by the client or, if appropriate, by the client's parent or other person 348.35authorized by statute to consent to mental health services for the client;349.1    (3) developing an individual behavior plan that documents services to be provided 349.2by the mental health behavioral aide. The individual behavior plan must include:349.3    (i) detailed instructions on the service to be provided;349.4    (ii) time allocated to each service;349.5    (iii) methods of documenting the child's behavior;349.6    (iv) methods of monitoring the child's progress in reaching objectives; and349.7    (v) goals to increase or decrease targeted behavior as identified in the individual 349.8treatment plan;349.9    (4) clinical supervision of the mental health practitioner and mental health behavioral 349.10aide. A mental health professional must document the clinical supervision the professional 349.11provides by cosigning individual treatment plans and making entries in the client's record 349.12on supervisory activities. Clinical supervision does not include the authority to make or 349.13terminate court-ordered placements of the child. A clinical supervisor must be available 349.14for urgent consultation as required by the individual client's needs or the situation. Clinical 349.15supervision may occur individually or in a small group to discuss treatment and review 349.16progress toward goals. The focus of clinical supervision must be the client's treatment 349.17needs and progress and the mental health practitioner's or behavioral aide's ability to 349.18provide services;349.19    (4a) CTSS certified provider entities providing day treatment programs must meet 349.20the conditions in items (i) to (iii):349.21    (i) the provider supervisor must be present and available on the premises more 349.22than 50 percent of the time in a five-working-day period during which the supervisee is 349.23providing a mental health service;349.24    (ii) the diagnosis and the client's individual treatment plan or a change in the 349.25diagnosis or individual treatment plan must be made by or reviewed, approved, and signed 349.26by the provider supervisor; and349.27    (iii) every 30 days, the supervisor must review and sign the record of the client's care 349.28for all activities in the preceding 30-day period;349.29    (4b) for all other services provided under CTSS, clinical supervision standards 349.30provided in items (i) to (iii) must be used:349.31    (i) medical assistance shall reimburse a mental health practitioner who maintains a 349.32consulting relationship with a mental health professional who accepts full professional 349.33responsibility and is present on site for at least one observation during the first 12 hours 349.34in which the mental health practitioner provides the individual, family, or group skills 349.35training to the child or the child's family;350.1    (ii) thereafter, the mental health professional is required to be present on site for 350.2observation as clinically appropriate when the mental health practitioner is providing 350.3individual, family, or group skills training to the child or the child's family; and350.4    (iii) the observation must be a minimum of one clinical unit. The on-site presence of 350.5the mental health professional must be documented in the child's record and signed by the 350.6mental health professional who accepts full professional responsibility;350.7    (5) providing direction to a mental health behavioral aide. For entities that employ 350.8mental health behavioral aides, the clinical supervisor must be employed by the provider 350.9entity or other certified children's therapeutic supports and services provider entity to 350.10ensure necessary and appropriate oversight for the client's treatment and continuity 350.11of care. The mental health professional or mental health practitioner giving direction 350.12must begin with the goals on the individualized treatment plan, and instruct the mental 350.13health behavioral aide on how to construct therapeutic activities and interventions that 350.14will lead to goal attainment. The professional or practitioner giving direction must also 350.15instruct the mental health behavioral aide about the client's diagnosis, functional status, 350.16and other characteristics that are likely to affect service delivery. Direction must also 350.17include determining that the mental health behavioral aide has the skills to interact with 350.18the client and the client's family in ways that convey personal and cultural respect and 350.19that the aide actively solicits information relevant to treatment from the family. The aide 350.20must be able to clearly explain the activities the aide is doing with the client and the 350.21activities' relationship to treatment goals. Direction is more didactic than is supervision 350.22and requires the professional or practitioner providing it to continuously evaluate the 350.23mental health behavioral aide's ability to carry out the activities of the individualized 350.24treatment plan and the individualized behavior plan. When providing direction, the 350.25professional or practitioner must:350.26    (i) review progress notes prepared by the mental health behavioral aide for accuracy 350.27and consistency with diagnostic assessment, treatment plan, and behavior goals and the 350.28professional or practitioner must approve and sign the progress notes;350.29    (ii) identify changes in treatment strategies, revise the individual behavior plan, 350.30and communicate treatment instructions and methodologies as appropriate to ensure 350.31that treatment is implemented correctly;350.32    (iii) demonstrate family-friendly behaviors that support healthy collaboration among 350.33the child, the child's family, and providers as treatment is planned and implemented;350.34    (iv) ensure that the mental health behavioral aide is able to effectively communicate 350.35with the child, the child's family, and the provider; and351.1    (v) record the results of any evaluation and corrective actions taken to modify the 351.2work of the mental health behavioral aide;351.3    (6) providing service delivery that implements the individual treatment plan and 351.4meets the requirements under subdivision 9; and351.5    (7) individual treatment plan review. The review must determine the extent to which 351.6the services have met the goals and objectives in the previous treatment plan. The review 351.7must assess the client's progress and ensure that services and treatment goals continue to 351.8be necessary and appropriate to the client and the client's family or foster family. Revision 351.9of the individual treatment plan does not require a new diagnostic assessment unless the 351.10client's mental health status has changed markedly. The updated treatment plan must be 351.11signed by the client, if appropriate, and by the client's parent or other person authorized by 351.12statute to give consent to the mental health services for the child.351.13    Sec. 25. Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to 351.14read:351.15    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a 351.16certified provider entity must ensure that:351.17    (1) each individual provider's caseload size permits the provider to deliver services 351.18to both clients with severe, complex needs and clients with less intensive needs. The 351.19provider's caseload size should reasonably enable the provider to play an active role in 351.20service planning, monitoring, and delivering services to meet the client's and client's 351.21family's needs, as specified in each client's individual treatment plan;351.22    (2) site-based programs, including day treatment and preschool programs, provide 351.23staffing and facilities to ensure the client's health, safety, and protection of rights, and that 351.24the programs are able to implement each client's individual treatment plan;351.25    (3) a day treatment program is provided to a group of clients by a multidisciplinary 351.26team under the clinical supervision of a mental health professional. The day treatment 351.27program must be provided in and by: (i) an outpatient hospital accredited by the Joint 351.28Commission on Accreditation of Health Organizations and licensed under sections 351.29144.50
          to 
         144.55; (ii) a community mental health center under section 
         245.62; and (iii) 351.30an entity that is under contract with the county board to operate a program that meets 351.31the requirements of sections 
         245.4712, subdivision 2, and 
         245.4884, subdivision 2, 351.32and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must 351.33stabilize the client's mental health status while developing and improving the client's 351.34independent living and socialization skills. The goal of the day treatment program must be 351.35to reduce or relieve the effects of mental illness and provide training to enable the client 352.1to live in the community. The program must be available at least one day a week for a 352.2minimum three-hour time block. The three-hour time block must include at least one 352.3hour, but no more than two hours, of individual or group psychotherapy. The remainder 352.4of the three-hour time block may include recreation therapy, socialization therapy, or 352.5independent living skills therapy, but only if the therapies are included in the client's 352.6individual treatment plan. Day treatment programs are not part of inpatient or residential 352.7treatment services; and 352.8    (4) a preschool program is a structured treatment program offered to a child who 352.9is at least 33 months old, but who has not yet reached the first day of kindergarten, by a 352.10preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts 352.119503.0005 to 9503.0175. The program must be available at least one day a week for a 352.12minimum two-hour time block. The structured treatment program may include individual 352.13or group psychotherapy and recreation therapy, socialization therapy, or independent 352.14living skills therapy, if included in the client's individual treatment plan.352.15    (b) A provider entity must deliver the service components of children's therapeutic 352.16services and supports in compliance with the following requirements:352.17    (1) individual, family, and group psychotherapy must be delivered as specified in 352.18Minnesota Rules, part 9505.0323;352.19    (2) individual, family, or group skills training must be provided by a mental health 352.20professional or a mental health practitioner who has a consulting relationship with a 352.21mental health professional who accepts full professional responsibility for the training;352.22    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis 352.23through arrangements for direct intervention and support services to the child and the 352.24child's family. Crisis assistance must utilize resources designed to address abrupt or 352.25substantial changes in the functioning of the child or the child's family as evidenced by 352.26a sudden change in behavior with negative consequences for well being, a loss of usual 352.27coping mechanisms, or the presentation of danger to self or others;352.28    (4) medically necessary services that are provided by a mental health behavioral 352.29aide must be designed to improve the functioning of the child and support the family in 352.30activities of daily and community living. A mental health behavioral aide must document 352.31the delivery of services in written progress notes. The mental health behavioral aide 352.32must implement goals in the treatment plan for the child's emotional disturbance that 352.33allow the child to acquire developmentally and therapeutically appropriate daily living 352.34skills, social skills, and leisure and recreational skills through targeted activities. These 352.35activities may include:353.1    (i) assisting a child as needed with skills development in dressing, eating, and 353.2toileting;353.3    (ii) assisting, monitoring, and guiding the child to complete tasks, including 353.4facilitating the child's participation in medical appointments;353.5    (iii) observing the child and intervening to redirect the child's inappropriate behavior;353.6    (iv) assisting the child in using age-appropriate self-management skills as related 353.7to the child's emotional disorder or mental illness, including problem solving, decision 353.8making, communication, conflict resolution, anger management, social skills, and 353.9recreational skills;353.10    (v) implementing deescalation techniques as recommended by the mental health 353.11professional;353.12    (vi) implementing any other mental health service that the mental health professional 353.13has approved as being within the scope of the behavioral aide's duties; or353.14    (vii) assisting the parents to develop and use parenting skills that help the child 353.15achieve the goals outlined in the child's individual treatment plan or individual behavioral 353.16plan. Parenting skills must be directed exclusively to the child's treatment; and353.17    (5) direction of a mental health behavioral aide must include the following:353.18    (i) a total of one hour of on-site observation by a mental health professional during 353.19the first 12 hours of service provided to a child;353.20    (ii) ongoing on-site observation by a mental health professional or mental health 353.21practitioner for at least a total of one hour during every 40 hours of service provided 353.22to a child; and353.23    (iii) immediate accessibility of the mental health professional or mental health 353.24practitioner to the mental health behavioral aide during service provision.353.25    Sec. 26. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to 353.26read:353.27    Subd. 11. Documentation and billing. (a) A provider entity must document the 353.28services it provides under this section. The provider entity must ensure that the entity's 353.29documentation standards meet the requirements of federal and state laws. Services billed 353.30under this section that are not documented according to this subdivision shall be subject to 353.31monetary recovery by the commissioner. The provider entity may not bill for anything 353.32other than direct service time.353.33    (b) An individual mental health provider must promptly document the following 353.34in a client's record after providing services to the client:354.1    (1) each occurrence of the client's mental health service, including the date, type, 354.2length, and scope of the service;354.3    (2) the name of the person who gave the service;354.4    (3) contact made with other persons interested in the client, including representatives 354.5of the courts, corrections systems, or schools. The provider must document the name 354.6and date of each contact;354.7    (4) any contact made with the client's other mental health providers, case manager, 354.8family members, primary caregiver, legal representative, or the reason the provider did 354.9not contact the client's family members, primary caregiver, or legal representative, if 354.10applicable; and354.11    (5) required clinical supervision, as appropriate.354.12    Sec. 27. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to 354.13read:354.14    Subd. 12. Excluded services. The following services are not eligible for medical 354.15assistance payment as children's therapeutic services and supports:354.16    (1) service components of children's therapeutic services and supports 354.17simultaneously provided by more than one provider entity unless prior authorization is 354.18obtained;354.19    (2) children's therapeutic services and supports provided in violation of medical 354.20assistance policy in Minnesota Rules, part 9505.0220;354.21    (3) mental health behavioral aide services provided by a personal care assistant who 354.22is not qualified as a mental health behavioral aide and employed by a certified children's 354.23therapeutic services and supports provider entity;354.24    (4) service components of CTSS that are the responsibility of a residential or 354.25program license holder, including foster care providers under the terms of a service 354.26agreement or administrative rules governing licensure; and354.27    (5) adjunctive activities that may be offered by a provider entity but are not 354.28otherwise covered by medical assistance, including:354.29    (i) a service that is primarily recreation oriented or that is provided in a setting that 354.30is not medically supervised. This includes sports activities, exercise groups, activities 354.31such as craft hours, leisure time, social hours, meal or snack time, trips to community 354.32activities, and tours;354.33    (ii) a social or educational service that does not have or cannot reasonably be 354.34expected to have a therapeutic outcome related to the client's emotional disturbance;355.1    (iii) consultation with other providers or service agency staff about the care or 355.2progress of a client;355.3    (iv) prevention or education programs provided to the community; and355.4    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse.; and355.5    (6) activities that are not direct service time.355.6    Sec. 28. [256B.764] REIMBURSEMENT FOR FAMILY PLANNING SERVICES.355.7    Effective for services rendered on or after July 1, 2007, payment rates for family 355.8planning services shall be increased by 25 percent over the rates in effect July 30, 2007, 355.9when these services are provided by a community clinic as defined in section 145.9268, 355.10subdivision 1.355.11    Sec. 29. Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:355.12    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.355.13    (b) "Family asset account" means a savings account opened by a household 355.14participating in the Minnesota family assets for independence initiative.355.15    (c) "Fiduciary organization" means:355.16    (1) a community action agency that has obtained recognition under section 
         268.53355.17256E.31;355.18    (2) a federal community development credit union serving the seven-county 355.19metropolitan area; or355.20    (3) a women-oriented economic development agency serving the seven-county 355.21metropolitan area.355.22    (d) "Financial institution" means a bank, bank and trust, savings bank, savings 355.23association, or credit union, the deposits of which are insured by the Federal Deposit 355.24Insurance Corporation or the National Credit Union Administration.355.25    (e) "Permissible use" means:355.26    (1) postsecondary educational expenses at an accredited public postsecondary 355.27institution including books, supplies, and equipment required for courses of instruction;355.28    (2) acquisition costs of acquiring, constructing, or reconstructing a residence, 355.29including any usual or reasonable settlement, financing, or other closing costs;355.30    (3) business capitalization expenses for expenditures on capital, plant, equipment, 355.31working capital, and inventory expenses of a legitimate business pursuant to a business 355.32plan approved by the fiduciary organization; and355.33    (4) acquisition costs of a principal residence within the meaning of section 1034 of 355.34the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area 356.1purchase price applicable to the residence determined according to section 143(e)(2) and 356.2(3) of the Internal Revenue Code of 1986.356.3    (f) "Household" means all individuals who share use of a dwelling unit as primary 356.4quarters for living and eating separate from other individuals.356.5    Sec. 30. [525A.01] SHORT TITLE.356.6    This chapter may be cited as the "Darlene Luther Revised Uniform Anatomical 356.7Gift Act."356.8    Sec. 31. [525A.02] DEFINITIONS.356.9    Subdivision 1.Scope.The definitions in this section apply to this chapter.356.10    Subd. 2.Adult."Adult" means an individual who is at least 18 years of age.356.11    Subd. 3.Agent."Agent" means an individual who is:356.12    (1) authorized to make health care decisions on the principal's behalf by a power of 356.13attorney for health care; or356.14    (2) expressly authorized to make an anatomical gift on the principal's behalf by 356.15any other record signed by the principal.356.16    Subd. 4.Anatomical gift."Anatomical gift" means a donation of all or part of 356.17a human body to take effect after the donor's death for the purpose of transplantation, 356.18therapy, research, or education.356.19    Subd. 5.Decedent."Decedent" means a deceased individual and includes a stillborn 356.20infant or an embryo or fetus that has died of natural causes in utero.356.21    Subd. 6.Disinterested witness."Disinterested witness" means a witness other than 356.22the spouse, child, parent, sibling, grandchild, grandparent, or guardian of the individual 356.23who makes, amends, revokes, or refuses to make an anatomical gift, or another adult who 356.24exhibited special care and concern for the individual. The term does not include a person 356.25to which an anatomical gift could pass under section 525A.11.356.26    Subd. 7.Document of gift."Document of gift" means a donor card or other record 356.27used to make an anatomical gift. The term includes a statement or symbol on a driver's 356.28license, identification card, or donor registry.356.29    Subd. 8.Donor."Donor" means an individual whose body or part is the subject of 356.30an anatomical gift.356.31    Subd. 9.Donor registry."Donor registry" means a database that contains records 356.32of anatomical gifts and amendments to or revocations of anatomical gifts.357.1    Subd. 10.Driver's license."Driver's license" means a license or permit issued 357.2under chapter 171 to operate a vehicle, whether or not conditions are attached to the 357.3license or permit.357.4    Subd. 11.Eye bank."Eye bank" means a person that is licensed, accredited, 357.5or regulated under federal or state law to engage in the recovery, screening, testing, 357.6processing, storage, or distribution of human eyes or portions of human eyes.357.7    Subd. 12.Guardian."Guardian" means a person appointed by a court to make 357.8decisions regarding the support, care, education, health, or welfare of an individual. The 357.9term does not include a guardian ad litem.357.10    Subd. 13.Hospital."Hospital" means a facility licensed as a hospital under the 357.11law of any state or a facility operated as a hospital by the United States, a state, or a 357.12subdivision of a state.357.13    Subd. 14.Identification card."Identification card" means a Minnesota 357.14identification card issued under chapter 171.357.15    Subd. 15.Know."Know" means to have actual knowledge.357.16    Subd. 16.Medical examiner."Medical examiner" includes coroner.357.17    Subd. 17.Minor."Minor" means an individual who is under 18 years of age.357.18    Subd. 18.Organ procurement organization."Organ procurement organization" 357.19means a person designated by the secretary of the United States Department of Health and 357.20Human Services as an organ procurement organization.357.21    Subd. 19.Parent."Parent" means a parent whose parental rights have not been 357.22terminated.357.23    Subd. 20.Part."Part" means an organ, an eye, or tissue of a human being. The term 357.24does not include the whole body.357.25    Subd. 21.Person."Person" means an individual, corporation, business trust, estate, 357.26trust, partnership, limited liability company, association, joint venture, public corporation, 357.27government or governmental subdivision, agency, or instrumentality, or any other legal or 357.28commercial entity.357.29    Subd. 22.Physician."Physician" means an individual authorized to practice 357.30medicine or osteopathy under the law of any state.357.31    Subd. 23.Procurement organization."Procurement organization" means an eye 357.32bank, organ procurement organization, or tissue bank.357.33    Subd. 24.Prospective donor."Prospective donor" means an individual who is dead 357.34or near death and has been determined by a procurement organization to have a part that 357.35could be medically suitable for transplantation, therapy, research, or education. The term 357.36does not include an individual who has made a refusal.358.1    Subd. 25.Reasonably available."Reasonably available" means able to be 358.2contacted by a procurement organization without undue effort and willing and able to act 358.3in a timely manner consistent with existing medical criteria necessary for the making of 358.4an anatomical gift.358.5    Subd. 26.Recipient."Recipient" means an individual into whose body a decedent's 358.6part has been or is intended to be transplanted.358.7    Subd. 27.Record."Record" means information that is inscribed on a tangible 358.8medium or that is stored in an electronic or other medium and is retrievable in perceivable 358.9form.358.10    Subd. 28.Refusal."Refusal" means a record created under section 525A.07 that 358.11expressly states an intent to bar other persons from making an anatomical gift of an 358.12individual's body or part.358.13    Subd. 29.Sign."Sign" means, with the present intent to authenticate or adopt 358.14a record:358.15    (1) to execute or adopt a tangible symbol; or358.16    (2) to attach to or logically associate with the record an electronic symbol, sound, 358.17or process.358.18    Subd. 30.State."State" means a state of the United States, the District of Columbia, 358.19Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject 358.20to the jurisdiction of the United States.358.21    Subd. 31.Technician."Technician" means an individual determined to be qualified 358.22to remove or process parts by an appropriate organization that is licensed, accredited, or 358.23regulated under federal or state law. The term includes an enucleator.358.24    Subd. 32.Tissue."Tissue" means a portion of the human body other than an organ 358.25or an eye. The term does not include blood unless the blood is donated for the purpose 358.26of research or education.358.27    Subd. 33.Tissue bank."Tissue bank" means a person that is licensed, accredited, 358.28or regulated under federal or state law to engage in the recovery, screening, testing, 358.29processing, storage, or distribution of tissue.358.30    Subd. 34.Transplant hospital."Transplant hospital" means a hospital that 358.31furnishes organ transplants and other medical and surgical specialty services required 358.32for the care of transplant patients.358.33    Sec. 32. [525A.03] APPLICABILITY.358.34    This chapter applies to an anatomical gift or amendment to, revocation of, or refusal 358.35to make an anatomical gift, whenever made.359.1    Sec. 33. [525A.04] WHO MAY MAKE ANATOMICAL GIFT BEFORE 359.2DONOR'S DEATH.359.3    Subject to section 525A.08, an anatomical gift of a donor's body or part may be 359.4made during the life of the donor for the purpose of transplantation, therapy, research, or 359.5education in the manner provided in section 525A.05 by:359.6    (1) the donor, if the donor is an adult or if the donor is a minor and is:359.7    (i) emancipated; or359.8    (ii) authorized under state law to apply for a driver's license because the donor is 359.9at least 16 years of age;359.10    (2) an agent of the donor, unless the power of attorney for health care or other record 359.11prohibits the agent from making an anatomical gift;359.12    (3) a parent of the donor, if the donor is an unemancipated minor; or359.13    (4) the donor's guardian.359.14    Sec. 34. [525A.05] MANNER OF MAKING ANATOMICAL GIFT BEFORE 359.15DONOR'S DEATH.359.16    (a) A donor may make an anatomical gift:359.17    (1) by authorizing a statement or symbol indicating that the donor has made an 359.18anatomical gift to be imprinted on the donor's driver's license or identification card;359.19    (2) in a will;359.20    (3) during a terminal illness or injury of the donor, by any form of communication 359.21addressed to at least two adults, at least one of whom is a disinterested witness; or359.22    (4) as provided in paragraph (b).359.23    (b) A donor or other person authorized to make an anatomical gift under section 359.24525A.04 may make a gift by a donor card or other record signed by the donor or other 359.25person making the gift or by authorizing that a statement or symbol indicating that the 359.26donor has made an anatomical gift be included on a donor registry. If the donor or 359.27other person is physically unable to sign a record, the record may be signed by another 359.28individual at the direction of the donor or other person and must:359.29    (1) be witnessed by at least two adults, at least one of whom is a disinterested 359.30witness, who have signed at the request of the donor or the other person; and359.31    (2) state that it has been signed and witnessed as provided in clause (1).359.32    (c) Revocation, suspension, expiration, or cancellation of a driver's license or 359.33identification card upon which an anatomical gift is indicated does not invalidate the gift.360.1    (d) An anatomical gift made by will takes effect upon the donor's death whether or 360.2not the will is probated. Invalidation of the will after the donor's death does not invalidate 360.3the gift.360.4    (e) The making of an anatomical gift shall not itself authorize or direct the denial 360.5of health care.360.6    Sec. 35. [525A.06] AMENDING OR REVOKING ANATOMICAL GIFT 360.7BEFORE DONOR'S DEATH.360.8    (a) Subject to section 525A.08, a donor or other person authorized to make an 360.9anatomical gift under section 525A.04 may amend or revoke an anatomical gift by:360.10    (1) a record signed by:360.11    (i) the donor;360.12    (ii) the other person; or360.13    (iii) subject to paragraph (b), another individual acting at the direction of the donor 360.14or the other person if the donor or other person is physically unable to sign; or360.15    (2) a later-executed document of gift that amends or revokes a previous anatomical 360.16gift or portion of an anatomical gift, either expressly or by inconsistency.360.17    (b) A record signed pursuant to paragraph (a), clause (1), item (iii), must:360.18    (1) be witnessed by at least two adults, at least one of whom is a disinterested 360.19witness, who have signed at the request of the donor or the other person; and360.20    (2) state that it has been signed and witnessed as provided in clause (1).360.21    (c) Subject to section 525A.08, a donor or other person authorized to make an 360.22anatomical gift under section 525A.04 may revoke an anatomical gift by the destruction or 360.23cancellation of the document of gift, or the portion of the document of gift used to make 360.24the gift, with the intent to revoke the gift.360.25    (d) A donor may amend or revoke an anatomical gift that was not made in a will 360.26by any form of communication during a terminal illness or injury addressed to at least 360.27two adults, at least one of whom is a disinterested witness.360.28    (e) A donor who makes an anatomical gift in a will may amend or revoke the gift in 360.29the manner provided for amendment or revocation of wills or as provided in paragraph (a).360.30    Sec. 36. [525A.07] REFUSAL TO MAKE ANATOMICAL GIFT; EFFECT OF 360.31REFUSAL.360.32    (a) An individual may refuse to make an anatomical gift of the individual's body 360.33or part by:360.34    (1) a record signed by:361.1    (i) the individual; or361.2    (ii) subject to paragraph (b), another individual acting at the direction of the 361.3individual if the individual is physically unable to sign;361.4    (2) the individual's will, whether or not the will is admitted to probate or invalidated 361.5after the individual's death; or361.6    (3) any form of communication made by the individual during the individual's 361.7terminal illness or injury addressed to at least two adults, at least one of whom is a 361.8disinterested witness.361.9    (b) A record signed pursuant to paragraph (a), clause (1), item (ii), must:361.10    (1) be witnessed by at least two adults, at least one of whom is a disinterested 361.11witness, who have signed at the request of the individual; and361.12    (2) state that it has been signed and witnessed as provided in clause (1).361.13    (c) An individual who has made a refusal may amend or revoke the refusal:361.14    (1) in the manner provided in paragraph (a) for making a refusal;361.15    (2) by subsequently making an anatomical gift pursuant to section 525A.05 that is 361.16inconsistent with the refusal; or361.17    (3) by destroying or canceling the record evidencing the refusal, or the portion of the 361.18record used to make the refusal, with the intent to revoke the refusal.361.19    (d) Except as otherwise provided in section 525A.08, paragraph (h), in the absence 361.20of an express, contrary indication by the individual set forth in the refusal, an individual's 361.21unrevoked refusal to make an anatomical gift of the individual's body or part bars all other 361.22persons from making an anatomical gift of the individual's body or part.361.23    Sec. 37. [525A.08] PRECLUSIVE EFFECT OF ANATOMICAL GIFT, 361.24AMENDMENT, OR REVOCATION.361.25    (a) Except as otherwise provided in paragraph (g) and subject to paragraph (f), in the 361.26absence of an express, contrary indication by the donor, a person other than the donor is 361.27barred from making, amending, or revoking an anatomical gift of a donor's body or part if 361.28the donor made an anatomical gift of the donor's body or part under section 525A.05 or an 361.29amendment to an anatomical gift of the donor's body or part under section 525A.06. An 361.30anatomical gift made in a will, a designation on a driver's license or identification card, or 361.31a health care directive under chapter 145C, and not revoked, establishes the intent of the 361.32person making the designation and may not be overridden by any other person.361.33    (b) A donor's revocation of an anatomical gift of the donor's body or part under 361.34section 525A.06 is not a refusal and does not bar another person specified in section 362.1525A.04 or 525A.09 from making an anatomical gift of the donor's body or part under 362.2section 525A.05 or 525A.10.362.3    (c) If a person other than the donor makes an unrevoked anatomical gift of the 362.4donor's body or part under section 525A.05 or an amendment to an anatomical gift of the 362.5donor's body or part under section 525A.06, another person may not make, amend, or 362.6revoke the gift of the donor's body or part under section 525A.10.362.7    (d) A revocation of an anatomical gift of a donor's body or part under section 362.8525A.06 by a person other than the donor does not bar another person from making an 362.9anatomical gift of the body or part under section 525A.05 or 525A.10.362.10    (e) In the absence of an express, contrary indication by the donor or other person 362.11authorized to make an anatomical gift under section 525A.04, an anatomical gift of a part 362.12is neither a refusal to give another part nor a limitation on the making of an anatomical gift 362.13of another part at a later time by the donor or another person.362.14    (f) In the absence of an express, contrary indication by the donor or other person 362.15authorized to make an anatomical gift under section 525A.04, an anatomical gift of a 362.16part for one or  more of the purposes set forth in section 525A.04 is not a limitation on 362.17the making of an anatomical gift of the part for any of the other purposes by the donor 362.18or any other person under section 525A.05 or 525A.10.362.19    (g) If a donor who is an unemancipated minor dies, a parent of the donor who is 362.20reasonably available may revoke or amend an anatomical gift of the donor's body or part.362.21    (h) If an unemancipated minor who signed a refusal dies, a parent of the minor who 362.22is reasonably available may revoke the minor's refusal.362.23    Sec. 38. [525A.09] WHO MAY MAKE ANATOMICAL GIFT OF DECEDENT'S 362.24BODY OR PART.362.25    (a) Subject to paragraphs (b) and (c) and unless barred by section 525A.07 or 362.26525A.08, an anatomical gift of a decedent's body or part for the purpose of transplantation, 362.27therapy, research, or education may be made by any member of the following classes of 362.28persons who is reasonably available, in the order of priority listed:362.29    (1) an agent of the decedent at the time of death who could have made an anatomical 362.30gift under section 525A.04, clause (2), immediately before the decedent's death;362.31    (2) the spouse of the decedent;362.32    (3) adult children of the decedent;362.33    (4) parents of the decedent;362.34    (5) adult siblings of the decedent;362.35    (6) adult grandchildren of the decedent;363.1    (7) grandparents of the decedent;363.2    (8) an adult who exhibited special care and concern for the decedent;363.3    (9) the persons who were acting as the guardians of the person of the decedent 363.4at the time of death; and 363.5    (10) any other person having the authority to dispose of the decedent's body.363.6    (b) If there is more than one member of a class listed in paragraph (a), clause (1), 363.7(3), (4), (5), (6), (7), or (9), entitled to make an anatomical gift, an anatomical gift may 363.8be made by a member of the class unless that member or a person to which the gift may 363.9pass under section 525A.11 knows of an objection by another member of the class. If 363.10an objection is known, the gift may be made only by a majority of the members of the 363.11class who are reasonably available.363.12    (c) A person may not make an anatomical gift if, at the time of the decedent's death, 363.13a person in a prior class under paragraph (a) is reasonably available to make or to object to 363.14the making of an anatomical gift.363.15    Sec. 39. [525A.10] MANNER OF MAKING, AMENDING, OR REVOKING 363.16ANATOMICAL GIFT OF DECEDENT'S BODY OR PART.363.17    (a) A person authorized to make an anatomical gift under section 525A.09 may 363.18make an anatomical gift by a document of gift signed by the person making the gift or by 363.19that person's oral communication that is electronically recorded or is contemporaneously 363.20reduced to a record and signed by the individual receiving the oral communication.363.21    (b) Subject to paragraph (c), an anatomical gift by a person authorized under section 363.22525A.09 may be amended or revoked orally or in a record by any member of a prior class 363.23who is reasonably available. If more than one member of the prior class is reasonably 363.24available, the gift made by a person authorized under section 525A.09 may be:363.25    (1) amended only if a majority of the reasonably available members agree to the 363.26amending of the gift; or363.27    (2) revoked only if a majority of the reasonably available members agree to the 363.28revoking of the gift or if they are equally divided as to whether to revoke the gift.363.29    (c) A revocation under paragraph (b) is effective only if, before an incision has been 363.30made to remove a part from the donor's body or before invasive procedures have begun to 363.31prepare the recipient, the procurement organization, transplant hospital, or physician or 363.32technician knows of the revocation.363.33    Sec. 40. [525A.11] PERSONS THAT MAY RECEIVE ANATOMICAL GIFT; 363.34PURPOSE OF ANATOMICAL GIFT.364.1    (a) An anatomical gift may be made to the following persons named in the document 364.2of gift:364.3    (1) a hospital; accredited medical school, dental school, college, or university; organ 364.4procurement organization; or nonprofit organization in medical education or research, 364.5for research or education;364.6    (2) subject to paragraph (b), an individual designated by the person making the 364.7anatomical gift if the individual is the recipient of the part; and 364.8    (3) an eye bank or tissue bank.364.9    (b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be 364.10transplanted into the individual, the part passes in accordance with paragraph (g) in the 364.11absence of an express, contrary indication by the person making the anatomical gift.364.12    (c) If an anatomical gift of one or more specific parts or of all parts is made in a 364.13document of gift that does not name a person described in paragraph (a) but identifies the 364.14purpose for which an anatomical gift may be used, the following rules apply:364.15    (1) if the part is an eye and the gift is for the purpose of transplantation or therapy, 364.16the gift passes to the appropriate eye bank;364.17    (2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the 364.18gift passes to the appropriate tissue bank;364.19    (3) if the part is an organ and the gift is for the purpose of transplantation or therapy, 364.20the gift passes to the appropriate organ procurement organization as custodian of the 364.21organ; and364.22    (4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research 364.23or education, the gift passes to the appropriate procurement organization.364.24    (d) For the purpose of paragraph (c), if there is more than one purpose of an 364.25anatomical gift set forth in the document of gift but the purposes are not set forth in any 364.26priority, the gift must be used for transplantation or therapy, if suitable. If the gift cannot 364.27be used for transplantation or therapy, the gift may be used for research or education. 364.28    (e) If an anatomical gift of one or more specific parts is made in a document of gift 364.29that does not name a person described in paragraph (a) and does not identify the purpose 364.30of the gift, the gift may be used only for transplantation or therapy, and the gift passes in 364.31accordance with paragraph (g).364.32    (f) If a document of gift specifies only a general intent to make an anatomical gift 364.33by words such as "donor," "organ donor," or "body donor," or by a symbol or statement 364.34of similar import, the gift may be used only for transplantation or therapy, and the gift 364.35passes in accordance with paragraph (g).364.36    (g) For purposes of paragraphs (b), (e), and (f), the following rules apply:365.1    (1) if the part is an eye, the gift passes to the appropriate eye bank;365.2    (2) if the part is tissue, the gift passes to the appropriate tissue bank; and365.3    (3) if the part is an organ, the gift passes to the appropriate organ procurement 365.4organization as custodian of the organ.365.5    (h) An anatomical gift of an organ for transplantation or therapy, other than 365.6an anatomical gift under paragraph (a), clause (2), passes to the organ procurement 365.7organization as custodian of the organ.365.8    (i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the 365.9decedent's body or part is not used for transplantation, therapy, research, or education, 365.10custody of the body or part passes to the person under obligation to dispose of the body or 365.11part.365.12    (j) A person may not accept an anatomical gift if the person knows that the gift was 365.13not effectively made under section 525A.05 or 525A.10 or if the person knows that the 365.14decedent made a refusal under section 525A.07 that was not revoked. For purposes of 365.15this paragraph, if a person knows that an anatomical gift was made on a document of gift, 365.16the person is deemed to know of any amendment or revocation of the gift or any refusal 365.17to make an anatomical gift on the same document of gift.365.18    (k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter 365.19affects the allocation of organs for transplantation or therapy.365.20    Sec. 41. [525A.12] SEARCH AND NOTIFICATION.365.21    (a) The following persons shall make a reasonable search of an individual who 365.22the person reasonably believes is dead or near death for a document of gift or other 365.23information identifying the individual as a donor or as an individual who made a refusal:365.24    (1) a law enforcement officer, firefighter, paramedic, or other emergency rescuer 365.25finding the individual; and365.26    (2) if no other source of the information is immediately available, a hospital, as soon 365.27as practical after the individual's arrival at the hospital.365.28    (b) If a document of gift or a refusal to make an anatomical gift is located by the 365.29search required by paragraph (a), clause (1), and the individual or deceased individual to 365.30whom it relates is taken to a hospital, the person responsible for conducting the search 365.31shall send the document of gift or refusal to the hospital. If a body is transferred to 365.32the custody of the medical examiner, the person who discovered the body must notify 365.33the person's dispatcher. A dispatcher notified under this section must notify the state's 365.34federally designated organ procurement organization and inform the organization of the 365.35deceased's name, donor status, and location.366.1    (c) A person is not subject to criminal or civil liability for failing to discharge the 366.2duties imposed by this section but may be subject to administrative sanctions.366.3    Sec. 42. [525A.13] DELIVERY OF DOCUMENT OF GIFT NOT REQUIRED; 366.4RIGHT TO EXAMINE.366.5    (a) A document of gift need not be delivered during the donor's lifetime to be 366.6effective.366.7    (b) Upon or after an individual's death, a person in possession of a document of 366.8gift or a refusal to make an anatomical gift with respect to the individual shall allow 366.9examination and copying of the document of gift or refusal by a person authorized to 366.10make or object to the making of an anatomical gift with respect to the individual or by a 366.11person to which the gift could pass under section 525A.11.366.12    Sec. 43. [525A.14] RIGHTS AND DUTIES OF PROCUREMENT 366.13ORGANIZATION AND OTHERS.366.14    (a) When a hospital refers an individual at or near death to a procurement 366.15organization, the organization shall make a reasonable search of the records of the 366.16Department of Public Safety and any donor registry that it knows exists for the 366.17geographical area in which the individual resides to ascertain whether the individual has 366.18made an anatomical gift.366.19    (b) A procurement organization must be allowed reasonable access to information 366.20in the records of the Department of Public Safety to ascertain whether an individual at 366.21or near death is a donor.366.22    (c) When a hospital refers an individual at or near death to a procurement 366.23organization, the organization may conduct any reasonable examination necessary to 366.24ensure the medical suitability of a part that is or could be the subject of an anatomical gift 366.25for transplantation, therapy, research, or education from a donor or a prospective donor. 366.26During the examination period, measures necessary to ensure the medical suitability of the 366.27part may not be withdrawn unless the hospital or procurement organization knows that 366.28the individual expressed a contrary intent.366.29    (d) Unless prohibited by law other than this chapter, at any time after a donor's death, 366.30the person to which a part passes under section 525A.11 may conduct any reasonable 366.31examination necessary to ensure the medical suitability of the body or part for its intended 366.32purpose.367.1    (e) Unless prohibited by law other than this chapter, an examination under paragraph 367.2(c) or (d) may include an examination of all medical and dental records of the donor or 367.3prospective donor.367.4    (f) Upon the death of a minor who was a donor or had signed a refusal, unless a 367.5procurement organization knows the minor is emancipated, the procurement organization 367.6shall conduct a reasonable search for the parents of the minor and provide the parents with 367.7an opportunity to revoke or amend the anatomical gift or revoke the refusal.367.8    (g) Upon referral by a hospital under paragraph (a), a procurement organization shall 367.9make a reasonable search for any person listed in section 525A.09 having priority to make 367.10an anatomical gift on behalf of a prospective donor. If a procurement organization receives 367.11information that an anatomical gift to any other person was made, amended, or revoked, it 367.12shall promptly advise the other person of all relevant information.367.13    (h) Subject to sections 525A.11, paragraph (i), and 525A.23, the rights of the person 367.14to which a part passes under section 525A.11 are superior to the rights of all others with 367.15respect to the part. The person may accept or reject an anatomical gift in whole or in part. 367.16Subject to the terms of the document of gift and this chapter, a person that accepts an 367.17anatomical gift of an entire body may allow embalming, burial, or cremation, and use of 367.18remains in a funeral service. If the gift is of a part, the person to which the part passes 367.19under section 525A.11, upon the death of the donor and before embalming, burial, or 367.20cremation, shall cause the part to be removed without unnecessary mutilation.367.21    (i) Neither the physician who attends the decedent at death nor the physician who 367.22determines the time of the decedent's death may participate in the procedures for removing 367.23or transplanting a part from the decedent.367.24    (j) A physician or technician may remove a donated part from the body of a donor 367.25that the physician or technician is qualified to remove.367.26    Sec. 44. [525A.15] COORDINATION OF PROCUREMENT AND USE.367.27    Each hospital in this state shall enter into agreements or affiliations with procurement 367.28organizations for coordination of procurement and use of anatomical gifts.367.29    Sec. 45. [525A.16] SALE OR PURCHASE OF PARTS PROHIBITED; FELONY.367.30    (a) Except as otherwise provided in paragraph (b), a person that, for valuable 367.31consideration, knowingly purchases or sells a part for transplantation or therapy if removal 367.32of a part from an individual is intended to occur after the individual's death, commits a 367.33felony and upon conviction is subject to a fine not exceeding $10,000 or imprisonment 367.34not exceeding five years, or both.368.1    (b) A person may charge a reasonable amount for the removal, processing, 368.2preservation, quality control, storage, transportation, implantation, or disposal of a part.368.3    Sec. 46. [525A.17] PROHIBITED ACTS; FELONY.368.4    A person that, in order to obtain a financial gain, intentionally falsifies, forges, 368.5conceals, defaces, or obliterates a document of gift, an amendment or revocation of a 368.6document of gift, or a refusal commits a felony and upon conviction is subject to a fine not 368.7exceeding $10,000 or imprisonment not exceeding five years, or both.368.8    Sec. 47. [525A.18] IMMUNITY.368.9    (a) A person that acts in accordance with this chapter or with the applicable 368.10anatomical gift law of another state, or attempts in good faith to do so, is not liable for the 368.11act in a civil action, criminal prosecution, or administrative proceeding.368.12    (b) Neither the person making an anatomical gift nor the donor's estate is liable for 368.13any injury or damage that results from the making or use of the gift.368.14    (c) In determining whether an anatomical gift has been made, amended, or revoked 368.15under this chapter, a person may rely upon representations of an individual listed in 368.16section 525A.09, paragraph (a), clause (2), (3), (4), (5), (6), (7), or (8), relating to the 368.17individual's relationship to the donor or prospective donor unless the person knows that 368.18the representation is untrue.368.19    (d) An anatomical gift under this chapter is not a sale of goods as that term is defined 368.20in section 336.2-105, paragraph (1), or the sale of a product.368.21    Sec. 48. [525A.19] LAW GOVERNING VALIDITY; CHOICE OF LAW AS TO 368.22EXECUTION OF DOCUMENT OF GIFT; PRESUMPTION OF VALIDITY.368.23    (a) A document of gift is valid if executed in accordance with:368.24    (1) this chapter;368.25    (2) the laws of the state or country where it was executed; or368.26    (3) the laws of the state or country where the person making the anatomical gift 368.27was domiciled, has a place of residence, or was a national at the time the document of 368.28gift was executed.368.29    (b) If a document of gift is valid under this section, the law of this state governs 368.30the interpretation of the document of gift.368.31    (c) A person may presume that a document of gift or amendment of an anatomical 368.32gift is valid unless that person knows that it was not validly executed or was revoked.369.1    Sec. 49. [525A.20] DONOR REGISTRY.369.2    (a) The Department of Health may establish or contract for the establishment of a 369.3donor registry.369.4    (b) The Department of Public Safety shall cooperate with a person that administers 369.5any donor registry that this state establishes, contracts for, or recognizes for the purpose 369.6of transferring to the donor registry all relevant information regarding a donor's making, 369.7amendment to, or revocation of an anatomical gift.369.8    (c) A donor registry must:369.9    (1) allow a donor or other person authorized under section 525A.04 to include on 369.10the donor registry a statement or symbol that the donor has made, amended, or revoked 369.11an anatomical gift;369.12    (2) be accessible to a procurement organization to allow it to obtain relevant 369.13information on the donor registry to determine, at or near death of the donor or a 369.14prospective donor, whether the donor or prospective donor has made, amended, or revoked 369.15an anatomical gift; and369.16    (3) be accessible, for purposes of clauses (1) and (2), seven days a week on a 369.1724-hour basis.369.18    (d) Personally identifiable information on a donor registry about a donor or 369.19prospective donor may not be used or disclosed without the express consent of the donor, 369.20prospective donor, or person that made the anatomical gift for any purpose other than 369.21to determine, at or near death of the donor or prospective donor, whether the donor or 369.22prospective donor has made, amended, or revoked an anatomical gift.369.23    (e) This section does not prohibit any person from creating or maintaining a donor 369.24registry that is not established by or under contract with the state. Any such registry 369.25must comply with paragraphs (c) and (d).369.26    Sec. 50. [525A.21] EFFECT OF ANATOMICAL GIFT ON ADVANCE HEALTH 369.27CARE DIRECTIVE.369.28    (a) In this section:369.29    (1) "advance health care directive" means a power of attorney for health care 369.30or a record signed by a prospective donor containing the prospective donor's direction 369.31concerning a health care decision for the prospective donor;369.32    (2) "declaration" means a record signed by a prospective donor specifying the 369.33circumstances under which a life support system may be withheld or withdrawn from 369.34the prospective donor; and370.1    (3) "health care decision" means any decision made regarding the health care of the 370.2prospective donor.370.3    (b) If a prospective donor has a declaration or advance health care directive, 370.4measures necessary to ensure the medical suitability of an organ for transplantation 370.5or therapy may not be withheld or withdrawn from the prospective donor, unless the 370.6declaration expressly provides to the contrary.370.7    Sec. 51. [525A.22] COOPERATION BETWEEN MEDICAL EXAMINER AND 370.8PROCUREMENT ORGANIZATION.370.9    (a) A medical examiner shall cooperate with procurement organizations to maximize 370.10the opportunity to recover anatomical gifts for the purpose of transplantation, therapy, 370.11research, or education.370.12    (b) If a medical examiner receives notice from a procurement organization that an 370.13anatomical gift might be available or was made with respect to a decedent whose body is 370.14under the jurisdiction of the medical examiner and a postmortem examination is going to 370.15be performed, unless the medical examiner denies recovery in accordance with section 370.16525A.23, the medical examiner or designee shall conduct a postmortem examination of 370.17the body or the part in a manner and within a period compatible with its preservation for 370.18the purposes of the gift.370.19    (c) A part may not be removed from the body of a decedent under the jurisdiction 370.20of a medical examiner for transplantation, therapy, research, or education unless the part 370.21is the subject of an anatomical gift. The body of a decedent under the jurisdiction of the 370.22medical examiner may not be delivered to a person for research or education unless the 370.23body is the subject of an anatomical gift. This paragraph does not preclude a medical 370.24examiner from performing the medicolegal investigation upon the body or parts of a 370.25decedent under the jurisdiction of the medical examiner.370.26    Sec. 52. [525A.23] FACILITATION OF ANATOMICAL GIFT FROM 370.27DECEDENT WHOSE BODY IS UNDER JURISDICTION OF MEDICAL 370.28EXAMINER.370.29    (a) Upon request of a procurement organization, a medical examiner shall release to 370.30the procurement organization the name, contact information, and available medical and 370.31social history of a decedent whose body is under the jurisdiction of the medical examiner. 370.32If the decedent's body or part is medically suitable for transplantation, therapy, research, 370.33or education, the medical examiner shall release postmortem examination results to 370.34the procurement organization. The procurement organization may make a subsequent 371.1disclosure of the postmortem examination results or other information received from the 371.2medical examiner only if relevant to transplantation or therapy.371.3    (b) The medical examiner may conduct a medicolegal examination by reviewing 371.4all medical records, laboratory test results, x-rays, other diagnostic results, and other 371.5information that any person possesses about a donor or prospective donor whose body is 371.6under the jurisdiction of the medical examiner which the medical examiner determines 371.7may be relevant to the investigation.371.8    (c) A person that has any information requested by a medical examiner pursuant 371.9to paragraph (b) shall provide that information as expeditiously as possible to allow the 371.10medical examiner to conduct the medicolegal investigation within a period compatible 371.11with the preservation of parts for the purpose of transplantation, therapy, research, or 371.12education.371.13    (d) If an anatomical gift has been or might be made of a part of a decedent whose 371.14body is under the jurisdiction of the medical examiner and a postmortem examination 371.15is not required, or the medical examiner determines that a postmortem examination is 371.16required but that the recovery of the part that is the subject of an anatomical gift will 371.17not interfere with the examination, the medical examiner and procurement organization 371.18shall cooperate in the timely removal of the part from the decedent for the purpose of 371.19transplantation, therapy, research, or education.371.20    (e) If an anatomical gift of a part from the decedent under the jurisdiction of 371.21the medical examiner has been or might be made, but the medical examiner initially 371.22believes that the recovery of the part could interfere with the postmortem investigation 371.23into the decedent's cause or manner of death, the medical examiner shall consult with 371.24the procurement organization or physician or technician designated by the procurement 371.25organization about the proposed recovery. After consultation, the medical examiner may 371.26allow the recovery.371.27    (f) Following the consultation under paragraph (e), in the absence of mutually 371.28agreed-upon protocols to resolve conflict between the medical examiner and the 371.29procurement organization, if the medical examiner intends to deny recovery of an organ 371.30for transplantation, the medical examiner or designee, at the request of the procurement 371.31organization, shall attend the removal procedure for the part before making a final 371.32determination not to allow the procurement organization to recover the part. During 371.33the removal procedure, the medical examiner or designee may allow recovery by the 371.34procurement organization to proceed, or, if the medical examiner or designee reasonably 371.35believes that the part may be involved in determining the decedent's cause or manner of 371.36death, deny recovery by the procurement organization.372.1    (g) If the medical examiner or designee denies recovery under paragraph (f), the 372.2medical examiner or designee shall:372.3    (1) explain in a record the specific reasons for not allowing recovery of the part;372.4    (2) include the specific reasons in the records of the medical examiner; and372.5    (3) provide a record with the specific reasons to the procurement organization.372.6    (h) If the medical examiner or designee allows recovery of a part under paragraph 372.7(d), (e), or (f), the procurement organization, upon request, shall cause the physician 372.8or technician who removes the part to provide the medical examiner with a record 372.9describing the condition of the part, a biopsy, a photograph, and any other information and 372.10observations that would assist in the postmortem examination.372.11    (i) If a medical examiner or designee is required to be present at a removal procedure 372.12under paragraph (f), upon request the procurement organization requesting the recovery 372.13of the part shall reimburse the medical examiner or designee for the additional costs 372.14incurred in complying with paragraph (f).372.15    Sec. 53. [525A.24] RELATION TO ELECTRONIC SIGNATURES IN GLOBAL 372.16AND NATIONAL COMMERCE ACT.372.17    This chapter modifies, limits, and supersedes the Electronic Signatures in Global and 372.18National Commerce Act, United States Code, title 15, section 7001 et seq., but does not 372.19modify, limit, or supersede section 101(a) of that act, United States Code, title 15, section 372.207001, or authorize electronic delivery of any of the notices described in section 103(b) 372.21of that act, United States Code, title 15, section 7003(b).372.22    Sec. 54. Laws 2005, chapter 98, article 3, section 25, is amended to read:372.23    Sec. 25. REPEALER.372.24    Minnesota Statutes 2004, sections 
         245.713, subdivisions 2 and subdivision 4; 372.25245.716
         ; and 
         626.5551, subdivision 4, are repealed.372.26EFFECTIVE DATE.This section is effective retroactively from August 1, 2005.372.27    Sec. 55. SOBER HOUSES.372.28    Subdivision 1.Sober house defined.For purposes of this section, a "sober house" 372.29means a cooperative living residence that:372.30    (1) provides temporary housing to persons with alcohol or other drug dependency 372.31and abuse problems in exchange for compensation;372.32    (2) stipulates residents must abstain from using alcohol or drugs and meet other 372.33requirements as a condition of living in the residence; and373.1    (3) does not provide counseling or treatment services to those residents within the 373.2meaning of Minnesota Statutes, chapter 148C or 254A.373.3    Subd. 2.Work group creation; membership.The commissioner of human services 373.4shall convene a sober house work group which is comprised of the following members:373.5    (1) sober house landlords;373.6    (2) sober house residents;373.7    (3) community members with knowledge of sober housing;373.8    (4) representatives of cities and counties;373.9    (5) a representative from the Department of Human Services, Chemical Health 373.10Division;373.11    (6) a representative from the Department of Human Services, Licensing Division;373.12    (7) a representative of chemical dependency treatment providers; and373.13    (8) a representative from the Department of Health.373.14    Subd. 3.Report.The work group created in subdivision 2 is directed to study the 373.15issue of sober houses in the state and determine whether state licensing or other regulation 373.16of sober houses is appropriate. Based on findings of the work group, the commissioner of 373.17human services shall submit a report of recommendations to the legislature by January 373.181, 2008.373.19    Sec. 56. INTERPRETER SERVICES WORK GROUP.373.20    (a) The commissioner of health shall, in consultation with the commissioners of 373.21commerce, human services, and employee relations, convene a work group to study the 373.22provision of interpreter services to patients in medical and dental care settings. The work 373.23group shall include one representative from each of the following groups:373.24    (1) consumers;373.25    (2) interpreters;373.26    (3) interpreter service providers or agencies;373.27    (4) health plan companies;373.28    (5) self-insured purchasers;373.29    (6) hospitals;373.30    (7) health care providers;373.31    (8) dental providers;373.32    (9) clinic administrators;373.33    (10) state agency staff from the Departments of Health, Human Services, and 373.34Employee Relations;373.35    (11) Minnesota Registry of Interpreters for the Deaf;374.1    (12) local county social services agencies;374.2    (13) local public health agencies;374.3    (14) interpreting stakeholders group;374.4    (15) one interpreter trainer; and374.5    (16) one interpreter certification examiner.374.6    (b) The work group shall develop findings and recommendations on the following: 374.7    (1) assuring access to interpreter services;374.8    (2) compliance with requirements of federal law and guidance;374.9    (3) developing a quality assurance program to ensure the quality of health care 374.10interpreting services, including requirements for training and establishing a certification 374.11process; and 374.12    (4) identifying broad-based funding mechanisms for interpreter services.374.13    (c) Based on the discussions of the work group, the commissioner shall make 374.14recommendations to the chairs of the health policy and finance committees in the house 374.15and senate by January 15, 2008, on how to ensure high quality interpreter services for 374.16patients in medical and dental settings, and for a broad-based funding mechanism for 374.17delivering these services.374.18EFFECTIVE DATE.This section is effective the day following final enactment.374.19    Sec. 57. FEDERAL GRANTS.374.20    The Board of Pharmacy shall apply for any applicable federal grants or other nonstate 374.21funds to establish and fully implement the prescription electronic reporting system.374.22EFFECTIVE DATE.This section is effective the day following final enactment.374.23    Sec. 58. BOARD OF PHARMACY.374.24    The Board of Pharmacy shall not increase the license fees of pharmacists or 374.25pharmacies in order to adequately fund the prescription electronic reporting system under 374.26Minnesota Statutes, section 152.126, without specific authority from the legislature.374.27EFFECTIVE DATE.This section is effective the day following final enactment.374.28    Sec. 59. BOARD OF MEDICAL PRACTICE.374.29    The Board of Medical Practice shall convene a work group to discuss the appropriate 374.30prescribing of controlled substances listed in Minnesota Statutes, section 152.02, 374.31subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under 375.1Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and 375.2shall report to the legislature by December 15, 2007.375.3    Sec. 60. AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.375.4    Subdivision 1.Pilot project requirements.The commissioner of commerce shall 375.5authorize a joint self-insurance pilot project administered by a trust sponsored by one 375.6or more agricultural cooperatives organized under Minnesota Statutes, chapter 308A, 375.7or under a federal charter for the purpose of offering health coverage to members of 375.8the cooperatives and their families, provided the project satisfies the requirements of 375.9Minnesota Statutes, chapter 62H, except as follows:375.10    (1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;375.11    (2) the notice period required under Minnesota Statutes, section 62H.02, paragraph 375.12(e), is 90 days;375.13    (3) the commissioner shall grant necessary waivers and approve an alternative 375.14arrangement that fully funds the plan's liability or incurred but unpaid claims under 375.15Minnesota Statutes, section 62H.02, paragraph (f), unless the commissioner provides 375.16evidence demonstrating that the insolvency protection proposed is substantially less than 375.17that typically provided by self-insured group plans of a similar size in Minnesota;375.18    (4) notwithstanding Minnesota Statutes, section 62H.04, paragraph (a), the joint 375.19self-insurance plan shall be considered a large group and not subject to the small group 375.20insurance requirements in Minnesota Statutes, chapter 62L, even if some employer 375.21groups enrolled in the plan would be defined as small employers, except that the joint 375.22self-insurance plan may elect to treat the sale of a health plan to or for an employer that 375.23has only one eligible employee who has not waived coverage as the sale of an individual 375.24health plan as allowed under Minnesota Statutes, section 62L.02, subdivision 26;375.25    (5) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), does not 375.26apply; and 375.27    (6) the trust must pay the assessment for the Minnesota comprehensive health 375.28association as provided under Minnesota Statutes, section 62E.11.375.29    Subd. 2.Evaluation and renewal.The pilot project authorized under this section 375.30is for a period of four years from the date of initial enrollment. The commissioner shall 375.31grant an extension of four additional years if the trust provides evidence that it remains in 375.32compliance with the requirements of this section and other applicable laws and rules. If the 375.33commissioner determines that the operation of the trust has not improved access, expanded 375.34health plan choices, or improved affordability of health coverage for farm families, or 375.35that it has significantly damaged access, choice, or affordability for other consumers not 376.1enrolled in the trust, the commissioner shall provide at least 180 days' advance written 376.2notice to the trust and to the chairs of the senate and house finance and policy committees 376.3with jurisdiction over health and insurance matters of the commissioner's intention not to 376.4renew the pilot project at the expiration of a four-year period.376.5EFFECTIVE DATE.This section is effective the day following final enactment.376.6    Sec. 61. HEALTH PLAN PURCHASING POOL STUDY GROUP.376.7    Subdivision 1.Creation; membership.A health care purchasing pool study group 376.8is created to study and make recommendations regarding the creation of a voluntary, 376.9statewide health care purchasing pool that would contract directly with providers to 376.10provide affordable health coverage to eligible Minnesota residents. The study group is 376.11composed of:376.12    (1) the chief house and senate authors of this act;376.13    (2) the chairs of the senate Committee on Health, Housing, and Family Security and 376.14the Health and Human Services Budget Division;376.15    (3) the chairs of the house Health Care and Human Services Committee and the 376.16Health Care and Human Services Division;376.17    (4) the attorney general or the attorney general's designated representative; 376.18    (5) three representatives of health care providers appointed as follows:376.19    (i) one member appointed by the governor;376.20    (ii) one member appointed by the speaker of the house; and376.21    (iii) one member appointed by the Subcommittee on Committees of the senate 376.22Committee on Rules and Administration; and376.23    (6) two consumers of health care appointed by the governor.376.24    All appointments to be made under this subdivision must be made within 30 days 376.25of the effective date of this act.376.26    Subd. 2.Study; report.The study group shall study and make recommendations 376.27on the following issues related to the creation, maintenance, and funding of a voluntary, 376.28statewide health plan purchasing pool to provide comprehensive, cost-effective, and 376.29medically appropriate health coverage to all public and private employees in Minnesota 376.30and all Minnesota residents:376.31    (1) the creation of an independent public entity to administer the pool; 376.32    (2) eligibility and participation requirements for existing public and private health 376.33care purchasing pools, public and private employers, and residents of this state; 376.34    (3) how to contract directly with providers to provide comprehensive coverage for 376.35preventive, mental health, dental and other medical services, and comprehensive drug 377.1benefits to enrollees and maximize the cost savings and other efficiencies that a large 377.2purchasing pool would be expected to generate without the need for a public subsidy; 377.3    (4) provisions that allow the pool to contract directly with health care providers 377.4to provide coverage to enrollees;377.5    (5) incentives designed to attract and retain the maximum number of enrollees; 377.6    (6) recommendations for the administration of the pool and the plans that will be 377.7available to enrollees including, but not limited to, recommendations to keep the pool 377.8solvent and profitable so that public subsidies are not necessary; and 377.9    (7) other elements the study group concludes are necessary or desirable for the 377.10pool to possess. 377.11    The study group shall submit its report and the draft legislation necessary to 377.12implement its recommendations to the chairs of the legislative committees and divisions 377.13with jurisdiction over health care policy and finance, the Health Care Access Commission, 377.14and the governor by February 1, 2008. 377.15    Subd. 3.Staffing.State agencies shall assist the study group with any requests for 377.16information the study group considers necessary to complete the study and report under 377.17subdivision 2.377.18    Subd. 4.Removal; vacancies; expenses.Removal of members, vacancies, and 377.19expenses for members shall be as provided in Minnesota Statutes, section 15.059.377.20    Subd. 5.Expiration.This section expires after the submission of the report as 377.21required in subdivision 2.377.22EFFECTIVE DATE.This section is effective the day following final enactment.377.23    Sec. 62.  REPEALER.377.24(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16; 377.25254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175; 377.26254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65, are repealed.377.27(b) Minnesota Rules, part 9503.0035, subpart 2, is repealed.377.28(c) Minnesota Statutes 2006, sections 525.921; 525.9211; 525.9212; 525.9213; 377.29525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222; 377.30525.9223; and 525.9224, are repealed.377.31ARTICLE 8377.32CHILDREN'S HEALTH SECURITY PROGRAM377.33    Section 1. [16A.726] CHILDREN'S HEALTH SECURITY ACCOUNT.378.1    A children's health security account is created in a special revenue fund in the 378.2state treasury. The commissioner shall deposit to the credit of the account money made 378.3available to the account. Notwithstanding section 11A.20, any investment income 378.4attributable to the investment of the children's health security account not currently needed 378.5shall be credited to the children's health security account.378.6    Sec. 2. Minnesota Statutes 2006, section 256B.057, subdivision 8, is amended to read:378.7    Subd. 8. Children under age two. Medical assistance may be paid for a child under 378.8two years of age whose countable family income is above 275 300 percent of the federal 378.9poverty guidelines for the same size family but less than or equal to 280 305 percent of the 378.10federal poverty guidelines for the same size family.378.11EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal 378.12approval, whichever is later.378.13    Sec. 3. [256N.01] CITATION.378.14    This chapter may be cited as the "Children's Health Security Act."378.15    Sec. 4. [256N.02] DEFINITIONS.378.16    Subdivision 1.Applicability.The terms used in this chapter have the following 378.17meanings unless otherwise provided for by text.378.18    Subd. 2.Child."Child" means an individual under age 21.378.19    Subd. 3.Commissioner."Commissioner" means the commissioner of human 378.20services.378.21    Subd. 4.Dependent child."Dependent child" means an unmarried child under 378.22age 25 who is claimed as a dependent for federal income tax purposes by a parent, 378.23grandparent, foster parent, relative caretaker, or legal guardian.378.24    Sec. 5. [256N.03] ESTABLISHMENT.378.25    The commissioner shall establish the children's health security program. The 378.26commissioner shall begin implementation of the program on October 1, 2008, or upon 378.27federal approval, whichever is later. The children's health security program must comply 378.28with title XIX of the federal Social Security Act, and waivers granted under title XIX.378.29    Sec. 6. [256N.05] ELIGIBILITY.378.30    Subdivision 1.General requirements.Children meeting the eligibility 378.31requirements of this section are eligible for the children's health security program.379.1    Subd. 2.Income limit.(a) Effective October 1, 2008, children in families with 379.2gross household incomes equal to or less than 225 percent of the federal poverty 379.3guidelines are eligible for the children's health security program. In determining gross 379.4income, the commissioner shall use the income methodology applied to children under the 379.5MinnesotaCare program.379.6    (b) Effective October 1, 2008, a dependent child who meets the program income 379.7limits under paragraph (a) and all other program eligibility requirements is eligible for 379.8state-funded benefits under this section. 379.9    (c) Effective January 1, 2011, or upon federal approval, whichever is later, children 379.10in families with household incomes equal to or less than 300 percent of the federal poverty 379.11guidelines must be included in the children's health security program.379.12    (d) The Legislative Task Force On Children's Health Care Coverage established 379.13under section 19 shall develop recommendations on options for extending health insurance 379.14coverage to children in families with household incomes in excess of 300 percent of the 379.15federal poverty guidelines.379.16    Subd. 3.Residency.Program participants must meet the residency requirements of 379.17section 256B.056, subdivision 1.379.18    Subd. 4.Enrollment voluntary.Enrollment in the children's health security 379.19program is voluntary. Parents or guardians may retain private sector or Medicare coverage 379.20for a child as the sole source of coverage. Parents or guardians who have private sector or 379.21Medicare coverage for children may also enroll children in the children's health security 379.22program. If private sector or Medicare coverage is available, coverage under the children's 379.23health security program is secondary to the private sector or Medicare coverage.379.24    Subd. 5.Emergency services.Payment must be made for care and services that 379.25are furnished to noncitizens, regardless of immigration status, who otherwise meet the 379.26eligibility requirements of this chapter, if the care and services are necessary for the 379.27treatment of an emergency medical condition, except for organ transplants and related 379.28care and services and routine prenatal care. For purposes of this subdivision, "emergency 379.29medical condition" means a medical condition that meets the requirements of United 379.30States Code, title 42, section 1396b(v).379.31    Subd. 6.Medical assistance standards and procedures.(a) Unless otherwise 379.32specified in this chapter, the commissioner shall use medical assistance procedures and 379.33methodology when determining initial eligibility and redetermining eligibility for the 379.34children's health security program.380.1    (b) The procedures and income standard specified in section 256B.056, subdivisions 380.25 and 5c, paragraph (a), apply to children who would be eligible for the children's health 380.3security program, except for excess income.380.4    (c) Retroactive coverage for the children's health security program must be provided 380.5as specified in section 256B.056, subdivision 7.380.6    Sec. 7. [256N.07] COVERED SERVICES.380.7    Covered services under the children's health security program must consist of all 380.8covered services under chapter 256B.380.9    Sec. 8. [256N.09] NO ENROLLEE PREMIUMS OR COST SHARING.380.10    In order to ensure broad access to coverage, the children's health security program 380.11has no enrollee premium or cost-sharing requirements.380.12    Sec. 9. [256N.11] APPLICATION PROCEDURES; ELIGIBILITY 380.13DETERMINATION.380.14    Subdivision 1.Application procedure.The application form for the program 380.15must be easily understandable and must not exceed two pages in length. Applications for 380.16the program must be made available to provider offices, local human services agencies, 380.17school districts, schools, community health offices, and other sites willing to cooperate in 380.18program outreach. These sites may accept applications and forward applications to the 380.19commissioner, and counties where applicable. Applications may also be made directly to 380.20the commissioner and to counties that determine eligibility.380.21    Subd. 2.Eligibility determination.Counties that determine eligibility for 380.22MinnesotaCare as of March 1, 2007, shall determine eligibility for the children's health 380.23security program. The commissioner, and counties where applicable, shall determine an 380.24applicant's eligibility for the program within 30 days of the date the application is received, 380.25according to the procedures in Code of Federal Regulations, title 42, section 435.911.380.26    Subd. 3.Presumptive eligibility.Coverage under the program is available during a 380.27presumptive eligibility period for children under age 19 whose family income does not 380.28exceed the applicable income standard. The presumptive eligibility period begins on the 380.29date on which a health care provider enrolled in the program, or other entity designated by 380.30the commissioner, determines, based on preliminary information, that the child's family 380.31income does not exceed the applicable income standard. The presumptive eligibility period 380.32ends the earlier of the day on which a determination is made of eligibility under this section 380.33or the last day of the month following the month presumptive eligibility was determined. 381.1    Subd. 4.Renewal of eligibility.The commissioner shall require enrollees to renew 381.2eligibility every 12 months.381.3    Subd. 5.Continuous eligibility.Children under the age of 19 who are eligible 381.4under this section shall be continuously eligible until the earlier of the next renewal period, 381.5or the time that a child exceeds age 19.381.6    Sec. 10. [256N.12] COUNTY ROLE.381.7    Counties not required to determine eligibility under section 256N.11, subdivision 381.82, may choose to determine eligibility under that section. Counties may also choose 381.9to provide assistance to applicants under section 256N.17, subdivision 1, and provide 381.10ombudsperson services under section 256N.17, subdivision 2. This must not limit the 381.11ability of the commissioner to establish reasonable staffing standards that relate to the 381.12number of persons served, and that provide a county option to hire part-time staff or pursue 381.13multicounty implementation models. If a county chooses not to deliver these services, they 381.14must be delivered by the commissioner. State and federal funding to support these services 381.15must be the same, whether delivered by the state or by a county or group of counties.381.16    Sec. 11. [256N.13] SERVICE DELIVERY.381.17    Subdivision 1.Contracts for service delivery.The commissioner, within each 381.18county, may contract with managed care organizations, including health maintenance 381.19organizations licensed under chapter 62D, community integrated service networks licensed 381.20under chapter 62N, accountable provider networks licensed under chapter 62T, and 381.21county-based purchasing plans established under section 256B.692, to provide covered 381.22health care services to program enrollees under a managed care system, and may contract 381.23with health care and social service providers to provide services on a fee-for-service basis. 381.24Section 256B.69, subdivision 26, applies to contracts with managed care organizations. In 381.25determining the method for service delivery, the commissioner shall consider the cost and 381.26quality of health care services; the breadth of services offered, including medical, dental 381.27and mental health services; the breadth of choice of medical providers for enrollees; the 381.28ease of access to quality medical care for enrollees; the efficiency and cost-effectiveness of 381.29service delivery; and the integration of best medical practice standards into the children's 381.30health security program.381.31    Subd. 2.Managed care organization requirements.(a) Managed care 381.32organizations under contract are responsible for coordinating covered health care services 381.33provided to eligible individuals. Managed care organizations under contract:382.1    (1) shall authorize and arrange for the provision of all needed covered health 382.2services under chapter 256B, with the exception of services available only under a medical 382.3assistance home and community-based waiver, in order to ensure appropriate health care 382.4is delivered to enrollees;382.5    (2) shall comply with the requirements of section 256B.69, subdivision 26;382.6    (3) shall accept the prospective, per capita payment from the commissioner in return 382.7for the provision of comprehensive and coordinated health care services for enrollees;382.8    (4) may contract with health care and social service providers to provide covered 382.9services to enrollees; and382.10    (5) shall institute enrollee grievance procedures according to the method established 382.11by the commissioner, utilizing applicable requirements of chapter 62D and Code of 382.12Federal Regulations, title 42, section 438, subpart F. Disputes may also be appealed to 382.13the commissioner using the procedures in section 256.045.382.14    (b) Upon implementation of the children's health security program, the commissioner 382.15shall withhold five percent of managed care organization payments pending completion 382.16of performance targets, including lead screening, well child services, immunizations, 382.17vision screening, and customer service performance targets. Effective January 1, 2011, 382.18the commissioner shall add treatment of asthma and screening for mental health as new 382.19performance targets. Each performance target must apply uniformly to all managed care 382.20organizations, and be qualitative, objective, measurable, and reasonably attainable, except 382.21in the case of a performance target based on federal or state law or rule. Criteria for 382.22assessment of each performance target must be outlined in writing prior to the contract 382.23effective date. The withhold funds must be returned no sooner than July of the following 382.24year if performance targets in the contract are achieved. The success of each managed care 382.25organization in reaching performance targets must be reported to the legislature annually.382.26    Subd. 3.Fee-for-service delivery.Disputes related to services provided under 382.27the fee-for-service system may be appealed to the commissioner using the procedures 382.28in section 256.045.382.29    Subd. 4.Contracts for waiver services.The commissioner, when services 382.30are delivered through managed care, may contract with health care and social service 382.31providers on a fee-for-service basis to provide program enrollees with covered services 382.32available only under a medical assistance home and community-based waiver. The 382.33commissioner shall determine eligibility for home and community-based waiver services 382.34using the criteria and procedures in chapter 256B. Disputes related to services provided 382.35on a fee-for-service basis may be appealed to the commissioner using the procedures 382.36in section 256.045.383.1    Subd. 5.Service delivery for Minnesota disabilities health option recipient.383.2    Individuals who voluntarily enroll in the Minnesota Disability Health Option (MnDHO), 383.3established under section 256B.69, subdivision 23, shall continue to receive their home 383.4and community-based waiver services through MnDHO.383.5    Subd. 6.Disabled or blind children.Children eligible for medical assistance due 383.6to blindness or disability as determined by the Social Security Administration or the state 383.7medical review team are exempt from enrolling in a managed care organization and shall 383.8be provided health benefits on a fee-for-service basis.383.9    Sec. 12. [256N.15] PAYMENT RATES.383.10    Subdivision 1.Establishment.The commissioner, in consultation with a health 383.11care actuary, shall establish the method and amount of payments for services. The 383.12commissioner shall annually contract with eligible entities to provide services to program 383.13enrollees. The commissioner, in consultation with the Risk Adjustment Association 383.14established under section 62Q.03, subdivision 6, shall develop and implement a risk 383.15adjustment system for the program.383.16    Subd. 2.Provider rates.In establishing the payment amount under subdivision 383.171, the commissioner shall ensure that fee-for-service payment rates for preventative 383.18care services provided on or after October 1, 2008, are at least five percent above the 383.19medical assistance rates for preventative services in effect on September 30, 2008, and 383.20shall ensure that fee-for-service payment rates for all other services provided on or after 383.21October 1, 2008, are at least three percent above the medical assistance rates for those 383.22services in effect on September 30, 2008. The commissioner shall adjust managed care 383.23capitation rates to reflect these increases, and shall require managed care organizations, as 383.24a condition of contract, to pass these increases on to providers under contract.383.25    Sec. 13. [256N.17] CONSUMER ASSISTANCE.383.26    Subdivision 1.Assistance to applicants.The commissioner shall assist applicants 383.27in choosing a managed care organization or fee-for-service provider by:383.28    (1) establishing a Web site to provide information about managed care organizations 383.29and fee-for-service providers and to allow online enrollment;383.30    (2) make information on managed care organizations and fee-for-service providers 383.31available at the sites specified in section 256N.11, subdivision 1;383.32    (3) make applications and information on managed care organizations and 383.33fee-for-service providers available to applicants and enrollees according to Title VI of the 384.1Civil Rights Act and federal regulations adopted under that law or any guidance from the 384.2United States Department of Health and Human Services; and384.3    (4) make benefit educators available to assist applicants in choosing a managed care 384.4organization or fee-for-service provider.384.5    Subd. 2.Ombudsperson.The commissioner shall designate an ombudsperson 384.6to advocate for children enrolled in the children's health security program. The 384.7ombudsperson shall assist enrollees in understanding and making use of complaint and 384.8appeal procedures and ensure that necessary medical services are provided to enrollees. At 384.9the time of enrollment, the commissioner shall inform enrollees about the ombudsperson 384.10program, the right to a resolution of the enrollee's complaint by the managed care 384.11organization if the enrollee experiences a problem with the managed care organization 384.12or its providers, and appeal rights under section 256.045.384.13    Sec. 14. [256N.19] MONITORING AND EVALUATION OF QUALITY AND 384.14COSTS.384.15    (a) The commissioner, as a condition of contract, shall require each participating 384.16managed care organization and participating provider to submit, in the form and manner 384.17specified by the commissioner, data required for assessing enrollee satisfaction, quality 384.18of care, cost, and utilization of services. The commissioner shall evaluate this data, in 384.19order to:384.20    (1) make summary information on the quality of care across managed care 384.21organizations, medical clinics, and providers available to consumers;384.22    (2) require managed care organizations and providers, as a condition of contract, to 384.23implement quality improvement plans; and384.24    (3) compare the cost and quality of services under the program to the cost and 384.25quality of services provided to private sector enrollees.384.26    (b) The commissioner shall implement this section to the extent allowed by federal 384.27and state laws on data privacy.384.28    Sec. 15. [256N.21] FEDERAL APPROVAL.384.29    The commissioner shall seek all federal waivers and approvals necessary to 384.30implement this chapter including, but not limited to, waivers and approvals necessary to:384.31    (1) coordinate medical assistance and MinnesotaCare coverage for children with the 384.32children's health security program;384.33    (2) use federal medical assistance and MinnesotaCare dollars to pay for health care 384.34services under the children's health security program;385.1    (3) maximize receipt of the federal medical assistance match for covered children, 385.2by increasing income standards through the use of more liberal income methodologies as 385.3provided under United States Code, title 42, sections 1396a and 1396u-1;385.4    (4) extend presumptive eligibility and continuous eligibility to children under age 385.521; and385.6    (5) use federal medical assistance and MinnesotaCare dollars to provide benefits to 385.7dependent children.385.8    Sec. 16. [256N.23] RULEMAKING.385.9    The commissioner shall adopt rules to implement this chapter.385.10    Sec. 17. [256N.25] CHILDREN'S HEALTH SECURITY PROGRAM 385.11OUTREACH.385.12    Subdivision 1.Grant awards.The commissioner shall award grants to public or 385.13private organizations to:385.14    (1) provide information, in areas of the state with high uninsured populations, on the 385.15importance of maintaining insurance coverage and on how to obtain coverage through 385.16the children's health security program; and385.17    (2) monitor and provide ongoing support to ensure enrolled children remain covered.385.18    Subd. 2.Criteria.In awarding the grants, the commissioner shall consider the 385.19following:385.20    (1) geographic areas and populations with high uninsured rates;385.21    (2) the ability to raise matching funds;385.22    (3) the ability to contact, effectively communicate with, or serve eligible populations; 385.23and385.24    (4) the applicant's plan to monitor and provide support to ensure enrolled children 385.25remain covered.385.26    Subd. 3.Monitoring and termination.The commissioner shall monitor the grants 385.27and may terminate a grant if the outreach effort does not increase enrollment in the 385.28children's health security program.385.29    Sec. 18. IMPLEMENTATION PLAN.385.30    The commissioner of human services shall develop an implementation plan for the 385.31children's health security program, which includes a health delivery plan based on the 385.32criteria specified in Minnesota Statutes, section 256N.13, subdivision 1. The commissioner 385.33shall present this plan, any necessary draft legislation, and a draft of proposed rules 386.1to the legislature by December 15, 2007. The plan must include recommendations 386.2for any additional legislative changes necessary to coordinate medical assistance and 386.3MinnesotaCare coverage for children with the children's health security program. The 386.4commissioner shall evaluate the provision of services under the program to children with 386.5disabilities and shall present recommendations to the legislature by December 15, 2009, 386.6for any program changes necessary to ensure the quality and continuity of care.386.7    Sec. 19. LEGISLATIVE TASK FORCE ON CHILDREN'S HEALTH CARE 386.8COVERAGE.386.9    Subdivision 1.Establishment; membership.(a) The Legislative Task Force on 386.10Children's Health Care Coverage is established. The task force is made up of 12 voting 386.11members and six nonvoting members.386.12    (b) The voting members are:386.13    (1) six members of the house of representatives appointed by the speaker, three from 386.14the majority party and three from the minority party; and386.15    (2) six members of the senate appointed by the Subcommittee on Committees of the 386.16senate Committee on Rules and Administration, three from the majority party and three 386.17from the minority party.386.18    (c) The nonvoting members are one representative selected by each of the following 386.19organizations:386.20    (1) the American Academy of Pediatrics, Minnesota chapter;386.21    (2) the Minnesota Nurses Association;386.22    (3) the Minnesota Council of Health Plans;386.23    (4) the Minnesota Children's Platform Coalition;386.24    (5) the Minnesota Universal Health Care Coalition; and386.25    (6) the Minnesota Business Partnership.386.26    (d) The task force members must be appointed by September 1, 2007. The majority 386.27leader of the senate and the speaker of the house of representatives must each designate 386.28a chair from their appointments. The chair appointed by the speaker of the house of 386.29representatives shall convene and chair the first meeting of the task force. The chair 386.30appointed by the majority leader of the senate shall chair the next meeting of the task 386.31force. The chairs shall then alternate for the duration of the task force.386.32    Subd. 2.Study; staff support.(a) The task force shall study viable options to extend 386.33coverage to all children as provided in Minnesota Statutes, section 256N.05, subdivision 386.342, paragraph (d), and provide recommendations to the legislature. The study must:387.1    (1) evaluate methods to achieve universal coverage for children, including, but not 387.2limited to, changes to the employer-based coverage system and an expansion of eligibility 387.3for the children's health security program established under Minnesota Statutes, chapter 387.4256N;387.5    (2) examine health care reform and cost containment methods that will contain costs 387.6and increase access and improve health outcomes;387.7    (3) examine how to increase access to preventive care and health care services; and387.8    (4) examine how to reduce health disparities among minority populations. 387.9    (b) The task force, through the Legislative Coordinating Commission, may hire staff 387.10or contract for staff support for the study.387.11    (c) The task force, in developing recommendations, shall hold meetings to hear 387.12public testimony at locations throughout the state, including locations outside of the 387.13seven-county metropolitan area.387.14    Subd. 3.Recommendations.The task force shall report its recommendations to 387.15the legislature by December 15, 2009. Recommendations must be consistent with the 387.16following criteria:387.17    (1) health care coverage must include preventive care and all other medically 387.18necessary services;387.19    (2) health care coverage must be affordable for families, with the family share of 387.20premium costs and cost-sharing in total not exceeding five percent of family income;387.21    (3) the system of coverage must give priority to ensuring access to and the quality 387.22and continuity of care; and387.23    (4) enrollment must be simple and seamless for families.387.24    Subd. 4.Expiration.This section expires December 16, 2009.387.25ARTICLE 9387.26HEALTH CARE REFORM387.27    Section 1. Minnesota Statutes 2006, section 62A.65, subdivision 3, is amended to read:387.28    Subd. 3. Premium rate restrictions. No individual health plan may be offered, 387.29sold, issued, or renewed to a Minnesota resident unless the premium rate charged is 387.30determined in accordance with the following requirements:387.31    (a) Premium rates must be no more than 25 percent above and no more than 25 387.32percent below the index rate charged to individuals for the same or similar coverage, 387.33adjusted pro rata for rating periods of less than one year. The premium variations 387.34permitted by this paragraph must be based only upon health status, claims experience, 387.35and occupation. For purposes of this paragraph, health status includes refraining from 388.1tobacco use or other actuarially valid lifestyle factors associated with good health, 388.2provided that the lifestyle factor and its effect upon premium rates have been determined 388.3by the commissioner to be actuarially valid and have been approved by the commissioner. 388.4Variations permitted under this paragraph must not be based upon age or applied 388.5differently at different ages. This paragraph does not prohibit use of a constant percentage 388.6adjustment for factors permitted to be used under this paragraph.388.7    (b) Premium rates may vary based upon the ages of covered persons only as 388.8provided in this paragraph. In addition to the variation permitted under paragraph (a), 388.9each health carrier may use an additional premium variation based upon age for adults 388.10aged 19 and above of up to plus or minus 50 percent of the index rate. Premium rates for 388.11children under the age of 19 may not vary based on age, regardless of whether the child is 388.12covered as a dependent or as a primary insured.388.13    (c) A health carrier may request approval by the commissioner to establish separate 388.14geographic regions determined by the health carrier and to establish separate index rates 388.15for each such region. The commissioner shall grant approval if the following conditions 388.16are met: 388.17    (1) the geographic regions must be applied uniformly by the health carrier;388.18    (2) each geographic region must be composed of no fewer than seven counties that 388.19create a contiguous region; and388.20    (3) the health carrier provides actuarial justification acceptable to the commissioner 388.21for the proposed geographic variations in index rates, establishing that the variations are 388.22based upon differences in the cost to the health carrier of providing coverage.388.23    (d) Health carriers may use rate cells and must file with the commissioner the rate 388.24cells they use. Rate cells must be based upon the number of adults or children covered 388.25under the policy and may reflect the availability of Medicare coverage. The rates for 388.26different rate cells must not in any way reflect generalized differences in expected costs 388.27between principal insureds and their spouses.388.28    (e) In developing its index rates and premiums for a health plan, a health carrier shall 388.29take into account only the following factors:388.30    (1) actuarially valid differences in rating factors permitted under paragraphs (a) 388.31and (b); and388.32    (2) actuarially valid geographic variations if approved by the commissioner as 388.33provided in paragraph (c).388.34    (f) All premium variations must be justified in initial rate filings and upon request of 388.35the commissioner in rate revision filings. All rate variations are subject to approval by 388.36the commissioner.389.1    (g) The loss ratio must comply with the section 
         62A.021 requirements for individual 389.2health plans. 389.3    (h) The rates must not be approved, unless the commissioner has determined that the 389.4rates are reasonable. In determining reasonableness, the commissioner shall consider the 389.5growth rates applied under section 
         62J.04, subdivision 1, paragraph (b), to the calendar 389.6year or years that the proposed premium rate would be in effect, actuarially valid changes 389.7in risks associated with the enrollee populations, and actuarially valid changes as a result 389.8of statutory changes in Laws 1992, chapter 549. 389.9    (i) An insurer may, as part of a minimum lifetime loss ratio guarantee filing under 389.10section 
         62A.02, subdivision 3a, include a rating practices guarantee as provided in this 389.11paragraph. The rating practices guarantee must be in writing and must guarantee that 389.12the policy form will be offered, sold, issued, and renewed only with premium rates and 389.13premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices 389.14guarantee must be accompanied by an actuarial memorandum that demonstrates that the 389.15premium rates and premium rating system used in connection with the policy form will 389.16satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to 389.17policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4, 389.18or 5. An insurer that complies with this paragraph in connection with a policy form is 389.19exempt from the requirement of prior approval by the commissioner under paragraphs 389.20(c), (f), and (h).389.21    Sec. 2. [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.389.22    Subdivision 1.Title; citation.This section may be cited as the "Minnesota Health 389.23Insurance Exchange."389.24    Subd. 2.Creation; tax exemption.The Minnesota Health Insurance Exchange 389.25is created for the limited purpose of providing individuals with greater access, choice, 389.26portability, and affordability of health insurance products. The Minnesota Health 389.27Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c) 389.28of the Internal Revenue Code.389.29    Subd. 3.Definitions.The following terms have the meanings given them unless 389.30otherwise provided in text.389.31    (a) "Board" means the board of directors of the Minnesota Health Insurance 389.32Exchange under subdivision 13.389.33    (b) "Commissioner" means: 389.34    (1) the commissioner of commerce for health insurers subject to the jurisdiction 389.35of the Department of Commerce; 390.1    (2) the commissioner of health for health insurers subject to the jurisdiction of the 390.2Department of Health; or 390.3    (3) either commissioner's designated representative.390.4    (c) "Exchange" means the Minnesota Health Insurance Exchange.390.5    (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.390.6    (e) "Individual market health plans," unless otherwise specified, means individual 390.7market health plans defined in section 62A.011.390.8    (f) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 of 390.9the Internal Revenue Code that allows employees to pay for health insurance premiums 390.10with pretax dollars.390.11    Subd. 4.Insurer and health plan participation.All health plans as defined in 390.12section 62A.011, subdivision 3, issued or renewed in the individual market shall participate 390.13in the exchange. No health plans in the individual market may be issued or renewed 390.14outside of the exchange. Group health plans as defined in section 62A.10 shall not be 390.15offered through the exchange. Health plans offered through the Minnesota Comprehensive 390.16Health Association as defined in section 62E.10 are offered through the exchange to 390.17eligible enrollees as determined by the Minnesota Comprehensive Health Association. 390.18Health plans offered through MinnesotaCare under chapter 256L are offered through the 390.19exchange to eligible enrollees as determined by the commissioner of human services.390.20    Subd. 5.Approval of health plans.No health plan may be offered through the 390.21exchange unless the commissioner has first certified that:390.22    (1) the insurer seeking to offer the health plan is licensed to issue health insurance in 390.23the state; and390.24    (2) the health plan meets the requirements of this section, and the health plan and the 390.25insurer are in compliance with all other applicable health insurance laws.390.26    Subd. 6.Individual market health plans.Individual market health plans offered 390.27through the exchange continue to be regulated by the commissioner as specified in 390.28chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions 390.29that apply to all health plans issued or renewed through the exchange:390.30    (1) premiums for children under the age of 19 shall not vary by age in the exchange; 390.31and390.32    (2) premiums for children under the age of 19 must be excluded from rating factors 390.33under section 62A.65, subdivision 3, paragraph (b).390.34    Subd. 7.Individual participation and eligibility.Individuals are eligible to 390.35purchase health plans directly through the exchange or through an employer Section 390.36125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of 391.1individual market health plans offered through the exchange. Individuals are eligible to 391.2purchase individual market health plans through the exchange by meeting one or more 391.3of the following qualifications:391.4    (1) the individual is a Minnesota resident, meaning the individual is physically 391.5residing on a permanent basis in a place that is the person's principal residence and from 391.6which the person is absent only for temporary purposes;391.7    (2) the individual is a student attending an institution outside of Minnesota and 391.8maintains Minnesota residency;391.9    (3) the individual is not a Minnesota resident but is employed by an employer 391.10physically located within the state and the individual's employer is required to offer a 391.11Section 125 Plan under section 62A.68;391.12    (4) the individual is not a Minnesota resident but is self-employed and the 391.13individual's principal place of business is in the state; or391.14    (5) the individual is a dependent as defined in section 62L.02, of another individual 391.15who is eligible to participate in the exchange.391.16    Subd. 8.Continuation of coverage.Enrollment in a health plan may be canceled 391.17for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under 391.18chapter 256L. Enrollment in an individual market health plan may not be canceled or 391.19nonrenewed because of any change in employer or employment status, marital status, 391.20health status, age, residence, or any other change that does not affect eligibility as defined 391.21in this section.391.22    Subd. 9.Responsibilities of the exchange.The exchange shall serve as the sole 391.23entity for enrollment and collection and transfer of premium payments for health plans 391.24sold to individuals through the exchange. The exchange shall be responsible for the 391.25following functions:391.26    (1) publicize the exchange, including but not limited to its functions, eligibility 391.27rules, and enrollment procedures;391.28    (2) provide assistance to employers to establish Section 125 Plans under section 391.2962A.68;391.30    (3) provide education and assistance to employers to help them understand the 391.31requirements of Section 125 Plans and compliance with applicable regulations;391.32    (4) create a system to allow individuals to compare and enroll in health plans offered 391.33through the exchange;391.34    (5) create a system to collect and transmit to the applicable plans all premium 391.35payments made by individuals, including developing mechanisms to receive and process 392.1automatic payroll deductions for individuals who purchase coverage through employer 392.2Section 125 Plans;392.3    (6) not accept premium payments for individual market health plans from an 392.4employer Section 125 Plan if the employer offers a group health plan as defined in section 392.562A.10, or if the employer is a self-insurer as defined in section 62E.02;392.6    (7) provide jointly with health insurers a cancellation notice directly to the primary 392.7insured at least ten days prior to termination of coverage for nonpayment of premium;392.8    (8) bill the employer for the premiums payable by an employee, provided that the 392.9employer is not liable for payment except from payroll deductions for that purpose;392.10    (9) refer individuals interested in MinnesotaCare under chapter 256L to the 392.11Department of Human Services to determine eligibility;392.12    (10) establish a mechanism with the Department of Human Services to transfer 392.13premiums and subsidies for MinnesotaCare to qualify for federal matching payments;392.14    (11) upon request, issue certificates of previous coverage according to the provisions 392.15of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be 392.16covered by a participating health plan through the exchange;392.17    (12) establish procedures to account for all funds received and disbursed by the 392.18exchange for individual participants of the exchange; 392.19    (13) make available to the public, at the end of each calendar year, a report of an 392.20independent audit of the exchange's accounts; and392.21    (14) provide copies of written and signed statements from employers stating that 392.22the employer is not contributing to the employee's premiums for health plans purchased 392.23by an employee through the exchange to all health insurers with enrolled employees of 392.24the employer.392.25    Health insurers may rely on the employer's statement in clause (4) provided by the 392.26Minnesota Health Insurance Exchange and are not required to guarantee-issue individual 392.27health plans to the employer's employees.392.28    Subd. 10.State not liable.The state of Minnesota shall not be liable for the actions 392.29of the Minnesota Health Insurance Exchange.392.30    Subd. 11.Powers of the exchange.The exchange shall have the power to:392.31    (1) contract with insurance producers licensed in accident and health insurance 392.32under chapter 60K and vendors to perform one or more of the functions specified in 392.33subdivision 10;392.34    (2) contract with employers to collect premiums through a Section 125 Plan for 392.35eligible individuals who purchase an individual market health plan through the exchange;393.1    (3) establish and assess fees on health plan premiums of health plans purchased 393.2through the exchange to fund the cost of administering the exchange;393.3    (4) seek and directly receive grant funding from government agencies or private 393.4philanthropic organizations to defray the costs of operating the exchange;393.5    (5) establish and administer rules and procedures governing the operations of the 393.6exchange;393.7    (6) establish one or more service centers within Minnesota;393.8    (7) sue or be sued or otherwise take any necessary or proper legal action;393.9    (8) establish bank accounts and borrow money; and393.10    (9) enter into agreements with the commissioners of commerce, health, human 393.11services, revenue, employment and economic development, and other state agencies as 393.12necessary for the exchange to implement the provisions of this section.393.13    Subd. 12.Dispute resolution.The exchange shall establish procedures for 393.14resolving disputes with respect to the eligibility of an individual to participate in the 393.15exchange. The exchange does not have the authority or responsibility to intervene in or 393.16resolve disputes between an individual and a health plan or health insurer. The exchange 393.17shall refer complaints from individuals participating in the exchange to the commissioner 393.18to be resolved according to sections 62Q.68 to 62Q.73.393.19    Subd. 13.Governance.The exchange shall be governed by a board of directors 393.20with 11 members. The board shall convene on or before July 1, 2007, after the initial board 393.21members have been selected. The initial board membership consists of the following:393.22    (1) the commissioner of commerce;393.23    (2) the commissioner of human services;393.24    (3) the commissioner of health;393.25    (4) four members appointed by a joint committee of the Minnesota senate and the 393.26Minnesota house of representatives to serve three-year terms; and393.27    (5) four members appointed by the governor to serve three-year terms.393.28    Subd. 14.Subsequent board membership.Ongoing membership of the exchange 393.29consists of the following effective July 1, 2010:393.30    (1) the commissioner of commerce;393.31    (2) the commissioner of human services;393.32    (3) the commissioner of health;393.33    (4) two members appointed by the governor with the approval of a joint committee 393.34of the senate and house of representatives to serve two-year terms; and394.1    (5) six members elected by the membership of the exchange of which three 394.2are elected to serve a two-year term and three are elected to serve a three-year term. 394.3Appointed and elected members may serve more than one term.394.4    Subd. 15.Operations of the board.Officers of the board of directors are elected by 394.5members of the board and serve one-year terms. Six members of the board constitutes a 394.6quorum, and the affirmative vote of six members of the board is necessary and sufficient 394.7for any action taken by the board. Board members serve without pay, but are reimbursed 394.8for actual expenses incurred in the performance of their duties.394.9    Subd. 16.Operations of the exchange.The board of directors shall appoint an 394.10exchange director who shall:394.11    (1) be a full-time employee of the exchange;394.12    (2) administer all of the activities and contracts of the exchange; and 394.13    (3) hire and supervise the staff of the exchange.394.14    Subd. 17.Insurance producers.An individual has the right to choose any 394.15insurance producer licensed in accident and health insurance under chapter 60K to assist 394.16them in purchasing an individual market health plan through the exchange. When a 394.17producer licensed in accident and health insurance under chapter 60K enrolls an eligible 394.18individual in the exchange, the health plan chosen by an individual may pay the producer 394.19a commission.394.20    Subd. 18.Implementation.Health plan coverage through the exchange begins on 394.21January 1, 2009. The exchange must be operational to assist employers and individuals 394.22by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees 394.23of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive 394.24Health Association as of December 2, 2008, are automatically enrolled in the exchange 394.25on January 1, 2009, in the same health plan and at the same premium that they were 394.26enrolled as of December 2, 2008, subject to the provisions of this section. As of January 1, 394.272009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota 394.28Comprehensive Health Association shall make premium payments to the exchange.394.29    Sec. 3. [62A.68] SECTION 125 PLANS.394.30    Subdivision 1.Definitions.The following terms have the meanings given unless 394.31otherwise provided in text:394.32    (a) "Current employee" means an employee currently on an employer's payroll other 394.33than a retiree or disabled former employee.395.1    (b) "Employer" means a person, firm, corporation, partnership, association, business 395.2trust, or other entity employing one or more persons, including a political subdivision of 395.3the state, filing payroll tax information on such employed person or persons.395.4    (c) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 395.5of the Internal Revenue Code that allows employees to purchase health insurance with 395.6pretax dollars.395.7    (d) "Exchange" means the Minnesota Health Insurance Exchange under section 395.862A.67.395.9    (e) "Exchange director" means the appointed director under section 62A.67, 395.10subdivision 16.395.11    Subd. 2.Section 125 Plan requirement.(a) Effective January 1, 2009, all 395.12employers with 11 or more current employees shall establish a Section 125 Plan to 395.13allow their employees to purchase individual market health plan coverage with pretax 395.14dollars. Nothing in this section requires or mandates employers to offer or purchase 395.15health insurance coverage for their employees. The following employers are exempt 395.16from the Section 125 Plan requirement:395.17    (1) employers that offer a group health insurance plan as defined in 62A.10;395.18    (2) employers that are self-insurers as defined in section 62E.02; and395.19    (3) employers with fewer than 11 current employees, except that employers under 395.20this clause may voluntarily offer a Section 125 Plan.395.21    (b) Employers that offer a Section 125 Plan may enter into an agreement with the 395.22exchange to administer the employer's Section 125 Plan.395.23    Subd. 3.Tracking compliance.By July 1, 2008, the exchange, in consultation with 395.24the commissioners of commerce, health, employment and economic development, and 395.25revenue shall establish a method for tracking employer compliance with the Section 125 395.26Plan requirement.395.27    Subd. 4.Employer requirements.Employers that are required to offer or choose 395.28to offer a Section 125 Plan shall:395.29    (1) allow employees to purchase any individual market health plan for themselves 395.30and their dependents through the exchange;395.31    (2) allow employees to choose any insurance producer licensed in accident and 395.32health insurance under chapter 60K to assist them in purchasing an individual market 395.33health plan through the exchange;395.34    (3) provide a written and signed statement to the exchange stating that the employer 395.35is not contributing to the employee's premiums for health plans purchased by an employee 395.36through the exchange;396.1    (4) upon an employee's request, deduct premium amounts on a pretax basis in an 396.2amount not to exceed an employee's wages, and remit these employee payments to the 396.3exchange; and396.4    (5) provide notice to employees that individual market health plans purchased 396.5through the exchange are not employer-sponsored or administered. Employers shall be 396.6held harmless from any and all liability claims related to the individual market health 396.7plans purchased through the exchange by employees under a Section 125 Plan.396.8    Subd. 5.Section 125 eligible health plans.Individuals who are eligible to use 396.9an employer Section 125 Plan to pay for health insurance coverage purchased through 396.10the exchange may enroll in any health plan offered through the exchange for which the 396.11individual is eligible including individual market health plans, MinnesotaCare, and the 396.12Minnesota Comprehensive Health Association.396.13    Sec. 4. Minnesota Statutes 2006, section 62E.141, is amended to read:396.1462E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.396.15    No employee of an employer that offers a group health plan, under which the 396.16employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in 396.17the comprehensive health association, except for enrollment or continued enrollment 396.18necessary to cover conditions that are subject to an unexpired preexisting condition 396.19limitation, preexisting condition exclusion, or exclusionary rider under the employer's 396.20health plan. This section does not apply to persons enrolled in the Comprehensive Health 396.21Association as of June 30, 1993. With respect to persons eligible to enroll in the health 396.22plan of an employer that has more than 29 current employees, as defined in section 396.2362L.02
         , this section does not apply to persons enrolled in the Comprehensive Health 396.24Association as of December 31, 1994. 396.25    Sec. 5. Minnesota Statutes 2006, section 62J.04, subdivision 3, is amended to read:396.26    Subd. 3. Cost containment duties. The commissioner shall:396.27    (1) establish statewide and regional cost containment goals for total health care 396.28spending under this section and, collect data as described in sections 
         62J.38 to 
         62J.41 to 396.29monitor statewide achievement of the cost containment goals, and annually report to the 396.30legislature on whether the goals were achieved and, if not, what action should be taken to 396.31ensure that goals are achieved in the future; 396.32    (2) divide the state into no fewer than four regions, with one of those regions being 396.33the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti, 396.34Wright, and Sherburne Counties, for purposes of fostering the development of regional 397.1health planning and coordination of health care delivery among regional health care 397.2systems and working to achieve the cost containment goals;397.3    (3) monitor the quality of health care throughout the state and take action as 397.4necessary to ensure an appropriate level of quality;397.5    (4) issue recommendations regarding uniform billing forms, uniform electronic 397.6billing procedures and data interchanges, patient identification cards, and other uniform 397.7claims and administrative procedures for health care providers and private and public 397.8sector payers. In developing the recommendations, the commissioner shall review the 397.9work of the work group on electronic data interchange (WEDI) and the American National 397.10Standards Institute (ANSI) at the national level, and the work being done at the state and 397.11local level. The commissioner may adopt rules requiring the use of the Uniform Bill 397.1282/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic 397.13version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized 397.14forms or procedures;397.15    (5) undertake health planning responsibilities;397.16    (6) authorize, fund, or promote research and experimentation on new technologies 397.17and health care procedures;397.18    (7) within the limits of appropriations for these purposes, administer or contract for 397.19statewide consumer education and wellness programs that will improve the health of 397.20Minnesotans and increase individual responsibility relating to personal health and the 397.21delivery of health care services, undertake prevention programs including initiatives to 397.22improve birth outcomes, expand childhood immunization efforts, and provide start-up 397.23grants for worksite wellness programs;397.24    (8) undertake other activities to monitor and oversee the delivery of health care 397.25services in Minnesota with the goal of improving affordability, quality, and accessibility of 397.26health care for all Minnesotans; and397.27    (9) make the cost containment goal data available to the public in a 397.28consumer-oriented manner.397.29EFFECTIVE DATE.This section is effective July 1, 2007.397.30    Sec. 6. Minnesota Statutes 2006, section 62J.495, is amended to read:397.3162J.495 HEALTH INFORMATION TECHNOLOGY AND 397.32INFRASTRUCTURE ADVISORY COMMITTEE.397.33    Subdivision 1. Establishment; members; duties Implementation.By January 397.341, 2012, all hospitals and health care providers must have in place an interoperable 398.1electronic health records system within their hospital system or clinical practice setting. 398.2The commissioner of health, in consultation with the Health Information Technology and 398.3Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal, 398.4including the adoption of uniform standards to be used for the interoperable system for 398.5sharing and synchronizing patient data across systems. The standards must be compatible 398.6with federal efforts. The uniform standards must be refined and adopted for use when 398.7a standard development organization accredited by the American National Standards 398.8Institute completes the development of a standard for sharing and synchronizing patient 398.9data across systems.398.10    Subd. 2. Health Information Technology and Infrastructure Advisory 398.11Committee. (a) The commissioner shall establish a Health Information Technology 398.12and Infrastructure Advisory Committee governed by section 
         15.059 to advise the 398.13commissioner on the following matters:398.14    (1) assessment of the use of health information technology by the state, licensed 398.15health care providers and facilities, and local public health agencies;398.16    (2) recommendations for implementing a statewide interoperable health information 398.17infrastructure, to include estimates of necessary resources, and for determining standards 398.18for administrative data exchange, clinical support programs, patient privacy requirements, 398.19and maintenance of the security and confidentiality of individual patient data; and398.20    (3) other related issues as requested by the commissioner.398.21    (b) The members of the Health Information Technology and Infrastructure Advisory 398.22Committee shall include the commissioners, or commissioners' designees, of health, 398.23human services, administration, and commerce and additional members to be appointed 398.24by the commissioner to include persons representing Minnesota's local public health 398.25agencies, licensed hospitals and other licensed facilities and providers, private purchasers, 398.26the medical and nursing professions, health insurers and health plans, the state quality 398.27improvement organization, academic and research institutions, consumer advisory 398.28organizations with an interest and expertise in health information technology, and other 398.29stakeholders as identified by the Health Information Technology and Infrastructure 398.30Advisory Committee.398.31    Subd. 2.Annual report.(c) The commissioner shall prepare and issue an annual 398.32report not later than January 30 of each year outlining progress to date in implementing a 398.33statewide health information infrastructure and recommending future projects.398.34    Subd. 3.Expiration.(d) Notwithstanding section 
         15.059, this sectionsubdivision 398.35expires June 30, 2009 2012.399.1    Sec. 7. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING 399.2ACCOUNT AND LOAN PROGRAM.399.3    Subdivision 1.Account establishment.The commissioner of finance shall establish 399.4and implement a revolving account in the state government special revenue fund to 399.5provide loans to eligible borrowers to assist in financing the installation or support of 399.6an interoperable health record system. The system must provide for the interoperable 399.7exchange of health care information between the applicant and, at a minimum, a hospital 399.8system, pharmacy, and a health care clinic or other physician group.399.9    Subd. 2.Eligibility.(a) "Eligible borrower" means one of the following:399.10    (1) community clinics, as defined under section 145.9268;399.11    (2) hospitals eligible for rural hospital capital improvement grants, as defined 399.12in section 144.148;399.13    (3) physician clinics located in a community with a population of less than 50,000 399.14according to United States Census Bureau statistics and outside the seven-county 399.15metropolitan area;399.16    (4) nursing facilities licensed under sections 144A.01 to 144A.27; and399.17    (5) other providers of health or health care services approved by the commissioner 399.18for which interoperable electronic health record capability would improve quality of 399.19care, patient safety, or community health.399.20    (b) To be eligible for a loan under this section, the applicant must submit a loan 399.21application to the commissioner of health on forms prescribed by the commissioner. The 399.22application must include, at a minimum:399.23    (1) the amount of the loan requested and a description of the purpose or project 399.24for which the loan proceeds will be used;399.25    (2) a quote from a vendor;399.26    (3) a description of the health care entities and other groups participating in the 399.27project;399.28    (4) evidence of financial stability and a demonstrated ability to repay the loan; and399.29    (5) a description of how the system to be financed interconnects or plans in the 399.30future to interconnect with other health care entities and provider groups located in the 399.31same geographical area.399.32    Subd. 3.Loans.(a) The commissioner of health may make a no interest loan 399.33to a provider or provider group who is eligible under subdivision 2 on a first-come, 399.34first-served basis provided that the applicant is able to comply with this section. The total 399.35accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of 399.36health has discretion over the size and number of loans made.400.1    (b) The commissioner of health may prescribe forms and establish an application 400.2process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable 400.3application fee to cover the cost of administering the loan program.400.4    (c) The borrower must begin repaying the principal no later than two years from the 400.5date of the loan. Loans must be amortized no later than six years from the date of the loan.400.6    (d) Repayments must be credited to the account.400.7    Subd. 4.Data classification.Data collected by the commissioner of health on the 400.8application to determine eligibility under subdivision 2 and to monitor borrowers' default 400.9risk or collect payments owed under subdivision 3 are (1) private data on individuals as 400.10defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section 400.1113.02, subdivision 9. The names of borrowers and the amounts of the loans granted are 400.12public data.400.13    Sec. 8. [62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND 400.14IMPLEMENTATION GUIDE STANDARDS.400.15    Subdivision 1.Electronic claims and eligibility transactions required.(a) 400.16Beginning January 15, 2009, all group purchasers must accept from health care providers 400.17the eligibility for a health plan transaction described under Code of Federal Regulations, 400.18title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept 400.19from health care providers the health care claims or equivalent encounter information 400.20transaction described under Code of Federal Regulations, title 45, part 162, subpart K.400.21    (b) Beginning January 15, 2009, all group purchasers must transmit to providers the 400.22eligibility for a health plan transaction described under Code of Federal Regulations, title 400.2345, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit 400.24to providers the health care payment and remittance advice transaction described under 400.25Code of Federal Regulations, title 45, part 162, subpart P.400.26    (c) Beginning January 15, 2009, all health care providers must submit to group 400.27purchasers the eligibility for a health plan transaction described under Code of Federal 400.28Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care 400.29providers must submit to group purchasers the health care claims or equivalent encounter 400.30information transaction described under Code of Federal Regulations, title 45, part 162, 400.31subpart K.400.32    (d) Beginning January 15, 2009, all health care providers must accept from group 400.33purchasers the eligibility for a health plan transaction described under Code of Federal 400.34Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care 400.35providers must accept from group purchasers the health care payment and remittance 401.1advice transaction described under Code of Federal Regulations, title 45, part 162, subpart 401.2P.401.3    (e) Each of the transactions described in paragraphs (a) to (d) shall require the use 401.4of a single, uniform companion guide to the implementation guides described under 401.5Code of Federal Regulations, title 45, part 162. The companion guides will be developed 401.6pursuant to subdivision 2.401.7    (f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group 401.8purchasers and health care providers must exchange claims and eligibility information 401.9electronically using the transactions, companion guides, implementation guides, and 401.10timelines required under this subdivision. Group purchasers may not impose any fee on 401.11providers for the use of the transactions prescribed in this subdivision.401.12    (g) Nothing in this subdivision shall prohibit group purchasers and health care 401.13providers from using a direct data entry, Web-based methodology for complying with 401.14the requirements of this subdivision. Any direct data entry method for conducting 401.15the transactions specified in this subdivision must be consistent with the data content 401.16component of the single, uniform companion guides required in paragraph (e) and the 401.17implementation guides described under Code of Federal Regulations, title 45, part 162.401.18    Subd. 2.Establishing uniform, standard companion guides.(a) At least 12 401.19months prior to the timelines required in subdivision 1, the commissioner of health shall 401.20promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers 401.21and health care providers to use the transactions and the uniform, standard companion 401.22guides required under subdivision 1, paragraph (e).401.23    (b) The commissioner of health must consult with the Minnesota Administrative 401.24Uniformity Committee on the development of the single, uniform companion guides 401.25required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1. 401.26The single uniform companion guides required under subdivision 1, paragraph (e), must 401.27specify uniform billing and coding standards. The commissioner of health shall base the 401.28companion guides required under subdivision 1, paragraph (e), billing and coding rules, 401.29and standards on the Medicare program, with modifications that the commissioner deems 401.30appropriate after consulting the Minnesota Administrative Uniformity Committee.401.31    (c) No group purchaser or health care provider may add to or modify the single, 401.32uniform companion guides defined in subdivision 1, paragraph (e), through additional 401.33companion guides or other requirements.401.34    (d) In promulgating the rules in paragraph (a), the commissioner shall not require 401.35data content that is not essential to accomplish the purpose of the transactions in 401.36subdivision 1.402.1    Sec. 9. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:402.2    Subdivision 1. Definitions. For purposes of this section, the following definitions 402.3apply:402.4    (a) "Accredited clinical training" means the clinical training provided by a 402.5medical education program that is accredited through an organization recognized by the 402.6Department of Education, the Centers for Medicare and Medicaid Services, or another 402.7national body who reviews the accrediting organizations for multiple disciplines and 402.8whose standards for recognizing accrediting organizations are reviewed and approved by 402.9the commissioner of health in consultation with the Medical Education and Research 402.10Advisory Committee.402.11    (b) "Commissioner" means the commissioner of health.402.12    (c) "Clinical medical education program" means the accredited clinical training of 402.13physicians (medical students and residents), doctor of pharmacy practitioners, doctors 402.14of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified 402.15registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and 402.16physician assistants.402.17    (d) "Sponsoring institution" means a hospital, school, or consortium located in 402.18Minnesota that sponsors and maintains primary organizational and financial responsibility 402.19for a clinical medical education program in Minnesota and which is accountable to the 402.20accrediting body.402.21    (e) "Teaching institution" means a hospital, medical center, clinic, or other 402.22organization that conducts a clinical medical education program in Minnesota.402.23    (f) "Trainee" means a student or resident involved in a clinical medical education 402.24program.402.25    (g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time 402.26equivalent counts, that are at training sites located in Minnesota with acurrently 402.27active medical assistance provider numberenrollment status and a National Provider 402.28Identification (NPI) number where training occurs in either an inpatient or ambulatory 402.29patient care setting and where the training is funded, in part, by patient care revenues.402.30    Sec. 10. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:402.31    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute 402.3290 percent of available medical education funds transferred according to section 402.33256B.69, subdivision 5c, paragraph (a), clause (1), to all qualifying applicants based on a 402.34distribution formula that reflects a summation of two factors:403.1    (1) an education factor, which is determined by the total number of eligible trainee 403.2FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical 403.3medical education program; and403.4    (2) a public program volume factor, which is determined by the total volume of 403.5public program revenue received by each training site as a percentage of all public 403.6program revenue received by all training sites in the fund pool.403.7    In this formula, the education factor is weighted at 67 percent and the public program 403.8volume factor is weighted at 33 percent.403.9    Public program revenue for the distribution formula includes revenue from medical 403.10assistance, prepaid medical assistance, general assistance medical care, and prepaid 403.11general assistance medical care. Training sites that receive no public program revenue 403.12are ineligible for funds available under this paragraph. Total statewide average costs per 403.13trainee for medical residents is based on audited clinical training costs per trainee in 403.14primary care clinical medical education programs for medical residents. Total statewide 403.15average costs per trainee for dental residents is based on audited clinical training costs 403.16per trainee in clinical medical education programs for dental students. Total statewide 403.17average costs per trainee for pharmacy residents is based on audited clinical training costs 403.18per trainee in clinical medical education programs for pharmacy students.403.19    (b) The commissioner shall annually distribute ten percent of total available medical 403.20education funds transferred according to section 256B.69, subdivision 5c, paragraph (a), 403.21clause (1), to all qualifying applicants based on the percentage received by each applicant 403.22under paragraph (a). These funds are to be used to offset clinical education costs at 403.23eligible clinical training sites based on criteria developed by the clinical medical education 403.24program. Applicants may choose to distribute funds allocated under this paragraph based 403.25on the distribution formula described in paragraph (a).403.26    (c) The commissioner shall annually distribute $5,000,000 of the funds dedicated 403.27to the commissioner under section 297F.10, subdivision 1, clause (2), plus any federal 403.28financial participation on these funds and on funds transferred under subdivision 10, to all 403.29qualifying applicants based on a distribution formula that gives 100 percent weight to a 403.30public program volume factor, which is determined by the total volume of public program 403.31revenue received by each training site as a percentage of all public program revenue 403.32received by all training sites in the fund pool. If federal approval is not obtained for 403.33federal financial participation on any portion of funds distributed under this paragraph, 403.3490 percent of the unmatched funds shall be distributed by the commissioner based on 403.35the formula described in paragraph (a) and ten percent of the unmatched funds shall be 403.36distributed by the commissioner based on the formula described in paragraph (b).404.1    (d) The commissioner shall annually distribute $3,060,000 of funds dedicated to the 404.2commissioner under section 297F.10, subdivision 1, clause (2), through a formula giving 404.3100 percent weight to an education factor, which is determined by the total number of 404.4eligible trainee full-time equivalents and the total statewide average costs per trainee, by 404.5type of trainee, in each clinical medical education program. If no matching funds are 404.6received on funds distributed under paragraph (c), funds distributed under this paragraph 404.7shall be distributed by the commissioner based on the formula described in paragraph (a).404.8    (e) The commissioner shall annually distribute $340,000 of funds dedicated to the 404.9commissioner under section 297F.10, subdivision 1, clause (2), to all qualifying applicants 404.10based on the percentage received by each applicant under paragraph (a). These funds are 404.11to be used to offset clinical education costs at eligible clinical training sites based on 404.12criteria developed by the clinical medical education program. Applicants may choose to 404.13distribute funds allocated under this paragraph based on the distribution formula described 404.14in paragraph (a). If no matching funds are received on funds distributed under paragraph 404.15(c), funds distributed under this paragraph shall be distributed by the commissioner based 404.16on the formula described in paragraph (b).404.17    (c) (f) Funds distributed shall not be used to displace current funding appropriations 404.18from federal or state sources.404.19    (d) (g) Funds shall be distributed to the sponsoring institutions indicating the amount 404.20to be distributed to each of the sponsor's clinical medical education programs based on 404.21the criteria in this subdivision and in accordance with the commissioner's approval letter. 404.22Each clinical medical education program must distribute funds allocated under paragraph 404.23(a) to the training sites as specified in the commissioner's approval letter. Sponsoring 404.24institutions, which are accredited through an organization recognized by the Department 404.25of Education or the Centers for Medicare and Medicaid Services, may contract directly 404.26with training sites to provide clinical training. To ensure the quality of clinical training, 404.27those accredited sponsoring institutions must:404.28    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical 404.29training conducted at sites; and404.30    (2) take necessary action if the contract requirements are not met. Action may 404.31include the withholding of payments under this section or the removal of students from 404.32the site.404.33    (e) (h) Any funds not distributed in accordance with the commissioner's approval 404.34letter must be returned to the medical education and research fund within 30 days of 404.35receiving notice from the commissioner. The commissioner shall distribute returned funds 404.36to the appropriate training sites in accordance with the commissioner's approval letter.405.1    (f) (i) The commissioner shall distribute by June 30 of each year an amount equal to 405.2the funds transferred under subdivision 10, plus five percent interest to the University of 405.3Minnesota Board of Regents for the instructional costs of health professional programs 405.4at the Academic Health Center and for interdisciplinary academic initiatives within the 405.5Academic Health Center.405.6    (g) (j) A maximum of $150,000 of the funds dedicated to the commissioner 405.7under section 
         297F.10, subdivision 1, paragraph (b), clause (2), may be used by the 405.8commissioner for administrative expenses associated with implementing this section.405.9    Sec. 11. Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to read:405.10    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner 405.11shall award grants to teaching institutions and clinical training sites for projects that 405.12increase dental access for underserved populations and promote innovative clinical 405.13training of dental professionals.405.14    (b) The commissioner shall award grants to teaching institutions and clinical training 405.15sites for projects that increase mental health access for underserved populations, promote 405.16innovative clinical training of mental health professionals, increase the number of mental 405.17health providers in rural or underserved areas, and promote the incorporation of patient 405.18safety principles into clinical medical education programs.405.19    (c) In awarding the grants, the commissioner, in consultation with the commissioner 405.20of human services, shall consider the following:405.21    (1) potential to successfully increase access to an underserved population;405.22    (2) the long-term viability of the project to improve access beyond the period 405.23of initial funding;405.24    (3) evidence of collaboration between the applicant and local communities;405.25    (4) the efficiency in the use of the funding; and405.26    (5) the priority level of the project in relation to state clinical education, access, 405.27patient safety, and workforce goals.; and405.28    (6) the potential of the project to impact the number or distribution of the health 405.29care workforce.405.30    (b) (d) The commissioner shall periodically evaluate the priorities in awarding the 405.31innovations grants in order to ensure that the priorities meet the changing workforce 405.32needs of the state.405.33    Sec. 12. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:406.1    Subd. 8. Federal financial participation. (a) The commissioner of human 406.2services shall seek to maximize federal financial participation in payments for medical 406.3education and research costs. If the commissioner of human services determines that 406.4federal financial participation is available for the medical education and research, the 406.5commissioner of health shall transfer to the commissioner of human services the amount 406.6of state funds necessary to maximize the federal funds available. The amount transferred 406.7to the commissioner of human services, plus the amount of federal financial participation, 406.8shall be distributed to medical assistance providers in accordance with the distribution 406.9methodology described in subdivision 4.406.10    (b) For the purposes of paragraph (a), the commissioner shall use physician clinic 406.11rates where possible to maximize federal financial participation.406.12    Sec. 13. Minnesota Statutes 2006, section 62J.692, subdivision 10, is amended to read:406.13    Subd. 10. Transfers from University of Minnesota. Of the funds dedicated to the 406.14Academic Health Center under section 
         297F.10, subdivision 1, clause (1), $4,850,000 406.15shall be transferred annually to the commissioner of health no later than April 15 of each 406.16year for distribution under subdivision 4, paragraph (f) (i).406.17    Sec. 14. Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:406.18    Subdivision 1. Required disclosure of estimated payment. (a) A health care 406.19provider, as defined in section 
         62J.03, subdivision 8, or the provider's designee as agreed 406.20to by that designee, shall, at the request of a consumer, provide that consumer with a good 406.21faith estimate of the reimbursementallowable payment the provider expects to receive 406.22from the health plan company in which the consumer is enrolled has agreed to accept from 406.23the consumer's health plan company for the services specified by the consumer, specifying 406.24the amount of the allowable payment due from the health plan company. Health plan 406.25companies must allow contracted providers, or their designee, to release this information. 406.26A good faith estimate must also be made available at the request of a consumer who 406.27is not enrolled in a health plan company.If a consumer has no applicable public or 406.28private coverage, the health care provider must give the consumer a good faith estimate 406.29of the average allowable reimbursement the provider accepts as payment from private 406.30third-party payers for the services specified by the consumer and the estimated amount 406.31the noncovered consumer will be required to pay. Payment information provided by a 406.32provider, or by the provider's designee as agreed to by that designee, to a patient pursuant 406.33to this subdivision does not constitute a legally binding estimate of the allowable charge 406.34for or cost to the consumer of services. 407.1    (b) A health plan company, as defined in section 
         62J.03, subdivision 10, shall, at 407.2the request of an enrollee or the enrollee's designee, provide that enrollee with a good 407.3faith estimate of the reimbursementallowable amount the health plan company would 407.4expect to pay tohas contracted for with a specified provider within the network as total 407.5payment for a health care service specified by the enrollee and the portion of the allowable 407.6amount due from the enrollee and the enrollee's out-of-pocket costs. If requested by the 407.7enrollee, the health plan company shall also provide to the enrollee a good faith estimate 407.8of the enrollee's out-of-pocket cost for the health care service. An estimate provided to 407.9an enrollee under this paragraph is not a legally binding estimate of the reimbursement407.10allowable amount or enrollee's out-of-pocket cost.407.11EFFECTIVE DATE.This section is effective August 1, 2007.407.12    Sec. 15. Minnesota Statutes 2006, section 62J.82, is amended to read:407.1362J.82 HOSPITAL CHARGEINFORMATION REPORTING DISCLOSURE.407.14    Subdivision 1.Required information. The Minnesota Hospital Association shall 407.15develop a Web-based system, available to the public free of charge, for reporting charge 407.16information the following, for Minnesota residents,:407.17    (1) hospital-specific performance on the measures of care developed under section 407.18256B.072 for acute myocardial infarction, heart failure, and pneumonia; 407.19    (2) by January 1, 2009, hospital-specific performance on the public reporting 407.20measures for hospital-acquired infections as published by the National Quality Forum 407.21and collected by the Minnesota Hospital Association and Stratis Health in collaboration 407.22with infection control practitioners; and 407.23    (3) charge information, including, but not limited to, number of discharges, average 407.24length of stay, average charge, average charge per day, and median charge, for each of the 407.2550 most common inpatient diagnosis-related groups and the 25 most common outpatient 407.26surgical procedures as specified by the Minnesota Hospital Association. 407.27    Subd. 2.Web site. The Web site must provide information that compares 407.28hospital-specific data to hospital statewide data. The Web site must be established by 407.29October 1, 2006, and must be updated annually. The commissioner shall provide a link to 407.30this reporting information on the department's Web site.407.31    Subd. 3.Enforcement.The commissioner shall provide a link to this information 407.32on the department's Web site. If a hospital does not provide this information to the 407.33Minnesota Hospital Association, the commissioner of health may require the hospital to 408.1do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a 408.2link to this information on the department's Web site.408.3    Sec. 16. [62J.84] HEALTH CARE TRANSFORMATION TASK FORCE.408.4    Subdivision 1.Task force.The governor shall convene a health care transformation 408.5task force to advise and assist the governor and the Minnesota legislature. The task force 408.6shall consist of:408.7    (1) four legislators from the house of representatives appointed by the speaker, two 408.8from the majority party and two from the minority party, and four legislators from the 408.9senate appointed by the Subcommittee on Committees of the senate Committee on Rules 408.10and Administration, two from the majority party and two from the minority party;408.11    (2) four representatives of the governor and state agencies appointed by the governor;408.12    (3) at least four persons appointed by the governor who have demonstrated 408.13leadership in health care organizations, health improvement initiatives, health care trade or 408.14professional associations, or other collaborative health system improvement activities; and408.15    (4) at least two persons appointed by the governor who have demonstrated leadership 408.16in employer and group purchaser activities related to health system improvement, at least 408.17one of which must be from a labor organization.408.18    Subd. 2.Public input.The commissioner of health shall review available research, 408.19and conduct statewide, regional, and local surveys, focus groups, and other activities as 408.20needed to fill gaps in existing research, to determine Minnesotans' values, preferences, 408.21opinions, and perceptions related to health care and to the issues confronting the task 408.22force, and shall report the findings to the task force.408.23    Subd. 3.Inventory and assessment of existing activities; action plan.The task 408.24force shall complete an inventory and assessment of all public and private organized 408.25activities, coalitions, and collaboratives working on tasks relating to health system 408.26improvement including, but not limited to, patient safety, quality measurement and 408.27reporting, evidence-based practice, adoption of health information technology, disease 408.28management and chronic care coordination, medical homes, access to health care, 408.29cultural competence, prevention and public health, consumer incentives, price and cost 408.30transparency, nonprofit organization community benefits, education, research, and health 408.31care workforce.408.32    Subd. 4.Action plan.By December 15, 2007, the governor, with the advice 408.33and assistance of the task force, shall develop and present to the legislature a statewide 408.34action plan for transforming the health care system to improve affordability, quality, 408.35and access. The plan shall include draft legislation needed to implement the plan. The 409.1plan may consist of legislative actions, administrative actions of governmental entities, 409.2collaborative actions, and actions of individuals and individual organizations. Among 409.3other things, the action plan must include the following, with specific and measurable 409.4goals and deadlines for each:409.5    (1) proposed actions that will slow the rate of increase in health care costs to a rate 409.6that does not exceed the increase in the Consumer Price Index for urban consumers for the 409.7preceding calendar year plus two percentage points, plus an additional percentage based 409.8on the added costs necessary to implement legislation enacted in 2007;409.9    (2) actions that will increase the affordable health coverage options for uninsured 409.10and underinsured Minnesotans and other strategies that will ensure that all Minnesotans 409.11will have health coverage by January 2011;409.12    (3) actions to improve the quality and safety of health care and reduce racial and 409.13ethnic disparities in access and quality;409.14    (4) actions that will reduce the rate of preventable chronic illness through prevention 409.15and public health and wellness initiatives; and409.16    (5) proposed changes to state health care purchasing and payment strategies used for 409.17state health care programs and state employees that will promote higher quality, lower 409.18cost health care through incentives that reward prevention and early intervention, use 409.19of cost-effective primary care, effective care coordination, and management of chronic 409.20disease;409.21    (6) actions that will promote the appropriate and cost-effective investment in new 409.22facilities, technologies, and drugs;409.23    (7) actions to reduce administrative costs; and409.24    (8) the results of the inventory completed under subdivision 3 and recommendations 409.25for how these activities can be coordinated and improved.409.26    Subd. 5.Options for small employers.The task force shall study and report back 409.27to the legislature by December 15, 2007, on options for serving small employers and their 409.28employees, and self-employed individuals.409.29    Sec. 17. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:409.30    Subd. 2. Exceptions. (a) A health carrier may sell, issue, or renew individual 409.31conversion policies to eligible employees otherwise eligible for conversion coverage under 409.32section 
         62D.104 as a result of leaving a health maintenance organization's service area.409.33    (b) A health carrier may sell, issue, or renew individual conversion policies to 409.34eligible employees otherwise eligible for conversion coverage as a result of the expiration 410.1of any continuation of group coverage required under sections 
         62A.146, 
         62A.17, 
         62A.21, 410.262C.142
         , 
         62D.101, and 
         62D.105.410.3    (c) A health carrier may sell, issue, or renew conversion policies under section 410.462E.16
          to eligible employees.410.5    (d) A health carrier may sell, issue, or renew individual continuation policies to 410.6eligible employees as required.410.7    (e) A health carrier may sell, issue, or renew individual health plans if the coverage 410.8is appropriate due to an unexpired preexisting condition limitation or exclusion applicable 410.9to the person under the employer's group health plan or due to the person's need for health 410.10care services not covered under the employer's group health plan.410.11    (f) A health carrier may sell, issue, or renew an individual health plan, if the 410.12individual has elected to buy the individual health plan not as part of a general plan to 410.13substitute individual health plans for a group health plan nor as a result of any violation of 410.14subdivision 3 or 4.410.15    (g) Nothing in this subdivision relieves a health carrier of any obligation to provide 410.16continuation or conversion coverage otherwise required under federal or state law.410.17    (h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage 410.18issued as a supplement to Medicare under sections 
         62A.3099 to 
         62A.44, or policies or 410.19contracts that supplement Medicare issued by health maintenance organizations, or those 410.20contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social 410.21Security Act, United States Code, title 42, section 1395 et seq., as amended.410.22    (i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual 410.23health plans necessary to comply with a court order.410.24    (j) A health carrier may offer, issue, sell, or renew an individual health plan to 410.25persons eligible for an employer group health plan, if the individual health plan is a high 410.26deductible health plan for use in connection with an existing health savings account, in 410.27compliance with the Internal Revenue Code, section 223. In that situation, the same or 410.28a different health carrier may offer, issue, sell, or renew a group health plan to cover 410.29the other eligible employees in the group.410.30    (k) A health carrier may offer, sell, issue, or renew an individual health plan to one 410.31or more employees of a small employer if the individual health plan is marketed directly410.32through the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 to 410.33all employees of the small employer and the small employer does not contribute directly 410.34or indirectly to the premiums or facilitate the administration of the individual health 410.35plan. The requirement to market an individual health plan to all employees through the 410.36Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 does not require 411.1the health carrier to offer or issue an individual health plan to any employee. For purposes 411.2of this paragraph, an employer is not contributing to the premiums or facilitating the 411.3administration of the individual health plan if the employer does not contribute to the 411.4premium and merely collects the premiums from an employee's wages or salary through 411.5payroll deductions and submits payment for the premiums of one or more employees in a 411.6lump sum to the health carrier to the Minnesota Health Insurance Exchange under section 411.762A.67 or 62A.68. Except for coverage under section 
         62A.65, subdivision 5, paragraph 411.8(b), or 
         62E.16, at the request of an employee, the health carrier Minnesota Health Insurance 411.9Exchange under section 62A.67 or 62A.68 may bill the employer for the premiums 411.10payable by the employee, provided that the employer is not liable for payment except 411.11from payroll deductions for that purpose. If an employer is submitting payments under 411.12this paragraph, the health carrier and the Minnesota Health Insurance Exchange under 411.13section 62A.67 or 62A.68 shall jointly provide a cancellation notice directly to the primary 411.14insured at least ten days prior to termination of coverage for nonpayment of premium. 411.15Individual coverage under this paragraph may be offered only if the small employer has 411.16not provided coverage under section 62L.03 to the employees within the past 12 months.411.17    The employer must provide a written and signed statement to the health carrier411.18Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 that the employer 411.19is not contributing directly or indirectly to the employee's premiums. The Minnesota 411.20Health Insurance Exchange under section 62A.67 or 62A.68 shall provide all health 411.21carriers with enrolled employees of the employer with a copy of the employer's statement. 411.22The health carrier may rely on the employer's statement provided by the Minnesota Health 411.23Insurance Exchange under section 62A.67 or 62A.68 and is not required to guarantee-issue 411.24individual health plans to the employer's other current or future employees.411.25    Sec. 18. Minnesota Statutes 2006, section 62L.12, subdivision 4, is amended to read:411.26    Subd. 4. Employer prohibition. A small employer offering a health benefit plan 411.27shall not encourage or direct an employee or applicant to:411.28    (1) refrain from filing an application for health coverage when other similarly 411.29situated employees may file an application for health coverage;411.30    (2) file an application for health coverage during initial eligibility for coverage, 411.31the acceptance of which is contingent on health status, when other similarly situated 411.32employees may apply for health coverage, the acceptance of which is not contingent on 411.33health status;411.34    (3) seek coverage from another health carrier, including, but not limited to, MCHA; 411.35or412.1    (4) cause coverage to be issued on different terms because of the health status or 412.2claims experience of that person or the person's dependents.412.3    Sec. 19. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:412.4    Subdivision 1. Definition. It is the commitment of the state to achieve universal 412.5health coverage for all Minnesotans by the year 2011. Universal coverage is achieved 412.6when:412.7    (1) every Minnesotan has access to a full range of quality health care services;412.8    (2) every Minnesotan is able to obtain affordable health coverage which pays for the 412.9full range of services, including preventive and primary care; and412.10    (3) every Minnesotan pays into the health care system according to that person's 412.11ability.412.12EFFECTIVE DATE.This section is effective July 1, 2007.412.13    Sec. 20. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:412.14    Subd. 2. Goal. It is the goal of the state to make continuous progress toward 412.15reducing the number of Minnesotans who do not have health coverage so that by January 412.161, 2000, fewer than four percent of the state's population will be without health coverage412.172011, all Minnesota residents have access to affordable health care. The goal will be 412.18achieved by improving access to private health coverage through insurance reforms and 412.19market reforms, by making health coverage more affordable for low-income Minnesotans 412.20through purchasing pools and state subsidies, and by reducing the cost of health coverage 412.21through cost containment programs and methods of ensuring that all Minnesotans are 412.22paying into the system according to their ability.412.23EFFECTIVE DATE.This section is effective July 1, 2007.412.24    Sec. 21. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:412.25    Subd. 3. Approval.  (a) Prior to the operation of a community-based health care 412.26coverage program, a community-based health initiative shall submit to the commissioner 412.27of health for approval the community-based health care coverage program developed by 412.28the initiative. The commissioner shall only approve a program that has been awarded 412.29a community access program grant from the United States Department of Health and 412.30Human Services. The commissioner shall ensure that the program meets the federal grant 412.31requirements and any requirements described in this section and is actuarially sound based 412.32on a review of appropriate records and methods utilized by the community-based health 413.1initiative in establishing premium rates for the community-based health care coverage 413.2program. 413.3    (b) Prior to approval, the commissioner shall also ensure that:413.4    (1) the benefits offered comply with subdivision 8 and that there are adequate 413.5numbers of health care providers participating in the community-based health network to 413.6deliver the benefits offered under the program;413.7    (2) the activities of the program are limited to activities that are exempt under this 413.8section or otherwise from regulation by the commissioner of commerce;413.9    (3) the complaint resolution process meets the requirements of subdivision 10; and 413.10    (4) the data privacy policies and procedures comply with state and federal law.413.11    Sec. 22. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:413.12    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval 413.13by the commissioner of health a community-based health care coverage program. The 413.14operational structure established by the initiative shall include, but is not limited to: 413.15    (1) establishing a process for enrolling eligible individuals and their dependents; 413.16    (2) collecting and coordinating premiums from enrollees and employers of enrollees;413.17    (3) providing payment to participating providers; 413.18    (4) establishing a benefit set according to subdivision 8 and establishing premium 413.19rates and cost-sharing requirements; 413.20    (5) creating incentives to encourage primary care and wellness services; and 413.21    (6) initiating disease management services, as appropriate. 413.22    (b) The payments collected under paragraph (a), clause (2), may be used to capture 413.23available federal funds.413.24    Sec. 23. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:413.25    Subd. 13. Report.  (a) The initiative shall submit quarterly status reports to the 413.26commissioner of health on January 15, April 15, July 15, and October 15 of each year, 413.27with the first report due January 15, 2007 2008. The status report shall include:413.28    (1) the financial status of the program, including the premium rates, cost per member 413.29per month, claims paid out, premiums received, and administrative expenses; 413.30    (2) a description of the health care benefits offered and the services utilized; 413.31    (3) the number of employers participating, the number of employees and dependents 413.32covered under the program, and the number of health care providers participating; 413.33    (4) a description of the health outcomes to be achieved by the program and a status 413.34report on the performance measurements to be used and collected; and 414.1    (5) any other information requested by the commissioner of health or commerce or 414.2the legislature. 414.3    (b) The initiative shall contract with an independent entity to conduct an evaluation 414.4of the program to be submitted to the commissioners of health and commerce and the 414.5legislature by January 15, 2009 2010. The evaluation shall include:414.6    (1) an analysis of the health outcomes established by the initiative and the 414.7performance measurements to determine whether the outcomes are being achieved;414.8    (2) an analysis of the financial status of the program, including the claims to 414.9premiums loss ratio and utilization and cost experience; 414.10    (3) the demographics of the enrollees, including their age, gender, family income, 414.11and the number of dependents; 414.12    (4) the number of employers and employees who have been denied access to the 414.13program and the basis for the denial; 414.14    (5) specific analysis on enrollees who have aggregate medical claims totaling over 414.15$5,000 per year, including data on the enrollee's main diagnosis and whether all the 414.16medical claims were covered by the program; 414.17    (6) number of enrollees referred to state public assistance programs; 414.18    (7) a comparison of employer-subsidized health coverage provided in a comparable 414.19geographic area to the designated community-based geographic area served by the 414.20program, including, to the extent available: 414.21    (i) the difference in the number of employers with 50 or fewer employees offering 414.22employer-subsidized health coverage; 414.23    (ii) the difference in uncompensated care being provided in each area; and414.24    (iii) a comparison of health care outcomes and measurements established by the 414.25initiative; and 414.26    (8) any other information requested by the commissioner of health or commerce.414.27    Sec. 24. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:414.28    Subd. 14. Sunset. This section expires December 31, 2011 2012.414.29    Sec. 25. Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:414.30    Subdivision 1. Yearly reports.(a) Each hospital and each outpatient surgical center, 414.31which has not filed the financial information required by this section with a voluntary, 414.32nonprofit reporting organization pursuant to section 
         144.702, shall file annually with the 414.33commissioner of health after the close of the fiscal year: 415.1    (1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or 415.2outpatient surgical center;415.3    (2) a detailed statement of income and expenses;415.4    (3) a copy of its most recent cost report, if any, filed pursuant to requirements of 415.5Title XVIII of the United States Social Security Act;415.6    (4) a copy of all changes to articles of incorporation or bylaws;415.7    (5) information on services provided to benefit the community, including services 415.8provided at no cost or for a reduced fee to patients unable to pay, teaching and research 415.9activities, or other community or charitable activities;415.10    (6) information required on the revenue and expense report form set in effect on 415.11July 1, 1989, or as amended by the commissioner in rule;415.12    (7) information on changes in ownership or control; and415.13    (8) other information required by the commissioner in rule.;415.14    (9) information on the number of available hospital beds that are dedicated to certain 415.15specialized services, as designated by the commissioner, and annual occupancy rates for 415.16those beds, separately for adult and pediatric care;415.17    (10) from outpatient surgical centers, the total number of surgeries; and415.18    (11) a report on health care capital expenditures during the previous year, as required 415.19by section 62J.17.415.20    (b) Beginning with hospital fiscal year 2009, each nonprofit hospital shall report on 415.21community benefits under paragraph (a), clause (5). "Community benefit" means the costs 415.22of community care, underpayment for services provided under state health care programs, 415.23research costs, community health services costs, financial and in-kind contributions, costs 415.24of community building activities, costs of community benefit operations, education, and 415.25the cost of operating subsidized services. The cost of bad debts and underpayment for 415.26Medicare services are not included in the calculation of community benefit.415.27    Sec. 26. Minnesota Statutes 2006, section 144.699, is amended by adding a subdivision 415.28to read:415.29    Subd. 5.Annual reports on community benefit, community care amounts, 415.30and state program underfunding.(a) For each hospital reporting health care cost 415.31information under section 144.698 or 144.702, the commissioner shall report annually 415.32on the hospital's community benefit, community care, and underpayment for state public 415.33health care programs.415.34    (b) For purposes of this subdivision, "community benefits" has the definition given 415.35in section 144.698, paragraph (b).416.1    (c) For purposes of this subdivision, "community care" means the costs for medical 416.2care for which a hospital has determined is charity care, as defined under Minnesota Rules, 416.3part 4650.0115, or for which the hospital determines after billing for the services that there 416.4is a demonstrated inability to pay. Any costs forgiven under a hospital's community care 416.5plan or under section 62J.83 may be counted in the hospital's calculation of community 416.6care. Bad debt expenses and discounted charges available to the uninsured shall not be 416.7included in the calculation of community care. The amount of community care is the value 416.8of costs incurred and not the charges made for services.416.9    (d) For purposes of this subdivision, underpayment for services provided by state 416.10public health care programs is the difference between hospital costs and public program 416.11payments. The information shall be reported in terms of total dollars and as a percentage 416.12of total operating costs for each hospital.416.13    Sec. 27. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:416.14    Subd. 2b. Performance payments.(a) The commissioner shall develop and 416.15implement a pay-for-performance system to provide performance payments to:416.16    (1) eligible medical groups and clinics that demonstrate optimum care in serving 416.17individuals with chronic diseases who are enrolled in health care programs administered 416.18by the commissioner under chapters 256B, 256D, and 256L.;416.19    (2) medical groups that implement effective medical home models of patient care 416.20that improve quality and reduce costs through effective primary and preventive care, care 416.21coordination, and management of chronic conditions; and416.22    (3) eligible medical groups and clinics that evaluate medical provider usage patterns 416.23and provide feedback to individual medical providers on that provider's practice patterns 416.24relative to peer medical providers.416.25    (b) The commissioner shall also develop and implement a patient incentive health 416.26program to provide incentives and rewards to patients who are enrolled in health care 416.27programs administered by the commissioner under chapters 256B, 256D, and 256L, and 416.28who have agreed to and meet personal health goals established with their primary care 416.29provider to manage a chronic disease or condition including, but not limited to, diabetes, 416.30high blood pressure, and coronary artery disease.416.31    (c) The commissioner may receive any federal matching money that is made 416.32available through the medical assistance program for managed care oversight contracted 416.33through vendors including consumer surveys, studies, and external quality reviews as 416.34required by the Federal Balanced Budget Act of 1997, Code of Federal Regulations, 416.35title 42, part 438, subpart E. Any federal money received for managed care oversight is 417.1appropriated to the commissioner for this purpose. The commissioner may expend the 417.2federal money received in either year of the biennium.417.3EFFECTIVE DATE.This section is effective July 1, 2007.417.4    Sec. 28. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 417.5subdivision to read:417.6    Subd. 49.Provider-directed care coordination services.The commissioner 417.7shall develop and implement a provider-directed care coordination program for medical 417.8assistance recipients who are not enrolled in the prepaid medical assistance program and 417.9who are receiving services on a fee-for-service basis. This program provides payment 417.10to primary care clinics for care coordination for people who have complex and chronic 417.11medical conditions. Clinics must meet certain criteria such as the capacity to develop care 417.12plans; have a dedicated care coordinator; and have an adequate number of fee-for-service 417.13clients, evaluation mechanisms, and quality improvement processes to qualify for 417.14reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic 417.15designated as the patient's first point of contact for medical care, available 24 hours a 417.16day, seven days a week, that provides or arranges for the patient's comprehensive health 417.17care needs, and provides overall integration, coordination and continuity over time and 417.18referrals for specialty care.417.19    Sec. 29. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:417.20    Subd. 4. Gross individual or gross family income. (a) "Gross individual or gross 417.21family income" for nonfarm self-employed means income calculated for the six-month 417.22period of eligibility using the net profit or loss reported on the applicant's federal income 417.23tax form for the previous year and using the medical assistance families with children 417.24methodology for determining allowable and nonallowable self-employment expenses and 417.25countable income.417.26    (b) "Gross individual or gross family income" for farm self-employed means income 417.27calculated for the six-month period of eligibility using as the baseline the adjusted gross 417.28income reported on the applicant's federal income tax form for the previous year and 417.29adding back in reported depreciation amounts that apply to the business in which the 417.30family is currently engaged.417.31    (c) "Gross individual or gross family income" means the total income for all family 417.32members, calculated for the six-month period of eligibility.417.33EFFECTIVE DATE.This section is effective July 1, 2007.418.1    Sec. 30. HEALTH CARE PAYMENT SYSTEM REFORM.418.2    Subdivision 1.Payment reform plan.The commissioners of employee relations, 418.3human services, commerce, and health shall develop a plan for promoting and facilitating 418.4changes in payment rates and methods for paying for health care services, drugs, devices, 418.5supplies, and equipment in order to:418.6    (1) reward the provision of cost-effective primary and preventive care;418.7    (2) reward the use of evidence-based care;418.8    (3) discourage underutilization, overuse, and misuse;418.9    (4) reward the use of the most cost-effective settings, drugs, devices, providers, 418.10and treatments; and418.11    (5) encourage consumers to maintain good health and use the health care system 418.12appropriately.418.13    In developing the plan, the commissioners shall analyze existing data to determine 418.14specific services and health conditions for which changes in payment rates and methods 418.15would lead to significant improvements in quality of care.418.16    Subd. 2.Report.The commissioners shall submit a report to the legislature by 418.17December 15, 2007, describing the payment reform plan. The report must include 418.18proposed legislation for implementing those components of the plan requiring legislative 418.19action or appropriations of money.418.20EFFECTIVE DATE.This section is effective July 1, 2007.418.21    Sec. 31. COMMUNITY COLLABORATIVE PILOT PROJECTS TO COVER 418.22THE UNINSURED.418.23    Subdivision 1.Community collaboratives.The commissioner of human services 418.24shall provide grants to and authorization for up to three community collaboratives that 418.25satisfy the requirements in this section. To be eligible to receive a grant and authorization 418.26under this section, a community collaborative must include:418.27    (1) one or more counties;418.28    (2) one or more local hospitals;418.29    (3) one or more local employers who collectively provide at least 300 jobs in the 418.30community;418.31    (4) one or more health care clinics or physician groups; and418.32    (5) a third-party payer, which may be a county-based purchasing plan operating 418.33under Minnesota Statutes, section 256B.692, a self-insured employer, or a health plan 418.34company as defined in Minnesota Statutes, section 62Q.01, subdivision 4.419.1    Subd. 2.Pilot project requirements.(a) Community collaborative pilot projects 419.2must:419.3    (1) identify and enroll persons in the community who are uninsured, and who have, 419.4or are at risk of developing, one of the following chronic conditions: mental illness, 419.5diabetes, asthma, hypertension, or other chronic condition designated by the project;419.6    (2) assist uninsured persons to obtain private-sector health insurance coverage if 419.7possible or to enroll in any public health care programs for which they are eligible. If the 419.8uninsured individual is unable to obtain health coverage, the community collaborative 419.9must enroll the individual in a local health care assistance program that provides specified 419.10services to prevent or effectively manage the chronic condition;419.11    (3) include components to help uninsured persons retain employment or to become 419.12employable, if currently unemployed;419.13    (4) ensure that each uninsured person enrolled in the program has a medical home 419.14responsible for providing, or arranging for, health care services and assisting in the 419.15effective management of the chronic condition;419.16    (5) coordinate services between all providers and agencies serving an enrolled 419.17individual; and419.18    (6) be coordinated with the state's Q-Care initiative and improve the use of 419.19evidence-based treatments and effective disease management programs in the broader 419.20community, beyond those individuals enrolled in the project.419.21    (b) Projects established under this section are not insurance and are not subject to 419.22state-mandated benefit requirements or insurance regulations.419.23    Subd. 3.Criteria.Proposals must be evaluated by actuarial, financial, and clinical 419.24experts based on the likelihood that the project would produce a positive return on 419.25investment for the community. In awarding grants, the commissioner of human services 419.26shall give preference to proposals that:419.27    (1) have broad community support from local businesses, provider counties, and 419.28other public and private organizations;419.29    (2) would provide services to uninsured persons who have, or are at risk of 419.30developing, multiple, co-occurring chronic conditions;419.31    (3) integrate or coordinate resources from multiple sources, such as employer 419.32contributions, county funds, social service programs, and provider financial or in-kind 419.33support;419.34    (4) provide continuity of treatment and services when uninsured individuals in 419.35the program become eligible for public or private health insurance or when insured 419.36individuals lose their coverage;420.1    (5) demonstrate how administrative costs for health plan companies and providers 420.2can be reduced through greater simplification, coordination, consolidation, standardization, 420.3reducing billing errors, or other methods; and420.4    (6) involve local contributions to the cost of the pilot projects.420.5    Subd. 4.Grants.The commissioner of human services shall provide 420.6implementation grants of up to one-half of the community collaborative's costs for 420.7planning, administration, and evaluation. The commissioner shall also provide grants to 420.8community collaboratives to develop a fund to pay up to 50 percent of the cost of the 420.9services provided to uninsured individuals. The remaining costs must be paid for through 420.10other sources or by agreement of a health care provider to contribute the cost as charity 420.11care.420.12    Subd. 5.Evaluation.The commissioner of human services shall evaluate the 420.13effectiveness of each community collaborative project awarded a grant, by comparing 420.14actual costs for serving the identified uninsured persons to the predicted costs that would 420.15have been incurred in the absence of early intervention and consistent treatment to manage 420.16the chronic condition, including the costs to medical assistance, MinnesotaCare, and 420.17general assistance medical care. The commissioner shall require community collaborative 420.18projects, as a condition of receipt of a grant award, to provide the commissioner with all 420.19information necessary for this evaluation.420.20EFFECTIVE DATE.This section is effective July 1, 2007.420.21    Sec. 32. HEALTH CARE PAYMENT REFORM PILOT PROJECTS.420.22    Subdivision 1.Pilot projects.(a) The commissioners of health, human services, 420.23and employee relations shall develop and administer payment reform pilot projects for 420.24state employees and persons enrolled in medical assistance, MinnesotaCare, or general 420.25assistance medical care, to the extent permitted by federal requirements. The purpose of 420.26the projects is to promote and facilitate changes in payment rates and methods for paying 420.27for health care services, drugs, devices, supplies, and equipment in order to:420.28    (1) reward the provision of cost-effective primary and preventive care;420.29    (2) reward the use of evidence-based care;420.30    (3) reward coordination of care for patients with chronic conditions;420.31    (4) discourage overuse and misuse;420.32    (5) reward the use of the most cost-effective settings, drugs, devices, providers, 420.33and treatments;420.34    (6) encourage consumers to maintain good health and use the health care system 420.35appropriately.421.1    (b) The pilot projects must involve the use of designated care professionals or 421.2clinics to serve as a patient's medical home and be responsible for coordinating health 421.3care services across the continuum of care. The pilot projects must evaluate different 421.4payment reform models and must be coordinated with the Minnesota senior health options 421.5program and the Minnesota disability health options program. To the extent possible, the 421.6commissioners shall coordinate state purchasing activities with other public employers 421.7and with private purchasers, self-insured groups, and health plan companies to promote 421.8the use of pilot projects encompassing both public and private purchasers and markets.421.9    Subd. 2.Payment methods and incentives.The commissioners shall modify 421.10existing payment methods and rates for those enrollees and health care providers 421.11participating in the pilot project in order to provide incentives for care management, 421.12team-based care, and practice redesign, and increase resources for primary care, chronic 421.13condition care, and care provided to complex patients. The commissioners may create 421.14financial incentives for patients to select a medical home under the pilot project by 421.15reducing, modifying, or eliminating deductibles and co-payments for certain services, or 421.16through other incentives. The commissioners may require patients to remain with their 421.17designated medical home for a specified period of time. Alternative payment methods 421.18may include complete or partial capitation, fee-for-service payments, or other payment 421.19methodologies. The payment methods may provide for the payment of bonuses to medical 421.20home providers or other providers, or to patients, for the achievement of performance 421.21goals. The payment methods may include allocating a portion of the payment that 421.22would otherwise be paid to health plans under state prepaid health care programs to the 421.23designated medical home for specified services.421.24    Subd. 3.Requirements.In order to be designated a medical home under the pilot 421.25project, health care professionals or clinics must demonstrate their ability to:421.26    (1) be the patient's first point of contact by telephone or other means, 24 hours a 421.27day, seven days a week;421.28    (2) provide or arrange for patients' comprehensive health care needs, including the 421.29ability to structure planned chronic disease visits and to manage chronic disease through 421.30the use of disease registries;421.31    (3) coordinate patients' care when care must be provided outside the medical home;421.32    (4) provide longitudinal care, not just episodic care, including meeting long-term 421.33and unique personal needs;421.34    (5) utilize an electronic health record and incorporate a plan to develop and make 421.35available to patients that choose a medical home an electronic personal health record that 422.1is prepopulated with the patient's data, consumer-directed, connected to the provider, 422.224-hour accessible, and owned and controlled by the patient;422.3    (6) systematically improve quality of care using, among other inputs, patient 422.4feedback; and422.5    (7) create a provider network that provides for increased reimbursement for a 422.6medical home in a cost-neutral manner.422.7    Subd. 4.Evaluation.Pilot projects must be evaluated based on patient satisfaction, 422.8provider satisfaction, clinical process and outcome measures, program costs and savings, 422.9and economic impact on health care providers. Pilot projects must be evaluated based 422.10on the extent to which the medical home:422.11    (1) coordinated health care services across the continuum of care and thereby 422.12reduced duplication of services and enhanced communication across providers;422.13    (2) provided safe and high-quality care by increasing utilization of effective 422.14treatments, reduced use of ineffective treatments, reduced barriers to essential care and 422.15services, and eliminated barriers to access;422.16    (3) reduced unnecessary hospitalizations and emergency room visits and increased 422.17use of cost-effective care and settings;422.18    (4) encouraged long-term patient and provider relationships by shifting from 422.19episodic care to consistent, coordinated communication and care with a specified team of 422.20providers or individual providers;422.21    (5) engaged and educated consumers by encouraging shared patient and provider 422.22responsibility and accountability for disease prevention, health promotion, chronic 422.23disease management, acute care, and overall well-being, encouraging informed medical 422.24decision-making, ensuring the availability of accurate medical information, and facilitated 422.25the transfer of accurate medical information;422.26    (6) encouraged innovation in payment methodologies by using patient and provider 422.27incentives to coordinate care and utilize medical home services and fostering the 422.28expansion of a technology infrastructure that supports collaboration; and422.29    (7) reduced overall health care costs as compared to conventional payment methods 422.30for similar patient populations.422.31    Subd. 5.Rulemaking.The commissioners are exempt from administrative 422.32rulemaking under chapter 14 for purposes of developing, administering, contracting 422.33for, and evaluating pilot projects under this section. The commissioner shall publish a 422.34proposed request for proposals in the State Register and allow 30 days for comment 422.35before issuing the final request for proposals.423.1    Subd. 6.Regulatory and payment barriers.The commissioners shall study state 423.2and federal statutory and regulatory barriers to the creation of medical homes and provide 423.3a report and recommendations to the legislature by December 15, 2007.423.4    Sec. 33. HEALTH CARE SYSTEM CONSOLIDATION.423.5    (a) The commissioner of health shall study the effect of health care provider and 423.6health plan company consolidation in the four metropolitan statistical areas in Minnesota 423.7on: health care costs, including provider payment rates; quality of care; and access to care. 423.8The commissioner shall separately consider hospitals, specialty groups, and primary care 423.9groups. The commissioner shall present findings and recommendations to the legislature 423.10by December 15, 2007.423.11    (b) For purposes of this study, health carriers, provider networks, and other health 423.12care providers shall provide data on network participation, contracted payment rates, 423.13charges, costs, payments received, patient referrals, and other information requested by 423.14the commissioner, in the form and manner specified by the commissioner. Provider-level 423.15information on contracted payment rates and payments from health plans provided to the 423.16commissioner of health for the purposes of this study are (1) private data on individuals as 423.17defined in Minnesota Statutes, section 13.02, subdivision 12, and (2) nonpublic data as 423.18defined in Minnesota Statutes, section 13.02, subdivision 9. The commissioner may not 423.19collect patient-identified data for purposes of this study. Data collected for purposes of 423.20this study may not be used for any other purposes.423.21    Sec. 34.  REPEALER.423.22Minnesota Statutes 2006, section 62J.052, subdivision 1, is repealed effective 423.23August 1, 2007.423.24ARTICLE 10423.25PUBLIC HEALTH423.26    Section 1. Minnesota Statutes 2006, section 13.3806, is amended by adding a 423.27subdivision to read:423.28    Subd. 21.Birth defects registry system.Data on individuals collected by the 423.29birth defects registry system are private data on individuals and classified pursuant to 423.30section 144.2215.423.31    Sec. 2. Minnesota Statutes 2006, section 16B.61, is amended by adding a subdivision 423.32to read:424.1    Subd. 3b.Window fall prevention device code.The commissioner of labor and 424.2industry shall adopt rules for window fall prevention devices as part of the state Building 424.3Code. Window fall prevention devices include, but are not limited to, safety screens, 424.4hardware, guards, and other devices that comply with the standards established by the 424.5commissioner of labor and industry. The rules must require compliance with standards 424.6for window fall prevention devices developed by ASTM International, contained in the 424.7International Building Code as the model language with amendments deemed necessary to 424.8coordinate with the other adopted building codes in Minnesota. The rules must establish a 424.9scope that includes the applicable building occupancies, and the types, locations, and sizes 424.10of windows that will require the installation of fall devices. The rules will be effective July 424.111, 2009. The commissioner shall report to the legislature on the status of the rulemaking 424.12on or before February 15, 2008.424.13    Sec. 3. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:424.14    Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable 424.15application fee of $175 $215 to cover the administrative cost of processing a request for a 424.16variance or modification of rules adopted by the commissioner under this chapter.424.17EFFECTIVE DATE.This section is effective July 1, 2008.424.18    Sec. 4. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:424.19    Subdivision 1. Well notification fee. The well notification fee to be paid by a 424.20property owner is:424.21    (1) for a new water supply well, $175 $215, which includes the state core function 424.22fee;424.23    (2) for a well sealing, $35 $50 for each well, which includes the state core function 424.24fee, except that for monitoring wells constructed on a single property, having depths 424.25within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of 424.26$35 $50; and424.27    (3) for construction of a dewatering well, $175 $215, which includes the state core 424.28function fee, for each dewatering well except a dewatering project comprising five or 424.29more dewatering wells shall be assessed a single fee of $875 $1,075 for the dewatering 424.30wells recorded on the notification.424.31EFFECTIVE DATE.This section is effective July 1, 2008.424.32    Sec. 5. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:425.1    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:425.2    (1) for a water supply well that is not in use under a maintenance permit, $150 $175425.3annually;425.4    (2) for construction of a monitoring well, $175 $215, which includes the state 425.5core function fee;425.6    (3) for a monitoring well that is unsealed under a maintenance permit, $150 $175425.7annually;425.8    (4) for monitoring wells used as a leak detection device at a single motor fuel retail 425.9outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural 425.10chemical facility site, the construction permit fee is $175 $215, which includes the state 425.11core function fee, per site regardless of the number of wells constructed on the site, and 425.12the annual fee for a maintenance permit for unsealed monitoring wells is $150 $175 per 425.13site regardless of the number of monitoring wells located on site;425.14    (5) for a groundwater thermal exchange device, in addition to the notification fee for 425.15water supply wells, $175 $215, which includes the state core function fee;425.16    (6) for a vertical heat exchanger, $175 $215;425.17    (7) for a dewatering well that is unsealed under a maintenance permit, $150 $175425.18annually for each dewatering well, except a dewatering project comprising more than five 425.19dewatering wells shall be issued a single permit for $750 $875 annually for dewatering 425.20wells recorded on the permit; and425.21    (8) for an elevator boring, $175 $215 for each boring.425.22EFFECTIVE DATE.This section is effective July 1, 2008.425.23    Sec. 6. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:425.24    Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to 425.25sell or transfer real property, the seller must disclose in writing to the buyer information 425.26about the status and location of all known wells on the property, by delivering to the buyer 425.27either a statement by the seller that the seller does not know of any wells on the property, 425.28or a disclosure statement indicating the legal description and county, and a map drawn 425.29from available information showing the location of each well to the extent practicable. 425.30In the disclosure statement, the seller must indicate, for each well, whether the well is in 425.31use, not in use, or sealed.425.32    (b) At the time of closing of the sale, the disclosure statement information, name and 425.33mailing address of the buyer, and the quartile, section, township, and range in which each 425.34well is located must be provided on a well disclosure certificate signed by the seller or a 425.35person authorized to act on behalf of the seller.426.1    (c) A well disclosure certificate need not be provided if the seller does not know 426.2of any wells on the property and the deed or other instrument of conveyance contains 426.3the statement: "The Seller certifies that the Seller does not know of any wells on the 426.4described real property."426.5    (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate 426.6required by this subdivision shall be signed by the buyer or a person authorized to act on 426.7behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure 426.8certificate is not required if the following statement appears on the deed followed by the 426.9signature of the grantee or, if there is more than one grantee, the signature of at least one 426.10of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the 426.11described real property." The statement and signature of the grantee may be on the front 426.12or back of the deed or on an attached sheet and an acknowledgment of the statement by 426.13the grantee is not required for the deed to be recordable.426.14    (e) This subdivision does not apply to the sale, exchange, or transfer of real property:426.15    (1) that consists solely of a sale or transfer of severed mineral interests; or426.16    (2) that consists of an individual condominium unit as described in chapters 515 426.17and 515B.426.18    (f) For an area owned in common under chapter 515 or 515B the association or other 426.19responsible person must report to the commissioner by July 1, 1992, the location and 426.20status of all wells in the common area. The association or other responsible person must 426.21notify the commissioner within 30 days of any change in the reported status of wells.426.22    (g) For real property sold by the state under section 
         92.67, the lessee at the time of 426.23the sale is responsible for compliance with this subdivision.426.24    (h) If the seller fails to provide a required well disclosure certificate, the buyer, or 426.25a person authorized to act on behalf of the buyer, may sign a well disclosure certificate 426.26based on the information provided on the disclosure statement required by this section 426.27or based on other available information.426.28    (i) A county recorder or registrar of titles may not record a deed or other instrument 426.29of conveyance dated after October 31, 1990, for which a certificate of value is required 426.30under section 
         272.115, or any deed or other instrument of conveyance dated after October 426.3131, 1990, from a governmental body exempt from the payment of state deed tax, unless 426.32the deed or other instrument of conveyance contains the statement made in accordance 426.33with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all 426.34the information required by paragraph (b) or (d). The county recorder or registrar of titles 426.35must not accept a certificate unless it contains all the required information. The county 426.36recorder or registrar of titles shall note on each deed or other instrument of conveyance 427.1accompanied by a well disclosure certificate that the well disclosure certificate was 427.2received. The notation must include the statement "No wells on property" if the disclosure 427.3certificate states there are no wells on the property. The well disclosure certificate shall not 427.4be filed or recorded in the records maintained by the county recorder or registrar of titles. 427.5After noting "No wells on property" on the deed or other instrument of conveyance, the 427.6county recorder or registrar of titles shall destroy or return to the buyer the well disclosure 427.7certificate. The county recorder or registrar of titles shall collect from the buyer or the 427.8person seeking to record a deed or other instrument of conveyance, a fee of $40 $45427.9for receipt of a completed well disclosure certificate. By the tenth day of each month, 427.10the county recorder or registrar of titles shall transmit the well disclosure certificates 427.11to the commissioner of health. By the tenth day after the end of each calendar quarter, 427.12the county recorder or registrar of titles shall transmit to the commissioner of health 427.13$32.50 $37.50 of the fee for each well disclosure certificate received during the quarter. 427.14The commissioner shall maintain the well disclosure certificate for at least six years. The 427.15commissioner may store the certificate as an electronic image. A copy of that image 427.16shall be as valid as the original.427.17    (j) No new well disclosure certificate is required under this subdivision if the buyer 427.18or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed 427.19or other instrument of conveyance that the status and number of wells on the property 427.20have not changed since the last previously filed well disclosure certificate. The following 427.21statement, if followed by the signature of the person making the statement, is sufficient 427.22to comply with the certification requirement of this paragraph: "I am familiar with the 427.23property described in this instrument and I certify that the status and number of wells on 427.24the described real property have not changed since the last previously filed well disclosure 427.25certificate." The certification and signature may be on the front or back of the deed or on 427.26an attached sheet and an acknowledgment of the statement is not required for the deed or 427.27other instrument of conveyance to be recordable.427.28    (k) The commissioner in consultation with county recorders shall prescribe the form 427.29for a well disclosure certificate and provide well disclosure certificate forms to county 427.30recorders and registrars of titles and other interested persons.427.31    (l) Failure to comply with a requirement of this subdivision does not impair:427.32    (1) the validity of a deed or other instrument of conveyance as between the parties 427.33to the deed or instrument or as to any other person who otherwise would be bound by 427.34the deed or instrument; or427.35    (2) the record, as notice, of any deed or other instrument of conveyance accepted for 427.36filing or recording contrary to the provisions of this subdivision.428.1EFFECTIVE DATE.This section is effective July 1, 2008.428.2    Sec. 7. Minnesota Statutes 2006, section 144.123, is amended to read:428.3144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES; 428.4EXCEPTIONS.428.5    Subdivision 1. Who must pay. Except for the limitation contained in this section, 428.6the commissioner of health shall charge a handling fee for each specimen submitted to 428.7the Department of Health for analysis for diagnostic purposes by any hospital, private 428.8laboratory, private clinic, or physician. No fee shall be charged to any entity which 428.9receives direct or indirect financial assistance from state or federal funds administered by 428.10the Department of Health, including any public health department, nonprofit community 428.11clinic, venereal sexually transmitted disease clinic, family planning clinic, or similar 428.12entity. No fee will be charged for any biological materials submitted to the Department 428.13of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological 428.14materials requested by the department to gather information for disease prevention or 428.15control purposes. The commissioner of health may establish by rule other exceptions to 428.16the handling fee as may be necessary to gather information for epidemiologic purposes428.17protect the public's health. All fees collected pursuant to this section shall be deposited in 428.18the state treasury and credited to the state government special revenue fund.428.19    Subd. 2. Rules for Fee amounts. The commissioner of health shall promulgate 428.20rules, in accordance with chapter 14, which shall specify the amount of the charge a428.21handling fee prescribed in subdivision 1. The fee shall approximate the costs to the 428.22department of handling specimens including reporting, postage, specimen kit preparation, 428.23and overhead costs. The fee prescribed in subdivision 1 shall be $15 $25 per specimen 428.24until the commissioner promulgates rules pursuant to this subdivision.428.25    Sec. 8. Minnesota Statutes 2006, section 144.125, is amended to read:428.26144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL 428.27DISORDERS.428.28    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative 428.29officer or other person in charge of each institution caring for infants 28 days or less 428.30of age, (2) the person required in pursuance of the provisions of section 
         144.215, to 428.31register the birth of a child, or (3) the nurse midwife or midwife in attendance at the 428.32birth, to arrange to have administered to every infant or child in its care tests for heritable 428.33and congenital disorders according to subdivision 2 and rules prescribed by the state 428.34commissioner of health. Testing and the recording and reporting of test results shall be 429.1performed at the times and in the manner prescribed by the commissioner of health. The 429.2commissioner shall charge laboratory service fees a fee so that the total of fees collected 429.3will approximate the costs of conducting the tests and implementing and maintaining 429.4a system to follow-up infants with heritable or congenital disorders. The laboratory 429.5service fee is $61 $101 per specimen. Costs associated with capital expenditures and 429.6the development of new procedures may be prorated over a three-year period when 429.7calculating the amount of the fees. 429.8    Subd. 2. Determination of tests to be administered. The commissioner shall 429.9periodically revise the list of tests to be administered for determining the presence of a 429.10heritable or congenital disorder. Revisions to the list shall reflect advances in medical 429.11science, new and improved testing methods, or other factors that will improve the public 429.12health. In determining whether a test must be administered, the commissioner shall take 429.13into consideration the adequacy of laboratory analytical methods to detect the heritable 429.14or congenital disorder, the ability to treat or prevent medical conditions caused by the 429.15heritable or congenital disorder, and the severity of the medical conditions caused by the 429.16heritable or congenital disorder. The list of tests to be performed may be revised if the 429.17changes are recommended by the advisory committee established under section 
         144.1255, 429.18approved by the commissioner, and published in the State Register. The revision is 429.19exempt from the rulemaking requirements in chapter 14, and sections 
         14.385 and 
         14.386429.20do not apply. 429.21    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under 429.22subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to 429.23perform testing thereunder as well as the results of such testing may be retained by the 429.24Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that 429.25the following options are available to them with respect to the testing: (i) to decline to 429.26have the tests, or (ii) to elect to have the tests but to require that all blood samples and 429.27records of test results be destroyed within 24 months of the testing. If the parents of 429.28an infant object in writing to testing for heritable and congenital disorders or elect to 429.29require that blood samples and test results be destroyed, the objection or election shall 429.30be recorded on a form that is signed by a parent or legal guardian and made part of the 429.31infant's medical record. A written objection exempts an infant from the requirements of 429.32this section and section 
         144.128. 429.33    Sec. 9. Minnesota Statutes 2006, section 144.2215, subdivision 1, is amended to read:429.34    Subdivision 1. Establishment.Within the limits of available appropriations, the 429.35commissioner of health shall establish and maintain an information system containing data 430.1on the cause, treatment, prevention, and cure of major birth defects. The commissioner 430.2shall consult with representatives and experts in epidemiology, medicine, insurance, 430.3health maintenance organizations, genetics, consumers, and voluntary organizations in 430.4developing the system and may phase in the implementation of the system. After the 430.5parents have provided informed consent under section 144.2216, subdivision 4, the 430.6commissioner shall offer the parents with their informed consent a visit by a trained health 430.7care worker to interview the parents about:430.8    (1) all previous home addresses, occupations, and places of work including from 430.9childhood;430.10    (2) the time and place of any military service; and430.11    (3) known occasions or sites of toxic exposures.430.12    Sec. 10. Minnesota Statutes 2006, section 144.672, subdivision 1, is amended to read:430.13    Subdivision 1. Rule authority. The commissioner of health shall collect cancer 430.14incidence information, analyze the information, and conduct special studies designed to 430.15determine the potential public health significance of an increase in cancer incidence.430.16    The commissioner shall adopt rules to administer the system, collect information, 430.17and distribute data. The rules must include, but not be limited to, the following:430.18    (1) the type of data to be reported, which must include current and previous 430.19occupational data;430.20    (2) standards for reporting specific types of data;430.21    (3) payments allowed to hospitals, pathologists, and registry systems to defray their 430.22costs in providing information to the system;430.23    (4) criteria relating to contracts made with outside entities to conduct studies using 430.24data collected by the system. The criteria may include requirements for a written protocol 430.25outlining the purpose and public benefit of the study, the description, methods, and 430.26projected results of the study, peer review by other scientists, the methods and facilities 430.27to protect the privacy of the data, and the qualifications of the researcher proposing to 430.28undertake the study; and430.29    (5) specification of fees to be charged under section 
         13.03, subdivision 3, for all 430.30out-of-pocket expenses for data summaries or specific analyses of data requested by 430.31public and private agencies, organizations, and individuals, and which are not otherwise 430.32included in the commissioner's annual summary reports. Fees collected are appropriated 430.33to the commissioner to offset the cost of providing the data.430.34    Sec. 11. Minnesota Statutes 2006, section 144.9502, subdivision 3, is amended to read:431.1    Subd. 3. Reports of blood lead analysis required. (a) Every hospital, medical 431.2clinic, medical laboratory, other facility, or individual performing blood lead analysis 431.3shall report the results after the analysis of each specimen analyzed, for both capillary 431.4and venous specimens, and epidemiologic information required in this section to the 431.5commissioner of health, within the time frames set forth in clauses (1) and (2):431.6    (1) within two working days by telephone, fax, or electronic transmission, with 431.7written or electronic confirmation within one month, for a venous blood lead level equal to 431.8or greater than 15 ten micrograms of lead per deciliter of whole blood; or431.9    (2) within one month in writing or by electronic transmission, for any capillary 431.10result or for a venous blood lead level less than 15 ten micrograms of lead per deciliter of 431.11whole blood.431.12    (b) If a blood lead analysis is performed outside of Minnesota and the facility 431.13performing the analysis does not report the blood lead analysis results and epidemiological 431.14information required in this section to the commissioner, the provider who collected the 431.15blood specimen must satisfy the reporting requirements of this section. For purposes of 431.16this section, "provider" has the meaning given in section 
         62D.02, subdivision 9. 431.17    (c) The commissioner shall coordinate with hospitals, medical clinics, medical 431.18laboratories, and other facilities performing blood lead analysis to develop a universal 431.19reporting form and mechanism.431.20    Sec. 12. Minnesota Statutes 2006, section 144.9504, subdivision 2, is amended to read:431.21    Subd. 2. Lead risk assessment. (a) An assessing agency shall conduct a lead risk 431.22assessment of a residence according to the venous blood lead level and time frame set 431.23forth in clauses (1) to (4) for purposes of secondary prevention:431.24    (1) within 48 hours of a child or pregnant female in the residence being identified to 431.25the agency as having a venous blood lead level equal to or greater than 60 45 micrograms 431.26of lead per deciliter of whole blood;431.27    (2) within five working days of a child or pregnant female in the residence being 431.28identified to the agency as having a venous blood lead level equal to or greater than 45 15431.29micrograms of lead per deciliter of whole blood;431.30    (3) within ten working days of a child in the residence being identified to the agency 431.31as having a venous blood lead level equal to or greater than 15 ten micrograms of lead 431.32per deciliter of whole blood; or431.33    (4) within ten working days of a pregnant female in the residence being identified to 431.34the agency as having a venous blood lead level equal to or greater than ten micrograms of 431.35lead per deciliter of whole blood.432.1    (b) Within the limits of available local, state, and federal appropriations, an assessing 432.2agency may also conduct a lead risk assessment for children with any elevated blood 432.3lead level.432.4    (c) In a building with two or more dwelling units, an assessing agency shall assess 432.5the individual unit in which the conditions of this section are met and shall inspect all 432.6common areas accessible to a child. If a child visits one or more other sites such as another 432.7residence, or a residential or commercial child care facility, playground, or school, the 432.8assessing agency shall also inspect the other sites. The assessing agency shall have one 432.9additional day added to the time frame set forth in this subdivision to complete the lead 432.10risk assessment for each additional site.432.11    (d) Within the limits of appropriations, the assessing agency shall identify the 432.12known addresses for the previous 12 months of the child or pregnant female with venous 432.13blood lead levels of at least 15 ten micrograms per deciliter for the child or at least ten 432.14micrograms per deciliter for the pregnant female; notify the property owners, landlords, 432.15and tenants at those addresses that an elevated blood lead level was found in a person 432.16who resided at the property; and give them primary prevention information. Within the 432.17limits of appropriations, the assessing agency may perform a risk assessment and issue 432.18corrective orders in the properties, if it is likely that the previous address contributed to 432.19the child's or pregnant female's blood lead level. The assessing agency shall provide the 432.20notice required by this subdivision without identifying the child or pregnant female with 432.21the elevated blood lead level. The assessing agency is not required to obtain the consent of 432.22the child's parent or guardian or the consent of the pregnant female for purposes of this 432.23subdivision. This information shall be classified as private data on individuals as defined 432.24under section 
         13.02, subdivision 12.432.25    (e) The assessing agency shall conduct the lead risk assessment according to rules 432.26adopted by the commissioner under section 
         144.9508. An assessing agency shall have 432.27lead risk assessments performed by lead risk assessors licensed by the commissioner 432.28according to rules adopted under section 
         144.9508. If a property owner refuses to allow 432.29a lead risk assessment, the assessing agency shall begin legal proceedings to gain entry 432.30to the property and the time frame for conducting a lead risk assessment set forth in this 432.31subdivision no longer applies. A lead risk assessor or assessing agency may observe the 432.32performance of lead hazard reduction in progress and shall enforce the provisions of this 432.33section under section 
         144.9509. Deteriorated painted surfaces, bare soil, and dust must be 432.34tested with appropriate analytical equipment to determine the lead content, except that 432.35deteriorated painted surfaces or bare soil need not be tested if the property owner agrees to 432.36engage in lead hazard reduction on those surfaces. The lead content of drinking water 433.1must be measured if another probable source of lead exposure is not identified. Within a 433.2standard metropolitan statistical area, an assessing agency may order lead hazard reduction 433.3of bare soil without measuring the lead content of the bare soil if the property is in a 433.4census tract in which soil sampling has been performed according to rules established by 433.5the commissioner and at least 25 percent of the soil samples contain lead concentrations 433.6above the standard in section 
         144.9508.433.7    (f) Each assessing agency shall establish an administrative appeal procedure which 433.8allows a property owner to contest the nature and conditions of any lead order issued by 433.9the assessing agency. Assessing agencies must consider appeals that propose lower cost 433.10methods that make the residence lead safe. The commissioner shall use the authority and 433.11appeal procedure granted under sections 
         144.989 to 
         144.993.433.12    (g) Sections 
         144.9501 to 
         144.9509 neither authorize nor prohibit an assessing agency 433.13from charging a property owner for the cost of a lead risk assessment.433.14    Sec. 13. Minnesota Statutes 2006, section 144.9507, is amended by adding a 433.15subdivision to read:433.16    Subd. 6.Medical assistance.Medical assistance reimbursement for lead risk 433.17assessment services under section 256B.0625, subdivision 49, shall not be used to replace 433.18or decrease existing state or local funding for lead services and lead-related activities.433.19    Sec. 14. Minnesota Statutes 2006, section 144.9512, is amended to read:433.20144.9512 LEAD ABATEMENT PROGRAM.433.21    Subdivision 1. Definitions. (a) The definitions in section 
         144.9501 and in this 433.22subdivision apply to this section.433.23    (b) "Eligible organization" means a lead contractor, city, board of health, community 433.24health department, community action agency as defined in section 256E.30, or community 433.25development corporation.433.26    (c) "Commissioner" means the commissioner of health, or the commissioner of the 433.27Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.433.28    Subd. 2. Grants; administration. Within the limits of the available appropriation, 433.29the commissioner must develop a swab team services program which may shall make 433.30demonstration and training grants to eligible organizationsa nonprofit organization 433.31currently operating the CLEARCorps lead hazard reduction project to train workers to 433.32provide swab team services and swab team services for residential property. Grants may 433.33be awarded to nonprofit organizations to provide technical assistance and training to 433.34ensure quality and consistency within the statewide program. Grants must be awarded to 434.1help ensure full-time employment to workers providing swab team services and must be 434.2awarded for a two-year period.434.3    Grants awarded under this section must be made in consultation with the 434.4commissioner of the Housing Finance Agency and representatives of neighborhood 434.5groups from areas at high risk for toxic lead exposure, a labor organization, the lead 434.6coalition, community action agencies, and the legal aid society. The consulting team must 434.7review grant applications and recommend awards to eligible organizations that meet 434.8requirements for receiving a grant under this section.434.9    Subd. 3.Applicants.(a) Interested eligible organizations may apply to the 434.10commissioner for grants under this section. Two or more eligible organizations may 434.11jointly apply for a grant. Priority shall be given to community action agencies in greater 434.12Minnesota and to either community action agencies or neighborhood based nonprofit 434.13organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may 434.14be used for administrative purposes. The commissioner may deviate from this percentage 434.15if a grantee can justify the need for a larger administrative allowance. Of this amount, 434.16up to five percent may be used by the commissioner for state administrative purposes. 434.17Applications must provide information requested by the commissioner, including at least 434.18the information required to assess the factors listed in paragraph (d).434.19    (b) The commissioner must consult with boards of health to provide swab team 434.20services for purposes of secondary prevention. The priority for swab teams created 434.21by grants to eligible organizations under this section must be work assigned by the 434.22commissioner of health, or by a board of health if so designated by the commissioner of 434.23health, to provide secondary prevention swab team services to fulfill the requirements 434.24of section 144.9504, subdivision 6, in response to a lead order. Swab teams assigned 434.25work under this section by the commissioner, that are not engaged daily in fulfilling the 434.26requirements of section 144.9504, subdivision 6, must deliver swab team services in 434.27response to elevated blood lead levels as defined in section 144.9501, subdivision 9, 434.28where lead orders were not issued, and for purposes of primary prevention in census 434.29tracts known to be in areas at high risk for toxic lead exposure as described in section 434.30144.9503, subdivision 2.434.31    (c) Any additional money must be used for grants to establish swab teams for 434.32primary prevention under section 144.9503, in census tracts in areas at high risk for toxic 434.33lead exposure as determined under section 144.9503, subdivision 2.434.34    (d) In evaluating grant applications, the commissioner must consider the following 434.35criteria:434.36    (1) the use of lead contractors and lead workers for residential swab team services;435.1    (2) the participation of neighborhood groups and individuals, as swab team workers, 435.2in areas at high risk for toxic lead exposure;435.3    (3) plans for the provision of swab team services for primary and secondary 435.4prevention as required under subdivision 4;435.5    (4) plans for supervision, training, career development, and postprogram placement 435.6of swab team members;435.7    (5) plans for resident and property owner education on lead safety;435.8    (6) plans for distributing cleaning supplies to area residents and educating residents 435.9and property owners on cleaning techniques;435.10    (7) sources of other funding and cost estimates for training, lead inspections, swab 435.11team services, equipment, monitoring, testing, and administration;435.12    (8) measures of program effectiveness;435.13    (9) coordination of program activities with other federal, state, and local public 435.14health, job training, apprenticeship, and housing renovation programs including programs 435.15under sections 116L.86 to 116L.881; and435.16    (10) prior experience in providing swab team services.435.17    Subd. 4. Lead supervisor or certified firm Eligible grant activities. (a) Eligible 435.18organizations and lead supervisors or certified firms may participate in the swab team 435.19program. An eligible organization The nonprofit receiving a grant under this section 435.20must assure ensure that all participating lead supervisors or certified firms are licensed 435.21and that all swab team workers are certified by the Department of Health under section 435.22144.9505
         . Eligible organizations and lead supervisors or certified firms may distinguish 435.23between interior and exterior services in assigning duties and The nonprofit organization435.24may participate in the program by: 435.25    (1) providing on-the-job training for swab team workers;435.26    (2) providing swab team services to meet the requirements of sections 
         144.9503, 435.27subdivision 4
         , and 
         144.9504, subdivision 6; 435.28    (3) providing a removal and replacement component using skilled craft workers 435.29under subdivision 7 lead hazard reduction to meet the requirements of section 144.9501, 435.30subdivision 17;435.31    (4) providing lead testing according to subdivision 8;435.32    (5) (4) providing lead dust cleaning supplies cleanup equipment and materials, as 435.33described in section 
         144.9507 144.9503, subdivision 4, paragraph (c) 1, to residents; or435.34    (6) (5) having a swab team worker instruct residents and property owners on 435.35appropriate lead control techniques, including the lead-safe directives developed by the 435.36commissioner of health.;436.1    (6) conducting blood lead testing events including screening children and pregnant 436.2women according to Department of Health screening guidelines;436.3    (7) performing case management services according to Department of Health case 436.4management guidelines; or436.5    (8) conducting mandated risk assessments under Minnesota Statutes, section 436.6144.9504, subdivision 2.436.7    (b) Participating lead supervisors or certified firms must:436.8    (1) demonstrate proof of workers' compensation and general liability insurance 436.9coverage;436.10    (2) be knowledgeable about lead abatement requirements established by the 436.11Department of Housing and Urban Development and the Occupational Safety and Health 436.12Administration and lead hazard reduction requirements and lead-safe directives of the 436.13commissioner of health;436.14    (3) demonstrate experience with on-the-job training programs;436.15    (4) demonstrate an ability to recruit employees from areas at high risk for toxic 436.16lead exposure; and436.17    (5) demonstrate experience in working with low-income clients.436.18    Subd. 5. Swab team workers. Each worker engaged in swab team services 436.19established under this section must have blood lead concentrations below 15 micrograms 436.20of lead per deciliter of whole blood as determined by a baseline blood lead screening. 436.21Any The nonprofit organization receiving a grant under this section is responsible for lead 436.22screening and must assure ensure that all swab team workers meet the standards established 436.23in this subdivision. Grantees The nonprofit organization must use appropriate workplace 436.24procedures including following the lead-safe directives developed by the commissioner of 436.25health to reduce risk of elevated blood lead levels. Grantees The nonprofit organization436.26and participating contractors must report all employee blood lead levels that exceed 15 436.27micrograms of lead per deciliter of whole blood to the commissioner of health.436.28    Subd. 6.On-the-job training component.(a) Programs established under this 436.29section must provide on-the-job training for swab team workers.436.30    (b) Swab team workers must receive monetary compensation equal to the prevailing 436.31wage as defined in section 177.42, subdivision 6, for comparable jobs in the licensed 436.32contractor's principal business. 436.33    Subd. 7.Removal and replacement component.(a) Within the limits of the 436.34available appropriation and if a need is identified by a lead inspector, the commissioner 436.35may establish a component for removal and replacement of deteriorated paint in residential 436.36properties according to the following criteria:437.1    (1) components within a residence must have both deteriorated lead-based paint and 437.2substrate damage beyond repair or rotting wooden framework to be eligible for removal 437.3and replacement;437.4    (2) all removal and replacement must be done using least-cost methods and 437.5following lead-safe directives;437.6    (3) whenever windows and doors or other components covered with deteriorated 437.7lead-based paint have sound substrate or are not rotting, those components should be 437.8repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or 437.9covered with protective guards instead of being replaced, provided that such an activity is 437.10the least-cost method of providing the swab team service;437.11    (4) removal and replacement or repair must be done by lead contractors using skilled 437.12craft workers or trained swab team members; and437.13    (5) all craft work that requires a state license must be supervised by a person with 437.14a state license in the craft work being supervised. The grant recipient may contract for 437.15this supervision.437.16    (b) The program design must:437.17    (1) identify the need for on-the-job training of swab team workers to be removal and 437.18replacement workers; and437.19    (2) describe plans to involve appropriate groups in designing methods to meet the 437.20need for training swab team workers.437.21    Subd. 8.Testing and evaluation.(a) Testing of the environment is not necessary 437.22by swab teams whose work is assigned by the commissioner of health or a designated 437.23board of health under section 144.9504. The commissioner of health or designated board 437.24of health must share the analytical testing data collected on each residence for purposes 437.25of secondary prevention under section 144.9504 with the swab team workers in order to 437.26provide constructive feedback on their work and to the commissioner for the purposes 437.27set forth in paragraph (c).437.28    (b) For purposes of primary prevention evaluation, the following samples must be 437.29collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a 437.30notation of the extent and location of bare soil and of deteriorated lead-based paint. The 437.31analytical testing data collected on each residence for purposes of primary prevention 437.32under section 144.9503 must be shared with the swab team workers in order to provide 437.33constructive feedback on their work and to the commissioner for the purposes set forth in 437.34paragraph (c).437.35    (c) The commissioner of health must establish a program to collect appropriate data 437.36as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of 438.1swab team services for primary and secondary prevention. Within the limits of available 438.2appropriations, the commissioner of health must conduct on up to 1,000 residences which 438.3have received primary or secondary prevention swab team services, a postremediation 438.4evaluation, on at least a quarterly basis for a period of at least two years for each residence. 438.5The evaluation must note the condition of the paint within the residence, the extent of bare 438.6soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample. 438.7The data collected must be evaluated to determine the efficacy of providing swab team 438.8services as a method of reducing lead exposure in young children. In evaluating this data, 438.9the commissioner of health must consider city size, community location, historic traffic 438.10flow, soil lead level of the property by area or census tract, distance to industrial point 438.11sources that emit lead, season of the year, age of the housing, age and number of children 438.12living at the residence, the presence of pets that move in and out of the residence, and 438.13other relevant factors as the commissioner of health may determine.438.14    Subd. 9. Program benefits. As a condition of providing swab team services under 438.15this section, an the nonprofit organization may require a property owner to not increase 438.16rents on a property solely as a result of a substantial improvement made with public 438.17funds under the programs in this section.438.18    Subd. 10. Requirements of organizations receiving grants the nonprofit 438.19organization.An eligible The nonprofit organization that is awarded a training and 438.20demonstration grant under this section must prepare and submit a quarterly progress report 438.21to the commissioner beginning three months after receipt of the grant.438.22    Sec. 15. [144.966] EARLY HEARING DETECTION AND INTERVENTION 438.23ACT.438.24    Subdivision 1.Definitions.(a) "Child" means a person 18 years of age or younger.438.25    (b) "False positive rate" means the proportion of infants identified as having a 438.26significant hearing loss by the screening process who are ultimately found to not have a 438.27significant hearing loss.438.28    (c) "False negative rate" means the proportion of infants not identified as having 438.29a significant hearing loss by the screening process who are ultimately found to have a 438.30significant hearing loss.438.31    (d) "Hearing screening test" means automated auditory brain stem response, 438.32otoacoustic emissions, or another appropriate screening test approved by the Department 438.33of Health.438.34    (e) "Hospital" means a birthing health care facility or birthing center licensed in 438.35this state that provides obstetrical services.439.1    (f) "Infant" means a child who is not a newborn and has not attained the age of 439.2one year.439.3    (g) "Newborn" means an infant 28 days old or younger.439.4    (h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or 439.5custodian of a newborn or infant.439.6    Subd. 2.Newborn Hearing Screening Advisory Committee.(a) The 439.7commissioner of health shall appoint a Newborn Hearing Screening Advisory Committee 439.8to advise and assist the Department of Health and the Department of Education in:439.9    (1) developing protocols and timelines for screening, rescreening, and diagnostic 439.10audiological assessment and early medical, audiological, and educational intervention 439.11services for children who are deaf or hard-of-hearing;439.12    (2) designing protocols for tracking children from birth through age three that may 439.13have passed newborn screening but are at risk for delayed or late onset of permanent 439.14hearing loss;439.15    (3) designing a technical assistance program to support facilities implementing the 439.16screening program and facilities conducting rescreening and diagnostic audiological 439.17assessment;439.18    (4) designing implementation and evaluation of a system of follow-up and tracking; 439.19and439.20    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure 439.21culturally appropriate services for children with a confirmed hearing loss and their families.439.22    (b) Membership of the committee shall include at least one member from each of the 439.23following groups with no less than two of the members being deaf or hard-of-hearing:439.24    (1) a representative from a consumer organization representing culturally deaf 439.25persons;439.26    (2) a parent with a child with hearing loss representing a parent organization;439.27    (3) a consumer from an organization representing oral communication options;439.28    (4) a consumer from an organization representing cued speech communication 439.29options;439.30    (5) an audiologist who has experience in evaluation and intervention of infants 439.31and young children;439.32    (6) a speech-language pathologist who has experience in evaluation and intervention 439.33of infants and young children;439.34    (7) two primary care providers who have experience in the care of infants and young 439.35children, one of which shall be a pediatrician;439.36    (8) a representative from the early hearing detection intervention teams;440.1    (9) a representative from the Department of Education resource center for the deaf 440.2and hard-of-hearing or their designee;440.3    (10) a representative of the Minnesota Commission Serving Deaf and Hard of 440.4Hearing People;440.5    (11) a representative from the Department of Human Services Deaf and Hard of 440.6Hearing Services Division;440.7    (12) one or more of the Part C coordinators from the Department of Education, the 440.8Department of Health, or the Department of Human Services or their designee;440.9    (13) the Department of Health early hearing detection and intervention coordinator;440.10    (14) two birth hospital representatives from one rural and one urban hospital;440.11    (15) a pediatric geneticist;440.12    (16) an otolaryngologist;440.13    (17) a representative from the Newborn Screening Advisory Committee under 440.14this subdivision; and440.15    (18) a representative of the Department of Education regional low-incidence 440.16facilitators.440.17    The Department of Health member shall chair the first meeting of the committee. 440.18At the first meeting, the committee shall elect a chairperson from its membership. The 440.19committee shall meet at the call of the chairperson, at least four times a year. The 440.20committee shall adopt written bylaws to govern its activities. The Department of Health 440.21shall provide technical and administrative support services as required by the committee. 440.22These services shall include technical support from individuals qualified to administer 440.23infant hearing screening, rescreening, and diagnostic audiological assessments.440.24    Members of the committee shall receive no compensation for their service, but 440.25shall be reimbursed for expenses incurred as a result of their duties as members of the 440.26committee.440.27    Subd. 3.Newborn and infant hearing screening programs.All hospitals shall 440.28establish a Universal Newborn Hearing and Infant Screening (UNHS) program. Each 440.29UNHS program shall:440.30    (1) in advance of any hearing screening testing, provide to the newborn's or infant's 440.31parents information concerning the nature of the screening procedure, applicable costs of 440.32the screening procedure, the potential risks and effects of hearing loss, and the benefits of 440.33early detection and intervention;440.34    (2) comply with parental consent under section 144.125, subdivision 3;440.35    (3) develop policies and procedures for screening and rescreening based on 440.36Department of Health recommendations;441.1    (4) provide appropriate training and monitoring of individuals responsible for 441.2performing hearing screening tests as recommended by the Department of Health;441.3    (5) test the newborn's hearing prior to discharge, or, if the newborn is expected to 441.4remain in the hospital for a prolonged period, testing shall be performed prior to three 441.5months of age, or when medically feasible;441.6    (6) develop and implement procedures for documenting the results of all hearing 441.7screening tests;441.8    (7) inform the baby's parents or parent, primary care physician, and the Department 441.9of Health according to recommendations of the Department of Health of the results of the 441.10hearing screening test or rescreening if conducted, or if the newborn or infant was not 441.11successfully tested. The hospital that discharges the baby to home is responsible for 441.12the screening; and441.13    (8) collect performance data specified by the Department of Health. 441.14    Subd. 4.Notification and information.(a) Notification to the parents, primary 441.15care provider, and Department of Health shall occur prior to discharge or no later than ten 441.16days following the date of testing. Notification shall include information recommended by 441.17the Department of Health.441.18    (b) A physician, nurse, midwife, or other health professional attending a birth outside 441.19a hospital or institution shall provide information, orally and in writing, as established by 441.20the Department of Health, to parents regarding places where the parents may have their 441.21infants' hearing screened and the importance of such screening.441.22    (c) The professional conducting the diagnostic procedure to confirm the hearing loss 441.23must report the results to the parents, primary care provider, and Department of Health 441.24according to the Department of Health recommendations.441.25    Subd. 5.Oversight responsibility.The Department of Health shall exercise 441.26oversight responsibility for UNHS programs, including establishing a performance data 441.27set and reviewing performance data collected by each hospital.441.28    Subd. 6.Civil and criminal immunity and penalties.(a) No physician or hospital 441.29shall be civilly or criminally liable for failure to conduct hearing screening testing.441.30    (b) No physician, midwife, nurse, other health professional, or hospital acting in 441.31compliance with this section shall be civilly or criminally liable for any acts conforming 441.32with this section, including furnishing information required according to this section.441.33    Subd. 7.Laboratory service fees.The commissioner shall charge laboratory 441.34service fees according to section 16A.1285 so that the total of fees collected will 441.35approximate the costs of implementing and maintaining a system to follow up infants, 441.36provide technical assistance, a tracking system, data management, and evaluation.442.1EFFECTIVE DATE.This section is effective the day following final enactment.442.2    Sec. 16. [144.967] ARSENIC HEALTH RISK STANDARD.442.3    Subdivision 1.Arsenic health risk standard established.The commissioner of 442.4health in cooperation with the commissioners of agriculture and the Pollution Control 442.5Agency responsible for monitoring land and water cleanup and soil contamination 442.6information shall determine a health risk standard for human exposure to arsenic. The 442.7commissioner of health shall ensure that the established arsenic health risk standard is 442.8included in all information provided to the public.442.9    Subd. 2.Information.The commissioner of health, in consultation with the 442.10commissioners of agriculture and the Pollution Control Agency with jurisdiction over 442.11soil and water contamination, shall establish a central information source available to 442.12the public to provide accurate information on arsenic soil and water contamination in 442.13residential areas.442.14    Subd. 3.Testing for arsenic.(a) The commissioner of health shall ensure access 442.15to medical testing for arsenical pesticide exposure to persons living within one mile of 442.16the CMC Heartland Lite Yard Superfund site who are not covered by health insurance or 442.17medical assistance.442.18    (b) Through an agreement with the United States Environmental Protection Agency, 442.19the commissioner shall ensure soil testing is available to households within one mile of the 442.20CMC Heartland Lite Yard Superfund site at no cost to the residents.442.21    Subd. 4.Evaluation.The commissioner of health shall evaluate the cumulative 442.22health impact burdens of environmental toxins in the residential communities impacted by 442.23arsenic-contaminated soil from the CMC Heartland Lite Yard Superfund site. The first 442.24priority shall be to evaluate health burdens to those communities experiencing health 442.25disparities as documented by the Minority and Multicultural Health Division of the 442.26Minnesota Department of Health.442.27    Sec. 17. [144.995] DEFINITIONS.442.28    (a) For purposes of sections 144.995 to 144.998, the terms in this section have 442.29the meanings given.442.30    (b) "Advisory panel" means the Environmental Health Tracking and Biomonitoring 442.31Advisory Panel established under section 144.998.442.32    (c) "Biomonitoring" means the process by which chemicals and their metabolites are 442.33identified and measured within a biospecimen.443.1    (d) "Biospecimen" means a sample of human fluid, serum, or tissue that is reasonably 443.2available as a medium to measure the presence and concentration of chemicals or their 443.3metabolites in a human body.443.4    (e) "Commissioner" means the commissioner of the Department of Health.443.5    (f) "Community" means geographically or nongeographically-based populations 443.6that may participate in the biomonitoring program. A "nongeographical community" 443.7includes, but is not limited to, populations that may share a common chemical exposure 443.8through similar occupations, populations experiencing a common health outcome that 443.9may be linked to chemical exposures, or populations that may experience similar chemical 443.10exposures because of comparable consumption, lifestyle, product use, or subpopulations 443.11that share ethnicity, age, or gender.443.12    (g) "Department" means the Department of Health.443.13    (h) "Designated chemicals" means those chemicals that are known to, or strongly 443.14suspected of, adversely impacting human health or development, based upon scientific, 443.15peer-reviewed animal, human, or in vitro studies, and baseline human exposure data, 443.16and consists of chemical families or metabolites that are included in the federal Centers 443.17for Disease Control and Prevention studies that are known collectively as the National 443.18Reports on Human Exposure to Environmental Chemicals program and any substances 443.19specified under section 144.998, subdivision 3, clause (6).443.20    (i) "Environmental hazard" means a chemical, metal, or other substance for which 443.21scientific, peer-reviewed studies of humans, animals, or cells have demonstrated that the 443.22chemical is known or reasonably anticipated to adversely impact human health.443.23    (j) "Environmental health tracking" means collection, integration, analysis, and 443.24dissemination of data on human exposures to  chemicals in the environment and on 443.25diseases potentially caused or aggravated by those chemicals.443.26    Sec. 18. [144.996] ENVIRONMENTAL HEALTH TRACKING; 443.27BIOMONITORING.443.28    Subdivision 1.Environmental health tracking.In cooperation with the 443.29commissioner of the Pollution Control Agency, the commissioner shall establish an 443.30environmental health tracking program to:443.31    (1) coordinate data collection activities with the Pollution Control Agency, 443.32Department of Agriculture, University of Minnesota, and any other relevant state agency 443.33and work to promote the sharing of and access to health and environmental databases 443.34in order to develop an environmental health tracking system for Minnesota, consistent 443.35with applicable data practices laws;444.1    (2) facilitate the dissemination of public health tracking data to the public and 444.2researchers in accessible format and provide technical assistance on interpreting the data;444.3    (3) develop written data sharing agreements with the Minnesota Pollution Control 444.4Agency, Department of Agriculture, and other relevant state agencies and organizations, 444.5and develop additional procedures as needed to protect individual privacy;444.6    (4) develop a strategic plan that includes a mission statement, the identification of 444.7core priorities for research and epidemiologic surveillance, the identification of internal 444.8and external stakeholders, and a work plan describing future program development;444.9    (5) organize, analyze, and interpret available data, in order to:444.10    (i) characterize statewide and localized trends and geographic patterns of prevalence 444.11and incidence of chronic diseases, including, but not limited to, cancer, respiratory 444.12diseases, reproductive problems, birth defects, neurologic diseases, and developmental 444.13disorders;444.14    (ii) recommend to the commissioner methods to improve data collection on 444.15statewide population rates of chronic diseases and the occurrence of environmental 444.16hazards and exposures;444.17    (iii) characterize statewide and localized trends and geographic patterns in the 444.18occurrence of environmental hazards and exposures;444.19    (iv) assess the level of correlation with disease rate data and indicators of exposure 444.20such as biomonitoring data, and other health and environmental data;444.21    (v) incorporate newly collected and existing health tracking and biomonitoring 444.22data into efforts to identify communities with elevated rates of chronic disease, higher 444.23likelihood of exposure to environmental pollutants, or both;444.24    (vi) analyze occurrence of environmental hazards, exposures, and diseases with 444.25relation to socioeconomic status, race, and ethnicity;444.26    (vii) develop and implement targeted plans to conduct more intensive health tracking 444.27and biomonitoring among communities;444.28    (viii) work with the Pollution Control Agency, the Department of Agriculture, and 444.29other relevant state agency personnel and organizations to develop, implement, and 444.30evaluate preventive measures to reduce elevated rates of diseases and exposures identified 444.31through activities performed under sections 144.995 to 144.998; and444.32    (ix) provide baseline data and present descriptive information relevant to policy 444.33formation that are consistent with existing goals of the department; and444.34    (6) submit a biennial report to the legislature by January 15, beginning January 444.3515, 2009, on the status of environmental health tracking activities and related research 445.1programs, and making recommendations regarding the continuation and improvement of 445.2the programs.445.3    Subd. 2.Biomonitoring.The commissioner shall:445.4    (1) conduct biomonitoring of communities on a voluntary  basis by collecting and 445.5analyzing biospecimens, as appropriate, to assess environmental exposures to designated 445.6chemicals;445.7    (2) conduct biomonitoring of pregnant women and minors on a voluntary basis, 445.8when scientifically appropriate; 445.9    (3) communicate findings to the public, and plan ensuing stages of biomonitoring 445.10and disease tracking work to further develop and refine the integrated analysis;445.11    (4) share analytical results with the advisory panel and work with the panel 445.12to interpret results, communicate findings to the public, and plan ensuing stages of 445.13biomonitoring work; and445.14    (5) submit a biennial report to the legislature by January 15, beginning January 445.1515, 2009, on the status of the biomonitoring program and any recommendations for 445.16improvement.445.17    Subd. 3.Health data.Data collected under the biomonitoring program are health 445.18data under section 13.3805.445.19    Sec. 19. [144.997] BIOMONITORING PILOT PROGRAM.445.20    Subdivision 1.Pilot program.With advice from the advisory panel, the 445.21commissioner shall develop a biomonitoring pilot program. The program shall collect 445.22one biospecimen from each of the voluntary participants. The biospecimen selected must 445.23be the biospecimen that most accurately represents body concentration of the chemical 445.24of interest. Each biospecimen from the voluntary participants must be analyzed for one 445.25type or class of related chemicals or metals, based on recommendations from the advisory 445.26panel. The panel shall determine the chemical or class of chemicals that community 445.27members were most likely exposed to. The program shall collect and assess biospecimens 445.28in accordance with the following: 445.29    (1) 30 voluntary participants from each of three communities that the advisory panel 445.30identifies as likely to have been exposed to a designated chemical; 445.31    (2) 100 voluntary participants from each of two communities: (i) that the advisory 445.32panel identifies as likely to have been exposed to arsenic and (ii) that the advisory panel 445.33identifies as likely to have been exposed to mercury; and 445.34    (3) 100 voluntary participants from each of two communities that the advisory panel 445.35identifies as likely to have been exposed to perfluorinated chemicals.446.1    Subd. 2.Base program.Following the conclusion of the pilot program and within 446.2the appropriations available, the program shall:446.3    (1) collect and assess biospecimens from at least as many voluntary participants and 446.4communities as identified in subdivision 1, clause (1); and446.5    (2) work with the advisory panel to assess the usefulness of continuing biomonitoring 446.6among members of communities assessed during the initial phase of the program, 446.7and to identify other communities and other designated chemicals to be assessed via 446.8biomonitoring.446.9    Subd. 3.Participation.(a) Participation in the biomonitoring program by providing 446.10biospecimens is voluntary and requires written, informed consent. Minors may participate 446.11in the program if a written consent is signed by the minor's parent or legal guardian. 446.12The written consent must include the information required to be provided under this 446.13subdivision to all voluntary participants.446.14    (b) All participants shall be evaluated for the presence of the designated chemical 446.15of interest as a component of the biomonitoring process. Participants shall be provided 446.16with information and fact sheets about the program's activities and its findings. 446.17Individual participants shall, if requested, receive their complete results. Any results 446.18provided to participants shall be subject to the Department of Health Institutional 446.19Review Board protocols and guidelines. When either physiological or chemical data 446.20obtained from a participant indicate a significant known health risk, program staff 446.21experienced in communicating biomonitoring results shall consult with the individual 446.22and recommend follow-up steps, as appropriate. Program administrators shall receive 446.23training in administering the program in an ethical, culturally sensitive, participatory, 446.24and community-based manner.446.25    Subd. 4.Program guidelines.(a) The commissioner, in consultation with the 446.26advisory panel, shall develop:446.27    (1) protocols or program guidelines that address the science and practice of 446.28biomonitoring to be utilized and procedures for changing those protocols to incorporate 446.29new and more accurate or efficient technologies as they become available. The protocols 446.30shall be developed utilizing a peer-review process in a manner that is participatory and 446.31community-based in design, implementation, and evaluation;446.32    (2) guidelines for ensuring the privacy of information; informed consent; follow-up 446.33counseling and support; and communicating findings to participants, communities, and 446.34the general public. The informed consent used for the program must meet the informed 446.35consent protocols developed by the National Institutes of Health;447.1    (3) educational and outreach materials that are culturally appropriate for 447.2dissemination to program participants and communities. Priority shall be given to the 447.3development of materials specifically designed to ensure that parents are informed about 447.4all of the benefits of breastfeeding so that the program does not result in an unjustified fear 447.5of toxins in breast milk, which might inadvertently lead parents to avoid breastfeeding. 447.6The materials shall communicate relevant scientific findings; data on the accumulation 447.7of pollutants to community health; and the required responses by local, state, and other 447.8governmental entities in regulating toxicant exposures;447.9    (4) a training program that is culturally sensitive specifically for health care 447.10providers, health educators, and other program administrators; 447.11    (5) a designation process for state and private laboratories that are qualified to 447.12analyze biospecimens and report the findings; and 447.13    (6) a method for informing affected communities and local governments representing 447.14those communities concerning biomonitoring activities and for receiving comments from 447.15citizens concerning those activities.447.16    (b) The commissioner may enter into contractual agreements with health clinics, 447.17community-based organizations, or experts in a particular field to perform any of the 447.18activities described under this section.447.19    Sec. 20. [144.998] ENVIRONMENTAL HEALTH TRACKING AND 447.20BIOMONITORING ADVISORY PANEL.447.21    Subdivision 1.Creation.The commissioner shall establish the Environmental 447.22Health Tracking and Biomonitoring Advisory Panel. The commissioner shall appoint, 447.23from the panel's membership, a chair. The panel shall meet as often as it deems necessary 447.24but, at a minimum, on a quarterly basis. Members of the panel shall serve without 447.25compensation but shall be reimbursed for travel and other necessary expenses incurred 447.26through performance of their duties. Members appointed under this subdivision are 447.27appointed for a three-year term and may be reappointed.447.28    Subd. 2.Members.The commissioner shall appoint eight members, none of whom 447.29may be lobbyists registered under chapter 10A, who have backgrounds or training in 447.30designing, implementing, and interpreting health tracking and biomonitoring studies or 447.31in related fields of science, including epidemiology, biostatistics, environmental health, 447.32laboratory sciences, occupational health, industrial hygiene, toxicology, and public health, 447.33including:448.1    (1) two scientists who represent nongovernmental organizations with a focus on 448.2environmental health, environmental justice, children's health, or on specific chronic 448.3diseases; and448.4    (2) one scientist who is a representative of the University of Minnesota.448.5    In addition, the commissioner shall appoint one member representing each of the 448.6following departments or divisions: the department's health promotion and chronic disease 448.7division, the Pollution Control Agency, and the Department of Agriculture.448.8    Subd. 3.Duties.The advisory panel shall make recommendations to the 448.9commissioner and the legislature on:448.10    (1) priorities for health tracking;448.11    (2) priorities for biomonitoring that are based on sound science and practice, and 448.12that will advance the state of public health in Minnesota;448.13    (3) specific chronic diseases to study under the environmental health tracking system;448.14    (4) specific environmental pollutant exposures to study under the environmental 448.15health tracking system, with the agreement of at least seven of the advisory panel members;448.16    (5) specific communities and geographic areas on which to focus environmental 448.17health tracking and biomonitoring efforts;448.18    (6) specific chemicals and metals to study under the biomonitoring program that meet 448.19the following criteria, with the agreement of at least seven of the advisory panel members:448.20    (i) the degree of potential exposure to the public or specific subgroups, including, 448.21but not limited to, occupational;448.22    (ii) the likelihood of a chemical being a carcinogen or toxicant based on 448.23peer-reviewed health data, the chemical structure, or the toxicology of chemically related 448.24compounds;448.25    (iii) the limits of laboratory detection for the chemical, including the ability to detect 448.26the chemical at low enough levels that could be expected in the general population;448.27    (iv) exposure or potential exposure to the public or specific subgroups;448.28    (v) the known or suspected health effects resulting from the same level of exposure 448.29based on peer-reviewed scientific studies;448.30    (vi) the need to assess the efficacy of public health actions to reduce exposure to a 448.31chemical;448.32    (vii) the availability of a biomonitoring analytical method with adequate accuracy, 448.33precision, sensitivity, specificity, and speed;448.34    (viii) the availability of adequate biospecimen samples; and448.35    (ix) other criteria that the panel may agree to; and449.1    (7) other aspects of the design, implementation, and evaluation of the environmental 449.2health tracking and biomonitoring system, including, but not limited to:449.3    (i) identifying possible community partners and sources of additional public or 449.4private funding;449.5    (ii) developing outreach and educational methods and materials; and449.6    (iii) disseminating environmental health tracking and biomonitoring findings to 449.7the public.449.8    Subd. 4.Liability.No member of the panel shall be held civilly or criminally liable 449.9for an act or omission by that person if the act or omission was in good faith and within 449.10the scope of the member's responsibilities under sections 144.995 to 144.998.449.11    Sec. 21. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:449.12    Subd. 6. Basic life support. (a) Except as provided in paragraph (e), a basic life 449.13support ambulance shall be staffed by at least two ambulance service personnel, at least 449.14one of which must be an EMT, who provide a level of care so as to ensure that:449.15    (1) life-threatening situations and potentially serious injuries are recognized;449.16    (2) patients are protected from additional hazards;449.17    (3) basic treatment to reduce the seriousness of emergency situations is administered; 449.18and449.19    (4) patients are transported to an appropriate medical facility for treatment.449.20    (b) A basic life support service shall provide basic airway management.449.21    (c) By January 1, 2001, a basic life support service shall provide automatic 449.22defibrillation, as provided in section 
         144E.103, subdivision 1, paragraph (b). 449.23    (d) A basic life support service licensee's medical director may authorize the 449.24ambulance service personnel to carry and to use medical antishock trousers and to perform 449.25intravenous infusion if the ambulance service personnel have been properly trained.449.26    (e) Upon application from an ambulance service that includes evidence 449.27demonstrating hardship, the board may grant a temporary variance from the staff 449.28requirements in paragraph (a) and may authorize a basic life support ambulance to be 449.29staffed by one EMT and one first responder. The variance shall apply to basic life support 449.30ambulances operated by the ambulance service for up to one year from the date of the 449.31variance's issuance until the ambulance service renews its license. When a variance 449.32expires, an ambulance service may apply for a new variance under this paragraph. For 449.33purposes of this paragraph, "ambulance service" means either an ambulance service whose 449.34primary service area is located outside the metropolitan counties listed in section 
         473.121, 450.1subdivision 4
         , and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. 450.2Cloud; or an ambulance service based in a community with a population of less than 1,000. 450.3    Sec. 22. Minnesota Statutes 2006, section 144E.127, is amended to read:450.4144E.127 INTERHOSPITAL; INTERFACILITY TRANSFER.450.5    Subdivision 1.Interhospital transfers. When transporting a patient from one 450.6licensed hospital to another, a licensee may substitute for one of the required ambulance 450.7service personnel, a physician, a registered nurse, or physician's assistant who has been 450.8trained to use the equipment in the ambulance and is knowledgeable of the licensee's 450.9ambulance service protocols.450.10    Subd. 2.Interfacility transfers.In an interfacility transport, a licensee whose 450.11primary service area is located outside the metropolitan counties listed in section 473.121, 450.12subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. 450.13Cloud; or an ambulance service based in a community with a population of less than 1,000, 450.14may substitute one EMT with a registered first responder if an EMT or EMT-paramedic, 450.15physician, registered nurse, or physician's assistant is in the patient compartment. If using 450.16a physician, registered nurse, or physician's assistant as the sole provider in the patient 450.17compartment, the individual must be trained to use the equipment in the ambulance and be 450.18knowledgeable of the ambulance service protocols.450.19    Sec. 23. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:450.20    Subdivision 1. Repayment for volunteer training.Any political subdivision, or 450.21nonprofit hospital or nonprofit corporation operating A licensed ambulance service shall 450.22be reimbursed by the board for the necessary expense of the initial training of a volunteer 450.23ambulance attendant upon successful completion by the attendant of a basic emergency 450.24care course, or a continuing education course for basic emergency care, or both, which has 450.25been approved by the board, pursuant to section 
         144E.285. Reimbursement may include 450.26tuition, transportation, food, lodging, hourly payment for the time spent in the training 450.27course, and other necessary expenditures, except that in no instance shall a volunteer 450.28ambulance attendant be reimbursed more than $450$600 for successful completion of a 450.29basic course, and $225$275 for successful completion of a continuing education course. 450.30    Sec. 24. [145.958] BISPHENOL-A IN PRODUCTS FOR CHILDREN.450.31    Subdivision. 1.Bisphenol-A and phthalates committee.The commissioner of 450.32health shall create a committee under the direction of the environmental health division of 450.33the Department of Health to study the scientific literature and make recommendations to 451.1the legislature on the health impact of bisphenol-A and phthalates on children in products 451.2intended for use by young children, including, but not limited to, toys, pacifiers, baby 451.3bottles, and teethers, and report back by January 15, 2008. The committee shall also 451.4identify least harmful alternatives. Of the seven committee members at least one shall be a 451.5representative of the Department of Health, one shall be a representative of environmental 451.6health sciences research, one shall be a representative of the Minnesota Nurses 451.7Association, one shall be a representative of environmental health consumer advocates, 451.8one shall be a member of a children's product manufacturer's association, and one shall be 451.9a representative of the University of Minnesota, chemical plastics research department.451.10    Subd. 2.Definitions.For the purposes of this section, the following terms have 451.11the meanings given them:451.12    (a) "Toy" means all products designed or intended by the manufacturer to be used by 451.13children when they play.451.14    (b) "Child care article" means all products designed or intended by the manufacturer 451.15to facilitate sleep, relaxation, or the feeding of children or to help children with sucking or 451.16teething.451.17    Sec. 25. Minnesota Statutes 2006, section 145A.17, is amended to read:451.18145A.17 FAMILY HOME VISITING PROGRAMS.451.19    Subdivision 1. Establishment; goals. The commissioner shall establish a program 451.20to fund family home visiting programs designed to foster a healthy beginning for children 451.21in families at or below 200 percent of the federal poverty guidelines beginnings, improve 451.22pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce 451.23juvenile delinquency, promote positive parenting and resiliency in children, and promote 451.24family health and economic self-sufficiency for children and families. The commissioner 451.25shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of 451.26professionals and paraprofessionals from the fields of public health nursing, social work, 451.27and early childhood education. A program funded under this section must serve families 451.28at or below 200 percent of the federal poverty guidelines, and other families determined 451.29to be at risk, including but not limited to being at risk for child abuse, child neglect, or 451.30juvenile delinquency. Programs must give priority for services to families considered to 451.31be in need of services, including but not limited tobegin prenatally whenever possible and 451.32must be targeted to families with:451.33    (1) adolescent parents;451.34    (2) a history of alcohol or other drug abuse;451.35    (3) a history of child abuse, domestic abuse, or other types of violence;452.1    (4) a history of domestic abuse, rape, or other forms of victimization;452.2    (5) reduced cognitive functioning;452.3    (6) a lack of knowledge of child growth and development stages;452.4    (7) low resiliency to adversities and environmental stresses; or452.5    (8) insufficient financial resources to meet family needs;452.6    (9) a history of homelessness;452.7    (10) a risk of long-term welfare dependence or family instability due to employment 452.8barriers; or452.9    (11) other risk factors as determined by the commissioner.452.10    Subd. 3. Requirements for programs; process. (a) Before a community health 452.11board or tribal government may receive an allocation under subdivision 2, a community 452.12health board or tribal government must submit a proposal to the commissioner that 452.13includes identification, based on a community assessment, of the populations at or below 452.14200 percent of the federal poverty guidelines that will be served and the other populations 452.15that will be served. Each program that receives funds must Community health boards 452.16and tribal governments that receive funding under this section must submit a plan to 452.17the commissioner describing a multidisciplinary approach to targeted home visiting for 452.18families. The plan must be submitted on forms provided by the commissioner. At a 452.19minimum, the plan must include the following:452.20    (1) a description of outreach strategies to families prenatally or at birth;452.21    (2) provisions for the seamless delivery of health, safety, and early learning services; 452.22    (3) methods to promote continuity of services when families move within the state;452.23    (4) a description of the community demographics;452.24    (5) a plan for meeting outcome measures; and452.25    (6) a proposed work plan that includes:452.26    (i) coordination to ensure nonduplication of services for children and families;452.27    (ii) a description of the strategies to ensure that children and families at greatest risk 452.28receive appropriate services; and452.29    (iii) collaboration with multidisciplinary partners including public health, 452.30ECFE, Head Start, community health workers, social workers, community home 452.31visiting programs, school districts, and other relevant partners. Letters of intent from 452.32multidisciplinary partners must be submitted with the plan.452.33    (b) Each program that receives funds must accomplish the following program 452.34requirements:452.35    (1) use either a broad community-based or selective community-based strategy to 452.36provide preventive and early intervention home visiting services;453.1    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first 453.2home visit must occur prenatally or as soon after birth as possible and must include a 453.3public health nursing assessment by a public health nurse;453.4    (3) offer, at a minimum, information on infant care, child growth and development, 453.5positive parenting, preventing diseases, preventing exposure to environmental hazards, 453.6and support services available in the community;453.7    (4) provide information on and referrals to health care services, if needed, including 453.8information on and assistance in applying for health care coverage for which the child or 453.9family may be eligible; and provide information on preventive services, developmental 453.10assessments, and the availability of public assistance programs as appropriate;453.11    (5) provide youth development programs when appropriate;453.12    (6) recruit home visitors who will represent, to the extent possible, the races, 453.13cultures, and languages spoken by families that may be served;453.14    (7) train and supervise home visitors in accordance with the requirements established 453.15under subdivision 4;453.16    (8) maximize resources and minimize duplication by coordinating activitiesor 453.17contracting with local social and human services organizations, education organizations, 453.18and other appropriate governmental entities and community-based organizations and 453.19agencies; and453.20    (9) utilize appropriate racial and ethnic approaches to providing home visiting 453.21services; and453.22    (10) connect eligible families, as needed, to additional resources available in the 453.23community, including, but not limited to, early care and education programs, health or 453.24mental health services, family literacy programs, employment agencies, social services, 453.25and child care resources and referral agencies.453.26    (c) When available, programs that receive funds under this section must offer or 453.27provide the family with a referral to center-based or group meetings that meet at least 453.28once per month for those families identified with additional needs. The meetings must 453.29focus on further enhancing the information, activities, and skill-building addressed during 453.30home visitation; offering opportunities for parents to meet with and support each other; 453.31and offering infants and toddlers a safe, nurturing, and stimulating environment for 453.32socialization and supervised play with qualified teachers.453.33    (b)(d) Funds available under this section shall not be used for medical services. The 453.34commissioner shall establish an administrative cost limit for recipients of funds. The 453.35outcome measures established under subdivision 6 must be specified to recipients of 453.36funds at the time the funds are distributed.454.1    (c)(e) Data collected on individuals served by the home visiting programs must 454.2remain confidential and must not be disclosed by providers of home visiting services 454.3without a specific informed written consent that identifies disclosures to be made. 454.4Upon request, agencies providing home visiting services must provide recipients with 454.5information on disclosures, including the names of entities and individuals receiving the 454.6information and the general purpose of the disclosure. Prospective and current recipients 454.7of home visiting services must be told and informed in writing that written consent for 454.8disclosure of data is not required for access to home visiting services.454.9    Subd. 4. Training. The commissioner shall establish training requirements for 454.10home visitors and minimum requirements for supervision by a public health nurse. The 454.11requirements for nurses must be consistent with chapter 148. The commissioner must 454.12provide training for home visitors. Training must include child development, positive 454.13parenting techniques, screening and referrals for child abuse and neglect, and diverse 454.14cultural practices in child rearing and family systems the following:454.15    (1) effective relationships for engaging and retaining families and ensuring family 454.16health, safety, and early learning;454.17    (2) effective methods of implementing parent education, conducting home visiting, 454.18and promoting quality early childhood development;454.19    (3) early childhood development from birth to age five;454.20    (4) diverse cultural practices in child rearing and family systems;454.21    (5) recruiting, supervising, and retaining qualified staff;454.22    (6) increasing services for underserved populations; and 454.23    (7) relevant issues related to child welfare and protective services, with information 454.24provided being consistent with state child welfare agency training.454.25    Subd. 5. Technical assistance. The commissioner shall provide administrative 454.26and technical assistance to each program, including assistance in data collection and 454.27other activities related to conducting short- and long-term evaluations of the programs 454.28as required under subdivision 7. The commissioner may request research and evaluation 454.29support from the University of Minnesota.454.30    Subd. 6. Outcome and performance measures. The commissioner shall establish 454.31outcomesmeasures to determine the impact of family home visiting programs funded 454.32under this section on the following areas:454.33    (1) appropriate utilization of preventive health care;454.34    (2) rates of substantiated child abuse and neglect;454.35    (3) rates of unintentional child injuries;454.36    (4) rates of children who are screened and who pass early childhood screening; and455.1    (5) rates of children accessing early care and educational services;455.2    (6) program retention rates;455.3    (7) number of home visits provided compared to the number of home visits planned;455.4    (8) participant satisfaction;455.5    (9) rates of at-risk populations reached; and455.6    (10) any additional qualitative goals and quantitative measures established by the 455.7commissioner.455.8    Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome and 455.9performance measures established under subdivisions 1 and 6, the commissioner shall 455.10conduct ongoing evaluations of the programs funded under this section. Community 455.11health boards and tribal governments shall cooperate with the commissioner in the 455.12evaluations and shall provide the commissioner with the information necessary to conduct 455.13the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact 455.14of the programs on the outcome measures listed in subdivision 6, and shall periodically 455.15determine whether home visiting programs are the best way to achieve the qualitative 455.16goals established under subdivisions 1 and 6. If the commissioner determines that home 455.17visiting programs are not the best way to achieve these goals, the commissioner shall 455.18provide the legislature with alternative methods for achieving them.455.19    Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered 455.20year thereafter, the commissioner shall submit a report to the legislature on the family 455.21home visiting programs funded under this section and on the results of the evaluations 455.22conducted under subdivision 7.455.23    Subd. 9. No supplanting of existing funds. Funding available under this section 455.24may be used only to supplement, not to replace, nonstate funds being used for home 455.25visiting services as of July 1, 2001.455.26    Sec. 26. Minnesota Statutes 2006, section 156.001, is amended by adding a subdivision 455.27to read:455.28    Subd. 10a.Program for the Assessment of Veterinary Education Equivalence; 455.29PAVE certificate.A "Program for the Assessment of Veterinary Education Equivalence" 455.30or "PAVE" certificate is issued by the American Association of Veterinary State Boards, 455.31indicating that the holder has demonstrated knowledge and skill equivalent to that 455.32possessed by a graduate of an accredited or approved college of veterinary medicine.455.33    Sec. 27. [156.015] FEES.456.1    Subdivision 1.Verification of licensure.The board may charge a fee of $25 per 456.2license verification to a licensee for verification of licensure status provided to other 456.3veterinary licensing boards.456.4    Subd. 2.Continuing education review.The board may charge a fee of $50 per 456.5submission to a sponsor for review and approval of individual continuing education 456.6seminars, courses, wet labs, and lectures. This fee does not apply to continuing education 456.7sponsors that already meet the criteria for preapproval under Minnesota Rules, part 456.89100.1000, subpart 3, item A.456.9    Sec. 28. Minnesota Statutes 2006, section 156.02, subdivision 1, is amended to read:456.10    Subdivision 1. License application. Application for a license to practice veterinary 456.11medicine in this state shall be made in writing to the Board of Veterinary Medicine upon a 456.12form furnished by the board, accompanied by satisfactory evidence that the applicant is at 456.13least 18 years of age, is of good moral character, and has one of the following:456.14    (1) a diploma conferring the degree of doctor of veterinary medicine, or an 456.15equivalent degree, from an accredited or approved college of veterinary medicine;456.16    (2) an ECFVG or PAVE certificate; or456.17    (3) a certificate from the dean of an accredited or approved college of veterinary 456.18medicine stating that the applicant is a student in good standing expecting to be graduated 456.19at the completion of the current academic year of the college in which the applicant is 456.20enrolled.456.21    The application shall contain the information and material required by subdivision 456.222 and any other information that the board may, in its sound judgment, require. The 456.23application shall be filed with the board at least 60 days before the date of the examination. 456.24If the board deems it advisable, it may require that such application be verified by the 456.25oath of the applicant.456.26    Sec. 29. Minnesota Statutes 2006, section 156.02, subdivision 2, is amended to read:456.27    Subd. 2. Required with application. Every application shall contain the following 456.28information and material:456.29    (1) the application fee set by the board in the form of a check or money order payable 456.30to the board, which fee is not returnable in the event permission to take the examination 456.31is denied for good cause;456.32    (2) a copy of a diploma from an accredited or approved college of veterinary 456.33medicine or a certificate from the dean or secretary of an accredited or approved college of 456.34veterinary medicine showing the time spent in the school and the date when the applicant 457.1was duly and regularly graduated or will duly and regularly graduate or verification of 457.2ECFVG or PAVE certification;457.3    (3) affidavits of at least two veterinarians and three adults who are not related to 457.4the applicant setting forth how long a time, when, and under what circumstances they 457.5have known the applicant, and any other facts as may be proper to enable the board to 457.6determine the qualifications of the applicant; and457.7    (4) if the applicant has served in the armed forces, a copy of discharge papers.457.8    Sec. 30. Minnesota Statutes 2006, section 156.04, is amended to read:457.9156.04 BOARD TO ISSUE LICENSE.457.10    The Board of Veterinary Medicine shall issue to every applicant who has successfully 457.11passed the required examination, who has received a diploma conferring the degree of 457.12doctor of veterinary medicine or an equivalent degree from an accredited or approved 457.13college of veterinary medicine or an ECFVG or PAVE certificate, and who shall have been 457.14adjudged to be duly qualified to practice veterinary medicine, a license to practice.457.15    Sec. 31. Minnesota Statutes 2006, section 156.072, subdivision 2, is amended to read:457.16    Subd. 2. Required with application. Such doctor of veterinary medicine shall 457.17accompany the application by the following:457.18    (1) a copy of a diploma from an accredited or approved college of veterinary 457.19medicine or certification from the dean, registrar, or secretary of an accredited or approved 457.20college of veterinary medicine attesting to the applicant's graduation from an accredited 457.21or approved college of veterinary medicine, or a certificate of satisfactory completion of 457.22the ECFVG or PAVE program.457.23    (2) affidavits of two licensed practicing doctors of veterinary medicine residing in 457.24the United States or Canadian licensing jurisdiction in which the applicant is currently 457.25practicing, attesting that they are well acquainted with the applicant, that the applicant is a 457.26person of good moral character, and has been actively engaged in practicing or teaching in 457.27such jurisdiction for the period above prescribed;457.28    (3) a certificate from the regulatory agency having jurisdiction over the conduct of 457.29practice of veterinary medicine that such applicant is in good standing and is not the 457.30subject of disciplinary action or pending disciplinary action;457.31    (4) a certificate from all other jurisdictions in which the applicant holds a currently 457.32active license or held a license within the past ten years, stating that the applicant is and 457.33was in good standing and has not been subject to disciplinary action;458.1    (5) in lieu of clauses (3) and (4), certification from the Veterinary Information 458.2Verification Agency that the applicant's licensure is in good standing;458.3    (6) a fee as set by the board in form of check or money order payable to the board, 458.4no part of which shall be refunded should the application be denied;458.5    (7) score reports on previously taken national examinations in veterinary medicine, 458.6certified by the Veterinary Information Verification Agency; and458.7    (8) if requesting waiver of examination, provide evidence of meeting licensure 458.8requirements in the state of the applicant's original licensure that were substantially equal 458.9to the requirements for licensure in Minnesota in existence at that time.458.10    Sec. 32. Minnesota Statutes 2006, section 156.073, is amended to read:458.11156.073 TEMPORARY PERMIT.458.12    The board may issue without examination a temporary permit to practice veterinary 458.13medicine in this state to a person who has submitted an application approved by the 458.14board for license pending examination, and holds a doctor of veterinary medicine degree 458.15or an equivalent degree from an approved or accredited college of veterinary medicine 458.16or an ECFVG or PAVE certification. The temporary permit shall expire the day after 458.17publication of the notice of results of the first examination given after the permit is 458.18issued. No temporary permit may be issued to any applicant who has previously failed 458.19the national examination and is currently not licensed in any licensing jurisdiction of the 458.20United States or Canada or to any person whose license has been revoked or suspended 458.21or who is currently subject to a disciplinary order in any licensing jurisdiction of the 458.22United States or Canada.458.23    Sec. 33. Minnesota Statutes 2006, section 156.12, subdivision 2, is amended to read:458.24    Subd. 2. Authorized activities. No provision of this chapter shall be construed to 458.25prohibit:458.26    (a) a person from rendering necessary gratuitous assistance in the treatment of any 458.27animal when the assistance does not amount to prescribing, testing for, or diagnosing, 458.28operating, or vaccinating and when the attendance of a licensed veterinarian cannot be 458.29procured;458.30    (b) a person who is a regular student in an accredited or approved college of 458.31veterinary medicine from performing duties or actions assigned by instructors or 458.32preceptors or working under the direct supervision of a licensed veterinarian;458.33    (c) a veterinarian regularly licensed in another jurisdiction from consulting with a 458.34licensed veterinarian in this state;459.1    (d) the owner of an animal and the owner's regular employee from caring for and 459.2administering to the animal belonging to the owner, except where the ownership of the 459.3animal was transferred for purposes of circumventing this chapter;459.4    (e) veterinarians who are in compliance with subdivision 6 and who are employed by 459.5the University of Minnesota from performing their duties with the College of Veterinary 459.6Medicine, College of Agriculture, Agricultural Experiment Station, Agricultural Extension 459.7Service, Medical School, School of Public Health, or other unit within the university; or 459.8a person from lecturing or giving instructions or demonstrations at the university or in 459.9connection with a continuing education course or seminar to veterinarians or pathologists 459.10at the University of Minnesota Veterinary Diagnostic Laboratory;459.11    (f) any person from selling or applying any pesticide, insecticide or herbicide;459.12    (g) any person from engaging in bona fide scientific research or investigations which 459.13reasonably requires experimentation involving animals;459.14    (h) any employee of a licensed veterinarian from performing duties other than 459.15diagnosis, prescription or surgical correction under the direction and supervision of the 459.16veterinarian, who shall be responsible for the performance of the employee;459.17    (i) a graduate of a foreign college of veterinary medicine from working under the 459.18direct personal instruction, control, or supervision of a veterinarian faculty member of 459.19the College of Veterinary Medicine, University of Minnesota in order to complete the 459.20requirements necessary to obtain an ECFVG or PAVE certificate.459.21    Sec. 34. Minnesota Statutes 2006, section 156.12, subdivision 4, is amended to read:459.22    Subd. 4. Titles. It is unlawful for a person who has not received a professional 459.23degree from an accredited or approved college of veterinary medicine, or ECFVG or PAVE 459.24certification, to use any of the following titles or designations: Veterinary, veterinarian, 459.25animal doctor, animal surgeon, animal dentist, animal chiropractor, animal acupuncturist, 459.26or any other title, designation, word, letter, abbreviation, sign, card, or device tending to 459.27indicate that the person is qualified to practice veterinary medicine.459.28    Sec. 35. Minnesota Statutes 2006, section 156.12, subdivision 6, is amended to read:459.29    Subd. 6. Faculty licensure. (a) Veterinary Medical Center clinicians at the College 459.30of Veterinary Medicine, University of Minnesota, who are engaged in the practice of 459.31veterinary medicine as defined in subdivision 1 and who treat animals owned by clients of 459.32the Veterinary Medical Center must possess the same license required by other veterinary 459.33practitioners in the state of Minnesota except for persons covered by paragraphs (b) and (c).460.1    (b) A specialty practitioner in a hard-to-fill faculty position who has been employed 460.2at the College of Veterinary Medicine, University of Minnesota, for five years or 460.3more prior to 2003 or is specialty board certified by the American Veterinary Medical 460.4Association or the European Board of Veterinary Specialization may be granted a specialty 460.5faculty Veterinary Medical Center clinician license which will allow the licensee to 460.6practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's 460.7training and only within the scope of employment at the Veterinary Medical Center.460.8    (c) A specialty practitioner in a hard-to-fill faculty position at the College of 460.9Veterinary Medicine, University of Minnesota, who has graduated from a board-approved 460.10foreign veterinary school may be granted a temporary faculty Veterinary Medical Center 460.11clinician license. The temporary faculty Veterinary Medical Center clinician license 460.12expires in two years and allows the licensee to practice veterinary medicine as defined 460.13in subdivision 1 and treat animals owned by clients of the Veterinary Medical Center. 460.14The temporary faculty Veterinary Medical Center clinician license allows the licensee to 460.15practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's 460.16training and only within the scope of employment at the Veterinary Medical Center while 460.17under the direct supervision of a veterinarian currently licensed and actively practicing 460.18veterinary medicine in Minnesota, as defined in section 156.04. The direct supervising 460.19veterinarian shall not have any current or past conditions, restrictions, or probationary 460.20status imposed on the veterinarian's license by the board within the past five years. The 460.21holder of a temporary faculty Veterinary Medical Center clinician license who is enrolled 460.22in a PhD program may apply for up to two additional consecutive two-year extensions 460.23of an expiring temporary faculty Veterinary Medical Center clinician license. Any other 460.24holder of a temporary faculty Veterinary Medical Center clinician license may apply for 460.25one two-year extension of the expiring temporary faculty Veterinary Medical Center 460.26clinician license. Temporary faculty Veterinary Medical Center clinician licenses that are 460.27allowed to expire may not be renewed. The board shall grant an extension to a licensee 460.28who demonstrates suitable progress toward completing the requirements of their academic 460.29program, specialty board certification, or full licensure in Minnesota by a graduate of a 460.30foreign veterinary college.460.31    (d) Temporary and specialty faculty Veterinary Medical Center clinician licensees 460.32must abide by all the laws governing the practice of veterinary medicine in the state 460.33of Minnesota and are subject to the same disciplinary action as any other veterinarian 460.34licensed in the state of Minnesota.461.1    (e) The fee for a license issued under this subdivision is the same as for a regular 461.2license to practice veterinary medicine in Minnesota. License payment deadlines, late 461.3payment fees, and other license requirements are also the same as for regular licenses.461.4    Sec. 36. Minnesota Statutes 2006, section 156.15, subdivision 2, is amended to read:461.5    Subd. 2. Service. Service of an order under this section is effective if the order is 461.6served on the person or counsel of record personally or by certified United States mail to 461.7the most recent address provided to the board for the person or counsel of record.461.8    Sec. 37. Minnesota Statutes 2006, section 156.16, subdivision 3, is amended to read:461.9    Subd. 3. Dispensing. "Dispensing" means distribution of veterinary prescription 461.10drugs or over-the-counter drugs for extra-label use or human drugs for extra-label use by a 461.11person licensed as a pharmacist by the Board of Pharmacy or a person licensed by the 461.12Board of Veterinary Medicine.461.13    Sec. 38. Minnesota Statutes 2006, section 156.16, subdivision 10, is amended to read:461.14    Subd. 10. Prescription. "Prescription" means an order from a veterinarian to a 461.15pharmacist or another veterinarian authorizing the dispensing of a veterinary prescription 461.16drug drugs, human drugs for extra-label use, or over-the-counter drugs for extra-label use461.17to a client for use on or in a patient.461.18    Sec. 39. Minnesota Statutes 2006, section 156.18, subdivision 1, is amended to read:461.19    Subdivision 1. Prescription. (a) A person may not dispense a veterinary 461.20prescription drug to a client without a prescription or other veterinary authorization. A 461.21person may not make extra-label use of an animal or human drug for an animal without a 461.22prescription from a veterinarian. A veterinarian or the veterinarian's authorized employee 461.23may dispense a veterinary prescription drug todrugs, human drugs for extra-label use, or 461.24an over-the-counter drug for extra-label use by a client or oversee the extra-label use of 461.25a veterinary drug directly by a client without a separate written prescription, providing 461.26there is documentation of the prescription in the medical record and there is an existing 461.27veterinarian-client-patient relationship. The prescribing veterinarian must monitor the use 461.28of veterinary prescription drugs, human drugs for extra-label use, or over-the-counter 461.29drugs for extra-label use by a client.461.30    (b) A veterinarian may dispense prescription veterinary drugs and prescribe and 461.31dispense extra-label use drugs to a client without personally examining the animal if 462.1a bona fide veterinarian-client-patient relationship exists and in the judgment of the 462.2veterinarian the client has sufficient knowledge to use the drugs properly.462.3    (c) A veterinarian may issue a prescription or other veterinary authorization by oral or 462.4written communication to the dispenser, or by computer connection. If the communication 462.5is oral, the veterinarian must enter it into the patient's record. The dispenser must record 462.6the veterinarian's prescription or other veterinary authorization within 72 hours.462.7    (d) A prescription or other veterinary authorization must include:462.8    (1) the name, address, and, if written, the signature of the prescriber;462.9    (2) the name and address of the client;462.10    (3) identification of the species for which the drug is prescribed or ordered;462.11    (4) the name, strength, and quantity of the drug;462.12    (5) the date of issue;462.13    (6) directions for use; and462.14    (7) withdrawal time., if applicable; and462.15    (8) number of authorized refills.462.16    (e) A veterinarian may, in the course of professional practice and an existing 462.17veterinarian-client-patient relationship, prepare medicaments that combine drugs approved 462.18by the United States Food and Drug Administration and other legally obtained ingredients 462.19with appropriate vehicles.462.20    (f) A veterinarian or a bona fide employee of a veterinarian may dispense veterinary 462.21prescription drugs to a person on the basis of a prescription issued by a licensed 462.22veterinarian. The provisions of paragraphs (c) and (d) apply.462.23    (g) This section does not limit the authority of the Minnesota Racing Commission to 462.24regulate veterinarians providing services at a licensed racetrack.462.25    Sec. 40. Minnesota Statutes 2006, section 156.18, subdivision 2, is amended to read:462.26    Subd. 2. Label of dispensed veterinary drugs. (a) A veterinarian or the 462.27veterinarian's authorized agent or employee dispensing a veterinary prescription drug 462.28or prescribing the extra-label use of an over-the-counter drug, an over-the-counter drug 462.29for extra-label use, or a human drug for extra-label use must provide written information 462.30which includes the name and address of the veterinarian, date of filling, species of patient, 462.31name or names of drug, strength of drug or drugs, directions for use, withdrawal time, 462.32and cautionary statements, if any, appropriate for the drug.462.33    (b) If the veterinary drug has been prepared, mixed, formulated, or packaged by the 462.34dispenser, all of the information required in paragraph (a) must be provided on a label 462.35affixed to the container.463.1    (c) If the veterinary drug is in the manufacturer's original package, the information 463.2required in paragraph (a) must be supplied in writing but need not be affixed to the 463.3container. Information required in paragraph (a) that is provided by the manufacturer on 463.4the original package does not need to be repeated in the separate written information. 463.5Written information required by this paragraph may be written on the sales invoice.463.6    Sec. 41. Minnesota Statutes 2006, section 156.19, is amended to read:463.7156.19 EXTRA-LABEL USE.463.8    A person, other than a veterinarian or a person working under the controlan 463.9employee of a veterinarian, must not make extra-label use of a veterinary drug in or 463.10on a food-producing animal, unless permitted by the prescription of a veterinarian. A 463.11veterinarian may prescribe the extra-label use of a veterinary drug if:463.12    (1) the veterinarian makes a careful medical diagnosis within the context of a valid 463.13veterinarian-client-patient relationship;463.14    (2) the veterinarian determines that there is no marketed drug specifically labeled to 463.15treat the condition diagnosed, or that drug therapy as recommended by the labeling has, in 463.16the judgment of the attending veterinarian, been found to be clinically ineffective;463.17    (3) the veterinarian recommends procedures to ensure that the identity of the treated 463.18animal will be carefully maintained; and463.19    (4) the veterinarian prescribes a significantly extended time period for drug 463.20withdrawal before marketing meat, milk, or eggs.; and463.21    (5) the veterinarian has met the criteria established in Code of Federal Regulations, 463.22title 21, part 530, which define the extra-label use of medication in or on animals.463.23    Sec. 42. Minnesota Statutes 2006, section 198.075, is amended to read:463.24198.075 MINNESOTA VETERANS HOME EMPLOYEES; EXCLUDED 463.25FROM COMMISSARY PRIVILEGES.463.26    Except as provided in this section, no commissary privileges including food, laundry 463.27service, janitorial service, and household supplies shall be furnished to any employee of 463.28the Minnesota veterans homes. An employee of the Minnesota veterans homes who works 463.29a second shift that is consecutive with a regularly scheduled shift may be allowed one free 463.30meal at the veterans home on the day of that extra shift.463.31    Sec. 43. Minnesota Statutes 2006, section 256B.0625, subdivision 14, is amended to 463.32read:464.1    Subd. 14. Diagnostic, screening, and preventive services. (a) Medical assistance 464.2covers diagnostic, screening, and preventive services.464.3    (b) "Preventive services" include services related to pregnancy, including:464.4    (1) services for those conditions which may complicate a pregnancy and which may 464.5be available to a pregnant woman determined to be at risk of poor pregnancy outcome;464.6    (2) prenatal HIV risk assessment, education, counseling, and testing; and464.7    (3) alcohol abuse assessment, education, and counseling on the effects of alcohol 464.8usage while pregnant. Preventive services available to a woman at risk of poor pregnancy 464.9outcome may differ in an amount, duration, or scope from those available to other 464.10individuals eligible for medical assistance.464.11    (c) "Screening services" include, but are not limited to, blood lead tests. Screening 464.12services also include, for children with blood lead levels equal to or greater than five 464.13micrograms of lead per deciliter of whole blood, environmental investigations to 464.14determine the source of lead exposure. Reimbursement is limited to a health professional's 464.15time and activities during an on-site investigation of a child's home or primary residence.464.16    Sec. 44. Minnesota Statutes 2006, section 256B.0625, is amended by adding a 464.17subdivision to read:464.18    Subd. 49.Lead risk assessments.(a) Effective October 1, 2007, or six months after 464.19federal approval, whichever is later, medical assistance covers lead risk assessments 464.20provided by a lead risk assessor who is licensed by the commissioner of health under 464.21section 144.9505 and employed by an assessing agency as defined in section 144.9501. 464.22Medical assistance covers a onetime on-site investigation of a recipient's home or primary 464.23residence to determine the existence of lead so long as the recipient is under the age 464.24of 21 and has a venous blood lead level specified in section 144.9504, subdivision 2, 464.25paragraph (a).464.26    (b) Medical assistance reimbursement covers the lead risk assessor's time to 464.27complete the following activities:464.28    (1) gathering samples;464.29    (2) interviewing family members;464.30    (3) gathering data, including meter readings; and464.31    (4) providing a report with the results of the investigation and options for reducing 464.32lead-based paint hazards.464.33    Medical assistance coverage of lead risk assessment does not include testing of 464.34environmental substances such as water, paint, or soil or any other laboratory services. 464.35Medical assistance coverage of lead risk assessments is not included in the capitated 465.1services for children enrolled in health plans through the prepaid medical assistance 465.2program and the MinnesotaCare program.465.3    (c) Payment for lead risk assessment must be cost-based and must meet the criteria 465.4for federal financial participation under the Medicaid program. The rate must be based 465.5on allowable expenditures from cost information gathered. Under section 144.9507, 465.6subdivision 5, federal medical assistance funds may not replace existing funding for 465.7lead-related activities. The nonfederal share of costs for services provided under this 465.8subdivision must be from state or local funds and is the responsibility of the agency 465.9providing the risk assessment. Eligible expenditures for the nonfederal share of costs may 465.10not be made from federal funds or funds used to match other federal funds. Any federal 465.11disallowances are the responsibility of the agency providing risk assessment services.465.12    Sec. 45. [325E.385] PRODUCTS CONTAINING POLYBROMINATED 465.13DIPHENYL ETHER.465.14    Subdivision 1.Definitions.For the purposes of sections 325E.386 to 325E.388, 465.15the terms in this section have the meanings given them.465.16    Subd. 2.Commercial decabromodiphenyl ether."Commercial 465.17decabromodiphenyl ether" means the chemical mixture of decabromodiphenyl ether, 465.18including associated polybrominated diphenyl ether impurities not intentionally added.465.19    Subd. 3.Commissioner."Commissioner" means the commissioner of the Pollution 465.20Control Agency.465.21    Subd. 4.Manufacturer."Manufacturer" means any person, firm, association, 465.22partnership, corporation, governmental entity, organization, or joint venture that produces 465.23a product containing polybrominated diphenyl ethers or an importer or domestic 465.24distributor of a noncomestible product containing polybrominated diphenyl ethers.465.25    Subd. 5.Polybrominated diphenyl ethers or PBDE's."Polybrominated diphenyl 465.26ethers" or "PBDE's" means chemical forms that consist of diphenyl ethers bound with 465.27bromine atoms. Polybrominated diphenyl ethers include, but are not limited to, the 465.28three primary forms of the commercial mixtures known as pentabromodiphenyl ether, 465.29octabromodiphenyl ether, and decabromodiphenyl ether.465.30    Subd. 6.Retailer."Retailer" means a person who offers a product for sale at retail 465.31through any means, including, but not limited to, remote offerings such as sales outlets, 465.32catalogs, or the Internet, but does not include a sale that is a wholesale transaction with a 465.33distributor or a retailer.466.1    Subd. 7.Used product."Used product" means any product that has been previously 466.2owned, purchased, or sold in commerce. Used product does not include any product 466.3manufactured after January 1, 2008.466.4    Sec. 46. [325E.386] PRODUCTS CONTAINING CERTAIN 466.5POLYBROMINATED DIPHENYL ETHERS BANNED; EXEMPTIONS.466.6    Subdivision 1.Penta- and octabromodiphenyl ethers.Except as provided in 466.7subdivision 3, beginning January 1, 2008, a person may not manufacture, process, or 466.8distribute in commerce a product or flame-retardant part of a product containing more 466.9than one-tenth of one percent of pentabromodiphenyl ether or octabromodiphenyl ether 466.10by mass.466.11    Subd. 2.Exemptions.The following products containing polybrominated diphenyl 466.12ethers are exempt from subdivision 1:466.13    (1) the sale or distribution of any used transportation vehicle with component parts 466.14containing polybrominated diphenyl ethers;466.15    (2) the sale or distribution of any used transportation vehicle parts or new 466.16transportation vehicle parts manufactured before January 1, 2008, that contain 466.17polybrominated diphenyl ethers;466.18    (3) the manufacture, sale, repair, distribution, maintenance, refurbishment, or 466.19modification of equipment containing polybrominated diphenyl ethers and used primarily 466.20for military or federally funded space program applications. This exemption does not 466.21cover consumer-based goods with broad applicability;466.22    (4) the sale or distribution by a business, charity, public entity, or private party of 466.23any used product containing polybrominated diphenyl ethers;466.24    (5) the manufacture, sale, or distribution of new carpet cushion made from recycled 466.25foam containing more than one-tenth of one percent penta polybrominated diphenyl 466.26ether; or466.27    (6) medical devices.466.28    In-state retailers in possession of products on January 1, 2008, that are banned for 466.29sale under subdivision 1 may exhaust their stock through sales to the public. Nothing in 466.30this section restricts the ability of a manufacturer, importer, or distributor  from transporting 466.31products containing polybrominated diphenyl ethers through the state,  or storing such 466.32products in the state for later distribution outside the state.466.33    Sec. 47. [325E.387] REVIEW OF DECABROMODIPHENYL ETHER.467.1    Subdivision 1.Commissioner duties.The commissioner in consultation 467.2with the commissioners of health and public safety shall review uses of commercial 467.3decabromodiphenyl ether, availability of technically feasible and safer alternatives, fire 467.4safety and any evidence regarding the potential harm to public health and the environment 467.5posed by commercial decabromodiphenyl ether and the alternatives. The commissioner 467.6must consult with key stakeholders. The commissioner must also review the findings from 467.7similar state and federal agencies and must report their findings and recommendations to 467.8the appropriate committees of the legislature no later than January 15, 2008.467.9    Subd. 2.State procurement.By January 1, 2008, the commissioner of 467.10administration shall make available for purchase and use by all state agencies only 467.11equipment, supplies, and other products that do not contain polybrominated diphenyl 467.12ethers, unless exempted under section 325E.386, subdivision 2.467.13    Sec. 48. [325E.388] PENALTIES.467.14    A manufacturer who violates sections 325E.386 to 325E.388 is subject to a 467.15civil penalty not to exceed $1,000 for each violation in the case of a first offense. A 467.16manufacturer is subject to a civil penalty not to exceed $5,000 for each repeat offense. 467.17Penalties collected under this section must be deposited in an account in the special 467.18revenue fund and are appropriated in fiscal years 2008 and 2009 to the commissioner to 467.19implement and enforce this section.467.20    Sec. 49. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2, 467.21is amended to read:

467.22467.23Subd. 2.Community and Family Health Improvement

467.24Summary by Fund467.25General40,413,00040,382,000467.26467.27State Government 
                  		Special Revenue141,000128,000467.28Health Care Access3,510,0003,516,000467.29Federal TANF6,000,0006,000,000

467.30Family Planning Base Reduction. Base 467.31level funding for the family planning 467.32special projects grant program is reduced 467.33by $1,877,000 each year of the biennium 467.34beginning July 1, 2007, provided that 467.35this reduction shall only take place 468.1upon full implementation of the family 468.2planning project section of the 1115 waiver. 468.3Notwithstanding Minnesota Statutes, section 468.4145.925, the commissioner shall give priority 468.5to community health care clinics providing 468.6family planning services that either serve a 468.7high number of women who do not qualify 468.8for medical assistance or are unable to 468.9participate in the medical assistance program 468.10as a medical assistance provider when 468.11allocating the remaining appropriations. 468.12Notwithstanding section 15, this paragraph 468.13shall not expire.468.14Shaken Baby Video. Of the state 468.15government special revenue fund 468.16appropriation, $13,000 in 2006 is 468.17appropriated to the commissioner of health 468.18to provide a video to hospitals on shaken 468.19baby syndrome. The commissioner of health 468.20shall assess a fee to hospitals to cover the 468.21cost of the approved shaken baby video and 468.22the revenue received is to be deposited in the 468.23state government special revenue fund.468.24    Sec. 50. FUNDING FOR ENVIRONMENTAL JUSTICE MAPPING.468.25    The commissioner of health, in conjunction with the commissioner of the Pollution 468.26Control Agency, shall establish an environmental justice mapping program and shall 468.27apply for federal funding to renew and expand the state's environmental justice mapping 468.28capacity in order to promote public health tracking. The commissioner shall coordinate 468.29the project with the Pollution Control Agency and the Department of Agriculture in order 468.30to explore possible links between environmental health and toxic exposures and to help 468.31create a system for environmental public health tracking. The commissioner shall also 468.32make recommendations to the legislature for additional sources of funding within the state.468.33EFFECTIVE DATE.This section is effective the day following final enactment.469.1    Sec. 51. LEGISLATIVE FINDINGS AND PURPOSE.469.2    The legislature hereby finds that hearing loss occurs in newborn infants more 469.3frequently than any other health condition for which newborn infant screening is required. 469.4Early detection of hearing loss in a child and early intervention and treatment has been 469.5demonstrated to be highly effective in facilitating a child's healthy development in a 469.6manner consistent with the child's age, language acquisition, and cognitive ability. 469.7Without early hearing detection and intervention, children with hearing loss experience 469.8serious delays in language acquisition and social and cognitive development. With 469.9appropriate testing and identification of newborn infants, hearing loss screening will 469.10facilitate early intervention and treatment and will serve the public purpose of promoting 469.11the healthy development of children.469.12    For these reasons, the legislature hereby determines that it is beneficial and in the 469.13best interests of the development of the children of the state of Minnesota that newborn 469.14infants' hearing be screened.469.15    Sec. 52. INFORMATION SHARING.469.16    By August 1, 2007, the commissioner of health, the Pollution Control Agency, the 469.17commissioner of agriculture, and the University of Minnesota are requested to jointly 469.18develop and sign a memorandum of understanding declaring their intent to share new 469.19and existing environmental hazard, exposure, and health outcome data, consistent with 469.20applicable data practices laws, and to cooperate and communicate effectively to ensure 469.21sufficient clarity and understanding of the data between these organizations.469.22    Sec. 53. COMMISSIONER OF HEALTH REPORT; ROUTINE RADIATION 469.23EMISSIONS.469.24    The commissioner of health, within the limits of available appropriations, in 469.25cooperation with the utilities that own the Monticello and Prairie Island nuclear plants, 469.26shall issue a report detailing where routine radiation releases go and the health impacts of 469.27the radiation emissions on affected communities. By April 1, 2008, the report must be 469.28distributed to house and senate committees having jurisdiction over public health and to 469.29all communities that are part of the emergency response planning.469.30    Sec. 54. FRAGRANCE-FREE SCHOOLS EDUCATION PILOT PROJECT.469.31    Subdivision 1.Purpose.Recognizing that scented products may trigger asthma or 469.32chemical sensitivity reactions in students and school staff, which can contribute to learning 470.1and breathing problems, the commissioner of health shall develop a fragrance-free schools 470.2education pilot project.470.3    Subd. 2.Education.The commissioner of health, in collaboration with the 470.4commissioner of education and the Minneapolis Board of Education, shall establish a 470.5working group composed of at least three students, two teachers, one school administrator, 470.6and one member of the Minneapolis Board of Education to recommend an education 470.7campaign in Minneapolis public schools to inform students and parents about the 470.8potentially harmful effects of the use of fragrance products on sensitive students and 470.9school personnel in Minneapolis schools. The commissioner shall report findings to the 470.10legislature by February 1, 2008.470.11EFFECTIVE DATE.This section is effective the day following final enactment.470.12    Sec. 55. LINDANE COMMITTEE.470.13    The commissioner of health shall create a committee of stakeholders, including 470.14at least one environmental health research scientist and at least one parent consumer 470.15advocate, to review the scientific literature and make recommendations to the legislature 470.16on the health impact of Lindane on children and report back by January 15, 2008.470.17    Sec. 56. MEDICAL ASSISTANCE COVERAGE FOR ARSENIC TESTING.470.18    The commissioner of human services shall ensure that testing for arsenic under 470.19Minnesota Statutes, section 144.967, is covered under medical assistance.470.20    Sec. 57. BLOOD LEAD TESTING STUDY.470.21    The commissioner of health, in consultation with the Department of Human 470.22Services; cities of the first class; health care providers; and other interested parties shall 470.23conduct a study to evaluate blood lead testing methods used to confirm elevated blood 470.24lead status. The study shall examine and/or develop:470.25    (1) the false positive rate of capillary tests for children less than 72 months old;470.26    (2) current protocols for conducting capillary testing, including filter paper 470.27methodology;470.28    (3) existing guidelines and regulations from other states and federal agencies 470.29regarding lead testing;470.30    (4) recommendations regarding the use of capillary tests to initiate environmental 470.31investigations and case management, including number and timing of tests and fiscal 470.32implications for state and local lead programs; and471.1    (5) recommendations regarding reducing the state mandatory intervention to ten 471.2micrograms of lead per deciliter of whole blood.471.3    The commissioner shall submit the results of the study and any recommendations, 471.4including any necessary legislative changes, to the legislature by February 15, 2008.471.5    Sec. 58. WINDOW SAFETY EDUCATION.471.6    The commissioner of health shall create in the department's current educational 471.7safety program a component targeted at parents and caregivers of young children to 471.8provide awareness of the need to take precautions to prevent children from falling 471.9through open windows. The commissioner of health shall consult with representatives 471.10of the residential building industry, the window products industry, the child safety 471.11advocacy community, and the Department of Labor and Industry to create the window 471.12safety program component. The program must include the gathering of data about 471.13falls from windows that result in severe injury in order to measure the effectiveness of 471.14the safety program. The commissioner of health may consult with other child safety 471.15advocacy groups, experts, and interested parties in the development and implementation 471.16of the window safety program. The commissioner of health shall prepare and submit 471.17a final report on the window safety program to the legislature by March 1, 2011. The 471.18commissioner shall prepare and submit a yearly progress report to the legislature by 471.19March 1 of each year beginning in 2008 until the submission of the final report. The 471.20final report must include a summary of the safety program, the impact of the program on 471.21children falling from windows, and any recommendations for further study or action.471.22    Sec. 59. REVISOR'S INSTRUCTION.471.23    The revisor of statutes shall change the range reference "144.9501 to 144.9509" 471.24to "144.9501 to 144.9512" wherever the reference appears in Minnesota Statutes and 471.25Minnesota Rules.471.26    Sec. 60.  REPEALER.471.27Laws 2004, chapter 288, article 6, section 27, is repealed.471.28ARTICLE 11471.29HUMAN SERVICES FORECAST ADJUSTMENTS

471.30471.31Section 1.  SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

472.1    The dollar amounts shown are added to or, if shown in parentheses, are subtracted 472.2from the appropriations in Laws 2006, chapter 282, from the general fund, or any other 472.3fund named, to the Department of Human Services for the purposes specified in this 472.4article, to be available for the fiscal year indicated for each purpose. The figure "2007" 472.5used in this article means that the appropriation or appropriations listed are available 472.6for the fiscal year ending June 30, 2007.

472.72007472.8General Fund$(25,226,000)472.9Health Care Access$(53,980,000)472.10TANF$(24,805,000)472.11Total$(104,011,000)

472.12472.13Sec. 2. COMMISSIONER OF HUMAN SERVICES

472.14Subdivision 1.Total Appropriation$(104,011,000)

472.15Appropriations by Fund472.162007472.17General(25,226,000)472.18Health Care Access(53,980,000)472.19TANF(24,805,000)

472.20Subd. 2.Revenue and Pass Through

472.21TANF(106,000)

472.22472.23Subd. 3.Children and Economic Assistance Grants

472.24General3,221,000472.25TANF(24,699,000)

472.26The amounts that may be spent from this 472.27appropriation for each purpose are as follows:

472.28(a) MFIP/DWP Grants472.29General13,827,000472.30TANF(24,699,000)

472.31(b) MFIP Child Care Assistance Grants472.32General(4,733,000)

472.33(c) General Assistance Grants472.34General1,081,000

473.1(d) Minnesota Supplemental Aid Grants473.2General(1,099,000)

473.3(e) Group Residential Housing Grants473.4General(5,855,000)

473.5Subd. 4.Basic Health Care Grants

473.6General17,592,000473.7Health Care Access(53,980,000)

473.8The amounts that may be spent from this 473.9appropriation for each purpose are as follows:

473.10(a) MinnesotaCare Health Care Access(53,980,000)

473.11(b) MA Basic Health Care - Families and Children473.12General15,729,000

473.13(c) MA Basic Health Care - Elderly and Disabled473.14General(4,540,000)

473.15(d) General Assistance Medical Care473.16General6,403,000

473.17Subd. 5.Continuing Care Grants

473.18General(46,039,000)

473.19The amounts that may be spent from this 473.20appropriation for each purpose are as follows:

473.21(a) MA Long-Term Care Facilities473.22General(15,028,000)

473.23(b) MA Long-Term Care Waivers473.24General(20,677,000)

473.25(c) Chemical Dependency Entitlement Grants473.26General(10,334,000)

473.27    Sec. 3. EFFECTIVE DATE.473.28    Sections 1 and 2 are effective the day following final enactment.473.29ARTICLE 12473.30HUMAN SERVICES APPROPRIATIONS

473.31Section 1. SUMMARY OF APPROPRIATIONS.

474.1    The amounts shown in this section summarize direct appropriations, by fund, made 474.2in this article.

474.320082009Total474.4General$4,559,985,000$4,920,502,000$9,480,487,000474.5474.6State Government Special Revenue13,854,00013,864,00027,718,000474.7Health Care Access432,115,000536,076,000968,191,000474.8Federal TANF244,463,000252,899,000497,362,000474.9Lottery Prize Fund2,184,0001,787,0003,971,000474.10Total$5,252,601,000$5,730,508,000$10,983,109,000

474.11Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

474.12    The sums shown in the columns marked "Appropriations" are appropriated to the 474.13agencies and for the purposes specified in this article. The appropriations are from the 474.14general fund, or another named fund, and are available for the fiscal years indicated 474.15for each purpose. The figures "2008" and "2009" used in this article mean that the 474.16appropriations listed under them are available for the fiscal year ending June 30, 2008, or 474.17June 30, 2009, respectively. "The first year" is fiscal year 2008. "The second year" is fiscal 474.18year 2009. "The biennium" is fiscal years 2008 and 2009. Appropriations for the fiscal 474.19year ending June 30, 2007, are effective the day following final enactment.

474.20APPROPRIATIONS474.21Available for the Year474.22Ending June 30474.2320082009

474.24Sec. 3. HUMAN SERVICES

474.25Subdivision 1.Total Appropriation$5,198,244,000$5,684,723,000

474.26Appropriations by Fund474.2720082009474.28General4,341,800,0004,904,289,000474.29474.30State Government Special Revenue545,000555,000474.31Health Care Access409,252,000519,813,000474.32Federal TANF244,463,000252,899,000474.33Lottery Prize Fund2,184,0001,787,000

474.34The amounts that may be spent for each 474.35purpose are specified in the following 474.36subdivisions.475.1Receipts for Systems Projects.475.2Appropriations and federal receipts for 475.3information system projects for MAXIS, 475.4PRISM, MMIS, and SSIS must be deposited 475.5in the state system account authorized in 475.6Minnesota Statutes, section 256.014. Money 475.7appropriated for computer projects approved 475.8by the Minnesota Office of Enterprise 475.9Technology, funded by the legislature, and 475.10approved by the commissioner of finance, 475.11may be transferred from one project to 475.12another and from development to operations 475.13as the commissioner of human services 475.14considers necessary. Any unexpended 475.15balance in the appropriation for these 475.16projects does not cancel but is available for 475.17ongoing development and operations.475.18Systems Continuity. In the event of 475.19disruption of technical systems or computer 475.20operations, the commissioner may use 475.21available grant appropriations to ensure 475.22continuity of payments for maintaining the 475.23health, safety, and well-being of clients 475.24served by programs administered by the 475.25Department of Human Services. Grant funds 475.26must be used in a manner consistent with the 475.27original intent of the appropriation.475.28Nonfederal Share Transfers. The 475.29nonfederal share of activities for which 475.30federal administrative reimbursement is 475.31appropriated to the commissioner may be 475.32transferred to the special revenue fund.475.33Gifts. Notwithstanding Minnesota 475.34Statutes, sections 16A.013 to 16A.016, the 475.35commissioner may accept, on behalf of the 476.1state, additional funding from sources other 476.2than state funds for the purpose of financing 476.3the cost of assistance program grants or 476.4nongrant administration. All additional 476.5funding is appropriated to the commissioner 476.6for use as designated by the grantor of 476.7funding.476.8TANF Funds Appropriated to Other 476.9Entities. Any expenditures from the TANF 476.10block grant shall be expended according 476.11to the requirements and limitations of part 476.12A of title IV of the Social Security Act, as 476.13amended, and any other applicable federal 476.14requirement or limitation. Prior to any 476.15expenditure of these funds, the commissioner 476.16shall ensure that funds are expended in 476.17compliance with the requirements and 476.18limitations of federal law and that any 476.19reporting requirements of federal law are 476.20met. It shall be the responsibility of any entity 476.21to which these funds are appropriated to 476.22implement a memorandum of understanding 476.23with the commissioner that provides the 476.24necessary assurance of compliance prior to 476.25any expenditure of funds. The commissioner 476.26shall receipt TANF funds appropriated 476.27to other state agencies and coordinate all 476.28related interagency accounting transactions 476.29necessary to implement these appropriations. 476.30Unexpended TANF funds appropriated to 476.31any state, local, or nonprofit entity cancel 476.32at the end of the state fiscal year unless 476.33appropriating or statutory language permits 476.34otherwise.476.35TANF Block Grant. Of this amount, 476.36$750,000 the first year and $750,000 the 477.1second year are onetime appropriations 477.2from the state's federal TANF block grant 477.3under Title I of Public Law 104-193. If the 477.4appropriation in either year is insufficient, the 477.5appropriation for the other year is available.477.6TANF Maintenance of Effort. (a) In 477.7order to meet the basic maintenance of 477.8effort (MOE) requirements of the TANF 477.9block grant specified under Code of Federal 477.10Regulations, title 45, section 263.1, the 477.11commissioner may only report nonfederal 477.12money expended for allowable activities 477.13listed in the following clauses as TANF/MOE 477.14expenditures:477.15(1) MFIP cash, diversionary work program, 477.16and food assistance benefits under Minnesota 477.17Statutes, chapter 256J;477.18(2) the child care assistance programs 477.19under Minnesota Statutes, sections 119B.03 477.20and 119B.05, and county child care 477.21administrative costs under Minnesota 477.22Statutes, section 119B.15;477.23(3) state and county MFIP administrative 477.24costs under Minnesota Statutes, chapters 477.25256J and 256K;477.26(4) state, county, and tribal MFIP 477.27employment services under Minnesota 477.28Statutes, chapters 256J and 256K;477.29(5) expenditures made on behalf of 477.30noncitizen MFIP recipients who qualify 477.31for the medical assistance without federal 477.32financial participation program under 477.33Minnesota Statutes, section 256B.06, 477.34subdivision 4, paragraphs (d), (e), and (j); 477.35and478.1(6) qualifying working family credit 478.2expenditures under Minnesota Statutes, 478.3section 290.0671.478.4(b) The commissioner shall ensure that 478.5sufficient qualified nonfederal expenditures 478.6are made each year to meet the state's 478.7TANF/MOE requirements. For the activities 478.8listed in paragraph (a), clauses (2) to 478.9(6), the commissioner may only report 478.10expenditures that are excluded from the 478.11definition of assistance under Code of 478.12Federal Regulations, title 45, section 260.31.478.13(c) The commissioner shall ensure that 478.14the maintenance of effort used by the 478.15commissioner of finance for the February 478.16and November forecasts required under 478.17Minnesota Statutes, section 16A.103, 478.18contains expenditures under paragraph (a), 478.19clause (1), equal to at least 25 percent of 478.20the total required under Code of Federal 478.21Regulations, title 45, section 263.1.478.22(d) Minnesota Statutes, section 256.011, 478.23subdivision 3, which requires that federal 478.24grants or aids secured or obtained under that 478.25subdivision be used to reduce any direct 478.26appropriations provided by law, does not 478.27apply if the grants or aids are federal TANF 478.28funds.478.29(e) Notwithstanding section 13, this rider 478.30expires June 30, 2011.478.31Working Family Credit Expenditures 478.32as TANF/MOE. The commissioner may 478.33claim as TANF maintenance of effort up 478.34to $6,707,000 per year for fiscal year 2008 479.1through fiscal year 2011. Notwithstanding 479.2section 13, this rider expires June 30, 2011.479.3Additional Working Family Credit 479.4Expenditures to be Claimed for 479.5TANF/MOE. In addition to the amounts 479.6provided in this section, the commissioner 479.7may count the following amounts of working 479.8family credit expenditure as TANF/MOE:479.9(1) fiscal year 2008, $4,269,000; and479.10(2) fiscal year 2009, $4,889,000.479.11Notwithstanding section 13, this rider expires 479.12June 30, 2011.479.13Capitation Rate Increase. Of the health care 479.14access fund appropriations to the University 479.15of Minnesota in the higher education 479.16omnibus appropriation bill, $2,157,000 in 479.17fiscal year 2008 and $2,157,000 in fiscal year 479.182009 are to be used to increase the capitation 479.19payments under Minnesota Statutes, section 479.20256B.69. 479.21Health Care Access Fund Transfer.479.22Notwithstanding Minnesota Statutes, section 479.23295.581, in addition to the transfers in 479.24Minnesota Statutes, section 16A.724, 479.25subdivision 2, the commissioner of finance 479.26shall transfer up to the following amounts 479.27from the health care access fund to the 479.28general fund on June 30 of each fiscal year:479.29(1) fiscal year 2008, $6,416,000;479.30(2) fiscal year 2009, $5,643,000;479.31(3) fiscal year 2010, $6,677,000; and479.32(4) fiscal year 2011, $7,866,000.480.1Notwithstanding section 13, this rider expires 480.2June 30, 2011.

480.3Subd. 2.Agency Management57,495,00057,696,000

480.4Appropriations by Fund480.5General48,181,00048,417,000480.6480.7State Government Special Revenue424,000432,000480.8Health Care Access8,018,0007,975,000480.9Federal TANF222,000222,000

480.10The amounts that may be spent from the 480.11appropriation for each purpose are as follows:

480.12(a) Financial Operations

480.13Appropriations by Fund480.14General7,102,0007,523,000480.15Health Care Access889,000880,000480.16Federal TANF122,000122,000

480.17(b) Legal and Regulation Operations

480.18Appropriations by Fund480.19General12,805,00012,673,000480.20480.21State Government Special Revenue424,000432,000480.22Health Care Access891,000908,000480.23Federal TANF100,000100,000

480.24Base Adjustment. The general fund base is 480.25decreased by $177,000 in fiscal year 2010 480.26and $353,000 in fiscal year 2011 for legal 480.27and regulatory.480.28Child Care Licensing. $697,000 is 480.29appropriated from the general fund to 480.30the commissioner of human services for 480.31the biennium beginning July 1, 2007, for 480.32purposes of completing background studies 480.33for family and group family child care 480.34providers under Minnesota Statutes, chapter 480.35245C. This appropriation will be $288,000 in 481.1fiscal year 2010 and $112,000 in fiscal year 481.22011.

481.3(c) Management Operations

481.4Appropriations by Fund481.5General4,390,0004,433,000481.6Health Care Access234,000238,000

481.7(d) Information Technology Operations

481.8Appropriations by Fund481.9General23,884,00023,788,000481.10Health Care Access6,004,0005,949,000

481.11481.12Subd. 3.Revenue and Pass-Through Expenditures56,509,00056,897,000

481.13Federal TANF56,509,00056,897,000

481.14TANF Transfer to Federal Child Care 481.15and Development Fund. The following 481.16TANF fund amounts are appropriated to 481.17the commissioner for the purposes of MFIP 481.18transition year child care under MFIP, 481.19Minnesota Statutes, section 119B.05:481.20(1) fiscal year 2008, $9,478,000481.21(2) fiscal year 2009, $13,022,000481.22(3) fiscal year 2010, $3,332,000 and481.23(4) fiscal year 2011, $4,668,000.481.24The commissioner shall authorize transfer 481.25of sufficient TANF funds to the federal 481.26child care and development fund to meet 481.27this appropriation and shall ensure that all 481.28transferred funds are expended according 481.29the federal child care and development fund 481.30regulations.

481.31481.32Subd. 4.Children and Economic Assistance Grants603,305,000581,714,000

481.33Appropriations by Fund481.34General416,519,000387,330,000482.1Federal TANF186,536,000194,584,000482.2Health Care Access250,000-0-

482.3The amounts that may be spent from this 482.4appropriation for each purpose are as follows:

482.5(a) MFIP/DWP Grants

482.6Appropriations by Fund482.7General62,000,00061,911,000482.8Federal TANF82,532,00090,003,000

482.9(b) Support Services Grants

482.10Appropriations by Fund482.11General8,815,0009,465,000482.12Federal TANF103,382,000103,382,000

482.13TANF Prior Appropriation Cancellation.482.14Notwithstanding Laws 2001, First Special 482.15Session chapter 9, article 17, section 482.162, subdivision 11, paragraph (b), any 482.17unexpended TANF funds appropriated to the 482.18commissioner to contract with the Board of 482.19Trustees of Minnesota State Colleges and 482.20Universities, to provide tuition waivers to 482.21employees of health care and human service 482.22providers that are members of qualifying 482.23consortia operating under Minnesota 482.24Statutes, sections 116L.10 to 116L.15, must 482.25cancel at the end of fiscal year 2007.482.26MFIP Pilot Program. Of the general fund 482.27appropriation, $100,000 in fiscal year 2008 482.28and $750,000 in fiscal year 2009 are for a 482.29grant to the Stearns-Benton Employment and 482.30Training Council for the Workforce U pilot 482.31program.482.32Work Study. $750,000 in fiscal year 482.332008 and $750,000 in fiscal year 2009 are 482.34appropriated from the TANF reserve account 483.1to the Minnesota Office of Higher Education 483.2for work study grants under Minnesota 483.3Statutes, section 136A.233, specifically 483.4for low-income individuals who receive 483.5assistance under Minnesota Statutes, chapter 483.6256J.

483.7(c) MFIP Child Care Assistance Grants

483.8General337,000553,000483.9Federal TANF32,000609,000

483.10(d) Child Support Enforcement Grants

483.11General11,705,0003,705,000

483.12Child Support Enforcement. $8,000,000 483.13for fiscal year 2008 is to make grants to 483.14counties for child support enforcement 483.15programs to make up for the loss under the 483.162006 federal Deficit Reduction Act of federal 483.17matching funds for federal incentive funds 483.18passed on to the counties by the state.483.19This appropriation is available until spent.

483.20483.21(e) Basic Sliding Fee Child Care Assistance Grants

483.22General43,012,00045,432,000

483.23Base Adjustment. The general fund base is 483.24increased by $3,583,000 in fiscal year 2010 483.25and $1,334,000 in fiscal year 2011 for basic 483.26sliding fee child care assistance grants.

483.27(f) Child Care Development Grants

483.28General5,865,0005,865,000

483.29Child Care Services Grants. $5,000,000 483.30is appropriated from the general fund to 483.31the commissioner of human services for 483.32the biennium beginning July 1, 2007, for 483.33purposes of providing child care services 484.1grants under Minnesota Statutes, section 484.2119B.21, subdivision 5. This appropriation 484.3is for the 2008-2009 biennium only, and does 484.4not increase the base funding.484.5Early Childhood Professional 484.6Development System. $2,000,000 is 484.7appropriated from the general fund to 484.8the commissioner of human services for 484.9the biennium beginning July 1, 2007, for 484.10purposes of the early childhood professional 484.11development system, which increases the 484.12quality and continuum of professional 484.13development opportunities for child care 484.14practitioners. This appropriation is for the 484.152008-2009 biennium only, and does not 484.16increase the base funding.484.17Family, Friend, and Neighbor Grant 484.18Program. $750,000 in fiscal year 2008 and 484.19$750,000 in fiscal year 2009 are appropriated 484.20from the general fund to the commissioner 484.21of human services for the family, friend, 484.22and neighbor grant program in section 31. 484.23Any balance in the first year does not cancel 484.24but is available in the second year. This 484.25appropriation is for the 2008-2009 biennium 484.26only, and does not increase the base funding. 484.27(g) Increased Child Care Provider 484.28Connections. (1) $200,000 is appropriated 484.29from the general fund to the commissioner of 484.30human services for the biennium beginning 484.31July 1, 2007, for the following purposes: 484.32$100,000 each year is for a grant to Hennepin 484.33County, and  $100,000 each year is for a grant 484.34to Ramsey County. The two counties shall 484.35each contract with a nonprofit organization 485.1to work with the contracting county 485.2and county-based licensed family child 485.3care providers to facilitate county-based 485.4information regarding family and children's 485.5resources and to make training and peer 485.6support available to licensed family child 485.7care providers consistent with clause (2). 485.8These appropriations are available until 485.9June 30, 2009, and shall not become part 485.10of base-level funding for the biennium 485.11beginning July 1, 2009.485.12(2) Programs to improve child care provider 485.13connections to county services shall be 485.14established in Hennepin and Ramsey 485.15counties to:485.16(i) improve county contact activities 485.17with county-licensed family child care 485.18providers that facilitate utilization of county 485.19educational, social service, public health, 485.20and economic assistance services by eligible 485.21families, parents, and children using licensed 485.22family child care; and485.23(ii) support licensed family child care 485.24providers to qualify as quality-rated child 485.25care providers through peer support and 485.26coaching networks. 485.27Hennepin and Ramsey Counties shall 485.28contract with a nonprofit organization under 485.29clause (1) that utilizes licensed family child 485.30care providers as contacts for families using 485.31licensed family child care and to provide 485.32peer support to licensed family child care 485.33providers.485.34(3) Hennepin and Ramsey Counties must 485.35report back on successful strategies for 486.1increasing contact with county-based 486.2licensed family child care providers and 486.3report their findings to the appropriate 486.4legislative committees by February 15, 2010.

486.5(h) Children's Services Grants

486.6Appropriations by Fund486.7General62,745,00073,133,000486.8Health Care Access250,000-0-

486.9Base Adjustment. The general fund base 486.10is decreased by $673,000 in fiscal year 486.112010 and $670,000 in fiscal year 2011 for 486.12children's services grants.486.13Privatized Adoption Grants. Federal 486.14reimbursement for privatized adoption grant 486.15and foster care recruitment grant expenditures 486.16is appropriated to the commissioner for 486.17adoption grants and foster care and adoption 486.18administrative purposes.486.19Adoption Assistance Incentive Grants.486.20Federal funds available during fiscal year 486.212008 and fiscal year 2009 for the adoption 486.22incentive grants are appropriated to the 486.23commissioner for these purposes.486.24Adoption Assistance and Relative Custody 486.25Assistance. The commissioner may transfer 486.26unencumbered appropriation balances for 486.27adoption assistance and relative custody 486.28assistance between fiscal years and between 486.29programs.486.30Adoption Assistance and Relative 486.31Custody Assistance Subsidy Payment 486.32Increase. Notwithstanding Minnesota 486.33Rules, part 9560.0083, subparts 5 and 6, the 486.34commissioner shall increase the payment 486.35schedules for basic and supplemental 487.1maintenance needs subsidies by 3.95 percent 487.2effective July 1, 2007. The commissioner 487.3may make cost-neutral adjustments between 487.4schedules and between brackets within 487.5schedules to allow for whole-dollar bracket 487.6levels and account for differential cost 487.7increases in caring for children with special 487.8needs. Counties have until December 31, 487.92007, to implement the relative custody 487.10assistance payment increases and shall make 487.11payment adjustments retroactive to July 1, 487.122007.487.13Crisis Nurseries. $1,100,000 in fiscal year 487.142008 and $1,100,000 in fiscal year 2009 are 487.15appropriated from the general fund for the 487.16crisis nurseries program. Of this amount, 487.17$100,000 each year is to be made available 487.18for capacity development and technical 487.19support for crisis nurseries.487.20Respite Care. Of the general fund 487.21appropriation, $1,250,000 in fiscal year 487.222008 and $2,500,000 in fiscal year 2009 are 487.23to the commissioner of human services to 487.24fund respite care for children who have a 487.25diagnosis of emotional disturbance or severe 487.26emotional disturbance.487.27Childhood Trauma; Grants. Of the general 487.28fund appropriation, $125,000 in fiscal year 487.292008 and $250,000 in fiscal year 2009 are 487.30to the commissioner of human services to 487.31make grants for the purpose of maintaining 487.32and expanding evidence-based practices that 487.33support children and youth who have been 487.34exposed to violence or who are refugees.488.1Collaborative Services for High-Risk 488.2Children. Of the general fund appropriation, 488.3$2,632,000 in fiscal year 2008 and 488.4$6,150,000 in fiscal year 2009 are to the 488.5commissioner of human services to fund 488.6early intervention collaborative programs.488.7Evidence-Based Practice. Of the general 488.8fund appropriation, $2,175,000 in fiscal year 488.92008 and $4,350,000 in fiscal year 2009 488.10are to the commissioner of human services 488.11to develop and implement evidence-based 488.12practice in children's mental health care and 488.13treatment.488.14MFIP and Children's Mental Health Pilot 488.15Project. Of the general fund appropriation, 488.16$100,000 in fiscal year 2008 and $200,000 488.17in fiscal year 2009 are to the commissioner 488.18of human services to fund the MFIP and 488.19children's mental health pilot project.488.20Regional Children's Mental Health 488.21Initiative. $700,000 in fiscal year 2008 and 488.22$700,000 in fiscal year 2009 are appropriated 488.23to the commissioner of human services to 488.24fund the Regional Children's Mental Health 488.25Initiative pilot project. This is a onetime 488.26appropriation.488.27Child Safety Efforts. $1,000,000 in fiscal 488.28year 2008 and $1,000,000 in fiscal year 2009 488.29are appropriated to counties based on their 488.30population of residents under age 18. Funds 488.31are to be used to maintain and improve child 488.32safety services. By February 1, 2008, each 488.33county shall submit a report regarding current 488.34child safety efforts, child safety funding, and 488.35unmet needs including investments needed. 489.1The report shall also include methods and 489.2community partners available to ensure 489.3early identification of at-risk families. The 489.4Association of Minnesota Counties and 489.5county agencies shall develop a uniform 489.6report structure so that statewide data can 489.7be easily summarized. This is a onetime 489.8appropriation.489.9Fetal Alcohol Syndrome. Of the general 489.10fund appropriation, $75,000 in fiscal year 489.112008 and $75,000 in fiscal year 2009 are 489.12for three programs that provide services 489.13to reduce fetal alcohol syndrome under 489.14Minnesota Statutes, section 145.9266. The 489.15three program grantees are the University 489.16of Minnesota, the Meeker-McLeod-Sibley 489.17Community, and the American Indian Family 489.18Center. This appropriation shall become part 489.19of the base appropriation.489.20Base Adjustment. The general fund base is 489.21increased by $366,000 in fiscal year 2010 and 489.22$369,000 in fiscal year 2011 for children's 489.23services grants.

489.24(i) Children and Community Services Grants

489.25General110,802,00069,567,000

489.26Base Adjustment. The general fund base is 489.27increased by $99,000 in each of fiscal years 489.282010 and 2011 for children and community 489.29services grants.489.30Targeted Case Management Temporary 489.31Funding. Of the general fund appropriation, 489.32$40,000,000 in fiscal year 2008 is allocated to 489.33counties and tribes affected by reductions in 489.34targeted case management federal Medicaid 489.35revenue as a result of the provisions in 490.1the federal Deficit Reduction Act of 2005, 490.2Public Law 109-171. The commissioner 490.3shall distribute the funds proportionate 490.4to each affected county or tribe's targeted 490.5case management federal earnings for 490.6calendar year 2005. Prior to distribution 490.7of funds, the commissioner shall estimate 490.8and certify the amount by which the federal 490.9regulations will reduce case management 490.10revenue over the 2008-2009 biennium. The 490.11commissioner may provide grants up to the 490.12amount of the estimated reduction, not to 490.13exceed $40,000,000 for the biennium. The 490.14commissioner may determine the timing and 490.15frequency of payments to counties. These 490.16funds are available in either year of the 490.17biennium. Counties shall use these funds to 490.18pay for social service-related costs, but the 490.19funds are not subject to provisions of the 490.20Children and Community Services Act grant 490.21under Minnesota Statutes, chapter 256M.490.22Child Welfare Project. Of the general fund 490.23appropriation, $2,000,000 for the biennium 490.24beginning July 1, 2007, is for expanding 490.25the American Indian chid welfare project 490.26under Minnesota Statutes, section 256.01, 490.27subdivision 14b, to include the Red Lake 490.28Band of Chippewa Indians Tribe, provided 490.29the tribe meets the criteria in Minnesota 490.30Statutes, section 256.01, subdivision 14b.

490.31(j) General Assistance Grants

490.32General37,876,00038,253,000

490.33General Assistance Standard. The 490.34commissioner shall set the monthly standard 490.35of assistance for general assistance units 491.1consisting of an adult recipient who is 491.2childless and unmarried or living apart 491.3from parents or a legal guardian at $203. 491.4The commissioner may reduce this amount 491.5according to Laws 1997, chapter 85, article 491.63, section 54.491.7Emergency General Assistance. The 491.8amount appropriated for emergency general 491.9assistance funds is limited to no more 491.10than $7,889,812 in fiscal year 2008 and 491.11$7,889,812 in fiscal year 2009. Funds 491.12to counties must be allocated by the 491.13commissioner using the allocation method 491.14specified in Minnesota Statutes, section 491.15256D.06.

491.16(k) Minnesota Supplemental Aid Grants

491.17General30,798,00031,439,000

491.18Emergency Minnesota Supplemental 491.19Aid Funds. The amount appropriated for 491.20emergency Minnesota supplemental aid 491.21funds is limited to no more than $1,100,000 491.22in fiscal year 2008 and $1,100,000 in fiscal 491.23year 2009. Funds to counties must be 491.24allocated by the commissioner using the 491.25allocation method specified in Minnesota 491.26Statutes, section 256D.46.

491.27(l) Group Residential Housing Grants

491.28General91,441,00099,304,000

491.29Base Adjustment. The general fund base is 491.30increased by $6,665,000 in fiscal year 2010 491.31and $13,419,000 in fiscal year 2011.491.32People Incorporated. $460,000 in fiscal 491.33year 2008 and $460,000 in fiscal year 2009 491.34are appropriated from the general fund to the 492.1commissioner of human services to augment 492.2community support and mental health 492.3services provided to individuals residing in 492.4facilities under Minnesota Statutes, section 492.5256I.05, subdivision 1h.

492.6492.7(m) Other Children and Economic Assistance Grants

492.8Federal TANF590,000590,000

492.9New Chance. $140,000 in fiscal year 492.102008 and $140,000 in fiscal year 2009 are 492.11appropriated from federal TANF funds to the 492.12Hennepin County new chance program.492.13Mothers First. Of the TANF appropriation, 492.14$450,000 in fiscal year 2008 and $450,000 492.15in fiscal year 2009 are to fund the Ramsey 492.16County mothers first program. The 492.17appropriations are available until spent and 492.18are a onetime appropriation.492.19Homeless and Runaway Youth. $3,500,000 492.20in the first year and $3,500,000 in the second 492.21year are for the Runaway and Homeless 492.22Youth Act under Minnesota Statutes, section 492.23256K.45. Funds shall be spent in each area 492.24of the continuum of care to ensure that 492.25programs are meeting the greatest need. The 492.26base is decreased by $2,000,000 each year in 492.27fiscal year 2010 and fiscal year 2011. 492.28Transitional Housing and Emergency 492.29Services.492.30(1) $750,000 each year from the federal 492.31TANF fund is for transitional housing 492.32programs under Minnesota Statutes, section 492.33256E.33. The TANF appropriations 492.34are onetime. The general fund base for 492.35transitional housing is increased by $422,000 493.1each year for the fiscal 2010-2011 biennium. 493.2Up to ten percent of this appropriation may 493.3be used for housing and services which 493.4extend beyond 24 months. $300,000 in each 493.5year of this amount is for grants for safe 493.6housing pilot projects for battered women 493.7and families in Anoka County, Houston 493.8County, and Beltrami County; and493.9(2) $527,000 each year is added to the 493.10base for emergency services grants under 493.11Laws 1997, chapter 162, article 3, section 493.127. The base for emergency services grants 493.13is decreased each year by $300,000 in fiscal 493.14year 2010 and fiscal year 2011.493.15Foodshelf Programs. $575,000 each year 493.16is added to the base for foodshelf programs 493.17under Minnesota Statutes, section 256E.34. 493.18The base is decreased by $250,000 each year 493.19in fiscal year 2010 and fiscal year 2011.493.20Long-term Homeless Services. $2,440,000 493.21each year is added to the base for the 493.22long-term homeless services under 493.23Minnesota Statutes, section 256K.26. The 493.24base is decreased by $1,000,000 each year in 493.25fiscal year 2010 and fiscal year 2011.493.26Minnesota Community Action Grants.493.27$1,500,000 each year is added to the base for 493.28the purposes of Minnesota community action 493.29grants under Minnesota Statutes, sections 493.30256E.30 to 256E.32. The base is reduced by 493.31$500,000 each year in fiscal year 2010 and 493.32fiscal year 2011.493.33Tenant Hotline Services Program. $50,000 493.34each year is added to the base for a grant to 494.1HOME Line for the tenant hotline services 494.2program. This is a onetime appropriation.

494.3494.4Subd. 5.Children and Economic Assistance Management46,507,00046,590,000

494.5Appropriations by Fund494.6General44,964,00045,040,000494.7Health Care Access347,000354,000494.8Federal TANF1,196,0001,196,000

494.9The amounts that may be spent from the 494.10appropriation for each purpose are as follows:

494.11494.12(a) Children and Economic Assistance Administration

494.13Appropriations by Fund494.14General9,321,0009,318,000494.15Federal TANF1,196,0001,196,000

494.16494.17(b) Children and Economic Assistance Operations

494.18Appropriations by Fund494.19General35,643,00035,722,000494.20Health Care Access347,000354,000

494.21Spending Authority for Food Stamps 494.22Bonus Awards. In the event that Minnesota 494.23qualifies for the United States Department 494.24of Agriculture Food and Nutrition Services 494.25Food Stamp Program performance bonus 494.26awards, the funding is appropriated to the 494.27commissioner. The commissioner shall 494.28retain 25 percent of the funding, with the 494.29other 75 percent divided among the counties 494.30according to a formula that takes into account 494.31each county's impact on state performance in 494.32the applicable bonus categories.494.33Child Support Payment Center. Payments 494.34to the commissioner from other governmental 494.35units, private enterprises, and individuals 494.36for services performed by the child support 495.1payment center must be deposited in the state 495.2systems account authorized under Minnesota 495.3Statutes, section 256.014. These payments 495.4are appropriated to the commissioner for the 495.5operation of the child support payment center 495.6or system, according to Minnesota Statutes, 495.7section 256.014.495.8Financial Institution Data Match and 495.9Payment of Fees. The commissioner is 495.10authorized to allocate up to $310,000 each 495.11year in fiscal years 2008 and 2009 from the 495.12PRISM special revenue account to make 495.13payments to financial institutions in exchange 495.14for performing data matches between account 495.15information held by financial institutions 495.16and the public authority's database of child 495.17support obligors as authorized by Minnesota 495.18Statutes, section 13B.06, subdivision 7.

495.19Subd. 6.Basic Health Care Grants2,396,290,0002,738,179,000

495.20Appropriations by Fund495.21General2,618,815,0002,250,170,000495.22Health Care Access377,475,000487,989,000

495.23The amounts that may be spent from the 495.24appropriation for each purpose are as follows:

495.25(a) MinnesotaCare Grants

495.26Health Care Access376,588,000455,429,000

495.27MinnesotaCare Federal Receipts. Receipts 495.28received as a result of federal participation 495.29in administering costs of the Minnesota 495.30health care reform waiver must be deposited 495.31as nondedicated revenue in the health care 495.32access fund. Receipts received as a result of 495.33federal participation in making grants must 495.34be deposited in the federal fund and must 496.1offset health care access funds for payments 496.2to providers.496.3MinnesotaCare Funding. The 496.4commissioner may expend money 496.5appropriated from the health care access fund 496.6for MinnesotaCare in either fiscal year of the 496.7biennium.496.8HealthMatch Delay. Of this appropriation, 496.9$2,560,000 in fiscal year 2008 and 496.10$25,508,000 in fiscal year 2009 are for 496.11MinnesotaCare program costs related to 496.12implementation of the HealthMatch program.

496.13496.14(b) MA Basic Health Care - Families and Children

496.15Appropriations by Fund496.16General759,866,000853,680,000496.17Health Care Access-0-31,661,000

496.18496.19(c) MA Basic Health Care - Elderly and Disabled

496.20General1,017,023,0001,142,719,000

496.21Provider-Directed Care Coordination. In 496.22addition to medical assistance reimbursement 496.23under Minnesota Statutes, sections 496.24256B.0625 and 256B.76, clinics participating 496.25in provider-directed care coordination under 496.26Minnesota Statutes, section 256B.0625, also 496.27receive a monthly payment per client when 496.28the clinic serves an eligible client. The 496.29payments across the program must average 496.30$50 per month per client.496.31Services for Developmentally Disabled.496.32The commissioner must serve: an additional 496.33200 persons in the MR/RC waiver program; 496.34an additional 200 persons in the family 496.35support grant program under Minnesota 497.1Statutes, section 252.32; and an additional 497.2200 persons in the semi-independent living 497.3services program under Minnesota Statutes, 497.4section 252.275.497.5Transfer of Funds. (1) The commissioner 497.6of human services shall transfer to qualifying 497.7counties medical assistance funds for 497.8fiscal year 2007 equal to the difference 497.9between the state allocation for community 497.10alternatives for disabled individuals (CADI) 497.11and actual county spending for persons who 497.12have been receiving personal care assistant 497.13services but were transferred to the CADI 497.14waivered services program according to 497.15Laws 2006, chapter 282, article 20, section 497.1635. The medical assistance funds shall be 497.17transferred from appropriations for personal 497.18care assistant services that went unspent 497.19as a result of the provisions of Laws 2006, 497.20chapter 282, article 20, section 35.497.21(2) Counties that qualify under paragraph (a) 497.22shall provide to the commissioner by June 10, 497.232007, all necessary information regarding the 497.24funding amount to which they are entitled. 497.25The commissioner shall transfer funds to 497.26qualifying counties by June 25, 2007.497.27(3) The amounts provided to counties 497.28under this section shall become part of each 497.29county's base level state allocation for CADI 497.30for the biennium beginning July 1, 2007.497.31(4) The provisions in paragraphs (a) to (c) 497.32shall apply to persons who transferred to 497.33the elderly waiver as a result of Laws 2006, 497.34chapter 282, article 20, section 35.498.1(5) This rider is effective the day following 498.2final enactment.

498.3(d) General Assistance Medical Care Grants

498.4General238,887,000251,082,000

498.5(e) Other Health Care Grants

498.6General3,039,0002,709,000498.7Health Care Access887,000899,000

498.8Care Coordination. Of the general fund 498.9appropriation, $500,000 in fiscal year 2008 498.10and $1,000,000 in fiscal year 2009 are for 498.11the commissioner of human services for 498.12contracting for care coordination with the 498.13U special kids program under Minnesota 498.14Statutes, section 256B.0751.498.15Community-Based Health Care. Of the 498.16general fund appropriation, $1,050,000 498.17for the biennium beginning July 1, 2007, 498.18is to the commissioner of human services 498.19for the demonstration project grant 498.20described in Minnesota Statutes, section 498.2162Q.80, subdivision 1a. This is a onetime 498.22appropriation and is available until June 30, 498.232012.498.24Community Collaboratives. Of the general 498.25fund appropriation, $330,000 in fiscal year 498.262008 and $850,000 in fiscal year 2009 are to 498.27provide grants to community collaboratives 498.28to cover the uninsured. These are onetime 498.29appropriations.498.30Health Care Payment Reform Pilot. Of 498.31the general fund appropriation, $1,018,000 498.32in fiscal year 2008 and $1,027,000 in fiscal 498.33year 2009 are for the health care payment 499.1reform pilot project. These are onetime 499.2appropriations.499.3Patient Incentive Programs. Of the general 499.4fund appropriation, $500,000 in fiscal year 499.52008 and $500,000 in fiscal year 2009 are 499.6for patient incentive programs.499.7State Health Policies Grant. Of the general 499.8fund appropriation, $300,000 in fiscal year 499.92008 is to provide a grant to a research center 499.10associated with a safety net hospital and 499.11county-affiliated health system to develop 499.12the capabilities necessary for evaluating the 499.13effects of changes in state health policies 499.14on low-income and uninsured individuals, 499.15including the impact on state health care 499.16program costs, health outcomes, cost-shifting 499.17to different units and levels of government, 499.18and utilization patterns including use of 499.19emergency room care and hospitalization 499.20rates.499.21Neighborhood Health Care Network. Of 499.22the general fund appropriation, $150,000 in 499.23fiscal year 2008 and $150,000 in fiscal year 499.242009 are for a grant to the Neighborhood 499.25Health Care Network to maintain and staff a 499.26toll-free health care access telephone number.

499.27Subd. 7.Health Care Management54,536,00058,696,000

499.28Appropriations by Fund499.29General32,416,00030,589,000499.30Health Care Access22,120,00028,125,000

499.31The amounts that may be spent from the 499.32appropriation for each purpose are as follows:

499.33(a) Health Care Policy Administration

500.1Appropriations by Fund500.2General10,236,0008,813,000500.3Health Care Access2,323,00010,074,000

500.4Minnesota Senior Health Options 500.5Reimbursement. Federal administrative 500.6reimbursement resulting from the Minnesota 500.7senior health options project is appropriated 500.8to the commissioner for this activity.500.9Utilization Review. Federal administrative 500.10reimbursement resulting from prior 500.11authorization and inpatient admission 500.12certification by a professional review 500.13organization is dedicated to the commissioner 500.14for these purposes. A portion of these funds 500.15must be used for activities to decrease 500.16unnecessary pharmaceutical costs in medical 500.17assistance.500.18Dental Access for Persons with Disabilities.500.19Of the general fund appropriation, $82,000 500.20in fiscal year 2008 is for a study on access to 500.21dental services for persons with disabilities.500.22Base Adjustment. The health care access 500.23fund base is $10,716,000 in fiscal year 2010 500.24and $8,870,000 in fiscal year 2011, for health 500.25care administration.

500.26(b) Health Care Operations

500.27Appropriations by Fund500.28General22,180,00021,776,000500.29Health Care Access19,797,00018,051,000

500.30Base Adjustment. The general fund base is 500.31decreased by $214,000 in fiscal year 2010 500.32for health care operations.

500.33Subd. 8.Continuing Care Grants1,697,359,0001,858,283,000

501.1Appropriations by Fund501.2General1,694,876,0001,855,900,000501.3Health Care Access750,000750,000501.4Lottery Prize1,733,0001,633,000

501.5The amounts that may be spent from the 501.6appropriation for each purpose are as follows: 

501.7(a) Aging and Adult Services Grants

501.8General15,986,00016,605,000

501.9Information and Assistance 501.10Reimbursement. Federal administrative 501.11reimbursement obtained from information 501.12and assistance services provided by the 501.13Senior LinkAge Line to people who are 501.14identified as eligible for medical assistance 501.15are appropriated to the commissioner for this 501.16activity.501.17Senior Companion Program. Of the 501.18general fund appropriation, $191,000 in 501.19fiscal year 2008 and $191,000 in fiscal year 501.202009 are for the senior companion program 501.21under Minnesota Statutes, section 256.977.501.22Volunteer Senior Citizens. Of the general 501.23fund appropriation, $192,000 in fiscal year 501.242008 and $192,000 in fiscal year 2009 are 501.25for the volunteer programs for retired senior 501.26citizens under Minnesota Statutes, section 501.27256.9753.501.28Foster Grandparent Program. Of the 501.29general fund appropriation, $192,000 in 501.30fiscal year 2008 and $192,000 in fiscal year 501.312009 are for the foster grandparent program 501.32in Minnesota Statutes, section 256.976.501.33Senior Nutrition. Of the general fund 501.34appropriation, $250,000 in fiscal year 502.12008 and $250,000 in fiscal year 2009 are 502.2for the senior nutrition programs under 502.3Minnesota Statutes, section 256.9752. 502.4The commissioner shall give priority to 502.5increase services to: (1) persons facing 502.6language or cultural barriers, (2) persons with 502.7special diets, (3) persons living in isolated 502.8rural areas, and (4) other hard-to-serve 502.9populations.502.10Living At Home/Block Nurse Program. Of 502.11the general fund appropriation, $580,000 in 502.12fiscal year 2008 and $655,000 in fiscal year 502.132009 are for the living at home/block nurse 502.14program. The purpose of the appropriation is 502.15to increase base funding levels to $25,000 502.16per program year, provide base funding for 502.17nine programs currently operating without 502.18base funding, provide base funding for five 502.19new programs beginning July 1, 2007, and 502.20provide base funding for six additional 502.21programs beginning July 1, 2008.502.22$76,000 in fiscal year 2008 and $62,000 in 502.23fiscal year 2009 are for increased staff for 502.24the ombudsman for older Minnesotans and 502.25related costs.502.26$150,000 in fiscal year 2008 and $150,000 in 502.27fiscal year 2009 are to increase the base of 502.28the Senior LinkAge line program.502.29Minnesota Kinship Caregivers 502.30Association. (1) Of the general fund 502.31appropriation, $175,000 in fiscal year 502.322008 and $175,000 in fiscal year 2009 502.33are transferred to a nonprofit organization 502.34experienced in kinship caregiver programs, 502.35with at least 50 percent of its board 503.1composed of kinship caregivers for purposes 503.2of providing support to grandparents or 503.3relatives who are raising kinship children. 503.4(2) The demonstration grant sites must 503.5include the Minnesota Kinship Caregivers 503.6Association central site in the metropolitan 503.7area and another site in the Bemidji region. 503.8The support must provide a one-stop services 503.9program. The services that may be provided 503.10include but are not limited to legal services, 503.11education, information, family activities, 503.12support groups, mental health access, 503.13advocacy, mentors, and information related 503.14to foster care licensing. The funds may also 503.15be used for a media campaign to inform 503.16kinship families about available information 503.17and services, support sites, and other program 503.18development. The general fund base for the 503.19program shall be $160,000 in fiscal year 503.202010 and $160,000 in fiscal year 2011.503.21Base Adjustment. The general fund base 503.22is increased by $72,000 in fiscal year 2010 503.23and $72,000 in fiscal year 2011 for aging and 503.24adult services grants.

503.25(b) Alternative Care Grants

503.26General50,063,00052,511,000

503.27Alternative Care Transfer. Any money 503.28allocated to the alternative care program that 503.29is not spent for the purposes indicated does 503.30not cancel but is transferred to the medical 503.31assistance account.503.32Base Adjustment. The general fund base is 503.33increased by $547,000 in fiscal year 2010 and 503.34$784,000 in fiscal year 2011 for alternative 503.35care grants.

504.1504.2(c) Medical Assistance Grants - Long-Term Care Facilities

504.3General499,278,000513,016,000

504.4New Nursing Facility Reimbursement 504.5System Delay. Notwithstanding Minnesota 504.6Statutes, section 256B.441, subdivision 1, 504.7paragraph (c), the commissioner shall begin 504.8to phase in the new reimbursement system 504.9for nursing facilities on or after October 1, 504.102009.504.11Long-Term Care Consultation Funding 504.12Increase. For the rate year beginning 504.13October 1, 2008, the county long-term 504.14care consultation allocations in Minnesota 504.15Statutes, section 256B.0911, subdivision 504.166, must be increased based on the number 504.17of transitional long-term care consultation 504.18visits projected by the commissioner in 504.19each county. For the rate year beginning 504.20October 1, 2009, final allocations must be 504.21determined based on the average between 504.22the actual number of transitional long-term 504.23care visits that were conducted in the prior 504.2412-month period and the projected number 504.25of consultations that will be provided in 504.26the rate year beginning October 1, 2009. 504.27Notwithstanding section 7, this rider expires 504.28June 30, 2010.504.29Life Safety Code Compliance. Of the 504.30general fund appropriation, $1,000,000 in 504.31fiscal year 2008 is for payments to nursing 504.32facilities for life safety code compliance 504.33under Minnesota Statutes, section 256B.434, 504.34subdivision 4, paragraph (e). This is a 505.1onetime appropriation and available until 505.2spent.

505.3505.4(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants

505.5General966,623,0001,099,540,000

505.6(e) Mental Health Grants

505.7Appropriations by Fund505.8General57,522,00060,678,000505.9Health Care Access750,000750,000505.10Lottery Prize1,733,0001,633,000

505.11Dual Diagnosis; Demonstration Project.505.12Of the general fund appropriation, $800,000 505.13in fiscal year 2008 and $1,600,000 in fiscal 505.14year 2009 are to the commissioner of 505.15human services to fund the dual diagnosis 505.16demonstration project.505.17Mobile Mental Health Crisis Services. Of 505.18the general fund appropriation, $2,500,000 505.19in fiscal year 2008 and $3,625,000 in fiscal 505.20year 2009 are to the commissioner of human 505.21services for statewide funding of adult mobile 505.22mental health crisis services. Providers must 505.23utilize all available funding streams.505.24National Council on Problem Gambling.505.25(1) $225,000 in fiscal year 2008 and $225,000 505.26in fiscal year 2009 are appropriated from 505.27the lottery prize fund to the commissioner 505.28of human services for a grant to the state 505.29affiliate recognized by the National Council 505.30on Problem Gambling. The affiliate must 505.31provide services to increase public awareness 505.32of problem gambling, education, and training 505.33for individuals and organizations providing 505.34effective treatment services to problem 505.35gamblers and their families, and research 506.1relating to problem gambling. These 506.2services must be complementary to and not 506.3duplicative of the services provided through 506.4the problem gambling program administered 506.5by the commissioner of human services. This 506.6grant does not prevent the commissioner 506.7from regular monitoring and oversight of the 506.8grant or the ability to reallocate the funds to 506.9other services within the problem gambling 506.10program for nonperformance of duties by 506.11the grantee.506.12(2) Of this appropriation, $100,000 in 506.13fiscal year 2008 and $100,000 in fiscal year 506.142009 are contingent on the contribution 506.15of nonstate matching funds. Matching 506.16funds may be either cash or qualifying 506.17in-kind contributions. The commissioner of 506.18finance may disburse the state portion of the 506.19matching funds in increments of $25,000 506.20upon receipt of a commitment for an equal 506.21amount of matching nonstate funds. The 506.22general fund base shall be $100,000 in fiscal 506.23year 2010 and $100,000 in fiscal year 2011506.24(3) $100,000 in fiscal year 2008 is 506.25appropriated from the lottery prize fund to 506.26the commissioner of human services for a 506.27grant or grants to be awarded competitively 506.28to develop programs and services for 506.29problem gambling treatment, prevention, 506.30and education in immigrant communities. 506.31This appropriation is available until June 506.3230, 2009, at which time the project must 506.33be completed and final products delivered, 506.34unless an earlier completion date is specified 506.35in the work program.507.1Compulsive Gambling. $300,000 in fiscal 507.2year 2008 and $100,000 in fiscal year 2009 507.3are appropriated from the lottery prize fund 507.4to the commissioner of human services for 507.5purposes of compulsive gambling education, 507.6assessment, and treatment under Minnesota 507.7Statutes, section 245.98.507.8Compulsive Gambling Study. $100,000 507.9in fiscal year 2008 is to continue the 507.10study currently being done on compulsive 507.11gambling treatment effectiveness and 507.12long-term effects of gambling.507.13Base Adjustment. The general fund base is 507.14increased by $266,000 in fiscal year 2010.

507.15(f) Deaf and Hard-of-Hearing Grants

507.16General1,932,0002,380,000

507.17Hearing Loss Mentors. Of the general fund 507.18appropriation, $80,000 is to provide mentors 507.19who have a hearing loss to parents of newly 507.20identified infants and children with hearing 507.21loss.507.22Base Adjustment. The general fund base 507.23is increased by $7,000 in fiscal year 2010 507.24and $7,000 in fiscal year 2011 for deaf and 507.25hard-of-hearing grants.

507.26(g) Chemical Dependency Entitlement Grants

507.27General78,749,00089,946,000

507.28507.29(h) Chemical Dependency Nonentitlement Grants

507.30General1,055,0001,055,000

507.31(i) Other Continuing Care Grants

507.32Appropriations by Fund507.33General23,668,00020,169,000

508.1Native American Juvenile Treatment 508.2Center. Of the general fund appropriation, 508.3$50,000 is to conduct a feasibility study 508.4of and to predesign a Native American 508.5juvenile treatment center on or near the 508.6White Earth Reservation. The facility must 508.7house and treat Native American juveniles 508.8and provide culturally specific programming 508.9to juveniles placed in the treatment center. 508.10The commissioner of human services may 508.11contract with parties who have experience 508.12in the design and construction of juvenile 508.13treatment centers to assist in the feasibility 508.14study and predesign. On or before January 508.1515, 2008, the commissioner shall present 508.16the results of the feasibility study and the 508.17predesign of the facility to the chairs of house 508.18of representatives and senate committees 508.19having jurisdiction over human services 508.20finance, public safety finance, and capital 508.21investment.508.22Leech Lake Youth Treatment Center. Of 508.23the general fund appropriation, $75,000 in 508.24fiscal year 2008 and $75,000 in fiscal year 508.252009 are for a grant to the Leech Lake Youth 508.26Treatment Center project partners, in order 508.27to pay the salaries and other directly related 508.28costs associated with the development of this 508.29project.508.30Assistive Technology. Of the general fund 508.31appropriation, $300,000 in fiscal year 2008 is 508.32to the Minnesota State Council on Disability 508.33for the purposes of providing $100,000 508.34in financial support to the Minnesota 508.35Regions Assistive Technology Collaborative 508.36and $200,000 in fiscal year 2008 is for 509.1a local match required to access the 509.2federal Technology-Related Assistance for 509.3Individuals with Disabilities Act, alternate 509.4finance project.509.5Repayment. For the fiscal year ending June 509.630, 2008, $5,287,000 is appropriated to the 509.7commissioner of human services to repay 509.8the amount of overspending in the waiver 509.9program for persons with developmental 509.10disabilities incurred by affected counties in 509.11calendar years 2004 and 2005.509.12Base Adjustment. The general fund base 509.13is $20,276,000 in fiscal year 2010 and 509.14$20,332,000 in fiscal year 2011 for other 509.15continuing care grants.

509.16Subd. 9.Continuing Care Management20,248,00019,400,000

509.17Appropriations by Fund509.18General19,384,00019,123,000509.19509.20State Government Special Revenue121,000123,000509.21Health Care Access292,000-0-509.22Lottery Prize451,000154,000

509.23Community Trainee and Consultation.509.24Of the general fund appropriation, $125,000 509.25in fiscal year 2008 is to the commissioner 509.26of human services to contract for training 509.27and consultation for clinical supervisors and 509.28staff of community mental health centers 509.29who provide services to children and adults. 509.30The purpose of the training and consultation 509.31is to improve clinical supervision of 509.32staff, strengthen compliance with federal 509.33and state rules and regulations, and to 509.34recommend strategies for standardization and 510.1simplification of administrative functions 510.2among community mental health centers.510.3Mental Health Tracking System. Of the 510.4general fund appropriation, $448,000 in fiscal 510.5year 2008 and $324,000 in fiscal year 2009 510.6are to the commissioner of human services 510.7to fund implementation of the mental health 510.8services outcomes and tracking system.510.9Quality Management; Assurance; and 510.10Improvement System for Minnesotans 510.11Receiving Disability Services. Of the 510.12general fund appropriation, up to $300,000 510.13for the biennium beginning July 1, 2007, 510.14may be used for the purposes of the quality 510.15management, assurance, and improvement 510.16system for Minnesotans receiving disability 510.17services. Federal Medicaid matching funds 510.18obtained for this purpose shall be dedicated 510.19to the commissioner for this purpose.510.20Base Adjustment. The health care access 510.21fund base is $0 in each of the fiscal years 2010 510.22and 2011 for continuing care management.510.23Disability Linkage Line. Of the general 510.24fund appropriation, $650,000 in fiscal year 510.252008 and $626,000 in fiscal year 2009 are to 510.26establish and maintain the disability linkage 510.27line.

510.28Subd. 10.State-Operated Services266,645,000267,718,000

510.29General266,645,000267,718,000

510.30Remembering With Dignity Project. (1) 510.31$200,000 is appropriated from the general 510.32fund to the commissioner of human services 510.33to be available until September 30, 2008, to 510.34make a grant to Advocating Change Together 511.1for the purposes of the Remembering With 511.2Dignity project in paragraph (2).511.3(2) As part of the Remembering With Dignity 511.4project, the grant recipient shall:511.5(i) conduct necessary research on persons 511.6buried in state cemeteries who were residents 511.7of state hospitals or regional treatment 511.8centers and buried in numbered or unmarked 511.9graves;511.10(ii) purchase and install headstones that are 511.11properly inscribed with their names on the 511.12graves of those persons; and511.13(iii) collaborate with community groups 511.14and state and local government agencies to 511.15build community involvement and public 511.16awareness, ensure public access to the 511.17graves, and ensure appropriate perpetual 511.18maintenance of state cemeteries.511.19(3) This rider is effective the day following 511.20final enactment.511.21Transfer Authority Related to 511.22State-Operated Services. Money 511.23appropriated to finance state-operated 511.24services programs and administrative 511.25services may be transferred between fiscal 511.26years of the biennium with the approval of 511.27the commissioner of finance.511.28The amounts that may be spent from the 511.29appropriation for each purpose are as follows:

511.30(a) Mental Health Services

511.31General116,270,000120,095,000

511.32Appropriation Limitation. No part of 511.33the appropriation in this article to the 511.34commissioner for mental health treatment 512.1services at the regional treatment centers 512.2shall be used for the Minnesota sex offender 512.3program.

512.4(b) Minnesota Sex Offender Services

512.5General67,719,00062,787,000

512.6512.7(c) Minnesota Security Hospital and METO Services

512.8General82,656,00084,836,000

512.9Minnesota Security Hospital. For the 512.10purposes of enhancing the safety of 512.11the public, improving supervision, and 512.12enhancing community-based mental health 512.13treatment, state-operated services may 512.14establish additional community capacity 512.15for providing treatment and supervision 512.16of clients who have been ordered into a 512.17less restrictive alternative care from the 512.18state-operated services transitional services 512.19program consistent with Minnesota Statutes, 512.20section 246.014.

512.21Sec. 4. COMMISSIONER OF HEALTH

512.22Subdivision 1.Total Appropriation$54,357,000$45,785,000

512.23Appropriations by Fund512.2420082009512.25General18,185,00016,213,000512.26512.27State Government Special Revenue13,309,00013,309,000512.28Health Care Access22,863,00016,263,000

512.29512.30Subd. 2.Community and Family Health Promotion

512.31Appropriations by Fund512.32General46,707,00046,443,000512.33512.34State Government Special Revenue468,000471,000512.35Health Care Access3,539,0003,562,000512.36Federal TANF8,667,0009,002,000

513.1TANF Appropriations. (a) $3,579,000 of 513.2the TANF funds is appropriated in each year 513.3of the biennium to the commissioner for 513.4home visiting and nutritional services listed 513.5under Minnesota Statutes, section 145.882, 513.6subdivision 7, clauses (6) and (7). Funding 513.7shall be distributed to community health 513.8boards based on Minnesota Statutes, section 513.9145A.131, subdivision 1.513.10(b) $5,088,000 in the first year and $5,423,000 513.11in the second year are appropriated to the 513.12commissioner of health for the family home 513.13visiting grant program. The commissioner 513.14shall distribute funds to community health 513.15boards using a formula developed in 513.16conjunction with the state Community 513.17Health Services Advisory Committee. The 513.18commissioner may use five percent of the 513.19funds appropriated in each fiscal year to 513.20conduct the ongoing evaluations required 513.21under Minnesota Statutes, section 145A.17, 513.22subdivision 7, and may use ten percent of 513.23the funds appropriated each fiscal year to 513.24provide training and technical assistance as 513.25required under Minnesota Statutes, section 513.26145A.17, subdivisions 4 and 5.513.27TANF Carryforward. Any unexpended 513.28balance of the TANF appropriation in the 513.29first year of the biennium does not cancel but 513.30is available for the second year.513.31Loan Forgiveness. $605,000 the first year 513.32and $775,000 the second year and thereafter 513.33are for the loan forgiveness program under 513.34Minnesota Statutes, section 144.1501. This 514.1funding is in addition to the loan forgiveness 514.2program base.514.3MN ENABL. Base level funding for the MN 514.4ENABL program, under Minnesota Statutes, 514.5section 145.9255, is reduced by $220,000 514.6each year of the biennium beginning July 1, 514.72007.514.8Fetal Alcohol Spectrum Disorder. (a) 514.9$900,000 each year is added to the base for 514.10fetal alcohol spectrum disorder. On July 1 514.11each fiscal year, the portion of the general 514.12fund appropriation to the commissioner of 514.13health for fetal alcohol spectrum disorder 514.14administration and grants shall be transferred 514.15to a statewide organization that focuses 514.16solely on prevention of and intervention with 514.17fetal alcohol spectrum disorder as follows:514.18(1) on July 1, 2007, $2,090,000; and514.19(2) on July 2, 2008, and annually thereafter, 514.20$2,090,000.514.21(b) The money shall be used for prevention 514.22and intervention services and programs, 514.23including, but not limited to, community 514.24grants, professional education, public 514.25awareness, and diagnosis. The organization 514.26may retain $60,000 of the transferred money 514.27for administrative costs. The organization 514.28shall report to the commissioner annually 514.29by January 15 on the services and programs 514.30funded by the appropriation.514.31Deaf or Hearing Loss Support. $100,000 514.32for the first year and $100,000 for the second 514.33year is for the purpose of providing family 514.34support and assistance to families with 514.35children who are deaf or have a hearing 515.1loss. The family support provided must 515.2include direct parent-to-parent assistance and 515.3information on communication, educational, 515.4and medical options. The commissioner 515.5may contract with a nonprofit organization 515.6that has the ability to provide these services 515.7throughout the state.515.8Heart Disease and Stroke Prevention.515.9$200,000 is appropriated in the first year for 515.10the heart disease and stroke prevention unit 515.11of the Department of Health to fund data 515.12collection and other activities to improve 515.13cardiovascular health and reduce the burden 515.14of heart disease and stroke in Minnesota. 515.15This is a onetime appropriation.515.16Family Planning Grants. $1,000,000 each 515.17year is for family planning grants under 515.18Minnesota Statutes, section 145.925.515.19Bright Smiles Pilot Project. (a) $384,000 515.20in the first year and $50,000 in the second 515.21year is to fund a grant for the Bright Smiles 515.22pilot project.515.23(b) Of these amounts, $50,000 each year is to 515.24fund a dental health coordinator position.515.25(c) The commissioner of health shall 515.26establish a pilot project to fund a Bright 515.27Smiles program designed to increase access 515.28to oral health care for low-income and 515.29immigrant children, ages birth to five 515.30years, and their families and to build the 515.31knowledge and ability of parents to care 515.32for the oral health of their children. Under 515.33this pilot project, a Bright Smiles program 515.34shall serve the medically underserved areas 516.1in Minneapolis and the Bemidji area, as 516.2determined by the commissioner of health.516.3(d) A grant shall be used to fund costs related 516.4to improving oral health outreach, education, 516.5screening, and access to care for families 516.6with children, ages birth to five years.516.7(e) Grant applicants shall submit to 516.8the commissioner a written plan that 516.9demonstrates the ability to provide the 516.10following:516.11(1) new programs or continued expansion 516.12of current access programs that have 516.13demonstrated success in providing dental 516.14services in underserved areas of Minneapolis 516.15and the Bemidji area;516.16(2) programs for screening children entering 516.17the Minneapolis and the Bemidji area public 516.18school systems and facilitating access to care 516.19for their families;516.20(3) programs testing new models of care 516.21that are sensitive to cultural needs of the 516.22recipients;516.23(4) programs creating new educational 516.24campaigns that inform individuals of the 516.25importance of good oral health and the 516.26link between dental diseases, overall health 516.27status, and success in school; and516.28(5) programs testing new delivery models 516.29by creating partnerships between local early 516.30childhood and school-age education and 516.31community clinic dental providers.516.32(f) Qualified applicants are partnerships 516.33among early childhood experts, Minneapolis 516.34or Bemidji area public schools, and nonprofit 517.1clinics that are established to provide health 517.2services to low-income patients, provide 517.3preventive and dental care services, and 517.4utilize a sliding-scale fee or other method of 517.5providing charity care that ensures that no 517.6person is denied services because of inability 517.7to pay.517.8(g) Applicants shall submit to the 517.9commissioner an application and supporting 517.10documentation, in the form and manner 517.11specified by the commissioner. Applicants 517.12must be able to provide culturally appropriate 517.13outreach, screenings, and access to dental 517.14care for children, ages birth to five years, 517.15their parents, and pregnant women most at 517.16risk of poor oral health due to lack of access 517.17to dental care. Applicants must also meet the 517.18following criteria:517.19(1) have the potential to successfully increase 517.20access to families with children, ages birth 517.21to five years;517.22(2) incorporate quality program evaluation;517.23(3) maximize use of grant funds; and517.24(4) have experience in providing services to 517.25the target populations of this program.517.26(h) The commissioner shall evaluate the 517.27effectiveness of this pilot program on the 517.28oral health of children and their families and 517.29report to the house of representatives and 517.30senate committees with jurisdiction over 517.31public health policy and finance by January 517.321, 2009, with recommendations as to how to 517.33develop programs throughout Minnesota that 517.34provide education and access to oral health 517.35care for low-income and immigrant children.518.1Suicide prevention programs. $600,000 518.2each year is to fund the suicide prevention 518.3program. The base for fiscal years 2010 and 518.42011 is reduced by $300,000.

518.5Subd. 3.Policy, Quality, and Compliance51,557,00045,785,000

518.6Appropriations by Fund518.7General18,185,00016,213,000518.8518.9State Government Special Revenue13,309,00013,309,000518.10Health Care Access22,863,00016,263,000

518.11Health Care Access Survey. Of the 518.12health care access fund appropriation, 518.13$600,000 in fiscal year 2008 is appropriated 518.14to the commissioner to conduct a health 518.15insurance survey of Minnesota households, 518.16in partnership with the State Health Access 518.17Data Assistance Center at the University 518.18of Minnesota. The commissioner shall 518.19contract with the State Health Access Data 518.20Assistance Center to conduct a survey that 518.21provides information on the characteristics 518.22of the uninsured in Minnesota and the 518.23reasons for changing patterns of insurance 518.24coverage and access to health care services. 518.25This appropriation shall become part of the 518.26agency's base budget for even-numbered 518.27fiscal years.518.28MERC. Of the general fund appropriation, 518.29$8,000,000 each fiscal year is for distribution 518.30of MERC grants as follows:518.31(1) $5,000,000 according to Minnesota 518.32Statutes, section 62J.692, subdivision 4, 518.33paragraph (c);519.1(2) $900,000 according to Minnesota 519.2Statutes, section 62J.692, subdivision 4, 519.3paragraph (d);519.4(3) $100,000 according to Minnesota 519.5Statutes, section 62J.692, subdivision 4, 519.6paragraph (e); and519.7(4) $2,000,000 according to Minnesota 519.8Statutes, section 62J.692, subdivision 7a, 519.9paragraph (b).519.10Health Information Technology. Of 519.11the health care access fund appropriation, 519.12$6,750,000 each fiscal year is to implement 519.13Minnesota Statutes, section 144.3345. Up 519.14to $350,000 each fiscal year is available for 519.15grant administration and health information 519.16technology technical assistance and 519.17$6,400,000 each year is to be transferred 519.18to the commissioner of finance to establish 519.19and implement a revolving account under 519.20Minnesota Statutes, section 62J.496. This 519.21appropriation shall not be included in the 519.22agency's base budget for the fiscal year 519.23beginning July 1, 2009.519.24Health Insurance Exchange. Of the health 519.25care access fund appropriation, $6,000,000 519.26in fiscal year 2008 is appropriated to 519.27the commissioner to establish the health 519.28insurance exchange in Minnesota Statutes, 519.29section 62A.76. Up to $50,000 in fiscal year 519.302008 is available for administrative costs 519.31incurred by the Department of Health in 519.32establishing and providing grant funding to 519.33the legal entity responsible for implementing 519.34the health insurance exchange. This is a 519.35onetime appropriation.520.1Hearing Aid Loan Bank. Of the general 520.2fund appropriation, $70,000 in fiscal year 520.32008 and $70,000 in fiscal year 2009 are 520.4for the purpose of providing a statewide 520.5hearing aid and instrument loan bank to 520.6families with children newly diagnosed with 520.7hearing loss from birth to the age of ten. This 520.8appropriation shall cover the administrative 520.9costs of the program.520.10Uncompensated Care Fund. Of the general 520.11fund appropriation, $65,000 in fiscal year 520.122008 is for the commissioner of health to 520.13study and present recommendations to the 520.14governor and the legislature by January 520.1515, 2008, on the design, operation, and 520.16funding of an uncompensated care fund to 520.17be used to provide subsidies to hospitals, 520.18community clinics, federally qualified health 520.19centers, community mental health centers, 520.20and other health care providers that serve 520.21a disproportionately large percentage of 520.22uninsured patients. An organization must not 520.23provide or perform abortion services under 520.24this program.520.25Community Collaboratives. Of the 520.26general fund appropriation, $300,000 for the 520.27biennium beginning July 1, 2007, is to the 520.28commissioner of health to provide grants 520.29to community collaboratives to cover the 520.30uninsured. This is a onetime appropriation.520.31Uniform Electronic Transactions. Of the 520.32general fund appropriation, $146,000 in fiscal 520.33year 2008 is for development of uniform 520.34electronic transactions and implementation 521.1guide standards under Minnesota Statutes, 521.2section 62J.536.521.3Medical Home Learning Collaborative.521.4Of the general fund appropriation, $500,000 521.5in fiscal year 2008 and $500,000 in fiscal 521.6year 2009 are to expand the medical 521.7home learning collaborative initiative in 521.8collaboration with the commissioner of 521.9human services. Services provided under 521.10this funding must support a medical home 521.11model for children with special health care 521.12needs. The collaborative shall report back to 521.13the legislature on use of the funds by January 521.1415, 2010.521.15Federally Qualified Health Centers. Of the 521.16general fund appropriation, $3,000,000 in 521.17fiscal year 2008 and $3,900,000 in fiscal year 521.182009 are for subsidies to federally qualified 521.19health centers under Minnesota Statutes, 521.20section 145.9269.521.21Pandemic Influenza Preparedness. Of 521.22the general fund appropriation to the 521.23commissioner, $2,800,000 in fiscal year 2008 521.24is for preparation, planning, and response 521.25to a pandemic influenza outbreak. This 521.26appropriation is available until June 30, 2009. 521.27Base funding for the 2010-2011 biennium is 521.28$0 each fiscal year.

521.29Subd. 4.Health Protection

521.30Appropriations by Fund521.31General17,744,00013,900,000521.32521.33State Government Special Revenue25,980,00026,674,000521.34Environmental300,000300,000

522.1Pandemic Influenza Preparedness. Of 522.2the general fund appropriation to the 522.3commissioner, $3,235,000 in fiscal year 2008 522.4is for preparation, planning, and response 522.5to a pandemic influenza outbreak. This 522.6appropriation is available until June 30, 2009.522.7Base funding for the 2010-2011 biennium is 522.8$0 each fiscal year.522.9Environmental Health Tracking and 522.10Biomonitoring. (a) $500,000 in the first 522.11year and $900,000 in the second year are 522.12for the environmental health tracking and 522.13biomonitoring program. The base for fiscal 522.14year 2010 and fiscal year 2011 is increased 522.15by $300,000 each year.522.16(b) $300,000 each year is from the 522.17environmental fund to the Pollution Control 522.18Agency for transfer to the Department 522.19of Health for the health tracking and 522.20biomonitoring program. The base for the 522.21environmental fund is $0 in fiscal year 2010 522.22and after.522.23AIDS Prevention Initiative Focusing 522.24on African-born Residents. $300,000 in 522.252008 is for an AIDS prevention initiative 522.26focusing on African-born residents. This 522.27appropriation is a onetime appropriation 522.28and shall not become part of the base-level 522.29funding for the 2010-2011 biennium.522.30The commissioner of health shall award 522.31grants in accordance with Minnesota Statutes, 522.32section 145.924, paragraph (b), for a public 522.33education and awareness campaign targeting 522.34communities of African-born Minnesota 522.35residents. The grants shall be designed to 523.1promote knowledge and understanding about 523.2HIV and to increase knowledge in order 523.3to eliminate and reduce the risk for HIV 523.4infection; to encourage screening and testing 523.5for HIV; and to link individuals to public 523.6health and health care resources. The grants 523.7must be awarded to collaborative efforts that 523.8bring together nonprofit community-based 523.9groups with demonstrated experience in 523.10addressing the public health, health care, 523.11and social service needs of African-born 523.12communities.523.13Arsenic Health Risk Standard. $920,000 in 523.14the first year and $461,000 in the second year 523.15is to fund the study relating to arsenic health 523.16risk standards, under Minnesota Statutes, 523.17section 144.967.523.18Lindane and Bisphenol-A Studies.523.19$114,000 in the first year is for the Lindane 523.20committee and the study of bisphenol-A, 523.21under Minnesota Statutes, section 145.958. 523.22This is a onetime appropriation.523.23Decabromodiphenyl Ether Study.523.24$118,000 in the first year is for transfer to the 523.25commissioner of the pollution control agency 523.26for the study of decabromodiphenyl ether 523.27under Minnesota Statutes, section 325E.387. 523.28This is a onetime appropriation.523.29Radiation Study. $45,000 in the first year 523.30from the general fund and $15,000 in the 523.31first year from the state government special 523.32revenue fund are for the radiation study in 523.33section 62. This is a onetime appropriation.523.34Lead Abatement. $925,000 in the first 523.35year and $950,000 in the second year are 524.1for changes in lead abatement requirements. 524.2Of this amount, $6,000 in the first year and 524.3$11,000 in the second year are for transfer 524.4to the commissioner of human services for 524.5increased medical assistance costs. A portion 524.6of this amount may be used to reimburse 524.7local governments for costs of implementing 524.8the new requirements.524.9Water Treatment. $40,000 in fiscal year 524.102008 is to augment any appropriation from the 524.11remediation fund to conduct an evaluation of 524.12point of use water treatment units at removing 524.13perfluorooctanoic acid, perfluorooctane 524.14sulfonate, and perfluorobutanoic acid from 524.15known concentrations of these compounds 524.16in drinking water. The evaluation shall be 524.17completed by December 31, 2007, and the 524.18commissioner may contract for services to 524.19complete the evaluation. This is a onetime 524.20appropriation.524.21Environmental Justice Mapping. $137,000 524.22in the first year and $53,000 in the second 524.23year is for environmental justice mapping.524.24HIV Information. $80,000 each year 524.25is to fund a community-based nonprofit 524.26organization with demonstrated capacity to 524.27operate a statewide HIV information and 524.28referral service using telephone, Internet, and 524.29other appropriate technologies.524.30Lead Hazard Reduction. $250,000 is 524.31appropriated each year of the biennium for a 524.32grant to a nonprofit organization operating 524.33the CLEARCorps to conduct a pilot project 524.34to determine the incidence of lead hazards in 524.35pre-1978 rental property. Any balance in the 525.1first year does not cancel but is available in 525.2the second year.525.3Minnesota Birth Defects Information 525.4System. $750,000 each year is to maintain 525.5the birth defects information system that was 525.6established by Minnesota Statutes, section 525.7144.2215.

525.8Subd. 5.Minority and Multicultural Health

525.9Appropriations by Fund525.10General5,042,0005,052,000525.11Federal TANF2,683,0002,998,000

525.12TANF Appropriations. (a) $2,421,000 of 525.13the TANF funds is appropriated in each year 525.14of the biennium to the commissioner for 525.15home visiting and nutritional services listed 525.16under Minnesota Statutes, section 145.882, 525.17subdivision 7, clauses (6) and (7). Funding 525.18shall be distributed to tribal governments 525.19based on Minnesota Statutes, section 525.20145A.14, subdivision 2a, paragraph (b).525.21(b) $262,000 in the first year and $577,000 525.22in the second year are appropriated 525.23to the commissioner of health for the 525.24family home visiting grant program. The 525.25commissioner shall distribute funds to tribal 525.26governments using a formula developed in 525.27conjunction with tribal governments. The 525.28commissioner may use five percent of the 525.29funds appropriated in each fiscal year to 525.30conduct the ongoing evaluations required 525.31under Minnesota Statutes, section 145A.17, 525.32subdivision 7, and may use ten percent of 525.33the funds appropriated each fiscal year to 525.34provide training and technical assistance as 526.1required under Minnesota Statutes, section 526.2145A.17, subdivisions 4 and 5.526.3TANF Carryforward. Any unexpended 526.4balance of the TANF appropriation in the 526.5first year of the biennium does not cancel but 526.6is available for the second year.

526.7Subd. 6.Administrative Support Services

526.8Appropriations by Fund526.9General 11,047,000 11,197,000

526.10Disease Surveillance. $2,000,000 each fiscal 526.11year is for redesigning and implementing 526.12coordinated and modern disease surveillance 526.13systems for the department, ensuring that 526.14occupational and residential histories are 526.15included in the database. Base level funding 526.16for the 2012-2013 biennium will be $600,000 526.17each fiscal year for maintaining and operating 526.18the systems.

526.19526.20Sec. 5. VETERANS NURSING HOMES BOARD$44,124,000$46,244,000

526.21Veterans Homes Special Revenue Account.526.22The general fund  appropriations made to 526.23the board may be transferred to a veterans 526.24homes special revenue account in the 526.25special revenue fund in the same manner 526.26as other receipts are deposited according to 526.27Minnesota Statutes, section 198.34, and are 526.28appropriated to the board for the operation of 526.29board facilities and programs.526.30Repair and Betterment. Of this 526.31appropriation, $4,000,000 in fiscal year 526.322008 and $4,000,000 in fiscal year 2009 526.33are to be used for repair, maintenance, 527.1rehabilitation, and betterment activities at 527.2facilities statewide.527.3Base Adjustment. The general fund base is 527.4decreased by $2,000,000 in fiscal year 2010 527.5and $2,000,000 in fiscal year 2011.

527.6Sec. 6. HEALTH-RELATED BOARDS

527.7527.8Subdivision 1.Total Appropriation; State Government Special Revenue Fund$14,654,000$14,527,000

527.9The commissioner of finance shall not permit 527.10the allotment, encumbrance, or expenditure 527.11of money appropriated in this section in 527.12excess of the anticipated biennial revenues 527.13or accumulated surplus revenues from fees 527.14collected by the boards.

527.15Subd. 2.Board of Chiropractic Examiners450,000447,000

527.16Subd. 3.Board of Dentistry987,0001,009,000

527.17527.18Subd. 4.Board of Dietetic and Nutrition Practice103,000119,000

527.19Base Adjustment. Of this appropriation in 527.20fiscal year 2009, $14,000 is onetime.

527.21527.22Subd. 5.Board of Marriage and Family Therapy134,000154,000

527.23Base Adjustment. Of this appropriation in 527.24fiscal year 2009, $17,000 is onetime.

527.25Subd. 6.Board of Medical Practice4,120,0003,674,000

527.26Subd. 7.Board of Nursing3,985,0004,146,000

527.27527.28Subd. 8.Board of Nursing Home Administrators633,000647,000

527.29Administrative Services Unit. Of this 527.30appropriation, $430,000 in fiscal year 527.312008 and $439,000 in fiscal year 2009 are 527.32for the administrative services unit. The 527.33administrative services unit may receive 528.1and expend reimbursements for services 528.2performed by other agencies.

528.3Subd. 9.Board of Optometry98,000114,000

528.4Base Adjustment. Of this appropriation in 528.5fiscal year 2009, $13,000 is onetime.

528.6Subd. 10.Board of Pharmacy1,375,0001,442,000

528.7Base Adjustment. Of this appropriation in 528.8fiscal year 2009, $29,000 is onetime.

528.9Subd. 11.Board of Physical Therapy306,000295,000

528.10Subd. 12.Board of Podiatry54,00063,000

528.11Base Adjustment. Of this appropriation in 528.12fiscal year 2009, $7,000 is onetime.

528.13Subd. 13.Board of Psychology788,000806,000

528.14Subd. 14.Board of Social Work997,0001,022,000

528.15Subd. 15.Board of Veterinary Medicine230,000195,000

528.16528.17Subd. 16.Board of Behavioral Health and Therapy394,000394,000

528.18528.19Sec. 7. EMERGENCY MEDICAL SERVICES BOARD$3,710,000$3,745,000

528.20Appropriations by Fund528.2120082009528.22General3,023,0003,041,000528.23528.24State Government Special Revenue687,000704,000

528.25Regional Emergency Medical Services 528.26Programs. $400,000 each year is for 528.27regional emergency medical services 528.28programs, to be distributed equally to the 528.29eight emergency medical service regions. 528.30This amount shall be added to the base 528.31funding. Notwithstanding Minnesota 528.32Statutes, section 144E.50, 100 percent of 529.1the appropriation shall be passed on to the 529.2emergency medical service regions.529.3Health Professional Services Program.529.4$687,000 in fiscal year 2008 and $704,000 in 529.5fiscal year 2009 from the state government 529.6special revenue fund are for the health 529.7professional services program.

529.8Sec. 8. COUNCIL ON DISABILITY$582,000$590,000

529.9Options Too. (a) $75,000 for the first 529.10year and $75,000 for the second year are 529.11to continue the work of the Options Too 529.12disability services interagency work group 529.13established under Laws 2005, First Special 529.14Session chapter 4, article 7, section 57. 529.15Funds shall be used to monitor and assist the 529.16work group and the Options Too Steering 529.17Committee in the implementation of the 529.18recommendations in the Options Too report 529.19dated February 15, 2007.529.20(b) For purposes of this section, the Options 529.21Too Steering Committee shall consist of the 529.22following members:529.23(1) a representative from the Minnesota 529.24Housing Finance Agency;529.25(2) a representative from the Minnesota State 529.26Council on Disability; 529.27(3) a representative from the Department of 529.28Veterans Affairs;529.29(4) a representative from the Department of 529.30Transportation;529.31(5) a representative from the Department of 529.32Human Services; and530.1(6) representatives from interested 530.2stakeholders including counties, local 530.3public housing authorities, the Metropolitan 530.4Council, disability service providers, and 530.5disability advocacy organizations who are 530.6appointed by the Minnesota State Council on 530.7Disability for two-year terms.530.8(c) Notwithstanding Laws 2005, First Special 530.9Session chapter 4, article 7, section 57, the 530.10interagency work group shall be administered 530.11by the Minnesota Housing Finance Agency, 530.12the Minnesota State Council on Disability, 530.13Department of Human Services, and the 530.14Department of Transportation.530.15(d) The Options Too Steering Committee 530.16shall report to the chairs of the health 530.17and human services policy and finance 530.18committees of the senate and house of 530.19representatives by October 15, 2007, and 530.20October 15, 2008, on the continued progress 530.21of the work group towards implementing the 530.22recommendations in the Options Too report 530.23dated February 15, 2007.

530.24530.25530.26Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES$1,567,000$1,621,000

530.27Sec. 10. OMBUDSMAN FOR FAMILIES$251,000$257,000

530.28    Sec. 11. TRANSFERS.530.29    Subdivision 1.Grants.The commissioner of human services, with the approval 530.30of the commissioner of finance and after notifying the chairs of the senate and house 530.31committees with jurisdiction, may transfer unencumbered appropriation balances for the 530.32biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance; 530.33general assistance medical care; medical assistance; MFIP child care assistance under 530.34Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential 531.1housing programs; and the entitlement portion of the chemical dependency consolidated 531.2treatment fund and between fiscal years of the biennium.531.3    Subd. 2.Administration.Positions, salary money, and nonsalary administrative 531.4money may be transferred within the Departments of Human Services and Health and 531.5within the programs operated by the Veterans Nursing Homes Board as the commissioners 531.6and the board consider necessary, with the advance approval of the commissioner of 531.7finance. The commissioner or the board shall inform the chairs of the house and senate 531.8committees with jurisdiction quarterly about transfers made under this provision.531.9    Sec. 12. INDIRECT COSTS NOT TO FUND PROGRAMS.531.10    The commissioners of health and of human services shall not use indirect cost 531.11allocations to pay for the operational costs of any program for which they are responsible.531.12    Sec. 13. SUNSET OF UNCODIFIED LANGUAGE.531.13    All uncodified language contained in this article expires on June 30, 2009, unless a 531.14different expiration date is explicit.531.15    Sec. 14. EFFECTIVE DATE.531.16    The provisions in this article are effective July 1, 2007, unless a different effective 531.17date is specified.